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Employers with 25 or more employees were required to offer federally certified HMO options alongside indemnity upon request; This last provision, called the dual choice provision, was the most important, as it gave HMOs access to the critical employer-based market that had often been blocked in the past.
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
Workplace health promotion is the combined efforts of employers, employees, and society to improve the mental and physical health and well-being of people at work. [1] The term workplace health promotion denotes a comprehensive analysis and design of human and organizational work levels with the strategic aim of developing and improving health resources in an enterprise.
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
As defined in the act, a federally-qualified HMO would, in exchange for a subscriber fee (premium), allow members access to a panel of employed physicians or a network of doctors and facilities including hospitals. In return, the HMO received mandated market access and could receive federal development funds.
In 1972, HMSA introduced the Community Health Program, its first Health maintenance organization (HMO). The Hawaii Prepaid Health Care Act of 1974 required nearly all employers to provide health insurance to full-time employees. In 1980, Health Plan Hawaii was certified as a federally qualified HMO. [4]
Employer-sponsored health insurance is partially paid for by businesses on behalf of their employees as part of an employee benefit package. Most private (non-government) health coverage in the US is employment-based. Nearly all large employers in America offer group health insurance to their employees. [71]
This is an accepted version of this page This is the latest accepted revision, reviewed on 9 December 2024. Economic sector focused on health An insurance form with pills The healthcare industry (also called the medical industry or health economy) is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive ...