Regence BlueShield   LifeWise of WA   Group Health   Comprehensive Plans     Balance 1250     Balance 1750     Welcome 750   Catastrophic Plans     Balance 2500     Balance 5000     Welcome 1820     Welcome 3500   HSA Plan     HealthPays HSA   Plan Rates   Apply Now!   Provider Directories   Exclusions &    Limitations   HSA Plans   Individual Dental   Group Medical   Group Dental   Grp Life & Disability   About the Plan   Premiums   Application   US Citizens   Foreign Nationals   Long Term		(Available to Washington State Residents Only) SUMMARY OF BENEFITS BALANCE 2500 FOR INDIVIDUALS & FAMILIES BALANCE 2500 - COVERAGE WHEN YOU NEET IT - Alliant Plus Network The Balance 2500 Catastrophic Plan -'10 is for those who need simple catastrophic coverage. If you don't think you'll need maternity care and you don't plan to access care a lot, this might be the plan for you. Like the other Balance plans, you can see any doctor you want. But in-network care comes at a higher coverage level, since your deductible doesn't apply to preventive care office visits, and to most in-network office visits. These plans let you choose between the Alliant Plus in-network and out-of-network options, with different levels of coverage. In-network care includes access to the more than 1,000 Group Health doctors and clinicians, and also includes the thousands of contracted community providers and the many doctors who practice with Virginia Mason and The Everett Clinic. Out-of-network care includes services from any other doctor, anywhere with discounted care from First Choice Health and Beech Street providers. Click here to look up a provider. Benefits Alliant Plus In-Network Alliant Plus Out-Of-Network Annual Deductible $2,500 per member or $7,500 per family Member Coinsurance 40% 40% Out-Of-Pocket Limit* (Deductible does not apply.) $8,000 per member or $24,000 per family Benefits No Deductible After Deductible, Member Pays Office Visits Including mental health outpatient services. $30/visit $30/visit Manipulative Therapy Limit total visits PCY** to 10 combined for both in- and out-of-network. $30/visit $30/visit Acupuncture $30/visit, up to 8 visits PCY $30/visit Naturopathy $30/visit, up to 3 visits PCY $30/visit Maternity Care Not Covered Not Covered Benefits After Deductible, Member Pays Hospital Visits - Inpatient Hospital room and board; inpatient surgery; anesthesia, intensive and coronary care; laboratory test; radiology services; drugs while in hospital. Includes mental health inpatient treatment. $100 per day up to 5 days/admit + 40% $100 per day up to 5 days/admit + 40% Lab/X-Ray Services Deductible waived on first $500 PCY, then deductible and 40% apply. 40% Devices, Equipment & Supplies (DME and prosthetics.) DME — 50% up to $5,000 in charges ($2,500 max. benefit PCY); Prosthetics — 50% up to $40,000 in charges ($20,000 max benefit PCY) Emergency Care $100 + 40% $150 + 40% Benefits Deductible Does Not Apply Preventive Care Visits For children and adults; including physicals and immunizations, as established in Group Health's preventive care schedule. $30/visit $30/visit $300 individual/ $600 family annual benefit maximum Prescription Drugs Not covered Not covered Vision Care Hardware not covered. $30 for routine eye exam per 12 months Covered up to $30 for routine eye exam per 12 months * Member coinsurance and emergency care copayment apply to out-of-pocket limit. Deductible does not apply to out-of-pocket limit. ** PCY = per calendar year Note: This is a summary of benefits. The contents are not to be accepted or construed as a substitute for the provisions of the master policy or agreement. Other terms and conditions apply. Lifetime benefit maximum of $2 million applies to all plans. All plans cover on-the-job-injury-related health care costs for partners, proprietors, or corporate officers who are not covered by a workers' compensation act, subject to the plan's cost shares and benefit limitations. Coverage provided by Group Health Options, Inc. E-mail us for more information and a free quote or CALL TOLL FREE 1-800-875-4490 (in the U.S.) or 1-253-854-0199 (outside the U.S.) Fax: 1-253-896-9411 Mailing address: Maddock & Associates, 1407 Willow Road E, Suite C, Tacoma, WA 98424 Serving all of Washington at 800-875-4490, Seattle at 206-682-1628, Bellevue at 425-454-6834, Kent at 253-854-0199 and Tacoma at 253-572-3291. Copyright© 1998-2010, Maddock & Associates  |  Privacy Statement Problems viewing this page? Contact the webmaster.