Preventive Health Plans

The power to customize your benefits and save money! 

 ASO MECPreventive BasicPreventive Advanced (most popular)
Group Size1+1+1+
Claims MethodClaims as AccruedBuilt InBuilt In
Preventive Care Services100%100%100%
Minimum Essencial CoverageYesYesYes
Minimum Value PlanNoNoNo
Primary Care Physician Office VisitNot CoveredNot Covered$20 Copay (max 3 visits per year)
Specialist Office VisitNot CoveredNot Covered$50 Copay (max 3 per year)
Urgent CareNot CoveredNot Covered$50 Copay (max 3 per year)
Diagnostic X-ray and LabNot CoveredNot Covered$50 Copay (max 5 per year)
Cat-Scan or MRINot CoveredNot Covered$200 Copay (1 per year)
Outpatient TestingNot CoveredNot Covered$200 Copay (1 per year up to $1,000)
NetworkAny Provider and PHCSAny Provider and PHCSAny Provider and PHCS
TelemedicineTelaDoc (no copay)TelaDoc (no copay)TelaDoc (no copay)
Blink Health Rx Discount PlanIncludedIncludedIncluded
Optum Rx BenefitsNot CoveredNot Covered2018 Rx Formulary
Tier 1 – Low CostN/AN/A$1 Copay
Tier 2 – GenericsN/AN/A10% Co-Insurance
Tier 3 – Preferred BrandN/AN/A20% Co-Insurance
Tier 4 – Non-Preferred 1N/AN/A40% Co-Insurance
Tier 5 – SpecialtyN/AN/A10% Co-Insurance (pays up to $150)
Tier 6 – Non-Preferred 2N/AN/A20% Co-Insurance (pays up to $250)
Learn more | See RatesLearn more | See RatesLearn more | See Rates

Preventive health plans meet the requirements for Minimum Essential Coverage (MEC) as outlined by the Affordable Care Act (ACA).  Groups of fifty (50+) or more employees should also consider a plan that meets the requirements to be a Minimum Value Plan (MVP) to avoid potential penalties for large employers.  Groups of fifty (50+) or more enrolled employees may be eligible for additional discounts.  Ask your Planstin representative for more information.

Our Preventive health plans are often paired with added benefits.  These added benefits may include catastrophic coverage, accident, critical illness, hospital or other complimentary plans.  Your insurance broker can help you customize a plan that will help you keep costs low while getting the coverage that you want.  See your health insurance broker or Planstin representative for more information.

Preventive Health Plans

 


Preventive Advanced

The Preventive Advanced plan includes the preventive coverages that meet the Minimum Essential Coverage (MEC) requirements along with many coverages that are most commonly utilized at a copay or with coinsurance.  These benefits include unlimited use of TelaDoc without a copay, copay to visit a doctor, copay for urgent care, prescription plan and more.

Monthly Rates

Preventive Advanced Monthly
Employee Only $150
Employee + Spouse $240
Employee + Children $240
Employee + Family $325

$150 group setup fee charged upon implementation.

 


Preventive Basic

The Preventive Basic plan is great for those who want to have the claims included in the plan but without the extras that the Preventive Advanced plan has.  This plan is designed to keep both the employer and employee compliant to avoid tax penalties by having Minimum Essential Coverage (MEC).

Monthly Rates

Preventive Basic Monthly
Employee Only $80
Employee + Spouse $110
Employee + Children $110
Employee + Family $150

$150 group setup fee charged upon implementation.

 


ASO MEC

The ASO MEC plan is a great plan to keep costs low and stay compliant.  For business owners, the ASO MEC plan is a compliance tool to avoid tax penalties along with a "use now, pay later" claims administration.  The claims are paid by the business owner as the benefits are used.  This strategy is great for those employers who are looking to avoid a tax penalty and keep costs low for Minimum Essential Coverage (MEC).

Monthly Rates

ASO MEC Monthly
Employee Only $30
Employee + Spouse $55
Employee + Children $55
Employee + Family $80

$150 group setup fee charged upon implementation.