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Shared Maximum Benefit Option

Most of our plans are composed of benefits that pay a fixed amount up to a per person, per calendar year maximum for each individual benefit. There's another type of plan available — one where a predetermined set of benefits share one calendar year maximum.

  

The benefits included in these Shared Maximum Benefits still pay a fixed payment for covered claims. Employees enjoy the flexibility of deciding which benefits they'd like to use under the maximum set for the policy which can range from $10,000 to $100,000. 
 
Employers also have the option of including additional benefits with individual maximums, providing the additional benefit isn’t already in the preselected benefits in the shared maximum plan. Even though there are two benefit options, there would conveniently only be one total premium amount for this plan design.
 
 
EXAMPLE SHARED MAXIMUM OPTION  (a $10,000 per person, per calendar year maximum)   ​
​​Doctor's Office Visit Benefit ​$55 per visit​
Outpatient Diagnostic X-Ray & Lab
Class A - $300 per procedure
Class B - $55 per procedure
Class C - $10 per procedure​
Hospital Inpatient Admission ​$900 per admission​
Surgical Benefit (Schedule C) ​Included​
Surgical Anesthesia Benefit ​$375 per surgery
 
ADDITIONAL BENEFITS WITH INDIVIDUAL PP/POLICY MAXIMUMS  ​
​​Doctor's Office Visit Benefit ​$55 per visit​
Outpatient Diagnostic X-Ray & Lab
Class A - $300 per procedure
Class B - $55 per procedure
Class C - $10 per procedure​
Hospital Inpatient Admission ​$900 per admission
  

For more information on the Shared Maximum Benefit option, please refer to the flyer we give to employees, “Understanding Your Shared Maximum Limited Benefit Medical Plan.”

 

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