MEDICAL & ANCILLARY PRODUCTS

Size: px

Start display at page:

Download "MEDICAL & ANCILLARY PRODUCTS"

Kelley Patterson
5 years ago
Views:

1 MEDICAL HMO/POS HEALTH PLAN PLAN NAME GROUP SIZE Aetna HMO 101+ Basic HMO 101+ HMO Deductible 101+ HRA 101+ AVN 101+ PrimeCare HMO 101+ Anthem Traditional Classic HMO 20/40/250Admit/125 OP Anthem Traditional Value HMO 30/40/750Day3x Anthem Traditional Value HMO Deductible 2000/30/45/20% Anthem Select Classic HMO 20/40/250Admit/125 OP Anthem Select Value HMO 30/40/750Day3x Anthem Select Value HMO Deductible 2000/30/45/20% Kaiser HMO Kaiser HMO Kaiser DHMO Deductible Kaiser HMO HSA 2700*** Anthem Blue Cross Premier HMO 101+ Classic HMO 101+ Value HMO Copay 101+ Value HMO Coinsurance 101+ Value Deductible HMO 101+ Healthy Support HMO 101+ Anthem Elements Choice HMO 101+ Advantage HMO**** 101+ Classic Choice HMO 101+ Point of Service (POS) - Traditional Network 101+ Premier HMO - Vivity Network 101+ Classic HMO - Vivity Network 101+ Value HMO Copay - Vivity Network 101+ Healthy Support HMO - Vivity Network 101+ Anthem Elements Choice EQ HMO 101+ Minimum Premium Plans 101+ Blue Shield HMO of California POS HRA SaveNet Local Access HMO CalCPA/Anthem Blue Cross Platinum HMO Gold HMO Cigna HMO POS Health Net SmartCare HMO Salud HMO y Mas EOA (Elect Open Access) HMO ExcelCare EOA ExcelCare HMO MediExcel Value Plan 5 (VP-5) 101+ Health Plan** Value Plan 10 (VP-10) 101+ Value Plan 20 (VP-20) 101+ Qualified Essential Plan 101+ Sharp Health Plan Sharp 5/5/0 - L 101+ Sharp 10/10/0 - L 101+ Sharp 10/10/20% - L 101+ Sharp 10/10/100 - L 101+ Sharp 10/10/ L 101+ Sharp 10/20/250 - L 101+ Sharp 10/20/500 - L 101+ Sharp 15/15/0 - L 101+ Sharp 15/15/250 - L 101+ Sharp 15/25/750 - L 101+ Sharp 15/25/1000- L 101+ Sharp 15/30/500 - L 101+ Sharp 20/20/20% - L 101+ Sharp 20/20/250 - L 101+ Sharp 20/30/300 (3-day max) - L 101+ Sharp 20/30/750 - L 101+ Sharp 20/40/20% - L 101+ Sharp 20/40/500 - L 101+ Sharp 25/25/500 - L 101+ Sharp 25/25/ L 101+ Sharp 25/35/500 (3-day max) - L 101+ Sharp 30/30/30%- L 101+ Sharp 30/30/250 - L 101+ Sharp 30/30/500 - L 101+ Sharp 30/30/ L 101+ Sharp 30/40/500 day - L 101+ Sharp 40/40/40%- L 101+ Sharp 40/40/500- L ST YEAR Administrative fees- Medical - (Anthem & Kaiser Large Group) 100+ Negotiated Standard (negotiable) : your resentative MEDICAL HMO/POS (Cont.) HEALTH PLAN MEDICAL PPO PLAN NAME GROUP SIZE Sharp Health Plan Sharp 40/40/750 - L 101+ (Cont.) Sharp 40/50/750 (3-day max) - L 101+ Sharp 500 ded 20/20 - L 101+ Sharp 1000 ded 20/20 - L 101+ Sharp 1000 ded/30/40 - L 101+ Sharp 1500 ded/40/40 - L 101+ Sharp 2500 Ded/40/40 - L 101+ Sharp 4500 Ded/40/50 - L 101+ Sharp POS 15/250_OON 1000ded_30% w/oop 1500/3000 MAX 101+ Sharp POS 15/250_OON 750ded_20% w/oop 1500/3000 MAX 101+ Sharp POS 20/250_OON 1000ded_20% 101+ Sharp POS 20/250_OON 1000ded_20% w/oop 2500/3500 MAX 101+ Sharp POS 25/35/500 (3-day max)_oon 1000ded_30% w/oop 3500/7000 MAX 101+ Sharp POS 25/500_OON 1000ded_30% w/oop 3000/3500 MAX 101+ Sharp POS 25/500_OON 1000ded_40% w/oop 3000/3500 MAX 101+ Sharp POS 25/500_OON 1500ded_40% w/oop 3000/4500 MAX 101+ Sharp POS 40/750_OON 2000ded_40% w/oop 3000/6000 MAX 101+ Sharp HSA 1500/30/30 - L 101+ Sharp HSA 2000/40/40 - L 101+ Sharp HSA 2500/40/40 - L 101+ Sharp HSA 3000/40/40 - L 101+ Sharp HSA 4500/40/40 - L 101+ SIMNSA Premier Access HMO 5/5** 101+ Premier Access HMO 7/10** 101+ UnitedHealthcare Signature HMO 101+ Advantage HMO 101+ Alliance HMO 101+ Alliance HMO HRA 101+ Alliance HMO HSA*** 101+ Western Health Premier 10, 15, 20, Advantage** Advantage 15-30, 420, 70, (Case-by-case basis) Western 4010, 2025, 4025, Western 1800*** 101+ Western 2800B*** 101+ Western 3000B*** 101+ Western 4000B*** 101+ Western 5500B*** 101+ * Call your resentative for details. ** Regional health plans are available in specific areas. your resentative for details. **** Tiered, Traditional and Select Plus HMO Networks For groups , please contact your sales resentative. Traditional, Select HMO, Select Plus HMO and Priority Select HMO 1ST YEAR unless Aetna OAMC 101+ HSA 101+ PPO 101+ PrimeCare OAMC 101+ SCCIPA EPO** 101+ Anthem Classic PPO / Anthem Solutions PPO 2000/20/ Anthem Lumenos HSA 3000/20/40*** Anthem Blue Cross Premier Plus (includes infertility) 101+ Premier PPO 101+ Classic PPO 101+ Classic Select PPO 101+ Solution PPO 101+ Healthy Support PPO 101+ Anthem Elements Choice PPO 101+ Exclusive Premier 101+ Exclusive Classic 101+ Exclusive Value 101+ EPO Plan 101+ Administrative fees- Medical - (Anthem & Kaiser Large Group) (Continued)

2 MEDICAL PPO (cont.) Anthem Blue Cross Care Advocate PPO 101+ (Cont.) Anthem Elements Choice EQ PPO 101+ Anthem Balanced PPO 101+ Anthem Balanced EPO 101+ ASO Plans 101+ Minimum Premium Plans 101+ Lumenos HSA*** 101+ Lumenos HSA Office Visit Copay*** 101+ Healthy Support HSA*** 101+ Anthem Elements Choice HSA*** 101+ Anthem Elemetns Choice EQ HSA*** 101+ Lumenos HRA 101+ Lumenos HRA First Dollar Copay 101+ Lumenos HIA Plus 101+ Lumenos HIA Plus First Dollary Copay 101+ Anthem Elements Choice EQ HSA*** 101+ Anthem Balanced PPO w/ HSA*** 101+ Blue Shield PPO of California HSA CalCPA/ Platinum Protect Anthem Blue Cross Gold Protect Gold Protect Silver Protect Silver Protect Silver Protect Bronze Protect Saver 100+ Silver Protect HRA 100+ Silver HSA Bronze HSA Bronze HSA Cigna PPO EPO HSA HRA Open Access Level Funded Plans Self-Funded Plans Health Net PPO PPO HSA-integrated PPO HRA-integrated MAA RBRVS NationCare PPO PPO 250 ded/$20/80%/60% 101+ Presented by Sharp PPO 250 ded/$15/90%/70% 101+ Health Plan PPO 500 ded/$15/90%/70% 101+ PPO 500 ded/$20/80%/60% 101+ PPO 500 ded/$25/80%/50% 101+ PPO 1000 ded/$30/80%/50% 101+ PPO 1500 ded/$30/70%/50% 101+ PPO 2000 ded/$30/70%/50% 101+ PPO 3000 ded/$40/60%/50% 101+ HSA 2000 ded/80%/50%** 101+ HSA 3000 ded/100%/70%** 101+ Nippon Life Benefits Evolution Evolution Value High Deductible Health Plans - Aggregate Ded High Deductible Health Plans - Embedded Ded UnitedHealthcare Select Plus 101+ Select Plus Direct 101+ Core 101+ Core Direct 101+ Select Plus Direct HRA 101+ Select Plus HSA*** 101+ Core Direct HRA 101+ Core HSA*** 101+ Non-Differential PPO 101+ All Savers Level Funding Negotiated Standard (negotiable) : your Next $5,000: 2.8 Next $10,000: 2.3 Next $20,000: 1.8 Next $200,000: 1.1 Next $500,000: 0.5 Over $2,000,000: 0. Flat commission % is DENTAL HMO Aetna DHMO + Volun 51+ MetLife DHMO Anthem Blue Cross Dental Net DHMO 101+ Blue Shield DHMO + Volun of California California Dental Advantage Plans + Volun 100+ Network Health Net DHMO DHMO DHMO MetLife DHMO + Volun MediExcel Health Plan** Dental Plan Reliance Standard Voluntary/Pretax plans 10+ SmileSaver/ SmileSaver DHMO MetLife DHMO SmileSaver DHMO SmileSaver DHMO SmileSaver DHMO SmileSaver 1000S SmileSaver 2000S SmileSaver 3000S UnitedHealthcare CA UHC DHMO + Volun 51+ Unum Dental Health Maintenance Organization (DHM) Insurance 10+ Western Health DHMO Advantage** (Case-by-case basis) DENTAL PPO Products Negotiable : contact Level - $50, , Level unless Aetna PPO + Volun 51+ MetLife Dental PPO Standard - Employer Paid or Voluntary MetLife Dental PPO Max - Employer Paid or Voluntary Ameritas Ameritas Edge Basic Plus 51+ Ameritas Edge Immediate Plan A 51+ Ameritas Edge Immediate Plan B 51+ Ameritas Edge MAC 51+ Ameritas Edge Plus Plan A 51+ Ameritas Edge Plus Plan B 51+ Ameritas Edge Premier 51+ Ameritas Edge Simple 51+ Ameritas Edge Two Tier 51+ Ameritas Edge No Deductible Premier 51+ Ameritas Edge Unique Plan A 51+ Ameritas Edge Unique Plan B 51+ Anthem Blue Cross Dental Prime 101+ Dental Complete 101+ Dental Blue 101+ BEST Life and PPO Dental + Vol Health Insurance Custom 100+ Products - Level 51-99, 100+ quotes available from agentservices@ ameritas.com Negotiable* * Call your resentative for details. ** Regional health plans are available in specific areas. your resentative for details. **** Tiered, Traditional and Select Plus HMO Networks For groups , please contact your sales resentative. Traditional, Select HMO, Select Plus HMO and Priority Select HMO (Continued)

3 DENTAL PPO (Cont.) Blue Shield PPO + Volun of California INO + Volun CalCPA/Delta Dental Protect Plus Dental Plan 50+ Cigna PPO + Volun First ChoiceDental Employer Sponsored Standard $ Basic $ Deluxe $ Deluxe Plus $ Voluntary Standard $ Basic $ Deluxe $ Deluxe Plus $ Health Net DPPO Essential 5 $1, DPPO Classic 3 $1, DPPO Classic Plus 1 $2,000 w/maxadvantage MetLife Dental PPO Options 2+ Voluntary PPO Options 10+ Nippon Life Benefits Dental PPO Principal Life EPO/POS/PPO + Volun Reliance Standard PPO 10+ Security Life ChoicePlus Security Life ChoicePlus Voluntary Option Security Life ChoicePlus Voluntary Option Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt Security Life ChoicePlus PPO Opt UnitedHealthcare Dental PPO + Volun 51+ Unum Passive PPO 10+ Active PPO 10+ Western Health PPO 1/ Advantage** PPO 2/ (Case-by-case basis) Standard (negotiable) Level enrolled members : Graded*- First $10,000: 10.00% Next $10,000: 7.50% Next $30,000: 5.00% Next $50,000: 2.50% Over $100,001: 1.00% First $5,000: Next $350,000: 2. $50, , : : : 4% 501+: 3% number of Employees enrolled unless DENTAL POS Principal Life POS + Volun DENTAL INDEMNITY First $5,000: Next $350,000: 2. BEST Life and IndemnityPlus + Vol Health Insurance Custom 100+ Cigna Indemnity + Volun Indemnity + Volun Security Life ChoicePlus Security Life ChoicePlus Indemnity UnitedHealthcare Dental Indemnity + Volun Negotiable* Standard (negotiable) : : : 4% 501+: 3% number of Employees enrolled * Call your resentative for details. ** Regional health plans are available in specific areas. your resentative for details. For groups , please contact your sales resentative.

4 VISION Aetna Aetna Vision 51+ Aetna Vision Preferred 51+ MetLife High/Low Plan - Employer Paid or Voluntary Ameritas Ameritas Edge Vision Perfect Plan A 51+ Ameritas Edge Vision Perfect Plan B 51+ Ameritas Edge Vision Plan A 51+ Ameritas Edge Vision Plan B 51+ Anthem Blue Cross Blue View Vision 101+ BEST Life and BEST Life Vision + Volun 51+ Health Insurance Blue Shield Basic of California Standard + Volun Plus Deluxe CalCPA/VSP Signature Option Standard Plan 100+ Signature Option Enhanced Plan 100+ Choice Option Standard Plan 100+ Choice Option Enhanced Plan 100+ Camden Advantage Plus A + Volun 51+ Advantage Plus B + Volun 51+ Advantage Plus C + Volun 51+ Cigna Vision + Volun First ChoiceVision Silver + Volun Gold + Volun Platinum + Volun Health Net Preferred Value Preferred Supreme MetLife Vision + Voluntary 10+ Nippon Life Benefits Vision Care Plan Principal Life Vision + Voluntary 51+ Reliance Standard Basic Vision 10+ Sharper Vision 10+ TrueView Vision 10+ Materials-Only 10+ Materials-Optional 10+ UnitedHealthcare Vision Plans + Volun 51+ VPA HMO Plan 1 + Volun 51+ HMO Plan 2 + Volun 51+ HMO Plan M-Plus Plan 51+ VSP Choice Plan (Voluntary) 10+ Choice Plan (Employer Paid) 5+ Western Health Full Service $ Advantage** Full Service $ (Case-by-case basis) Eyewear Only $ Eyewear Only $ ** Regional health plans are available in specific areas. your resentative for details. Products - Level Level Standard (negotiable) Level enrolled members Standard (negotiable) Level - For the first $250, % For the next $250, Over $500, % First $5,000: Next $350,000: 2. $50, , Graded unless DISABILITY Aetna STD + Volun 51+ LTD + Volun 51+ MetLife STD - Employer Paid or Voluntary MetLife LTD - Employer Paid or Voluntary Anthem Blue Cross Disability 101+ STD + Volun 101+ LTD + Volun 101+ Cigna STD + Volun LTD + Volun MetLife STD 10+ LTD + Volun 10+ Nippon Life Benefits LTD STD Principal Life STD + Volun 51+ LTD + Volun 51+ Reliance Standard STD 10+ LTD 10+ STD Voluntary 10+ LTD Voluntary 10+ UnitedHealthcare LTD + Volun 51+ Unum LTD 2+ STD 10+ LTD Voluntary 10+ STD Voluntary 10+ Products - Standard (negotiable) Varies - LTD (50+): First $15,000: 15.00% Next $10,000: 12.50% Next $75,000: 10.00% Over $100,001: 5.00% LTD (100+): First $5,000: 15.00% Next $15,000: 10.00% Next $5,000: 5.00% Next $5,000: 2.3 Next $20,000: 1.8 Next $50,000: 1.1 Next $150,000: 0.5 Next $250,000: 0. Over $500,000: 0. STD (50+): First $10,000: 10.00% Next $10,000: 7.50% Next $30,000: 5.00% Next $50,000: 2.50% Over $100,001: 1.00% STD (100+): Next $5,000: 2.8 Next $10,000: 2.3 Next $20,000: 1.8 Next $200,000: 1.1 Next $500,000: 0.5 Over $2,000,000: 0. your for details STD: First $5,000: Next $350,000: 2. LTD: First $15,000: 1 Next $10,000: Next $25,000: Next $50,000: 2% Next $100,000: 1% Next $300,000: 0.6% Next $500,000: 0.3% Over $1,000,000: 0.1% LTD $0-15, % $15,001-25, % $25,001-50, % $50,000 and over 1.0% STD $0-15, % $15,001-25, % $25,001-50, % $50,000 and over 1.0% Voluntary LTD and Voluntary STD up to 20% First $15K - 1 Next $10K - Next $25K - $50K+ - 1% First $15K - Next $10K - Next $25K - Next $50K - 1% $100K

5 LIFE INSURANCE Aetna Term Life + Volun 51+ MetLife Basic Life/AD&D MetLife Supplemental Term Life/AD&D MetLife Dep. Supplemental Life Anthem Blue Cross Group Term Life/AD&D 101+ Voluntary Group Term Life/AD&D 101+ Optional Group Term Life/AD&D 101+ BEST Life and Health Insurance Term Life & AD&D + Volun 51+ Blue Shield of California Term Life & AD&D Cigna Term Life + Volun Health Net Term Life & AD&D MetLife Term Life & AD&D + Volun * Nippon Life Benefits Life Principal Life Term Life + Volun 51+ Reliance Standard Group Term Life/al Death & Dismemberment (AD&D) 10+ Voluntary Term Life 10+ Voluntary AD&D 10+ UnitedHealthcare Term Life & AD&D + Volun 51+ Unum Group Term Life & AD&D 2+ Group Term Life & AD&D Voluntary 10+ Products - up to 20% Standard (negotiable) contact 1 Graded - (50+) First $10,000: 15.00% Next $10,000: 10.00% Next $30,000: 7.50% Next $50,000: 5.00% Over $100,001: 2.50% (100+) Next $5,000: 2.8 Next $10,000: 2.3 Next $20,000: 1.8 Next $200,000: 1.1 Next $500,000: 0.5 Over $2,000,000: 0. First $5,000: Next $350,000: 2. Commissions payable at a flat percentage are available for all group coverages. Group Life $0-10, % $10,001-20, % $20,001-30, % $30,001-50, % $50,001-00, % $100,001 and over Voluntary Group Term Life Flat Voluntary AD&D Flat 15.0% First $15K - Next $10K - Next $25K - Next $50K - 1% $100K CREATIVE SOLUTIONS HEALTH PLAN PLAN NAME 1ST YEAR Aflac (Individual Voluntary Insurance Policies) Colonial Life DefiniteBenefits (Employer-Paid & Voluntary) HealthiestYou International Medical Group (IMG) MetLife Cancer/Specified-Disease Dental Hospital Confinement Indemnity Hospital Confinement Sickness Indemnity Hospital Intensive Care Life Specified Health Event Short-Term Disability Vision PEO (3+ Lives/No max. limit) ASO (3+ Lives/No max. limit) MetLife MetLife Cancer MetLife Critical Illness MetLife Hospital Indemnity MetLife Hyatt Legal Dental STD Cancer Critical Illness Medical Bridge 3000 Term Life Universal Life Whole Life Group Group STD Group Cancer Group Critical Illness Group Medical Bridge Group Term Life Medical Lifestyle TeleHealth The Global Employer s Option SM Cancer Critical Illness Hospital Indemnity Hyatt Legal Whole Life Reliance Standard RSL BasicCare Limited Benefit Medical Products 10+ RSL Advantage 10+ RSL Risk Solutions 50+ Counselor DI 10+ Business Travel 10+ Voluntary Critical Illness 10+ Voluntary 10+ Begins at Commission increases with agent involvement and production < $499 Admin Fee - $500 - $750 Admin Fee - 1 $751 - $999 Admin Fee - 18% $1,000+ Admin Fee - 20% Products - In addition to full, standard carrier broker commissions for cases placed through Varies by product 20% 20% 1 Varies Products offered to groups 200+ Varies - Commissions are paid based on the actual enrollment of the group. RSL BasicCare Limited Benefit Medical Products, RSL Advantage, RSL Risk Solutions & Counselor DI: Voluntary Critical Illness & Voluntary Group : 1 OR 60% Business Travel : 1 Flat Gap Plans: 10.0% Flat

MEDICAL UNDERWRITING GUIDELINES LARGE GROUP

MEDICAL UNDERWRITING GUIDELINES LARGE GROUP This comparison reflects the general guidelines set by a carrier. Guidelines may vary depending on group demographics and carrier approval. Product Networks