What is the Premium Saver?
The Premium Saver is an employer sponsored group supplemental insurance plan which is designed to help reduce the cost of group medical coverage. Combining the Premium Saver with certain major medical plans can deliver coverage groups want and can afford.
How does the Premium Saver pay claims? It’s simple!
The Premium Saver pays off of the underlying major medical plan EOB, and it pays benefits directly to the provider. When the insured goes in-network they always receive the carrier’s in-network discounts.
What coverage does the Premium Saver provide?
Supplemental Deductible and Co-Insurance
Premium Saver plans have a supplemental deductible and co-insurance per insured person that must be satisfied before benefits are paid. After the insured’s deductible has been satisfied the plan pays the benefits described in the policy until the payments reach the Maximum Benefit Amount.
Benefits for Hospital and Outpatient Expenses
Our most frequently selected Premium Saver plan pays the amount applied to your major medical deductible, co-insurance, and co-payments. It covers the same expenses as your major medical plan, with the exception of charges for professional fees in a doctor’s office or medical clinic or for outpatient prescription drugs.
What Premium Saver plan designs are available?
Each group can choose the plan design and benefit amount to achieve the maximum overall premium savings for their group. The Premium Saver is extremely flexible.
Maximum Benefit Amount Options are any amount from $1,000 to $9,500 per person per calendar year
Deductible Options are from $250 to $3,000 (higher deductible available upon request)
Co-Insurance Options are 0%, 90/10%, 80/20%, 70/30%, 75/25%, 50/50% from $0 to $10,000 Out-of-Pocket
Are there any participation requirements or waiting periods?
Everyone (employees and dependents) enrolled on the group’s major medical plan must be enrolled with the Premium Saver plan. On the Premium Saver effective date, everyone covered by the group’s major medical plan will be covered by the Premium Saver plan.
What are the underwriting guidelines?
There are no excluded groups. The minimum group size is 5.
An Example of How The Premium Saver Works
The example below shows a 68 person broadcasting company that currently offers their employees a $2,000 deductible BC/BS plan. At renewal, the group received a 19% increase, raising their $400,000 annual premium to $477,980.76. To save the employer premium and maintain benefits, the broker recommended changing to an affordable High Deductible Major Medical, then adding our group supplemental insurance plan to fill the deductible and cost sharing holes.
The Result? A guaranteed annual savings of over $50,000. The employer saved money. The employees maintained the same deductible. And the agent earned commission on both plans — the major medical and the Premium Saver.
How does a group get a quote and proposal? It’s as simple as 1,2,3!
- Contact MWG Marketing or go to our web site to acquire a “Request for Premium Saver Quote” form.
- Complete the simple, one page form and send it to MWG Marketing. We do not need a census.
- MWG will generate proposals designed to meet the group’s goals that you describe on the quote form. Each proposal will show projected savings compared to the renewal rate. You will normally receive the custom proposals within 24 hours.
How does a group enroll? It’s simple! Employee applications are not required.
- The employer signs a group application.
- The agent sends MWG the group application and the enrollment information with the first month’s premium 14 days prior to the requested effective date. (MWG prefers electronic transfer of enrollment information – ask about Simplified Enrollment Guidelines)
How to file a Claim:
Let the Provider file the claim. This is the easiest and best way to receive benefits.
MWG will send insurance cardholders for each employee. All the insured has to do is to put their Major Medical and Premium Saver insurance cards in the cardholder and hand the cardholder to the provider. Most providers will file the claims because the benefits are paid to the provider. Guidelines and claims assistance phone number are printed on the cardholder. On the back of the group application, MWG requests a list of the providers the group expects to use. MWA Administrators will send a letter to each provider explaining how to file claims.
If the insured files the Premium Saver claim they should follow these steps:
- The insured’s claim is filed with their major medical carrier.
- The insured’s major medical carrier will provide the insured with an EOB (Explanation of Benefits). This form describes the procedures covered, facility used, benefit paid and the amount applied to the insured’s deductible or co-insurance.
- The insured should ask their doctor and/or hospital to provide them with a Health Insurance Claim Form (CMS 1500) or a Hospital Claim Form (UB04). These forms describe the procedure codes and provides us with the provider’s address and federal identification number so that the claim can be paid on your behalf.
- The insured will then send the EOB and Doctor or Hospital form from the medical provider to Morgan White Administrators.