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  Program II – Limited Fixed Medical Indemnity Plan
 
Minimum number of eligible participating members – 5,000
Minimum number of participating employees per corporate member - 10
   
 

This unique program allows affinity organizations to custom design up to three different medical plans offering their members access to vital health care services from hundreds of thousands of providers throughout the country. Association decision makers specify monthly plan costs (example: three levels of coverage starting at $75 Value Plan, $150 Select Plan, or $225 Premier Plan, per month for single coverage) and benefits that are of greatest importance to a majority of the members (example: emphasis on outpatient care and preventive care services).

Plans can include popular features such as physician visit reimbursements and urgent care coverage. These plans do not require payment of a deductible before benefits are payable. Similarly, benefits are payable for any physician or hospital, although patients will incur a smaller portion of the charges if using a network provider. Benefits on these plans are assignable which means that payment is not required from the patient at the time of service. Medical providers bill the insurance companies and balances due, if any, are billed to the patient after the fact.

   
Services That Can Be Covered By These Plans Include:
 

  • Doctor’s Office Visits
  • Adult Wellness Visits
  • Well Child Visits
  • Outpatient X-Ray & Laboratory Tests
  • Emergency Room Benefits
  • In-Patient/Out-Patient Surgery & Anesthesia Benefits
  • Hospital Confinement
  • Maternity Benefits
  • ICU Confinement
  • Substance Abuse Confinement
  • Mental or Nervous Condition Confinement
  • Skilled Nursing Facility Confinement
  • Access to Deep Discounts from more than 900,000 Healthcare Providers
  • Accident Medical
  • Accidental Death and Dismemberment
  • Term Life Insurance
  • Pharmaceutical Benefits/Copay Prescription Benefit
  • 24-Hour Nurse Hotline