What types of health plans should we be considering (PPO, EPO, HMO, HDHP, MEC, or ICHRA)?

The best plan for your business depends on your workforce’s needs, your budget, and how much flexibility you want employees to have. Each plan type balances cost, choice, and coverage differently, many employers pair them with accessible primary care to drive engagement and control costs.

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• PPO (Preferred Provider Organization):
  Offers the greatest provider flexibility, employees can see in-network or out-of-network providers, though out-of-network care costs more. Premiums are higher, but convenience and choice are strong.
• EPO (Exclusive Provider Organization):
  A lower-cost option than PPOs, EPOs don’t require referrals but only cover in-network care (except for emergencies). They offer balance between affordability and simplicity.
• HMO (Health Maintenance Organization):
  Focuses on coordinated, lower-cost care. Employees select a primary care provider (PCP) and need referrals for specialists. Predictable costs and strong care management make HMOs effective but less flexible.
• HDHP (High Deductible Health Plan):
  Offers lower monthly premiums with higher out-of-pocket costs. Often paired with a Health Savings Account (HSA), HDHPs work well for teams that can handle upfront expenses and want tax advantages.
• MEC (Minimum Essential Coverage):
  Meets ACA requirements for preventive care but doesn’t include major medical coverage. MEC plans are an affordable, compliance-friendly choice for part-time or hourly employees.‍
• ICHRA (Individual Coverage Health Reimbursement Arrangement):
  Allows employers to reimburse employees tax-free for individual insurance premiums and eligible medical expenses. This model provides flexibility and predictable costs but requires employees to choose and manage their own plans.

Vitable enhances or replaces traditional plan structures by making primary care the foundation of every benefit design. Every member receives $0 virtual or in-home visits, mental health support, and prescriptions through one simple, affordable platform. Paired with MEC, HDHP, or ICHRA options, Vitable ensures employees have accessible, everyday care they’ll actually use.

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Each plan type has its strengths, but the most effective designs combine affordability, accessibility, and prevention. By layering Vitable’s primary-care-first model with any plan type, employers can keep costs predictable while improving engagement, satisfaction, and long-term outcomes.

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