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INFORMATION
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RATES
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OPTIONS
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Flex Health PRO • FLICA
Flex Health PRO Value
Flex Health PRO Value includes the following benefits:
$200 Hospital Confinement/30 Days Per Calendar Year,
$200 Intensive Care Confinement/5 Per Calendar Year,
$50 Emergency Room Visit/1 Per Calendar Year,
$65 Provider Office Visit/3 Per Calendar Year Per Insured,
$50 Health Screening Benefit/1 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/1 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$125 Calendar Year Maximum Per Insured,
$500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$2,500 AD&D - Primary/$1,250 - Spouse/$625 - Child,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, PR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$144.00
per Month
for Member
$217.00
per Month
for Member plus One (Spouse or Child)
$306.00
per Month
for Member plus Family
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Flex Health PRO • FLICA
Flex Health PRO 1
Flex Health PRO 1 includes the following benefits:
$250 Hospital Confinement/30 Days Per Calendar Year,
$250 Intensive Care Confinement/5 Per Calendar Year,
$100 Emergency Room Visit/1 Per Calendar Year,
$2,000 Per Surgical Procedure/3 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/3 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$150 Calendar Year Maximum Per Insured,
$500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$2,500 AD&D - Primary/$1,250 - Spouse/$625 - Child,
$15,000 GI Term Life (Principal Financial Group),
CVS 4-Tier Discount Plan,
ConsultADoctor,
Karis - Patient Advocacy,
NAC,
NVA Vision,
Premier Ancillary
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, PR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$213.00
per Month
for Member
$363.00
per Month
for Member plus One (Spouse or Child)
$493.00
per Month
for Member plus Family
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Flex Health PRO • FLICA
Flex Health PRO 2
Flex Health PRO 2 includes the following benefits:
$500 Hospital Confinement/30 Days Per Calendar Year,
$500 Intensive Care Confinement/5 Per Calendar Year,
$150 Emergency Room Visit/1 Per Calendar Year,
$2,000 Per Surgical Procedure/3 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/3 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$250 Calendar Year Maximum Per Insured,
$2,500 Critical Illness Benefit,
$2,500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$5,000 AD&D - Primary/$2,500 - Spouse/$2,500 - Child,
$15,000 GI Term Life (Principal Financial Group),
CVS 4-Tier Discount Plan,
ConsultADoctor,
Karis - Patient Advocacy,
NAC,
NVA Vision,
Premier Ancillary
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, PR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$253.00
per Month
for Member
$423.00
per Month
for Member plus One (Spouse or Child)
$573.00
per Month
for Member plus Family
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Flex Health PRO • FLICA
Flex Health PRO 3
Flex Health PRO 3 includes the following benefits:
$1,000 Hospital Confinement/30 Days Per Calendar Year,
$1,000 Intensive Care Confinement/5 Per Calendar Year,
$200 Emergency Room Visit/1 Per Calendar Year,
$5,000 Per Surgical Procedure/4 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/4 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$250 Calendar Year Maximum Per Insured,
$2,500 Critical Illness Benefit,
$2,500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$7,500 AD&D - Primary/$3,750 - Spouse/$3,750 - Child,
$15,000 GI Term Life (Principal Financial Group),
CVS 4-Tier Discount Plan,
ConsultADoctor,
Karis - Patient Advocacy,
NAC,
NVA Vision,
Premier Ancillary
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, PR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$353.00
per Month
for Member
$643.00
per Month
for Member plus One (Spouse or Child)
$853.00
per Month
for Member plus Family
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Flex Health PRO • FLICA
Flex Health PRO 4
Flex Health PRO 4 includes the following benefits:
$1,500 Hospital Confinement/30 Days Per Calendar Year,
$1,500 Intensive Care Confinement/5 Per Calendar Year,
$250 Emergency Room Visit/1 Per Calendar Year,
$8,000 Per Surgical Procedure/4 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/4 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$500 Calendar Year Maximum Per Insured,
$5,000 Critical Illness Benefit,
$5,000 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$15,000 AD&D - Primary/$7,500 - Spouse/$7,500 - Child,
$15,000 GI Term Life (Principal Financial Group),
CVS 4-Tier Discount Plan,
ConsultADoctor,
Karis - Patient Advocacy,
NAC,
NVA Vision,
Premier Ancillary
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, PR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$463.00
per Month
for Member
$873.00
per Month
for Member plus One (Spouse or Child)
$1,143.00
per Month
for Member plus Family
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SmartCare • FLICA
SmartCare PPO 1
Association benefits include Scheduled Benefit Indemnity insurance with $250 daily hospital confinement, $50 provider office visits, $50 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $2,000 Accident Medical Expense, up to $10,000 Accidental Death & Dismemberment, NAC benefits, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$153.00
per Month
for Member
$227.00
per Month
for Member plus One (Spouse or Child)
$299.00
per Month
for Member plus Family
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SmartCare • FLICA
SmartCare PPO 2
Association benefits include Scheduled Benefit Indemnity insurance with $250 daily hospital confinement, up to $2,000 for surgical procedure (as per surgical schedule), $50 provider office visits, $50 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $2,000 Accident Medical Expense, up to $10,000 Accidental Death & Dismemberment, NAC benefits, ProFlowers, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$216.00
per Month
for Member
$353.00
per Month
for Member plus One (Spouse or Child)
$464.00
per Month
for Member plus Family
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SmartCare • FLICA
SmartCare PPO 3
Association benefits include Scheduled Benefit Indemnity Insurance with $500 daily hospital confinement, $100 Emergency Room benefit, up to $2,500 for surgical procedures (as per surgical schedule), $75 provider office visits, $75 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $2,000 Accident Medical Expense, up to $20,000 Accidental Death & Dismemberment, $2,500 Critical Illness benefit, NAC benefits, Cherry Moon Farms, ProFlowers, RedEnvelope, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$311.00
per Month
for Member
$549.00
per Month
for Member plus One (Spouse or Child)
$739.00
per Month
for Member plus Family
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SmartCare • FLICA
SmartCare PPO 4
Association benefits include Scheduled Benefit Indemnity Insurance with $1,000 daily hospital confinement, $150 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $100 provider office visits, $100 Rountine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $5,000 Accident Medical Expense, up to $30,000 Accidental Death & Dismemberment, $5,000 Critical Illness benefit, NAC benefits, Cherry Moon Farms, ProFlowers, RedEnvelope, Meineke Car Care, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$430.00
per Month
for Member
$801.00
per Month
for Member plus One (Spouse or Child)
$1,078.00
per Month
for Member plus Family
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SmartCare • FLICA
SmartCare PPO 5
Association benefits include Scheduled Benefit Indemnity Insurance with $1,500 daily hospital confinement, $250 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $100 provider office visits, $100 Rountine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $5,000 Accident Medical Expense, up to $40,000 Accidental Death & Dismemberment, $10,000 Critical Illness benefit, NAC benefits, MyHomeBenefits, Montrose Travel, Cherry Moon Farms, ProFlowers, RedEnvelope, Meineke Care Care, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$517.00
per Month
for Member
$980.00
per Month
for Member plus One (Spouse or Child)
$1,319.00
per Month
for Member plus Family
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PrimeCare Rx • FLICA
PrimeCare Rx 1
Association benefits include Scheduled Benefit Indemnity Insurance with $250 daily hospital confinement, $50 provider office visits, $50 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $2,000 Accident Medical Expense, up to $10,000 Accidental Death & Dismemberment, NAC benefits, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group), Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$155.00
per Month
for Member
$231.00
per Month
for Member plus One (Spouse or Child)
$307.00
per Month
for Member plus Family
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PrimeCare Rx • FLICA
PrimeCare Rx 2
Association benefits include Scheduled Benefit Indemnity Insurance with $500 daily hospital confinement, $100 Emergency Room benefit, up to $2,500 for surgical procedures (as per surgical schedule), $50 provider office visits, $50 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $2,000 Accident Medical Expense, up to $20,000 Accidental Death & Dismemberment, $2,500 Critical Illness benefit, NAC benefits, ProFlowers, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group), Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$248.00
per Month
for Member
$427.00
per Month
for Member plus One (Spouse or Child)
$574.00
per Month
for Member plus Family
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PrimeCare Rx • FLICA
PrimeCare Rx 3
Association benefits include Scheduled Benefit Indemnity Insurance with $750 daily hospital confinement, $150 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $75 provider office visits, $50 Routine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $5,000 Accident Medical Expense, up to $30,000 Accidental Death & Dismemberment, $5,000 Critical Illness benefit, NAC benefits, Cherry Moon Farms, ProFlowers, RedEnvelope, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group), and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$330.00
per Month
for Member
$601.00
per Month
for Member plus One (Spouse or Child)
$803.00
per Month
for Member plus Family
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PrimeCare Rx • FLICA
PrimeCare Rx 4
Association benefits include Scheduled Benefit Indemnity Insurance with $1,000 daily hospital confinement, $250 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $100 provider office visits, $50 Rountine Wellness, $25 DXL, $10 Prescription Drug benefit, up to $5,000 Accident Medical Expense, up to $50,000 Accidental Death & Dismemberment, $10,000 Critical Illness benefit, NAC benefits, MyHomeBenefits, Montrose Travel, Cherry Moon Farms, ProFlowers, RedEnvelope, Meineke Care Care, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group), and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$374.00
per Month
for Member
$692.00
per Month
for Member plus One (Spouse or Child)
$935.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare Value
Association benefits include Scheduled Benefit Indemnity Health Insurance with $250 daily hospital confinement, $50 provider office visits, $50 Routine Wellness, $25 DXL, up to $2,000 Accident Excess Medical Expense, up to $10,000 Accidental Death & Dismemberment, CVS 4-Tier Rx and NAC benefits.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$123.00
per Month
for Member
$190.00
per Month
for Member plus One (Spouse or Child)
$258.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare 1
Association benefits include Scheduled Benefit Indemnity Health Insurance with $250 daily hospital confinement, $50 provider office visits, $50 Routine Wellness, $25 DXL, up to $2,000 Accident Excess Medical Expense, up to $10,000 Accidental Death & Dismemberment, CVS 4-Tier Rx, NAC benefits, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$176.00
per Month
for Member
$256.00
per Month
for Member plus One (Spouse or Child)
$338.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare 2
Association benefits include Scheduled Benefit Indemnity Health Insurance with $250 daily hospital confinement, $50 provider office visits, $50 Routine Wellness, $25 DXL, up to $2,000 Accident Excess Medical Expense, up to $10,000 Accidental Death & Dismemberment, Benecard Insured Rx, NAC benefits, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$210.00
per Month
for Member
$323.00
per Month
for Member plus One (Spouse or Child)
$415.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare 3
Association benefits include Scheduled Benefit Indemnity Health Insurance with $500 daily hospital confinement, $100 Emergency Room benefit, up to $2,500 for surgical procedures (as per surgical schedule), $50 provider office visits, $50 Routine Wellness, $25 DXL, up to $2,000 Accident Excess Medical Expense, up to $20,000 Accidental Death & Dismemberment, $2,500 Critical Illness benefit, Benecard Insured Rx, NAC benefits, ProFlowers, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$322.00
per Month
for Member
$559.00
per Month
for Member plus One (Spouse or Child)
$737.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare 4
Association benefits include Scheduled Benefit Indemnity Health Insurance with $750 daily hospital confinement, $150 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $75 provider office visits, $50 Routine Wellness, $25 DXL, up to $5,000 Accident Excess Medical Expense, up to $30,000 Accidental Death & Dismemberment, $5,000 Critical Illness benefit, Benecard Insured Rx, NAC benefits, Cherry Moon Farms, ProFlowers, RedEnvelope, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$418.00
per Month
for Member
$763.00
per Month
for Member plus One (Spouse or Child)
$1,013.00
per Month
for Member plus Family
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SelectCare • FLICA
SelectCare 5
Association benefits include Scheduled Benefit Indemnity Health Insurance with $1,000 daily hospital confinement, $250 Emergency Room benefit, up to $5,000 for surgical procedures (as per surgical schedule), $100 provider office visits, $50 Routine Wellness, $25 DXL, up to $5,000 Accident Excess Medical Expense, up to $50,000 Accidental Death & Dismemberment, $10,000 Critical Illness benefit, Benecard Insured Rx, NAC benefits, MyHomeBenefits, Montrose Travel, Cherry Moon Farms, ProFlowers, RedEnvelope, Meineke Care Care, ConsultADoctor, Compass - Patient Advocacy, NVA Vision, $15,000 GI Term Life (Principal Financial Group) and Premier Ancillary.
States Not Available: AK, CA, CT, DC, HI, ID, KS, KY, ME, MD, MA, MI, MN, MT, NH, NJ, NM, NY, NC, ND, OR, RI, SD, VT, WA, WI
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Administration Fee
$15.00
per Month
Product
$474.00
per Month
for Member
$878.00
per Month
for Member plus One (Spouse or Child)
$1,172.00
per Month
for Member plus Family
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Cali Flex Health PRO • NFL
Cali Flex Health PRO Value
Cali Flex Health PRO Value includes the following benefits:
$200 Hospital Confinement/30 Days Per Calendar Year,
$200 Intensive Care Confinement/5 Per Calendar Year,
$50 Emergency Room Visit/1 Per Calendar Year,
$65 Provider Office Visit/3 Per Calendar Year Per Insured,
$50 Health Screening Benefit/1 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/1 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$125 Calendar Year Maximum Per Insured,
$500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$2,500 AD&D - Primary/$1,250 - Spouse/$625 - Child,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Admin - AIBC
$15.00
per Month
Product
$147.00
per Month
for Member
$220.00
per Month
for Member plus One (Spouse or Child)
$309.00
per Month
for Member plus Family
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Cali Flex Health PRO • NFL
Cali Flex Health PRO 1
Cali Flex Health PRO 1 includes the following benefits:
$250 Hospital Confinement/30 Days Per Calendar Year,
$250 Intensive Care Confinement/5 Per Calendar Year,
$100 Emergency Room Visit/1 Per Calendar Year,
$2,000 Per Surgical Procedure/3 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/3 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$150 Calendar Year Maximum Per Insured,
$500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$2,500 AD&D - Primary/$1,250 - Spouse/$625 - Child,
$15,000 GI Term Life (Principal Financial Group),
NVA Vision,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
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Enrollment Processing Fee
$99.00
one-time fee
Monthly Admin - AIBC
$15.00
per Month
Product
$218.00
per Month
for Member
$367.00
per Month
for Member plus One (Spouse or Child)
$497.00
per Month
for Member plus Family
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Cali Flex Health PRO • NFL
Cali Flex Health PRO 2
Cali Flex Health PRO 2 includes the following benefits:
$500 Hospital Confinement/30 Days Per Calendar Year,
$500 Intensive Care Confinement/5 Per Calendar Year,
$150 Emergency Room Visit/1 Per Calendar Year,
$2,000 Per Surgical Procedure/3 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/3 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$250 Calendar Year Maximum Per Insured,
$2,500 Critical Illness Benefit,
$2,500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$5,000 AD&D - Primary/$2,500 - Spouse/$2,500 - Child,
$15,000 GI Term Life (Principal Financial Group),
NVA Vision,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
|
Enrollment Processing Fee
$99.00
one-time fee
Monthly Admin - AIBC
$15.00
per Month
Product
$257.00
per Month
for Member
$427.00
per Month
for Member plus One (Spouse or Child)
$577.00
per Month
for Member plus Family
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Cali Flex Health PRO • NFL
Cali Flex Health PRO 3
Cali Flex Health PRO 3 includes the following benefits:
$1,000 Hospital Confinement/30 Days Per Calendar Year,
$1,000 Intensive Care Confinement/5 Per Calendar Year,
$200 Emergency Room Visit/1 Per Calendar Year,
$5,000 Per Surgical Procedure/4 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/4 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$250 Calendar Year Maximum Per Insured,
$2,500 Critical Illness Benefit,
$2,500 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$7,500 AD&D - Primary/$3,750 - Spouse/$3,750 - Child,
$15,000 GI Term Life (Principal Financial Group),
NVA Vision,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
|
Enrollment Processing Fee
$99.00
one-time fee
Monthly Admin - AIBC
$15.00
per Month
Product
$357.00
per Month
for Member
$647.00
per Month
for Member plus One (Spouse or Child)
$857.00
per Month
for Member plus Family
|
|
|
Cali Flex Health PRO • NFL
Cali Flex Health PRO 4
Cali Flex Health PRO 4 includes the following benefits:
$1,500 Hospital Confinement/30 Days Per Calendar Year,
$1,500 Intensive Care Confinement/5 Per Calendar Year,
$250 Emergency Room Visit/1 Per Calendar Year,
$8,000 Per Surgical Procedure/4 Per Calendar Year,
Anesthesia Benefit - 25% of Amount Shown in the Schedule of Operations/4 Per Calendar Year,
$100 Provider Office Visit/5 Per Calendar Year Per Insured,
$50 Health Screening Benefit/2 Per Calendar Year Per Insured,
$50 Routine Well Child Care Benefit/2 Per Calendar Year Per Insured,
$25 Diagnostic X-Ray and Lab/$500 Calendar Year Maximum Per Insured,
$5,000 Critical Illness Benefit,
$5,000 Excess Medical Expense Per Accident Per Insured/$100 Deductible,
$15,000 AD&D - Primary/$7,500 - Spouse/$7,500 - Child,
$15,000 GI Term Life (Principal Financial Group),
NVA Vision,
CVS 4-Tier Discount Plan,
NAC
States Not Available: AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY
|
Enrollment Processing Fee
$99.00
one-time fee
Monthly Admin - AIBC
$15.00
per Month
Product
$467.00
per Month
for Member
$882.00
per Month
for Member plus One (Spouse or Child)
$1,146.00
per Month
for Member plus Family
|
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|
United Concordia Dental • United Concordia
United Concordia Dental (Add-On)
AWA dental product is fully insured through United Concordia. Dental has a $1,000 yearly maximum per person with a $50/$150 deductible per person/ per family. Dental includes the Preventive Incentive Program that provides 100% coverage In-Network for Diagnostic/Preventive Services (Excluded from Annual Program Maximum). A 6-month waiting period applies to Class III Major Services. Dental work started prior to members effective date is not covered.
States Not Available: KY, MT, MI
|
Product
$39.95
per Month
for Member
$69.95
per Month
for Member plus One (Spouse or Child)
$109.95
per Month
for Member plus Family
|
|
|
United Concordia Dental • United Concordia
United Concordia Dental (Stand-Alone)
AWA dental product is fully insured through United Concordia. Dental has a $1,000 yearly maximum per person with a $50/$150 deductible per person/ per family. Dental includes the Preventive Incentive Program that provides 100% coverage In-Network for Diagnostic/Preventive Services (Excluded from Annual Program Maximum). A 6-month waiting period applies to Class III Major Services. Dental work started prior to members effective date is not covered.
States Not Available: KY, MT, MI
|
Enrollment Processing Fee
$33.00
one-time fee
Monthly Administration Fee
$2.00
per Month
Product
$39.95
per Month
for Member
$69.95
per Month
for Member plus One (Spouse or Child)
$109.95
per Month
for Member plus Family
|
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