Page 4 - Benefits Guide
P. 4
2019 Benefits Guide
MEDICAL AND PRESCRIPTION
What is a Network?
A network is a group of providers DRUG
your plan contracts with at
discounted rates. You will almost [Client Name] offers a robust medical insurance program to our
always pay less when you receive employees. We partner with [Carrier] to offer this coverage.
care in-network.
If you choose to see an out-of- Plan Highlights
network provider, you may be
balance billed, which means you You have the option of choosing one of [X] plans. Our plans offer
will be responsible for charges coverage for most healthcare services. When you receive care in-network
above [Carrier]’s reimbursement you beneit from our negotiated discounts with [Carrier].
amount.
[Carrier] Member Site
Visit www.[Carrier].com to take advantage of all the helpful tools and
resources available including the following.
Important z In-network provider and pharmacy searches
Insurance Terms z A list of prescription drugs covered by our plans
z Deductible: the amount of
money you are responsible z Access to temporary ID cards and means to order another ID card
for paying up-front before Information regarding paid and pending claims
your plan shares your costs z
z Coinsurance: the
percentage you and the plan Employee [Monthly/Weekly/Bi-Weekly] Medical
pay; in our plans, you pay a Contributions
smaller percentage and the
plan pays a larger percentage [Plan 1] [Plan 2]
z Copay: a ixed amount for Employee Only $ $
certain services you pay in Employee and Spouse $ $
some of our plans Employee and Child(ren) $ $
z Out-of-pocket maximum: Family
the limit on your expenses; $ $
once you reach this limit,
the plan covers all eligible
expenses for the remainder
of the plan year
4
MEDICAL AND PRESCRIPTION
What is a Network?
A network is a group of providers DRUG
your plan contracts with at
discounted rates. You will almost [Client Name] offers a robust medical insurance program to our
always pay less when you receive employees. We partner with [Carrier] to offer this coverage.
care in-network.
If you choose to see an out-of- Plan Highlights
network provider, you may be
balance billed, which means you You have the option of choosing one of [X] plans. Our plans offer
will be responsible for charges coverage for most healthcare services. When you receive care in-network
above [Carrier]’s reimbursement you beneit from our negotiated discounts with [Carrier].
amount.
[Carrier] Member Site
Visit www.[Carrier].com to take advantage of all the helpful tools and
resources available including the following.
Important z In-network provider and pharmacy searches
Insurance Terms z A list of prescription drugs covered by our plans
z Deductible: the amount of
money you are responsible z Access to temporary ID cards and means to order another ID card
for paying up-front before Information regarding paid and pending claims
your plan shares your costs z
z Coinsurance: the
percentage you and the plan Employee [Monthly/Weekly/Bi-Weekly] Medical
pay; in our plans, you pay a Contributions
smaller percentage and the
plan pays a larger percentage [Plan 1] [Plan 2]
z Copay: a ixed amount for Employee Only $ $
certain services you pay in Employee and Spouse $ $
some of our plans Employee and Child(ren) $ $
z Out-of-pocket maximum: Family
the limit on your expenses; $ $
once you reach this limit,
the plan covers all eligible
expenses for the remainder
of the plan year
4
