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 Health Insurance Plan Comparison Chart 

HMO
Health Maintenance Organization
PPO
Preferred Provider Organization
POS
Point of Service
Annual Deductible No, most plans Yes, most plans No, for in-network coverage on most plans
Set Copayment Amounts Yes No Yes, for in-network coverage
Coinsurance Yes, some plans Yes Yes, for out-of-network coverage
Out-of-Network Coverage Emergent care only Yes Yes
Primary Care Physician Required Yes No Yes
Referral Needed No* No No
Chiropractic Care or Spinal Manipulation Included ***Yes, QHP plans Yes ***Yes, QHP plans
Premium Cost $ $$ $$$
Individual and Family Coverage Yes ****Yes ****Yes
Preventive Care No charge No charge (in-network only) No charge (in-network only)
Lifetime Maximum No No No
Health Savings Account (HSA) Yes Yes Yes
Health Reimbursement Arrangement (HRA) Yes Yes Yes
Flexible Spending Account (FSA)** Yes Yes Yes

* Optima Health does not require referrals for HMO plans; however other insurance carriers may require a referral for specialist treatment.

** Flexible Spending Accounts are generally offered by an employer and are not specifically tied to a health plan.

*** Spinal manipulation is covered under all Affordable Care Act-compliant qualified health plans (QHP).

**** Optima Health does not currently offer Individual & Family PPO or POS plans.

Funding Options for Consumer Driven Plans

HSA
Health Savings Account
FSA
Flexible Spending Account
HRA
Health Reimbursement Account
Who Contributes? Employee and/or Employer Employee Employee and/or Employer
Pre-Tax Contribution? Yes Yes Yes
Uses Qualified medical expenses Qualified medical expenses Qualified medical expenses
Unused Funds at End of Year Roll over to next year Use it or lose it Given back to employer