HCIS has partnered with two industry leading

benet companies Midwest Business Advantage

and Ternian Insurance Group, to help our member
companies offer affordable insurance coverage
to their employees, including:
A Minimum Essential Coverage plan (MEC) plan that
helps your organization avoid the $2,000 per employee
penalty from the ACAs employer mandate.*
An employee that choses this MEC plan will also avoid the
individual penalty which is set to increase in 2015 to $325
per uninsured person or 2 percent of household income.
Other health benet plans that help reduce your employees
out-of-pocket costs for a variety of common healthcare services.
A variety of other valuable options like vision, dental
and renters insurance.
Our streamlined administration also makes these plans
easy to manage.
* Employer may be subject to remaining $3,000 penalty for employees who buy
a plan through a health insurance exchange and receive a subsidy.
An affordable
solution for
HCIS member
companies
looking to
comply with the
Affordable Care
Act (ACA)
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Our partners have made every effort to ensure
that the management of these benets is
simple and turnkey through the following features
and services:
All of these plans can be offered within a single online
beneft portal, allowing your employees to view plan information,
price these options and enroll all in one place.
You will have access to an administrative portal that
makes it easy for you to manage new eligible employees,
view your enrollment data and much more.
Our HealthSelect and MEC plans, which provide an ideal
bundle for non-insured employees, require just one ID card
and have integrated claims processing.
We provide premier customer service for all of these plan options,
with one number for employees to contact for assistance.
Offering
streamlined
enrollment
and
administration
ADMINISTRATION
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The offering of health benets is an essential part
of your efforts to recruit and retain quality employees.
Its also a requirement for many employers now
that the ACA is in place.
HCIS has selected health plans that can meet the needs of all of your
workers, including those who already have comprehensive medical
coverage as well as employees who are currently uninsured. Learn more
about these products by selecting from the links below.
Plans ideally suited to uninsured employees:
Minimum Essential Coverage (MEC) & HealthSelect Plans
A plan that can reduce out-of-pocket expense
for employees who already have medical coverage:
HealthAssist Plan
Dental & Vision Plans
Affordable
plans that t
the needs of
your employees
while helping
you comply
with the ACA
HEALTH PLANS
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An MEC helps protect you and your employees
from ACA penalties
This plan provides preventive health benefts that meet Minimum Essential
Coverage requirements from the Affordable Care Act (ACA).
Employees who select this coverage wont face the individual
penalty for being uninsured.
Your organization wont be subject to the $2,000 per employee
penalty related to the ACAs employer mandate.*
Learn more about the key benefts and rates for this plan.
HealthSelect complements this plan by providing
coverage for everyday health issues
Since this MEC plan provides access only to preventive health benefts,
it is also bundled with a HealthSelect plan.
HealthSelect provides dollar coverage for a variety of common,
everyday health issues with no deductibles for your employees to meet.
In addition to physician offce prepays and prescription benefts,
this plan also provides a fxed dollar amount toward laboratory testing,
radiology and inpatient/outpatient surgery.
Learn more about the key benefts and rates for this plan.
Minimum Essential Coverage
(MEC) + HealthSelect
MEC & HEALTH SELECT
* Employer may be subject to remaining $3,000 penalty for employees who buy
a plan through a health insurance exchange and receive a subsidy.
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Even if your employees have comprehensive
medical coverage through a government exchange
or their spouse, its likely that they have signicant
out-of-pocket expenses.
Thats because many of these plans now have high deductibles
and cost-share requirements. HealthAssist provides frst-dollar coverage
that will help reduce your employees exposure to these costs.
These plans include the following:
Outpatient accident, medical hospitalization and
critical illness coverage.
An employee assistance program including with 24/7/365
telephonic access to behavioral health support and three in-person
counselor visits.
A telemedicine program than offers unlimited consultations
with a board-certifed physician.
Learn more about the key benefts and rates for this plan.
Coverage that reduces
out-of-pocket costs
for employees with major
medical coverage
HEALTH ASSIST
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We know that when employees understand their
coverage and know what to expect, they are more
satised with their benets. Thats why we offer an
easy-to-use voluntary dental plan that provides
transparent pricing details for hundreds of dental
procedures. Our members have access to the contracted
amount that the dentist will accept, as well as the
amount covered by the insurance plan per procedure.
These Dental plans provide members with access to network discounts
averaging 20-40% below normal cost for services such as: Preventive and
Diagnostic, Minor and Major Restorative, Endodontics, Periodontics, Oral
Surgery, General Anesthesia and Orthodontia. These plans also include basic
vision coverage which can be used at any vision provider, including benefts
for exams and vision-related materials.
Below you will nd highlights of the plan
benets and rates:
Affordable dental
coverage plus value-added
vision benets
DENTAL & VISION PLANS
Maximum Plan Year Limit $1,000 $2,000
Periodontics lifetime maximum $500 $1,000
Orthodontics lifetime maximum $500 $1,000
Vision Examination beneft included every year $35 $35
Vision Materials beneft included every two years $75 $75
Dentemax Provider Network Discounts Included Included
MONTHLY RATES
Employee $24.95 $33.55
Employee + Spouse $53.83 $72.48
Employee + Family $74.64 $101.51
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This MEC plan includes all 63 federally mandated wellness/preventive
services, each of which are covered at 100% by the plan with no out-of-
pocket costs for the employee or their covered dependents. These
coverage includes exams, vaccinations and testing specic to medical
guidelines for adults and children such as:
Cholesterol screening for adults of certain ages or at higher risk
Colorectal Cancer screening for adults over 50
Type 2 Diabetes screening for adults with high blood pressure
Diet counseling for adults at higher risk for chronic disease
HIV screening for all adults at higher risk
Immunization vaccines for adults and children doses, recommended ages,
and recommended populations vary
Obesity screening and counseling for all adults
Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
Breast Cancer Mammography screenings every 1 to 2 years for women over 40
Cervical Cancer screening for sexually active women
Following are the rates for our MEC Plan.
For more information on HealthSelect, click here.
Minimum Essential Coverage
(MEC) Benets & Rates
MEC BENEFITS & RATES
ANTICIPATED CLAIMS COSTS HIGH RANGE
Employee Only $32.00
Employee + Spouse $75.00
Family $116.00
Funding rates illustrated are actuarial suggested funding based on anticipated claims and shall be fully self insured.
MONTHLY ADMINISTRATIVE FEES: $4 per employee
The above rates refect a fully self insured MEC Program, however Stop Loss Insurance (Re-insurance)
is available to groups with at least 50 employees for a nominal additional premium.
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Provides limited medical coverage for accidents, illness and specifed disease to help cover basic, minor-medical
expenses for employees that are not eligible for major medical and would like an affordable option.
HEALTH SELECT BENEFITS & RATES
INPATIENT
(1)
BASIC CHOICE MAX
Hospital confnement day 1 beneft amount $750 per day $750 per day $1,000 per day
x 1 day x 1 day x 1 day
Hospital confnement days 2+ beneft amount - per day $500 thereafter $500 thereafter $500 thereafter
Maximum Beneft 5 days 5 days 10 days
per Plan Year per Plan Year per Plan Year
Days 1+ additional ICU beneft amount - per day N/A $1,000 per day $1,000 per day
x 5 days x 5 days
Surgery beneft amount (incl. maternity) - per day N/A $500 per day $1,000 per day
x 1 day x 1 day
Anesthesia beneft amount - per day N/A $125 per day $250 per day
x 1 day x 1 day
OUTPATIENT
(1)

Physician Offce Visit Pre-pay
(2)
$10 $10 $10
Beneft amount - per day $75 per day $85 per day $100 per day
x 3 days x 3 days x 5 days
Accident maximum beneft amount per year up to: $2,500 $5,000 $5,000
Beneft % payable 80% U&C 80% U&C 80% U&C
Deductible per Accident $0 $0 $0
Emergency Room (sickness) beneft amount - per day $100 per day $100 per day $200 per day
x 2 days x 2 days x 2 days
Surgery beneft amount - per day N/A $500 per day $750 per day
x 1 day x 1 day
Anesthesia beneft amount - per day N/A $125 per day $185 per day
x 1 day x 1 day
Diagnostic, X-ray, Lab Beneft amount - per day:
Class I: Laboratory - Blood work, CMP, Lipid Panel, ECG, Pap/PSA, $30 per day $30 per day $30 per day
urinalysis and all other laboratory tests x 2 days x 4 days x 4 days
Class II: Radiology, Ultrasound, Mammogram, Sonogram, Angiogram $60 per day $75 per day $75 per day
x 2 days x 2 days x 2 days
Class III: Imaging CT, PET, MRI $100 per day $125 per day $125 per day
x 1 day x 1 day x 2 days
Class IV: Other Diagnostic test- Endoscopy, Bronchoscopy, $200 per day $250 per day $350 per day
Colonoscopy without Biopsy x 1 day x 1 day x 1 day
PRESCRIPTION
(3)

Retail - Generic RX copay Discount Only $10 $10
Retail - Preferred Brand RX copay Discount Only Discount Only $30
Mail Order - Generic RX copay Discount Only $30 $30
Mail Order - Preferred Brand RX copay Discount Only Discount Only $90
Monthly beneft maximum INDIVIDUAL N/A $200/$400 $200/$400
AD&D
Accidental Death & Dismemberment
(1)
beneft $15,000/5,000/1,000 $20,000/5,000/1,000 $25,000/5,000/1,000
amount*
OTHER SERVICES (4)

Consult a Doctor: Unlimited Free Telemedicine Yes Yes Yes
SupportLinc Employee Assistance Program Yes Yes Yes
First Health PPO Network Discounts Yes Yes Yes
HEALTHSELECT LIMITED MEDICAL PLAN PRICING BASIC CHOICE MAX
MONTHLY RATES Low Range
(1)
Employee Only $46 $78 $114
Employee + Spouse $100 $168 $244
Family $145 $243 $356
MONTHLY RATES High Range
(1)
Employee $76 $121 $173
Employee + Spouse $167 $262 $375
Employee + Family $243 $380 $546
(1) The Fixed Hospital Indemnity, Outpatient Accidental-Only, Critical Illness and AD&D Beneft Plans are underwritten by AXIS Insurance Company. (2) The offce visit pre-pay is a service through the First Health PPO
Network. (3) Prescription benefts are underwritten by an A.M. Best Rated Carrier. (4) Term Life is underwritten by Minnesota Life. *Beneft amounts listed are for: Employee/Spouse/Child(ren)
NOTICE: The insurance described in this proposal provides limited benets. Limited benets plans are insurance products with reduced benets and are not intended to be an alternative to or integrated
with comprehensive coverage. This insurance does not coordinate with any other insurance plan. It does not provide major medical or comprehensive medical coverage and is not designed to replace major
medical insurance. Further, this insurance is not minimum essential benets as set forth under the Patient Protection and Affordable Care Act.
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Provides supplemental insurance coverage for employees with Major Medical high deductible plans.
These plans focuses on the unexpected by offering outpatient accident, medical, hospitalization and critical
illness coverage at a price employees can afford.
HEALTH ASSIST BENEFITS & RATES
MONTHLY RATES OFFERED ON A VOLUNTARY BASIS $2,500 $5,000 $10,000
Employee Only $23.12 $37.08 $51.31
Employee + Spouse $50.87 $81.58 $112.87
Family $73.99 $118.66 $164.18
OUTPATIENT ACCIDENT COVERAGE
(1)

Deductible per Accident $0 $0 $0
Paid at 100% 100% 100%
INPATIENT BENEFIT
(1)

Day 1 cash beneft $500 per day $1,000 per day $1,000 per day
x 1 day x 1 day x 1 day
Day 2+ cash beneft - per day $500 per day $800 per day $1,000 per day
x 4 days x 5 days x 9 days
CRITICAL ILLNESS
(1)

Payable for 10 conditions: $2,500 $5,000 $10,000
Cancer, Heart Attack, Renal Failure, Stroke, Major Organ Transplant,
Multiple Sclerosis, Coronary Artery Bypass Surgery, Alzheimers, ALS, Terminal Illness.
ACCIDENTAL DEATH & DISMEMBERMENT
(3)

Employee $5,000 $10,000 $15,000
Spouse $2,000 $5,000 $5,000
Child(ren) $1,000 $1,000 $1,000
SUPPLEMENTAL ASSIST PACKAGE
(3)
MONTHLY RATES

Consult a Doctor: Unlimited Free Telemedicine Employee Only $4.75
SupportLinc Employee Assistance Program Employee +1 $8.00
3 Free face-to-face, unlimited tele
RX Discount Card Family $10.00
(1) The Fixed Hospital Indemnity, Outpatient Accidental-Only, Critical Illness and AD&D Beneft Plans are underwritten by AXIS Insurance Company. (2) Prescription benefts are underwritten by an A.M. Best Rated Carrier.
(3) These services are not insurance and are not provided by the underwriting companies shown here. *Beneft amounts listed are for: Employee/Spouse/Child(ren)
NOTICE: The insurance described in this proposal provides limited benets. Limited benets plans are insurance products with reduced benets and are not intended to be an alternative to or integrated
with comprehensive coverage. This insurance does not coordinate with any other insurance plan. It does not provide major medical or comprehensive medical coverage and is not designed to replace major
medical insurance. Further, this insurance is not minimum essential benets as set forth under the Patient Protection and Affordable Care Act.
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If you would like to begin offering these benets
to your employees, or for more information about
any of the plan options and features included
here, please contact:
Midwest Business Advantage
at 1-800-370-7039 and mention HCIS
or email BEV@MBAGROUPS.COM.
At HCIS,
we consider
each and
every client
our partner
in success
CONTACT US
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