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mimic the basic look of a commercial major medi- cal plan that is being offered to full time employees. These plans typically offer co-pays, deductibles and PPO Networks which are what Human Resources and other insurance purchasers are accustomed to buying.

Advantages for Employers Limited Benefit Medical Plans can increase a com- pany’s ability to attract and retain the best people. Whether the program chosen is mandatory or voluntary, a Limited Benefit Medical plan offers the following advantages: Enhances Flexibility—The program’s flexible

benefit levels allow for customization to suit each employer’s preferences—from maximum cover- age to maximum affordability. Employers can select a standard program or custom design a program, choosing from a variety of benefit options and cover- age amounts. Controls Costs—As a voluntary program payable

through convenient payroll deductions or individual bank draft, this entails minimal cost and virtually no administration. Streamlines Administration—Cutting edge tech-

nology reduces costs and simplifies administration at every level. Delivers a Competitive Edge—These programs

offer innovative ways to improve a company’s benefits package and extend coverage to all personnel in a competitive hiring market. Provides an alternative to COBRA—Employers

are able to offer an alternative to COBRA for those employees whom face stop gaps or waiting periods while transferring from one job to another. Furthermore, Limited Benefit Medical plans give

employers the freedom to choose whether they will participate in the sharing of the employee’s medical expenses and to what extent.

Advantages for Employees Limited Benefit Medical Plans offer the U.S. work- force an affordable means to help cover their health care costs. Depending on the plan design chosen by the employer, a Limited Benefit Medical plan may also include the following benefits:

■ Payment for doctor office visits, maternity check- ups, accidents, surgical diagnostic, x-ray and lab

■ In-hospital benefit payment and hospital admission benefit payment

■ Limited or no restrictions on physician networks ■ Prescription benefit (Rx)—no annual maximums ■ Guaranteed issue coverage for immediate family with no health underwriting

■ No pre-existing condition limitations ■ No deductibles, no co-pays ■ Pre-tax deduction under IRS Sec. 125 ■ No carrier mandated benefit periods

In addition, a few plans will allow “Portable Cover-

age,” which allows the covered insured to keep their coverage via continuance provisions even if they leave their company. If this is the case, extensive benefits depending on needs, and cash benefits may some- times be paid directly to cover insured [if requested] and benefits can also be assigned to the doctor of healthcare facility. Another option that may be included under the

Limited Benefit Medical plan is a set amount of cash from the employer to use for medical expenses or to spend as an employee chooses. Specific cash benefits are paid directly to the insured without deductible or co-payments, in addition to any other insurance they may have. An employee can use the money for nonreimbursed medical expenses, alternative treatments, travel, home help or any other purpose. Some plans may even include network and pre-

scription drug discount programs offering additional savings on Medical, Dental, Vision, Rx and other services which help maximize plan benefits. Optional benefits available on some plans may include in- creased levels of insurance for Dental/Vision, Life and AD&D, Short Term Disability, EAP, and a 24-hour Nurse Line. For these reasons, Limited Medical Plans have

become an increasingly popular option for employers in the U.S. Whether a company is as large as Star- bucks or as small as a local grocery store, employers have come to the realization that they must offer something more to their hourly workers if they are to attract and retain the best employees.


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