Definition of "Point-of-service (pos)"

Alixandria Considine real estate agent

Written by

Alixandria Considineelite badge icon

Suncoast Realty Group Llc

Device that enables the health maintenance organization (HMO) to present a premium quotation to the employer that would encourage the employer to replace the current health carrier. The POS offers three options for the delivery of health care:

  1. traditional gatekeeper (GK) option HMO network provides the care and there is a gatekeeper director.
  2. open access (OA) option HMO network provides the care but there is no gatekeeper director. At the time care is required, the member selects the provider.
  3. out-of-network option (OON) care is permitted outside the HMO network and there is no gatekeeper director. At the time care is required, the member selects the provider.
The member has increasing payments under the OA and OON options as compared with the GK option. For example, the GK option may have a $15 physician CO PAYMENT and provide total hospital benefits. The OA option may have a $30 physician co payment with a 10% COINSURANCE requirement. The OON option may provide for a $500 DEDUCTIBLE, an 80/20 coinsurance requirement until the employee's out-of-pocket medical expenses reach $5000, and then the plan would pay all expenses up to a $750,000 lifetime maximum.

image of a real estate dictionary page

Have a question or comment?

We're here to help.

*** Your email address will remain confidential.
 

 

Popular Insurance Terms

Means of projecting the costs of pension plans on a level basis over a specified future period of time. The actuarial value of each employee's future benefits to be paid at retirement is ...

Deliberate act or omission. These torts include trespass an individual enters property owned or in the possession of another without permission; conversion an individual exerts control and ...

Landmark legislation passed by Congress providing the first regulation of the securities markets. The law, enforced by the securities and exchange commission (sec), requires registration of ...

Organization that calculates rates and develops insurance policies for its property and casualty member companies. The suggested rates are used by smaller companies where the loss ...

Period allowed an insured to notify an insurer of loss. Many policies require immediate written notice, or notice as soon as practicable. Different types of policies have their own time ...

Coverage for an insured whose property is damaged or destroyed by an insured peril, or whose negligent acts or omissions damage or destroy another party's property or cause bodily injury to ...

Requiring assets and liabilities of an insurance company to go up or down together on a proportional basis. The duration of the asset and liability should be approximately the same. For ...

Frequency and severity of accidents resulting from conditions and environment surrounding one's workplace. Occupation is an important underwriting factor when considering an applicant for ...

In property insurance policy, clause that stipulates that if legislative acts or acts of the insurance commissioner's office expand the coverage of an insurance policy or endorsement forms ...

Popular Insurance Questions