Guaranteed
Issue: Acceptance of your employees is guaranteed.
No Pre-existing Conditions: Regardless of past health
history, your employees are eligible and will
not be subject to any pre-existing conditions limitations
or exclusions.
No Coordination of Benefits: Plans pay in addition to
any other coverage that the employee may
have and benefits can be paid directly to the insured or
the provider.
Fully Insured: Medical Benefits are fully insured. In
addition, OptiMed qualifies under ERISA and
complies with Section 125 (cafeteria) and COBRA.
Maternity Benefit: Maternity is covered as any other illness.
Universal Rates: Provides both a voluntary or non-voluntary
rate structure that is the same
regardless of demographics, industry or location.
Assignment of Benefits: Benefits for doctors' office visits
and in patient hospital stays can be
assigned to the provider or paid directly to the insured.
Easy to Understand and Use: OptiMed's defined benefit
structure clearly outlines the benefits
payable for services rendered, thus eliminating the confusion
of co-pays, co-insurance and
reasonable and customary charges.
Friendly, Convenient Customer Service: Dedicated Account
Customer Service Representatives are
available to assist in benefit enrollment, finding network
providers, and helping solve claim issues.
In addition, Spanish-speaking customer service representatives
are available.
Access to National PPO Network: While the insured can
go to the provider of their choice, a
national preferred provider network is included that offers
discounted services. Locating a provider
is quick and simple.
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