Group Products
HM Care Advantage
A Limited Benefit Medical Plan
About HM Care Advantage
Bridging Employee Health Care Gaps
HM Care Advantage, a Limited Benefit Medical Plan, is an option that employers can offer to help bridge the gaps for employees who do not have coverage, whose coverage is being reduced or who can no longer afford family coverage. Our group indemnity plan provides a solution to help employers attract and maintain a talented workforce.
- Group platform: employer or voluntary contributions
- Benefits are guaranteed issue - no medical questions, individual underwriting or evidence of insurability (except for late enrollees)
- Complete flexibility in the design of the plan
- Employer selects the benefit amounts and frequency
- Payment based on a Schedule of Benefits
- No overall calendar year or lifetime maximum (beyond limits shown on the Schedule of Benefits)
- No limits for pre-existing conditions
- Dependents-only coverage available (subject to applicable law)
- Pregnancy and newborn nursery care covered
- Dependent child pregnancy covered
- Access to a Preferred Provider Network resulting in discounted expenses for employees
- Surgical schedules
- Physician office visits include sick and wellness
- Home health care visits available
- Emergency room coverage for accidents and illness
- Health Information On-Call and On-Line
- COBRA Administration
- Missed payment flexibility
- Insured Dental, Vision and Drug plans
Promoting Healthier Employees
HM Care Advantage has an emphasis on wellness. Our plan offers an opportunity for the employee to visit a physician before a minor illness or injury could turn into something more serious. HM Care Advantage also offers a well-visit to the doctor (such as a routine annual physical exam). Employers can enhance the wellness offering by adding a prescription drug benefit, emergency room care and wellness screening tests such as colonoscopy and mammography or wellness services such as a Pap test, PSA or immunization.
Networks That Help to Reduce Members’ Expenses
The value of each benefit in an HM Care Advantage plan can be extended when covered employees use one of the plan’s networks. These networks have been selected to provide access to health and health-related services on a national basis. Use of a network provider or participating retailer could reduce the cost to the covered person at the point of service.
With more than 560,000 physicians, approximately 4,500 acute care facilities (hospitals and other licensed providers) and 98,000 ancillary care provider locations, the MultiPlan provider network accepts HM Care Advantage plans across the county. In the state of Indiana, the Provider Network is provided by Indiana Health Network (IHN). Use of a contracted network for vision coverage may also help employees with the cost of care.
The HM Partnership Advantage
HM Insurance Group is offering HM Care Advantage through a partnership with Key Benefit Administrators (KBA). Headquartered in Indianapolis, Indiana, KBA has more than 25 years experience in benefits management and a focus on customer service.
A Web-based calculator allows the HM Insurance Group sales consultant or producer to create practically any combination of core and additional benefit selections – at the frequency and dollar amount levels that can meet an employer’s price point or plan design objective. Premium payments can be made on a weekly, bi-weekly or monthly basis to fit with group payroll and system requirements. Enrollment services, via the Internet or a call center, are provided at no additional cost to the employer.
KBA's supporting infrastructure and experience administering Limited Benefit Medical Plans allows them to be responsive to the needs of producers, employers and employees alike. All member questions and claims are handled by a single toll-free telephone number. Policyholders receive a single membership card to access all benefits.
Worksite Products Complement HM Care Advantage
HM Insurance Group offers HM Worksite Advantage products to complement our Limited Benefit Medical Plans and help provide additional benefits to employees. These products may address the potential financial impact of illness and accident, and benefits are paid regardless of other insurance plans. In addition, guaranteed issue is available on certain products. Critical Illness, Accident, Cancer and Universal Life have a portability feature that allows employees to continue coverage even if they leave their employer or retire. HM Worksite Advantage also offers Disability and Supplemental Hospital Indemnity coverage.
HM Care Advantage is an HM Life Insurance Company product administered by Key Benefit Administrators (KBA). Based on the plan selected, Medical and Vision coverages are underwritten by HM Life Insurance Company, Pittsburgh, PA, under policy form series HM905, GP902 or similar. For other insured products when available: Dental and Outpatient Prescription Drug coverages are underwritten by Fidelity Security Life Insurance Company, Kansas City, MO, under policy form series M-9037 and M-9031/M-9022. In certain states, Dental is underwritten by Renaissance Life & Health Insurance Company of America, Greenwood, IN, under policy form series DT-300A or DT-310A. Administrative and/or customer support services when available are provided: for Health Information On-Call – Health Dialog Services Corporation; for Complementary Wellness Discount Program – Healthways WholeHealth Networks, Inc.; for Health Information On-Line – HealthMedia® Inc.; for Pharmacy Discount Card – Caremark, Inc.; for Vision – Davis Vision; for Provider Network Discounts – different network discount options exist and are specified at time of offer. Other administrative and/or customer support services may be provided by HM Life Insurance Company and HM Benefits Administrators. Certain exclusions and limitations may apply. See your certificate or other evidence of coverage for details. Coverage or service requested or the use of a specific association, franchise, trust or union may not be available in all states and is subject to all applicable state rules, laws and regulations.
