Traditional and Innovative Health Insurance Plans
Our employees are critical to our success and we want to offer health benefits that cover all aspects of the needed medical events that you or your family members are experiencing. Our offering this year does just that but, unlike previous years, we now have tools that will help to ensure you are getting the care you need at the doctors you choose at rates that make sense.
Insurance doesn’t have to be complicated, it can be as simple as buckets! Dollars go into bucket each month and, when medical events happen, dollars leave those buckets. The better we can do at not allowing health insurance to overcharge for our medical needs, the more dollars that stay in the buckets and rates from year to year won’t dramatically increase. This means, as we work together, more dollars can stay with you, our valued employees via lower premiums or more HSA dollars! We have two bucket options:
As we all work together and use the tools provided with our new health plans, we can:
1. Use our Same Preferred Doctors & Facilities (Open Access Plans)
2. Save Significant Dollars with HCap Mack and Care Coordination
3. Keep Dollars in and Grow our Health Savings Accounts
4. Keep Lower Premium Rates from Year to Year
There is a smarter way to get health care than arriving at the doctor or hospital, showing your card, and allowing them to bill you at unknown rates. Care Coordination is a better way and ensures that you get the right care at the right time, from the provider or facility you want to use, all while reducing financial stress and improving outcomes. It is as simple as making a phone call and using this included service to help you coordinate your care.
Plus, when you use Care Coordination, you are guaranteed not to have a balance bill!
Planstin Preventive MEC Plan Pairing with Zion HealthShare means no deductible to meet, rather for any qualifying expense (see Zion HealthShare member guidelines), you pay the first $1,250 (known as your Initial Unshareable Amount or IUA) of qualifying medical events and the HealthShare pays the rest. After you pay 3 IUAs, in a 12 month period, any other major event over $500 is paid by Zion HealthShare w/o requiring another $1,250 IUA. More money can go into your Health Savings Account if the HSA Plan is selected or choose the Copay plan if you prefer a copay instead of receiving HSA dollars. All Preventive care 100% covered. Rx Discounts.
See Member Guidelines and talk to an HCap Insurance Agent to learn how Pre-Membership Conditions are handled on this plan.
With these plans you present yourself as a “Self-Pay” Patient for anything that is not preventive coverage and pay at time of service or when billed. Your responsibility is for first $1,250 IUA using your HSA (if applicable). You have responsibility to learn the Zion HealthShare Member Guidelines. Your employer will also contribute to your Health Savings Account Plan.
Note: High blood pressure, high cholesterol, and diabetes (types 1 & 2) are not considered pre-membership medical conditions as long as 1. no hospitalization for the condition in 12 months prior to joining and 2. the member is able to control the condition through medication or diet.
Similar to other all insurance offerings that tend to have a higher premium, a fairly high deductible (depending on monthly premium), potential for either an HSA or a Copay Plan and no need to ever present yourself as a self-pay patient. Rx Coverage. All preventive is 100% covered. No network restrictions.
Generally the more expensive option but may be the best option if dealing with a pre-existing condition or have had an event in the last 24 months that will only be covered according to the Zion HealthShare Pre-Membership Medical Condition Phase-In Period. Also a great option for those that just want traditional health insurance.
Employee Only – $29/mo
Employee + Spouse or Children – $57/mo
Employee + Family – $83/mo
Employee Only – $42/mo
Employee + Spouse or Children – $75/mo
Employee + Family – $101/mo
Member Services 888-920-7526 or
member@planstin.com
Claims Fax 435-631-9478 or
claims@planstin.com
Questions? 435-239-3154 or
support@hcapstrategy.com
Your plan may include a Health Savings Account. Contributions can be made to this account per the chart below. Some contributions may be included in your health plan. Some contributions may be included due to your healthy behaviors through Doable Wellness. You can take full advantage of your HSA by adding additional contributions per the limits below. All HSA Contributions are tax free and can be used for any qualified medical expenses (click below).
Health Equity Bank Contact Info
Member Services 1-866-346-5800 or www.healthequity.com
