Premier Plan 500
Copyright 2008 First Mutual Insurance Group, Inc.
Features:
Fidelity Security Insurance Company rated A- Excellent by AM BEST
$5,000,000 per person in Major Medical Coverage
Strongest National Network of Doctors and Hospitals
PPO Coverage
Fidelity Security Insurance Company rated A- Excellent by AM BEST
$5,000,000 per person in Major Medical Coverage
Strongest National Network of Doctors and Hospitals
PPO Coverage
Wellness......................................
Doctor Visits.................................
Specialists...................................
Urgent Care Center.........................
Prescriptions................................
Emergency Room............................
Outpatient Surgeries/Testing.............
Inpatient Hospitalization...................
Out of Pocket Maximum....................
Doctor Visits.................................
Specialists...................................
Urgent Care Center.........................
Prescriptions................................
Emergency Room............................
Outpatient Surgeries/Testing.............
Inpatient Hospitalization...................
Out of Pocket Maximum....................
100% up to $500 per year per person
$40 Co-pay, then 100% of History and Exam
$40 Co-pay, then 100% of History and Exam
$40 Co-pay, then 100% of History and Exam
Co-Pay Card Option or Discount Card Option
$500 Co-pay, then 100%
$500 Co-pay, then 100%
$500 Co-pay per day, then 100%
$4000 per person, up to (2) per family
$40 Co-pay, then 100% of History and Exam
$40 Co-pay, then 100% of History and Exam
$40 Co-pay, then 100% of History and Exam
Co-Pay Card Option or Discount Card Option
$500 Co-pay, then 100%
$500 Co-pay, then 100%
$500 Co-pay per day, then 100%
$4000 per person, up to (2) per family
This is a simplified outline of benefits. Please refer to the plan brochure for full outline of benefits, limitations and exclusions.
Other Co-pay/ Deductible Options:
Medical Insurance
Individuals and Families
Group Insurance
Dental Insurance
Erik Marx
(800) 831-2958 ext. 103
(800) 831-2958 ext. 103
