Association PPO Plans Available To Individuals And Families

These plans are provided by Associations and are written on a group chassis to individuals and families who qualify. Applicants must successfully answer health questions to qualify for enrollment, but there are no pre-existing condition limitations in these plans. Plans are available in all states except Washington.

The plans are administered by MBA Employee Benefits, which is a third-party administrator. Applicants must become members of the Association for the plan they choose to become eligible to join. Individuals must apply by the 25th of the preceding month to be eligible for enrollment the first of the following month. Payment is processed upon acceptance and starting the second month payments are taken out as of the 15th of the month.

Enrollment in these plans is continuous (i.e., enrollees do not have to re-enroll annually).

Four of the plans are traditional major medical plans, whereas three of the plans offered through the BMI Association are limited day-benefit plans which have exclusions and limitations not associated with major medical plans.

These four major medical plans are offered through the AFI Association.

Here are the questions that must be answered successfully to qualify for membership for the major medical plans.

These three limited benefits plans are offered through the BMI Association.

Note: all seven plans must be offered through the BMI Association for legal reasons, but the limited-day benefits plans are offered ONLY through that Association. Diabetics are excluded from membership in any of the major medical plans, but diabetics can be enrolled in one of these plans. Enrollees must successfully these questions.

Except for the MVP Basic limited-day benefits plan, all plans include eligibility for maternity.

The four major medical plans include an indemnity plan from Colonial that provides payments to beneficiaries. Colonial provides a $2500 indemnity payment for hospitalization due to sickness and $3500 for hospitalization due to injury for the four major medical plans. (This reduces costs for hospitalization by the amount of the indemnity.) The other indemnity payments are for items like office visits and diagnostic x-rays and labs and include $20,000 of guaranteed issue life insurance.

The indemnity benefits are described in this brochure for the major medical plans. (Note: the plan benefits are identified by items with white lettering in the left-hand column of the brochure; the indemnity benefits are listed in black lettering in this column.) There are no indemnity benefits for the limited day benefits plans.

Premiums for these plans are based on the size of the membership group (member only, member and spouse, member and children, and family), are not age-banded, and are the same nationally.

The four Association major medical plans are especially attractive for older individuals, whereas the limited-day benefit plans are generally most attractive for younger, healthy individuals who are not concerned about long-duration hospital stays.

These plans are not limited to being offered to people under age 65 and are very good alternatives for those who can’t qualify for or afford Medicare as well as those who do not have Social Security numbers.

Please contact us at 786-970-0740 (Cell) for more information, pricing, and/or enrollment in any of these plans.