Employer Sponsored Health Plans

Employers that establish a health plan for the benefit for their employees and their dependents can use the medical services  of the physician members of PPC and Provider/Employer Stop Loss  to create a Plan that will conform to the Accountable Care Act or its replacement or modified plan. The ERISA plan has no deductibles but has $25 copayments for professional services and $500 per day copayment for hospitalizations. It has a maximum fee schedule for all claims based on Medicare rates.  There is a maximum out of pocket expense for individuals of $6,350 per year and for a family of $12,700 per year not including charges that are above the maximum fees listed in the Plan document.  The average monhtly costs of these ERISA Plans is $414.75 for adults and $194.25 for each child.  Employers pay half of the cost for employees, but sometimes the employer will pay a greater share than 50%.

 

ERISA Summary Plan Description with waiver and adoption and application info

 

HIPAA_Authorization_Letter

 

EMPLOYER SPONSORED EMPLOYEE WELFARE BENEFIT PLAN 1-31-17

 

ERISA Plan Q & A Booklet and Enrollment Application