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In order to properly prepare for your upcoming open enrollment, we will need to look at your current plan, as well as your employee census, including the number of singles, families, and in some cases 2 person families as well.
Once we have this information we can also take a look at the physicians most commonly used by members of your group, your preference for prescription coverage, and whether or not you prefer lower costs, or broader benefits.
We can also look at adding benefits where it makes sense in order to enhance your overall program for employee retention and recruitment, and we can even make suggestions for stand alone programs.
If you are unfamiliar with the plans here, this may help you to see the kinds of things that are available.
We can prepare a side by side comparison, along with your existing program, and compare the total costs based on census and other factors.
Once the plans have been chosen, we work with you to present it to your employees, and we activate your private web area loaded with literature, plan details, forms, and tools for your employees to get the most out of their coverage.
Contact us today to get started. Its never too early.
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Compare Plan Features
Use the control below to compare plan features. The comparisons show here are for general comparison purposes only. Plan features are subject to change and the latest benefits summaries can be obtained by having us put together a customized benefits comparison for your group.
Start planning early for open enrollment and renewal and call today! |
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Back to Glossary |
| Glossary |
Restrictions |
Here you can see what plan restrictions, if any, apply. These include things like limiting you to in-network physicians and hospitals, pre authorization and other aspects of the plan that need to be met prior to receiving services |
Deductible |
The deductible is the portion of the cost of your treatment you must pay first before the plan pays for anything |
Co insurance |
This is usually expressed as a percentage, like 80/20 (the plan pays 80 % and you pay 20%). The co insurance is the portion of the TOTAL cost that you must pay.
Remember, this portion refers to the portion that the plan allows, which is sometimes less than the total you will be billed. That is why it is important to find out what things will cost before you incur the costs for out of network services |
Referrals Necessary |
Do you need to get a referral or can you just decide to seek treatment on your own? |
Out of Pocket Max |
Some plans set a limit to the total amount of money you have to put out, after which the plan pays 100%. This is sometimes expressed as an annual figure, and sometimes as a "lifetime" amount |
Lifetime Max |
The total amount of money you will ever have to pay towards your benefits. Once you reach this amount, the plan pays the rest. This protects you from catastrophic costs. |
Preventive Care |
Things like routine check-ups, well baby and well child visits, mammograms, etc. |
Outpatient Care |
Tests or procedures you may get in an outpatient setting like a hospital, surgeons office, etc, where you are NOT admitted. |
Home Health Care |
Treatment in your own home by a visiting specialist |
Allergy Care |
Shots and other treatments on a regular basis |
Hospitalization |
The costs associated with being admitted to a hospital |
Emergency Care |
This is for treatment considered both sudden, and serious, and in most cases must also be life threatening, or of serious threat to life or limb |
Maternity Care |
both pre-natal and post-natal care |
Mental Health Care |
treatment by a licensed psychiatrist, psychologist, or social worker, as well as inpatient treatment in a mental health facility |
Substance Abuse Coverage |
Outpatient counseling by a licensed professional as well as in-patient treatment for alcohol and substance abuse |
Skilled Nursing |
In-patient treatment in a licensed Skilled Nursing Facility |
Prescription Drug Coverage |
Your prescription drug coverage will often have multiple costs associated with in-formulary drugs, non formulary drugs, generic, and brand name. |
Extras |
Things like Weight Watchers meetings, Health Club memberships, Chiropractic Care, Acupuncture and more |
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