Mission Benefits

Description

HMOs assume the financial risks and responsibility for delivering all covered health services to members in a particular geographic area, usually in return for a fixed, prepaid fee. Some HMOs employ all providers and provide the facility or facilities. Others contract with medical groups, paying them a negotiated, per capita rate. Problems with the HMO model soon appeared, however. Employees enrolled in HMOs began to push back against plan restrictions.

One of the primary purposes of ERISA, the federal Employee Retirement Income Security Act, is to protect promised benefits. To help accomplish that goal, the statute and regulations require sponsors of ERISA plans to provide summary plan descriptions (SPDs), adhere to ERISA claims procedures, and to file an annual Form 5500 financial status report. These, and other requirements, make administering an ERISA plan more complex than other plans. Plans that do not fall under ERISA avoid ERISA’s fiduciary provisions and do not require SPDs, ERISA claims procedures or Form 5500 filings.

Our experienced Medical Benefit Advisors help you design the optimal package that combines the best medical, dental, vision, and other benefit plans to meet your unique needs. Call us today (408) 419-2600 to find out how we can help you.

Is your company in compliance with the new federal laws for same sex benefits? Contact Mission Benefits for more information!

Mission Benefits specializes in helping California businesses and non-profit organizations navigate the complex employee benefits market. Our experienced Medical Benefit Advisors help you design the optimal employee package that combines the best medical, dental, vision, and other benefit plans to meet your unique needs.

Products & services

Similar companies nearby