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Health Benefit Planning for the New Millennium
Throughout the past decade, we have witnessed a myriad of changes in the way healthcare is delivered and financed. While many of these changes have been positive, a number of problems remain unresolved. These include, but are not limited to:
- An increasing percentage of the population has no healthcare insurance.
- An increase in the number of employers who are reducing healthcare benefit premium contribution participation, or in some cases providing no contribution at all.
- An increase in the cost to employees for their own healthcare coverage and for that or their dependents, resulting in a decrease of health benefit plan participation.
- A decrease in small employer access to benefit purchasing power.
While the nation seeks a method for providing universally available, cost-effective, high-quality, comprehensive healthcare, SMARTER CHOICE™ has developed a truly innovate approach to help address this important issue…
Not all Employees view Employer Provided
Healthcare Benefits in the same way…
"Mr. Smith thank you for helping me understand my coverage."
"My boss has the marketing power to get the best benefits and rates."
"We're unanimous Mr. Smith. We believe that your choice of health plans is driven by corporate bottom line not by our needs or welfare."
What the Smarter Choice™ Health Benefit Approach
Can Do For You!
"The Employer"
The Smarter Choice™ Health Benefit Plan overcomes a variety of problems associated with today's "traditional/managed care" insurance products. Smarter Choice™ Health Benefits are based on a concept which:
- Addresses the needs of both insured and self-funded organizations.
- Provides a modular approach to both plan content and cost.
- Recognizes that "one size does NOT fit all", and that the virtue of customizing health benefits increases value to both employer and employee.
- Closes the gap between the "haves" and the "have nots".
- Provides a mechanism for decreasing the level of adverse risk by spreading the risk over a larger population.
- Remains cognizant of the importance of both the corporate bottom line and the need for employee dignity.
Tell Me More…
Smarter Choice™ approach to health benefits provides employees and their families with real choices. Employees can choose the level of benefits that are most meaningful to them, and can make this choice annually in accordance with their financial situation.
Each option utilizes the services of quality medical providers (physicians, hospitals, etc.), who participate in the Plan's Preferred Provider Organization (PPO) which is available throughout most of the nation. The PPO provides valuable discounts to the Plan Members.
Smarter Choice™ Health Benefit Plans provide benefits and cost flexibility through the application of unique plan design and risk-sharing models that accommodate, without penalty, significant increases in employee and dependent participation.
Viva La Difference!
We all purchase consumer goods based on our needs, desires and ability to pay. We don't all…
- Drive The Same Cars
- Live in the Same Kind of Home
- Wear the Same Style of Clothes
- East the Same Foods
WE PREFER…
Smarter Choice™
"Smarter Choice for Smarter People!"
Let's Talk Smarter Choice™ Health Benefits
Selected Health Benefit
The Selected Health Benefit Plan provides access to comprehensive basic health services at affordable costs. This in turn helps employers reduce lost time and productivity from sick employees and family members.
The Selected Health Benefit Plan provides healthcare services usually required by almost every adult and child.
- Physician Office Services (excluding surgical procedures)
- X-ray and Laboratory
- Emergency Room Services
- Prescription Drug Card Services
- Vision Discount Network (up to 50% discounts)
- Dental Discount Network (20-50% discounts)
- Employee Assistance Program
- "Ask a Nurse" 24 hour nurses on call
- Annual Oral Exam and Cleaning
$2,000 Per Plan Year Maximum Benefit
plus Prescription Drugs and Laboratory Services
Let's Talk More Smarter Choice™ Health Benefits
The Expanded Health Benefit Plan – provides the following list of additional features to those already included in the Selected Health Benefit Plan.
ADDED FEATURES:
- In and Outpatient Medical and Surgical Services
- Private Duty Nurse
- Branded Name Drug Services
- Hospice Services
- Durable Medical Equipment
- Prosthetic Devices
- Out-of Network Services
- Chiropractic Services
- Behavioral Health Services
$10,000 Per Plan Year Maximum Benefit
Let's Talk Smarter Choice™ Health Benefits
Comprehensive Health Benefit
The Comprehensive Health Benefit provides a major medical reimbursement feature to the Expanded Health Benefit Plan.
- 100% benefit after $10,000 in eligible in-Network charges per calendar year.
- $1,000,000 Lifetime Maximum
Health Benefit Plan Market Place
Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs) dominate today's Health Benefit Plan Market Place.
HMO and/or PPO Feature:
- Office Co-pays
- High Deductibles ($500 to $1,000) – 3 per family
- 80% In-Network / 60% Out-of-Network to $10,000
- Limited Network/Provider Choice
- Prescription Drug Card with limited formulary
Current Cost Vary by Geographical Area
Employee Cost: $180-$230 monthly
Full Family Cost: $460-$700 monthly
OR MORE
The Smarter Choice™ Health Benefit Plan
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Selected Health Benefit
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Expanded Health Benefit
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Comprehensive Health Benefits
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In-Network
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In or Out-of-Network
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In or Out-of Network
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Featuring:
- Office Copays
- X-ray & laboratory
- Emergency Room
- Annual Dental Exam & Cleaning
- Prescription Drug Card
- Employee Assistance Plan
- Dental Service Discounts
- Visions Service Discount
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Featuring everything in the Selective Health Plan Plus:
- Hospital Services
- Surgical Services
- Expanded Prescription Drug Card Benefit
- Hospice Care
- Behavior Health
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Takes All the Features Expanded Health to the high limits needed to cover the major medical risk
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Monthly Cost:*
1st Member $ 60.00
2 Members $120.00
3 Members $180.00
4 Members $240.00
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Monthly Cost:*
1st Member $ 90/$140
2 Members $180/$280
3 Members $270/$420
4 Members $360/$560
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Monthly Cost:*
1st Member $140 plus
2 Members $280 plus
3 Members $420 plus
4 Members $560 plus
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