Message from Wiley Long
President - ColoHealth
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World HSA Insurance

World HSA Insurance

Plans: HD Advantage

 

 

 

Coverage Synopsis Optional Riders Rate Information PPO Networks Underwriting Effective Dates About World

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

Before HSA legislation went into place, the majority of our business with World was their catastrophic Value Advantage plans.  Since HSAs went into effect, World's HD Advantage plan is often a very good option, particularly for those over age 55.

If you are looking for an inexpensive catastrophic plan, World's Value Advantage plan is a good option, but it is not HSA compatible.

HD Advantage Brochure World HD Adobe Acrobat Reader Information

World HD Advantage plans at a glance:

Lifetime Maximum for all plans - Choice of $2 million with option to increase to $5 million

 

PPO Individual In-PPO Out-of-PPO
Deductible Then you pay Max amount you pay (1) Deductible Then you pay Max amount you pay (1)
HD Advantage 100 $1,500 0% $1,500 $3,000 20% of next
$7,500
$4,500
$2,700 0% $2,700 $5,400 20% of next
$18,750
$9,150
$5,250 0% $5,250 $10,500 20% of next
$18,750
$14,250
HD Advantage 80 $1,500 20% of next
$5,000
$2,500 $3,000 40% of next
$7,500
$6,000
$2,700 20% of next $12,500 $5,400 $5,400 40% of next
$18,750
$12,900
HD Advantage 50 (3) $1,500 50% of next
$3,000
$3,000 $3,000 70% of next
$4,500
$6,150
$2,700 50% of next
$5,000
$5,400 $5,400 70% of next
$7,500
$10,650
PPO Individual In-PPO Out-of-PPO
Deductible Then you pay Max amount you pay (1) Deductible Then you pay Max amount you pay (1)
HD Advantage 100 $3,000 0% $3,000 $6,000 20% of next $18,750 $9,750
$5,450 0% $5,450 $10,900 20% of next $37,500 $18,400
$10,500 0% $10,500 $21,000 20% of next $37,500 $28,500
HD Advantage 80 $3,000 20% of next $12,500 $5,600 $6,000 40% of next $18,750 $13,500
$5,450 20% of next $25,000 $10,450 $10,900 40% of next $37,500 $25,900
HD Advantage 50 (3) $3,000 50% of next $7,000 $6,500 $6,000 70% of next $10,500 $13,350
$5,450 50% of next $10,000 $10,450 $10,900 70% of next $15,000 $21,400

 

Traditional
Individual
Deductible Then you pay Max amount you pay (1)
HD Advantage
100
$1,500 0% $1,500
$2,700 0% $2,700
$5,250 0% $5,250
HD Advantage
80
$1,500 20% of next $5,000 $2,500
$2,700 20% of next $12,500 $5,200
Traditional
Families
Deductible Then you pay Max amount you pay (1)
HD Advantage
100
$3,000 0% $3,000
$5,450 0% $5,450
$10,500 0% $10,500
HD Advantage
80
$3,000 20% of next $12,500 $5,600
$5,450 20% of next $25,000 $10,450
Additional coverage information for basic plans
Inpatient Hospital Subject to deductible and coinsurance
Outpatient Medical Limited benefit, unless optional benefit is chosen (2)
Emergency Room $100 access fee if visit is for an illness and patient is not admitted directly into hospital as inpatient, then subject to deductible and coinsurance.
Physician Office Visits Not covered, unless optional benefit is chosen (2)
Prescription Drugs Limited benefit for inpatient only, unless optional benefit is chosen (2)
Wellness Benefit Not included, unless optional benefit is chosen (2(not available on Traditional plans)
Foreign Travel Emergency Not included, unless optional benefit is chosen (2)
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.
 

This is a basic limited plan unless the optional Comprehensive HSA Benefit is selected.  Please note that expenses from non-PPO providers are subject to the usual and customary charge limitation described in the World brochure.  Generally speaking, the “usual and customary” charge is the amount World would expect most physicians to charge for a particular medical procedure, service or supply.  Each year refers to calendar year.

World HSA Insurance in Colorado

Coverage Synopsis:

World HD Advantage

With this plan, the deductible only needs to be met once per family per year.  After you have met your deductible, the plan pays 100% of all covered expenses, up to either $2 or $5 million per person.  There is also an option for 50% of 80% coverage, with a co-insurance limit of $10,000.  Routine doctor visits are not covered by this plan, even after the deductible has been met.

Foreign travel is also covered for 60 days, with a $100,000 lifetime limit.

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.

This plan qualifies as HSA-eligible.  Combining a Health Savings Account with any the World High Deductible Health 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, contact lenses, or most types of alternative medicine (see the qualified medical expenses).  If you do not use these funds, they simply accumulate, with interest, for distribution upon your retirement.

See the WorldCARE Advantage Series – Product Comparison chart to see how this plan compares with the Value Advantage plan.

World HSA Insurance in Colorado

Optional Riders:

Comprehensive HSA Benefit

This optional benefit provides the following additional benefits.

  1. Rx Benefits - subject to deductible and coinsurance.  Prescription drugs or medicines for a covered illness or injury when prescribed by a physician and dispensed by a licensed pharmacist.

  2. Physician Office Visit Benefits - subject to deductible and coinsurance for medical services provided by a physician.

  3. Outpatient Services - subject to deductible and coinsurance.  Services include, but are not limited to, physical, 
    occupational, speech and manipulative therapy, and diagnostic testing.

  4. Wellness Benefits - a maximum of $150 first dollar coverage for wellness benefits per covered person, per calendar year.  Eligibility starts for each covered person 12 months after the plan is effective for that covered individual.

Maximum Benefit Option

Your HD Advantage policy/certificate's lifetime coverage maximum is $2 million per covered person.  The Maximum Benefit Option increases the lifetime maximum to $5 million.  It also increases the per-organ transplant maximum from $500,000 to $1,000,000 at nationwide Centers of Excellence, facilities that specialize in specific types of transplants and can provide you with quality care on a cost efficient basis.

Term Life Benefit Option

The Term Life Benefit Rider provides you and/or your spouse with annually renewable term life insurance coverage in benefit amounts of $10,000, $25,000 or $50,000.  Plus, you also have the option of converting your term-life policy to a World whole life policy.(Note: Not available in Georgia, Ohio and Oklahoma.)

Outpatient Accident Benefit Option

With the Outpatient Accident Benefit Rider, your plan pays 100 percent of expenses for a covered injury, not to exceed the amount you choose ($500, $1,000, $1,500, $2,000, $2,500, $3,000 or $5,000) per calendar year for treatment of injuries on an outpatient basis, with no deductible or coinsurance.  Additional benefits are subject to your deductible and coinsurance.  (Note: Not all levels are available in all states)

Expenses covered under this rider include:

  • Services, supplies, and physician's care; 
  • X-ray and laboratory tests; and 
  • Treatment or services received in a hospital emergency room, urgent care center, physician's office, or ambulatory surgical center or facility.

World HSA Insurance in Colorado

Rates:

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 optional benefits such as term life, supplemental accident, maternity, and Rx riders.

Please contact us via email for rates on the optional benefits.  Rates depend on gender, smoking status, zip code, and health status.

The premium can be paid via quarterly, semi-annual, or annual billing, or a monthly bank draft or credit card.  The bank draft will occur on the premium due date each month. The initial premium can be paid with a check or credit card.

The following chart shows when you can expect payment to be deducted from your credit card:

App Effective Date Credit Card Charged
1st of the month 1st of month
2nd - 5th of month 5th of month
6th - 10th of month 10th of month
11th - 15th of month 15th of month
16th - 20th of month 20th of month
21th - 28th of month 25th of month

PPO Network:

World Insurance Company recently signed an agreement with Great-West Healthcare, a division of Great-West Life & Annuity Insurance Company.  Great-West Healthcare operates a substantial multi-state (national) healthcare network that includes more than 4,200 hospitals and 530,000 providers.  It provides network and other services to more than 2 million people.  Find a Doctor

World HSA Insurance in Colorado

Underwriting:

Underwriting of your application with World normally takes two to four weeks, though if medical records are ordered it could take longer.  World's underwriting seems fairly lenient compared to many other companies, and often accept applicants who may have been turned down by other companies.

It is standard practice for them to request a Blood Pressure Inquiry if you are currently being treated for or have recently discontinued treatment for high blood pressure.  Certain conditions may be waivered with a temporary rider (usually for one to twos years), or an indefinite rider.

World HSA Insurance in Colorado

Effective dates:

The earliest your coverage can go into effect is ten days after you have signed your application.  You may request an effective date any time between 10 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 World Insurance that your coverage has been approved and is in force.

World HSA Insurance in Colorado

About World Insurance:

World Insurance was founded in 1903 in Omaha, Nebraska, as the World Accident Association.  The company began hiring agents in 1925 and became World Insurance Company in 1929.  The first general agency was established in Colorado in 1938.  In 1943, World mutualized and was authorized to sell life insurance as well as accident and sickness policies.

By the late 1950s, World was licensed in 45 states with 500 agents nationwide.  The company's product portfolio included a wide variety of individual hospital, life and disability policies.

Today, World is licensed in 46 states and the District of Columbia.  More than 11,200 general agents and agents represent the company.

World Insurance has been assigned a rating of A- (Excellent) from the A.M. Best Company, an independent insurance rating organization.