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Point of Service POS

The definition of Point of Service POS, and how it fits into the Zenefits Health Insurance Marketplace

What is a Point of Service POS?

A Point Of Service (POS) plan is a type of health insurance plan that a company can offer their employees. It combines elements of HMO plans and PPO plans, in the opposite way that an EPO does.

 

How does a Point of Service POS work?

POS plans usually require you to designate a Primary Care Physician, like an HMO. POS plans offer out-of-network coverage, like a PPO.

*Product And Service Information

All insurance quotes provided through Zenefits are estimates and are not guaranteed to match the final rates and details of your policy.

All insurance quotes provided to you through Zenefits (which are based on information provided to us by you and information provided and general assumptions made by the insurance companies) are made available to you for pricing comparison and quotation estimate purposes only and the actual final rates and details of your policy may vary. Many factors may cause estimated rates, details and availability to differ from actual. These may include changes in employee numbers, ages or other characteristics, selection of optional benefits, insurance company underwriting guidelines, selected locations as well as rate and plan changes implemented by insurance companies, which may occur at any time – particularly at calendar year end.

All insurance quotes are made available as a free service to Zenefits customers without any express or implied warranties of any kind.

The information and descriptions of insurance products contained herein are not intended to be complete descriptions of all terms, conditions, limitations, or exclusions, and are provided solely for general informational purposes. In no way is Zenefits responsible for the accuracy, reliability, currency, or completeness of any quote or related information or materials, including any information, content, materials, advice, products, services, functionality, or resources provided by or communicated through any insurance company or third party agent.

Zenefits has no control over whether you ultimately qualify for insurance at the estimated rates, and we make no warranties or guarantees that you will qualify.

The insurance quotes provided through Zenefits do not constitute an offer, solicitation, sale or negotiation of insurance, nor is any contract, agreement, or insurance coverage implied, formed or bound by the provision of rate quotes. Insurability, final insurance premium rate quotes and an offer of insurance, if any, will be determined by the insurance company providing your insurance policy.

Underwriting will not begin until after the completed and signed application is received by the insurance company. If a policy is issued to you, the premium will be based on the information, rates and rules in effect at that time for the issuing insurance company. Please refer to the actual policy for complete details of coverage of a particular policy. Policy forms vary by state and may be changed by each insurer without prior notice.

Zenefits does not guarantee that you will qualify for any products or services offered by any insurance company. Do not cancel any current health insurance coverage until you receive an approval letter and insurance policy, also known as insurance contract or certificate, from the insurance company you select. Make sure you understand and agree with the terms of the policy.

As a result of contractual relationships between Zenefits and certain insurance companies and others, Zenefits may receive a referral fee or commission share with respect to insurance sold to you by an insurance company. It is possible that several competing products may be available at the same, or similar, pricing and that the sale of one of them may result in a higher total compensation paid to us than the sale of another.

Your Consent

The information you provide us in any quote request is on a strictly voluntary basis. By voluntarily providing your contact information to us, you are consenting to be contacted for telemarketing purposes by via telephone, text message, email or other legally permissible means. In addition, by providing us with your contact information, you are consenting to being contacted by insurance companies and/or brokers and agents via these methods for telemarketing purposes in connection with your application or in response to your request. You understand that your telephone company may impose charges on you for these contacts.

You may contact us at any time to change your preference of how we communicate with you. We honor requests made to be added to our internal do not call list, within a reasonable period of time, and we will then no longer call you at such phone numbers again, unless you subsequently provide us your proper consent.

Product Information

"Sidecar Health", "Sidecar Health insurance", "Sidecar Health coverage" and "Sidecar Health plans", collectively, refer to the fixed indemnity insurance product marketed and administered by Sidecar Health Insurance Solutions, LLC. and underwritten by the insurance carriers described below. This is only a brief description of the insurance coverage available. The Policy contains reductions, limitations, exclusions, and termination provisions. Full details of the coverage are contained in the Policy. If there are any conflicts between this document and the Policy, the Policy shall govern in all cases. Insurance plans in Alabama, Florida, Georgia, Indiana, Maryland, North Carolina, Oklahoma, South Carolina, Tennessee and Texas are underwritten by United States Fire Insurance Company, 5 Christopher Way, 2nd Floor, Eatontown, NJ 07724. Insurance plans in Arkansas, Kentucky, Mississippi and Ohio are underwritten by Sirius America Insurance Company, 140 Broadway, 32nd Floor, New York, NY 10005. Coverage under these plans is unavailable to applicants age 65 years or older.

§ This is a limited benefits insurance plan and is not an expense incurred medical plan. The benefits provided under this plan are limited in nature and are not related to the costs you may incur for health care services. As a fixed indemnity insurance plan, this plan is exempt from many state and federal requirements that apply to other types of health benefit plans. This policy does not provide major medical expenses coverage, minimum essential coverage or essential health benefits.

Fixed indemnity insurance plans do not provide ACA-qualified Essential Health Benefits or Minimum Essential Coverage. You cannot receive a subsidy (premium tax credit and/or cost-sharing reduction) under the ACA in connection with your purchase of such a fixed indemnity insurance plan. Also, the termination or loss of this policy does not entitle you to a special enrollment period to purchase a health benefit plan that qualifies as minimum essential coverage outside of an open enrollment period.

†† Coverage and plan options may vary or may not be available in all states.

‡ Information on doctor and health care facility charges is not a recommendation or advice on which doctor or facility you should see. Members must perform their own research.

† Savings estimate based on a study of more than 1 billion claims comparing self-pay prices for a frequency-weighted market basket of procedures to insurer-negotiated rates for the same. Claims were collected between July 2017 and July 2019. R. Lawrence Van Horn, Arthur Laffer, Robert L. Metcalf. 2019. The Transformative Potential for Price Transparency in healthcare: Benefits for Consumers and Providers. Health Management Policy and Innovation, Volume 4, Issue 3. https://hmpi.org/2019/12/09/the-transformative-potential-for-price-transparency-in-healthcare-benefits-for-consumers-and-providers/

‡‡ Picture is for illustrative purposes. Premiums vary by state. Get a quote to see your premiums.

§§ Changes to your plan are subject to re-underwriting and premium changes.

Sidecar Health issues only individual policies and does not offer group policies.