Mid/Large Group Health Maintenance Organization (HMO) Plans

For groups with 51+ employees

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High-quality coverage with deep discounts

Our HMO plans offer access to high-quality doctors and hospitals within our comprehensive network. The in-network providers offer their services to Network Health at a discounted rate, which helps keep the cost of health care low. In addition, Network Health doesn’t require a referral to see a specialist.

HMO plans are ideal for a company that is seeking broad coverage and has employees who are willing to see in-network providers. HMO plans are available for groups with 51+ employees. Some high-deductible Network Health HMO plans qualify for a Health Savings Account (HSA) to help offset medical expenses. You can find links to specific plan benefits here.

HMO Advantages 

• WellnessWays Wellness Program – Our WellnessWays wellness program gives your employees a variety of tools, resources and services needed to improve their overall health. They also have the opportunity to earn prepaid gift cards for completing a wide range of activities throughout the year. By actively promoting better health among your employees, your claims costs go down.
• Condition Management – Our team of registered nurses is here to help manage specific health conditions by offering local workshops and educational events.
• Care Management – If you are diagnosed with a serious health problem, our case managers will help you coordinate care and answer any questions you may have.
• Built-In Pharmacy Benefits – Through our partnership with Express Scripts®, Inc. (ESI), members have access to an extensive pharmacy network, both large chain and local.

Out-of-Area Coverage Solutions

If your organization has employees living outside the Network Health service area, you may be eligible to use the Network Options wrap plan as part of your Network Health HMO plan. The Network Options wrap plan allows out-of-area members to use participating health care facilities in their area. Those members will not have coverage for services received by non-participating facilities, except for emergency care. To find a participating provider, go to myfirsthealth.com and enter your zip code to get started. To qualify for the Network Options wrap plan, your company must have:

• A total of at least 51 employees with 35+ enrolled in Network Health care plan.
• A minimum of 80 percent of enrolled employees must live within the Network Health service area.
• Approval is required for participation. Talk to your agent for more information. If you don’t have an agent, call 920-720-1250.