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Abc Bank Employee Medical Benefits

Autor:   •  January 27, 2019  •  Coursework  •  377 Words (2 Pages)  •  37 Views

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Overview of Medical Benefits:

For employee medical benefits ABC Bank offers two policies: 1 PPO plan and 1 HMO plan. Our PPO plan offers both in and out-of-network benefits at a higher out-of-pocket cost and allows employees the flexibility of seeing any provider they want. This plan can also be utilized to see providers out-of-state which would be ideal for those that travel often. Employees that select our HMO plan can enjoy lower out-of-pocket cost but can only use providers that are in-network; this policy does not have coverage while traveling out-of-state unless in the case of a true emergency.

Our PPO Plan not only offers the flexibility of utilizing providers in network and out-of-network; but there is also flexibility in the services that employees can receive without any authorization requirements or referrals. Our HMO plan however, is a tightly managed product that requires a referral from an assigned Primary Care Physician (PCP) and pre-authorizations for most health care services. Failure to obtain the required authorizations or referrals while on this product will result in denial of claims.

Pricing for our PPO Plan: Individual: $30 per pay period

                              Family: $60 per pay period

Pricing for our HMO Plan: Individual: $45 per pay period

                                            Family: $90 per pay period

Who is eligible to sign up for benefits?  

Full-time employees working 40 hours a week are eligible to sign up for benefits. Enrollment in benefits occur during the following:

  • Within 30 days of hiring new employees
  • During Open Enrollment period from October 1st-October 14th of every year
  • Within 30 days of a qualified life event such as: marriage, newborn baby, adopting a child

Once an employee has selected their benefit package, no changes will be made until the next open enrollment period.

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