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