An HMO plan has unique advantages and disadvantages

It is very difficult to go to a third party administrator and get a point of service or HMO based network that has those really, really deep discounts.  If you are fully-insured today with let's say an AETNA or a Humana or even a CIGNA where they have those point of service networks that are even though you have the in and out of network benefits but that in network platform, you get those deep discounts, that’s very, very important in managing your claims on a self-funded basis.

If you are on any type of HMO based platform today fully-insured, you're probably going to want to look to a carrier because you can go self-funded and be a part of that risk, be a part of that you still get those deep discounts. Now, it doesn’t mean that you can't go to a TPA. It just means that when you're evaluating what you're buying, you need to look at your discounts. That's a very important part of being self-funded.

With the carrier, they're going to provide you a deeper discount if they're HMO based products or point of service or open access type products. Those discounts typically are the deepest.  It doesn’t mean you can't look at a third party. You just need to make sure that when you're doing your evaluation that you look at the discounts.