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Consumer Reports Article 04/06/2009
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 Group Advantage Small Group Health Insurance policies are provided by the Independence Holding Group an insurance  organization comprised of Independence Holding Company (NYSE: IHC) and its operating  subsidiaries and affiliates. With more  than $1.3 billion in assets, the IHC Group serves more than one million customers through its operating companies, which include  three A- (Excellent) A.M. Best-rated insurance carriers, third-party administrators, managing general underwriters and marketing  organizations. The IHC Group has been providing life, health and stop-loss insurance solutions  for over 25 years.

 Group Advantage Small Group Health Insurance policies are administered by Insurers Administrative Corporation a member of  the IHC Group. IAC is a leading administration and marketing organization in the fully insured, partially self-funded and  international  markets. Established in 1978, IAC specializes in small group plan (2-50 lives), Individual Health Plans short-term  medical, dental and other insurance products.

Communicating for America, Inc. endorses the IAC Personal Health Plans and is a national non-profit association founded in 1972. Originally founded as an advocate for the self-employed and rural members, CA has evolved into one of the largest and most respected associations in the country with members in communities of all sizes. Along with a legislative voice on important issues in Washington, D.C., CA provides high quality, valuable member benefits. CA, Inc. is not compensated by Standard Security Life Insurance Company of New York for its endorsement. Association membership not required or available in Colorado, Georgia, Kansas, Montana and South Dakota.

Standard Security Life Insurance Company of New York is the insurer for health, dental, life, accidental death and dismemberment benefits described in the Group Advantage Small Group Health Insurance brochure below. Standard Security Life Insurance Company of New York, a member of the IHC Group, is rated A-(Excellent) by A.M. Best Company, a widely recognized rating agency that rates insurance companies on their relative financial strength and ability to meet their obligations to their insured's. Standard Security Life Insurance Company of New York was founded in 1958, and is domiciled in the State of New York, and headquartered in New York City. It is licensed in all 50 states, the District of Columbia, the Virgin Islands, and Puerto Rico.

Group Advantage Small Group Health Insurance policies provide high and low deductible plans with unlimited "first dollar" outpatient doctor office visit co pays. A "first dollar" benefit is defined as "a benefit you receive without paying your calendar year health plan deductible first e.g. outpatient doctor office visit co pays, outpatient prescription drug co pays, outpatient Preventative care or Wellness benefits". They also provide very competitively priced HSA qualified HDHP's and HRA's (Health Reimbursement Arrangements).


Calendar Year Health Plan Deductible choices range from $500 to $8,000. There are three different "co-insurance" options to choose from as well with "stop loss numbers" ranging from as low as 10,000 to as high as $25,000. Since the terms "co-insurance" and "stop loss number" are very rarely if ever explained to the prospective insured. We will make an effort to do so below. For ease of reference the "stop loss number" in the below scenarios will remain constant in all three examples. If anything remains unclear be sure to ask your broker of record for further clarification. The first (and most expensive) "co-insurance" arrangement scenario is the 100% option. With this option there would be nothing else to pay for in network treatment once you have satisfied your calendar year deductible.

The second "co-insurance" arrangement scenario is the 90/10 of $10,000 "co-insurance" percentage split. This simply means that after you have satisfied your calendar year deductible, the insurance company will pay 90% ($9,000) and the insured will pay 10% ($1,000) of the first $10,000 in medical bills that you incur each year. This first $10,000 is known as the "stop loss number". After this brief sharing arrangement is over, the insurance company pays 100% up to $5 Million for the rest of that calendar year. Everything starts over again on the first of each subsequent year.

The third "co-insurance" option is the 80/20 of $10,000 "co-insurance" percentage split. This means that after you have satisfied your calendar year deductible, United Health Care will pay 80% ($8,000) and the insured will pay 20% ($2,000) of the first $10,000 in medical bills that you incur. This first $10,000 is known as the "stop loss number". After this brief sharing arrangement is over, the insurance company pays 100% up to $5 Million for the rest of that calendar year. Everything starts over again on the first of each subsequent year. If the "stop loss number" in the above scenario increases from $10,000 to $15,000, $20,000 or $25,000 then your 10% or 20% portion will increase respectively. The point to remember is that you are not responsible for 10% or 20% of your entire medical bill. There is always a safety net and that safety net is referred to as the "stop loss number."

Group Advantage Small Group Health Insurance policies also offer four different prescription drug card arrangements:

Option 1: Provides a discount on prescription drugs at participating pharmacies (www.expresscripts.com)
Option 2: Generic $15 Specialty Drugs $90 $250 deductible per insured per calendar year, then: Preferred Brand $45
Non-Preferred Brand $60

Option 3:
Generic $10 Preferred Brand $25 Non-Preferred Brand $40 Specialty Drugs $50
Option 4:
All covered prescription drug purchases apply toward the medical deductible and coinsurance.

Group Advantage Small Group Health Insurance policies also offer the following optional benefits:
 
Dental -
No waiting periods; see separate brochure below for details:
Your employees can get immediate insurance coverage for basic and major services.
Vision -
Choose from two plan designs; see separate brochure for details:
Offer your employees vision insurance coverage. Includes exams, lenses and frames.
Optional Wellness Benefit - Routine physical exams, flu shots, child wellness screening and immunizations, colorectal and prostate cancer screening are covered at 100% up to $350, $500 or $1,000 per insured per calendar year after a $35 co pay. There is no waiting period and both in and out-of-network services are included.
Supplemental Accident Coverage - Choose a $500, $1,000 or $2,000 per accident benefit amount for your employees. Benefit applies to both in and out of network.
Maternity Coverage -
Covered charges include treatment, hospital expenses, nursery charges, cesarean section delivery, prenatal charges & postnatal charges.
Life Insurance and Accidental Death & Dismemberment -
Available options range from $10,000 to $100,000 of coverage.
24-Hour Occupational Coverage - Get protection against work-related injuries and sickness. Available to eligible business owners, sole proprietors or corporate.

 

                          Standard Security Life Group Advantage Health Insurance Plan Product Highlights

  •  Standard Security Life Insurance Company of NY Rated A-(Excellent) By A.M. Best www.sslicny.com

  •  A member of  Independence Holding Group A $1.3 Billion Insurance Organization www.ihcgroup.com

  •  Administered by I.A.C. One of the nations largest administrators: www.iacusa.com

  •  Nationwide P.P.O. Network. Search for providers at: Cigna/Great West

  •  $2 Million or $5 million in lifetime Health Insurance benefits per insured.

  •  Very competitively priced HSA qualified HDHP

  •  Optional unlimited $40 doctor office sick visits co pays with the traditional plans.

  •  Optional Child & adult Preventative care included immediately; pay only the co pay. Also available with HSA qualified HDHP.

  •  Free yearly mammograms & Pap tests. Pay $0 out of pocket. Also available with HSA qualified HDHP.
    Discount drug card included with base premium or 3 other outpatient prescription drug card plans to choose from.

  •  100%, 90/10 or 80/20, co-insurance plans to choose from.

  •  Stop Loss Numbers ranging from $10,000 to $25,000.

  •  Optional Accident Medical Expense plan pays the first $500, $1,000 or $2,000 per accident in the ER.

  •  Fully HIPAA compliant plans that cover pre-existing conditions from day one providing applicants can produce a certificate of creditable coverage which shows at least 18 months of prior continuous coverage with no lapse of more than 63 days.

  •  Check the brochure for additional policy additions or exclusions depending on your State's mandates.

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IAC Group Advantage Small Group Health Insurance Plans Brochure ( PDF format)

IAC Group Advantage Small Group Health Insurance Plans State Variations ( PDF format)

IAC Dental Advantage Small Group Health Insurance Plans Brochure ( PDF format)

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