Abc Bank Employee Medical Benefits
Autor: angelatoro • January 27, 2019 • Coursework • 377 Words (2 Pages) • 548 Views
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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