The employer pays a fixed amount (premium + admin) per month for catastrophic coverage only,
including surgery, hospital room & board, and emergency care. Generally the overall savings
is 30 to 40% when compared to the employer's current plan.
Then, employer under IRS Section 105 can reimburse employees for the smaller routine outpatient
services from the reduction of monies above. The total reimbursements are usually far less
than the monies available. The reimbursements are tax free to the employee and the Employer
can take a tax deduction for the amount of the reimbursements.
Primary Coverage - This component provides a plan benefit
for catastrophic coverage insured by a traditional insurance company.
Self-Insured Secondary Coverage - The Employer can now choose to use these
premium savings to self-insure a plan of out-patient benefits.
In addition, the supplemental plan may also include benefits to enrich the catastrophic coverage.
The employer-funded portion is administered by the Arrowhead
Administrators (AA) in accordance with a Medical Reimbursement
Plan (MRP) established by the employer under Section 105 of the Internal
Revenue Code.
The difference is this plan uses some of the largest networks of providers without the need
for specialist referrals making easy access for employees.
Administration and Provider Network - Arrowhead
Administrators (AA) is located in San Bernardino;
they administer Employer-funded benefit plans. The plan uses Beech Street Corporation,
a PPO network which is among the highest quality national health plan networks. In California
alone there are 11,000 primary care physicians, 18,000 specialists and 5,000 ancillary
providers who are members of this network. Beech Street is NCQA and URAC-accredited.
The plan offers an optional PPO network called Interplan
Health Group which is also one of the largest PPO networks in the United
States.
BENEFIT
