We offer special Flexible Health Care coverage with options that help you balance the need for health insurance and still stay in your budget. You have a full range of benefit options divided into the 3 sections below, so you can customize your coverage to your needs.

1. You may choose your Base coverage from the Comprehensive options below:

Deductible: Is the amount you pay for covered medical expenses before your coinsurance is applied. Choose From, $0, $500, $1,000, $1,500, $2,500, $3,500, $5,000, $7,500, $10,000, $15,000 or $25,000.

Coinsurance (coins): the insurer and the insured share costs incurred after the deductible is met, according to a specific formula. It is expressed as a percentage or a pair of percentages (such as 80/20) where the insurer’s portion is stated first. Choose from, 100%/0% you pay 0%, 80/20, 70/30 to a choice of a 50%/50% split, all in-network percentages. Select your Coinsurance Limit: Choose from, $5,000, $10,000, $20,000 or $50,000 and apply your chosen percentage.

Lifetime Maximum: Choose from, $500,000, $3,000,000, $5,000,000 or $10,000,000.

Calendar Year Maximum: Choose from, $100,000, $250,000, $500,000 or $5,000,000.

Rate Guarantee: Choose from, 12, 24 or 36 months rate “lock” (24 & 36 month lock available on deductibles of $2,500 or greater).

2. You may stop here and keep your monthly costs lower or choose additional benefits to add to your Comprehensive Base coverage from the options below:

Outpatient Rx: Choose from, Not covered, Subject to Deductible and Coinsurance, $15 (generic)/$30 (Brand name drugs)/$45 non-formulary copay or 20% (generic)/50% (Brand name drugs)/50% non-formulary coinsurance, whichever is greater, with $0/$200 deductible. Or $15 (generic)/$30 (Brand name drugs)/$45 non-formulary copay or 20% (generic)/50% (Brand name drugs)/50% non-formulary coinsurance, whichever is greater, with no deductible.

Doctor Office Visits: Choose from, Not covered, Subject to Deductible and Coinsurance, $40 copay with unlimited visits, $30 copay with unlimited visits to $0 copay with 2 visits and $40 copay thereafter.

Wellness Care: Choose from, Not covered, Subject to Deductible and Coinsurance, $250max/year 6 month wait, $40 copay with $200 (benefits first year)/$400 (benefits second year)/$600 (caps in third year and thereafter) per year, 6 month wait. Or $40 copay with $100 (benefits first year)/$200 (benefits second year) /$300 (caps in third year and thereafter) per year, 6 month wait.

X-ray/Lab: Choose from, Not covered, Subject to Deductible and Coinsurance, $200max/year or Subject to Deductible and Coinsurance, $500max/year.

MRI/CAT: Choose from, Not covered, Subject to Deductible and Coinsurance, $1,000max/year or Subject to Deductible and Coinsurance, $2,500max/year.

Emergency Room: Choose from, Subject to Deductible and Coinsurance, $100 access fee or Subject to Deductible and Coinsurance, $100 access fee with $1,000 max/year. Access fee waived if you are admitted to the hospital.

Outpatient Facility Calendar Year Maximum: Choose from, No maximum, $5,000, $10,000 or $15,000 maximum.

3. You may stop here or choose additional benefits to meet your needs from the options below:

Maternity: Helps pay pregnancy-related expenses such as prenatal care, delivery, newborn hospital costs and postpartum care after delivery. Choose from, None, $2,500 deductible and 20% coinsurance of $20,000 or $10,000 deductible and 20% coinsurance of $20,000 with a 6 month wait for both options (the out-of-network deductible is 2 times the deductible).

Accident Expense: Pays first -dollar benefits for covered injuries right away. First dollar means you don’t pay deductibles or coinsurance before benefits are paid. Benefit must be less than or equal to deductible. Benefit paid does not count to deductible. Choose from, None, $500, $1,000, $1,500, $2,000, $2,500, $3,000, $5,000 or $10,000 benefit amount.

Term Life: Choose from, None, Individual $15,000, Spouse $7,500 or Individual $25,000, Spouse $12,500 and children can be included, please contact us for further information regarding this or with any question.

Accidental Death Benefit: Cash benefits paid for a covered person in the event of a fatal accident.   Choose from, None, $2,500, $5,000, $10,000, $15,000 or $25,000.

Critical Illness Benefit: Cash benefits paid directly to you upon diagnosis of a critical illness. Available to applicants age 19 or older. Choose from, None or $25,000.

Short-Term Convalescent Care Benefit: Pays a daily cash benefit to help with expenses if you are confined in a nursing home or assisted living facility. There is a 20-day waiting period before benefits will be paid. Choose from, None, Daily benefit of $___ available in $10 increments from $100 to $200 and choose a Lifetime Maximum Benefit of 90 days, 180 days or 360 days. This is not Long-Term Care insurance.

You have the freedom to choose your doctor and hospital and coverage is provided whether treatment is received in or out of the network. You can achieve maximum savings by utilizing in network providers, which is similar to “buying” at the wholesale rather than retail level.

Please contact us and we will be glad to answer all your questions and/or help you customize a plan to deliver benefits you need at a price that fits your budget.