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(Available to Washington State Residents Only)
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SUMMARY OF BENEFITS
HEALTHPAYS HSA
FOR INDIVIDUALS & FAMILIES
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HEALTHPAYS HSA - CONTROL YOUR MONEY - Alliant Plus Network
HealthPays® Health Savings Account 2750 Individual/5500 Family Catastrophic Plan - '10 is a qualified, high-deductible health plan that lets you set up a bank account so you can sock away pretax money to use for your health care expenses. You don't need to pay toward your deductible for any preventive care office visits, no matter whether you get care. Notice that the coinsurance is slightly lower if you opt for in-network care.
 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.
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Benefits |
Alliant Plus
In-Network |
Alliant Plus
Out-Of-Network |
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Annual Deductible |
$2,750 per member or $5,500 per family
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Memeber Coinsurance |
10% |
20% |
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Out-Of-Pocket Limit*
(Deductible does not apply.)
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$5,100 per member or $10,200 per family
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Benefits |
After Deductible, Member Pays |
Office Visits
Includes mental health outpatient services.
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10% |
20% |
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Manipulative Therapy
Limit total visits PCY** to 10 combined for both in- and out-of-network.
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10%
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20%
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Acupuncture
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10%,
up to 8 visits PCY |
20% |
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| Naturopathy |
10%,
up to 3 visits PCY |
20% |
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Maternity Care
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Not covered |
Not covered |
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Lab/X-Ray Services
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10% |
20% |
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Hospital Visits - Inpatient
Hospital room and board; inpatient surgery; anesthesia, intensive and coronary care; laboratory tests; radiology services; drugs while in hospital. Includes mental health inpatient treatment. Maternity care not covered.
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10% |
20% |
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Devices, Equipment & Supplies
(DME and prosthetics.)
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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) |
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Prescription Drugs
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Not covered |
Not covered |
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Emergency Care
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10% |
10% |
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Vision Care
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Not Covered |
Not Covered
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Benefits |
Deductible Does Not Apply |
Preventive Care
For children and adults; including physicals and immunizations, as established in Group Health's preventive care schedule.
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10% |
20%
$300 individual/
$600 family annual
benefit maximum
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* 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.
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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.
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