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The
CelticSaver HSA health plan is a qualified high deductible
health plan designed to provide you with major medical coverage
including up to $5,000,000 of health insurance protection,
combined with a Health Savings Account (HSA) option to make
your health plan even more affordable.
Health
Savings Accounts (HSAs) are savings accounts that
are coupled to high-deductible health insurance policies.
You can deposit tax-deductible money into the HSA and use
it to pay health care expenses throughout the year that aren't
covered by your health insurance plan.
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Features/Benefits
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Specifics
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PPO**
or Managed Indemnity |
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Non-Preventive
office visits |
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Covered
after deductible subject to coinsurance. |
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Emergency
Room Deductible
(in addition to annual plan deductible)
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$250
per visit, (waived if admitted to hospital) |
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Covered
after deductible subject to coinsurance. |
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Eligible
expenses for medical services and supplies incurred
for preventive care in
an asymptomatic individual are covered up to $300
per person, per calendar year,
which includes up to $50 for routine eye exams. |
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Inpatient
annual maximum of $2,500 per person, per calendar
year. Outpatient
annual maximum of $1,000 per person, per calendar
year. Lifetime maximum of
$10,000 per person for inpatient and outpatient
combined. |
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$500
maximum per person, per calendar year. |
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Average
semi-private room rate. Intensive care at four times
the average semi-private room rate. |
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30
visits per person, per calendar year. |
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Inpatient
- up to 30 days confinement per person, per calendar
year. |
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Outpatient
- up to 30 visits per person, per calendar year. |
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Up
to 12 days of confinement per person, per calendar
year. |
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Covered
up to amount negotiated by network if Transplant
Network used; capped at $100,000 per procedure if
insured goes out of network. |
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$3,000
maximum per person, per calendar year, for emergency
air or ground
ambulance service. |
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*
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The
Primary Applicant cannot be claimed as a dependent on any
tax return. |
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If
PPO plan is chosen, out-of-network eligible charges reduced
additional 20%. |
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Benefit
will vary by state. |
This information
is presented only as a very brief overview of some of the benefits
of this plan, and is intended only for general education.
The amount of benefits provided depends on the plan selected.
Premium will vary with the type of benefits selected. These
plans contain exclusions from and limitations of coverage.
Please see the product brochure for more complete information,
as well as information about terms of renew ability, preexisting
conditions, out-of-network penalties, and notification requirements.
Plans are subject to health underwriting. To be considered
for reimbursement, expenses must qualify as covered expenses.
Expenses are also subject to reasonable and customary limits,
unless you use a network, and all other policy provisions, including
determinations of medical necessity.
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Coverage
Synopsis:
CelticSaver
HSA PPO Plan
After you
have met your deductible (one deductible for the entire family),
the plan pays 100% of all covered expenses, up to $5 million per
person. This plan also covers wellness services up to $300
per year, after the deductible is met, including $50 for routine
eye exams. Chiropractic care is also covered, after the
deductible has been satisfied, up to $500 per person, per calendar
year. Eligible expenses for medical services and supplies
incurred for preventive care in an asymptomatic individual are
covered up to $300 per insured person per calendar year.
CelticSaver
HSA Managed Indemnity Plan
This plan
offers you the same comprehensive coverage as above, with the
flexibility to select the doctors and hospitals of your choice.
This plan is more popular in very rural areas where there may
not be many doctors in the PPO network.
Full Credit
for Meeting Prior Deductibles: If you choose to replace
your current insurance coverage with the CelticSaver HSA health
plan, you'll receive credit for satisfying any portion of a previous
carrier's deductible met during the same calendar year.
This valuable benefit is very rare to find in today's health insurance
market.
The deductible
for each of these plans needs to be met only once for the entire
family. Both plans cover up to $500 per person in preventive
care after the deductible, including routine physicals.
Expenses for mammogram exams, prostate screenings, and
age-appropriate well-child visits and routine immunizations
(up to age 13) are not subject to the deductible.
These plans
both qualify as HSA-eligible. Combining a Health
Savings Account with any CelticSaver HSA plan allows you to make
tax-deductible contributions, pay medical expenses with pre-tax
dollars, and earn tax-deferred interest. This account works
much like an IRA, except you may use your tax-free savings for
qualified medical expenses your health plan does not cover, such
as your deductible, dental, eyewear, and most types of alternative
medicine (see the HSA qualified
medical expenses page). If you do not use these
funds, they are always yours and continue to grow tax-deferred.
Optional
Riders:
Supplemental
Accident Coverage
Many of our
customers add a supplemental accident plan to their coverage.
These plans cover a set amount ($2,000, $5000, or $10,000) for
any accident, after a $100 deductible. Having a supplemental
accident plan can greatly reduce the exposure of a high-deductible
plan. These plans are not associated with Celtic Insurance
Company, and must be purchased separately. Complete information
is available on our Accident Plans
page.
Rates:
All deductible
options have a 12 month rate guarantee.
Preferred
rates without riders are available on our instant
quote page. The quoted rates are for the $5 million maximum
benefit, and do not include any optional benefits. Rates depend
on gender, smoking status, zip code, and health status.
The premium
can be paid via monthly quarterly, semi-annual, or annual billing,
or a monthly bank draft. The bank draft will occur on the premium
due date each month. The initial premium can be paid with a check
or credit card. All monthly and quarterly billing includes an
$8 fee per billing cycle.
PPO
Network:
Celtic's
PHCS network includes more than 320,000 physicians and
ancillary care providers in 50 states and the District of Columbia,
serving 1.3 million PPO members. The nationwide Celtic PPO
network assures you access even when traveling or relocating to
another state.
Celtic also
partners with the largest network of pharmacies in the country
to give you prescription drugs at the lowest pre-negotiated rates.
Show your Celtic ID card at any of the 50,000 participating pharmacies
nationwide and receive substantial savings on your prescription
drug purchases.
Underwriting:
Underwriting
of your application with Celtic normally takes two to four weeks,
though again if medical records are ordered it could take longer.
Celtic is fairly lenient compared to many other insurance companies,
and often accepts applicants who may have been turned down by
other insurance companies.
It is standard
practice to request a Blood Pressure Inquiry on all applicants
who are currently being treated for or who have recently discontinued
treatment for high blood pressure. Certain conditions may
be waived with a temporary rider (usually for one to two years),
or an indefinite rider.
Effective
dates:
The earliest
your coverage can go into effect is the day after you have signed
your application. You may request an effective date any
time between 1 and 60 days after you sign your application.
Please note,
if you are requesting an effective date of less than 21 days from
the time you complete the application, you may not receive notification
of your approval until after your effective date. If you
have claims during this period, they will be eligible for coverage
if submitted after you have been approved. Also note that
you will be billed starting on your requested effective date,
even if you have not yet been notified that you have been approved.
This is very good for someone who does not have any present coverage
and would like for their benefits to begin right away. For
those who are already covered, it is suggested that you maintain
your current coverage in force until you have received notice
from either ColoHealth
or directly from Celtic that your coverage has been approved
and is in force.
Because underwriting
can sometimes take 3 weeks or longer, if you do not currently
have coverage we recommend that you apply for a Short
Term plan. This plan can go into effect tomorrow,
giving you important protection until your new permanent plan
is in place.
About
Celtic:
Celtic
Insurance Company is headquartered in Chicago, IL.
Celtic began operating in 1978 as a broker, insurance and reinsurance
company for group life and health coverage. Today, the company
has narrowed its focus and holds a strong commitment to the individual
health marketplace.
Celtic
has been assigned an "A-" (Excellent)
rating from A.M. Best, an independent rating organization.
A.M. Best assigned this rating after a thorough quantitative and
qualitative evaluation of a company's financial condition and
operating performance. For more than 10 years, Celtic has
earned a rating of "Excellent" for consistently demonstrating
profitable operating results, high-quality investment portfolio
and favorable capital position. Celtic holds no junk bonds,
real estate or direct mortgage loans and maintains no outstanding
debt.
ColoHealth
is an independent authorized Celtic agent in Colorado.
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