It is important that you understand your staffing insurance policy and its applications. Different plans may have special benefits or provisions, but there are a few key concepts that are important in any policy.
The deductible is the amount of money that you will have to pay before your insurance provider will begin making payments. This usually does not include annual checkups, but is more so for accidents and medical procedures.
Your co-pay is the amount that you pay for routine procedures, such as physicals. This payment is usually either a percentage of the cost or a set price.
In and Out of Network Coverage
Your insurer has a network of medical providers that it has set up relationships and agreements with concerning costs and payments for procedures. These providers would be considered in network, while those providers that are not included would be out of network. In network provider visits are generally cheaper.
Scope of Coverage
The amount of coverage that you are offered under any particular benefit is its scope. This is important to know for benefits you plan to utilize regularly.
Limit or Cap
The highest amount that a provider will pay for a benefit or a policy is called a limit or cap.
Understanding these common terms will help you to best understand your staffing insurance policy, so that you may educate and prepare your employees.