Cancer – KBS (Kansas Board Solutions)
IMPORTANT INFORMATION
Available on groups with 25+ eligible lives.
• •
Valid in KS.
• Not available for all industries. Please see limitations & exclusions section. • Rates shown are valid thru January 1, 2027. • SBA Code 0012 (Internal Use Only).
MONTHLY RATES
Value Plan
Advantage Plan
Premier Plan
Employee
$21.00
$35.00
$41.00
Employee & Spouse
$44.00
$56.00
$65.00
Employee & Child
$22.00
$36.00
$42.00
Family
$45.00
$57.00
$66.00
Rate Guarantee Contributory Status Minimum Participation Portability Issue Underwriting Child(ren) Age Limits
2 Years Voluntary 5 enrolled employees
Included without evidence Annual Open Enrollment Birth to 26 yrs (26 if full-time), subject to state limitations
Rate Basis
Premiums listed are for Issue Age and will not increase due to an insured’s age.
BENEFITS
Value Plan
Advantage Plan
Premier Plan
12 month look back period; 12 month exclusion period, Continuity of Coverage
Pre-existing condition limitation
Employee: $1,500 Spouse: $1,500 Child: $1,500
Employee: $1,500 Spouse: $1,500 Child: $1,500
Employee: $1,500 Spouse: $1,500 Child: $1,500
Initial Diagnosis Benefit Amount
30 days
30 days
30 days
Initial Diagnosis Waiting Period
$50; $50 follow-up screening
$75; $75 follow-up screening
$100; $100 follow-up screening
Cancer Screening
$250/trip, limit 2 trips per hospital confinement
$1,500/trip, limit 2 trips per hospital confinement
$2,000/trip, limit 2 trips per hospital confinement
Air Ambulance
No Benefit
No Benefit
$50/visit up to 20 visits
Alternative Care
$200/trip, limit 2 trips per hospital confinement 25% of surgery benefit
$200/trip, limit 2 trips per hospital confinement 25% of surgery benefit
$250/trip, limit 2 trips per hospital confinement 25% of surgery benefit
Ambulance
Anesthesia Anti-Nausea
No Benefit
$50/day up to $150 per month $25/day while hospital confined. Limit 75 visits Actual Costs up to $20,000 per 12 month period Bone Marrow: $7,500 Stem Cell: $1,500 50% benefit for 2 nd transplant $1,000 benefit if a donor $100/day up to $1,000/month $100/day up to 90 days per year $300/day in lieu of all other benefits
$50/day up to $250 per month $25/day while hospital confined. Limit 75 visits Actual Costs up to $25,000 per 12 month period Bone Marrow: $10,000 Stem Cell: $2,500 50% benefit for 2 nd transplant $1,500 benefit if a donor $200/day up to $2,400/month $150/day up to 90 days per year $400/day in lieu of all other benefits
$25/day while hospital confined. Limit 75 visits Actual Costs up to $15,000 per 12 month period
Attending Physician
Blood/Plasma/Platelets
No Benefit
Bone Marrow/Stem Cell Experimental Treatment
No Benefit
Extended Care Facility/Skilled Nursing Care
$100/day up to 90 days per year
Government or Charity Hospital
No Benefit
No Benefit
$50/visit up to 30 visits per year $100/visit up to 30 visits per year
Home Health Care
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