| About Specialty Contractors Benefit
Trust Program: |
Q: What is the IDA Group
Benefit healthcare plan?
A: The IDA Group Benefit Plan is a new employee healthcare
program designed exclusively for IDA member employers. It is a fully insured employee benefit plan that meets all federal
standards including ERISA and HIPPA. Some of the major plan features include:
• Comprehensive medical and
prescription drug coverage
• Benefits are fully guaranteed by qualified “A” rated insurers
•
Easy access to local, regional and national PPO networks like PHCS (www.phcs.com) and First Health (www.firsthealth.com)
• Additional coverage is available for vision, dental, group life, and short-term disability
• Up to $1 million per covered person per year
• All benefits are fully guaranteed to the 1st eligible dollar
• Plan deductibles starting at $250
Q: What is the minimum number of employees required to participate
in the program?
A: To qualify for the program, an IDA member firm must have at least 2 full-time eligible employees
(a husband/wife count as one employee with a dependent). Firms with four or less full-time employees must
have 100% of eligible employees participate in the program, those with five or more must have at least 75% of eligible
employees participating in the program.
If you do not have enough participating employees to qualify for the group
IDA plan, we also offer Individual/Family health insurance coverage in most states. For more information about this coverage, please refer to the section of the website.
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Q: Is the IDA
Group Benefit Plan categorized as insurance?
A: The IDA Group Benefit Plan is not in
and of itself insurance. The plan however, purchases insurance direct from the world insurance market under one policy guaranteeing
all of the eligible medical benefits from the first eligible dollar to the limits set forth in the Summary Plan Description.
The benefits under the IDA Group Benefit Plan are guaranteed in full from the first eligible dollar to the limits of
the plan by qualified “A” rated underwriters at Lloyd’s London.
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Q: Will the IDA Group Medical Program save my company money?
A:
Each employer may select and provide the benefit plan that fits their pocketbook and all other things being equal, the cost
of providing benefits under the new Plan has been reduced by 10% to 15% and in some cases as much as 20% or more when compared
with other available commercially insured group benefit plans.
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Q: I have looked at a variety of healthcare programs for my employees and nobody has been able to deliver
10% to 15% savings on our employee benefit costs. How do you do it?
A: In order to deliver
these cost reductions, we have reduced acquisition costs, insurance related costs and margins, administration costs and other
related expenses through volume purchasing.
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Q:
Do I need to be an IDA member in order to sign my company up for this program?
A: Yes.
In order to participate in the IDA Group Benefit program, a company must maintain a current IDA membership. Non-member
firms may request a quote from the program but they must join the IDA before enrolling in the Medical Plan.
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Q: Is life insurance available under the plan?
A:
Yes. $50,000 employee life insurance is available, as well as 1 times annual employee salary.
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Q: Can the IDA Group Benefit Program provide international
coverage?
A: Yes. The plan provides seamless coverage for domestic and international employees.
While abroad, the provider services are tailored to international employees needs.
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Q: What are the maximum limits of the Plan?
A: $1,000,000
per covered person annually and up to $5,000,000 per covered person lifetime.
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Q: What PPO´s are available?
A: National
PPO networks: Private Healthcare Systems (www.phcs.com). and First Health (www.firsthealth.com) are the primary national networks. Many other PPO networks are available to supplement national network coverage.
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Q: "I am currently a subscriber to
an HMO. Is this a better or worse option for me?"
A: The IDA Group Medical Program can
provide benefits not available to subscribers of many HMO plans. In some circumstances, HMO’s do not have the facilities
to provide specialized services such as transplants. Both an HMO and the IDA Medical Program have preferred medical providers.
With the IDA Program, however, your employees can use non network providers if they are willing to pay the differential in
coinsurance and deductible. Individuals that travel may find themselves in an area where they have no HMO coverage. This will
not be the case with the IDA Program because there is a National PPO. When plan participants are out of their own local
PPO area, they will have access to a PPO. This provides the participants with maximum PPO access.
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Q: "If my doctor is not a part of the PPO, will I need to change doctors?"
A: No benefit program or insurer has preferred access to all medical providers. Most insurers have
a PPO network that they own (or partially own) and insist on that network. The IDA Medical Plan has access to most PPO
providers and the administrator will work with the individual employer in the selection of their local PPO. Therefore, the
chances are good that your doctor will be a part of the selected PPO. If not, the plan still pays the out of network fees.
This would, in most cases, relate only to the doctor and not to a hospital.
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Q: Can the IDA Group Medical Program be tailored to the needs of my specific company?
A: Yes. The summary plan description can be amended to include or exclude certain coverage, limits,
varying co-payments, co-insurance and out-of-pocket maximums. Additional coverage is also available for vision, dental, and
group life coverage. |
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Q: Who is Medical Benefit Administrators of Maryland (MBA)?
A: MBA is a national benefit administration firm retained by the IDA and Plan Administrator
to provide claims and administrative services to the plan. MBA specializes in administering association health plans
and is the leader in this marketplace. |
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Q: How are employee and dependent benefit rates established?
A: The Administrator employs the Tillinghast HealthMaps System with specific assumptions reviewed by actuaries
to establish contribution rates. The employee and dependent group rates are established based on fixed overhead cost; the
cost of medical services in the specific geographic area; the age, sex, family status, and general medical condition of the
specific employer group.
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Q: Who is Affintiy
Benefit Services LLC (ABS)?
A: Affinity Benefit Services has been retained by the
IDA to assist the IDA in management of the plan, and work with the IDA member employers in the implementation, design,
presentation, and enrollment of employees and dependents with the program. ABS will be working with the various individual
member companies across the United States that wish to participate in the IDA Group Benefit Trust program.
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