Understand products offered
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A. Health Maintenance Organization - Hometown Health Plan is northern Nevada's oldest, largest and most experienced health maintenance organization (HMO). Locally-owned, it was established in 1988 and operates as a non-profit organization. Hometown Health Plan provides comprehensive benefits to members solely through employer groups.
Because we believe quality care is cost-effective care, we are relentless in our quest to keep health care affordable. Our HMO network applies strict credentialing criteria to provide the highest quality of care at the lowest possible cost. We also use many cost-effective contracting techniques in areas such as hospital, primary care physician (PCP), specialist and ancillary services. Our philosophy centers on assisting the member's PCP to direct his/her patient's care.
Another key to success is our Health Services Department. This team of professionals, led by our medical director, consistently applies a professional health care philosophy to the many facets of the coordination of care for our members.
For more information on Hometown Health's products and services, please contact your Hometown Health Account Executive. Be sure to download the latest PDF of HMO Plan Designs.
Attributes of Health Maintenance Organization (HMO)
- No deductible
- No coinsurance
- No claim forms
- No excess billed charges
- Has either copay or no charge
- Only providers in directory are covered
- No preexisting condition limitations
- Primary Care Physician selection required
- Specialist access through Primary Care Physician referral
- Physician is responsible for obtaining referral
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B. Preferred Provider Organization (PPO) - Many employers prefer the freedom of choice offered by a Preferred Provider Organization (PPO). Hometown Health Providers Insurance Company offers both a northern and a southern Nevada network. This allows coverage of employees in any city or town throughout the state.
Incentives, such as low co-payments at a physician's office, encourage member to use preferred providers. When members use preferred providers, Hometown Health's discounted fee schedules keep claims costs down, which helps keep premium to a minimum. In addition, precertification requirements for most major treatments assist in keeping costs down.
For more information on Hometown Health's products and services, please contact your Hometown Health Account Executive. Be sure to download the latest PDF of PPO Plan Designs.
Attributes of Preferred Provider Organization (PPO)
- Providers in and out of directory are covered
- No Primary Care Physician selection required
- No referral needed to see specialist
- Copayments required for certain services
- Deductible applies on certain services
- Coinsurance applies on certain services
- Claim forms needed only when using nonparticipating providers
- Nonparticipating providers may bill members for charges that Hometown Health does not pay
- Preexisting condition limitations may apply
- Member is responsible for obtaining prior authorization
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C. Dental - Employer groups with 10 or more employees can add a dental plan to any of Hometown Health's medical plans. For your convenience, we offer a variety of deductibles and annual maximums as well as an orthodontic rider.
For more information on Hometown Health's products and services, please contact your Hometown Health Account Executive.
D. Vision - Hometown Health offers vision coverage through Vision Service Plan (VSP) which can be added to any of our medical plans. VSP offers a large eye care doctor network, with doctors located in both metropolitan and rural areas.
For more information visit Vision Service Plan
For more information on Hometown Health's products and services, please contact your Hometown Health Account Executive.
E. Employee Assistance Program (EAP) -Solutions EAP aims to help employees identify and solve problems before those problems affect their performance. Early intervention with Solutions EAP can reduce costly, long-term treatment or the continued loss of a worker's productivity.
Research on EAPs demonstrates that for every dollar invested, employers can save $3-$16 in the following areas:
- health care claims
- problem sick days
- chronic absenteeism
- disciplinary actions
- workers' compensation claims
- terminations and frequent turnover
Solutions EAP provides free education, assessment, and referrals for employees and their families. A counselor is available to discuss issues such as:
- stress
- marital
- legal
- job
- anxiety
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- school
- drugs
- health
- family
- grief and loss
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- finances
- depression
- alcohol
- gambling
- work performance issues
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Employees and their families have an opportunity to discuss their concerns in person or over the phone with a Solutions EAP counselor. All contact between the employee and the counselor(s) is strictly confidential. Solutions EAP will not disclose personal matters to anyone without the employee's written request, except for cases in which the law requires reporting, such as child or elder abuse.
Please contact your Hometown Health Account Executive to see how to implement a Solutions Employee Assistance Program (EAP).
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