Defined
Benefit Medical Plan – Low As $50/member/month
Minimum membership requirement –
50 Eligible Members/10 Enrolled Members
This unique program allows affinity
organizations to “build” up to three different
medical plans offering their members access to vital health
care services from hundreds of thousands of providers throughout
the country. The sponsoring association or affinity group
is responsible for payment and collection of the monthly
premiums from the members. 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
copayments 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.
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
