SECTION4. TYPESOFPLANSOFFERED Thesurveycollectsinformationonafirm’splanwiththelargestenrollmentineachoftheplantypes. Whileweknowthe numberofplantypesafirmhas,wedonotknowthetotalnumberofplansafirmoffersworkers. Inaddition,firmsmayoffer differenttypesofplanstodifferentworkers. Forexample,someworkersmightbeofferedonetypeofplanatonelocation, whileworkersatanotherlocationareofferedadifferenttypeofplan. HMO isahealthmaintenanceorganization. ThesurveydefinesanHMOasaplanthatdoesnotcovernon-emergency out-of-networkservices. PPO isapreferredproviderorganization. ThesurveydefinesPPOsasplansthathavelowercostsharingforin-network providerservices,anddonotrequireaprimarycaregatekeepertoscreenforspecialistandhospitalvisits. POS isapoint-of-serviceplan. ThesurveydefinesPOSplansasthosethathavelowercostsharingforin-networkprovider services, but do require a primary care gatekeeper to screen for specialist and hospital visits. HDHP/SO isahigh-deductiblehealthplanwithasavingsoptionsuchasanHRAorHSA.ThesurveytreatsHDHP/SOsasa distinct plan type even if the plan would otherwise be considered a PPO, HMO,POSplan,orindemnityplan. The Kaiser Family Foundation and Health Research & Educational Trust / Page 69
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