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Sue Fudge Health Plan Director
(208) 472-0455
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Ellen Lee Health Enrollment/Eligibility Specialist
(208) 472-0454 |
Healthy Employees Healthy Business
Operating a successful construction business
requires the right resources to get the job done.
This means healthy, able employees who come
to work ready to work. With AGC Benefit Trust
Health Insurance, you have an effective, affordable
resource for providing comprehensive health
benefi ts for your workers.
The AGC Advantage
AGC gives your business affordable access to costeffective
medical, dental, vision and life insurance
benefits for employees and their families. With a
variety of plans to choose from, your business can
enjoy highly competitive medical plan rates that
keep employees healthy and productive. Coupled
with dental and vision benefits, AGC gives you the
resources your business needs to succeed.
"Health benefits designed for AGC member businesses"
The AGC Health Benefit Plan offers:
- Competitive, affordable rates
- Broad provider choice through Blue Cross of Idaho’s networks of participating doctors
- Comprehensive dental plans through Delta Dental
- Underwritten fi nancially by stable carriers Blue Cross of Idaho and MetLife Assurance Company
- Responsive customer service and administration
by Idaho AGC
- COBRA Administration
- HIPAA Compliant
- Hour bank option available
"AGC 2007—2008 Health Plan Offering"
Basic:
$600 Deductible Plan — Blue Cross of Idaho
- $600 individual/$1,200 family deductible
- $30 Primary Care/$45 Specialist offi ce visit copay
- 75%/25% coinsurance in-network
- 55%/45% coinsurance out-of-network
- $3,000 individual/$6,000 family out-of-pocket maximum in-network
- $4,500 individual/$9,000 family out-of-pocket
maximum out-of-network
- Rx—$5 generic, 25% brand formulary,
50% nonformulary with $5,000 out-of-pocket limit
$1,000 Deductible Plan — Blue Cross of Idaho
- $1,000 individual/$2,000 family deductible
- $30 Primary Care/$45 Specialist office visit copay
- 75%/25% coinsurance in-network
- 55%/45% coinsurance out-of-network
- $3,000 individual/$6,000 family out-of-pocket
maximum in-network
- $4,500 individual/$9,000 family out-of-pocket
maximum out-of-network
- Rx—$5 generic, 25% brand formulary,
50% nonformulary with $5,000 out-of-pocket limit
$1,500 Deductible Plan — Blue Cross of Idaho
- $1,500 individual/$3,000 family deductible
- $30 Primary Care/$45 Specialist office visit copay
- 75%/25% coinsurance in-network
- 55%/45% coinsurance out-of-network
- $3,000 individual/$6,000 family out-of-pocket
maximum in-network
- $4,500 individual/$9,000 family out-of-pocket
maximum out-of-network
- Rx—$5 generic, 25% brand formulary,
50% nonformulary with $5,000 out-of-pocket limit
$2,500 Deductible Plan — Blue Cross of Idaho
- $2,500 individual/$5,000 family deductible
- $30 Primary Care/$45 Specialist offi ce visit copay
- 75%/25% coinsurance in-network
- 55%/45% coinsurance out-of-network
- $3,000 individual/$6,000 family out-of-pocket
maximum in-network
- $4,500 individual/$9,000 family out-of-pocket
maximum out-of-network
- Rx—$5 generic, 25% brand formulary,
50% nonformulary with $5,000 out-of-pocket limit
HSA Plan – Blue Cross of Idaho
- $2,500 individual plan deductible
- $5,500 individual plan out-of-pocket maximum
- $5,000 family plan deductible
- $11,000 family plan out-of-pocket maximum
- $30 office visit copay for preventive care
- 75%/25% coinsurance in-network
- 55%/45% coinsurance out-of-network
- Rx – subject to deductible and 75%/25%
coinsurance
This is not a policy. Please refer to the actual policy for
complete benefits, exclusions, limitations and other general provisions.
To learn more about the benefits of working
with AGC or obtain a list of brokers, contact
the Idaho AGC at (208) 344-9755.
AGC Deluxe Plans
Dental — Delta Dental
- $50 individual/$150 family deductible
- 80% preventive services (not subject to deductible)
- 80% basic services
- 50% major services
Life Insurance - Met Life
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Short-Term Disability $100 weekly benefit 14/14/13 wk
- $25,000 life insurance
- $25,000 accidental death and dismemberment
life insurance
- $5,000 dependent life
Vision — VSP
- $10 copay for exam
- $20 copay for materials, one set of lenses every
12 months and frames once every 24 months
All deductibles are effective November 1, 2007, through December 31, 2008.
Terms and Conditions
Groups of 2–50 eligible employees are able to purchase health
care coverage regardless of health status. An eligible employee is
an employee who works at least 30 hours per week.
“Family” as mentioned herein refers to dependent coverage.
A dependent is:
- a legal spouse
- an unmarried child under the age of 21 years
- an unmarried child who is a full-time student under the age of 25
years and who is financially dependent upon the parent.
- an unmarried child of any age who is medically certified as
disabled and dependent upon the parent
Initial premium is established based on expected claims costs
as determined by the underwriting information provided by the
group. Blue Cross of Idaho’s Underwriting Department may adjust
renewal premium for past or expected future utilization. Premium
will change for the group as the age and/or number of enrolled
members change.
Policies shall be in force and guaranteed renewable unless
terminated due to the following:
- termination by the employer without cause with 30 days’
written notice
- nonpayment of premium
- fraud or intentional misrepresentation of material fact by
the employer
- noncompliance of minimum participation requirements set forth
by Blue Cross of Idaho
Waiting periods for preexisting conditions will be credited for
employees and their dependents who were enrolled under
previous qualifying coverage. This is contingent upon the previous
qualifying coverage ending not more than 63 days prior to the
effective date under this coverage. New enrollees without previous
qualifying coverage will be subject to a 12-month waiting period
for preexisting conditions. Benefi ts for preexisting conditions may
be denied until the member has been enrolled for coverage on
this policy for a continuous 12-month period. This waiting period
shall not apply to newborn children who shall be covered from the
moment of birth or to adopted children or children in the process
of adoption who have been placed with the enrolled employee.
Preexisting condition means a physical or mental condition,
regardless of the cause of the condition, for which medical advice,
diagnosis, care or treatment was recommended or received
within six (6) months prior to the effective date of this coverage.
Genetic information shall not be considered a preexisting
condition in absence of a diagnosis of the condition related to
such information. A pregnancy existing on the effective date of
coverage will not be considered a preexisting condition.
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