Benefit proposal prepared for: Sample Proposal (3/17) PLANSTIN INC 5200 Meadows Rd Suite 150, Lake Oswego OR

Transcription

1 Benefit proposal prepared for: Sample Proposal (3/17) 2017 PLANSTIN INC 5200 Meadows Rd Suite 150, Lake Oswego OR

2 BENEFIT SOLUTIONS Thank you for your consideration in the Planstin Benefit Administration, Risk Management and Human Resources Tools. For your benefit solutions please consider the following plans: Preventive Advanced Health Plan Option Preventive Advanced Preventive Services (ACA) 100% Primary Care Physician Office Visit $20 Copay (max 3 per year) Specialist Physician Office Visit $50 Copay (max 3 per year) Urgent Care $50 Copay (max 3 per year) Diagnostic X-ray and Lab $50 Copay (in office, max 5 services) Cat-Scan or MRI $200 Copay (1 per year) Outpatient Testing $200 Copay (1 per year) Network MultiPlan Telemedicine TelaDoc (no consultation fee) Prescription Benefits Tier 1 Low Cost $1 Copay Tier 2 Generics 10% Co-Insurance Tier 3 Preferred Brand 20% Co-Insurance Tier 4 Non-Preferred 1 40% Co-Insurance Tier 5 Specialty 10% Co-Insurance (Plan pays 90% up to max of $150) Tier 6 Non-Preferred 2 20% Co-Insurance (Plan pays 80% up to max of $250) Employee $150 Employee + Spouse $240 Employee + Children $240 Employee + Family $325 1

3 Medical Plan MVP Bronze MVP Silver MVP Gold Group Size (most states) Network Aetna, Cigna or PHCS Aetna, Cigna or PHCS Aetna, Cigna or PHCS Network Benefits In Out In Out In Out Deductible Individual / Family $5,000 / $10,000 / $25,400 $2,000 / $4,000 $4,000 / $8,000 $1,000 / $3,000 $4,000 / $8,000 Out-of-Pocket Maximum Individual / Family $6,350 / / $25,400 $3,500 / $10,500 Coinsurance 70% after 80% after 90% after Hospitalization In-Patient 70% after 80% after 90% after Hospitalization Out-Patient 70% after 80% after 90% after Emergency Room Services 70% after 70% after 80% after 80% after 90% after 80% after Primary Care Visit $40 copay $40 copay $20 copay Specialist Visits $80 copay $60 copay $30 copay Imaging 70% after 80% after 90% after Laboratory Outpatient and Professional Services 70% after 80% after 90% after X-ray and Diagnostic 70% after 80% after 90% after Generic Prescription Drugs Covered at Covered at Covered at 100% 100% 100% Preferred Brand Drugs $50 $50 $35 Non-Preferred Brand $100 $100 $50 Drugs Specialty Drugs Not Covered Not Covered $150 Not Covered $150 Not Covered Example Monthly Rate Schedule* Employee Only $330 $420 $495 Employee + Spouse $564 $712 $862 Employee + Children $524 $676 $798 Employee Family $751 $987 $1,176 *Final rates are based on underwriting approval. Rates will vary by overall health of group, participation, location, network, age, and more. 2

4 Ancillary Benefits to round out the benefit package and provide employees with options that matter. Product availability and benefits vary by carrier, state and selected plan. See a Planstin benefits consultant for details. a. Dental Insurance Please quote b. Vision Insurance Please quote c. Life Insurance Please quote d. Critical Illness Insurance Please quote e. Disability Insurance Please quote f. Hospital Plans Please quote g. Accident Plans Please quote Essential Edge Package includes $10,000 group term life insurance, $10,000 critical illness insurance and group accident insurance. Plan requires 5 or more employees enrolled. Employee monthly rate for 100% participation in this plan is $25. See for details or contact Planstin. Additional options and services TelaDoc Membership. No fee consultation with physician anytime. Already included in MEC plans. $10.00 per employee monthly rate for membership and dependents are automatically included without additional charge. SelfHealthWorks Membership. Cognitive-based lifestyle and disease management programs to improve your employee health. Rate for membership is $3.00 per member. Payroll Processing. Integration and coordination of benefit deductions made easy through our payroll service. See a Planstin benefits consultant for details. Value added services at no additional cost: HR Hotline Unlimited access to professional human resource answer service. HRIS Human Resource Information System (groups of 5+). Manage employee data, ACA lookback and more. HR Tools Unlimited access to HR forms, publications, learning resources and more. ACA Reporting Easy to use service to manage your ACA forms including the 6055 and

5 Group setup group setup fee of $250 to help cover the costs of implementation and plan documents. This fee is not refundable and collected prior to implementation of plans or other services provided. ACCEPTANCE Please signify your understanding and acceptance of the proposal outlined. Employer Representative Signature Title Date 4