Building Plans That Personalize Coverage Save You Money
Building Plans That Personalize Coverage & Save You Money We Assure You Don’t Pay for Benefits You & Your Family Don’t Need!
OUR OBJECTIVE AND MISSION Objective: Introduce to the employer and their workforce a one-of-a-kind partnership offering multiple health coverage options. This will provide a greater coverage of health care options, while lowering the benefit cost to the employer! Mission: To provide the highest quality of health benefits at the lowest price to today’s employer and their workforce.
HEALTHCARE TODAY IN OUR COUNTRY The new health care reform legislation is called The Patient Protection and Affordable Care Act (PPACA)— Commonly known as “Obama. Care” or “ACA”
MAKES SENSE, RIGHT?
HEALTH COVERAGE OPTIONS • NO Coverage • Group/Employer Sponsored • Healthcare. gov • Healthshare
NO COVERAGE OPTION • Increased Health Risks • Risks to Loved Ones & Community • Financial Risks • Medical debt has been the leading cause of American bankruptcy for years. • Most Facilities will deny treatment if you do not have insurance or money up front to pay for treatment. (ER is exception)
HEALTHCARE. GOV OPTION • Unstable market, even before the Affordable Care Act • Many insurers have exited the individual market, leaving areas with only a single insurer • Remaining insurers suffered significant losses in the individual market, leading to very substantial premium increases • Congress’s decision to repeal the individual mandate and halt “cost-sharing reduction” created further uncertainty • The ACA’s individual market is in generally the same shape now as it was at the end of 2016. Prices are high and insurer participation is down. The measures currently available to states are unlikely, however, to improve the individual market to the extent that is needed
GROUP/EMPLOYER SPONSORED OPTION • Traditional options, like group health insurance, have grown out of reach… • They’re too expensive • They’re Deductibles are too high • They’re too one-size-fits-all • Recent studies show less than half of businesses with fewer than 50 employees offer group health insurance
HAVE YOU HEARD OF A HEALTHSHARE OR, THE PAST. . .
HEALTHSHARE OPTION • Health share's have been around for over 30 years • Same format that insurance started on in the early 1900’s • The cost of Healthshare plans is about 1/3 the cost of traditional insurance; while providing significant benefit packages • No Open Enrollment Period • Healthshare members can use their membership anywhere in the United States • Any Hospital/Any Provider, No network • Healthshare can even be used when traveling abroad
ALTRUA HEALTHSHARE • Altrua Healthshare is a 501(c)(3), operated by Crown Healthshare Administrators, Inc. • Continuous Sharing since 1999 • CMS Recognized and Audited (tax penalty exempt) • Only 2 rate increases in history • Providers are paid directly from Altrua Escrow Account • Any individual can always go back to the ACA Jan 1
HOW DOES ALTRUA HEALTH SHARING WORK? Even though Altrua Health. Share is classified as Not Insurance, it still operates similar to the same process. The chart below shows you how!!
HEALTHSHARE-SELECT SILVER PLAN Select Silver Plan MRA $2, 750 person per calendar year, then 0% Age 1 Life 2 Life Family Office Visits None 2– 39 $160 $225 $295 Telemedicine $0 Per visit 40– 49 $180 $255 $325 Outpatient & Hospital Subject to Plan MRA 50– 59 $230 $365 $420 60– 64 $275 $485 $525 Lifetime Maximum $1, 000
MEMBER RESPONSIBILITY • $2, 750 for Eligible medical expenses Ineligible medical expenses. • Office Visits (No preventative, PCP, Specialist, Urgent Care) • Prescription Drugs (unless part of outpatient or Inpatient/hospital treatment) • Mental / Behavioral Health • Maternity • Medical Needs exceeding $1, 000 • Pre-Existing Conditions during the first 2 years (some conditions are 5 years
Eligible Medical Expenses Lifetime Plus Shares 100% Exceeding at an additional Member Responsibility Freedom Plan $1, 000 benefits $1, 000 Covers • $2, 750 MRA (eligible expenses) • (Ineligible expenses) $2, 750 MRA • Office visits • Mental health Select Silver shares 100% • Maternity Up to $1, 000 • Prescription Drugs Lifetime • Pre-existing conditions Member Responsibility
YOUR CUSTOM PLAN Lifetime Plus Select Silver Freedom Plan
FREEDOM PLAN B IN‐NETWORK PROVIDER (PPO) ONLY Preventive Care Covered 100% (Including Adult, Women, Child Preventative Services ‐Screenings & Services ) 24 Hour Virtual Clinic (On‐line & Telephonic Doctor Calls) Primary Care Office Visits (3 per year) Providers limited to Internal Medicine, Family Practice, Pediatrician, & OBGYN ‐ Office and Other Outpatient Services (CPT‐ 499201‐ 99215) Plan Annual Deductible Covered 100% No Copayment Unlimited $20 Copay Per Visit (3 Visits Per Year) (Additional visits apply to Deductible/ Co-Insurance) None Co‐insurance Percentage Covered (plan pays based on contracted amounts) 100% Preventative items (MEC) 50% Co‐ins on 1 st $10, 000 80% of Next $10, 000 Annual Maximum of Covered Services Individual / Family $20, 000/$40, 000
BENEFIT RECAP • $20 office Copay’s • No Deductible • Immediate 50% & 80% co insurance (freedom plans) • • Office visits Drugs Pre Ex Maternity • Up to $2, 000 in benefit (health share) • Family Rates around $1, 000 per month
BENEFITS TO THE EMPLOYER Here are just a few of the benefits you as an Employer will experience: • Unparalleled Savings to Bottom line providing flexibility to do more with budgets! • Low Participation Rates Requirements • No minimum contribution amounts. • A La Cart style approach, only pay for the benefits you want or need. • Strengthen employee retention & attract higher quality employees. • With Lower costs, employers & employees can now more easily cover their dependents. • Employee can keep their benefits after they leave, no high cobra cost or time restrictions. • Easy enrollment and on-going support • Partnering with a team of experienced professionals who have served members for over 20 years
HOW EMPLOYER PARTICIPATES • No Contribution Requirement • Identify how much you are willing to spend per Employee • Allow the Employee’s to go Shopping and pick out the benefits that make the most sense for them. • Freedom Plan requires 25% participation • 2 household Minimum
NEXT TO MEMBERSHIP
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