What is the Premium Saver?
The Premium Saver is an employer sponsored group supplemental insurance plan which is designed to help reduce the cost of group medical coverage. Combining the Premium Saver with certain major medical plans can deliver coverage groups want and can afford.
How does the Premium Saver pay claims? It's simple!
The Premium Saver pays off of the underlying major medical plan EOB, and it pays benefits directly to the provider. When the insured goes in-network they always receive the carrier's in-network discounts.
What coverage does the Premium Saver provide?
Supplemental Deductible and Co-Insurance
Premium Saver plans have a supplemental deductible and co-insurance per insured person that must be satisfied before benefits are paid. After the insured's deductible has been satisfied the plan pays the benefits described in the policy until the payments reach the Maximum Benefit Amount.
Benefits for Hospital and Outpatient Expenses
Our most frequently selected Premium Saver plan pays the amount applied to your major medical deductible, co-insurance, and co-payments. It covers the same expenses as your major medical plan, with the exception of charges for professional fees in a doctor's office or medical clinic or for outpatient prescription drugs.
What Premium Saver plan designs are available?
Each group can choose the plan design and benefit amount to achieve the maximum overall premium savings for their group. The Premium Saver is extremely flexible.
Maximum Benefit Amount Options are any amount from $1,000 to $9,500 per person per calendar year
Deductible Options are from $250 to $3,000 (higher deductible available upon request)
Co-Insurance Options are 0%, 90/10%, 80/20%, 70/30%, 75/25%, 50/50% from $0 to $10,000 Out-of-Pocket
Are there any participation requirements or waiting periods?
Everyone (employees and dependents) enrolled on the group's major medical plan must be enrolled with the Premium Saver plan. On the Premium Saver effective date, everyone covered by the group's major medical plan will be covered by the Premium Saver plan.
What are the underwriting guidelines?
There are no excluded groups. The minimum group size is 5.
An Example of How The Premium Saver Works
In the EXAMPLE below the group received a 23% rate increase on their major medical rate plan. If the group accepted the renewal, the cost for medical coverage would increase by over $50,000 per year. The group could not afford the renewal rates, so they started looking for alternatives. The current carrier gave a 29% rate decrease if the group changed from a $500 deductible to a $5,000 deductible plan. Combining the Premium Saver with a $5,000 deductible major medical plan delivered the coverage the group wanted, and it saved the group $25,617 per year.