Page 4 - 2020-21 Sample Benefits Guide
P. 4
20XX
What is a Network? Medical and
A network is a group of providers your plan contracts with at Prescription Drug
discounted rates. You will almost always pay less when you
receive care in-network. [Client Name] partners with [carrier] to offer medical
and prescription drug insurance.
If you choose to see an out-of-network provider, you may
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. Plan Highlights
You have the option of choosing one of [X] plans.
Important Insurance Terms Our plans offer coverage for most healthcare services.
When you receive care in-network you beneit from our
Deductible: the amount of money you are responsible negotiated discounts with [Carrier].
for paying up-front before your plan shares your costs
Coinsurance: the percentage you and the plan pay; in [Carrier] Member Site
our plans, you pay a smaller percentage and the plan
pays a larger percentage Visit www.[Carrier].com to take advantage of all
the helpful tools and resources available including the
Copay: a ixed amount for certain services you pay in following.
some of our plans
Out-of-pocket maximum: the limit on your In-network provider and pharmacy searches
expenses; once you reach this limit, the plan covers all A list of prescription drugs covered by our plans
eligible expenses for the remainder of the plan year Access to temporary ID cards and means to order
another ID card
Information regarding paid and pending claims
Employee [Monthly/Weekly/Bi-
Weekly] Medical Contributions
[Plan 1] [Plan 2]
Employee Only $ $
Employee and $ $
Spouse
Employee and $ $
Child(ren)
Family $ $
4
What is a Network? Medical and
A network is a group of providers your plan contracts with at Prescription Drug
discounted rates. You will almost always pay less when you
receive care in-network. [Client Name] partners with [carrier] to offer medical
and prescription drug insurance.
If you choose to see an out-of-network provider, you may
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. Plan Highlights
You have the option of choosing one of [X] plans.
Important Insurance Terms Our plans offer coverage for most healthcare services.
When you receive care in-network you beneit from our
Deductible: the amount of money you are responsible negotiated discounts with [Carrier].
for paying up-front before your plan shares your costs
Coinsurance: the percentage you and the plan pay; in [Carrier] Member Site
our plans, you pay a smaller percentage and the plan
pays a larger percentage Visit www.[Carrier].com to take advantage of all
the helpful tools and resources available including the
Copay: a ixed amount for certain services you pay in following.
some of our plans
Out-of-pocket maximum: the limit on your In-network provider and pharmacy searches
expenses; once you reach this limit, the plan covers all A list of prescription drugs covered by our plans
eligible expenses for the remainder of the plan year Access to temporary ID cards and means to order
another ID card
Information regarding paid and pending claims
Employee [Monthly/Weekly/Bi-
Weekly] Medical Contributions
[Plan 1] [Plan 2]
Employee Only $ $
Employee and $ $
Spouse
Employee and $ $
Child(ren)
Family $ $
4
