ADVANTAGES And AVAILABLE COVERAGES ● Guarantee Issue ● No Pre-existing Condition Clauses (No evidence of insurability required) ● Benefits are Assignable ● No Waiting Periods ● No Questionnaires to be filled out ● Fully Insured Benefits ● Provider of Choice – No mandatory network usage ● No Deductibles ● Maternity Covered Same as any other illness ● No Usual, Customary and Reasonable Language – Benefits are paid as stated ● Universal Rates – No demographics used ● Assignment of Benefits for Providers and Hospitals – No claim forms ● Dedicated Account Representatives ● Bi-lingual Toll Free Customer Service EMPLOYER ADVANTAGES ● Employer defines eligibility ● Employer can contribute or decide not to contribute ELIGIBLE PARTICIPANTS ● Part-time, seasonal, and hourly employees are eligible ● 1099 Independent Contractors are eligible ● Employees or 1099s working more than 15 hours per week | |
AVAILABLE COVERAGES ● Office Visits ● Wellness/Preventive Care Benefits ● Prescription Drugs, Including $5 Generic Co-Pay ● Diagnostic Lab & X-Ray ● Surgical Benefits ● Hospital Inpatient Benefits ● Intensive Care Benefits ● Substance Abuse Benefits ● Skilled Nursing Benefits ● Mental Illness Benefits ● Life Insurance and AD&D ● Dependent Life ● Employee Disability Weekly Benefit ● Accident Benefit ● Vision Care Benefit ● Dental Care Benefit ● Pharmacy Programs ● Survivor Benefit (available with all plans at no additional charge) | ADDITIONAL “NO-COST” INCLUDED OPTIMED BENEFITS ● National Medical PPO Discount Network ● National Dental Network ● National Vision Network ● 24 Hour Nurseline ● Employee Assistance Plan ADDITIONAL GUARANTEE ISSUE ADD-ON BENEFITS ● Critical Illness ● Short Term Disability ● Dental |