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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.
Health Maintenance Organization (HMO) is a term first conceived of by Dr. Paul M. Ellwood, Jr. [4] The concept for the HMO Act began with discussions Ellwood and his Interstudy group members had with Nixon administration advisors [5] who were looking for a way to curb medical inflation. [6] Ellwood's work led to the eventual HMO Act of 1973. [7]
For independently insured people and those eligible for workplace-sponsored plans, selecting the type of insurance plan can be hard to navigate. For many, health care plan abbreviations like HMO ...
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]
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.
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.
Typically, services are not covered if performed by a provider not an employee of or specifically approved by the HMO unless it defines the situation to be an emergency. Financial sanctions for use of emergency facilities in non-emergency situations were once an issue, but prudent layperson language now applies to all emergency-service ...
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]