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Group Medical Ins.

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Group Medical Insurance

Many individuals get their Group Medical Insurance through their jobs or are covered because a family member has insurance at work. Group Medical Insurance is generally the least expensive kind. In many cases, the employer pays part or all of the cost.

Fee-For-Service (or Traditional Medical Insurance) 

This is the traditional kind of health care policy. Insurance companies pay fees for the services provided to the insured people covered by the policy. This type of Medical Insurance offers the most choices of doctors and hospitals.


Health Maintenance Organizations (or HMOs) 

 Health maintenance organizations are prepaid health plans. As an HMO member, you pay a monthly premium. In exchange, the HMO provides comprehensive care for you and your family, including doctors' visits, hospital stays, emergency care, surgery, lab tests, x-rays, and therapy. The HMO arranges for this care either directly in its own group practice and/or through doctors and other health care professionals under contract. Usually, your choices of doctors and hospitals are limited to those that have agreements with the HMO to provide care.


Preferred Provider Organizations (or PPOs) 

 The preferred provider organization is a combination of traditional fee-for-service and an HMO. Like an HMO, there are a limited number of doctors and hospitals to choose from. When you use those providers (sometimes called "preferred" providers, other times called "network" providers), most of your medical bills are covered. When you go to doctors in the PPO, you present a card and do not have to fill out forms. Usually there is a small co-payment for each visit. For some services, you may have to pay a deductible and coinsurance. As with an HMO, a PPO requires that you choose a primary care doctor to monitor your health care. Most PPO's cover preventive care. This usually includes visits to the doctor, well-baby care, immunizations, and mammograms. In a PPO, you can use doctors who are not part of the plan and still receive some coverage. Many people like this option because even if their doctor is not a part of the network, it means they don't have to change doctors to join a PPO.

 

 

Policyholder Name:
Contact Name:
City:
State:
ZIP Code:
Phone:
FAX:
E-mail Address:
Existing Carrier:
(if applicable)
Current Plan:
(if applicable)
Current Rate:
(if applicable)
Effective Date: / /
Renewal Date: / /
Current Rates:
Single:
Husband/Wife:
Parent/Child:
Family:
Plan Design: HMO
POS
In Network Only
In/Out Of Network
Contributions: Employer Paid
Employee Paid
Employer and Employee Paid

For groups over 5 employees, please fax your census to 201-703-0045!!

Employee #1

DOB: / /
Sex: Male
Female
Coverage: Single
Husband/Wife
Parent/Child
Family

Employee #2
(if applicable)

DOB: / /
Sex: Male
Female
Annual Salary:
Coverage: Single
Husband/Wife
Parent/Child
Family

Employee #3
(if applicable)

DOB: / /
Sex: Male
Female
Annual Salary:
Coverage: Single
Husband/Wife
Parent/Child
Family

Employee #4
(if applicable)

DOB: / /
Sex: Male
Female
Annual Salary:
Coverage: Single
Husband/Wife
Parent/Child
Family

Employee #5
(if applicable)

DOB: / /
Sex: Male
Female
Annual Salary:
Coverage: Single
Husband/Wife
Parent/Child
Family