CoverageFirst^SM

CoverageFirst is a unique Preferred Provider Organization (PPO) or Point of Service (POS) plan design that includes coverage for basic healthcare, plus protection in case of a major unexpected illness or injury.

The plan includes a “benefit allowance” for each covered member – money that can be used before the member has to meet the deductible. At the other end of the spectrum, CoverageFirst has an out-of-pocket maximum to limit a member’s costs in case of a serious illness or injury.

Value for employers and employees

It's likely many of your employees visit the doctor just a few times a year – or less – and have annual medical costs below $500. With CoverageFirst, those employees would pay only copayments and premiums – premiums that are lower than with most traditional health plans.

And since CoverageFirst has a "safety net," even employees who need more medical care can have peace of mind knowing there's a limit on their out-of-pocket costs.

How CoverageFirst Works

For each person insured under CoverageFirst, the plan pays the first $500 of eligible expenses for covered services from in-network providers – other than copayments.
Once a member uses the entire allowance, the individual starts paying toward the annual deductible.
After the deductible is met, coinsurance covers most additional eligible medical expenses until the member satisfies the annual out-of-pocket maximum.