818 Route 202-206, Bridgewater, NJ 08807
Telephone 908-722-6868, Toll Free: 1-800-392-0980, Fax: 1-908-722-2827,
E-Mail: info@forefin.com
New Jersey Small Employer Plans (2-49)
I) HMO with Rider Options
This information is for illustrative purposes only. See individual contract for details and exclusions.
| Copay
Option w/ Rider REFERRED |
|
| FINANCIAL Deductible Single/Family Coinsurance Coinsurance Limit: Single/Family Lifetime Maximum Benefit |
N/A N/A N/A N/A |
| PRIMARY CARE
PHYSICIAN VISITS SPECIALTY CARE Office Visits Diagnostic Outpatient Testing Outpatient Therapy OUTPATIENT SURGERY |
$10,$15,20,$25,$30,$40,50 copay copay per visit copay per visit copay per visit copay per visit |
| HOSPITALIZATION Room & /Board (Semi-Private) Surgery & Anesthesia Medical & Surgical Specialist Care Diagnostic Testing |
copay per visit |
| SKILLED NURSING FACILITY EMERGENCY ROOM HOME CARE MATERNITY First OB Visit |
No copay $50 copay No copay $25 copay |
| MENTAL HEALTH
& SUBSTANCE ABUSE Inpatient |
no copay Maximum of 30 inpatient days |
| Outpatient | copay/visit, 20 visits |
| PREVENTATIVE CARE Routine Physicals Routine GYN Exam Immunizations Mammography CHIROPRACTIC CARE PRESCRIPTIONS (generic/brand) |
copay per visit copay per visit copay per visit copay per visit Not covered $5/10/15/20/30 copay |
II)Point-of-Service Plans
Open Access (Point-Of-Service Plan) : Visit In-Network physicians without a referral. No primary physician required.
This information is for illustrative purposes only. See individual contract for details and exclusions.
| Copay
Option w/ Rider In-Network |
Out-of-Network |
|
| FINANCIAL Deductible: Single Deductible: Family Coinsurance Maximum Out-of-Pocket Lifetime Maximum Benefit |
N/A N/A N/A N/A N/A N/A |
$500/$1,000 $1,000/$2,000 Plan C 70/30 Plan D 80/20 Plan C $3,000 Plan D $2,000 unlimited |
| PRIMARY CARE
PHYSICIAN VISITS Office Visits Diagnostic Outpatient Testing Outpatient Therapy* OUTPATIENT SURGERY* |
$5,$10,$15,$20,$30,$40,$50 copay copay per visit copay per visit copay per visit copay per visit |
subject to deductible
& coinsurance subject to deductible & coinsurance subject to deductible & coinsurance subject to deductible & coinsurance subject to deductible & coinsurance |
| HOSPITALIZATION* Room & /Board (Semi-Private) Surgery & Anesthesia Medical & Surgical Specialist Care Diagnostic Testing |
no copay |
subject to deductible & coinsurance |
| SKILLED NURSING FACILITY* EMERGENCY ROOM HOME CARE* MATERNITY First OB Visit |
No copay $50 copay No copay $25 copay |
subject to deductible
& coinsurance subject to deductible & coinsurance subject to deductible & coinsurance |
| MENTAL HEALTH
& SUBSTANCE ABUSE Inpatient Outpatient* |
no copay Maximum of 30 inpatient days copay/visit, 20 visits |
|
| PREVENTATIVE CARE Routine Physicals Routine GYN Exam Immunizations Mammography CHIROPRACTIC CARE PRESCRIPTIONS (generic/brand) |
copay per visit copay per visit copay per visit copay per visit Not covered $5/10/$15/$20/$30 copay |
$500 to age 1 $300 per covered person 30 visits max. deductible & coins. subject to deductible & coinsurance |
* Member pre-certification required or benefits paid will be substantially reduced.
III) Health Savings Accounts (HSA)
HSA Plans include two components: a lower cost, high deductible health insurance plan and a tax-favored savings account. The money you save on premiums with your high deductible plan can be put into your tax-favored savings account (HSA). You can withdraw the money to help pay your deductible or other qualified health care expenses. Once your deductible is met, the insurance plan starts paying for covered expenses. The best part of the HSA, is that your unspent savings roll over year after year.
An HSA Plan may be right for you if you want:
 | More control over how your health care dollars are spent |
| One annual deductible per family |
| To save money on monthly premiums and taxes |
| Tax Savings |
| Portability for any employee to take the HSA when leaving the job. Whether an employee changes jobs or retires, the funds and interest travel with him or her. |
| Long-term savings because the funds may be withdrawn for any reason after age 65. |
For additional information on your insurance needs or information about our Financial Services, call 1-800-392-0980, complete the inquiry request form, or simply E-Mail us at: info@forefin.com.
Top | Foresight Index | Inquiry Request Form
Copyright, 1996-2001, Foresight Financial, LLC