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2017 Small Group Plan Materials

50 Or Less Employees - Piedmont Plan Materials

 
 
  Schedules of Benefits PPO
  Summary of Benefits and Coverage PPO
   
  Schedules of Benefits HMO
Summary of Benefits and Coverage HMO
   
Forms

The Affordable Care Act established four levels of coverage, or "Metal Tiers", based on the concept of "Actuarial Value", a term that refers to the share of health care expenses the plan will cover on average:

SML-GRP-TABLE


All benefits described herein are subject to other benefit limits and exclusions as described in the Certificate of Coverage and Schedule of Benefits. Please read all plan documents together carefully.

The ACA required Pediatric Dental benefits are NOT included in these plans. Separate coverage must be obtained by the group. These plan designs are only applicable to small groups with 2-50 FTE employees. Additional morbid obesity coverage may be purchased for all plans shown at a higher premium. Emergency Room copay is waived if admitted, then subject to inpatient deductible/coinsurance. All plans listed are Calendar Year by default; a Plan Year option is also available.

Does this Coverage Provide Minimum Essential Coverage?
The Affordable Care Act requires most people to have health care coverage that qualifies as “minimum essential coverage”.  All plans shown do provide minimum essential coverage.

Does this Coverage Meet the Minimum Value Standard?
The Affordable Care Act establishes a minimum value standard of benefits of a health plan. The minimum value standard is 60% (actuarial value). All plans shown do meet the minimum value standard for the benefits it provides.