We’ve been in the health care industry for a long time. It’s our purpose - and our passion. We started out as Sierra Health Services over 30 years ago and were acquired by UnitedHealthcare in 2008. Our approach is simple. We help you navigate your group health plan so you can keep your employees – and your business – healthy. And, the best part is, we’re local.
Your employees either have a health maintenance organization (HMO) or point of service (POS) plan depending on the group health plan you selected.
Everything you need to get started is right here at your fingertips.
Group health plans
HMO plan explained
Easier on the wallet, HMO plans are designed to save health plan members money on out-of-pocket costs. In exchange, HMO members are required to choose a primary care provider (PCP) and stay within a network of providers, urgent cares and hospitals to receive coverage under your group health plan.
To have a specialist visit covered, an HMO member must see his/her PCP for an initial exam. Then his/her PCP will provide a referral to a specialist for a more thorough diagnosis, if needed.
POS Plan Explained
POS plans are designed to offer the most flexibility. This means health plan members can choose how they want to use the plan based on three tiers:
Tier I HMO: A member can visit his/her primary care provider (PCP) to receive an initial exam and a referral to a specialist for a more thorough diagnosis. This option provides the most coverage for the least out-of-pocket cost.
Tier II PPO: A member can bypass his/her PCP to see a specialist or a doctor in network, but he/she will share more of the cost. This may include copayments or coinsurance for office visits, coinsurance for other covered services and a deductible. This tier also has a preferred provider network.
Tier III Out of Network: This option allows a member to visit any licensed health care provider or hospital. However, he/she is responsible for paying all costs for care at the time of service, filing claim forms for reimbursement, meeting a deductible and sharing higher coinsurance.