Prestige Series Group Single Bucket GAP Insurance Providing supplemental medical benefits for you and your family.
Underwritten by ManhattanLife Insurance and Annuity Company Prestige is a suite of products brought to you by ManhattanLife.
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Not available in all states.
Prestige Group Single Bucket GAP Insurance Providing supplemental medical benefits for you and your family.
Supplemental Medical Coverage for your family in a Group Single Bucket GAP plan.
Did you know that the average single and family deductibles for high deductible health plans have trended upward over the last seven years? In fact, the average family deductible has risen by over 35% since 2013!* Individuals and families need more coverage to supplement their medical plans. ManhattanLife can help.
Average Deductible for High Deductible Health Plans
$3,800 $3,500 $3,000 $2,500 $2,000 $1,500 $1,000 $500 $0
2015
2016
2017
2018
2019
2020
2013 2014
Single Deductible Family Deductible
*The Kaiser Foundation and Health Research & Educational Trust. Employer Benefits 2017 Annual Survey.
MANHATTANLIFE GROUP GAP COVERAGE TO HELP SUPPLEMENT OUT OF POCKET MEDICAL COSTS. We designed our GAP program to be fully customizable to work seamlessly with an employer medical plan. Coverage selection is simple. Employers work with one of our sales experts – we customize benefits that complement and help fill the gaps in the employer’s major medical plan. Our GAP plan is easy to understand and provides the much- needed coverage to help fill the holes left behind, particularly by HDHP’s. A single bucket plan allows the employee to utilize their benefit for both Inpatient/Outpatient benefits, without a maximum amount for each, other than the total amount selected. In other words, 100% of the benefit amount could be used for outpatient benefits.
*Please note - this plan is not HSA compatible.
Our plan provides the following included benefits.
INPATIENT/OUTPATIENT HOSPITAL INDEMNITY BENEFITS
Benefits are determined by the employer based on the employer’s major medical plan. Available coverage amounts for the employer to select from are: $250, $500, $750, $1,000, $1,250, $1,500, $1,750, $2,000, $2,250, $2,500, $2,750, $3,000, $3,250, $3,500, $3,750, $4,000, $4,250, $4,500, $4,750, $5,000, $5,250, $5,500, $5,750,$6,000, $6,250, $6,500, $7,000, $7,500, $8,000, $8,500, $9,000, $9,500, $10,000, $10,500, $11,000, $11,500, $12,000, $12,500, $13,000, $13,500, $14,000, $14,500, $15,000. We will pay benefits for Covered Charges if a Covered Person: • incurs the Covered Charges while the Covered Person is an Inpatient or outpatient due to an Injury or Sickness; and • the expenses are covered by the Covered Person’s Medical Plan
Pays a benefit for covered charges if a covered person incurs the Covered Charges while the Covered Person is an Inpatient for Injury or Sickness or for Outpatient Treatment due to an Injury or Sickness; and the expenses are covered by the Covered Person’s Medical Plan. This benefit does not include: expenses incurred for an examination of a Covered Person by a Doctor in a Doctor’s Office; expenses incurred for Outpatient Prescription Drugs; or transportation of a Covered Person via air or ground Ambulance. Deductible for inpatient/outpatient is available. Deductible is not available for all amounts, so check with your sales representative if choosing this benefit.
Benefit bucket may be used for Inpatient, Outpatient, or a combination of both.
OUTPATIENT PRESCRIPTIONS DRUGS
Plan Year Maximum Per Covered Person: $100 - $500 in $100 Increments
AMBULANCE BENEFITS
Ground Ambulance Benefit: $150 - $1,000 per day, $150 Increments to $900 and $1,000 Air Ambulance Benefit: 2X the benefit chosen for ground ambulance Plan Year Maximum: 4 transports
DOCTOR’S OFFICE VISIT
Doctor’s Office Visit Benefit: $25-$100 per visit, $25 increments Plan Year Maximum: 4 visits
Underwritten by: ManhattanLife Insurance and Annuity Company Administrative Office: 10777 Northwest Freeway, Houston, TX 77092 Toll Free Telephone: 800-669-9030
Benefit: $7,500 IPH/OPH Member has a major medical plan with a $7,500 annual deductible and 20% coinsurance along with a Gap Plan. Sarah, had severe abdominal pain and was taken to the Emergency Room for treatment. Sarah was diagnosed with appendicitis, had an emergency appendectomy, and spent one night in the hospital. The major medical carrier processed the medical claim and sent Sarah an Explanation of Benefits (EOB) showing that, after network discounts, $3,882 was applied to her annual deductible. Sarah submitted the UB04 along with the EOB, to ManhattanLife and received a check/direct deposit in the amount of $3,882. Sarah has a remaining GAP benefit of $3,618.
Total Charges from the Hospital
$6,324
--
Contracted Discount
$2,422
--
ManhattanLife GAP Plan Benefit
$3,882
$0
Sarah’s Out of Pocket Cost
This example is for illustrative purposes only and not based on specific plans.
According to research published by the Kaiser Family Foundation in 2019, the average cost of employer-sponsored health insurance for annual premiums was $7,188 for single coverage and $20,576 for family coverage. The report also found that the average annual deductible amount for single coverage was $1,655 for covered workers. Source: eHealth; Average Cost of Employer-Sponsored Health Insurance (ehealthinsurance.com)
Act now and take advantage of a Group Single Bucket Gap Plan.
Do your employees and bottom line a favor. Call your ManhattanLife representative now and receive all of the facts about our Voluntary Benefits Group Single Bucket GAP product!
This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Supplemental Medical Expense (GAP) product at disclosure.manhattanlife.com . Please review this information before applying for coverage. The amounts of benefits provided depend on the plan selected. Premiums will vary according to the selection made. THIS POLICY PROVIDES LIMITED BENEFITS. Policy: M-8038
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