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Benefit Package 1 Benefit Package 2
Standard Plans Professional Health + Accident Prescription Buy-Up Options

  Silver Gold Platinum
  PPO Non-PPO PPO Non-PPO PPO Non-PPO
    Plan Maximum Benefit Per Insured $4,000 $4,000 $5,000 $5,000 $10,000 $10,000
 
    Within this Maximum, the Following Limits Apply
 
 Inpatient Benefits per insured Silver Gold Platinum
  PPO Non-PPO PPO Non-PPO PPO Non-PPO
    Total Inpatient Benefit Limit $3,000 $3,000 $3,000 $3,000 $7,000 $7,000
    Inpatient Facility Maximum (Other than R&B) $1,000 $1,000 $1,000 $1,000 $1,000 $1,000
      Daily Room & Board Limits:  
        Intensive Care- per day $400 $400 $400 $400 $600 $600
        All Other Accomodations- per day $200 $200 $200 $200 $300 $300
 
 Outpatient Benefits per insured Silver Gold Platinum
  PPO Non-PPO PPO Non-PPO PPO Non-PPO
    Outpatient Maximum- per insured $1,000 $1,000 $2,000 $2,000 $3,000 $3,000
    Insured Percent (percentage paid by AHL) 70% 60% 80% 80% 80% 70%
    Co-payment by Insured Person- per visit $201 $202 $153 $154 $155 $156
 
    1All in office procedures covered at 100% after Co Pay   2Only office visit covered at 100% after Co Pay other procedures covered at 70%  
    3All In office procedures covered at 100% after Co Pay   4Only office visit covered at 100% after Co Pay other procedures covered at 70%  
    5All in office procedures covered at 100% after Co Pay   6Only office visit covered at 100% after Co Pay other procedures covered at 70%  
 
     All Other procedures subject to deductible and coinsurance
 
 Prescription Drug Card Benefits Silver Gold Platinum
     Prescriptions covered at 70% once the plans $250/$750 deductible has been met. Discount up to 35% on brand and generic. Prescriptions covered at 80% once the plans $200/$500 deductible has been met. Discount up to 35% on brand and generic. Prescriptions covered at 80% once the plans $200/$500 deductible has been met. Discount up to 35% on brand and generic.
 
 Deductible Silver Gold Platinum
  PPO Non-PPO PPO Non-PPO PPO Non-PPO
    Per Insured Person $250 $250 $200 $200 $200 $200
    Per Family $750 $750 $500 $500 $500 $500
 
 Accidental Death & Dismemberment Silver Gold Platinum
    Employee Amount $10,000 $10,000 $20,000
    Spouse Amount $5,000 $5,000 $10,000
    Child Amount (for children age 6 months +) $5,000 $5,000 $10,000
 

The inpatient and outpatient limits under medical expense insurance are internal limits that accumulate towards the annual medical expense insurance maximum. The daily room & board benefits are in addition to the inpatient limit and accumulate with that limit towards the annual medical expense insurance maximum. The supplemental medical expense insurance benefits are payable after the medical expense insurance benefits have been exhausted. This benefit covers inpatient services only.
 

Benefits In A Card has contracted with Private Healthcare Systems (PHCS), the largest proprietary Preferred Provider Organizations (PPO’s) in the Country. Private Healthcare Systems has over 450,000 providers and 4,200 facilities in their network. They are the first and only PPO to earn four endorsements of quality and their strong relationships with providers mean they’re able to offer customers the best savings in the industry.

    • Private Healthcare Systems gives you the opportunity to choose one of their in-network providers which will stretch your benefit dollars.
    • You can easily access the network providers by going on line at www.phcs.com or your account manager at Benefits In A Card at 800-226-2770 for any assistance
    • PHCS On Call -Through PHCS On Call Benefits-In-A-Card offers employees access to a 24- hour Nurse Advice Line and an audio library containing information on more than 2,000 health topics. With PHCS On Call employees receive piece of mind knowing that medical advice is just a phone call away.
    • Enjoy the freedom to seek any healthcare provider