People are asking...

Are more workers covered by indemnity plans or HMOs?

Answer: According to data from the 2005 BLS survey of employee benefits, 76 percent of all private industry workers covered by an employer medical care plan were enrolled in an indemnity plan. Only 7 percent of workers were traditional plans that allowed the participant the choice of any provider without affecting reimbursement. Indemnity in and outside of network plans (also referred to as Preferred Provider Organizations or PPOs), were available to 64 percent of all private industry workers. Preferred-provider plans allow enrollees to obtain services from any provider, but offer incentives if services are obtained from selected providers.

About 24 percent of workers were covered in prepaid or Health Maintenance Organizations (HMO) plans, which provide comprehensive medical services on a prepaid basis. Twenty-one percent of workers were in prepaid in network only plans (traditional HMOs) that provide no benefits outside the network. Prepaid in and outside of network plans (Point of Service HMOs) were available to 4 percent of workers. These plans allow services received outside the network to be reimbursed in a manner similar to traditional indemnity plans.

For more information, see the latest benefit publication, found at www.bls.gov/ncs/#publications. Definitions of health insurance plans and other terms may be found at www.bls.gov/ncs/ebs/sp/healthterms.pdf.

 

Last Modified Date: October 30, 2008