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Text Box: Benefits reflect Utah group health insurance coverage's as "In-network"

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Typical Plan Benefit designs that we recommend  

    



Humana
Health
Plans

  


IHC HEALTH PLANS

  


Regence
BCBS ValueCare

  


United Health

  


ALTIUS
             
Office Visit Copay   $20 $15 $15 $15 $15
             
Calendar Yr. Ded.   250, 500, 1000, 2000

Multiple Deductible Choices Can be Added

 250, 500, 1000, 2000 250, 500, 1000, 2000, 2500, 4000 250, 500, 1000, 2500, 5000 250, 500, 1000, 2000
Options to choose from Options to choose from Options to choose from Options to choose from
             
Out of Pocket Max.   1000-6000 Options to choose from 2000-6000 Options to choose from 2000-6000 Options to choose from 2000-6000 Options to choose from 2000-6000 Options to choose from
Single   1000 assuming 250 ded. 3000 assuming 250 ded. 2000 assuming 250 ded. 1500 assuming 250 ded. 2000 assuming 250 ded.
Family   2000 6000 4000 3000 4000
             
Lifetime Max.   5 million Unlimited  5 million Unlimited 5 million
             
Pre-existing Waiting Period:   12 Month for 12 Month for 12 Month for 12 Month for
There is a 12 month waiting period prior medical  prior medical  prior medical  prior medical 
for prior medical conditions at the point  conditions conditions conditions conditions
of effective date here IF you do not Waived if you  Waived if you  Waived if you  Waived if you 
have current coverage being replaced by us are replacing are replacing are replacing are replacing
             
Prescription                  Humana
Coverage		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
Generic   $10 $10 $10 $15 $15
Name Brand   $35 25% of Cost of RX 25% of Cost of RX $25 $25
Non-Preferred   $55 50% of Cost of RX 50% of Cost of RX $50 $50
             
Hospitalization Humana
Health
Plans		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
Room & Board   Multiple Choices that you can pay from 20% to nothing. You Pay 20% You Pay 20% You Pay 20% You Pay 20%
Inpatient Physician   Same
as above		 After Ded.  After Ded.  After Ded.  After Ded. 
Surgeon & Anesthesiologist Same
as above		 The Insurance  The Insurance  The Insurance  The Insurance 
      Carrier pays difference Carrier pays difference Carrier pays difference Carrier pays difference
Maternity    Humana
Health
Plans		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
Outpatient Care   Multiple Choices that you can pay from 20% to nothing. You Pay 20% You Pay 20% You Pay 20% You Pay 20%
Physician Delivery Fee Same
as above		 After Ded.  After Ded.  After Ded.  After Ded. 
Hospital Room & Board Same
as above		 Maternity Coverage is: Maternity Coverage is: Maternity Coverage is: Maternity Coverage is:
      (Optional Coverage) (Mandatory Coverage) (Mandatory Coverage) (Mandatory Coverage)
Out-Patient Care Humana
Health
Plans		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
             
Doctor Office Coverage:        
Preventative Care - by Primary Doctor.                        $20copay $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded.
Annual Physical   $20copay 100% Coverage $300 limit per Adult $15 copay - No Ded. 100% Coverage
Immunizations   $20copay No Limit Maximum No limit on children $15 copay - No Ded. No Limit Maximum
             
Office Visits - Primary Care $20copay $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded.
Office Visits - After Hours $20copay $25 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded. $25 copay - No Ded.
Office Visits - Specialist $20copay $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded. $25 copay - No Ded.
Minor Lab/X-ray w/ mammography 100% No Deductible 100% No Deductible $15 copay - No Ded. 100% No Deductible
    $20copay        
Major Lab/X-ray w/ CT scan, MRI/MRA You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
    Multiple Choices that you can pay from 20% to nothing.        
Physiotherapy -    No max No max No max No max 10 visits max
Speech therapy -    No max No max No max No max 10 visits max
Providers Office -   $20copay $15 copay - No Ded. $15 copay - No Ded. $15 copay - No Ded. $25 copay - No Ded.
Outpatient Facility -   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
             
Out Patient Surgery   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
             
Outpatient Hospital Services   You Pay You Pay You Pay You Pay
Chemotherapy, Radiation therapy 20% 20% 20% 20%
Kidney Dialysis   Multiple Choices that you can pay from 20% to nothing. After Ded. After Ded. After Ded. After Ded.
             
Eye Exams - Optometrist Discount 100% Coverage No Coverage No Coverage $15 copay - No Ded.
             
Emergency Care Humana
Health
Plans		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
             
Emergency Room Visit   Full Coverage Full Coverage $75 Copay - No Ded. Full Coverage
In-network Hospital   Multiple Choices that you can pay from 20% to nothing. $25 & Ded. & 20% Full Coverage $75 Copay - No Ded. $75 Copay - No Ded.
Out-of-network Hospital  

Same
as above

 

 $75 & Ded. & 20% Full Coverage $75 Copay - No Ded. $150 Copay - No Ded.
Non - Accidental Visit Same
as above		 $75 & Ded. & 20% $75 & Ded. & 20% $75 Copay - No Ded. $75 Copay - No Ded.
Accidental Visit   Same
as above		 100% Coverage $75 then 20% $75 Copay - No Ded. $75 Copay - No Ded.
             
Urgent Care at Dr. Office $20Copay $15 copay - No Ded. $15 copay - No Ded. $25 copay - No Ded. $25 copay - No Ded.
Urgent Care at Facility (Clinic) $20Copay $25 copay - No Ded. $15 copay - No Ded. $25 copay - No Ded. $25 copay - No Ded.
             
Ambulance, Paramedics Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
Air Ambulance   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
             
Other Benefits Humana
Health
Plans		 IHC HEALTH PLANS Regence BC / BS UHC ALTIUS
             
Medical Supplies   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded. You Pay 20% After Ded.
Accident-Related Dental Services You Pay 50% After Ded. You Pay 50% After Ded. You Pay 20% After Ded. You Pay 50% After Ded.
Lifetime Max   $1,000 $1,000 $1,000 No Max $1,000
             
Allergy Conditions:          
Testing & Treatment   $20Copay $15 copay - No Ded. No Coverage For Test $15 copay - No Ded. $25 copay - No Ded.
Injections   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. No Coverage     You Pay 20% After Ded. 100% Coverage
             
Serum   Multiple Choices that you can pay from 20% to nothing. You Pay 20% After Ded. Limited Coverage You Pay 20% After Ded. You Pay 20% After Ded.
             
Infertility Treatment -     Diagnostic Only Diagnostic Only Diagnostic Only Diagnostic Only
Limited To:             
Yearly Maximum Benefit Same $1,500 $1,500 $1,500 $1,500
Lifetime Maximum Benefit Same $5,000 $5,000 $5,000 $5,000
             
Adoption Benefit Payable to You Same $3,155 Per Adoption $3,155 Per Adoption $3,155 Per Adoption $3,155 Per Adoption
             
Chiropractic Care -   $20Copay Not Covered $15 copay - No Ded. $25 copay - No Ded. $25 copay - No Ded.
             
Maximum Visits Per Year Same   $1500 max benefit 10 Per Member 10 Per Member
             
Mental Health Inpatient or Out Inpatient or Out After Ded. & $15 copay Inpatient or Out Not Covered
Substance Abuse 50% After Ded. 50% After Ded. ValueCare Pays 80% 50% After Ded.  
       

Comparing prices and benefits can be confusing. Benefits Manager can answer your questions via phone or e-mail. We pride ourselves on providing top quality policies and services and standing by our customers through the years. We'll be here to answer your questions and concerns even after you've purchased your policy.

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