Select Level-Funding Plan
- Two Powerful Stop-Loss Options
- Select Core Plan offers aggregate-only stop-loss, protecting against high claims for the entire group with a 100% claims refund option.
- The Select Core Plus Plan combines specific and aggregate – providing a 50% or a 100% claims refund option.
- Complimentary Added-Value Services
- Wellness plans with monetary incentives
- Virtual care telehealth services
- Human resources enrollment and eligibility software
- Pricing comparison tool for local medical services and chances to earn up to $1,500, mailed to members automatically
- Bundle Discount. Save up to 2.5% when you bundle your benefits with our Guardian ancillary products.
- 66 Plan Options. 47 PPO benefit plan options and 19 high-deductible plans to choose from.
- Broad National Network. Aetna Choice POS II network of doctors and hospitals, plus more than 75,000 pharmacies nationwide.
- Dedicated Customer Service. Attentive service team to meet your needs.
- ACA Exemptions. A level-funded plan governed by the Employee Retirement Income Security Act (ERISA), exempt from the rate and pricing requirements under the Affordable Care Act (ACA).
Availability
The Select Level-Funding Plan is available to member firms whose main offices or headquarters are in one of the 33 states shown in blue below. However, employees can work in any of the 50 states to be eligible.
*Only available for firms with more than 100 employees in NY
Choose Your Stop-loss Option
Our self-funded program offers both specific coverage and aggregate level-funded coverage.
- Specific stop-loss insurance provides protection against high claims from any single individual.
- Aggregate stop-loss provides protection against higher-than-expected claims for the entire group.
- Firms can adjust coverage upon renewal as risk tolerance and underlying medical trends occur.
| Select Core Plus Plan Specific and Aggregate |
Select Core Plan Aggregate Only |
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| Best fit for | Specific stop-loss insurance works best if your organization is concerned with medical costs associated with a specific employee or family member. In addition, firms are also protected from higher-than-expected claims for the entire group. |
Aggregate stop-loss insurance works best if your organization is concerned with overall costs, rather than costs associated with a specific employee or family member. |
| How it works | When a specific member’s medical claims exceed a predetermined limit, Meritain reimburses the employer for the difference. You choose a level of acceptable risk per participant and purchase coverage at that amount. (Specific deductible can range from $10K to $50K) When overall claims for the group exceed an overall expected level, Meritain reimburses the employer for claims greater than the expected level. |
If claims for the group exceed an overall expected level, Meritain reimburses the employer. |
Our Plans
Copay Plans
47 different plans offer a variety of rates within the following ranges.
| In-Network | Out-of-Network | |
| Coinsurance | 0% - 20% | 30% - 50% |
| Deductible (Single) | $250 - $7,000 | $5,000 - $21,000 |
| Deductible (Family) | $500 - $14,000 | $2,000 - $42,000 |
| Out-of-Pocket Max (Single) | $1,750 - $7,350 | $5,250 - $22,050 |
| Out-of-Pocket Max (Family) | $3,500 - $14,700 | $10,500 - $44,100 |
High-Deductible Health Plans
19 different health savings account (HSA)-qualified plans offer a variety of rates within the following ranges.
| In-Network | Out-of-Network | |
| Coinsurance | 0% - 20% | 20% - 50% |
| Deductible (Single) | $1,500 - $6,350 | $5,000 - $10,000 |
| Deductible (Family) | $3,000 - $12,700 | $10,000 - $30,000 |
| Out-of-Pocket Max (Single) | $2,500 - $6,650 | $10,000 - $25,000 |
| Out-of-Pocket Max (Family) | $5,000 - $13,300 | $20,000 - $50,000 |
