Prominence Health Plans, formerly Saint Mary’s Health Plans, just released nine (9) new small group plan designs that will be available on October 1st, 2014.
These plans are available for employer groups with 2 – 50 employees. All nine Prominence Health Plans are in full compliance with the requirements of the Affordable Care Act.
These new plans will be using the current Prominence/Saint Mary’s HMO and PPO provider directories. The medical premiums, which the NV Division of Insurance approved, are with the 2014 Saint Mary’s plans.
Five of the new policies are Preferred Provider Plans (PPO’s) and four of their new plan designs are Health Maintenance Organization Plans (HMO’s). PPO plans allow insured members to use any doctor and facility in the nation. Members should use the Prominence Health Plans PPO network list to obtain lower co-pays and lower out of pocket costs.
The approved HMO plans provide a more restricted list of participating physicians and facilities.
Traditionally, HMO plans do not pay for medical expenses or for doctors not included on the network list. However, “emergency situations” will be covered anywhere in the nation giving members options for care when in times of urgent need.
Five of these new plans have deductibles ranging from $3,000 – $6,350 for in-network services. The other four plans have no deductible at all. On 8 out of the 9 new plans, the co-pays for in-network physician office visits range from $20 – $80. These same plans include urgent care coverage.
Pediatric dental coverage is on all of Prominence Health Plans’ medical policies. Although, this new Affordable Care Act mandate allows children under the age of 19 to receive dental benefits. Therefore, all of these pediatric dental benefits include a $50 deductible.
For more information about the transition of ownership from Saint Mary’s to Prominence, please click here.
If you would like a complete description of the plans or rates, please contact us for more information. We are more than happy to provide you with firm rates for your small group.
P: (775) 828-1216
F: (775) 828-1277