Advantage Series Group Affordable Choice An Alternative Solution for the Modern Employer
This is a Hospital Confinement and other Fixed Indemnity Insurance Policy Underwritten by ManhattanLife Insurance and Annuity Company and Family Life Insurance Company
GAFC7010-BR 0924
Group Affordable Choice Designed with your employees in mind
More than ever, supplemental healthcare options are essential, whether you are an employer looking to offer them or an employee seeking to obtain them. Providing supplemental healthcare options says a lot about the employer’s sincere commitment to staff, as it empowers employees to proactively prepare for any unforeseen challenges that may arise. That is why ManhattanLife has developed a Supplemental Hospital Indemnity plan, with the goals to further prioritize the employee’s health, strengthen the connection between the employers and staff, and help enrich the work experience.
KEY ANCILLARY SERVICES • CareGuide - Helps with healthcare coordination • RxEDO – Rx discounts up to 80%. KEY BENEFITS • No Deductibles or Coinsurance • Hospital Admission Benefit • Robust Hospital Confinement • Doctor Office Visits
• Green Imaging - Discounted imaging services. • DirectLabs – Discounted laboratory testing.
• Prescription Benefit • Emergency Room and Urgent Care
• Outpatient Benefit • Surgical Benefits
THE PERFECT COMPLEMENT TO ANY BENEFIT PACKAGE Even with comprehensive health insurance, employees can still be exposed to out-of-pocket costs left behind by deductibles and coinsurance. Group Affordable Choice gives your employees greater peace of mind in the event of a hospital stay. Consider this:
57% of Americans can't afford a $1,000 emergency expense. 2
The average cost of a 3-day hospital stay is $30,000. 1
1-2 Source information on back.
Why Affordable Choice?
THERE ARE SEVERAL STATISTICS THAT SUPPORT EMPLOYERS OFFERING HEALTH CARE OPTIONS:
The average premium for employer-sponsored health care jumped nearly 7% for both individual and family coverage in 2023, according to a study by KFF, a non-profit health policy research firm. 4
According to a MetLife study, 60% of employers found that health benefits helped their staff become more productive. Healthy people are able to accomplish much more in their time at work, and are less prone to burnout in the workplace. 5
Productivity
Prescription drug spending increased 7.8% to 378 billion in 2021, faster than the 3.7% growth in 2020. 6
On average, a single person pays about $477 a month for a plan on the health insurance marketplace, before any subsidies. Besides monthly premiums, health insurance expenses include copayments, coinsurance, and spending to meet your deductible. 7
24% of adults are past due or unable to pay Medical or dental bills. 8
4-8 Source information on back.
AFFORDABLE CHOICE PLAN COMPARISON Surgical and Hospitalization Benefits PLAN 1 PLAN 2
Inpatient Hospital Confinement (Per Inpatient Day)
$500
$1,000
12-23 Hours: 25% Inpatient ($125 - $250) 24-47 Hours: 50% Inpatient ($250 - $500) 48 Hours: 75% Inpatient ($375 - $750)
Observation Unit
Hospital Admission Benefits (For the first Inpatient Day per calendar year)
$500
$1,000
Emergency Room (Per day; 1/CY)
$200
$300
Urgent Care (Per day; 2/CY)
$200
$300
Surgery Benefit (Maximum $50,000 benefit per calendar year)
1 X Medicare Fee Schedule
2 X Medicare Fee Schedule
Ambulatory Surgical Benefit
$1,000
$2,000
Daily Assistant Surgeon Benefit
Pays 20% of the eligible surgical benefit
Daily Anesthesiologist Benefit
Pays 25% of the eligible surgical benefit
Doctor's Visits
$75 per day ; 4/CY
$125 per day ; 4/CY
Prescription Benefit (Per Day)
$25 ; $250/CY
$50 ; $500/CY
Outpatient Medical Benefits
Wellness Benefit: (1/CY, 30 day waiting period)
$100
Preventative Services: (Per service)
$250 $250
$300 $300
Pap PSA
Laboratory Services: (Per day)
$200 $50
$300 $50
Surgical Pathology Other Laboratory Services
Therapy Services: (Per day for physical, occupational, speech) Radiology Services: (per day: MRI/PET scan/ CT scan/mammogram/other radiology tests)
$50
$75
$300/$300/ $300/$250/$200
$600/$600/ $600/$300/$250
Calendar year limit for all Outpatient Benefits
$4,000
AFFORDABLE CHOICE PLAN COMPARISON CONTINUED Surgical and Hospitalization Benefits PLAN 1 PLAN 2
Ground and Air Ambulance Limit of 2 daily benefits per calendar year for all ambulance transportation (per day) Allergy Shots and Immunization (child only) (per day allergy shots/immunizations)
Ground: $500 Air: $1,500
$10 per day
$25 per day
$1,000/day 31 days/Confinement
$2,250/day 31 days/Confinement
ICU Confinement
Health Care Practitioner Visit during Confinement
$50/day ; 1 day per year
$50/day ; 2 day per year
Hospital Benefits
$1,000,000 Calendar Year Limit
Allergy Shots and Immunization
$100 Calendar Year Maximum
Lifetime Maximum
$5,000,000
The plans shown above are limited benefit fixed-indemnity plans and benefits are per Covered Person. This is not a major medical insurance plan. Fixed-indemnity benefits are provided for hospital confinement and specified medical and surgical events. These benefits are paid in daily amounts for covered events without regard to the costs of services rendered. This plan does not provide expense reimbursement for charges based on your health care provider’s statement.
Low Cost Ancillary Services
n Assistance with 2nd opinions n Medical Bill Saver & RX Shopper n CareGuide offers you expert
assistance with a wide range of healthcare and insurance related issues.
Phone: 888-221-1140 Web: www.cgasaves.com Email: services@cgasaves.com
Prescription Benefit Partner* www.rxedo.com
n Discounts to 80% n Accepted at over 67,000 pharmacies nationwide n Discounts on over 10,000 medications n Completely free to use
Phone: 888-879-7336
Drug Pricing Tool: www.findlowrx.com Web: https://www.rxedo.com/
n Wellness Profile n Cardio Plus n Lipid Profile n CMP-14 n PSA n Vitamin D
DirectLabs is a leader in direct access laboratory testing. They offer a wide variety of blood chemistry tests directly to you at discounted rates.
Phone: 1-800-908-0000
Email: contact@directlabs.com
Web: https://www.directlabs.com/
Client Code: R-MLAC (code for all phone orders)
Services Include:
ManhattanLife has partnered with Green Imaging to provide diagnostic imaging services to you at a significantly discounted rate. Text: 713-524-9190
n MRI n Ultrasound n Mammography n Nuclear Medicine
n DXA n PET/CT n X-Ray n CT n Other
Phone: 1-844-968-4647 Email: info@greenimaging.net
Web: https://greenimaging.net/
*Network and prescription drug are not part of this policy. First Health Network and RXedo are value added healthcare programs from other providers designed to enhance your healthcare experience without additional cost to you.
Underwritten by: ManhattanLife Insurance and Annuity Company and Family Life Insurance Company Administrative Office: 10777 Northwest Freeway, Houston, TX 77092 Toll Free Telephone: 800-669-9030
Benefits and riders may vary by state and may not be available in all states. This is not a complete disclosure of plan qualifications and limitations. Please access our website to obtain a completed list for the Affordable Choice 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 Form Numbers AN7002SS, AN7002-OK, AN7002-TX, AN7002 (including state variations)
This product does not constitute comprehensive health insurance coverage (often referred to as, “major medical coverage”). Therefore, this product does not satisfy the requirement of Minimum Essential Coverage under the Federal Patient Protection and Affordable Care Act. For additional information, you can contact us, refer the official federal website at www.healthcare.gov, or call their toll-free number at 800-318-2596.
SOURCE INFORMATION 1 https://www.peoplekeep.com/blog/why-do-employers-offer-health-insurance#:~:text=Caring%20about%20your%20 employees'%20overall,their%20health%20is%20a%20priority 2 https://www.healthcare.gov/why-coverage-is-important/protection-from-high-medical-costs/ 3 https://fortune.com/recommends/banking/57-percent-of-americans-cant-afford-a-1000-emergency-expense/ 4 https://www.investopedia.com/health-care-premiums-jump-in-2023-after-modest-rise-last-year-8363873 5 https://www.pacificprime.com/blog/employee-medical-insurance-why.html 6 https://www.cms.gov/data-research/statistics-trends-andreports/national-health-expenditure-data/nhe-fact-sheet 7 https://www.usatoday.com/money/blueprint/health-insurance/how-much-is-health-insurance/ 8 https://www.kff.org/report-section/kff-health-care-debt-survey-main-findings/
Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8Made with FlippingBook - PDF hosting