Page 51 - Weinberg & Schwartz Allstate Brochure Flipbook

Maximum Rollover Feature

… Rolls over a portion of a member’s unused annual maximum for future use

► Get More for Less: An innovative tool to stretch annual maximums while lowering premium.
A $1000 maximum benefit with maximum rollover is comparable to a $1500 Maximum benefit
plan, and costs less!
► Promote Cost Saving Network: Participants receive additional funds in their Maximum Rollover
Account if they visit an in-network dentist for all their dental needs during the benefit year.
This is in addition to network discounts averaging 30%.
* Not available to members residing in Texas or groups sitused in Georgia.
► A Solution for Everyone: Feature is available for all groups sizes, and for both employer paid
and voluntary plans.

How the Maximum Rollover Account (MRA) Works - $1000 Annual Max

Claims Rollover Amount
Threshold Rollover Amount (W/ Network Bonus) MRA Limit

$500 $250 $350 $1,000

Sample Member Experience
► Year 1 (2012) MRA: $0 Paid Claims: $400 (some out-of-network)
The paid claims do not exceed the $500 threshold for the Plan Annual Maximum of $1000. Therefore,
$250 is added to the MRA for Year 2.
► Year 2 (2013) MRA: $250 Paid Claims: $900
The paid claims exceed the threshold of $500. Therefore, no additional amount is added to the MRA
for Year 3 (2013). None of the MRA is used.
► Year 3 (2014) MRA: $250 Paid Claims: $1100
The member's Year 3 paid claims exceed the $1000 annual maximum; therefore, $100 of the MRA is
used. No additional amount is added to the member’s MRA because Year 3 paid claims exceeded the
threshold of $500.
► Year 4 (2015) MRA: $150 Paid Claims: $400 (all in-network)
The member’s MRA for the next year is now $500. Year 4 paid claims did not exceed the threshold
and $350 was added to the account since the member used network providers.
► Year 5 (2016) MRA: $500 Paid Claims: $400 (all in-network)
The member’s MRA for the next year is now $850, meaning they are covered for $1850 next year
($1000 plan maximum plus the $850 MRA built from two years of claims below the threshold
submitted by network providers).

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The Guardian Life Insurance Company of America, 7 Hanover Square, New York, NY 10004