EXCLUSIVE PROVIDER ORGANIZATION (EPO)

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An EPO (Exclusive Provider Organization) is a health plan that provides access to a local network of doctors and hospitals, typically offering a broader network than an HMO. EPOs are generally more cost-effective than PPO plans, but care received outside of the network may not be covered, except in emergencies. Unlike PPOs, EPOs usually do not require you to select a primary care physician (PCP), giving you the flexibility to see specialists within the network without needing a referral.

This plan can be particularly beneficial for individuals who want a balance between cost savings and access to a wide range of in-network providers. However, it’s essential to carefully review the provider network to ensure it includes the healthcare professionals and facilities that meet your needs, as coverage outside the network is limited.

SMALL BUSINESS HEALTH INSURANCE

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Health Insurance Help in Temecula, Murrieta, Rancho Cucamonga and Surrounding Areas

Our Temecula office is serving small business owners in San Diego County and Riverside County – while our Rancho Cucamonga office is serving Orange County, Ventura County and all of Greater Los Angeles. I work with small businesses of 1 to 100 employees and Large groups 101 and above. The key to increasing productivity is limiting turnover and retaining outstanding employees by offering a total competitive package that includes health insurance.

The health insurance professionals at Deborah Reyes Insurance Services, Inc. will help you strike a balance between costs and benefit packages by re-shopping your group’s Health, Dental, Vision Chiropractic, Life Insurance, Disability, Cancer plans, 401K with FSA plans.

Our goal at Reyes Insurance services is to tailor a plan to meet your company’s business goals.  We shop every carrier in the marketplace and make recommendations on your companies needs.  We do not change broker fees as we are compensated by the insurance carriers.

Things to keep in mind:

  • Premiums for group health insurance plans for small business are regulated by law in the state of California: No entity can offer the same group health insurance plan a for a lower price—and that includes the health insurance providers themselves. In other words, the price Deborah Reyes Insurance Services, Inc.  quotes for a plan is the lowest price available by law. That means you will pay the same price even if you contract directly with a health insurance provider—without receiving the same level of service and individual attention that you get from Deborah Reyes Insurance Services, Inc.
  • To qualify to receive a group health insurance plan, you do not need 100% of employees to participate.  Contact us and we can explain what carriers require.
  • You could save even more with Deborah Reyes Insurance Services, Inc. when you sign up for group insurance for your employees at the same time as you buy health insurance or switch health insurance providers

Deborah Reyes Insurance Services, Inc. excels with small business group plans for health insurance. You can feel confident and secure in the knowledge that we will maximize your health insurance dollars while enhancing your reputation for employee satisfaction and retention.

GET A FREE QUOTE FOR GROUP HEALTH INSURANCE

MEDIGAP SUPPLEMENTAL INFO

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Closing the Gaps in Medicare Coverage with Supplemental Health Insurance

The California metropolitan area is home to hundreds of thousands of people aged 65 and over who receive federally funded Medicare health insurance or will be eligible to receive it soon. Most of those people are in or approaching their senior years—an exciting time of personal growth and exploration but also a confusing time for health insurance planning. Many people are surprised to learn that there are gaps in Medicare coverage. To ensure that their life savings are not exposed to the high cost of uninsured medical needs, millions of seniors buy private health insurance that closes the gaps in standard Medicare coverage. This supplemental insurance is often called “Medigap” insurance.

Failing to close the gaps in standard Medicare health insurance coverage can cost a fortune. For example, Medicare Part A insurance covers most hospitalization costs, but it comes with significant coinsurance requirements and deductible amounts. Medicare Part B, which covers many standard medical services, pays up to eight percent of costs approved in the Medicare guidelines. However, if a doctor charges more than the guidelines allow, it is up to the Medicare patient to pay the outstanding balance. The patient also must meet the annual deductible before Medicare Part B coverage begins.

Medigap insurance is not overly expensive because it covers only those areas left open to exposure by Medicare. The professionals at Deborah Reyes Insurance Services, Inc. are experts in Medicare coverage and supplemental insurance. We know where the exposure lies and how to eliminate it. We can find a supplemental insurance provider and policy that protects you from the devastating effects of uninsured medical expenses.

No one should spend their senior years worrying about exposure to runaway medical costs. Allow Deborah Reyes Insurance Services, Inc. to safeguard your life savings from gaps in Medicare coverage by finding the right Medigap supplemental policy for you!

Let us do the work and find out what plans your doctors work with and what plans have the most cost effective prescription coverage.

 

Health Maintenance Organization

HEALTH MAINTENANCE ORGANIZATION (HMO)

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HMO is an acronym for Health Maintenance Organization. An HMO is an organization delivers medical services through a network of healthcare professionals who follow specific guidelines for care and costs. By allowing the HMO to manage care, the participating physicians and related healthcare professionals receive a steady flow of patients through the HMO. A consumer who obtains care through an HMO must receive services from the healthcare professionals in the HMO network. Otherwise, the HMO will not cover medical expenses. The HMO manages policyholder care through a main point of contact—the primary care physician—who provides care and makes referrals when necessary.

Health Maintenance OrganizationThe major benefit of an HMO is affordability. By managing care through the primary care physician, the HMO can contain many costs and offer lower premiums. To help keep premiums low, HMOs require members to pay a flat fee—a co-payment or co-pay—when obtaining many services, including doctor office visits and prescription medications. HMOs also control costs by emphasizing wellness over treatment. By promoting preventative measures such as screenings, mammograms, and PAP smears, the HMO is able to detect and arrest medical conditions before they become more costly to treat. HMOs also cover medical services such as vision care, dental care, and psychiatry.