Fallon has many plans, like the other HMO’s. They have one design called Premium Saver (PS) Basic I and II plan that had a $1,200 hospitalization co-payment. In early August, the Division of Insurance (DOI) told them to stop selling these plans.
Now they are back but with a $1,000 hospatalization co-payment. Fallon is saying that they are doing this at no additional cost, but of course it has to be figured into the rates at some point ($200 more of coverage, $1,000 versus $1,200).
Employers are looking for higher and higher co-payments to keep premiums down and the DOI should let Fallon, or any other HMO offer hospitalization co-payments of more then $1,000. Especially when this is exactly what the consumer is looking for.