Health insurance can be confusing. Amidst our work and personal lives, it is hard to find the time to figure it out and yet it is so important that we understand it. It is with this in mind that I have created this page to provide quick and easy to understand resources to help employees understand the different types of medical plans and the terminology used by insurance providers.
This is a glossary of terms that are typically used in a plan summary design. A plan summary design is a document that insurance providers are legally required to prepare and it includes different types of services a person may access and the cost associated with these services. Examples of services would be visiting a primary care physician or a specialty care physician, going to urgent care or the emergency room, or filling prescriptions.
This glossary is a bit longer but covers more terms with great explanations.
Click on the handouts below for a brief summary of how HMO, PPO, or HDHP (High Deductible Health Care Plan) plans operate.
This is a general description of HMO insurance plans and is not a plan summary design.
This is a general description of HDHP insurance plans and is not a plan summary design.
This is a general description of PPO insurance plans and is not a plan summary design.
This is a great brief overview of the differences between HSAs and FSAs.
This video explains the differences between HMO, PPO, and HDHP plans in less than 4 minutes.
This is a one-minute video explaining what premiums, deductibles, coinsurance, and copays are in a health plan.
HMO, PPO, and HDHP plans cover preventive care at 100%. If you aren't sure what qualifies as preventive care, this webpage includes a brief overview. If you aren't sure if something is preventive care, then you can check before you receive the service by:
This one-minute video explains the differences between medical flexible spending accounts and health savings accounts. You can only have a health savings account if you are enrolled in a High Deductible Healthcare Plan (HDHP).
For Flexible Spending Accounts, the video says that when the year is over you typically lose what you don't spend; however, our FSA at Garrett enables employees to carry over up to $500 from one calendar year (Jan-Dec) to the next calendar year. Since you have from January to March of the next calendar year to apply expenses from the last calendar year to that year's balance, the up to $500 balance from a prior year does not carry over until early April of the next year.
For example, at the end of 2020 you have $300 dollars in your FSA. You have from January to March 31, 2021 to still submit 2020 medical expenses against that balance. If by March 31, 2021, you still have a remaining balance from 2020, that balance will be transferred in early April to your FSA 2021 balance.