11385S1014 PF Email Template

Dear ______Employee Name______,

Our new group health benefit plan with Allied National features the Freedom Plan instead of a Preferred Provider Organization (PPO). There is no network with the Freedom Plan. You are free to use the services of any provider without penalty and still be eligible for PPO-like discounts on your bill. Just present your card at the beginning of your visit as you would any other benefitcoverage card. There is a number on the card your provider can call to verify benefits and coverage of your plan.

How the Freedom Plan works

The Freedom Plan reimburses providers by using Medicare accepted payment levels as the reference point from which to make provider payments. Your Freedom Plan pays physicians at 125% of Medicare allowable reimbursement and facilities at 150% of Medicare allowable. This means providers are paid above Medicare levels and this level is often above what they might receive from the dominant insurers in your area.

What you should do if you are balanced billed

Balanced billing is when a provider bills you for the difference between their charge and what your group benefit covers. If you are balanced billed, first make sure you've paid your portion of the bill and that the balance is not for your copay, deductible or coinsurance amount. If in doubt about your portion of the bill, reference the explanation of benefits you received in the mail (and which is available online on the Self-Service Site at member.alliednational.com) or contact Allied Client Services for assistance at 1-800-825-7531.

If the bill shows an amount due other than the portion for which you are responsible, immediately contact Client Services so that Allied can work with the provider to resolve the situation. While you are responsible for your share of the bill, you are not responsible for any portion of a disputed discount.

The Freedom Plan gives you the cost savings of a PPO plan with the freedom to see any provider you choose. No network lists, penalties or hassles trying to determine available providers in a network.

No penalties

The Affordable Care Act requires all individuals to have minimum essential health coverage, and your plan satisfies this requirement. You will not be assessed a fee or penalty when you file your annual income tax return.

If you have any questions about the Freedom Plan, feel free to call Allied Client Services at 1-800-825-7531 or call ___(Company Contact)______at ______(Company Phone #)______.

Best Wishes,

______(Name of Company)______ 11643s0816