Comparison_Chart_2012-2022.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Health & Life Insurance Services
- Solicitation number
- SPM070-17-R-0001
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Comparison Chart of Benefits
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HEALTH
| Benefits | Contract 2012-2017 | Contract 2017-2022 |
| Premiums | 75% paid by the USG for employee and dependents 25% paid by the employee for the employee and dependents | 100% paid by the USG for employee and dependents |
| Deductible | $130 | $150 |
| Hospitalization | 100% reimbursement of room and board for a ward room or semi-private room. 80% reimbursement of room and board for a private room, not to exceed 100% of the cost of a semi-private room. | 100% coverage of room and board expenses for a either private or semi-private room - no limit on length of stay. |
| Hospital medical services | 80% reimbursement | 80% coverage of hospital medical expenses including laboratory test and x-rays, operating room expenses, intensive care, nursing care, and prescription medicines |
| Ambulance | 100% reimbursement with a max of $150 for land and $1,000 for air | 100% coverage of land ambulance with a max of USD 360 per event and 60% coverage of air transport with a max of USD 9,000 per event |
| Doctor's visits | 90% reimbursement (home or office) for general doctor. 80% reimbursement (home or office) for specialists (includes child visit to pediatrician) 100% reimbursement for doctor's visit at hospital | 100% coverage of doctor's, surgeon's, and specialist's fees incurred while hospitalized, at a clinic or doctor's office. Visits to a doctor's office or a specialist have a copay of $20 per visit |
| Surgeon's fees | 100% reimbursement | 100% reimbursement |
| Anesthesiologist fees | 100% reimbursement | 100% coverage of anesthesia |
| Assistant fees | 70% reimbursement | 50% coverage of surgical assistants |
| Ambulatory Surgery | 100% reimbursement | 100% coverage |
| Emergency Room | 100% reimbursement with no co-pay or deductible for accidents. 100% reimbursement with a $20 co-pay for illnessess. ER overseas is not covered | 100% coverage of emergency room services |
| Prescription drugs and medicines | 80% reimbursement (after deductible) of the cost of medicines and drugs for which a prescription is legally required. Expenses for medicines, vitamins, cold remedies, etch that are available over the counter without prescriptio will not be reimbursed even if prescribed by a physician. | 80% coverage (after deductible) of the cost of medicines and drugs for which a prescription is legally required. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician. |
| Obstetrical Care | Prenatal care: 70% reimbursement (Appointments and ultrasounds) Routine Delivery: 100% reimbursement Cesarean: 100% reimbursement Legal Miscarriage: 100% reimbursement | Prenatal care: 80% coverage (Appointments and ultrasounds) Routine Delivery: 100% coverage Cesarean: 100% coverage Miscarriage: 100% coverage |
| Postnatal care | 70% reimbursement; maximum $6,000 | 80% coverage |
| Psychiatric Treatment | 80% reimbursement | 80% coverage for psychiatric treatment up to USD 60 per session and max of 29 sessions per contract year |
| Physical Therapy | 80% reimbursement | 80% coverage of physical therapy |
| Immunizations | 80% reimbursement (includes child's vaccines) | 60% coverage for immunizations (includes child's vaccines) |
| Benefits | Contract 2012-2017 | Contract 2017-2022 |
| Dental care | 40% reimbursement of expenses for dental services including dentist's fees, x-rays, examination and treatment, cleaning, fillings, extractins, false teeth, crowns, and bridges | 50% coverage for minor restorative care 50% coverage for major restorative care 50% coverage for preventive care Maximum of USD 600 per year for all dental expenses Orthodontic expenses are not covered |
| Optical Care | none | 50% Coverage of expenses for eye examination and treatment |
| Routine annual physical examination | 80% reimbursement | 90% coverage for annual exams |
| Stop loss for hospital charges | none | none |
| Maximum agregate reimbursement | $450,000USD (Per patient per life time of the insurance contract) | $240,000USD (per covered individual per contract year) |
LIFE
| Benefits - Life Insurance | Contract 2012-2017 | Contract 2017-2022 |
| Premiums | 100% paid by the USG for employee | 100% paid by the USG for employee |
| Non-Accidental Death Coverage | 20 times his or her basic monthly salary, not to exceed USD $120,000 | 20 months’ basic salary (USD) |
| Accidental Death Coverage | 28 times his or her basic monthly salary in the event the employee is killed in an accident, not to exceed USD $170,000 | 27 months’ basic salary (USD) |
| Dismemberment Coverage |
• 100% - both arms or hands; both legs or feet; 1 arm or hand and 1 leg or foot; loss of vision in both eyes
• 50% - 1 arm or hand; 1 leg or foot; loss of vision in one eye; total loss of speech or hearing
Partial Disability: 100% for lost of both arms or hands; both legs or feet; one arm or hand and one leg or foot; loss of vision in both eyes. 50% for the loss of one arm or hand; one leg or foot; loss of vision in one eye; total loss of speech or hearing. All percentages are based on the amount for natural death.
| Total Permanent Disability Coverage | In the event of permanent disability the employee is eligible for an amount of coverage equal to twenty (20) times his or her monthly basic salary | Total Disability: 100%, based on natural death amount |
| Funeral Benefit | $2,500 | USD 2,000 |
| Age of Eligibility at the time of hiring | New employees who have reached the age of 60 prior to entering on duty with the U.S. Government will not be eligible for life insurance coverage. | New employees who have reached the age of 65 prior to entering on duty with the U.S. Government will not be eligible for life insurance coverage |
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