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Health Maintenance Organizations (HMOs) are often a cost-effective plan, but most of the time they are regional plans only, and to manage several of them would be impossible and would require more specialists within the Benefits Department. Instead, for the past several years, Commerce has chosen to go with a Cigna Point of Service (POS) plan which offers in-network providers in most states, the ability to see specialists with a referral and the option to go out-of-network or to see a specialist without a referral if need be, often times with a deductible that would need to be met first...

Most plans that offer countrywide coverage are quite expensive, and Cigna’s plan was no exception.

Recently, a partnership between Harvard Pilgrim Health Care and United formed, thus resulting in a countrywide Preferred Provider Organization (PPO) (Harvard Pilgrim). A PPO plan is similar to a POS plan in that there are in-network and out-of-network providers, but a referral is not needed at all...

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