7 Tips for Picking the Right Corporate HMO (Health Maintenance Org.)

The term HMO stands for Health Maintenance Organization, a business which provides their customers access to a full range of medical facil...

The term HMO stands for Health Maintenance Organization, a business which provides their customers access to a full range of medical facilities at their time of need.

Nowadays, with so much pollution, malnutrition, and CHEAP unhealthy food, maintaining good health have become a problem.

For companies big or small, health benefits for your employees would mean the world to them. They will feel safe and secure with your company and in return, having it would give them the drive to perform more.

If you value health and care for your employees, one of the most seamless and affordable way to provide health benefits is to acquire a partner Health Maintenance Organization (HMO).

Why partner with an HMO?

  • People with HMO Cards are spared from the burden of worry and anxiety about inevitable things that may happen like accidents or illnesses. Peace of Mind is what an HMO truly provides.
  • Alleviate administrative expenses. A number of administrative tasks will be provided by the HMO such as but not limited to, Hospital Support, Printing of HMO Cards, Billing, Account Management, etc. 
  • Accessibility. In cases of emergency, the most accessible way to get IN-patient services in a hospital is to simply provide your HMO card. Some hospitals here in the Philippines would require you to provide a down-payment for your in-patient needs. With an HMO, the only thing you need is your Health Card.


HOW I WOULD PICK MY PARTNER HMO?




1. I should research their financial capabilities. Can they back me up? Is there a contingency plan?

Why do this? I would want to be secure  24/7 for the span of my contract. Making sure that the HMO takes good care of their clients as well as their network of providers.


2. I would check their Accredited Networks and Affiliated Physicians.

Why do this? I want to feel safe anywhere I go in the country. Hence, the coverage should be nationwide.



3. I contacted some high traffic hospitals and see how my prospected HMO is doing.

Why do this? Good partnership is a MUST! However, even if the partnership with YOU and your HMO is doing great, it would mean little if the HMO's partnership with their providers are falling behind.









4. I would listen closely and converse with their Business Development Officers / Sales Professionals; if the offer is too good to be true (budget-wise/benefit-wise), I should not hesitate to ask questions.

Why do this? Sales Professionals are front-liners, they know their craft like the back of their hands, everything you would need to know about the product and services of their HMO may be answered by them.


5. I will ask my friends or people who experienced my prospected HMO. I must also keep in mind that the benefit package or exclusions may vary depending on the preference of their company.

Why do this? Service can only be justified through experience, the best way to find out about the services of your prospected HMO is through word of mouth. Intel from people who experienced having them as a health care provider would be very much helpful.


6.1. If it's my first time acquiring a corporate HMO. I should probably start with a benefit package that has all my "NEEDS", my "WANTS" can come at a later date.

Why? Similar to the popular phrase "with great power, comes great responsibility", I would say "with great benefit package, comes great utilization". 

Define Utilization = Amount used by your HMO to pay for your company's health care needs.

What does high utilization do? 
- High probability of increased renewal rates for the following year

What are the drawbacks of an extravagant benefit package?
- No turning back for benefits applied (labor law: Non-Dimunition of Benefits)


6.2. I am experienced in having an HMO, but I need a new HMO due to X concerns. What should I do?

What to do?
  • Provide your utilization summary from the previous year
  • Provide the list of your current benefit package
  • Provide the list of members to be enrolled
Why do this?
The Business Development Officer of your prospect HMO will do a thorough study and provide inputs from the data provided. This may also be used to provide a comprehensive health benefit package.


7. Are they technologically in tune? are they up-to-date with the current trend?

Why ask this? Mobile/Online applications and the like will help me have a better understanding of my health benefit package. Also increase my accessibility to the services they provide.



If you need a Holistic HMO which may provide various Health Care solutions for your company. (Philippines)


Don't hesitate to contact me and I'll be glad to provide inputs and options.

Reynier Chua - Intellicare / Avega Managed Care, Inc.

Mobile: 09172400810 (Globe) or 09193707108 (Smart)

Stay well and healthy!

Extending my thanks to Ms. Dorothy Tiangco and Mr. Daryl Sarroca for allowing me to take pictures of them for this post! :)

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