Member
Benefits: Corporate Style Benefits
The opportunity has arrived for you to truly maintain your independence and have
access to corporate style benefits!
401K Participation
You may contribute the bonuses you earn to our John Hancock 401K plan!
Life Insurance Coverage
Coverage is available to you at no cost up to $10,000.00. You may increase your
death benefit at your own expense.
Elite Producer Medical Plan
The Elite Producer Program is offering you Humana
Health Insurance coverage, Vision and Dental.
Coverage Details:
Coverage 1st with $500 allowance per member and 100% in-network / 70%
out-of-network. Click on the below tabs for additional coverage detail.
-
In-Network Benefits
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Physician Services
-
Preventive Care
-
Facility Services
-
Other Medical Services
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Behavioral Health
-
Prescriptions
-
Vision
-
Dental
| In-Network Benefits |
In-Network
|
| Lifetime Maximum |
5 Million
|
| First Dollar Benefit |
$500 per member per calendar
year
|
| Deductible (calendar year) |
$2,500 individual/ $5,000
family
|
| Deductible Calculation for family |
By member (family max
applies)
|
| Co-Insurance (after Deductible) |
100%
|
| Out of Pocket Maximum |
Not Applicable
|
| Physician Services |
In-Network
|
| Primary Care Physician |
$20 copay
|
| Specialist |
$40 copay
|
| Diagnostic Lab & X-Ray |
Deductible
|
| Urgent Care |
Deductible plus $40 copay
|
| Preventive Care (Does not reduce $500 up-front benefit allowance) |
In-Network
|
| Primary Care Physician |
$20 copay
|
| Specialist |
$40 copay
|
| Diagnostic Lab & X-Ray |
100%
|
| Pap Smear & Mammogram |
100%
|
| Prostate Screening |
100%
|
| Child immunizations to age 18 |
100%
|
| Flu & pneumonia immunizations |
100%
|
| Endoscopic services (including, but not limited to colonoscopy) |
Deductible
|
| Facility Services |
In-Network
|
| In-Patient Services |
Deductible plus $250 copay per confinement
|
| Out-Patient Surgery |
Deductible plus $50 copay per visit
|
| Out-Patient Services |
Deductible
|
| Out-Patient - Advance Imaging (PET, MRI, MRA, CAT, SPECT) |
Deductible
|
| Emergency Room |
Deductible plus $150 copay
|
| Other Medical Services |
In-Network
|
| Skilled nursing facility (up to 60 days per calendar year) |
Deductible
|
| Hospice |
Deductible
|
| Home Health Care |
Deductible
|
| Physical, occupational, cognitive, speech, audiology - combined 25 visits per calendar year |
Deductible
|
| Spinal treatment |
Deductible plus $40 copay
|
| Durable medical equipment (limited to $2,500 per calendar year) |
Deductible
|
| Ambulance |
Deductible
|
| In-Network Benefits |
In-Network
|
| In-Patient Services (combined limit up to 10 days per calendar year) |
Deductible plus copay per confinement
|
| Out-Patient & therapy sessions (combined limit up to 15 visits per calendar year) |
Deductible plus copay
|
| In-Network Benefits |
In-Network
|
| Level 1 |
$10
|
| Level 2 |
$35
|
| Level 3 |
$55
|
| Level 4 ($2,500 per member per calendar year) |
25%
|
| Mail Order (up to 90 day supply) |
2.5 x copay
|
| In-Network Benefits |
Frequency
|
Benefit
|
| Exam |
1 per 12
months
|
$10 Copay
|
| Basic Lenses |
1 per 12
months
|
$10 Copay
|
| Frames |
1 per 24
months
|
up to $110 Retail
|
| Contacts-med.nec. |
1 per 24
months
|
$10 Copay
|
| Contacts-elective |
1 per 24
months
|
$100 Allowance
|
| |
|
|
| In-Network Benefits |
Frequency
|
Benefit
|
| Exam |
1 per 12
months
|
up to $34
|
| Basic Lenses |
1 per 12
months
|
up to $125
|
| Frames |
1 per 24
months
|
up to $35
|
| Contacts-med.nec. |
1 per 24
months
|
up to $210
|
| Contacts-elective |
1 per 24
months
|
up to $75
|
| |
|
|
| In-Network Benefits |
Voluntary
|
|
| Employee |
$7.95
|
|
| Employee plus Spouse |
$14.73
|
|
| Employee plus Children |
$15.52
|
|
| Employee plus Family |
$19.01
|
|
| The COPAY PLAN (1A-199) |
Network
|
Non-network
|
| Office Visit COPAY |
$10
|
$10
|
| Type I Coverage* |
$0 Copay's
|
See Schedule
|
| Type II Coverage* |
See Schedule
|
See Schedule
|
| Type III Coverage* |
See Schedule
|
See Schedule
|
| Orthodontia |
See Ortho
|
None
|
| |
|
|
| Annual Deductible |
$50/150 -
Type II&III Services
|
$50/150 - Type II&III Services
|
| Annual Maximum |
None
|
None
|
| Type I - Waiting Period |
None
|
None
|
| Type II - Waiting Period |
None
|
None
|
| Type III - Waiting Period |
None
|
12 Months
|
| Orthodontia Waiting Period |
None
|
N/A
|
| |
|
|
| Monthly Premium** |
|
|
| Employee |
$15.42
|
|
| Employee plus Spouse |
$29.39
|
|
| Employee plus Children |
$24.73
|
|
| Employee plus Family |
$44.21
|
|