GROUP PLANS International Employee Benefit Plans Renewal Booklet

Transcription

1 GROUP PLANS 08 International Employee Benefit Plans Renewal Booklet

2 Effective January, 08 GLOBAL HEALTH 00 MEDICAL BENEFITS OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. Annual deductibles: individual/family $00/$,000 $00/$,000 $,000/$,000 Plan pays/individual pays (co-insurance) () /0% /0% / () N/A N/A $0,000/$0,000 Maximum out-of-pocket (medical and Rx): individual/family $,000/$,000 $,000/$,000 N/A (no deductible or ) facility () () $/ Not covered Outpatient surgery () Chiropractic services (0 visits annually) Inpatient/intensive outpatient services () after $00 $ $ Travel immunizations (for employees and dependents) no deductible no deductible no deductible PRESCRIPTION DRUG BENEFITS (YOU PAY) OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. 0-DAY SUPPLY Generic drug 0% $ Preferred drug 0% $ PRESCRIPTION Non-preferred drug DRUG BENEFITS (YOU PAY) OUTSIDE 0% U.S. IN-NETWORK $0 U.S. OUT-OF-NETWORK U.S. Generic drug N/A N/A Preferred drug N/A $0 N/A Non-preferred drug N/A $0 N/A The deductible does not apply under emergency room for in-network U.S. However, if you are admitted to the hospital, the is waived and the deductible applies. If the cost of the prescription (in-network U.S.) is less than the, the participant will pay the full cost of the prescription. A -month supply of your prescription is available for international assignments.

3 Effective January, 08 GLOBAL HEALTH 000 MEDICAL BENEFITS OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. Annual deductibles: individual/family $,000/$,000 $,000/$,000 $,000/$,000 Plan pays/individual pays (co-insurance) () /0% /0% / () N/A N/A $0,000/$0,000 Maximum out-of-pocket (medical and Rx): individual/family $,0/$8,000 $,0/$8,000 N/A (no deductible or ) facility () () $/ Not covered Outpatient surgery () Chiropractic services (0 visits annually) Inpatient/intensive outpatient services () after $00 $ $ Travel immunizations (for employees and dependents) no deductible no deductible no deductible PRESCRIPTION DRUG BENEFITS (YOU PAY) OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. 0-DAY SUPPLY Generic drug 0% $ Preferred drug 0% $ PRESCRIPTION Non-preferred drug DRUG BENEFITS (YOU PAY) OUTSIDE 0% U.S. IN-NETWORK $0 U.S. OUT-OF-NETWORK U.S. Generic drug N/A N/A Preferred drug N/A $0 N/A Non-preferred drug N/A $0 N/A The deductible does not apply under emergency room for in-network U.S. However, if you are admitted to the hospital, the is waived and the deductible applies. If the cost of the prescription (in-network U.S.) is less than the, the participant will pay the full cost of the prescription. A -month supply of your prescription is available for international assignments.

4 Effective January, 08 GLOBAL HEALTH 000 MEDICAL BENEFITS OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. Annual deductibles: individual/family $,000/$,000 $,000/$,000 $,000/$8,000 Plan pays/individual pays (co-insurance) () /0% /0% / () N/A N/A $0,000/$0,000 Maximum out-of-pocket (medical and Rx): individual/family $,0/$0,000 $,0/$0,000 N/A (no deductible or ) facility () () $/ Not covered Outpatient surgery () Chiropractic services (0 visits annually) Inpatient/intensive outpatient services () after $00 $ $ Travel immunizations (for employees and dependents) no deductible no deductible no deductible PRESCRIPTION DRUG BENEFITS (YOU PAY) OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. 0-DAY SUPPLY Generic drug 0% $ Preferred drug 0% $ PRESCRIPTION Non-preferred drug DRUG BENEFITS (YOU PAY) OUTSIDE 0% U.S. IN-NETWORK $0 U.S. OUT-OF-NETWORK U.S. Generic drug N/A N/A Preferred drug N/A $0 N/A Non-preferred drug N/A $0 N/A The deductible does not apply under emergency room for in-network U.S. However, if you are admitted to the hospital, the is waived and the deductible applies. If the cost of the prescription (in-network U.S.) is less than the, the participant will pay the full cost of the prescription. A -month supply of your prescription is available for international assignments.

5 Effective January, 08 GLOBAL HEALTH 000 PLUS MEDICAL BENEFITS OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. Annual deductibles: individual/family $,000/$,000 $,000/$,000 $,000/$8,000 Plan pays/individual pays (co-insurance) () /0% /0% / () N/A N/A $0,000/$0,000 Maximum out-of-pocket (medical and Rx): individual/family $,0/$0,000 $,0/$0,000 N/A (no deductible or ) facility () () $/ Not covered Outpatient surgery () Chiropractic services (0 visits annually) Inpatient/intensive outpatient services () after $00 $ $ Travel immunizations (for employees and dependents) no deductible no deductible no deductible PRESCRIPTION DRUG BENEFITS (YOU PAY) OUTSIDE U.S. IN-NETWORK U.S. OUT-OF-NETWORK U.S. 0-DAY SUPPLY Generic drug 0% $ Preferred drug 0% $ PRESCRIPTION Non-preferred drug DRUG BENEFITS (YOU PAY) OUTSIDE 0% U.S. IN-NETWORK $0 U.S. OUT-OF-NETWORK U.S. Generic drug N/A N/A Preferred drug N/A $0 N/A Non-preferred drug N/A $0 N/A The deductible does not apply under emergency room for in-network U.S. However, if you are admitted to the hospital, the is waived and the deductible applies. If the cost of the prescription (in-network U.S.) is less than the, the participant will pay the full cost of the prescription. A -month supply of your prescription is available for international assignments.

6 International Dental Plans GuideStone s international dental plans allow your employees to receive quality care through Cigna s global network of providers. You and your employees can rest assured knowing that each of these providers has passed Cigna s rigorous screening process. Like their U.S. counterparts, these international dental plans include full coverage for preventive care to help employees stay healthy while on the field. When they return to the U.S., they can easily visit a dentist within Cigna s U.S. network. DENTAL PLANS AT-A-GLANCE GLOBAL DENTAL PLUS GLOBAL DENTAL BASIC Deductible (per person per year) $0 $0 Annual maximum benefit $,00 $,000 Class I: Preventive care no deductible no deductible Class II: Basic restorative Do you need dental insurance? Get A Quote! Class III: Major restorative Class IV: Orthodontia Not covered Class V: Implants Not covered Not covered Applies only to a dependent child less than 9 years of age. Lifetime maximum is $,00. Term Life and Accident Plans Term life and accident plans are available to international employees, excluding those who work in the following countries: Afghanistan, Algeria, Central African Republic, Chad, Democratic Republic of the Congo, East Timor (Timor-Leste), Eritrea, Iran, Iraq, Kenya, Lebanon, Pakistan, Somalia, South Sudan, Sudan, Syria, Tanzania, Uganda, Uzbekistan or Yemen. See the 08 Employee Benefit Plans Renewal Booklet for additional details. Long-Term Disability Plans Long-term disability plans are available to international employees, excluding those who work in the following countries: Afghanistan, Algeria, Central African Republic, Chad, Democratic Republic of the Congo, East Timor (Timor-Leste), Eritrea, Iran, Iraq, Kenya, Lebanon, Pakistan, Somalia, South Sudan, Sudan, Syria, Tanzania, Uganda, Uzbekistan or Yemen. See the 08 Employee Benefit Plans Renewal Booklet for additional details. Note: Short-term disability plans are available only within the United States. Additional Information You can find the International Group Plans Enrollment Form and International Employee Annual Change Request in the Group Plans Re-enrollment section of your Employer Access Program. All international notices are available in Important Notices. For more information on GuideStone s international plans, visit GuideStone.org/International.

7 0 Cedar Springs Road, Dallas, TX GUIDE GuideStoneInsurance.org 07 GuideStone Financial Resources /7