Plan Specifics
No pre-existing condition limitation.
Mental health and substance abuse disorders covered the same as any other sickness.
Guarantee issue. No health questions.
Voluntary payroll deduction group plan.
Various eligibility waiting periods are available.
Benefits may be assigned to providers.
Pays in addition to any other insurance. Work-related accidents and sicknesses are not covered.
Eligible for pre-tax treatment under Section 125, except Short -Term Disability Income Insurance.
Premium rates are guaranteed for the first 12 months of coverage. Thereafter, premium rates are subject to change.
Minimal eligibility requirements:
Employee must be actively at work.
Company must have and maintain at least 51 eligible employees.
10 enrolled lives required at initial enrollment and renewal.
Administration
Employee missed premium provision (for non-monthly groups) due to insufficient paycheck
Various pay cycles
COBRA services included
Various billing formats
Plastic ID cards
Account management
Toll-free, English/Spanish customer service
Enrollment
Quality enrollment guides and collateral materials
Dedicated implementation team
Telephone enrollment using specialized benefit counselors
Web-based enrollment through TPA
Paper enrollment available
Networks
Health Plan Not Subject to PPACA
The health indemnity plans described in this website are considered “excepted benefits” under the Health Insurance Portability and Accountability Act (HIPAA) and, as such, are not currently subject to the mandated benefits of the Patient Protection and Affordable Care Act (PPACA). It is important to know that excepted benefits do not count as creditable coverage, and certificates of prior (creditable) coverage will not be issued upon termination of indemnity coverage under any of the AFA policy forms. However, AFA voluntarily incorporated HIPAA special enrollment provisions in policy form series G-505.SA and G-513.SA (which are not included in policy form series G-501B).