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(Available to Washington State Residents Only)
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SUMMARY OF BENEFITS
BALANCE 2500
FOR INDIVIDUALS & FAMILIES
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BALANCE 2500 - Alliant Plus Network
If choice is first and foremost, the Balance
plans are for you because you can see any
doctor you want for primary, specialty,
and alternative care.
 These plans let you
choose between the Alliant Plus in-network options, with different
levels of coverage.
Structured like traditional copayment plans, you'll
pay a fee for your in- and out-of-network office
visits. For some benefits (in- or out-of-network)
your coinsurance won’t apply until after you
pay your deductible. And, your deductible
doesn’t apply to preventive care office visits,
and to most in-network office visits, which is
a whole lot of value. Click here to look up a provider.
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Benefits |
Alliant Plus
In-Network |
Alliant Plus
Out-Of-Network |
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Annual Deductible |
$2,500 per member or $7,500 per family
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Memeber Coinsurance |
40% |
40% |
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Out-Of-Pocket Limit*
(Deductible does not apply.)
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$8,000 per member or $24,000 per family
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Benefits |
No Deductible |
After Deductible,
Member Pays |
Office Visits
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Primary: $30/visit
Speciality: $50/visit |
Primary: $30/visit + 40%
Speciality: $50/visit + 40% |
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Manipulative Therapy
Limit total visits PCY** to 10 combined for both in- and out-of-network.
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$30/visit |
$30/visit + 40% |
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Acupuncture
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$30/visit,
up to 8 visits PCY |
$30/visit + 40% |
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| Naturopathy |
$30/visit,
up to 3 visits PCY |
$30/visit + 40% |
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Maternity Care
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Not Covered |
Not Covered |
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Benefits |
After Deductible, Member Pays |
Hospital Visits - Inpatient
Hospital room and board; inpatient surgery; anesthesia, intensive and coronary care; laboratory test; radiology services; drugs while in hospital. Includes mental health inpatient treatment.
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$100 per day up to 5 days/admit + 40% |
$100 per day up to 5 days/admit + 40% |
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Lab/X-Ray Services
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Deducible waived on first $200 PCY, then deductible and 40% apply. |
40% |
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Devices, Equipment & Supplies
(DME and prosthetics.)
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Covered at 50% |
Covered at 50% |
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Emergency Care
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$100 + 40% |
$100 + 40% |
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Benefits |
Deductible Does Not Apply |
Preventive Care Visits
For children and adults; including physicals and immunizations, as established in Group Health's well-care schedule.
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Covered in full |
$30/visit + 40%
$300 individual/
$600 family annual
benefit maximum |
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Prescription Drugs |
Not covered |
Not covered |
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Vision Care
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$30 for routine
eye exam per 12 months |
Covered up to $30 for routine eye exam per 12 months |
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* Member coinsurance and emergency care copayment apply. No other fees for covered services apply to out-of-pocket limit.
** PCY = per calendar year
CARRYOVER: There is no 4th quarter deductible carryover.
Note: This is a summary of benefits. The contents are not to be accepted or construed as a substitute for the provisions of the master policy or agreement. Other terms and conditions apply. All plans cover on-the-job-injury-related health care costs for partners, proprietors, or corporate officers who are not covered by a workers' compensation act, subject to the plan's cost shares and benefit limitations.
Coverage provided by Group Health Options, Inc.
E-mail us for more information and a free quote or CALL TOLL FREE
1-800-875-4490 (in the U.S.)
or 1-253-854-0199 (outside the U.S.)
Fax: 1-253-896-9411
Mailing address: Maddock & Associates, 1407 Willow Road E, Suite C, Tacoma, WA 98424
Serving all of Washington at 800-875-4490, Seattle at 206-682-1628,
Bellevue at 425-454-6834, Kent at 253-854-0199 and Tacoma at 253-572-3291.
Copyright© 1998-2011, Maddock & Associates | Privacy Statement
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