Lifestyle Health Plans are available in most states. Details and restrictions based on the specific carrier partner utilized by Lifestyle Health Plans for each client. Please see a sales representative for details.
Applications from all industries will be reviewed for eligibility. Some businesses or industries are subject to special rates or restrictions based on the specific requirements of the sponsoring carrier.
Eligible employees are defined as all full time, active employees working at least 30 hours per week, who are paid a salary or earnings from which Federal, State and Social Security taxes are withheld (may vary by State). There must be a bona fide employer-employee relationship. 1099 employees are not eligible unless permitted by the State. Eligible dependents include spouses and dependent children. Dependent children are eligible until they reach a limiting age, which may vary by each state and/or specific carrier partner utilized by Lifestyle Health Plans.
Individuals Not Eligible
Other individuals typically not eligible for coverage include: non-resident aliens; employees not working at the employer’s regular place of business on a full time basis; any outside consultant, directors & stockholders who are not physically working at the place of business; retired, temporary, part-time, or seasonal employees. Specific details and restrictions may vary by sponsoring carrier.
Employee participation will vary by size of employer and their respective number of eligible employees. Please see a Lifestyle Health Plans sales representative for details.
In the majority of circumstances, employer contributions for employee coverage must be at least 50% for all enrolling employees. Specific details may vary by sponsoring carrier. Please see a Lifestyle Health Plans sales representative for details.
Deductible and Co-pays
Deductibles, other than specific service deductibles, accrue on a calendar year basis unless otherwise specified. Co-payments and ineligible expenses do not apply toward satisfaction of the calendar year deductible(s). Out of network plan deductibles may accrue separately based on the specific specifications of the sponsoring carrier.
Plan Provisions, Limitations, and Exclusions
A complete list of plan limitations and /or exclusions is contained in the Summary Plan Description provided by the sponsoring carrier to each participating employee.
Lifestyle Health Plans respects and treats the personal and health information of our members in a confidential manner. We abide by established policies and procedures designed to maintain physical, electronic, and procedural safeguards to protect such information. These policies and procedures may be revised as needed to maintain our compliance with the Health Insurance Portability and Accountability Act (HIPAA), or other such controlling laws that may be enacted.
Smaller groups (<100 Employees) will require medical underwriting. Larger groups (>100 Employees) may provide claims history in lieu of individual employee health applications. Specific guidelines for group medical underwriting vary by carrier. Firm rates are determined at the time of underwriting. DO NOT cancel your policy until your group has been approved in writing.