Whether purchasing individual health coverage or through an employer’s group health insurance, choosing the right plan is critical. With so many options and acronyms, it can be difficult to navigate. Check out some of the most common plan types and see how they differ below.

PPO – Preferred Provider Organizations

The most common type of healthcare plan, PPOs offer members a wide network of providers. Members are not required to obtain referrals when seeing specialists in-network.  Out-of-network providers can be utilized but do charge a higher cost. These plans tend to come at a higher premium.

POS – Point-of-Service Plans

These types of healthcare plans are similar to PPOs in which there is a wide network of providers and out-of-network providers can be seen at a higher cost. However, for POS plans, members are required to get referrals from their primary care provider (PCP) for specialist visits.

HDHP – High-Deductible Health Plans

This type of health plan combines lower premiums with higher deductibles and is typically paired with an HSA. A Health Savings Account (HSA) allows employees to set aside pre-tax funds to pay for eligible healthcare expenses.

HMO – Health Maintenance Organizations

These types of health plans have lower premiums but offer a more restricted network of providers. Members are required to choose a PCP and receive referrals for any specialists they visit. HMOs do not cover any out-of-network care (except in an emergency), and they may require members to live in the specific service area to qualify for coverage.

EPO – Exclusive Provider Organizations

These types of healthcare plans are similar to HMOs in that members are required to choose a PCP and coverage is restricted to a specific network of providers. EPOs do not cover any out-of-network care (except in emergencies), and they do not require a referral to see a specialist.

Partnering with Pierce Group Benefits

A robust health insurance offering can play an important role in supporting current employees and attracting new talent. Many organizations opt to offer it as a part of their benefits strategy. To learn more, contact your Pierce Group Benefits Account Executive or email partnership@piercegroupbenefits.com.

Additional Resources

Employer-based Health Insurance. PCH Global. (n.d.). https://pchhealth.global/glossary/employer-based-health-insurance

Claxton, G., Rae, M., & Winger, A. (2026, April 15). Employer-sponsored health insurance 101. KFF. https://www.kff.org/health-costs/health-policy-101-employer-sponsored-health-insurance/?entry=table-of-contents-what-types-of-employer-sponsored-health-insurance-plans-do-workers-have

What you should know about provider networks. Healthcare.gov. (n.d.). https://www.cms.gov/marketplace/outreach-and-education/what-you-should-know-provider-networks.pdf