Medical Benefit Plans

Last Updated: 1/9/2014 2:19:27 PM

Listed below are the services The Health Plan has to offer.

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Health Maintenance Organization (HMO)

The Health Plan's fully funded Health Maintenance Organization (HMO) is perhaps the most cost effective plan offered. This plan limits members to a network of providers contracted through aggressive pricing arrangements. The HMO provides comprehensive benefits to enrollees at a reasonable cost to employers. Affordable copays, virtually no claim forms, and plans with or without deductibles will encourage members to establish ongoing relationships with their physicians. The physician relationship, along with preventive care services, will help to deter major health problems.

Various benefit levels can be provided to facilitate employer savings while maintaining a comprehensive benefit plan for good health for your employees. The HMO plan has an unlimited lifetime maximum and complete coverage for preventive care.

National Committee for Quality Assurance (NCQA) Accredited.

THP Insurance Company Fully Insured Plans

Point of Service Plan (POS)
Employers and employees can enjoy the same cost effective features and benefits of the health maintenance organization (HMO) with the added option to leave the network. Primary care physicians oversee member care and refer members to specialists in the network when available. If necessary, members may receive care outside of The Health Plan network at reduced benefit levels.

The Health Plan offers competitive premiums through established contracts with physicians and hospitals. This plan does require the selection of a Primary Care Physician (PCP).

Preferred Provider Organization (PPO)
This option enables employees to receive care from virtually any healthcare provider. The benefits are paid at the highest level when contracted providers are utilized. Members can elect to receive care outside The Health Plan network at reduced benefit levels. Competitive premiums are available by virtue of established contracts with contracted physicians and hospitals. This plan requires NO selection of a Primary Care Physician (PCP).

Allied Services Division/Self Funding Specialists

Developed in 1991 to assist as a Third Party Administrator (TPA) for self funded medical, dental, and vision plans, The Allied Services Division of the Health Plan is a licensed TPA in Ohio, West Virginia, Pennsylvania, Illinois and Kentucky.

The Health Plan offers a full service TPA with complete range of integrated services and programs. We offer comprehensive plan administration services to employers with self funded medical plans, including claims payments, medical case management, utilization review, bank account development and reconciliation, management reports, enrollment services, and medical plan reinsurance. This plan offers affordable administrative fees, superior claims payment service, speedy response time, and access to The Health Plan's network discounts on any plan design.