Health Insurance
Which statement correctly describes a preferred provider organization (PPO) plan?
Answer
A network plan that lets the enrollee see a non-participating provider at a lower level of benefits
Conn. Insurance Dept. Glossary: 'PREFERRED PROVIDER ORGANIZATION PLAN – A network plan that allows an enrollee to seek treatment from a non-participating provider at a lower level of benefits.' A health maintenance organization (HMO) 'provides, offers or arranges for coverage of health services needed by plan members for a fixed, prepaid premium', and replacing lost income is disability income insurance.
Source: Conn. Insurance Dept., Glossary of Insurance Terms, 'Preferred Provider Organization Plan', 'Health Maintenance Organization (HMO)', 'Disability Income Insurance'
Not the answer
- It replaces income lost during a disability
- It pays only for services delivered by its own salaried staff doctors, with no out-of-network benefits at all
- It pays the same benefit in and out of network
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