Imerica Health Saver Series
Health Savings Accounts are available to anyone who isn't eligible for medicare. Although the deductibles seem higher for families, the whole family accumulates toward the same deductible.
| Health Saver One | Health Saver Family | |
|---|---|---|
| Lifetime Maximum | $2,000,000 or $5,000,000 | $2,000,000 or $5,000,000 |
| Deductible Choices | Calendar-Year Deductibles: 100% Series: $1,800, $2,600, $5,000 80% Series: $1,200, $1,800, $2,600 50% Series: $1,200, $1,800, $2,600 |
Calendar-Year Deductibles: 100% Series: $3,000, $5,150, $10,000 80% Series: $3,500, $5,150 50% Series: $3,500, $5,150 |
| Coinsurance Choices | Coinsurance (Plan Pays/You Pay) up to the amount indicated. 100% Series: 100% Out-of-Network: 60/40 to $20,000 80% Series: 80/20 to $18,000 for $1,200 Deductible Choice 80/20 to $15,000 for $1,800 Deductible Choice 80/20 to $11,000 for $2,600 Deductible Choice Out-of-Network: 60/40 to $20,000 50% Series: 50/50 to $7,000 for $1,200 Deductible Choice 50/50 to $6,000 for $1,800 Deductible Choice 50/50 to $4,400 for $2,600 Deductible Choice Out-of-Network: 50/50 to $20,000 |
Coinsurance (Plan Pays/You Pay) up to the amount indicated. 100% Series: 100% Out-of-Network: 60/40 to $20,000 80% Series: 80/20 to $16,000 for $3,500 Deductible Choice 80/20 to $20,000 for $5,150 Deductible Choice Out-of-Network: 60/40 to $20,000 50% Series: 50/50 to $6,000 for $3,500 Deductible Choice 50/50 to $8,000 for $5,150 Deductible Choice Out-of-Network: 50/50 to $20,000 |
| Coinsurance Maximums | Out-of-Pocket Maximums 100% Series: $1,800 Deductible = $1,800 $2,600 Deductible = $2,600 $5,000 Deductible = $5,000 80% Series: $1,200 Deductible = $4,800 $1,800 Deductible = $4,800 $2,600 Deductible = $4,800 50% Series: $1,200 Deductible = $4,700 $1,800 Deductible = $4,800 $2,600 Deductible = $4,800 |
Out-of-Pocket Maximums 100% Series: $3,000 Deductible = $3,000 $5,150 Deductible = $5,150 $10,000 Deductible = $10,000 80% Series: $3,500 Deductible = $6,700 $5,150 Deductible = $9,150 50% Series: $3,500 Deductible = $6,500 $5,150 Deductible = $9,150 |
| Additional Information | There is an additional deductible of $2,500 for Out-of-Network usage, in addition to the major medical Calendar-Year plan Deductible. After the Deductible and Coinsurance are met, the plan pays 100% of Covered Changes for the remainder of the Calendar-Year. (For the 100% Series, only the Deductible applies, and once it is met, then the plan pays 100% of Covered Charges for the remainder of the Calendar-Year.) For single coverage, you can contribute up to 100% of the Deductible amount annually into an HSA. (Calculated on a monthly basis subject to effective date.) |
There is an additional deductible of $2,500 for Out-of-Network usage, in addition to the major medical Calendar-Year plan Deductible. After the Deductible and Coinsurance are met, the plan pays 100% of Covered Changes for the remainder of the Calendar-Year. (For the 100% Series, only the Deductible applies, and once it is met, then the plan pays 100% of Covered Charges for the remainder of the Calendar-Year.) For single coverage, you can contribute up to 100% of the Deductible amount annually into an HSA. (Calculated on a monthly basis subject to effective date.) |
| Physician Office Visit | Subject to Deductible and Coinsurance (Deductible only for 100% Series) | Subject to Deductible and Coinsurance (Deductible only for 100% Series) |
| Outpatient Prescription Drugs | Subject to Deductible and Coinsurance (Deductible only for 100% Series) | Subject to Deductible and Coinsurance (Deductible only for 100% Series) |
| Emergency Room Care | Subject to Deductible and Coinsurance (Deductible only for 100% Series) | Subject to Deductible and Coinsurance (Deductible only for 100% Series) |
| Routine Physical Exam | Subject to Deductible and Coinsurance (Deductible only for 100% Series). Benefit available after the individual has been covered for at least 12 months. Maximum benefit of $500 per Insured per Calendar-Year. | Subject to Deductible and Coinsurance (Deductible only for 100% Series). Benefit available after the individual has been covered for at least 12 months. Maximum benefit of $500 per Insured per Calendar-Year. |
| Human Organ, Tissue and Bone Marrow Transplant | The Lifetime Maximum benefit is $500,000 per individual for In-Transplant Network and $200,000 for Out-of-Transplant Network. | The Lifetime Maximum benefit is $500,000 per individual for In-Transplant Network and $200,000 for Out-of-Transplant Network. |
More detailed Imerica of Colorado Health Saver Series plan information can be seen by downloading a Brochure. You can compare the rates of Imerica Health Saver Series plans to other plans in Colorado using our instant quotes, or get quotes from the Imerica website.
Application Options
Applications can be done by downloading a Paper Application and faxing or mailing it to us at the fax number or address in the instructions. Or, Imerica has created a very user friendly Online Application that speeds up the underwriting process considerably.
Important - If you meet the preferred criteria, make sure you are getting a preferred quote instead of a standard quote. Even if you meet the preferred criteria and a standard quote is submitted to Imerica, you will receive standard rates.
- There is a one time non-refundable application fee of $25 per application
- In Colorado, the rates include a membership in HealthStyle Benefits Association. You can see more about what is included in this membership here; http://www.healthstylebenefits.com/
- A Discount Card for brand and generic drug purchases is provided. The discount card is not an insurance benefit. Average discounts may range from 15% to 35%. The In-Network and Out-of-Network Coinsurance maximums accumulate separately. Those individuals age 55 and over may contribute an additional $600 to an HSA for tax year 2005. See "Catch Up Amounts". Family HSA plans maintain separate eligibility rules. If two individuals have HSA qualifying insurance plans, the lowest Deductible determines the contribution level into the HSA for the couple. HSA features listed in this brochure apply to Individual and Family plans. See Plan Exclusions, Limitations and Additional Information in the brochure.
- Imerica offers American Health Value as an HSA administrator, but you can work with any HSA administrator, and you can not set up an HSA at all.
- Where applicable, the Master Group Policy will be issued to an Association Group, which may vary by or within a state. Please refer to the enrollment application of the plan for which you are enrolling for specific association benefit information. Benefits, exclusions, limitations and availability may vary by state. Not all provisions are listed on this web site. Please refer to the Certificate of Insurance for the actual terms and conditions. In the event there are discrepancies with the information given here, the terms and conditions of the coverage documents will govern. Any errors or omissions in this brochure are unintentional. DO NOT CANCEL ANY EXISTING HEALTH INSURANCE UNTIL RECEIVING WRITTEN NOTICE OF APPROVAL.
**Any descriptions of coverage on this page may not be current and should not be taken as a description of coverage. Any persons seeking to get a full description of coverage should view Colorado plan description forms and/or brochures for the plan they are interested in.
