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PLAN HIGHLIGHTS
(Coverage
Options)
Lifetime Maximum.
The benefit is $5,000,000 while you
are insured.
General Wellness
Benefits
include mammograms, prostate examinations, flu vaccinations, and Pap smears.
Prescription Drug
Benefits
You pay
a generic drug company
of $7 or brand
name company of $15 for prescriptions and refills, after meeting a yearly
prescription drug deductible:
• Your drug deductible is $100 when your plan deductible is
less than $500.
• Your drug deductible is $150 when your plan deductible is
from $500 to $1000.
• Your drug deductible is $250 when your plan deductible is
more than $1000.
Certain
prescription drugs are covered under the medical provisions of your plan and are
subject to the plan deductible and coinsurance.
Catastrophic Case Management
This service helps you determine the most appropriate
rehabilitation specialists and facilities, in case of a catastrophic illness or
accident.
Life and
AD&D Insurance
This coverage
is automatically included for employees.
OPTIONAL COVERAGES
Enhanced Prescription Drug Benefits. You
pay only a generic
drug copay of $7
or brand name copay
of$15 for prescriptions and refills, with no prescription drug deductible.
Supplemental Accident
Benefit. An optional benefit
of $1000 per year
for accidents, without application of the deductible, coinsurance, and copays,
is available for employees.
Dental Benefits. Dental
benefits are available
for you, subject to group size and location.
Supplemental Life and
AD&D
Insurance. Additional
life and AD&D benefits are available for you.
Dependent Life Insurance. Life insurance is available for your spouse and
dependents.
Disability Benefits. Short
term disability and long
term disability coverages are available for you.
NOTES
The family deductible is three times the individual
for plans with deductibles of$l000 or less.
The family deductible is twice the individual for
plans with deductibles of more than $1000.
The family drug deductible is always twice the
individual drug deductible.
The family out-of-pocket limit is always twice the
individual out-of-pocket limit.
Maternity benefits are an option for groups initially
insuring three to nine employees for medical coverage and automatically included
for groups initially insuring ten or more employees for medical coverage.
Mental Health/Substance Abuse benefits are
automatically included for groups initially insuring three or more employees for medical coverage.
Enhanced prescription drug benefits are an option for
groups initially insuring three or more employees for medical coverage.
Outpatient Mental Health/Substance Abuse coinsurance
is not credited to the out-of-pocket limit.
LIMITS
The following types of coverages may be subject to
separate limits:
This information is only a summary. Please refer to
the John Alden Health group, dental, and disability brochures for additional details. The plan certificate includes
complete details on all plan provisions and is the governing document in
case of discrepancies. Some plan benefits vary by state. Please refer to the
Special State Provisions Supplement.
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