Sample Group (52 Lives)
|
|
|
- Marsha Morton
- 8 years ago
- Views:
Transcription
1 Group Insurance Analysis BEN-E-LECT can use a variety of insurance Companies to meet the needs of our clients. We quote the carriers that best address those needs. Group Insurance Proposal For: Effective Date 08/01/2013 BEN-E-LECT Plan is available for exclusive benefit of a select group of benefit experts Proposed By: BEN-E-LECT, Insurance License 5429 Avenida de Los Robles Suite A Visalia CA Phone: Fax: And Provided by: BEN-E-LECT Insurance License Visalia, California PH: (559) FAX: (559)
2 BEN-E-LECT Group Medical EDHP 51+ Proposal/Comparison for Medical Option 1 (10K) Option 2 (20K) Option 3 (30K) (1) Carrier Rates Effective as of: FSL 51+ FSL 51+ FSL 51+ Plan Name Network Cigna Cigna Cigna Carrier Specific Deductible $10,000 $20,000,000 Proposed Annual FSL Stop Loss Coverage Proposed Annual FSL Admin & Sales Cost Proposed Annual FSL Claim Fund $149,056 $38,020 $96,356 $118,452 $37,779 $122,393 $98,870 $37,526 $137,170 Proposed Annual Maximum FSL Cost Proposed Monthly Maximum FSL Cost $283,432 $23,619 $278,624 $23,219 $273,566 $22,797 (2) Current Annual Premium Current Monthly Premium $312,013 $26,001 $312,013 $26,001 $312,013 $26,001 Projected Instant (Annually) $28,581 $33,389 $38,447 (3) Proposed Plan Design Individual Deductible (In/Out of Network) 500/ / /1000 Coinsurance (In/Out of Network) 80/50 80/50 80/50 PCP Co-pay Specialist Co-pay Rx Co-pays 15/30/50 15/30/50 15/30/50 Coinsurance Max (In/Out of Network) 3000/ / /6000 (4) Census Count Employee EE/Spouse EE/Child Family Total Employees (5) Projected Scenarios % of Claims Fund Depleted FSL Claims Fund Remaining Instant Total FSL Claims Fund Remaining Instant Total FSL Claims Fund Remaining Instant Total Best Case Worst Case 0% 25% 75% 100% $96,356 + $28,581 $124,937 $72,267 + $28,581 $100,848 $48,178 + $28,581 $76,759 $24,089 + $28,581 $52,670 $0 + $28,581 $28,581 $122,393 + $33,389 $155,782 $91,795 + $33,389 $125,184 $61,197 + $33,389 $94,586,598 + $33,389 $63,987 $0 + $33,389 $33,389 $137,170 + $38,447 $175,617 $102,878 + $38,447 $141,325 $68,585 + $38,447 $107,032 $34,293 + $38,447 $72,740 $0 + $38,447 $38,447 This proposal is for illustrative purposes only. Final rates are determined by the carrier s underwriting guidelines by underwriting and final enrollment. Results may vary based on utilization. Plan administered by BEN-E-LECT Employer Driven Benefits. Refer to the BEN-E-LECT Assumptions and Disclosures included with this proposal for further details on the terms, conditions, and administrative fees associated with the details outlined within this proposal. BEN-E-LECT Copyright BEN-E-LECT. All rights reserved. Date Printed: 8/16/2013 Proposal: Benelect Inc. License: Effective Date:
3 Schedule of Benefits For KEY BENEFITS PLAN MAXIMUMS PPO OUT-OF-NETWORK Calendar year deductible (For family coverage, the $500 Single (Employee only $1,000 Single (Employee only enrolled employee and dependents must collectively pay coverage) / $1,000 Family coverage) / $2,000 Family the family amount before benefits are payable.) (Employee and dependent (Employee and dependent coverage) coverage) Out-of-pocket maximum (Deductible not included) $3,000 Single / $6,000 Family $6,000 Single / $12,000 Family Annual medical benefit maximum $2,000,000 PROFESSIONAL SERVICES Office visit co-pay Preventive care services for children (through age 16) 0% 0% Preventive care services for adults (age 17 and older) 0% 0% Annual routine physical examination (age 17 and older) 0% 0% Specialist consultation co-pay X-ray LABORATORY PROCEDURES: Lab work related to surgery or pre-surgical procedures Lab work related to regular office visit Physical therapy and speech therapy (Up to 30 combined visits per calendar year) Self-injectable drugs HOSPITAL SERVICES Inpatient hospital facility services (includes maternity) Outpatient facility services (other than surgery) Outpatient surgery (hospital or outpatient surgery center charges only) Skilled nursing facility (up to 100 days per calendar year) EMERGENCY SERVICES Professional services Emergency room facility (co-pay waived if admitted) Urgent care Ambulance services (ground and air) OTHER SERVICES Durable medical equipment / prosthetics / orthothics ($2,000 combined maximum per calendar year) Diabetic equipment Spinal Manipulation and Acupuncture ($500 combined maximum per calendar year) PRESCRIPTION DRUG COVERAGE Prescription drugs - Retail (up to a 30-day supply) Prescription drugs - Mail Order (up to a 90-day supply) $75 co-pay + $75 co-pay + $15 Generic Brand $50 Non-Formulary Generic $60 Brand $100 Non-Formulary Medical This Proposal is for illustrative purposes only. Plan administered by BEN-E-LECT Employer Driven Benefits. The above benefits are for general information and discussion purposes only and not valid unless approved by the carrier. BEN-E-LECT Copyright BEN-E-LECT. All rights reserved. Date Printed: 8/16/2013 Proposal: Benelect Inc. License: Effective Date:
4 Employer Name: Claims Administrator: BEN-E-LECT Proposed Effective Date: Plan Summary: Coverage Type: Specific Stop Loss: Medical Aggregate Stop Loss: Medical & Rx Plan Design Details Contract Type: 12/18 PCP Copay Specific Deductible $10,000 Specialist Copay Aggregate Corridor 125% Deductible (In/Out of Network) $500 / $1000 Medical Group Size: 52 Coinsurance (In/Out of Network) 80% / Plan Description: Option 1 Coinsurance Max (In/Out of Network) 00 / $6000 Network: Cigna Rx Copays $15//$50 Coverage Type: Employee EE/Spouse EE/Child Family Total Total Employee Count: Monthly Annual Fixed Cost: Specific Stop Loss $ $ $ $ $11, $135, Aggregate Stop Loss $17.46 $38.40 $31.42 $52.37 $1, $13, PPO, Cobra, Web Portal & Med Mgmt $21.00 $21.00 $21.00 $21.00 $1, $13, TPA Fees $18.98 $39.42 $32.60 $53.04 $1, $14, Admin Fee - Medical - BenELect $10.00 $10.00 $10.00 $10.00 $ $6, Admin Fee - Medical - Broker $6.00 $6.00 $6.00 $6.00 $ $3, Billing Fee & One-Time Setup $25.00 $ Total Fixed Cost $ $ $ $ $15, $187, Estimated Expected Claims* $ $ $ $6, $77, Estimated Expected Cost* $ $ $ $ $21, $264, Estimated Aggregate Corridor* $25.41 $55.90 $45.74 $76.23 $1, $19, Estimated Maximum Cost* $ $ $ $1, $23, $283, Fixed Cost + Estimated Aggregate Deductible) *based on current census Model Version 3.5 Quote ID 0 Date Quote Issued 6/12/2013 Underwriting Adjustments: Specific Premium Aggregate Deductible Aggregate Premium This quote was prepared based on rates for Oxnard-Thousand Oaks-Ventura, CA. Rates will vary if enrollment information differs from census information submitted, and are subject to final approval. Do not cancel coverage until written approval is received. Administered by: BEN-E-LECT Stop Loss Insurance Underwritten by: Fidelity Security Life Insurance Company Signed acceptance of offered rates, subject to any and all underwriting contingencies: This proposal must be signed by the Employer and submitted with the Employer Application. The final rates will be based on the rate in effect at the time of the final quote, the benefits elected, and the final employee census of those applying for coverage. No warranties are made regarding rates, underwriting requirements, transfer of benefits or industry acceptability. Employer Representative Signature and Title Date
5 Employer Name: Claims Administrator: BEN-E-LECT Proposed Effective Date: Plan Summary: Coverage Type: Specific Stop Loss: Medical Aggregate Stop Loss: Medical & Rx Plan Design Details Contract Type: 12/18 PCP Copay Specific Deductible $20,000 Specialist Copay Aggregate Corridor 125% Deductible (In/Out of Network) $500 / $1000 Medical Group Size: 52 Coinsurance (In/Out of Network) 80% / Plan Description: Option 1 Coinsurance Max (In/Out of Network) 00 / $6000 Network: Cigna Rx Copays $15//$50 Coverage Type: Employee EE/Spouse EE/Child Family Total Total Employee Count: Monthly Annual Fixed Cost: Specific Stop Loss $ $ $ $8, $104, Aggregate Stop Loss $17.94 $39.46 $32.29 $53.82 $1, $13, PPO, Cobra, Web Portal & Med Mgmt $21.00 $21.00 $21.00 $21.00 $1, $13, TPA Fees $18.66 $38.72 $32.03 $52.09 $1, $13, Admin Fee - Medical - BenELect $10.00 $10.00 $10.00 $10.00 $ $6, Admin Fee - Medical - Broker $6.00 $6.00 $6.00 $6.00 $ $3, Billing Fee & One-Time Setup $25.00 $ Total Fixed Cost $ $ $ $ $12, $156, Estimated Expected Claims* $ $ $ $ $8, $97, Estimated Expected Cost* $ $ $ $ $21, $254, Estimated Aggregate Corridor* $32.28 $71.01 $58.10 $96.83 $2, $24, Estimated Maximum Cost* $ $ $ $1, $23, $278, Fixed Cost + Estimated Aggregate Deductible) *based on current census Model Version 3.5 Quote ID 0 Date Quote Issued 6/12/2013 Underwriting Adjustments: Specific Premium Aggregate Deductible Aggregate Premium This quote was prepared based on rates for Oxnard-Thousand Oaks-Ventura, CA. Rates will vary if enrollment information differs from census information submitted, and are subject to final approval. Do not cancel coverage until written approval is received. Administered by: BEN-E-LECT Stop Loss Insurance Underwritten by: Fidelity Security Life Insurance Company Signed acceptance of offered rates, subject to any and all underwriting contingencies: This proposal must be signed by the Employer and submitted with the Employer Application. The final rates will be based on the rate in effect at the time of the final quote, the benefits elected, and the final employee census of those applying for coverage. No warranties are made regarding rates, underwriting requirements, transfer of benefits or industry acceptability. Employer Representative Signature and Title Date
6 Employer Name: Claims Administrator: BEN-E-LECT Proposed Effective Date: Plan Summary: Coverage Type: Specific Stop Loss: Medical Aggregate Stop Loss: Medical & Rx Plan Design Details Contract Type: 12/18 PCP Copay Specific Deductible,000 Specialist Copay Aggregate Corridor 125% Deductible (In/Out of Network) $500 / $1000 Medical Group Size: 52 Coinsurance (In/Out of Network) 80% / Plan Description: Option 1 Coinsurance Max (In/Out of Network) 00 / $6000 Network: Cigna Rx Copays $15//$50 Coverage Type: Employee EE/Spouse EE/Child Family Total Total Employee Count: Monthly Annual Fixed Cost: Specific Stop Loss $ $ $ $ $7, $85, Aggregate Stop Loss $17.81 $39.18 $32.05 $53.42 $1, $13, PPO, Cobra, Web Portal & Med Mgmt $21.00 $21.00 $21.00 $21.00 $1, $13, TPA Fees $18.33 $37.98 $31.43 $51.09 $1, $13, Admin Fee - Medical - BenELect $10.00 $10.00 $10.00 $10.00 $ $6, Admin Fee - Medical - Broker $6.00 $6.00 $6.00 $6.00 $ $3, Billing Fee & One-Time Setup $25.00 $ Total Fixed Cost $ $ $ $11, $136, Estimated Expected Claims* $ $ $ $ $9, $109, Estimated Expected Cost* $ $ $ $ $20, $246, Estimated Aggregate Corridor* $36.17 $79.58 $65.11 $ $2, $27, Estimated Maximum Cost* $ $ $ $1, $22, $273, Fixed Cost + Estimated Aggregate Deductible) *based on current census Model Version 3.5 Quote ID 0 Date Quote Issued 6/12/2013 Underwriting Adjustments: Specific Premium Aggregate Deductible Aggregate Premium This quote was prepared based on rates for Oxnard-Thousand Oaks-Ventura, CA. Rates will vary if enrollment information differs from census information submitted, and are subject to final approval. Do not cancel coverage until written approval is received. Administered by: BEN-E-LECT Stop Loss Insurance Underwritten by: Fidelity Security Life Insurance Company Signed acceptance of offered rates, subject to any and all underwriting contingencies: This proposal must be signed by the Employer and submitted with the Employer Application. The final rates will be based on the rate in effect at the time of the final quote, the benefits elected, and the final employee census of those applying for coverage. No warranties are made regarding rates, underwriting requirements, transfer of benefits or industry acceptability. Employer Representative Signature and Title Date
7 Stop Loss Proposal for: Fidelity Security Life Insurance Company Employer Name: Proposed Effective Date: Stop Loss Conditions and Underwriting Terms & Qualifications: The specific and aggregate stop loss coverage is offered with the same incurred and paid contract type. Prescription Drug is covered according to the plan provisions and tracks towards the Aggregate attachment point, but not the Specific Deductible. Aggregate stop loss coverage cannot be purchased without specific stop loss coverage. Minimum Monthly aggregate attachment point is the maximum claim factors times the census in the first month of the plan year times This Specific and Aggregate stop loss quotation is based upon standard policy provisions, limitations and exclusions and is subject to change upon receipt of final employee enrollment census and health history review, plan design changes, current and renewal rates, industry classification, medical claims experience and receipt and review of the following information: Application for Excess Loss Insurance Employer Disclosure Notice if applicable Employee Enrollment Forms and Authorizations Copy of Current Carrier Billing Most recent filing of Employer Wage and Tax Report including employee listing First Month's Premium and Total Claims Funding This quotation was prepared based on rates for Oxnard-Thousand Oaks-Ventura, CA. A group will not be issued coverage with outstanding requirements and is subject to meeting all plan participation and eligibility requirements. Proposal is valid up to and including the proposed effective date. Enrollment information must be signed and dated prior to the requested effective date and all qualified information is subject to receipt within 31 days from proposed effective date or the effective date may be changed and/or coverage denied. Additional requirements may be requested by the underwriter to facilitate the processing of a new group applying for stop loss coverage. Important note: Agents nor Administrators have the authority to bind or modify the terms of this quotation or the policy to be issued. Any broker(s) involved in any communication with Strategic Underwriting Solutions, LLC or the Stop Loss Insurer is/are at all times acting solely as the agent(s) of the Employer and not the agent(s) of Strategic Underwriting Solutions, LLC or the Stop Loss Insurer. Employer should not cancel current coverage until written notification of approval is received. Page 2 of 2
Health Plans Comparison Chart
Health Plans Comparison Chart PPO Deductible Coinsurance (Plan pays) Annual Out-of-Pocket Maximum (Medical) (all medical s, deductibles and coinsurance for covered services will apply. Once limit is met,
Coventry Health and Life Insurance Company PPO Schedule of Benefits
State(s) of Issue: Oklahoma PPO Plan: OI08C30050 30 Coventry Health and Life Insurance Company PPO Schedule of Benefits Covered Services Contract Year Deductible For All Eligible Expenses (unless otherwise
LEGACY PLAN Medical In-Ntwk Out-of-Ntwk
Preventive Services Age, gender and frequency criteria Adult physical/immunizations Well child visits/immunizations Screenings 0 Co-Insurance (after deductible) Out-of-Pocket Maximums Office Visit (copays)
Service AvMed Cigna Leon Cares Humana HMO Humana PPO UnitedHealthcare. Out-of- Network
2016 Medicare Advantage Plans Comparison Chart This comparison chart is a side-by-side representation of services offered through the AvMed, Cigna, UHC, and Humana Medicare Advantage Plans for both in-network
Medical Plan Comparison - Retirees Age 65 or Over
* Plan Type Medicare Cost Plan with Prescription Coordinates with Medicare and includes Medicare prescription drug program Medicare Cost Plan with Prescription Medicare Advantage Plan with Prescription
Operating Engineers Public Employees Health and Welfare Trust Fund Plan D vs PERS CHOICE and PERS SELECT PPO Plan
Calendar Year Deductible $500 Individual / $1,000 Family per calendar year Does not apply to PPO physician office visits, PPO preventive care or hospital emergency room charges for an emergency medical
Your Plan: Anthem Bronze PPO 5500/30%/6450 w/hsa Your Network: Prudent Buyer PPO
Your Plan: Anthem Bronze PPO 5500/30%/6450 w/hsa Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
Additional Information Provided by Aetna Life Insurance Company
Additional Information Provided by Aetna Life Insurance Company Inquiry Procedure The plan of benefits described in the Booklet-Certificate is underwritten by: Aetna Life Insurance Company (Aetna) 151
CHOOSE A PLAN DEDUCTIBLE PLANS DEDUCTIBLE PLANS. What deductible plans offer and how they work IN THIS BROCHURE. n How our deductible plans work
DEDUCTIBLE PLANS CHOOSE A PLAN DEDUCTIBLE PLANS What deductible plans offer and how they work IN THIS BROCHURE n How our deductible plans work n Understanding deductibles and out-of-pocket maximums n Benefit
Fee-for-Service. Medicare Supplemental Retiree Health Plans
Sheet Metal Workers Health Plan of Southern California, Arizona & Nevada April 2011 Summary Comparison Of Benefits Available under the Fee-for-Service and Medicare Supplemental Retiree Health Plans Important:
Northeastern University 2015 Medical Benefits
Northeastern University 2015 Medical Benefits Northeastern s 2015 Open Enrollment Effective Date: January 1, 2015 2015 Medical Plan Options Blue Choice New England Core POS Plan New Plan Blue Choice New
S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/15-6/30/16
S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/15-6/30/16 This information sheet is for reference only. Please refer to Evidence of Coverage requirements, limitations
MAYFLOWER MUNICIPAL HEALTH GROUP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PPO REVIEW OF BENEFITS
Fiscal Year 2015 2016 MAYFLOWER MUNICIPAL HEALTH GROUP ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ PPO REVIEW OF S ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Your Plan: Anthem Silver HMO 1500/30%/6550 Your Network: California Care HMO
Your Plan: Anthem Silver HMO 1500/30%/6550 Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does
Cigna Open Access Plans for Tennessee
Individual & Family Plans Insured by Connecticut General Life Insurance Company Cigna Open Access Plans for Tennessee medical & PHARMACY INSURANCE with the ONE-AND-ONLY YOU IN MIND. 858436 a 12/12 Services
Pace University CIGNA Medical Detailed Benefit Summaries July 1, 2015 - June 30, 2016
Consumer Core HDHP In Net $50 (ONLY APPLICABLE TO THOSE Network Core $25 ALREADY ENROLLED) Network Choice Fund In Network In Network In Network Deductible $1,300/$2,600 (Cumulative) N/A N/A Coinsurance
Cost Sharing Definitions
SU Pro ( and ) Annual Deductible 1 Coinsurance Cost Sharing Definitions $200 per individual with a maximum of $400 for a family 5% of allowable amount for inpatient hospitalization - or - 50% of allowable
Small Business Solutions Medical Plan Options
Small Business Solutions Medical Plan Options Indiana Choice. Simplicity. Affordability. 14.02.927.1-IN (10/04) AETNA SMALL GROUP MEDICAL PLANS AETNA CHOICE PPO PLAN OPTIONS Plan Option 1 Plan Option 2
RETIREE OPEN ENROLLMENT 2014
RETIREE OPEN ENROLLMENT 2014 The month of August 2014 is open enrollment for eligible retirees to switch from one retiree health plan to another. Open enrollment is also the time when you are allowed to
S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15
S c h o o l s I n s u r a n c e G r o u p Health Net Plan Comparison Fiscal Year 7/1/14-6/30/15 This information sheet is for reference only. Please refer to Evidence of Coverage requirements, limitations
2015 plan comparison guide
2015 plan comparison guide Groups of 1 50 Plans available Jan. 1, 2015, through Dec. 31, 2015 Washington Better health starts here Hello. Welcome to Moda Health, the place you go when you want more than
OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVE and RETIRED PARTICIPANTS
Employee Premium None None None None None Explanation of Plans and Options Available to You Deductible Annual Out-of-Pocket Calendar Year (Applicable to members who reside in California & Nevada Only.)
Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison
Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison Information Needed: Eligibility, Benefits, COBRA or Disability Claims: Indemnity Medical Plan Indemnity Hearing Aid Benefit
2015 Health Benefits
2015 Health Benefits Product Cost Sharing - Member's Responsibility Health Care Reform Compliant Health Care Reform Compliant Health Care Reform Compliant Deductible (DED) (Per Person/Family Aggregate)
OverVIEW of Your Eligibility Class by determineing Benefits
OVERVIEW OF YOUR BENEFITS IMPORTANT PHONE NUMBERS Benefit Fund s Member Services Department (646) 473-9200 For answers to questions about your eligibility or prescription drug benefit. You can also visit
BRYN MAWR COLLEGE MEDICAL INSURANCE BENEFITS COMPARISON EFFECTIVE NOVEMBER 1, 2009
BENEFITS Description of Plan Annual Deductible (January - December) - Individual - Family PERSONAL CHOICE PPO BRYN MAWR COLLEGE KEYSTONE HEALTH PLAN EAST KEYSTONE POS Provides comprehensive health Provides
State Retiree Medicare Advantage Plans
State Retiree Medicare Advantage Plans October/November 2015 Copyright 2013 by The Segal Group, Inc. All rights reserved. Your 2016 Retiree Benefits www.cms.illinois.gov/thetrail 2 Eligibility Who is Required
2015 IBM Health Benefit Comparison Charts for IBM Active Employees
2015 IBM Health Benefit Comparison Charts for IBM Active Employees These Health Benefit Comparison Charts provide a summary overview of the coverage available for medical, mental health/substance care
2016 HealthFlex Plan Comparison: PPO B1000 with HRA and HDHP H1500 with HSA
Caring For Those Who Serve 1901 Chestnut Avenue Glenview, Illinois 60025-1604 1-800-851-2201 www.gbophb.org 2016 HealthFlex Plan Comparison: PPO B1000 with HRA and HDHP H1500 with HSA Please note: This
Graduate Student Insurance Comparison Summary Student Insurance Plan vs. Employer Group Insurance Program
Graduate Student Insurance Comparison Summary Student Insurance Plan vs. Employer Group Insurance Program Revised 08/20/2015 Graduate Student employees may choose between the Student Insurance Plan administered
Napa County. Medicare Advantage Plans. (Medicare Part C Plans) Compliments of HICAP. (Health Insurance Counseling and Advocacy Program)
2015 Napa County Medicare Advantage Plans (Medicare Part C Plans) HICAP Volunteer Counselors are available to help compare health plans in an objective and unbiased manner. They can help consumers understand
PPO Schedule of Payments (Maryland Large Group) Qualified High Deductible Health Plan National QA2000-20
PPO Schedule of Payments (Maryland Large Group) Qualified High Health Plan National QA2000-20 Benefit Year Individual Family (Amounts for Participating and s services are separated in calculating when
Banner Health - Choice Plus Coverage Period: 1/1/2015-12/31/2015
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document at www.bannerbenefits.com by clicking on the Resources tab and then Plan
UNIVERSITY OF VIRGINIA HEALTH PLAN 2015 SCHEDULE OF BENEFITS CHOICE HEALTH
UNIVERSITY OF VIRGINIA HEALTH PLAN 2015 SCHEDULE OF BENEFITS CHOICE HEALTH SERVICES PROVIDED Direct Access through UVa Provider Network 1. PLAN COINSURANCE Applies to all expenses unless otherwise stated.
Human Energy. Yours. TM
Human Energy. Yours. TM Chevron Global Choice Plan (U.S.-Payroll Expatriates) (008) Summary of Benefits and Coverage What This Plan Covers and What it Costs Coverage Period January 1, 2015 December 31,
STANDARD AND SELECT NETWORK PRODUCTS FROM TUFTS HEALTH PLAN
STANDARD AND SELECT NETWORK PRODUCTS FROM TUFTS HEALTH PLAN 2015 PLAN OPTIONS Standard Network: The Standard Network plans provide members with a choice of more than 25,000 participating doctors and 90
Summary of Benefits and Coverage What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document at www.mpiphp.org or by calling 1-855-275-4674. Important Questions Answers
Reliability and predictable costs for individuals and families
INDIVIDUAL & FAMILY PLANS HEALTH NET HMO PLANS Reliability and predictable costs for individuals and families If you re looking for a health plan that s simple to use and easy to understand, you ve found
What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/cuhealthplan or by calling 1-800-735-6072.
THE MITRE CORPORATION PPO High Deductible Plan with a Health Saving Account (HSA)
THE MITRE CORPORATION PPO High Deductible Plan with a Health Saving Account (HSA) Effective Date: 01-01-2016 PLAN FEATURES Annual Deductible $1,500 Employee $3,000 Employee $3,000 Employee + 1 Dependent
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.etf.wi.gov or by calling 1-877-533-5020. Important Questions
Entertainment Industry Health Plan Comparison DGA-Producer Health MPI Health Plan SAG-Producers Health Plan Participant only - $0
Earned Coverage Premiums AFTRA Health Individual Participant Only - $381 per quarter Participant +1 Dependent only - $2,446 per quarter ($381 + buyup premium $2,065) Participant +2 or more Dependents -
OPERATING ENGINEERS HEALTH & WELFARE FUND BENEFIT PLANS SUMMARY COMPARISON FOR ACTIVES and EARLY RETIREES
PPO Kaiser Permanente For Non-PPO Providers Employee Premium None None None None None Explanation of s and Options Available to You If you choose a doctor who is not contracted with Anthem Blue Cross the
Kraft Foods Group, Inc. Retiree Medical and Prescription Plan Summary High Deductible Health Plan
General Provisions Deductible (eligible medical and prescription drug expenses apply to the deductible) Kraft Foods Group, Inc. Retiree Medical and Prescription Plan Summary Care can be obtained in-network
National PPO 1000. PPO Schedule of Payments (Maryland Small Group)
PPO Schedule of Payments (Maryland Small Group) National PPO 1000 The benefits outlined in this Schedule are in addition to the benefits offered under Coventry Health & Life Insurance Company Small Employer
Employee + 2 Dependents
FUND FEATURES HealthFund Amount $500 Individual $1,000 Employee + 1 Dependent $1,000 Employee + 2 Dependents $1,000 Family Amount contributed to the Fund by the employer Fund Coinsurance Percentage at
Summary of Benefits and Coverage What this Plan Covers & What it Costs - 2015
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the plan document at www.mpiphp.org or by calling 1-855-275-4674. Important Questions Answers
PLAN DESIGN AND BENEFITS POS Open Access Plan 1944
PLAN FEATURES PARTICIPATING Deductible (per calendar year) $3,000 Individual $9,000 Family $4,000 Individual $12,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being
Medical Plan - Healthfund
18 Medical Plan - Healthfund Oklahoma City Community College Effective Date: 07-01-2010 Aetna HealthFund Open Choice (PPO) - Oklahoma PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY -
Anthem BCBS PPO 80/60. Network Out-of-Network Network Out-of-Network Network Out-of-Network $1,750 per person. $2,500 per person $5,000 per family
Plan PPO 90/70 PPO 80/60 PPO 75/50 Annual Medical Deductible Network Out-of-Network Network Out-of-Network Network Out-of-Network $250 per person $500 per person $500 per person $1,000 per person $900
Medical Benefits Analysis
Medical Benefits Analysis (Active and Retired Under Age 65) Insurance Plan Health Net 5KF Kaiser Maximum Lifetime Benefit Deductible Maximum Out-of-Pocket Hospitalization Outpatient Surgery Emergency Room
Health Plan Comparison
A healthier bottom line. For Agent Use Only Starmark Healthy Incentives Health Plan Comparison Self-Funded Health Plans Specifically for Businesses With Five or More Employees PPO Indemnity CDHP PPO CDHP
HDHP/HSA. $3,000 per person $6,000 per family (deductible includes medical & prescriptions) $7,000 per person $13,000 per family
Plan Aetna Select EPO BCBS PPO 90/70 BCBS HDHP/HSA High Option EPO EPO 80 Choice Choice Plus 80/60 Annual Medical Deductible Annual Out-of-Pocket Maximum (includes deductible) Network Only Network Out-of-Network
Important Questions Answers Why this Matters:
Anthem Blue Cross Life and Health Insurance Company Unify: PPO Coverage Period: 01/01/2015 12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family
2015 Why Are There Changes With Healthcare? Copyright 2014 Five Points ICT, Inc. All rights reserved.
2015 Why Are There Changes With Healthcare? Health Care Reform Beginning Jan 1, 2015 HCR Requires: Large employers must offer a health plan: To employees averaging 30+ hrs per week That is considered HCR
CENTRAL MICHIGAN UNIVERSITY - Premier Plan (PPO1) 007000285-0002 0004 Effective Date: July 1, 2015 Benefits-at-a-Glance
CENTRAL MICHIGAN UNIVERSITY - Premier Plan (PPO1) 007000285-0002 0004 Effective Date: July 1, 2015 Benefits-at-a-Glance This is intended as an easy-to-read summary and provides only a general overview
PLAN DESIGN AND BENEFITS AETNA LIFE INSURANCE COMPANY - Insured
PLAN FEATURES Deductible (per calendar year) Individual $750 Individual $1,500 Family $2,250 Family $4,500 All covered expenses accumulate simultaneously toward both the preferred and non-preferred Deductible.
Utah Renewal Instructions
Utah Renewal Instructions For 2 50 Eligible Employees Effective August 1, 2009 Easy steps to renew your coverage 14.02.138.1-UT A (5/09) Aetna is the brand name used for products and services provided
Health Alliance Plan. Coverage Period: 01/01/2014-12/31/2014. document at www.hap.org or by calling 1-800-759-3436.
Health Alliance Plan Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2014-12/31/2014 Coverage for: Individual Family Plan Type: HMO This is only a summary.
2013 IBM Health Benefit Comparison Charts
203 IBM Health Benefit Comparison Charts for IBM Active Employees These Health Benefit Comparison Charts provide a summary overview of the coverage available for medical services, mental health/substance
Bates College Effective date: 01-01-2010 HMO - Maine PLAN DESIGN AND BENEFITS PROVIDED BY AETNA HEALTH INC. - FULL RISK PLAN FEATURES
PLAN FEATURES Deductible (per calendar year) $500 Individual $1,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. Once Family Deductible is met, all family
Important Questions Answers Why this Matters:
Anthem BlueCross Premier HMO 20 / $10/$25/$45/20% Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2014-12/31/2014 Coverage For: Individual/Family Plan Type:
HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES. Insuring Minnesota One Life At A Time. www.preferredone.com
foreveryone HEALTH INSURANCE FOR INDIVIDUALS AND FAMILIES Insuring Minnesota One Life At A Time www.preferredone.com for EveryOne Insuring Minnesota One Life At A Time Thank you for your interest in the
Sherwin-Williams Medical, Prescription Drug and Dental Plans Plan Comparison Charts
Sherwin-Williams Medical, Prescription Drug and Dental Plans Plan Comparison Charts You and Sherwin-Williams share the cost of certain benefits including medical and dental coverage and you have the opportunity
What is the overall deductible? $250 per person/$500 per family. Are there other deductibles for specific services? No.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.etf.wi.gov or by calling 1-877-533-5020. Important Questions
STATE OF IOWA HEALTH INSURANCE PLAN COMPARISON EFFECTIVE JANUARY 1, 2016
This comparison is only a summary of benefits. Benefits will be administered as described in each plan s Summary of Benefits & Coverage. For further details, refer to those documents or call Wellmark Blue
2015-2016. New England Conservatory. Student Health PPO Plan. Policy Number: SP100104. Underwritten by Tufts Insurance Company.
New England Conservatory Student Health PPO Plan Underwritten by Tufts Insurance Company. Policy Number: SP100104 2015-2016 Form Number: 100104-1-1R3 New England Conservatory Health and Counseling Services
Summaries of Benefits and Coverage
Summaries of Benefits and Coverage Tufts Health Direct ConnectorCare Plan Type I Tufts Health Direct ConnectorCare Plan Type II Tufts Health Direct ConnectorCare Plan Type III Tufts Health Direct Silver
Highlights of your Health Care Coverage
MEDICAL COST SHARE OPTIONS Individual Deductible PCY (Family deductible 2X Individual) Coinsurance (Member's percentage of costs after deductible based on allowable charges) Individual Out of Pocket Maximum
Medical Insurance Part 2 - Deductible and Prevention Plans
KAISER PERMANENTE FOR INDIVIDUALS AND FAMILIES Deductible Plans How Deductible plans work Deductible plans generally offer lower monthly premiums in exchange for higher out-of-pocket payments for covered
PDS Tech, Inc Proposed Effective Date: 01-01-2012 Aetna HealthFund Aetna Choice POS ll - ASC
FUND FEATURES HealthFund Amount $500 Individual $1,000 Employee + 1 Dependent $1,000 Employee + 2 Dependents $1,000 Family Amount contributed to the Fund by the employer Fund Coinsurance 100% Percentage
LGC HealthTrust: MT Blue 5-RX10/20/45 Coverage Period: 07/01/2013 06/30/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-800-870-3057. Important Questions
2015 Medicare Supplement
THE MANHATTAN LIFE 2015 Supplement This brochure is for solicitation of insurance and contact will be made by an insurance agent or insurance company. Underwritten by The Manhattan Life Insurance Company.
Administered by Capital BlueCross 1
Administered by Capital BlueCross 1 PPO HRA Plan/Rx Plan This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at
Group Hospital Confinement Indemnity Gap Insurance
Group Hospital Confinement Indemnity Insurance Maltby Electric Supply Co., Inc. announces Insurance protection Proposed effective date: 03/01/2013 Help for the in-between time Managing routine health care
Important Questions Answers Why this Matters:
Anthem BlueCross BlueShield Blue Access PPO Option D58 / Rx Option 8 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 12/01/2013-11/30/2014 Coverage For: Individual/Family
How To Pay For Health Care With Bluecrossma
PPO Student/Affiliate Plan MIT Student/Affiliate Extended Insurance Plan Coverage Period: 2014-2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual, Couple,
2016 Plan Comparison For HealthFlex Exchange Participants
2016 Plan Comparison For HealthFlex Exchange Participants This comparison highlights key differences and similarities between plans offered through HealthFlex Exchange in 2016. All plans use the same network
Business Life Insurance - Health & Medical Billing Requirements
PLAN FEATURES Deductible (per plan year) $2,000 Employee $2,000 Employee $3,000 Employee + Spouse $3,000 Employee + Spouse $3,000 Employee + Child(ren) $3,000 Employee + Child(ren) $4,000 Family $4,000
Terms Defined. Participating/Non-Participating Provider. Benefits Coverage Charts. Prescription Drug Purchases. Pre-Authorization
Medical Coverage Terms Defined Participating/Non-Participating Provider Benefits Coverage Charts Prescription Drug Purchases Section Two MEDICAL COVERAGE Pre-Authorization Coordination of Benefits Questions
EPO Insurance Plans. Individual & Family. Available through Covered California For coverage, go to www.coveredca.com to apply today!
Individual & Family Plans Covered California Individual & Family EPO Insurance Plans Available through Covered California For coverage, go to www.coveredca.com to apply today! Outline of Coverage and Exclusions
Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015
Blue Care Elect Preferred 90 Copay Coverage Period: on or after 09/01/2015 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual Only Plan Type: PPO This is only
Member s responsibility (deductibles, copays, coinsurance and dollar maximums)
MICHIGAN CATHOLIC CONFERENCE January 2015 Benefit Summary This is intended as an easy-to-read summary and provides only a general overview of your benefits. It is not a contract. Additional limitations
Oregon Nurses Association/Coquille Valley Hospital Comparison of Former and New Health Insurance Plan
2013-2014 Monthly Premium Employee Only Monthly Cost $628.11 Monthly Cost $396.95 Employee and Spouse Monthly Cost $1,444.67 Monthly Cost $873.30 Employee and Children Monthly Cost $1,155.73 Monthly Cost
California Small Group MC Aetna Life Insurance Company
PLAN FEATURES Deductible (per calendar year) $3,000 Individual $6,000 Family Unless otherwise indicated, the Deductible must be met prior to benefits being payable. All covered expenses accumulate separately
Health Insurance Overview
Spotsylvania County Open Enrollment August 10 to 28, 2015 Plan Year: October 1, 2015 to September 30, 2016 Health Insurance Overview All Full Time employees are eligible to participate in the County Health
Connecticut General Life Insurance Co.: Open Access 1000/80% Plan Coverage Period: Beginning on or after 9/23/2012
Connecticut General Life Insurance Co.: Open Access 1000/80% Plan Coverage Period: Beginning on or after 9/23/2012 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for:
Benefit Coverage Chart & Rates
Benefit Coverage Chart & Rates Effective July 1, 2014- June 30, 2015 PPO Medical Coverage by Category The following coverages are included with the PPO plan: o Prescription o Vision Additional Benefits
Understanding your. Medicare options. Medicare Made Clear TM. Get Answers Series. Y0066_120629_084915 CMS Accepted
Understanding your Medicare options. Medicare Made Clear TM Get Answers Series Y0066_120629_084915 CMS Accepted learning about Medicare Choices. Eligibility Coverage options When to enroll Next steps and
Monumental Life Insurance Company: Northpoint Bible College Student Injury and Sickness Plan Coverage Period: 08/20/2013 08/20/2014
Summary of Benefits and Coverage: What this Covers & What it Costs Coverage for: Individual Type: PPO This is only a summary. If you want more detail about your coverage and costs, you can get the complete
Monumental Life Insurance Company: Bennington College Student Injury and Sickness Plan Coverage Period: 08/15/2013 08/15/2014
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bollingercolleges.com/bennington or by calling 1-866-267-0092.
www.bcbsla.com independent licensees of the Blue Cross and Blue Shield Association.
Point of Service Plans for Individuals A subsidiary A subsidiary of Blue of Blue Cross Cross and and Blue Blue Shield Shield of of Louisiana, www.bcbsla.com 01100 00752 0207R FROM A COMPANY YOU ALREADY
ROCHESTER INSTITUTE OF TECHNOLOGY 2014 Medical Benefits Comparison Chart Medicare-Eligible Retirees in the Rochester Area
Contacting the Carrier Voice: (877) 883-9577 TTY: (585) 454-2845 Website: Voice: (800) 665-7924 TTY: (800) 252-2452 Website: www.excellusbcbs.com www.mvphealthcare.com Deductible Carry Over None None Deductible,
Schedule of Benefits Summary. Health Plan. Out-of-network Provider
Schedule of Benefits Summary University Name: University of Nebraska - Student Plan Health Plan : 2014/2015 Academic Year (see attached) Payment for Services Covered Services are reimbursed based on the
UMC Health Plan Operations Coverage Period: 01/01/2013-12/31/2013
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthplanoperations@umchealthsystem.com or by calling
Short Term Medical Plans Product Training. February 13, 2013
Short Term Medical Plans Product Training February 13, 2013 Short term medical Insurance What is it? Short term policies are individual and family or child Only PPOs that will be issued in 1 through 11
Your Plan: Anthem Gold HMO 500/20%/5000 Your Network: California Care HMO
Your Plan: Anthem Gold HMO 500/20%/5000 Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary does not
Monumental Life Insurance Company: Millsaps College Student Injury and Sickness Plan Coverage Period: 08/20/2013 08/20/2014
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.bollingercolleges.com/millsaps or by calling 1-866-267-0092.
Lesser of $200 or 20% (surgery) $10 per visit. $35 $100/trip $50/trip $75/trip $50/trip
HOSPITAL SERVICES Hospital Inpatient : Paid in full, Non-network: Hospital charges subject to 10% of billed charges up to coinsurance maximum. Non-participating provider charges subject to Basic Medical