Health Insurance

Eilers Insurance Associates, LLC specializes in group medical insurance for companies with 250 or fewer employees, and can also provide benefits for all types of businesses. Let Eilers Insurance Associates, LLC help you choose the best benefits package to fit your business.

We represent over 30 national insurance companies offering a comprehensive variety of Group medical coverage, group dental, vision plans, partially self-funded programs, section 125 or "cafeteria" plans and health savings accounts (HSAs). The following link to the IRS provides answers to frequently asked questions.

There are three basic types of managed care health insurance plans:

Health Maintenance Organization (HMO) is probably the most familiar option as one of the original managed care plans available. Members of an HMO choose a primary care physician (PCP) to coordinate the member's care and coordinates the patient's care from a list of available participating providers contracted with the particular HMO. All medical care must be authorized by the PCP. Unauthorized visits to other healthcare providers are not covered by the plan and become the financial responsibility of the member. As a member of an HMO plan you are rewarded with low premiums, no deductibles and aside from a minimal co payment for each visit, 100 percent health care coverage.

Preferred Provider Organization (PPO) works similarly to traditional insurance plans. No primary care physician is required. A PPO is flexible where participants are allowed to use any physician they choose; however, the plan will pay a higher percentage for using a "preferred provider" whose name appears on the plan's preferred provider list. Plan participants can usually expect to pay a higher premium, be subject to a deductible and be responsible for a percentage of their medical expenses.

Point of Service (POS) plans are hybrids, combining elements from both the HMO and PPO. In a POS the plan participant must select a primary care physician upon enrollment. The member is also responsible for a co-payment with each visit; however there are no deductibles and healthcare is covered 100 percent. Should specialized care be necessary, the participant has the option of going through the primary care physician for a referral to a participating POS specialist for 100 percent coverage. In the event the participant elects to use a physician who is not a member of the POS, coverage will still be provided, but at a lower rate. The premiums for a POS plan usually fall somewhere between those for HMO's and PPO's. Participants may need pre certification for admission to the hospital.