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June 1983, Vol. 106, No. 6
HMOs and other health plans:
coverage and employee premiums
Allan Blostin and William Marclay
How do Health Maintenance Organizations (HMOs) compare with traditional health insurerssuch as Blue Cross and Blue Shield organizations and commercial carriersin terms of benefits provided and premiums required of employees? Although HMOs account for a small portion of the individuals with health insurance protection, interest in them has grown in recent years, particularly since the passage of the Health Maintenance Organization Act of 1973.
The Bureau of Labor Statistics' annual surveys of the incidence and characteristics of employee benefit plans in medium and large firms shed considerable light on the comparative coverages provided by HMOs and other sources of health insurance protection. Data from the 1981 study demonstrate that HMOs as a rule provide unlimited hospital-related care for physical ailmentssuch as room and board, surgical care, and doctors' visits to the hospitalwith no charges over subscriber premiums; other health insurers typically curb such benefits through deductible or coinsurance provisions, ceilings on dollar payments, and limits on the maximum number of days of hospitalization coverage.
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