Limited Benefit Health Insurance Plans Limited Benefit Health Insurance Plans For Individuals and Families Exclusively for Members of the National Congress of Employers
LIMITED MEDICAL INDEMNITY PLANS Benefit Benefits are based on an annual period Description 300 500 750 1000 1000 Plus from effective date. There is a 30 day (Per waiting period for all sickness benefits. Insured) Per Visit $50 $50 $50 $75 $100 Doctor's Office Visit (Primary Care or Specialist): The carrier will pay the benefit shown if you incur charges for and require a doctor's Maximum 5 5 5 5 5 office visit due to injuries received in an accident Visits or due to an illness. Emergency Room: The carrier will pay the Per Visit $50 $50 $75 $100 $200 benefit shown when an emergency room visit is made due to an accident or illness. Maximum 1 1 1 1 1 Visits Hospital Admission : The carrier will pay the Per Admission N/A N/A N/A N/A $1,000 benefit shown when admitted to a hospital due to accident or sickness. Per Day $300 $500 $750 $1,000 $1,000 Hospital Confinement: The carrier will pay the benefit shown if you incur charges for and are confined in a hospital due to Maximum 30 30 30 30 30 accident or sickness. Days ICU/CCU: The benefit will only be payable if the Per Day N/A N/A N/A N/A $1,000 Hospital Confinement Benefit is also payable. Hospital Confinement Benefit is also payable. Benefit will be payable in addition to the Hospital Maximum 15 Confinement Benefit. Days RBRVS* 50% 70% 80% 100% 100% Surgery and Anesthesia (Inpatient and Outpatient): Percentage The carrier will pay the benefit shown if you undergo a surgical procedure due to an accident 3 Maximum or illness. *Reimbursements are based on the Surgeries per 2010 Medicare/RBRVS benefit schedule. Annual Period 20% 20% 20% 20% 25% No coinsurance is applicable. The indemnity Anesthesia benefit is paid according to the percentage of Percentage of RBRVS included in the plan selected. amount paid to Surgeon Wellness and Preventive Care: Coverage for Per Visit $100 $100 $100 $100 $200 routine examination or well child care. Covered services include: medical history, immunizations, Maximum Visit 1 1 1 1 1 physical examination, X-rays and laboratory tests including a Pap test, colorectal screening, prostate cancer screening, mammography and bone density screening. Diagnostic, X-Ray and Laboratory Tests: The Per Visit N/A $50 $50 $75 $200 carrier will pay the benefit shown if you incur charges for Outpatient diagnostic, x-ray, and/or Maximum 2 2 3 3 laboratory testing caused by an accident or Visits illness. Accidental Death Benefit: Covered Spouse – Maximum $10,000 $10,000 $10,000 $10,000 $10,000 50% of Benefit - Covered Child(ren) – 25% of Benefit Benefit
NCE Membership Benefits Consumer Discount Benefits Category Products/Services Typical Savings 5 - 50%, Optometry, laser vision correction, mail-order Vision Care Annual exams for $40 max products Laser vision correction: 5-15% Laser vision correction: 5-15% General and cosmetic dentistry, orthodontics, Dental care 10-35% specialty care Chiropractic, acupuncture, massage therapy, Alternative Care 20% naturopathy Weight management, smoking cessation, fitness Wellness 10-50% equipment Nursing and assisted living facilities, home Long-term Care health care, hospice/respite, homemaker and 5-30% Services personal care Lower of 30% off MSRP or $300 off Hearing Hearing aids total retail price Infertility Reproductive endocrinology, IVF 5-20% Treatment
Monthly Membership (Does Not Include One-Time NCE Non-Refundable Enrollment Fee: $135) 300 500 750 1000 1000 Plus Individual $199 $266 $305 $409 $658 $341 $341 $475 $475 $553 $553 $761 $761 $1,259 $1,259 Individual Plus Spouse Individual Plus Spouse Individual Plus One Child $309 $430 $500 $687 $1,136 $433 $614 $720 $1,000 $1,672 Family (unlimited family members)
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