Plan Design Guidelines
The Signature Care PPO network recognizes that area employers have varying needs to gain control of their healthcare costs. For that reason we have designed a portfolio of products to meet those needs. As you consider which product appears to be an appropriate fit, please consider the suggested guidelines. If your plan design varies slightly from these guidelines, contact us to determine for which product your group qualifies.
Signature Care EPO (Exclusive Provider Organization)
Our most aggressive product is built using a three-tiered plan design. The top tier is for the EPO hospitals. Signature Care EPO employers will receive unsurpassed discounts at those facilities. However, all members still have access to the entire Signature Care network expanding to include more than 21,000 Healthcare providers and facilities in Indiana and northwest Ohio. In addition to each of the high quality, 4-star rated Parkview Hospitals, Signature Care is pleased to have the Cleveland Clinic, Indiana University Health and University of Michigan as in-network Centers of Excellence Hospitals.
The second tier is for all other Signature Care in-network services.
The third tier is for out of network services. The second and third tiers are similar to a typical plan design.
To qualify for EPO, we ask that the differentials are as follows:
|
Tier 1
(EPO Hospitals)
|
Tier 2
(Other in-network)
|
Tier 3
(Out of network)
|
Coinsurance
|
Starting Coinsurance
|
10% more than Tier 1
|
30% more than Tier 1
|
Deductible
|
Starting Deductible
|
$1,000 more than Tier 1
|
$3,000 more than Tier 1
|
OOP Max
|
Starting OOP Max
|
$3,000 more than Tier 1
|
No Limit
|
For additional information or to review a sample plan design, contact us.
Signature Care Exclusive Elite
Employers who choose an exclusive arrangement with the Signature Care PPO network are quick to discover the additional savings by forming that partnership. When you choose Exclusive Elite, you can expect more than just noteworthy discounts. Exclusive Elite employers receive case rates on the most common inpatient procedures at Parkview facilities. As you progress to higher levels of exclusivity, you can expect additional discount savings.
The suggested differentials between in and out of network for Exclusive Elite are as follows:
|
Exclusive Elite
|
Coinsurance Differential
|
30%
|
Deductible Differential
|
$1,000
|
|
OOP Max
|
$5,000
|
|