Preferred Provider Organization (PPO)
Instructions and Application
Preferred Provider Organizations (PPOs) are regulated by the Pennsylvania Departments of Insurance and Health. Generally, PPOs include entities who have entered into arrangements with health care providers either to establish a provider network or to provide health care services for the PPO's enrollees. PPO health insurance policies provide incentives, such as a higher level of coverage, to enrollees when those enrollees use network providers.
If you are applying for a Gatekeeper PPO (GPPO) or submitting a GPPO product filing, you must address the requirements of the Pennsylvania Quality Health Care Accountability and Protection Act (Act 68 of 1998) and related regulations in your application and policy forms.