




| |
Nippon Life of America
TotalMed America
Group Medical Insurance
Administered by: Total Plan Services,
Inc. -Dallas, Texas
 |
Calendar Year Deductible Options:
Individual $300, $500, $1,000, $2,500 or $5,000
Family Limit - 3 Individuals per family
Same for covered charges IN or OUT of NETWORK.
|
 |
Coinsurance Options:
PPO/Non PPO 90/70, 90/60, 80/60, 80/50, or 70/50
After out of pocket requirements are met, 100% up plan limits.
|
 |
Stop Loss (Coinsurance Expense Maximum)
Options:
Individual
$5,000, $10,000, or $15,000
Family Limit - 3 Individuals per calendar year.
|
 |
PPO Practitioner's Office Visit
Copay Options:
$15, $20, $25, $40, & $50 (not all copays available with all
deductibles and coinsurance options). Non-PPO Office Visits
subject to deductible and co-insurance.
|
 |
Supplemental Accident Option:
Available on the $300 and $500 deductible plans only. Benefit is equal
to the deductible amount. |
 |
Prescription Drug Card:
Two Tier & Three Tier Plans
available with various co-pays with or without a deductible.
Plans also available without Prescription co-pays,
but provided with a discount card good at any participating pharmacy.
|
 |
Maternity covered as any other illness
for employees and covered spouses. |
 |
Utilization Review is required. |
 |
12 month rate guarantee. |
 |
Optional 24 hour coverage for sole
proprietors, owner, partners and corporate officers when not legally
eligible to participate in worker's compensation. |
For complete details and rates, please contact
us.
|