ABC Corporation Benefit Plan
Blue Cross Blue Shield of Texas
Member Login: http://www.bcbstx.com/member
Benefit Connection Gap Coverage
Benefit Connection is a GAP plan designed to complement major medical insurance plans by helping to cover out-of-pocket expenses, such as deductibles, copays and coinsurance. The base plan offers benefits to help cover hospital confinement stays. Optional benefits for outpatient treatment and physician office visits are also available, allowing employers to customize a plan for their employees.
May be sold to any employer group that has a major medical policy in place for employees. This supplemental policy covers portions of the expenses employees and their families incur due to treatment of injuries and illnesses under their major medical insurance as a result of the application of deductibles and coinsurance.
This product does not pay 100% of out‐of‐pocket expenses.
- Reduces Out-of-Pocket Expenses due to high deductibles & coinsurance maximums
- Employer Paid or Voluntary Participation
- Guaranteed Issue – No Medical Underwriting
- Hospital Confinement Benefit
- Out-Patient Benefit (2 options available)
- Optional Physician Office Visit Benefit
- Term Life and AD&D available
- Critical Illness coverage available
- A+ Rated Carrier*
Critical Illness – $25,000.00
(Policy Form No. W H1108 – Individual; G H1107/G H1107C – Group)
Critical Illness Insurance is designed to pay a lump sum to the insured upon diagnosis of specified diseases and illnesses. This product provides for the possibility of multiple payments by using a category approach.
Issue Ages: 18 and over
Benefit Amounts: $5,000-$100,000 – employee and spouse; $10,000 Children
Highlights: Coverage can include spouse and children. Coverage begins immediately for all conditions except for Loss of Independent Living Benefit, Cancer Rider and Wellness Rider, each with 30-day waiting period. Coverage is portable. 100% of employee premium returned when insured dies of any cause (minus any benefits received). Multiple benefits may be paid for illnesses from the “heart/stroke” category, the “other illnesses” category and the Cancer Rider.
Four optional riders including Recurrence Benefit Rider
Covered Health Conditions:
Heart Attack, Major Organ Transplant (heart or combination transplant, including heart), Stroke, Coronary Bypass Surgery, Angioplasty, Advanced Alzheimer’s Disease, Coma, Kidney (Renal) Failure, Major Organ Transplant not Covered in Category 1, Occupational HIV, Paralysis Not the Result of a Stroke, Severe Burns, Loss of Independent Living (ADLs),Invasive Cancer and Cancer in Situ
Delta Dental Group # 556043DPrem
Greatest Patient Savings Least Patient Savings
Network Delta Dental
Delta Dental Premier dentist
Non-participating dentist In-network
Fee charged by dentist $1,000 $1,000 $1000
Maximum dentist can charge $710 $950
Unlimited Benefit percentage 50% 50% 50%
Delta Dental pays $355 $475 $300
Patient Pays $355 $475 $700