Last Updated: 7/1/2014 1:04:54 PM
Health Maintenance Organization (HMO)
The Health Plan's fully-funded 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) (large groups only)
Employers and employees can enjoy the same cost effective features and benefits of the HMO with the added option to leave the network. Primary care physicians (PCP) oversee member care and refer members to specialists in the network, when care is available. If necessary, members can receive care outside of The Health Plan network at specific benefit levels.
The Health Plan offers competitive premiums through established contracts with physicians and hospitals. This plan does require the selection of a PCP.
Preferred Provider Organization (PPO)
This option enables employees to receive care from virtually any health care 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 specific benefit levels. Reduced costs are available through established contracts with physicians and hospitals. This plan requires NO selection of a 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, Allied Services Division is a licensed TPA in Ohio, West Virginia, Pennsylvania, Kentucky, and Illinois.
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.
Workers' Compensation Programs
Managed Workers' Compensation Program
The Health Plan provides case management services to injured workers in all 88 Ohio counties. We are an Ohio Bureau of Workers' Compensation (BWC) Certified Managed Care Organization (MCO) that provides program assistance to facilitate a safe and timely return to work. We are URAC accredited for case management.
Managed Disability Program
The Health Plan offers support to Ohio and West Virginia employers in administering benefits to employees with non-work related periods of disability. Our certified case managers utilize the managed care principles of early intervention and care coordination. We handle control of both direct and indirect costs associated with short-term disability.
As a workers' compensation TPA, we offer administrative support to both insured and self-insured employers in Ohio and West Virginia. The Health Plan is experienced in claims management and provides quality customer service. We also offer group rating programs for Ohio employers.
The Health Plan is a vocational rehabilitation provider to both Ohio and West Virginia workers' compensation systems. We have an experienced staff to address return to work issues for injured workers and assist employers with workplace restriction accommodations. The Health Plan develops and implements transitional work programs for employers.
Family Medical Leave Act (FMLA) Services
Responding to the requests of employers, The Health Plan delivers administrative services to assist employers with managing FMLA benefits. The Health Plan’s experience and understanding coupled with the support of advanced software applications allows employers to strategically and effectively navigate FMLA.
It's not about health insurance. It's about peace of mind. With all the choices in health care plans, how do you know which one is right for your needs? It is not just a matter of getting the right benefits. It is also a matter of choosing a doctor who knows you. A hospital that is close to home. Access to doctors who specialize in care of seniors. Service that is responsive and personal.
We have designed our Medicare managed care plans with a focus on all of these needs to give you the health coverage you need and the peace of mind you want. We offer several plan options for people with Medicare.
Prescription Drug Coverage
The Health Plan offers various plan designs that cover generic, brand name, and non-formulary options with various copay options. Prescription riders offer formulary plans. Our pharmacy benefits manager (PBM) administers The Health Plan prescription drug benefit and also offers mail-order service.
View participating pharmacies in our local network by state.
The Health Plan has an arrangement with Vision Service Plan (VSP) to offer several options. The plans provide coverage for a comprehensive eye examination as well as discounts or copays on glasses, contact lenses, and associated professional services. VSP has a national network of member eye professionals for member selection.
The Health Plan is affiliated with INFINISOURCE in Coldwater, Michigan, to outsource COBRA services to those employers with 20 or more employees. INFINISOURCE will ease the burden of COBRA administration by providing client service from the initial notice through premium collection.
The Health Plan can administer health savings accounts (HSA) and health retirement accounts (HRA) through arrangements with a qualified plan administrator. We have employer-designed plans to meet the company's needs and assets can be retained by employer or employee. There is a nominal administrative fee and it is an excellent recruitment and retention tool.