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In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
In May 2014, Anthem Blue Cross refused to pay for the hospitalization of a Sonoma County, California man for stage four cancers, although he had paid Anthem over $100,000 in premiums. [ 101 ] [ 102 ] Anthem ended up paying for coverage following public outcry.
Proposition 35 would permanently impose a tax on health insurance providers like Anthem Blue Cross and L.A. Care, known as managed care organizations, that provide or arrange services for a ...
An Exclusive Provider Organization plan, like a POS, combines different facets of basic HMO and PPO plans. Unlike POS and HMO plans, however, EPOs allow you to choose your own PCP and see ...
Both plan types use a network of healthcare services. The main difference between them is the way the insured person can use those networks. View the table below for a comparison of HMO and PPO plans.
Prior to 1986, organizations administering BCBS were tax exempt under 501(c)(4) as social welfare plans. The Tax Reform Act of 1986 revoked the exemption, however, because the plans sold commercial-type insurance. They became 501(m) organizations, subject to federal taxation, but entitled to "special tax benefits" [12] under IRC 833. [13]
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