Health Plan Comparisons in Northern Virginia
(rates effective 8/1/2005)
VL = very low; L = low; M = medium; H = high; VH = very high
Note: For more details, see A Guide to Health Insurance Options for Small Businesses. The selected plans are not all inclusive. For additional options
contact a local insurance broker or visit online comparison websites such as: insure.com, allquotesinsurance.com, or ehealthinsurance.com. In
addition, association-sponsored plans, discussed in the accompanying Guide, may provide other options as well.
1 PPO is a preferred provider organization. HSA is a health savings account that uses a PPO plan type. HMO is a health maintenance organization. POS is an
HMO with a point of service or non-network option. OA is an open access plan: a POS plan in which patients can self-refer to specialists.
2 The premium is the monthly cost of the insurance policy for the entire firm plus dependents. "Before medical underwriting" means that these premiums do
not take into account the health status of the group. Good health is assumed; poor health would result in higher premiums than presented here. Typically, the
employer pays part of the premium and the employee pays part of the premium. An employer's costs are a fully deductible business expense. Moreover, the
cost of this benefit is excluded from employees' taxable income (for Social Security and Medicare payroll taxes).
3 Employees' cost sharing is an "average" estimated by considering plans' unique combinations of office and prescription co-pays, deductibles, coinsurance, and
maximum out-of-pocket limits. Utilization will affect the amount of employee cost sharing, up to the maximum out-of-pocket limit (see Employee Cost
Sharing Chart in this Overview). For employees with very different levels of health care use, the relative rating of the cost sharing associated with different
plans could be different from what is shown here.
4 At one extreme, patients can see virtually any provider of their choosing; whereas at the other, patients' access to care is limited to in-network providers and
they typically must seek a referral to a specialist.