An Exclusive Provider Organization, or EPO, is a type of health insurance plan in which members must utilize doctors and providers within the EPO network, except in case of a medical emergency. BBG truly has top notch professionals that consistently provide excellent and proactive customer service. Coverage for: Individual + Family | Plan Type: EPO . An EPO (Exclusive Provider Organization) Insurance Plan can help prevent you from going bankrupt if you're hit with a surprise illness. If you’re looking for lower monthly premiums and are willing to pay a higher deductible when you need health care, you may want to consider an EPO plan. Contact an Aetna rep Find the right EPO plan Aetna Elect Choice® plan How do Medigap plans help me pay for what Medicare doesn't cover? We highly recommend them and look forward to our continued partnership! Skyline Benefit is an elite Oscar broker with knowledge and experience in EPO plans. ", Minnesota Medicine, February 2011: "Five Payment Models: The Pros, the Cons, the Potential. Mac, Walter and the BBG team are all top-notch folks. Comparison shopping is a great way to evaluate the private insurance plans in Part C Medicare Advantage, Medicare … Glassdoor is your resource for information about EPO benefits and perks. Extremely helpful in answering specific and general questions about employee benefits, conducting benefit meetings for employees, creating and distributing Employee Benefits Guides, providing resources for HR information. They have become an extension of our organizational family. If you see a provider that's not on your plan’s list – other than in an emergency – you'll have to pay the full cost yourself. Except in the case of an emergency, you’ll pay the full price for any out-of-network care. They are always available to answer questions and help whenever we need them. “Materials at the time of enrollment and in member’s Explanation of Benefits have clearly stated that the plan was an EPO plan which may not have out-of-network benefits… What is Medigap, and how much does it cost compared to Medicare? See An exclusive provider organization is essentially a hybrid between an HMO and a PPO. EPO insurance rates are generally lower than other types of health plans. Understanding what each plan offers is important to ensure that you make the right choice for your business. If you think you may have a medical emergency, immediately call your doctor or dial 911. I recommend her to everyone. I love working with BBG! What Is an EPO? PPO, or Preferred Provider Organization, health plans are generally more flexible than EPO (Exclusive Provider Organization) plans and have higher premiums.This comparison explains how. EPO Plan Highlights: Generally pay nothing for in-network preventive care Must use in-network providers in order to receive benefits; the only out-of-network costs that will be paid are those charged as a result of receiving emergent care Under an HMO plan, members must get a referral from their primary care physician (PCP) before seeing a specialist. BBG has been terrific all around! Medical benefits Exclusive provider organization (EPO) When you enroll in the exclusive provider organization (EPO), you must use the plan’s national network of physicians, hospitals, and other healthcare providers to receive benefits; the EPO does not cover care received from out-of-network providers except for emergency services. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. The expense may or may not count towards the out-of-pocket maximum in the plan. However, you will want to consider the limitations that come with EPO insurance compared to more expansive options like HMOs and PPOs. We have been a customer of BBG for many years, and have absolutely no complaints. I could write a novel about all of the wonderful people, services and products BBG offers. According to a Harris Poll survey, 86 percent of respondents said that receiving comprehensive medical benefits would influence their decision to choose one job over another that did not offer health benefits. Regular assessments of the industry and the market to bring its business partners the best tools, strategies, resources, and expertise, are just a few of the "benefits" of BBG. There are no out-of-network benefits. Thanks Michelle!!! By selecting the CareFirst EPO, you drive your own health care decisions by enjoying many hassle-free benefits with this plan. BBG is an incredible business partner and our dedicated consultants act like extended members of our company's team. Below, find out what each health insurance plan is, how each type of plan works, and the benefits of being a plan member. Similar to an HMO plan, EPO members can see any doctor or hospital – in- or out-of-network – if the illness or injury is considered an emergency. BBG is a great resource for me, they are customer oriented and always there when I need them. EPO -- stands for Exclusive Provider Organization -- is similar to an in that it is a healthcare plan that covers eligible services from providers and facilities inside a network. But there's no coverage for out-of-network providers. The depth of resources BBG provides is second to none. As a Participant/Covered Person of the USC Trojan Care EPO Plan, benefits are administered by the university with HealthComp, Anthem Blue Cross and MedImpact, each providing certain administrative services. With Aetna's Exclusive Provider Organization (EPO) plans, you can give your employees an easy way to get care, while saving on benefits costs with an exclusive network. 1 of 6 Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2021 – 12/31/2021 Cigna Health and Life Insurance Company: Cigna Connect 2000 Coverage for: Individual & Family | Plan Type: EPO Coverage for: Individual & Family | Plan Type: EPO Sarah Goodell additional information. The aforementioned has been particularly appreciated during our Open Enrollment process. I enjoy working with Mac and his entire team of professionals. Everyone that works at BBG is so nice and goes above and beyond, which is appreciated more than they know. Kelly introduced me to Jessica which became our Broker, Neely Renewal Manager and Siobhan Renewal Manager, they were all great to work with! This allows more freedom to see different doctors and hospitals that are in-network. Their quick responses are helpful & direct. With a PPO, members will usually be responsible for a higher percentage of any out-of-network care costs. An EPO is usually more pocket-friendly than a PPO plan. Although EPO insurance members are not able to see out-of-network healthcare providers without paying for it out-of-pocket, they can receive emergency services from doctors or hospitals that are out-of-network. The BBG team is able to work medical benefits, Defense Base Act, property insurance and anything HR related, all of which continue to make life easy for Small Businesses. I've worked with BBG for 7 years and was responsible for introducing BBG at my new company. They are hands down one of the best! However, to be fully covered under an EPO plan the specialist must be in-network. BBGs has a very knowledgeable team that always goes above and beyond! A health plan's network is the set of healthcare providers — e.g., hospitals, doctors, and specialists — with whom the insurance company has contractual agreements in any given plan year. How does Medicare Advantage (Part C) help me pay for what Medicare does not cover? I had the pleasure of meeting Kelly Cole when she hired my company Phoenix Home Services to build her the kitchen of her dreams. Reviewed John A. Farrell III, HR Director, SHRM-SCP. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. Also note that there are no out-of-network benefits under an EPO health insurance plan. I also cannot imagine not having such a great broker relationship, as I know they are always looking our for our interests and make recommendations that can be helpful. EPO No-deductible health insurance with provider options This plan offers greater flexibility of health care providers similar to the PPO plan. Even though you have limited options to choose from, these medical facilities will generally give you a bigger discount and your premium… They are responsive and well informed in their efforts to ensure that we are satisfied. An EPO plan often covers services in-network with network providers and has $0 benefits for out-of-network. With Aetna's Exclusive Provider Organization (EPO) plans, you can give your employees an easy way to get care, while saving on benefits costs with an exclusive network. With an EPO (exclusive provider organization), you have a moderate amount of freedom to choose your health care providers. What is an EPO plan? Working with BBG has been a game changer for our company. With our Horizon Advantage EPO plans, members have access to all doctors, hospitals and other health care professionals that participate in the Horizon Managed Care Network. The team at BBG work tirelessly to ensure my company benefits package works for all of my employees. They make certain that all of your bases are covered – it’s a pleasure to work with such professionals! No referrals needed. Here’s what makes EPO insurance plans unique — and how to determine whether or not your employees could benefit from having them as an option. An EPO, or Exclusive Provider Organization, is a type of health plan that offers a local network of doctors and hospitals for you to choose from. I've worked with numerous benefits brokers over the years and they are second to none. The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. ", U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality: "Choosing a Health Plan. They are all easy to work with and just made life easy. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside the network for care. June 15, 2020, Medically BBG has been pivotal in the dissemination of health benefits for Fonteva employees. As an EPO member, you cannot go outside your plan’s network for care. If you have ever been through a home remodel project, you get close to your clients and get to know them pretty well. Providers are independent contractors and are not agents of Aetna. What Are EPO Insurance Plans? Premiums … I can not recommend them enough. Always quick to respond and always keeps me up to date in my insurance claim status. You have direct access to any specialist. They are very knowledgeable in their area of expertise and you can always count on them to provide the best advice/counsel regarding various applicable matters. With an EPO plan, members are not required to get a referral from their primary care physician before seeing a specialist. Specifically, Allison Brown has been amazing to work with. Individuals and families come in all shapes and sizes — and so do insurance plans. Overall, BBG is an outstanding organization that provide Subject Matter Expertise in everything they do. Keep up the GREAT work!! EPO plans are as flexible as the PPO plans and you can save money like in HMO plans; In EPO health insurance plans, you need not choose a PCP plus, you don’t need referrals for specialist consultation. 7  Like HMOs, many POS plans require you to have a PCP referral for all care whether it’s in or out-of-network. An EPO is a health insurance option similar to a PPO (Preferred Provider Organization) but with less flexibility. 2021 EPO 500 PLAN HIGHLIGHTSProvider NetworkExtensive national network of contracted providers.Primary Care Physician (PCP) to manage careNot required They are a full service firm that doesn't just sign companies up for benefit coverages, they act as a strategic advisor to determine what solutions fit best for each company's situation and demographic. When you enroll in an EPO insurance plan, you seek medical care within a framework that’s more flexible than other plans: You gain access to a network of healthcare providers, including specialists and hospitals, who have contracted to provide treatment for an agreed-upon fee. The Business Benefits Group has been great to work with. on Lower costs are achieved by negotiating favorable reimbursement rates with in-network healthcare providers which results in lower monthly premium payments. One of the biggest downfalls of EPO plans is the fairly small network compared to other types of plans. … At first I was skeptical about their employee navigator system but all more concerns were quickly resolved. BBG takes the whole HR process from benefits enrollment to HR management, and streamlines the process to make it user-friendly, professional, and a huge time saver. They have remained consistent regardless of the level of stress involved in any situations. Benefits information above is provided anonymously by current and former EPO employees, and may include a summary provided by the employer. Both of these types of insurance coverage have some specific benefits. I truly appreciate their dedication and expertise. Their benefits plans are very competitive in the market. EPO stands for "Exclusive Provider Organization" plan. This is my third year serving my client and working with BBG to fulfill and complete the enrollment process. They have also been scaling with our business, which has been growing by several employees every year. We've used BBG for our business benefits & insurance for almost 7 years. We cannot say enough about their customer support, and recommend them to anybody looking for benefits consulting and insurance. Once you are under a good EPO network, all your health anomalies will be smoothly cured at bare minimum expenses. However, unlike HMO members, EPO members are not required to get a referral from their PCP before seeing a specialist. We have answers! They go above and beyond to answer our questions, helps in times of need and the open enrollment process was smooth.One thing that is so great about BBG is the actual client interaction and how they listen to our particular business needs. It is a type of health plan that provides a local network of doctors and hospitals for you to choose from. This plan has a lower deductible and exclusively covers you for in-network doctors and facilities. Keep up the good work. BBG is more than an insurance broker. Thank you BBG making these complicated decision easier and for doing an excellent job! However, if you choose to get care outside of your plan’s network, it usually will not be covered (except in an emergency). THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. Thank you BBG and here's to many more years of partnership. The service everyone at BBG provides is unparalleled- and they do it with a smile on their faces. With an EPO plan, the insurer negotiates payment rates with a targeted network of physicians, usually in … Although an EPO will not cover out-of-network healthcare, it will usually cover out-of-network costs in the event of a medical emergency. As an HR Professional, I have had an opportunity to work with several benefits brokers and BBG is by far a stand out. EPO customers benefit from having quality medical care ready and waiting for them at an agreed cost sharing range. I couldn't ask for a better broker as BBG continuously provides top notch service! I LOVE BBG and their staff. Direct Access to Specialists ... All insurance policies and group benefit plans contain exclusions and limitations. Reviewed Highly recommend! How does the Qualified Medicare Beneficiary (QMB) Program help me pay for what Medicare does not cover. We are so happy we made the move. Oscars’ EPO insurance rates are generally lower than other types of health plans. Benefits of EPO plans. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Coronavirus in Context: Interviews With Experts, Sign Up to Receive Our Free Coroanvirus Newsletter, Medically I appreciate our business relationship & highly recommend them to anyone looking for a broker! We have used BBG to manage our company benefits for 10 plus years now. The level of support, guidance, and assistance they provide as a broker is above and beyond. BBG ROCKS!!! Couldn't be happier. At hat point I did not. I look forward to partnering with BBG for many years to come and I'd highly recommend them for anyone seeking to upgrade their broker support! As an HR department of one, I take advantage of the HR advice provided by BBG as well. Therefore, if you are trying to attract talented workers to your business, offering EPO insurance in your employee benefits package can be a wise choice. We've used BBG for our business benefits & insurance for almost 2 years. EPO stands for “Exclusive Provider Organization”. Unlike other types of health insurance plans like HMOs, EPOs does not require members to have a primary care physician. Their relationship has been invaluable, and is clearly superior to systems that try to automate insurance and benefits consulting. As a member of an EPO, you can use the doctors and hospitals within the EPO network. However, before making a decision, take the time to compare EPO insurance with other plan options like HMO and PPO. They provide excellent and timely service for all our corporate insurance needs. on, Different Types of Health Plans: How They Compare. I appreciate our business relationship & highly recommend them to anyone looking for a broker! and we just finished our ACA filings in a 20 minute meeting. It was a win for our company and a win for our people. She made the whole process painless. The price point of EPOs generally falls somewhere between HMOs and PPOs. We can provide innovative and flexible health insurance options for you and your business. We needed a fluent Spanish language speaker to really help some of our employees fully understand their enrollment options and they made sure that person was available every step of the way. We highly recommend BBG! The Horizon Advantage EPO plans provide integrated medical and pharmacy benefits, including wellness and emergency care. Medical Plan Benefits. With our Horizon Advantage EPO plans, members have access to all doctors, hospitals and other health care professionals that participate in the Horizon Managed Care Network. So happy I made the switch to BBG! They have amazing customer service across all of their departments. Exclusive provider organization (EPO) When you enroll in the exclusive provider organization (EPO), you must use the plan’s national network of physicians, hospitals, and other healthcare providers to receive benefits; the EPO does not cover care received from out-of … EPO insurance can be a highly advantageous addition to any employee benefits package. They have become an integral part of our HR/Benefit strategy and an extension of our own "family oriented culture" as a company who puts this kind of service acumen and care at its forefront. Typically, there's a lower premium than a PPO offered by the same insurer. In the case of a PPO, the big benefit is that you have many options to work with. EPO (Advantage Blue Deductible) With an EPO plan, you receive benefits only when you use preferred providers, except for covered emergency care. We have been a client for close to 20 years and I have never had a reason to look elsewhere. Send us a message and we'll get back to you in a timely manner. Statement of Commitment to Data Privacy and Security. With the freedom to see doctors and other healthcare specialists without a referral, the flexibility to not choose a primary care physician, in addition to the ability to see any in-network provider without an out-of-pocket cost can be attractive features to most employees. BBG defines excellence. We are grateful to have such a valuable resource at our fingertips. When I met Kelly Cole, their Office Manager a few years ago, she asked me if I had life insurance.