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
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
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