Common Insurance Terms You Should Know

CDHP (Consumer-Driven Health Plan)
Members may choose any physician or hospital for medical services; however, members receive enhanced benefits, resulting in lower out-of-pocket costs, when receiving services from a CDHP in network provider. And, when paired with the Health Savings Account (HSA), CDHP/HSA members can choose to receive a State contribution of one-third of the CDHP deductible for the plan year. CDHP has a nationwide network of providers through Aetna PPO. Benefits are outlined in the plan's Summary Plan Document (SPD).  It is the member's responsibility to know and follow the specific requirements of the CDHP and HSA. Click here for more information.

HMO (Health Maintenance Organization)
A plan with personal care from a set network. You’ll need to choose a personal doctor, called a Primary Care Physician (PCP), to manage your care and refer you to specialists. You must go to certain doctors and hospitals, unless it’s an emergency or for urgent care.

OAP (Open Access Plan)
Combine similar benefits of an HMO with the same type of coverage benefits as a traditional health plan. Members who elect an OAP will have three tiers of providers from which to choose to obtain services. The benefit level is determined by the tier in which the healthcare provider is contracted. Members enrolled in an OAP can mix and match providers and tiers. Click here for more information.

PPO (Preferred Provider Organization)
A plan that contracts with medical providers, such doctors, clinics and hospitals, to create a network or participating providers. You pay less if you use providers that belong to the plan's network. 

QCHP (Quality Care Health Plan)
A medical plan where plan participants receive enhanced benefits resulting in lower out-of-pocket amounts when receiving services from a QCHP network provider. The QCHP has a nationwide network that consists of physicians, hospitals, ancillary providers, pharmacies, and behavioral health services. Click here for more information.