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Group Limited Indemnity Plan for Part-time, Hourly and Seasonal Workforce

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70%

of workers are living paycheck to paycheck.  WHILE ACA health insurance premiums have increased by 123% since 2013.

40%

of workers have enough savings to cover a $1,000 emergency. BUT ACA maximum deductibles have increased from $6,350 to $7,900.

75%

of workers agree that a monthly premium over $200 would be unfair. YET the national average for ACA unsubsidized insurance premium is $440.

Working adults average $6,632 annually in medical expenses.


Less than 5 percent of insured individuals incur over $17,402 annually in medical expenses.

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1 Centers for Medicare and Medicaid Services: Research, Statistics, Data & Systems. Selected dates - 2012. IMPORTANT NOTICE: Insurance policies providing certain health insurance coverage issued or renewed on or after September 23, 2010, are required to comply with all applicable requirements of the Patient Protection and Affordable Care Act (PPACA). However, there are a number of insurance coverages that are specifically exempt from the requirements of PPACA (See § 2791 of the Public Health Services Act).

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COVERAGE

  • Group Limited Benefit Indemnity Plans for employer groups

 

  • Available with and without Minimum Essential Coverage (MEC) and Minimum Value (MVP)

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  • Affinity group Limited Benefit Indemnity Plans

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  • Coordinating and Non-coordinating GAP Plans

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BUY UP OPTIONS

  • Copay Rx Card​

  • Critical Illness​​

  • Accident Medical Expense

  • AD&D

  • Term Life

  • Dental and Vision

  • Short-term Disability

  • Virtual Primary Care (VPC)

WHAT IS a Limited benefit indemnity plan?

A fixed-indemnity medical plan designed to provide a basic to mid-level medical benefit for employees and association members who are not covered by a major medical plan. Can be offered on a voluntary or employer contributory basis. Coverage levels are higher than mini-med plans but still less than our Limited-Day Plan. Various levels of plans provide total potential fixed-indemnity, accident medical payments and reimbursements of $15,000 to $100,000 per year at a premium that is 40% to 60% less than the cost of a major medical plan. Plus, PPO discounts, telephonic and video doctor visits, and Rx copays.

When I asked my agent for affordable healthcare, he showed me a high deductible major medical plan. I would have to pay thousands out of pocket before I was reimbursed for anything other than a few office visits. If I had thousands to spend, I wouldn’t need insurance so badly. I need a plan that helps cover my expenses on day one!

FUNDAMENTAL CARE

LIMITED BENEFIT INDEMNITY

Custom plans designed for employer groups and affinity groups looking to provide affordable healthcare alternatives.  Limited benefit indemnity coverage helps with first-dollar expenses with no deductibles, which provides coverage that individuals can actually use. Can be offered on a voluntary basis or with employer contribution.

FUNDAMENTAL CARE

ENHANCED BENEFITS

In addition to the core Limited Benefit Indemnity plans, Fundamental Care includes access to Enhanced Benefits which adds significant plan value. Enhanced Benefit options include: PPO network, Telemedicine, EAP, Health and Financial Wellness benefits, Virtual Primary Care, DMPO savings plan, and more!  

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GROUPS THAT WE SERVE

  • Employer Groups

  • Hourly Employees

  • Seasonal Employee

  • Part-time Employee

  • High-Turnover Employee Populations

  • 1099'ers

  • Employers subject to San Francisco Healthcare Service Ordinance

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INDUSTRIES

  • Restaurants

  • Retail

  • Hospitality

  • Home Health Care

  • Staffing

  • Janitorial

  • Landscaping

  • Transportation

  • Construction

  • Manufacturing

  • Security

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PLAN HIGHLIGHTS

  • First dollar Coverage

  • Customizable Plan Designs

  • Customizable Price points

  • Guarantee Issued

  • No Medical Underwriting

  • No Deductible or Co-insurance

  • ACA qualified MEC available

  • $10 Doctor Visit Prepay

  • Unlimited Telemedicine

  • RX Discounts and RX Copay program

What Benefits are Included​?

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  • Inpatient- Hospitalization, ICU, Surgery, Anesthesia

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  • Outpatient- Office Visits, Emergency Room, Major / Minor Surgery, Anesthesia, Diagnostic Lab, X-Ray, Major Testing 

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  • Accident- Accident Medical, AD&D

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  • ACA qualified MEC Plans available

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  • Critical Illness

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  • Prescription- Discount and Drug Copay Card

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  • Term Life

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  • Enhanced Plan Service - PPO Network, Telemedicine, EAP, Wellness, VPC, DMPO, Student Loan Assistance

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BUY-UP OPTIONS

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In addition to the core Limited Benefit Indemnity Medical Plans and Enhanced Benefit Plans, Fundamental Care offers buy-up options that can be bundled with the medical plans and in some instances, offered on a stand-alone basis.  The buy-up options help to complement the medical plan offering providing coverage that individuals need and will use.  Benefit options include: Prescription Copay Card, Critical Illness, Accident Medical Expense, AD&D, Term Life, Dental, Vision, and Short-term Disability, 

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