Group Health Plans of La.   CALL 1-888-456-1858 or  info@ghpla.com 

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Features of Consumer Directed Health Plans....

In General there are:

Three Tiers of Payment (Reimbursement Levels for expenses)

  1. Tier One is normally  a tax-exempt account from which to pay health care expenses.  It is a discretionary account that provides flexibility concerning which providers can be seen and what types of services are covered.

  2. Tier Two of payment is personal employee payment for health care expenses after money in the personal health care account is used up, and before the deductible for the high-deductible insurance is reached.  Since this is a "gap" in coverage compared to traditional health insurance; this tier is sometimes called a "hole" or "coverage gap."  It is basically the planned "deductible" during which the employee pays his/her bills.

  3. Tier Three pays allowable health care expenses for the year that go above the "deductible"  of the underlying insurance policy.  However HSAs or HRAs  are one form of plan that need not have such a policy.  It can be offered without an insurance plan. There need be no insurance involved, just money in the account from which an employee pays expenses until it is exhausted.  When insurance is in place it generally pays a high percentage (or all) of health care expenses over the deductible.  However, sometimes this insurance has restrictions similar to those in managed care plans.

Contributions to the Account

The amount contributed to the account by an employer may be:

  1. The amount of money that would otherwise have spent on the premium for insurance.
  2. An Employer determined amount of  money.
  3. A part of, or a percentage of, any  money the employer saves because of the lower premiums of a Consumer Directed Health Plan, when compared to the premium for the prior insurance plan.

Internet-Based Support to drive "Consumer" decisions?

  1. Track and manage their health care bills.
  2. Manage and improve their health with useful information and preventative services.
  3. Get information about provider quality and get group-rate prices from providers.

    Electronic Medical Records are the wave of the future.  This is going to allow internet-based support for consumer decision making information and guidelines with respect to health care coverage and health care costs to increase annually.  This, will enable the employee to make wiser health care and cost effective decisions to help hold down future costs..

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