OptiRater Makes Customizing Gap A Snap
Real-Time Quotes, Instant Revisions
A quick question:
With OptiMed Gap, a group member may never pay a major medical medical plan deductible, coinsurance or a copay for services?
The quick answer: that is true, but it depends upon options selected within numerous benefit customizations.
Gap is a work for master chefs, not hamburger flippers.
How many and precisely what options are available depend on the combination of state of issue, and choice of carrier, but the basic selections involve:
- Inpatient Coverage– covers eligible expenses if insured person is hospital confined under the regular care and attendance of a physician.
- Outpatient Coverage –covers eligible expenses for treatment at a licensed facility, including physician’s office, diagnostic clinic, urgent care clinic, outpatient surgical center and others.
- Prescription Drug Rider –may cover generic only or generic plus brand drugs.
- Combined Benefits Option– offers one limit over both inpatient and outpatient eligible expenses.
- HSA Compliant Option– add a deductible to satisfy IRS regulations and allow employer to offer GAP along with HSA qualified medical plans.
- Cost sharing– employer can choose to pay all or a percentage of the premium, making the coverage optional for employees.
- Physician Services Copay – fixed amount and fixed occurences to reimburse copays.
- Mental Nervous and Substance Abuse – include or exclude coverage for these services.
Each option, obviously, impacts the premium and affects feasibility. Gap may not be the best choice in every situation, but its flexibility makes it a strong contender for cost-effectiveness in a broad range of applications, and is always worth exploring.
The OptiMed Gap brochure recounts an employer that achieved more than a quarter-million-dollar savings by replacing its major medical coverage with an HDHP and Gap.
A great tool for becoming a Gap master chef is OptiMed’s online OptiRater, a number-crunching hybrid supplying quick and easy quotations of just about every OptiMed product. You’ll find OptiRater inside a just-developed broker portal accommodating the relevant functions to help licensed health insurance brokers finely tune benefits packages.
To start generating instant, online price quotations of OptiMed's vast product portfolio, contact your OptiMed Sales Rep, or if new to OptiMed:
Remember that plan options are dependent upon state of issue and carrier – some combinations have numerous options while others have fewer.
We’re confident you can cook up a great Gap recipe.