Medical

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TriNet offers a wide variety of medical plans, and has engaged national and regional carriers. To learn about specific benefit plan changes, click here.

Medical Plan Carriers

To view greater plan details, click on the national and regional medical plan carriers below:

Note: Carrier availability may vary; contact your TriNet Customer Experience Contact for more information.

Medical Plan Types

National and regional plan offerings may include the following plan types:

Accountable Care Organization (ACO) Plans

ACOs are groups of hospitals, physicians and other providers who work together voluntarily to provide coordinated care for their participants. Some plans offer coverage for in- and out-of-network providers, while other plans don’t. These plans include copays, deductibles and coinsurance similar to other plan designs. The network is comprised of regionally located providers to allow them to coordinate care. Thus, the network is narrower than what you might see on other plan designs. The rate for ACO plans is more affordable than PPO plans. These plans are available in just a few locations.

Exclusive Provider Organization (EPO) Plans

EPO plans are closely related to HMOs. They offer care exclusively through in-network providers (no benefits are paid for care received outside the EPO plan’s network, except in emergencies). However, worksite employees do not need referrals from their primary care physician (PCP) to access specialists and other providers in the EPO plan’s network.

High-Deductible Health Plans (HDHPs)

HDHPs often offer lower rates in exchange for a higher deductible that must be met before the plan begins to cover eligible services. However, preventive services are covered at 100% in-network. Because HDHPs have a higher deductible, participating worksite employees have the option to contribute to (or receive company contributions to) a health savings account (HSA), which lets them set aside pre-tax money to pay for eligible health care expenses.

Health Maintenance Organization (HMO) Plans

HMO plans offer care through a network of providers, but no benefits are paid for care received outside the HMO plan’s network (except in emergencies). For many services, worksite employees pay a flat fee called a "copay." And with some HMO plans, they must first meet an annual deductible and pay coinsurance for certain services. Also, some HMOs require worksite employees to get referrals from their primary care physician (PCP) to access specialists and other providers in the HMO plan’s network.

Point-of-Service (POS) Plans

A POS plan is an HMO/PPO hybrid. Some POS plans resemble HMOs for in-network services, requiring that the member pay only a copayment for in-network services. Other POS plans require a per-visit copayment for certain in-network services; for more complex services, these plans may require a deductible to be met before a “coinsurance” or percentage of cost is applied. Services received outside of the network are usually reimbursed in a manner similar to PPO plans (e.g., provider reimbursement based on a fee schedule or usual, customary and reasonable charges).

Preferred Provider Organization (PPO) Plans

PPO plans give worksite employees the flexibility to receive care from any provider. But their costs are generally lower when they use providers inside a designated network of providers. Some services require a deductible to be met before a "coinsurance" or percentage of cost is applied, while other services may only require a "copay" or flat-dollar amount be paid.