Page 6 - Practice
P. 6
Suites 5 — design
Cover design Suite 5 Back cover Suite 5
20XX
BENEFITS GUIDE
This Beneits Guide is only intended to highlight some of the major beneit provisions of the
Company plan and should not be relied upon as a complete detailed representation of the plan.
This publication contains important information Please refer to the plan’s Summary Plan Descriptions for further detail. Should this guide difer
about your employee benefit program. from the Summary Plan Descriptions, the Summary Plan Descriptions prevail.
Please read thoroughly. © 2020 Lockton, Inc. All rights reserved.
[Rev 01/13/20] _____________\Untitled-4.pdf
Inside spread design Suite 5
2 0 X X
A network is a group of providers your plan contracts with at MEDICAL AND VISION Finding In-Network Providers
What is a Network?
discounted rates. You will almost always pay less when you PRESCRIPTION We partner with [Carrier] to offer you and your family Remember to visit in-network dentists to receive the deepest
level of discount on your services.
receive care in-network. members vision insurance. Visit www.[Carrier].com
If you choose to see an out-of-network provider, you may DRUG to ind in-network providers and access to a variety of To ind a participating in-network dentist in your area go to
www.website.com or call 555.555.5555.
online tools and programs.
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. [Client Name] partners with [carrier] to offer medical
and prescription drug insurance. Copay In-Network Out-of-Network
Important Insurance Terms Plan Highlights Exam
Materials
z Deductible: the amount of money you are responsible
for paying up-front before your plan shares your costs You have the option of choosing one of [X] plans. Lenses
z Coinsurance: the percentage you and the plan pay; in Our plans offer coverage for most healthcare services. Single
Bifocal
When you receive care in-network you beneit from our
our plans, you pay a smaller percentage and the plan
pays a larger percentage negotiated discounts with [Carrier]. Trifocal
z Copay: a ixed amount for certain services you pay in Lenticular
some of our plans [Carrier] Member Site Frames
z Out-of-pocket maximum: the limit on your expenses; Visit www.[Carrier].com to take advantage of all Contacts
once you reach this limit, the plan covers all eligible the helpful tools and resources available including the
expenses for the remainder of the plan year
following. Frequency
z In-network provider and pharmacy searches Exam
z A list of prescription drugs covered by our plans Lenses
Contacts (in lieu of
z Access to temporary ID cards and means to order glasses)
another ID card Frames
z Information regarding paid and pending claims This is a high level summary of your beneit coverage. Full coverage
Employee [Monthly/Weekly/Bi- details are available in your summary plan description (SPD). In the event
there is a discrepancy between what is relected in this guide and what is
communicated in your SPD, the terms of your SPD will prevail.
Weekly] Medical Contributions
[Plan 1] [Plan 2] Employee [Monthly/Weekly/Bi-
Employee Only $ $ Weekly] Vision Contributions
Employee and $ $
Spouse Employee Only $
Employee and $ $ Employee and Spouse $
Child(ren) Employee and Child(ren) $
Family $ $ Family $
4 20XX ENROLLMENT GUIDE 9
Cover design Suite 5 Back cover Suite 5
20XX
BENEFITS GUIDE
This Beneits Guide is only intended to highlight some of the major beneit provisions of the
Company plan and should not be relied upon as a complete detailed representation of the plan.
This publication contains important information Please refer to the plan’s Summary Plan Descriptions for further detail. Should this guide difer
about your employee benefit program. from the Summary Plan Descriptions, the Summary Plan Descriptions prevail.
Please read thoroughly. © 2020 Lockton, Inc. All rights reserved.
[Rev 01/13/20] _____________\Untitled-4.pdf
Inside spread design Suite 5
2 0 X X
A network is a group of providers your plan contracts with at MEDICAL AND VISION Finding In-Network Providers
What is a Network?
discounted rates. You will almost always pay less when you PRESCRIPTION We partner with [Carrier] to offer you and your family Remember to visit in-network dentists to receive the deepest
level of discount on your services.
receive care in-network. members vision insurance. Visit www.[Carrier].com
If you choose to see an out-of-network provider, you may DRUG to ind in-network providers and access to a variety of To ind a participating in-network dentist in your area go to
www.website.com or call 555.555.5555.
online tools and programs.
be balance billed, which means you will be responsible for
charges above [Carrier]’s reimbursement amount. [Client Name] partners with [carrier] to offer medical
and prescription drug insurance. Copay In-Network Out-of-Network
Important Insurance Terms Plan Highlights Exam
Materials
z Deductible: the amount of money you are responsible
for paying up-front before your plan shares your costs You have the option of choosing one of [X] plans. Lenses
z Coinsurance: the percentage you and the plan pay; in Our plans offer coverage for most healthcare services. Single
Bifocal
When you receive care in-network you beneit from our
our plans, you pay a smaller percentage and the plan
pays a larger percentage negotiated discounts with [Carrier]. Trifocal
z Copay: a ixed amount for certain services you pay in Lenticular
some of our plans [Carrier] Member Site Frames
z Out-of-pocket maximum: the limit on your expenses; Visit www.[Carrier].com to take advantage of all Contacts
once you reach this limit, the plan covers all eligible the helpful tools and resources available including the
expenses for the remainder of the plan year
following. Frequency
z In-network provider and pharmacy searches Exam
z A list of prescription drugs covered by our plans Lenses
Contacts (in lieu of
z Access to temporary ID cards and means to order glasses)
another ID card Frames
z Information regarding paid and pending claims This is a high level summary of your beneit coverage. Full coverage
Employee [Monthly/Weekly/Bi- details are available in your summary plan description (SPD). In the event
there is a discrepancy between what is relected in this guide and what is
communicated in your SPD, the terms of your SPD will prevail.
Weekly] Medical Contributions
[Plan 1] [Plan 2] Employee [Monthly/Weekly/Bi-
Employee Only $ $ Weekly] Vision Contributions
Employee and $ $
Spouse Employee Only $
Employee and $ $ Employee and Spouse $
Child(ren) Employee and Child(ren) $
Family $ $ Family $
4 20XX ENROLLMENT GUIDE
