Review and Edit Terms

Slide the toggle to Yes to include specific coverage.

Slide the toggle to Yes to include Medical under specific coverage.

Slide the toggle to Yes if you want to include prescription drugs under medical coverage. Note that this will automatically set Prescription Drug Card to No.

Slide the toggle to Yes if you want prescription drug card coverage. Note that this will automatically set Prescription Drugs under Medical to No.

Slide the toggle to Yes to exclude non-specialty only.

Slide the toggle to Yes to include custom coverage. This enables the text field below the slide. Enter a description of the coverage in this field.

Select the desired contract type from the drop-down.

Specify the annual deductible per person here.

Slide the toggle to Yes if deductible is famly.

Slide the toggle to Yes if coverage is unlimited. This disables the Maximum Coverage Limit drop-down and the Maximum Coverage Amount field.

Specify how the maximum coverage limit is calculated from this drop-down. This drop-down is disabled if Unlimited Coverage is set to Yes.

Specify the maximum coverage amount here. This field is disabled if Unlimited Coverage is set to Yes.

Enter the reimbursement percentage here.

Specify the terminal liability provision using this drop-down.

Toggle the slider to Yes if renewal is laser free.

Toggle the slider to Yes if aggregating specific is allowed. This enables the Additional Liability field.

Enter the additional liability amount here. This field is enabled when Aggregating Specific is set to Yes.

Toggle the slider to Yes if split funding is allowed.

Enter the corridor percentage here.

Slide the toggle to Yes if simultaneous reimbursement is permitted.

Slide the toggle to Yes if supplemental coverage is included.

Slide the toggle to Yes if gapless renewal is permitted.

Slide the toggle to Yes if there is renewal guarantee.

Slide the toggle to Yes if there is a rate cap on renewals. This enables the Maximum Rate Increase field.

If you set Renewal Rate Cap to Yes, enter the maximum rate increase allowed in this field.

Slide the toggle to Yes to enable a premium load in lieu of lasering. This enables the Premium Load field.

If you set Premium Load in Lieu of Laser to Yes, enter the premium load amount here.

Enter any commission amount here.

Specify the tier schedule for specific rates from this drop-down.

Slide the toggle to Yes to include the specific composite rate.

Slide to toggle to Yes to include aggregate coverage.

Slide the toggle to Yes to include medical under aggregate coverage.

Slide the toggle to Yes if prescription drug includes major medical. This automatically sets Rx Drug Card to No.

Slide the toggle to Yes for separate drug card prescription coverage. This automatically sets Rx Drug Card and Rx Drug Card under Separate Aggregate Factors to No.

Slide the toggle to Yes to include dental under aggregate coverage.

Slide the toggle to Yes to include vision under aggregate coverage.

Slide the toggle to Yes to include disability under aggregate coverage.

Slide the toggle to Yes to include any additional benefit under aggregate coverage. Enter a description for the additonal benefit in the field below the slider. The field becomes active when you set the toggle to Yes. 

Slide the toggle to Yes to enable aggregate stand-alone.

Specify the type of contract from the drop-down.

Specify the maximum liability per person here.

Slide the toggle to Yes if coverage is unlimited. This disables the Maximum Annual Reimbursement field.

If Unlimited Coverage is set to No, specify the maximum annual reimbursement here.

Specify the run-in percentage here.

Specify the reimbursement percentage here.

Enter the deductible corridor here.

Enter the minimum attachment point percent here.

Slide the toggle to Yes to enable split-funded aggregate and specify the corridor and reimbursement percentage in the corresponding fields below the slider.

Specify the terminal liability provision using the drop-down. If you select a value other than None, specify the corridor in the corresponding field below the drop-down.

Slide the toggle to Yes to enable limited maximum liability per person.

Slide the toggle to Yes to enable monthly aggregate accommodation.

Enter any commission percentage here.

Specify the aggregate rate tier schedule from this drop-down.

Specify the aggregate premium payment schedule from this drop-down.

Specify the aggregate factor tier schedule from this drop-down.

Slide the toggle to Yes to include the aggregate composite factor.

Slide each toggle (Rx Drug Card, Dental, Vision, Weekly Income, and Other)  to No if you want the factor included in medical.

Slide the toggle to Yes to enable plan mirroring. This enables the Exclusion(s) field.

If you set Plan Mirroring to Yes, enter any exclusions in this field.

Slide the toggle to Yes to waive actively at work requirements for coverage.

Slide the toggle to Yes to include retirees in coverage.

Slide the toggle to Yes to include domestic hospital reimbursements. This enables the Domestic Reimbursement Percentage, Utilization, and Adjustment Factors fields.

If you set Domestic Hospital Reimbursement to Yes, enter the reimbursement percentage here.

If you set Domestic Hospital Reimbursement to Yes, enter the utilization percentage here.

If you set Domestic Hospital Reimbursement to Yes, enter the adjustment factor here.

Specify the specific rate type from this drop-down list.

Slide the toggle to Yes to enable cost reduction minimums. This enables the Reduction Percent Minimum field.

If you set Cost Reduction Minimum to Yes, enter the reduction minimum percent reduction here.

Slide the toggle to Yes to enable cost reduction maximums. This enables the Reduction Percent Maximum field.

If you set Cost Reduction Maximum to Yes, enter the reduction maximum percent here.