Premier Adv
How many times can an insured go to the doctors each year policy year?
As many times as he or she would like
What is the underwriting company for our plans in the state of FL?
Freedom Life
How many types of networks are there, what are they and what does its acronym stand for?
HMO - Health Maintenance Organization
PPO - Preferred Provider Organization
EPO - Exclusive Provider Organization
POS - Point of Service
Name major 5 carriers outside of UHC or Blue Cross that may be found on the marketplace?
Cigna, Oscar, Molina, Ambetter, Wellpoint, Kaiser
Under Diamond and Exec Diamond, up to how much are the benefits in the event of an accident?
Diamond: Up to $12,500
Exec. Diamond: Up to $20,000
What is the out of pocket maximum under PremierMed when out of network?
$9,000
In the state of Florida, what are the age limitations for a dependents?
Under the age of 19
Up to 24 if a full time student
What are the dates for Open Enrollment?
What are the common extension dates for OE after the 1st round?
November 1st - December 15th
December 16th - January 15th
What are the two main scenarios that short-term plans are intended for?
Bridging a gap from one employer based plan to another
Bridging a gap short gap to Medicare
What network do the vision plans we offer utilize?
Spectera
What are the maximum outpatient surgeon benefits per insured per policy year for plan 1, 2, 3?
Plan 1: 0
Plan 2: $4,000
Plan 3: $8,000
How many different underwriting companies are there for the plans we offer what are their names?
Freedom Life Insurance Company of America
National Foundation Life Insurance Company
Enterprise Life Insurance Company of America
How long can a Qualifying Life Event Last for?
60 days
What are the ONLY plans that someone can be locked into until the next open enrollment period?
Employer Plans
Under SecureDental Plus in FL, what are the waiting periods for preventative services, basic care, and major care?
Preventative: No waiting period
Basic Care: 1 month
Major Care: 12 months
What is the minimum age requirement for a female to be eligible for one mammogram benefit per year?
35
Under what circumstances would a knee replacement be considered Standard as opposed to declinable?
After 3 years, with successful surgery, recovery, and no other complications
What does the acronym COBRA stand for?
Consolidated Omnibus Budget Reconciliation Act
At what point must employers offer ACA-Compliant plans and subsidize at least 50% of the monthly premium?
Once they have 50 Full-Time employees
Heart Attack, Life Threatening Cancer, Stroke, Permanent Paralysis, Terminal Illness, Coma, Kidney Failure,
How many types of Annual Wellness benefits are offered? Name at least 10
Physical Exam, Health Screening Labs, Child Routine Immunization, Pap Smear, Mammogram, PSA Test, Colonoscopy, Osteoporosis Screening, Health Screening Chest X-Ray, EKG, Stress EKG, Adult Immunization
For HealthAccess, how many days must an applicant with a previously lapsed policy thru us wait before re-signing up?
90 Days
What state do we sell in that pregnancy is a QLE?
Maryland
What is the name of the discount that lowers out of pocket expenses (deductible, copays, and coinsurance/max) on the marketplace based on income?
Cost Sharing Reduction
For hospital room and board, what is the benefit amount provided, maximum amount of days, and elimination period?
Benefit Amount: $1,200
Up to: 30 Days
Elimination Period: 1 Day