CoreMed
Plan at a Glance:
|
Features
|
In-Network
|
Out-of-Network
|
| Lifetime
Maximum Benefit |
- $2
million or $6 million |
- $2
million or $6 million |
| |
Plan
Deductibles
This is the amount you pay each calendar
year before benefits are paid. |
|
|
Individual:
$0
Family: $0
|
Individual:
$500, $1,000, $1,500, $2,000,
$3,500, $5,000, $10,000
Family (per family): Two times the individual
deductible and is met collectively with 2 or more family
members
|
|
|
Individual:
$1,000
Family: $2,000
|
Individual:
$1,500, $2,000, $2,500, $3,000,
$4,500, $6,000, $11,000
Family (per family): Two times the individual
non-network deductible and is met collectively with
2 or more family members
|
|
| |
Network
Coinsurance
This is the percentage of covered medical expenses Assurant/Time
pays after the deductible is met. |
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| Doctor
Office Visits |
|
$45
copay
|
80%,
70%, or 50%
after deductible or
$35 copay -
optional benefit
for Mammograms, Pap smears and PSA screenings (All other
approved preventive services are covered up to a max
of $500)
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible for Mammograms, Pap smears and
PSA screenings (All other approved preventive services
are covered up to a max of $500)
|
|
| Prescription
Drugs |
$15
copay for generic,no deductible or coinsurance
$25 copay plus 50% coinsurance for brand name
after a $500 deductible
|
$15 copay for generic,no deductible or coinsurance
$25 copay plus 50% coinsurance for brand name
after a $500 deductible
|
| Hospital
Services |
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
|
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Diagnostic
Imaging, Laboratory Services, Outpatient Hospital, Surgical
Center, Urgent Care Facility, and Professional Ground
and Air Ambulance |
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Emergency
Room
($75
emergency room fee-waived if admitted to the hospital)
|
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Health
Care Practitioner Services
(Doctors,
Surgeons, Assistant Surgeons, Anesthesiologists, Physician
Assistants, and Nurses) |
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Outpatient
Physical Medicine
(Physical,
Speech and Occupational therapies; Cardiac and Pulmonary
rehabilitation; Treatment of Developmental Delay)
(Up to $3,000 in benefits) |
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Home
Health Care
(Up
to 160 hours) |
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Inpatient
Rehabilitation Facility, Sub acute Rehabilitation and
Skilled Nursing Facilities
(Up
to 90 days)
|
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
|
|
|
50%
|
80%,
70%, or 50%
after deductible
|
|
|
30%
after deductible
|
60%,
50%, or 30%
after deductible
|
|
| |
Behavioral
Health and Substance Abuse |
|
Not
Covered
|
Not
Covered
|
Optional
Features
(See
below
for details)
|
Office
Visit Copay, Suite Solutions, Accident Medical Expense, Hospital
Indemnity Insurance, Maternity
|
Office
Visit Copay, Suite Solutions, Accident Medical Expense, Hospital
Indemnity Insurance, Maternity
|
|
|
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.
|
|
CoreMed
Coverage Synopsis:
This
is a cost effective plan that still provides broad coverage and
enough options to make sure you and/or your family are covered
for everyday and catastrophic needs. It is the middle ground
for all the Assurant non-HSA plans.
You
have the option of a $0 deductible that has a $45 office visit
copay benefit and 50% coinsurance built in, as well as the option
to select a $35 copay benefit with any of the other deductibles.
This office visit copay benefit applies to four network office
visits per year and then all other visits are subject to the deductible
and coinsurance.
After
you have met your individual/family deductible, the plan pays
80%, 70%, or 50% of all covered expenses up to $2 million lifetime
maximum, with the choice to increase your coverage to $6 million
lifetime maximum, per person.
This
plan also covers preventive services after you have been insured
for 6 months including mammograms, pap smear and PSA screening
and up to $500 for other approved preventive services such as
office visits and immunizations.
With
this plan your prescriptions are also covered after a $15 copay
for generic or with brand name prescriptions 70% is covered after
a $500 deductible with a $25 copay. You have a choice of using
two different networks, which almost guarantees you'll find your
current providers or save you money by choosing a larger network.
You also have the option of expanding your coverage by selecting
any of the optional features available.
Time
CoreMed Plan Brochure 
- complete plan details
CoreMed
Optional Riders:
Office
Visit Copay
With
this benefit the plan pays 100% after you pay your copay of
$35 for any eligible network office visit up to 4 per year.
Eligible office visits include annual examination, consultation,
evaluation, and development of a treatment plan, immunizations
and allergy shots. Any associated imaging and laboratory
services are not eligible under this benefit, but are subject
to the deductible and coinsurance.
Other
services not covered under this benefit are visits with non-participating
providers, surgical procedures, allergy tests, treatment of
behavioral health or substance abuse and maternity related visits.
Suite
Solutions
This
option allows you to increase your coverage and reduce your
personal medical costs. This feature reimburses you for
qualified expenses regardless of your deductible. Two
options are available in the Suite Solutions benefit.
|
Features
|
Secure
Solution
|
Select
Solution*
|
|
Accident
Medical Expense Benefit
Benefit Options: $2,500, $5,000, or $10,000
$100 Deductible
(per insured, per accident)
|
|
|
|
|
Accidental
Death and Dismemberment Benefit
Up to $10,000 for the primary insured and
up to $1,000 for the spouse and each child
|
|
|
|
|
Weekly
Accident Indemnity Benefit
70% of basic weekly salary up to $250 per
week for up to 52 weeks, for primary insured
only
|
|
|
|
|
Critical
Illness Expense Benefit
Benefit Options: Must be the same as the Accident
Medical Expense Benefit
Covers life-threatening cancer, heart attack,
stroke, paralysis, renal failure, coma, transplants
and more for primary insured and spouse
|
|
|
|
|
Identity
Network Child Safety Services
Pre-registry of children using photos and
descriptions
|
|
|
|
|
Identity
Theft Benefit
Up to $2,500 in financial relief, including
reimbursement for related costs, lost wages,
legal fees and expenses
|
|
|
|
|
Travel
Assistance
Emergency medical, financial, legal and communication
assistance, plus a multilingual information
service available before and during travel,
for members who are traveling 100 or more
miles from home
|
|
|
|
|
Discounts**
Up to 60% off items such as health club dues,
hearing aids and hotels and travel packages
|
|
|
|
|
* Select
Solution is not available in all states
** Not all discounts are available in all states
Accident
Medical Expense Benefit
In
the event of an accident this benefit will pay up to $500, $1,000,
or $2,500, whichever amount you choose, before you pay any copay,
access fee, deductible or coinsurance.
Maternity
Benefit *
A
Maternity benefit is also available with this plan, after a
90 day benefit waiting period. You can choose from four
different deductibles and in addition receive significant network
discounts - often between 15 to 50% when using in network providers
- before you even meet your deductible. You pay only this
deductible for a maternity claim, including pre-natal care all
the way through delivery. You then receive 100% coverage
after the deductible is met.
This
limits your expenses for maternity care to the amount of your
maternity deductible. See below for examples of additional
cost for each deductible:
|
Deductible
|
Premium/Month
|
|
$10,000
|
$10.75
|
|
$5,000
|
$47.05
|
|
$2,500
|
$154.58
|
|
$1,000
|
$356.21
|
|
* You may
only sign up for this additional benefit at the time of your
initial application with Time. Coverage must begin 90
days before conception or no coverage is provided.
CoreMed
Rates:
Preferred
rates without riders are available on our instant
quote page. The quoted rates are for the $8 million
maximum benefit, and do not include optional benefits such as
term life, supplemental accident, maternity, and Rx riders. Check
to see if you qualify for preferred
rates.
Please
contact us via
email for rates on the optional benefits. All rates depend
on gender, smoking status, zip code, and health status.
The
premium can be paid via quarterly, semi-annual, or annual billing
or credit card payment. Premiums can be paid monthly via
bank draft, or by credit card in AZ, CT, KS, NC, and OH.
There is a one-time $20 application fee, which is refunded if
the application is declined or not accepted. The initial
premium can be paid with a check or credit card.
Initial
Monthly Premium: Unlike most companies, Time Insurance will
allow you to submit an application on a C.O.D. basis. What
this means is that you may submit your application without submitting
the first month's premium, which would not be due until your application
has been approved. At that time, you will instantly be billed
for your first month's coverage. At times, depending upon
your requested effective date, your first bill may be for two
month's coverage, as you will be billed for the period of time
that you have been covered prior to receiving your approval (if
applicable), as well as the full premium for the next month of
coverage.
CoreMed
PPO Networks:
PHCS
- Nationwide Network
- PHCS Network is one of the largest PPO networks in the country,
with over 400,000 providers and nearly 3,700 facilities. - Find
a Provider
or
Sloans
Lake Preferred Health Network has a very comprehensive
health care provider network within the state of Colorado, with
more than 6,500 individual providers and facilities representing
every medical specialty. - Find
a Provider
Having access
to the PPO network can mean substantial discounts in what you
pay for your health care, even before you meet your deductible.
CoreMed
Underwriting:
If
you are in good health, Assurant has the quickest underwriting
in the industry. About 25 percent of our applications go
through the Express Yes approval, and you can print
out your insurance card today. Just apply
online, and if you answer “no” to all 17 questions
and the electronic check of your Medical Information Bureau and
Rx record comes back clean, you will be approved immediately.
Seventy-five
percent of the remaining apps are approved within 48 hours.
If medical records are needed, then it may take significantly
longer while the underwriter waits for the physician to send the
records.
Certain
conditions may be wavered with a temporary rider (usually for
one to two years), or an indefinite rider. If pre-existing
conditions are disclosed on the application they will not be determined
to be pre-existing and will be considered for coverage.
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.
CoreMed
Effective dates:
Time
Insurance
coverage can go into effect as quickly as one day, though you
risk being declined if claims are submitted before the underwriting
process is completed. You may request an effective date
any time between the day after you sign the application and 45
days later, with the exception being that an application cannot
become effective the 29, 30 or 31 of any month.
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 Time Insurance
that your coverage has been approved and is in force.
About
Time Insurance:
Time
Insurance
is a national health insurance company developing and providing
individual medical, small group, short term and student health
insurance products. In business since 1892, the company
provides health insurance coverage for over one million people
nationwide. With almost 3,000 employees, Time Insurance
is headquartered in Milwaukee, Wis., and has operations offices
in Minnesota, Idaho, and Florida, as well as sales offices across
the country.
Time Insurance
has been assigned a rating of A- (Excellent) from
the A.M.
Best Company, an independent insurance rating organization.
For a complete
listing of all available plans, please visit our main Time
Insurance page.
ColoHealth
is an independent authorized Time Insurance
agent in Colorado.
"I
couldn’t feel more comfortable with my decision."
My name is Keith Guastella and I am a new client of agent/broker
Chelsea Miller. I wanted to take this moment to
express my sincere compliments regarding the service I
recently received.
Chelsea
has been the utmost professional from first contact.
Prior to meeting Chelsea, I shopped for close to a month
for insurance and felt confused and uneasy about the products
and process.
Chelsea
provided me sound guidance, follow-up, patience, and expertise.
She made recommendations, called to make sure my current
Doctor was in network, routed me to online resources,
and assisted real-time as I completed the application
process. In the end, I couldn’t feel more comfortable
with my decision.
Many
thanks to her.....and your company!
Keith
Guastella
Longmont, CO
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