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Changes to Core Health Insurance

announcement from plan administrator effective May 2011


We are proud to announce that even with the new Health Care Reform changes (below); we are not increasing the premium rates of the Core Health Insurance (CHI) plans for the next plan year.

The recently passed Health Care Reform Bill has impacted the health care community and your CHI plan. The benefits underwritten by the United States Fire Insurance Company (rated “A” by AM Best 2010) will experience the following changes.

The changes below will take place for date of service incurred on or after May 1, 2011.

1. The eligible dependent child age will increase from 24 to 26.

2. All benefits will be paid as per the amounts listed in your current Schedule of Benefits which may be higher in some cases than the “up to” payout amounts previously paid. This means that if you have a claim submitted for a specific benefit, the plan will pay the full benefit amount, even if the charge is less than the benefit amount. The provider is paid directly, and then any difference is sent directly to you.

3. Your doctor office visit co-pay benefit will be replaced by an indemnity amount for your doctor visit benefit, which is a flat amount. This amount should leave you with a similar out of pocket expense as stated above, however, that expense may be higher or lower depending on the plan you enrolled into (Physician, Value, Gold, and Platinum). Your out-of-pocket expenses will almost always be less when you visit a doctor in the SASid provider network.

Example: Previous visit to the doctor: You were responsible for a $30 co-pay. Current benefit change means that when you visit the doctor, the claim is sent to our claims department and re-priced, and then the plan will provide a flat benefit ($100 Physician, $110 Value, $120 Gold, and $125 Platinum). The doctor will be paid directly, and if the benefit exceeds the charge, you will receive the difference. If the charge exceeds the flat benefit amount, you will be responsible for the difference.

If you would like an updated schedule of benefits you can login to the website and access account information. If you have any questions or concerns please feel free to call us at 800-279-2290 Monday through Friday from 8:30 a.m. to 5:00 p.m. CST.

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This web site is independently owned and managed by Tony Novak operating under the trademarks "Freedom Benefits", "OnlineAdviser" and "OnlineNavigator". Opinions expressed are the sole responsibility of the author and do not represent the opinion of any other person, company or entity mentioned. Tony Novak is not an agent, broker, producer or navigator for any federal or state health insurance exchange but may provide uncompensated advice, reviews and referrals to these official resources. Novak is compensated as an accountant, adviser, affiliate consultant, marketer, reviewer, endorser, producer, lead generator or referrer to some of the other commercial companies listed on this site. Information is from sources believed to be reliable but cannot be guaranteed.