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 0125
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 PLAN 3 PLAN 4
PLAN 5
Inpatient Hospital Confinement (31 day maximum per confinement)
$500
$1,000
$1,500
$2,000
$2,000
12-23 Hours: 25% Inpatient 24-47 Hours: 50% Inpatient 48 Hours: 75% Inpatient
Observation Unit
ICU Confinement (31 day maximum per confinement)
$1,000/day
$2,250/day
$3,000/day
$4,000/day
$3,000/day
Hospital Benefits
$1,000,000 Calendar Year Limit
First Day Hospitalization Benefit (For the first Inpatient Day per calendar year) Emergency Room (Max 1 day per calendar year)
$500
$1,000
$1,500
$2,000
$2,000
$200
$300
$400
$500
$250
Urgent Care (Max 2 days per calendar year)
$200
$300
$400
$500
$250
1 Unit of Surgical Schedule
2 Units of Surgical Schedule
3 Units of Surgical Schedule
3 Units of Surgical Schedule
1 Unit of Surgical Schedule
Surgery Benefit
Ambulatory/Outpatient Facility Benefit
$1,000
$2,000
$3,000
$4,000
$1,000
Surgical Benefits
Maximum $50,000 benefit per calendar year
20% (1 unit) of the eligible surgical schedule
20% (2 unit) of the eligible surgical schedule
20% (3 unit) of the eligible surgical schedule
20% (3 unit) of the eligible surgical schedule
20% (1 unit) of the eligible surgical schedule 20% (1 unit) of the eligible surgical schedule
Assistant Surgeon Benefit
25% (1 unit) of the eligible surgical schedule
25% (2 unit) of the eligible surgical schedule
25% (3 unit) of the eligible surgical schedule
25% (3 unit) of the eligible surgical schedule
Anesthesiologist Benefit
Doctor's Visits (4 days maximum per calendar year for plans 1-4) Prescription Benefit (CY stands for Calendar year maximum)
$75
$125
$175
$225
N/A
$25 ; $250/CY $50 ; $500/CY $75 ; $750/CY $100; $1,000/CY
N/A
AFFORDABLE CHOICE PLAN COMPARISON CONTINUED Surgical and Hospitalization Benefits PLAN 1 PLAN 2 PLAN 3 PLAN 4 PLAN 5 Outpatient Medical Benefits
Wellness Benefit: (1 day per calendar year)
$100
N/A
Surgical Pathology: $200 Preventative Pap:$250 Preventative PSA: $250 All other Labs: $50
Surgical Pathology: $300 Preventative Pap:$300 Preventative PSA: $300 All other Labs: $50
Surgical Pathology: $400 Preventative Pap:$350 Preventative PSA: $350 All other Labs: $50
Surgical Pathology: $500 Preventative Pap:$400 Preventative PSA: $400 All other Labs: $50
Surgical Pathology: $250 Preventative Pap:$250 Preventative PSA: $250 All other Labs: $100
Laboratory Test (Per day)
Therapy Services: (Per day for physical, occupational, speech)
$50
$75
$100
$125
$100
MRI: $300 PET Scan: $300 CT Scan: $300 Mammogram: $250/ Other: $200
MRI: $600 PET Scan: $600 CT Scan: $600 Mammogram: $300 Other: $250
MRI: $900 PET Scan: $900 CT Scan: $900 Mammogram: $350 Other: $300
MRI: $1,000 PET Scan: $1,000 CT Scan: $1,000 Mammogram: $400 Other: $350
MRI: $300 PET Scan: $300 CT Scan: $300 Mammogram: $300 Other: $300
Radiology Services: (per day: MRI/PET scan/ CT scan/mammogram/ other radiology tests)
Calendar year limit for all Outpatient Benefits
$4,000
Ground and Air Ambulance (Limit of 2 trips per calendar year for all ambulance transportation.)
Ground: $500 Air: $1,500
N/A
Allergy Shots and Immunization (child only) (per day allergy shots/ immunizations)
Allergy Shots: $10 Immunizations: $25 Calendar year Maximum: $100
Health Care Practitioner Visit during Confinement
$50/day ; 1 day per year
$50/day ; 2 days per year
$50/day ; 3 days per year
$50/day ; 4 days per year
$50/day ; 4 days per year
Lifetime Maximum
$5,000,000
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/
* Prescription drug are not part of this policy. RXedo is a 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 (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/
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