April 1, 2011
TO:
HII AGT NO.:
FM: Alfred G. Dietrich
Attention: All Agents Selling Med Plus STM and Health Essential Plan
This email news letter contains important information regarding the Med Plus STM and Health Essential Plans.MED PLUS STM
Med Plus STM new business applications submitted beginning on April 1, 2011 have a 5% trend rate increase. The new rates are in effect from April 1, 2011 through September 30, 2011.
There
are 5 states (LA, MT, ND, NV, WA &
WV) that were not applying the September 1,
2010 rates. Beginning April 1, 2011, these states will be on
the September 1, 2010 rates with the April 1, 2011 trend
increase.
The new rates do not affect any applications submitted prior to April 1, 2011.
HEALTH ESSENTIAL PLAN
Health Essential Plan members that have a Doctor Office Visit Co-Pay benefit are changing effective May 1, 2011As a result of the Health Care Reform Bill of 2010, Limited Medical Indemnity plans had to adjust the Co-pay benefit to an Indemnity amount. In many cases these changes have a favorable result. CBPI, the claims TPA, has indicated they will offer payment direct to the doctor for the amount charged, and if less than the benefit, will pay the balance to the insured. Using a Beechstreet Network Provider will ensure more benefits to the customer.
Beginning on April 6th Health Essential Plans will be updated to reflect the Doctors Office Visit higher indemnity benefit. Any new members until them will be made aware of the changes.
Please see grid below:
| HEALTH ESSENTIAL | CO-PAY BENEFIT | INDEMNITY BENEFIT 5/1/2011 |
| Basic500 | ||
| DOCTORS OFFICE VISIT COPAY | $30 | $95 |
| Plus750 & Choice1000 | ||
| DOCTORS OFFICE VISIT COPAY | $30 | $95 |
| WELLNESS - DOCTORS OFFICE | $30 | $95 |
| Max500 | ||
| DOCTORS OFFICE VISIT COPAY | $20 | $105 |
| WELLNESS - DOCTORS OFFICE | $20 | $105 |
Please feel free to call us or email us regarding any questions on these changes.
Included below, is a sample of the letter being mailed next week to all insured that have a Health Essential Plan with a Doctors Office Visit Co-pay benefit:
|
Dear _______: This letter is to inform you about benefit changes on your Health Essential Limited Medical Indemnity Plan effective May 1, 2011. These changes are required to comply with the Health Care Reform Bill of 2010. Please see below chart listing the benefit and
changes:
Service
Current
Benefit
Effective May 1,
2011
Doctor Office
Visit $30
Co-pay
$95 Indemnity Benefit
Wellness
Visit $30
Co-pay 95
Indemnity Benefit
The benefit change from Co-Pay to an Indemnity can
have a favorable impact. With an Indemnity Benefit, the full benefit is
always paid, regardless of what the doctor charges. Please
see the claims example below which demonstrates how this new benefit
would be applied to an expense:
On April 15, 2011
Mr. Brown visited his doctor for a sinus infection. He is charged
$75.00 for the visit and he paid the $30 Co-pay to his
doctor. The balance will be paid to his doctor by the
insurance company.
On May 20, 2011 Mr.
Brown visits the same doctor to follow-up on his sinus
infection. He’s charged $75 for the
visit. The new indemnity benefit is $95. His doctor
will be paid $75 and Mr. Brown will be paid $20, the balance of the
Indemnity Benefit.
Your Certificate Amendment is enclosed. It
should be kept with your other important insurance
documents.
Our Customer Service Department is prepared to answer
any questions or concerns you may have regarding this new benefit.
Please feel free call 1-877-376-5831 between the hours
of 8:30 AM to 5:30 PM, Monday through Thursday or 8:30 t0 5:00 Eastern
Standard Time.
Thank you for your continued loyalty to the Med Sense
Guaranteed Association.
Sincerely Yours, Health Insurance Innovations, LLC
|
If you have questions regarding these actions, please call us at 888-402-7204 Ext. 1.
Call
us
today for information
F: 913-945-4393
E: sales@allied-brokerage.com