Home / Education / Cover Florida Opinion / Cover Florida Health Insurance Detail / Cover Florida and Non-Medically Underwritten Plans

Cover Florida and Non-Medically Underwritten Plans

Here is the information that we send to agents regarding non medically underwritten health plans in Florida.  If you are uninsurable in Florida this will pertain to you, so please read this as well as head over to our Florida Public Health Care Assistance section.

Relevant Documents in this Section:

Non-Medically Underwritten Plans in Florida

Before assuming that you are uninsurable, you should verify that in fact you are ineligible for individual coverage, since it is too often the case that an individual is told by their group insurance agent or whatever the case may be that they will not be able to enroll in an individual plan in Florida due to their preexisting conditions.  While this may be the case for a wide array of medical conditions, it is surprisingly not the case for many medical conditions that one would assume would be deemed as uninsurable.  Depending on the insurance carrier, some may have broader underwriting guidelines.  For instance, AARP has broader guidelines for hypertension, cholesterol, body mass index, anxiety, GERD, etc.

So, before enrolling in a conversion plan or applying for a HIPAA application it would be worthwhile for you to check with your insurance agent and have them send in a prescreening form to the insurance carrier.  99% of insurance carriers have a prescreening form that an agent is able to send to the underwriting department in so they may provide an overall assessment of what to expect if you apply for individual coverage, they would respond with what they feel your risk category would be although it ultimately depends on the final determination of the underwriter and often times upon completing their review of your medical records.

But instead of applying for coverage blindly, wasting your time, and possibly having a decline in the MIB (Medical Information Bureau) for 10 years, you may as well send in the prescreening form for evaluation that only takes about 24-48 hours.  If your agent does not have access to all insurance carriers or you do not have an agent, contact our office and we’ll be more than happy to obtain all the necessary medical information that we will need to complete the prescreening.  You should expect to provide your height, weight, age or date of birth, name, and medical conditions and respective medication along with dosages and frequencies.

If you find that you are in fact not eligible for an individual medically underwritten plan in Florida then you do have several options that you may also obtain additional information by going to the US Department of Health and Human Services resource center online, you’ll find the official documents and laws that govern the Florida insurance industry.

  • If you currently have a COBRA plan that is about to exhaust after 18 months (or more if you qualified for an extension on the COBRA policy) then the insurance carrier administering the COBRA policy may be offer a conversion plan.  If you are offered a conversion plan, you must accept the plan should you decide to maintain the same level of coverage.
  • If a conversion plan is not offered to you then you are most probably eligible for a guaranteed issue policy as mandated by HIPAA law.
  • You may also consider Cover Florida in which also has certain eligibility requirements but is guaranteed issued.
  • Insurance companies are required to offer 2 individual plan options for HIPAA eligible individuals, or what is often referenced as HIPAA applications and must approve all eligible HIPAA applicants although they are allowed to rate up the premium; meaning that the insurance company will approve you and cover all pre-existing conditions but possibly with a 100% rate increase on the preferred premium.
  • August is the only month in Florida that you can enroll in a one life group and is a viable alternative for self-employed individuals. Note that 2 employees is the minimum number of employees required to establish a small group policy.

Please find attached document that I created a little while ago regarding HIPAA eligibility with regards to uninsurable applicants – also, I attached the Cover Florida documents and other pertinent documents  Medicaid and FL Kid Care…

This information is good to know to

a. guide people and advise what their options may be

b. to establish credibility with a prospect

c. to determine whether an individual may be better off enrolling in a medically underwritten plan

Preventive Catastrophic Available Statewide (Individual) Preventive Catastrophic Available Statewide (Group)
Benefits $0 deductible Medical benefits up to: $500,000 lifetime $500 deductible $500,000 lifetime Medical benefits up to: $0 deductible Medical benefits up to: $500,000 lifetime $500 deductible $500,000 lifetime Medical benefits up to:
Doctor Visits $10 co-pay Up to $450 in office visits per year for in-network physicians Up to $1,000 in office visits per year for in-network physicians $20 co-pay $10 co-pay Up to $450 in office visits per year for in-network physicians Up to $1,000 in office visits per year for in-network physicians $20 co-pay
Preventive Care No co-pay for preventive services including 1 annual adult exam, 1 annual gynecological, prostate, colorectal, cervical cancer screenings and mammograms. No co-pay for preventive services including 1 annual adult exam, 1 annual gynecological, prostate, colorectal, cervical cancer screenings and mammograms. No co-pay for preventive services including 1 annual adult exam, 1 annual gynecological, prostate, colorectal, cervical cancer screenings and mammograms. No co-pay for preventive services including 1 annual adult exam, 1 annual gynecological, prostate, colorectal, cervical cancer screenings and mammograms.
Hospital Inpatient Services N/A 10 days of inpatient hospital stays per year Services up to $2,000 per day (in-network) and $1,000 per day (out-of-network) $500 annual deductible N/A 10 days of inpatient hospital stays per year Services up to $2,000 per day (in-network) and $1,000 per day (out-of-network) $500 annual deductible
Hospital Outpatient Services 100% in network coverage up to $600 per year, for preventive services only Coverage up to $600 per year in preventive services (100% of charges covered in-network) and $400 per year in non-preventive services (80% of charges covered in-network) 100% in network coverage up to $600 per year, for preventive services only Coverage up to $600 per year in preventive services (100% of charges covered in-network) and $400 per year in non-preventive services (80% of charges covered in-network)
Emergency Care N/A Hospital ER services up to $1,500 per year; 80% of charges covered for accident, trauma, heart attack, stroke Coverage for ambulance services up to $500 per year ($100 co-pay for ambulance services) N/A Hospital ER services up to $1,500 per year; 80% of charges covered for accident, trauma, heart attack, stroke Coverage for ambulance services up to $500 per year ($100 co-pay for ambulance services)
Prescription Drugs $10 co-pay for generic drugs, up to $500 per year. $10 co-pay for generic drugs, up to $500 per year. $10 co-pay for generic drugs, up to $500 per year. $10 co-pay for generic drugs, up to $500 per year.
Other Services Included in Plans Durable Medical Equipment: 80% of charges covered (in-network); up to $500 per yr Behavioral Health: $40 co-pay (5 office visits/yr) Durable Medical Equipment: 80% of charges covered (in-network); up to $500 per yr Diagnostic Services: 80% of charges covered up to $500 with no co-pay for X-ray and other diagnostic services Behavioral Health: $40 co-pay Durable Medical Equipment: 80% of charges covered (in-network); up to $500 per yr Behavioral Health: $40 co-pay (5 office visits/yr) Durable Medical Equipment: 80% of charges covered (in-network); up to $500 per yr Diagnostic Services: 80% of charges covered up to $500 with no co-pay for X-ray and other diagnostic services Behavioral Health: $40 co-pay
Diabetic Supplies: $25 co-pay (in-network), $100 per year coverage. (5 office visits/yr) $500 co-pay (inpatient hospital; coverage limited to 5 days) Diabetic Supplies: $25 co-pay (in-network), $100 per year coverage. Diabetic Supplies: $25 co-pay (in-network), $100 per year coverage. (5 office visits/yr) $500 co-pay (inpatient hospital; coverage limited to 5 days) Diabetic Supplies: $25 co-pay (in-network), $100 per year coverage.
Monthly Rates
(by age) Female Male Female Male Female Male Female Male
0 – 18 $87.63 $87.63 $228.62 $228.62 $58.42 $58.42 $152.41 $152.41
19 – 29 $132.68 $80.60 $346.17 $210.29 $88.46 $53.74 $230.78 $140.19
30 – 39 $139.67 to $142.00 $84.84 to $102.85 $364.39 to $370.47 $221.36 to $268.34 $93.11 to $94.67 $56.56 to $68.57 $242.93 to $246.98 $147.57 to $178.90
40 – 49 $140.53 to $143.68 $112.16 to $125.83 $366.63 to $374.86 $292.62 to $328.28 $93.68 to $95.79 $74.77 to $83.88 $244.42 to $249.91 $195.08 to $218.85
50 – 59 $155.41 to $189.61 $147.63 to $188.84 $405.46 to $494.69 $385.16 to $492.69 $103.61 to $126.41 $98.42 to $125.89 $270.31 to $329.79 $256.77 to $328.46
60 – 64 $189.61 $188.84 $494.69 $492.69 $126.41 $125.89 $329.79 $328.46
65+ $189.61 $188.84 $494.69 $492.69 $126.41 $125.89 $329.79 $328.46
Average Rate $131.83 $322.41 $82.38 $214.94

*For example, if the doctor charges $100 for a visit, the plan will pay $50 for the visit and the Member is responsible for the remaining $50. ** Out-of-Network providers are those that do not participate in this plan but are within the plan’s network of physicians. *** JMH Catastrophic Plans are not available for children aged 0 to 4. These prices are for plans for children 5 through 18.

Disclaimer: This sample benefit and premium information is for comparison purposes only. Consumers should carefully consider the benefits provided by each plan before purchasing. Additional information regarding each plan should be obtained by contacting the carrier directly.

Preventive Catastrophic
Benefits $0 deductible $3,000 deductible Medical Benefits up to: $25,000 annually $50,000 lifetime
Doctor Visits *Plan pays $50 or the allowed amount (whichever is less). Member pays the difference between the allowed amount and the plan’s maximum payment amount. *Plan pays $50 or the allowed amount (whichever is less). Member pays the difference between the allowed amount and the plan’s maximum payment amount.
Preventive Care *Member pays difference between plan’s payment and the allowed amount for cervical cancer screening, prostate screening and colorectal screening; Free annual mammogram *Member pays difference between plan’s payment and the allowed amount for cervical cancer screening, prostate screening and colorectal screening; Free annual mammogram
Hospital Inpatient Services N/A In-Network: Member pays annual deductible + 20% of charges Out-of-network**: Member pays annual deductible + preadmission deductible + 20% of charges Non-participating provider: Member pays preadmission deductible + 40% of charges Rehabilitation up to 21 days per year
Hospital Outpatient Services N/A In-Network/Out-of-Network**: Member pays annual deductible + 20% of charges Non-participating provider: Member pays annual deductible + portion of the charges that is not covered by the plan
Emergency Care N/A In-Network: Member pays annual deductible + 20% of charges Non-participating provider: Member pays annual deductible + 40% of charges
Prescription Drugs Plan pays $15 per covered prescription drugs and Member pays remainder. Plan pays $15 per covered prescription drugs and Member pays remainder.
Other Services Included in Plans Diagnostic Services: No co-pay for Mammograms and Osteoporosis Screening Durable Medical Equipment: Member pays annual deductible + 20% of charges (this covers DME related to surgery only) Behavioral Health: limited to $500 per year with a $10,000 lifetime maximum Diagnostic Services: No co-pay for Mammograms and Osteoporosis Screening Durable Medical Equipment: Member pays annual deductible + 20% of charges (this covers DME related to surgery only) Behavioral Health: limited to $500 per year with a $10,000 lifetime maximum
Monthly Rates
(by age) Female Male Female Male
0 – 18 Not Offered Not Offered Not Offered Not Offered
19 – 29 $23.70 to $40.51 $23.70 to $40.51 $67.39 to $106.63 $57.91 to $89.90
30 – 39 $41.64 to $48.96 $41.64 to $48.96 $109.59 to $133.44 $92.41 to $116.26
40 – 49 $49.56 to $54.57 $49.56 to $54.57 $135.96 to $159.95 $119.66 to $162.32
50 – 59 $55.19 to $62.85 $55.19 to $62.85 $163.06 to $198.01 $168.83 to $253.10
60 – 64 $64.03 to $69.71 $64.03 to $69.71 $203.05 to $225.41 $265.69 to $323.30
65+
Average Rate $50.75 $148.08

*For example, if the doctor charges $100 for a visit, the plan will pay $50 for the visit and the Member is responsible for the remaining $50. ** Out-of-Network providers are those that do not participate in this plan but are within the plan’s network of physicians. *** JMH Catastrophic Plans are not available for children aged 0 to 4. These prices are for plans for children 5 through 18.

Disclaimer: This sample benefit and premium information is for comparison purposes only. Consumers should carefully consider the benefits provided by each plan before purchasing. Additional information regarding each plan should be obtained by contacting the carrier directly. These rates may vary by county.

Preventive Catastrophic Florida Health Care Plan Available in Volusia & Flagler Counties Toll-free Phone Number: 1-800-232-0578 Web Site: http://www.fhcp.com Medica Health Plan of Florida Preventive Catastrophic Toll-free Phone Number: 1-866-260-5278 Web Site: http://www.mhpfl.com Available in Miami-Dade & Broward Counties
Benefits $0 deductible plan $250 deductible plan $500 deductible plan $0 deductible plan $250 deductible plan $500 deductible plan $0 deductible Benefits up to $25,000 per year $0 deductible Benefits up to $50,000 per year
Doctor Visits $20 co-pay for primary care physicians $75 co-pay for specialists $20 co-pay for primary care physicians $75 co-pay for specialists $15 co-pay (primary care physician) $30 co-pay (specialist) $25 co-pay (primary care physician) $50 co-pay (specialist)
1 annual adult exam ($20 co-pay) 1 annual adult exam ($20 co-pay)
1 well woman assessment ($20 co 1 well woman assessment ($20 co 1 annual adult exam 1 annual adult exam
Preventive pay for primary care physician and pay for primary care physician and 1 annual well woman exam 1 annual well woman exam
Care $35 co-pay for OB/GYN) Well baby care and child health supervision services ($20 co-pay) $35 co-pay for OB/GYN) Well baby care and child health supervision services ($20 co-pay) $15 co-pay (PCP); $30 co-pay (specialist) $25 co-pay (PCP); $50 co-pay (specialist)
Hospital Inpatient Services N/A $750 per day co-pay Coverage up to 12 days per year N/A $200 per day co-pay for first 5 days of admission
Hospital Outpatient Services N/A $500 co-pay per visit for outpatient surgery N/A Rehabilitative Services ($100 co-pay; up to 20 visits per year)
Emergency Care N/A $250 co-pay per visit $75 co-pay per urgent care visit N/A Urgent Care: $50 co-pay Emergency: $200 co-pay (waived if admitted)
Prescription Drugs $4 co-pay for generic, preferred drugs $10 co-pay for generic, non-preferred drugs $4 co-pay for generic, preferred drugs $10 co-pay for generic, non-preferred drugs $10 co-pay for generic drugs Plan discounts for brand drugs Benefit up to $500 per year $10 co-pay for generic drugs Plan discounts for brand drugs Benefit up to $500 per year
Other Services Included in Plans Office Surgery: including anesthesia and supplies in provider’s office $500 co-pay per visit Behavioral Health: Individual/Group Therapy ($50 co-pay individual; $25 group); Medication Management ($35 co-pay); Up to 12 outpatient visits per year Office Surgery: including anesthesia and supplies in provider’s office $500 co-pay per visit Behavioral Health: Individual/Group Therapy ($50 co-pay individual; $25 group); Medication Management ($35 co-pay); Up to 12 outpatient visits per year Behavioral Health: $30 co-pay for office counseling services Up to $1,200 per year Durable Medical Equipment: No copay Up to $500 per year Diabetic Supplies: 20% of charges for Behavioral Health: $50 co-pay for office counseling services Up to $1,200 per year Durable Medical Equipment: No copay Up to $500 per year Diabetic Supplies: 20% of charges for
Diabetic Supplies: glucometer covered in full; $12 co-pay for lancets; $12 co-pay for 50 test strips Diabetic Supplies: glucometer covered in full; $12 co-pay for lancets; $12 co-pay for 50 test strips lancets, syringes, insulin, strips and monitor Up to $1,500 per year lancets, syringes, insulin, strips and monitor Up to $1,500 per year
Monthly Rates
(by age) Female Male Female Male Female Male Female Male
0 – 18 $57.61 to $70.93 $21.01 to $45.23 $128.39 to $143.96 $79.81 to $103.75 $47.61 to $138.41 $41.97 to $128.00 $75.27 to $218.84 $66.36 to $202.38
19 – 29 $57.61 to $82.88 $21.01 to $35.83 $128.39 to $168.92 $79.81 to $96.19 $61.75 to $73.86 $43.70 to $53.24 $97.64 to $116.77 $69.10 to $84.17
30 – 39 $74.55 to $97.69 $36.09 to $55.04 $171.93 to $212.71 $106.72 to $142.75 $75.75 to $87.05 $55.39 to $65.99 $119.77 to $137.63 $87.57 to $104.34
40 – 49 $94.04 to $129.61 $55.88 to $85.79 $223.04 to $280.29 $166.41 to $236.15 $89.49 to $107.52 $67.15 to $94.56 $141.50 to $170.00 $106.17 to $144.77
50 – 59 $135.39 to $184.13 $93.85 to $146.49 $322.49 to $414.71 $299.32 to $432.85 $108.85 to $137.61 $96.04 to $155.22 $172.11 to $217.58 $151.85 to $245.42
60 – 64 $181.97 to $207.07 $160.15 to $183.97 $484.15 to $509.64 $547.55 to $570.81 $140.37 to $163.24 $164.39 to $193.16 $221.95 to $258.10 $259.92 to $305.41
65+ $215.01 to $242.01 $219.25 to $246.04 $638.24 to $664.88 $731.27 to $757.36 $163.24 to $225.95 $193.16 to $267.37 $258.10 to $357.25 $305.41 to $422.73
Average Rate $67.98 ($500 deductible) $71.12 ($250 deductible) $81.69 ($0 deductible) $181.21 ($500 deductible) $185.37 ($250 deductible) $196.37 ($0 deductible) $83.90 $141.20

*For example, if the doctor charges $100 for a visit, plan will pay $50 for the visit and the Member is responsible for the remaining $50. ** Out-of-Network providers are those that do not participate in this plan but are within the plan’s network of physicians. *** JMH Catastrophic Plans are not available for children aged 0 to 4. These prices are for plans for children 5 through 18.

Disclaimer: This sample benefit and premium information is for comparison purposes only. Consumers should carefully consider the benefits provided by each plan before purchasing. Additional information regarding each plan should be obtained by contacting the carrier directly.

Total Health Choice Available in Miami-Dade & Broward Counties Toll-free Phone Numbers: JMH Health Plan Available in Miami-Dade County
1-305-408-5825 within Miami-Dade County; 1-800-213-1133 outside Miami-Dade County; 1-800-955-8771 TDD Toll-free Phone Number: 1-800-721-2993 Web Site: http://www.jmhhp.com
Web Site: http://www.totalhealthchoiceonline.com
Catastrophic (Plans III, IV) Preventive (Plans I, II) Preventive CombinedCatastrophic
Benefits Plan I: No prescription drug benefit Plan II: Includes prescription drug benefit Plan III: No prescription drug benefit Plan IV: Includes prescription drug benefit Medical benefits up to $40,000 per year $0 deductible plan Medical Benefits up to: $500,000 lifetime $500 deductible plan $1,000 deductible plan $2,500 deductible plan $5,000 deductible plan Medical Benefits up to: $15,000 annual $500,000 lifetime $500 deductible plan $1,000 deductible plan $2,500 deductible plan $5,000 deductible plan Medical Benefits up to: $15,000 per year $500,000 lifetime
Doctor Visits $30 co-pay (primary care physician) $50 co-pay (specialist) $50 co-pay (allergy testing) $30 co-pay (primary care physician) $50 co-pay (specialist) $50 co-pay (allergy testing) $15 co-pay (primary care physician) $25 co-pay (specialist) N/A $15 co-pay (primary care physician) $25 co-pay (specialist)
1 annual adult exam 1 annual adult exam
Preventive Care 1 annual well woman exam $30 co-pay (No co-pay for mammograms, 1 annual well woman exam $30 co-pay (No co-pay for mammograms, 1 annual adult exam 1 annual well woman exam N/A 1 annual adult exam 1 annual well woman exam
prostate, cervical cancer and colorectal screenings) prostate, cervical cancer and colorectal screenings) $25 co-pay $25 co-pay
Hospital Inpatient Services N/A $500 per day co-pay for first 5 days N/A $100 co-pay per day for first 5 days Up to 12 days per year $100 co-pay per day for first 5 days Up to 12 days of inpatient coverage per year
Hospital Outpatient Services Coverage for therapies, observation, chemotherapy and nuclear medicine in non-hospital outpatient setting Co-pays of $500 (facilities), $100 (nuclear medicine), $50 (chemotherapy), $30 (radiation therapy) Coverage for therapies, observation, chemotherapy and nuclear medicine Co-pays of $500 (facilities), $100 (nuclear medicine), $50 (chemotherapy), $30 (radiation therapy) N/A $50 co-pay for outpatient surgery $25 co-pay for outpatient care services $50 co-pay for outpatient surgery $25 co-pay for outpatient care services
Emergency Care $250 co-pay (hospital in-network) $500 co-pay (hospital out-ofnetwork) $50 co-pay (urgent care services) $100 co-pay (ambulance services) $250 co-pay (hospital in-network) $500 co-pay (hospital out-ofnetwork) $50 co-pay (urgent care services) $100 co-pay (ambulance services) N/A Coverage for 3 hospital ER visits per year $175 co-pay (in-network) $200 co-pay + 40% of charges (out-of-network) Coverage for 6 urgent care visits per year $50 co-pay for each visit Coverage for 3 hospital ER visits per year $175 co-pay (in-network) $200 co-pay + 40% of charges (out-of-network) Coverage for 6 urgent care visits per year $50 co-pay for each visit
Prescription Drugs $30 co-pay: generic drugs $45 co-pay: brand drugs Up to $1,000 per year Available in Plan II only (no drug coverage under Plan I but a pharmacy discount card allows purchase of drugs at a discount at participating pharmacies) $30 co-pay: generic drugs $45 co-pay: brand drugs Up to $1,000 per year Available in Plan IV only (no coverage under Plan III but a pharmacy discount drug card allows purchase of drugs at a discount at participating pharmacies) $5 co-pay for generic drugs Discount on brand drugs Up $100 of coverage for drugs per month and $1,200 per year N/A $5 co-pay for generic drugs Discount on brand drugs Up $100 of coverage for drugs per month and $1,200 per year
Other Services Included in Plans Diagnostic Services: $100 co-pay (CT scans, nuclear medicine, ultrasound) Diabetic Supplies: $30 co-pay Behavioral Health: $50 co-pay (not including substance abuse services) Up to 20 visits per year Diagnostic Services: $100 co-pay (CT scans, nuclear medicine, ultrasound) Diabetic Supplies: $30 co-pay Behavioral Health: $50 co-pay (not including substance abuse services) Up to 20 visits per year Behavioral Health: $35 co-pay; Up to 20 outpatient visits per year Durable Medical Equipment: $25 co-pay; up to $400 per year Diabetic Supplies: $25 co-pay; coverage for 50 test strips per month Diagnostic Services: $25 co-pay Diagnostic Services: $25 co-pay Behavioral Health: $35 co-pay; up to 20 outpatient visits per year Durable Medical Equipment: $25 copay; up to $400 per year Diabetic Supplies: $25 co-pay; coverage for 50 test strips per month
Monthly Rates
(by age) Female Male Female Male Female Male Female Male Female Male
0 – 18 Not Offered Not Offered Not Offered Not Offered $41.21 $41.21 $52.38 to $103.06*** $52.38 to $103.06*** $87.23 to $135.58*** $87.23 to $135.58***
19 – 29 $72.19 to $127.64 $57.32 to $74.96 $147.66 to $237.86 $115.97 to $139.68 $46.89 to $63.17 $35.65 to $46.22 $59.61 to $157.98 $45.31 to $115.59 $99.27 to $207.83 $75.47 to $152.07
30 – 39 $96.53 to $123.74 $63.40 to $86.92 $195.29 to $230.59 $128.27 to $161.98 $64.81 to $72.90 $47.33 to $56.81 $82.38 to $182.32 $60.17 to $142.07 $137.20 to $239.85 $100.20 to $186.90
40 – 49 $98.32 to $146.12 $74.87 to $114.14 $198.92 to $272.29 $151.48 to $212.70 $73.43 to $86.88 $59.03 to $80.19 $93.35 to $217.28 $75.04 to $200.55 $155.46 to $285.84 $124.97 to $263.84
50 – 59 $130.92 to $190.40 $102.39 to $227.25 $264.87 to $354.82 $207.16 to $423.49 $89.10 to $117.51 $83.38 to $123.65 $113.26 to $293.90 $105.99 to $309.26 $188.63 to $386.64 $176.52 to $406.85
60 – 64 $167.64 to $235.20 $203.40 to $313.39 $339.16 to $438.31 $411.52 to $584.02 $125.86 to $163.73 $132.15 to $173.53 $159.99 to $409.50 $167.98 to $434.02 $266.45 to $538.71 $279.76 to $570.97
65+ $404.83 to $479.66 $404.83 to $479.66 $819.03 to $893.86 $819.03 to $893.86 $251.17 $242.82 $319.28 to $628.17 $308.68 to $607.31 $531.73 to $826.39 $514.07 to $798.95
Average Rate $130.85 (Plan I) $155.03 (Plan II) $264.72 (Plan III) $288.91 (Plan IV) $70.53 $92.43 ($5,000 deductible) $119.75 ($2,500 deductible) $165.14 ($1,000 deductible) $190.07 ($500 deductible) $153.93 ($5,000 deductible) $184.50 ($2,500 deductible) $220.04 ($1,000 deductible) $239.23 ($500 deductible)

*For example, if the doctor charges $100 for a visit, the plan will pay $50 for the visit and the Member is responsible for the remaining $50. **Out-of-Network providers are those that do not participate in this plan but are within the plan’s network of physicians. *** JMH Catastrophic Plans are not available for children aged 0 to 4. These prices are for plans for children 5 through 18.

Disclaimer: This sample benefit and premium information is for comparison purposes only. Consumers should carefully consider the benefits provided by each plan before purchasing. Additional information regarding each plan should be obtained by contacting the carrier directly.

Top