Commercial Health Insurance
What Does Commercial Health Insurance Mean?
Commercial health insurance refers to any type of health insurance policy that is not offered or provided by the government. These providers are for-profit and offer both group and individual plans. Typically, individuals enroll through an employer, who may cover the entire premium or a portion of it, with the remaining cost deducted from the participating employee’s payroll. Because employer-sponsored plans differ in how much of the premium the company pays and in which doctors are in-network, it pays to spend time comparing health insurance plans during open enrollment rather than sticking with last year’s pick by default.
Insuranceopedia Explains Commercial Health Insurance
Commercial health insurance is generally structured in one of three ways. The most popular option is the point of service (POS) plan, which allows policyholders to choose a primary care physician (PCP) from a list provided by the insurer. If a policyholder sees a doctor outside this network, they typically receive lower benefits for covered services. Another model is the health maintenance organization (HMO) plan, which also enables policyholders to select a PCP from a network of healthcare professionals established by the insurer. However, it generally does not cover services received outside the network. Finally, the indemnity or fee-for-service model provides coverage for certain healthcare services and allows policyholders to see any healthcare professional they choose, although coverage is typically limited. Whichever plan type you end up with, your actual spending over the year comes from how the premiums, deductibles, co-pays, and coinsurance stack up together once you start using the plan.
