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Horizons® Cost
Saver
Horizons® Cost Saver is a unique alternative for an employer
faced with the out of control costs of health insurance. Cost Saver
provides essential medical benefits to employers faced with the prospect
of dropping coverage all together, or to employers who have never
provided health insurance to their employees.
With no medical underwriting and premium savings as much as 60% over traditional
health coverage, this limited benefit plan is easily accessible while
providing the types of benefits employees request most—benefits like
Office Visits and Prescription Drugs.
Employee benefit plans are a key way for an employer to attract and retain
quality employees. Horizons Cost Saver provides an affordable, cost
effective alternative.
Cost Saver offers three different benefit levels from which to choose.
From the cost savings of the Bronze Plan to the richer benefit Gold
Plan, Cost Saver has a plan to fit your budget.
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Deductible
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$250 or $500 per person per year as selected
by employer (waived for office visits)
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Coinsurance
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80% in-network and 50% out-of-network.
(Office visits paid at 100% in-network and 80% out-of-network.)
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Benefit Category
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Outpatient Benefits
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Benefit Schedules
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Type of Service
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Basic Benefit
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Bronze
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Silver
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Gold
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Professional Services
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Office Visit
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$20 copay per visit for certain in-office services
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$2,000
Per Calendar Year
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$3,000
Per Calendar Year
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$4,000
Per Calendar Year
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Other Professional Services
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$50 copay per bill for all other professional services including,
surgery. No benefit limit per bill
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Non-Surgical Outpatient & Emergency
Services
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Emergency Room
Outpatient Services
Miscellaneous Medical Services
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Each service has a $50 copay per visit, and a maximum benefit
of $500 per bill
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$1,000
Per Calendar Year
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$2,000
Per Calendar Year
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$3,000
Per Calendar Year
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Outpatient Surgical Facility
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$250 copay per surgery, no annual limit
on number of outpatient surgeries
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$500
Maximum Benefit
Per Surgery
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$1,000
Maximum Benefit
Per Surgery
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$2,000
Maximum Benefit
Per Surgery
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Inpatient Facility Benefits* – $250
copay per admission then a daily benefit of:
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Critical Care
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$1,000
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$1,500
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$2,000
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Intermediate or Step-Down Care
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$750
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$,1250
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$1,750
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Standard Care
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$500
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$1,000
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$1,500
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Skilled Nursing or Rehabilitation
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$250
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$500
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$750
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Extended Care
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$50
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$100
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$150
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Substance Abuse or Mental & Nervous
(limited to 31 days in any 12 month period)
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$50
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$100
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$150
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Maximum benefit in any 12 consecutive months
(the lesser of 75 days or)
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$75,000
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$100,000
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$125,000
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Lifetime Maximum Benefit
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$250,000
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$500,000
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$750,000
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Outpatient Prescription Drugs
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Option One:
• Generic: $15 copay ($20 generic contraceptive copay) per prescription. No limit
on number of prescriptions. $2,500 maximum benefit per Calendar Year.
• Brand name: Provided at Allied’s contracted discount.
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Option Two:
• Generic: $15 copay per prescription. No limit on number of prescriptions. $2,500
maximum benefit per Calendar Year.
• Brand name: $150 deductible, $30 copay, 80% coinsurance. $1,500 maximum benefit
per Calendar Year.
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*Professional Services while hospitalized are covered under the
Professional Services benefit, separately from the Inpatient Facility
Benefit.
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