A Point-of-Service (POS) plan is BEST distinguished from a pure HMO by which of the following features?

Explanation

A Point-of-Service (POS) plan is a managed-care hybrid that gives the member a choice 'at the point of service.' In-network with a primary-care-physician referral, the member receives HMO-level benefits with low cost-sharing. Out-of-network or without a referral, the member can still get covered care, but at PPO-like cost levels (a higher deductible, higher coinsurance, and balance-billing risk) — that two-tier structure is the correct distinction from a pure HMO. The description of a plan with no provider network paying a fixed percentage of usual and customary charges to any licensed provider is wrong; POS plans have networks and gatekeepers. The description that never requires a referral and reimburses out-of-network providers at 100% of billed charges is wrong; the very point of the structure is to make out-of-network MORE expensive, not free. And limiting the plan to emergency and urgent care with routine services bought through a separate indemnity rider is fabricated. The defining feature is the two-tier benefit structure tied to whether the member uses the HMO core or steps outside it.