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How TransChoice Advance Plans Work

The base policy pays a specified amount for each day a covered person is confined to the hospital, up to specified maximum limits. Benefit payments go straight to the employee to help with expenses unless they are assigned to health care providers. Through a series of optional riders the policy can provide benefits for a range of other medical situations. By establishing packaged plans, you can keep it simple for your employees to choose the benefit amounts that work best for their individual situations. The proposed packages are described below. The Affordable Care Act and High-Deductible Health Plan Status TransChoice Advance is designed to be an excepted benefit under the Affordable Care Act. 






Product Highlights for TransChoice Advance

  • Individual and Family coverage available
  • No coinsurance, co-pays, waiting period, or deductibles
  • Benefits are paid in addition to other insurance (except for workers’ compensation)
  • No health questions, exams, or blood tests
  • Guaranteed renewable through age 74

Rates and Payment Info

  • Monthly recurring premium rates are as indicated above.
  • Coverage for enrollment between the 1st - 25th is effective on the first of the following month. Enrollment between the 26th - month end, is effective on the first of the next month.
    (I.E. enrollment on January 1 - 25th, is effective on February 1. Enrollment on January 26-31st, is effective on March 1)
  • Enrollment in this product requires membership in DSWA.
  • Your first payment will be collected from your credit/debit card upon enrollment.
  • Future payments will be collected on the 25th of each month thereafter, after your effective date.

Product Details

Daily In-Hospital Indemnity Benefit
Pays each day an insured person isconfined to a hospital (but not anemergency room, outpatient stay orstay in an observation unit) as the resultof a covered accident or sickness.

 

$100

max. 31 days

INCLUDED RIDERS:

Emergency Room Sickness Benefit

Pays each day an insured personreceives treatment in the emergencyroom for a sickness. This rider does notpay benefits for emergency roomtreatments as a result of an accident.

$50

max. 2 days

Outpatient Diagnostic Lab Test Benefit

Pays each day an insured personundergoes an outpatient laboratory testperformed for the purpose of diagnosisfor a covered accident or sickness.Does not include tests covered underany other rider.

$25

max. 2 days per calendar year

Outpatient Select Diagnostic Test Benefit

Pays each day an insured personundergoes an outpatient X-ray, ultrasound, Electroencephalogram(EEG), or sleep study for the purposeof diagnosis for a covered accident orsickness.

$125

max. 1 day per calendar year

Outpatient Adv. Studies Diagnostic Benefit

Pays each day an insured personundergoes an outpatient ComputerTomography (CT) Scan, MagneticResonance Imaging (MRI), Myelogram,Positron Emission Tomography (PET),Angiogram, Arteriogram, or ThalliumStress Test for the purpose of diagnosisfor a covered accident or sickness.

$500

max. 1 day per calendar year

Outpatient Office Visit Benefit

Pays each day an insured personreceives outpatient treatment in aphysician's office or at an urgent carefacility as the result of a coveredaccident or sickness.

$50

max. 6 days per calendar year

Inpatient Mental/Nervous Disorder Benefit

Pays each day an insured person isconfined, on an inpatient basis, to ahospital or mental health facility as theresult of a mental or nervous disorderfor a minimum of 24 continuous hours.Mental or nervous disorder includesneurosis, psychoneurosis, psychopathy,psychosis, or other mental or emotionaldisease or disorder of any kind.

$100

max. 31 days per calendar year / 60 days lifetime

Inpatient Drug/Alcohol Addiction Benefit

Pays each day an insured person isconfined, on an inpatient basis, to ahospital or residential treatment facilityas the result of drug or alcohol addictionfor a minimum of 24 continuous hours.

$100

max. 31 days per calendar year / 60 days lifetime

 

Additional non-Insurance Benefits* Included:

Multiplan PPO Network

If an insured person utilizes one of the member providers (hospitals or physicians) in the Multiplan network, then
discounts will apply to lower out-of-pocket expenses. Multiplan's network is comprised of more than 550,000 physician
locations, approximately 4,000 acute care facilities and nearly 100,000 ancillary care provider locations.

Member Discount Card

This discount card is administered by New Benefits, Ltd. It offers employees access to a discount Vision Plan, NurseHotline, Counseling Services and benefits for Hearing Aids.This is not an insurance plan.

The discount Vision Plan through Coast to Coast VisionTM allows the employee to receive discounts of 20% to 60% on eyeglasses and frames or 10% to 20% of contact lenses (excluding disposables) from nationwide providers as well as10% to 30% savings on eye exams and surgical procedures, including LASIK.*

The Nurse Hotlineallows access to experienced registered nurses 24 hours a day, 7 days a week, 365 days a year.These hotline nurses are an immediate, reliable and caring source of health information, education and support. Servicesprovided by this plan include:

  • General information on all types of health concerns,
  • Information based on physician-approved guidelines,
  • Answers about medication usage and interaction,
  • Information on non-medical support groups,
  • Translation services for non-English speaking callers, and
  • Full-time medical director on staff.

The Counseling Service benefitallows the employee to speak with a counselor 24 hours a day, 7 days a week,regarding any personal problems they may be facing. In addition, the employee may be referred to a local therapist.

The Hearing Aid benefitprovides savings of up to 15% on Beltone® hearing aids at participating Beltone™ locations nationwide. Or, the employees can realize savings of 40% to 60% average national retail pricing on 100 models of hearinginstruments through mail order.*

VIP Health Vitaminsprovides discounted vitamins on trusted brand names like, Twinlab, Nature's Way, Carlson's, and Country Life to name a few. Automatic monthly shipments are available. The insured can order online or call toll-free toplace an order with a customer service representative.

The Diabetic Supplies benefitoffers discounted product packages designed for everyday testing or individual testing supplies. Product packages include:

Free Glucose Meter Lancets Control Solution Battery Manual Log Book
Test Strips Lancing Device Swabs Carrying Case Free Shipping

To receive the discount and to schedule home delivery visit our website or call toll free to place your order with acustomer service representative.


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