Page 4 - Precision Health Plans - Brochure 2024

Precision Health Plans
PRECISION SERIES HEALTH PLANS VALUE PROPOSITION
These health plans are designed on a self-funded platform, which is regulated under less
burdensome Federal regulations enabling us to provide maximum design flexibility,
cost controls and unique advantages.
Each month, you will be billed for all eligible plan costs including administration,
insurance, claims funding, and commissions (which can vary based only upon
enrollment). Your stop-loss protection extends beyond the end of your plan to allow
for the settlement of claims incurred but not yet reported during the actual plan year.
All of these extended plan costs are included in your monthly funding, so there is no
need for added costs when you change to another plan or when you renew. See your
proposal for details.
Any claims funding that remains in your account at the end of your contract is returned
to you in FULL*.
* Early termination will cause forfeiture of any unused claims funds to offset administrative costs.
PRECISION SERIES HEALTH PLANS GENERAL GUIDELINES
Minimum Participation:
➢ Less than 51 lives enrolled for medical: 75%
➢ 51+ lives enrolled for medical: 60%
An employee is eligible for coverage if working full-time for the employer on a regular
basis for 30 hours or more per week (details in your SPD). All eligible employees not
covered under another qualified plan are included in the calculation of participation.
For Example:
➢ 38 Full-Time Employees;
➢ 7 of those Employees have coverage on their spouse’s/parent’s plan OR are
covered in the exchange;
➢ 31 Employees remaining x 75% = 24 Employees Must Enroll (rounded up from 23.25).
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Precision Health Plans
ADMINISTRATIVE ADVANTAGES
The Precision Series provides you full administrative services, including customer
service, COBRA administration and billing as applicable, online access to benefits and
reporting, our exclusive SmartCare Network, and full optional and automated HRA
and/or FSA administration, all in one place.
EMPLOYER REQUIREMENTS
Contributions: The employer must contribute at least 50% of the cost of the
least expensive plan (excluding MEC Preventive Only) in order to qualify.
Group’s Domicile: Precision Series is available in most states subject to state
stop-loss regulations.
Rates: Precision Series rates are guaranteed for one year, but have minimum
requirements and provisions for significant census changes, or acquisitions during
the contract year. Refer to the stop-loss contract for details. The Precision Series
provides a return of 100% of unused claims funding at the end of the contract
period. In the event of early termination, these funds will be forfeited, coverage
may be terminated, and additional fees may apply.
Broker of Record (BOR): Policies for BIC’s Precision Series include certain
requirements. BIC reserves the right to approve or deny any BOR change.
Notifications: Employers are required to notify the administrator promptly
whenever an employee or dependent status change occurs. Coverage additions
and terminations cannot be executed retroactively. Failure to notify on a timely
basis may result in loss of coverage or claims denial. Please review Summary Plan
Description for detailed eligibility requirements.
In all cases, we reserve the sole and exclusive right to authorize a broker to represent
these products. We reserve the right to change and/or make exceptions to the Guidelines
from time to time. Please consult with your representative for details as they pertain to
your group size and enrollment.