HMO, PPO, POS – which right for your company

Apr 10

Which Type of Health Plan Is Best for Your Company?

Having a health insurance for your business might seem like a lot to handle when you’ve already got so much on your plate. However, there are ways that you can save money on insurance costs for your company. Doroshow Insurance can help you navigate the different types of plans to determine which one, or which combination of plans, will be best. Here is a brief breakdown of the different plans available and their varying options.


A Health Maintenance Organization or HMO plan is a type of plan that involves all patient care being coordinated through a primary care physician. Under an HMO, members see the primary care physician and then coordinate care and specialized services through that physician’s network. This is commonly called the referral process. HMO plans are usually less stress for members. They boast lower premiums and usually incentivize plan members to focus on preventive care.


A Preferred Provider Organization or PPO healthcare plan operates in many ways similarly to an HMO, but you are not required to work through a primary care physician. A PPO allows members the flexibility to work with any in-network medical provider, or in a specified group of contracted medical providers. 

PPOs are more flexible for individual members because they have more options regarding the medical providers they can see, although out of pocket expenses are typically higher under this type of plan.


A Point of Service or POS health insurance plan combines elements from PPO and HMO plans. At the time of service the member decides if he wants to utilize the HMO or PPO part of the plan. If the member elects the HMO then the member must visit his primary care physician and use the referral process to see a specialist. If the member elects to use the PPO part of the plan than he can go to any provider in the PPO network without a referral but member costs are likely to be higher.

Working with an experienced and highly rated insurance partner like Doroshow Insurance is the key to really breaking down all of these plan types to find out what will work for you. When it comes time for you to find the best health insurance plan, contact Doroshow Insurance to find a plan that fits your business needs best.

Understanding High Deductible Health Plans and Health Savings Accounts

Apr 10

Health insurance has become a major expense for many households. With the costs of healthcare on the rise, individuals must become educated in insurance options available to them. Healthcare rates have increased consistently for the past several decades. It is now more important than ever to fully understand your healthcare options, Doroshow Insurance can help. 

What do I need to know about high deductible health plans?

High deductible health plans require that all healthcare costs are paid upfront. Often once the required deductible has been met, employees are no longer required to pay for medical expenses out of pocket. 

Pros of HDHP plans

  • The premiums are lower than other POS and PPO plans.
  • Members can save money if health benefits are infrequently used.
  • Monthly bills may actually be reduced if the person is not on many expensive medications.
  • Patients enjoy access to a wide range of providers.
  • Any expenses paid up front are negotiated, contracted rates agreed to by the provider.

High deductible health plans are common in the marketplace. Companies are actively looking for ways to contain costs, so healthcare plans for employees are often the target for the cost-cutting initiatives. This is why high deductible plans are offered by nearly one-third of employers.

What do I need to know about health savings accounts?

Health savings accounts allow you to make tax-deductible contributions to an account that are later used to manage health care expenses. These accounts, which are available only to people who have a high-deductible health plan, offer a trifecta of tax benefits for people who use them to save money for medical expenses: you put money in pre-tax, the money grows tax-free and is distributed tax-free as long as you use it on qualified medical expenses. If there are any withdrawals made for non-medical expenses, the withdrawal will be taxed. A 20 percent penalty is assessed for these withdrawals as well if you are under 65 years old. The annual contribution amount for 2018 is $3,450 for individuals and $6,900 for families. 

Pros of HSA plans

  • Funds can be used after the person retires.
  • Individuals and employers can contribute to an HSA. 
  • Tax breaks are allowable for contributions.
  • Money in the funds do not have to be spent by year’s end.
  • Money in the account grows tax-deferred. 

According to research, 30 percent of employers offer health savings accounts. An estimated 20 to 22 million people in the United States are enrolled in an HSA plan. Employers typically pair these plans with high deductible health plans to reduce the burden of out-of-pocket expenses. Employees benefit the most from contributing the maximum amount to the HSA account each year.

Importance of knowing the ins and outs of health plans

Employees should fully understand the basics about their health plans offered by their employer, which includes network providers, premiums, and deductible amounts. Employees must be well-informed about what their tax obligations are when funds from their health savings accounts are used. Understanding the interest, penalties, and parameters for use of these accounts can translate into thousands of dollars in a matter of years when funds are permitted to grow.

What are the Benefits of HRIS?

Jan 30

The Human Resource department is often taken for granted and underappreciated within many corporate environments. This is unfortunate because an efficient human resource department is essential to the success of any company. Employees working within an organization’s human resource department must deal with a multitude of often complicated issues. Human resource employees must deal with everything from hiring, training and disciplining employees to ensuring that the company is in compliance with an a great many ever-changing laws and regulations. Fortunately, modern technology makes it possible for companies to use a Human Resource Information System (HRIS) to greatly increase the efficiency of its human resource employees.

Human Resource Information System (HRIS)

A HRIS is a software program that provides the tools for human resource employees to tackle a multitude of issues in an accurate, efficient and speedy manner. A comprehensive HRIS can handle everything from keeping track of payroll to maintaining compliance with a multitude of laws and regulations. One major benefit of a good HRIS is that it greatly reduces errors on the part of human resource employees. This is important because even seemingly minor errors can expose a company to considerable legal liabilities and financial losses. Another essential benefit of a HRIS is that it can allow employees to
efficiently deal with complicated issues related to employee health insurance. Fortunately, when it comes to administrating employee health insurance benefits, your company can gain from experienced insurance professionals.

Doroshow Insurance

Doroshow Insurance has been helping people with Nevada health insurance since 1980. They specialize in providing outstanding customer service that will take the stress off of your company’s human resource employees when it comes to insurance related matters. A Doroshow benefits specialist will handle all of the daily issues that arise from administering your company’s health benefits plan. They can communicate directly with your employees to ensure that any problems are resolved in an efficient and satisfactory manner. Additionally, the Doroshow specialist will use state-of-the-art HRIS technology to constantly evaluate your company’s changing insurance needs and make recommendations for changes when necessary. Don’t try to handle these complicated insurance matters on your own. Call Doroshow insurance today to speak with a Nevada health Insurance expert.


Understanding Health Insurance Deductibles, Coinsurance and Copays

Jan 11

Understanding Deductibles, Coinsurance and Copays

When you’re shopping for health insurance there are some common health insurance terms that you need to understand. Almost all PPO and HSA health insurance policies have deductibles, coinsurance and copays that apply.

A deductible is a set amount that you the policyholder are required to pay before the insurer pays for any healthcare bills, with the exception of some copays. For instance, you may have a healthcare plan with a $1,000 deductible. You would have to pay $1,000 dollars toward your medical bills before the insurer would begin to pay any of your healthcare bills.

After you have reached your deductible for the year, this is when coinsurance comes into play. Coinsurance is the amount that you must pay for medical bills after the deductible is met. Most plans have a coinsurance percentage and different percentages that apply to in-network and out-of-network providers. The insurer may pay 80 percent of the bill to in-network providers, and your coinsurance amount would be 20 percent. The amount the insurer would pay to out-of-network providers might be 60 percent, and your coinsurance amount would be 40 percent in this case.

Copays exist on some policies. These are set amounts for services. You may have a copay of $30 for each office visit. There may be set copays for certain procedures. These copays would be paid before you reach your deductible in most instances.
You would pay your copays, deductible, and coinsurance for medical care until your out of pocket maximum is met for the year. This out of pocket maximum is the limit of what you would have to pay for all your care for the year except the premium payment.

Health insurance can be confusing, and there are many different plans available. A Henderson, Nevada brokerage like Doroshow Insurance will be able to help you with all of your health insurance questions. Call Doroshow Insurance today for a consultation.


Urgent Care vs. ER: When Should You Look for Emergency Care

Aug 25

Urgent Care vs. Emergency Room

Unexpected medical emergencies are a nuisance and sometimes unavoidable. Appropriately assessing your health issue can help you choose the best place to seek professional care, potentially saving you time and money. Here are a few things to keep in mind when making the decision to visit urgent care or the emergency room.

Urgent Care

Urgent care is the best option if your regular physician is not available and you don’t believe it is a good idea to wait for the next available appointment. Urgent care facility wait time is often shorter, and could be less expensive.

Most retail health clinics and urgent care facilities can treat:

  • Low fever
  • Minor cuts
  • Minor flu or cold symptoms
  • Minor infections
  • Minor trauma (ex: broken finger)
  • Rashes
  • Small cuts
  • Sore throat
  • Sprains
  • Strains
  • Vomiting

Emergency Room

Emergency room visits should be reserved for medical issues requiring immediate professional care. Often the wait time at the E.R. is very long, as patients with more severe injuries or illnesses are treated first. The benefit of going to the E.R. instead of urgent care is that since you are at a hospital, the healthcare professionals are prepared for any medical issues that come their way. If you are experiencing a life-threatening medical emergency and there is no one around to take you to the hospital, call an ambulance immediately.

You should go to the emergency room for treatment of things like:

  • Chest pain
  • Deep wound or laceration requiring stitches
  • Difficulty breathing
  • High fever
  • Injury to the eyes or head
  • Major broken bones
  • Numbness on one side of your body
  • Persistent or heavy bleeding
  • Poisoning
  • Seizure
  • Severe burn
  • Severe heart palpitations
  • Sudden head pain
  • Sudden weakness or trouble walking
  • Vision loss or sudden change in vision