Providing Health Insurance Coverage for your Practice

Updated: Aug 24, 2020

One of the largest expense’s a medical practice faces today continues to be health insurance coverage for employees. Premiums are rising and coverage continues to change year to year. Ohio’s small practices face particular challenges as the small employer market typically experiences the largest increases and fluctuations in coverage—and often with limited options.


Finding the right health plan for you and your staff has always been challenging, made even more so in recent years with the introduction of the Affordable Care Act (ACA) and now with the effects of COVID-19. The Ohio State Medical Association continues to partner with the OSMA Insurance Agency to provide quality solutions which includes the OSMA Health Benefits Plan.


The OSMA Health Benefits Plan was established in 2015 to provide a competitive alternative to the Affordable Care Act plans. Our plan allows for small practices to come together to collectively form a self-insured plan with benefits that would usually only be an option available to larger employers. The OSMA Health Benefits Plan now has nearly 200 enrolled groups with over 1,000 active employees participating in the plan. Since inception, the plan has provided stable rates with renewals averaging below 5% over the past five years. With stable rates and quality benefit options, the plan continues to provide a valuable solution to our members.


Unlike traditional health plans that are managed by insurance companies, the OSMA Health Benefits Plan is governed by a Board of Trustees made up of OSMA member Physicians actively practicing medicine and participating in the plan. These trustees oversee the plan and make decisions to best benefit the participating employers and employees.


The OSMA Health Benefits Plan is available to practices with up to 99 eligible full-time employees and allows for sole proprietors with no additional employees to apply for coverage. The plan is flexible and designed to accommodate various employee situations.


The OSMA Health Benefits Plan offers:

· Cost-Effective Affordable Benefits

· 11 Traditional Plan Designs

· HRA & HSA Funding Options

· A broad network of doctors and hospitals in Ohio and across the country.

· Telemedicine

· Nurse Hot Line

· Urgent Care Coverage

· Chronic Medical Disease and Maternity Management Programs

Members of the OSMA Health Benefits Plan have access to an online secured portal, My Health Plan, 24/7/365 for a variety of services including:

· Selecting a primary care physician (PCP)

· Search for in-network providers

· Access to Express Scripts for prescription pricing and refills

· Use the My Care Compare tool to find in-network doctors and facilities at the best cost

· View real-time claims and deductible status

· Read important care gap reminders and messages

· Obtain an online plan identification card (ID)

· Review your plan benefits

· Take a Health Assessment

· View interactive heath learning courses

· See available healthy living and wellness discount programs


Additionally, the OSMA Health Benefits Plan has supported all the Ohio Department of Insurance Healthcare COVID-19 Mandates. This includes the 60-day premium grace period and no deductible or copay on COVID-19 testing or medical services. To further assist our insured members as it relates to COVID-19 issues, the OSMA Insurance Agency provides an online COVID-19 Employer Guidance service through their human resource provider, Think HR. Simply go to OSMAIA.com to access this information.


As you review your 2021 health insurance renewal this fall, we urge you to consider learning about how the OSMA Health Benefits Plan can provide quality benefits at affordable costs – the health insurance plan built and run by your colleagues, Ohio Physicians.