Health Insurance:
We provide Health coverage through Humana and Dental through Guardian.
Health Plan:
Humana PPO
(POS Group)
Co-Insurance 80% in network / 50% out of network
Deductable $1500.00 ($5,000 through Humana / $3500 through Stuart-Rodgers
direct reimbursement)
Out of
Pocket Max $3,000 ($7,000 through Humana, remaining through Stuart-Rodgers
direct reimbursement)
RX Copay See plan doc below
ER Copay See plan doc below
Humana Plan Details
Document
Direct Reimbursement
Program:
In order to
make the premiums affordable to you and Stuart-Rodgers, we provide a self
insurance program. This program is offered to full time staff only. That means that you are enrolled in a high deductable
policy through Humana ($5,000 deductable / $7,000 max out of pocket) and
Stuart-Rodgers pays the difference between the Humana deductable and $1500.00.
So, as example:
You have
a hospital stay that invoices you $6000.00
You
submit the claim to Humana
Human
pays $1000.00 and send you a Benefit Statement
You
submit the Benefit Statement to Stuart-Rodgers with the
attached form (Gayle)
On
approval of the Humana Benefit statement Stuart-Rodgers will pay you
$3500.00 (tax exempt)
Your net
result is:
6000.00 claim
800.00 (Humana)
3700.00 (Stuart-Rodgers)
---------
1500.00 - Paid by you
Humana
1-800-448-6262
Our
Group Number is - 557573
They
do not use claim forms as all invoicing is handled directly through your doctor
with your insurance card. There are doctor locator services, forms etc.
available on their website at:
www.humana.com
Dental
Deductable $50.00 in network / $100.00 out of
network
100 / 80 / 50
Max Annual 1000.00 benefit
Guardian
Guardian Online
Our Insurance Broker:
Marianne Mascio
Account Executive
VistaNational Insurance Group, Inc.
1415 W. 22nd Street, Suite 1000
Oak Brook, IL 60523
(800) 944-3645 - toll free
(630-468-6536) - direct
(630) 468-6509 - direct
(630) 468-6600 - fax
masciom@vistanational.com