Health Maintenance Organization


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Health Maintenance Organization

Commonly called an HMO. A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. Most HMOs require policyholders to have a primary physician who provides referrals for specialists and other medical services. Without these referrals, medical care generally will not be covered. This fact has made HMOs somewhat controversial. However, they generally operate at a lower out-of-pocket cost to consumers. They trace their origins to the early 20th century, but became more popular after the Health Maintenance Organization Act of 1973.
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Qualified (q) Rating Modifiers may be assigned to Health Maintenance Organizations (HMOs), Canadian insurers and UK insurers that meet the minimum size and operating experience requirements for a Best's Rating but do not subscribe to our interactive rating process.
Best's Rating Changes
As increasing numbers of health maintenance organizations look at cost-cutting measures to put their companies back in the black, many are considering or implementing premium hikes.
A Double Dose
Frank Keating, a Republican, has signed into law a bill that allows patients to sue their health maintenance organizations for punitive damages.
New Oklahoma Law Puts HMOs on Defensive
Qualified Ratings assigned to Health Maintenance Organizations (HMOs), Canadian insurers and U.
Best's Rating Changes

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