MaxPlan
Details at a Glance:
|
Features
|
In-Network
|
Out-of-Network
|
| Lifetime
Maximum Benefit |
- $3
million or $8 million |
- $3
million or $8 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, $15,000,
or $25,000
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, $16,000, $15,000,
or $26,000
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%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| Doctor
Office Visits |
|
$45
copay
|
100%,
80%, 70%, or 50% after deductible
or
$35 copay -
optional benefit
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| Prescription
Drugs |
$15
copay for generic,no deductible or coinsurance
$25 copay plus 70% coinsurance for brand name
after a $500 deductible
|
$15 copay for generic,no deductible or coinsurance
$25 copay plus 70% coinsurance for brand name
after a $500 deductible
|
| Hospital
Services |
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
|
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Diagnostic
Imaging, Laboratory Services, Outpatient Hospital, Surgical
Center, Urgent Care Facility, and Professional Ground
and Air Ambulance |
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Emergency
Room
($75
emergency room fee-waived if admitted to the hospital)
|
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Health
Care Practitioner Services
(Doctors,
Surgeons, Assistant Surgeons, Anesthesiologists, Physician
Assistants, and Nurses) |
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
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%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Home
Health Care
(Up
to 160 hours) |
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Inpatient
Rehabilitation Facility, Sub acute Rehabilitation and
Skilled Nursing Facilities
(Up
to 90 days)
|
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
|
|
|
50%
|
100%,
80%, 70%, or 50% after deductible
|
|
|
30%
after deductible
|
80%,
60%, 50%, or
30% after deductible
|
|
| |
Behavioral
Health and Substance Abuse |
|
50%
|
30%
|
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
|
|
* For plans
with an effective date of 2/1/08 through 9/28/08 a deductible
credit of 10% of the total deductible will be applied for proof
of prior coverage that was in force 63 days prior to the effective
date. Credits cannot be applied to $0 deductible plans or
OneDeductible plans with a deductible of $1100/$2200. The
credit will carry over from year to year if not used in the initial
year. The credit does not change the deductible amount on
the insurance contract.
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.
|
|
MaxPlan
Coverage Synopsis:
This
is the most extensive plan Time Insurance
offers with the most additional benefits available. This
gives you the broadest coverage and the piece of mind when a major
medical situation arises. 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.
After
you have met your individual/family deductible, the MaxPlan
pays 100%, 80%, 70%, or 50% of all covered expenses up to $3 million
lifetime maximum, with the choice to increase your coverage to
$8 million lifetime maximum, per person. This plan also
covers wellness services after the deductible is met with no special
limits for mammograms, pap smear and PSA screening and up to $1,000
for other approved preventive services including office visits
and immunizations.
With
the MaxPlan, 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
(details below).
Time
MaxPlan Plan Brochure 
- complete plan details
MaxPlan
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.
MaxPlan
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.
MaxPlan
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.
MaxPlan
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.
MaxPlan
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.
"You
were able to answer all of my questions one on one, personalized
to my specific situation."
This was the first time I ever used an independent broker
and I’m glad I did because I was able to shop for
all the available carriers in one place. Plus, your
website is pretty good about providing the quotes and
the sort functions are wonderful.
Your
service stands out from the rest in that you were able
to answer all of my questions one on one, personalized
to my specific situation. Other agents I’ve
used weren’t nearly as knowledgeable and were transparent
as sales people with only one goal which was to get me
to sign up regardless of my concerns and questions.
Julie
Jee
Greenwood Village, CO
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