Medical

At Nippon Life Benefits, we understand the importance of finding exactly the right fit when it comes to employee benefits. That's why we offer a full range of health care solutions with multiple networks and plan designs - designed to meet specific customer needs.

Our medical plans:

  • Utilize innovative and flexible designs
  • Provide top-tier, comprehensive choices
  • Offer convenience, affordability, and support
  • Are delivered with the highest level of customer service

FlexChoice

FlexChoice

We know customers value flexibility in designing their health benefits. With FlexChoice, employers can choose from a wide range of options to meet their specific needs.

  • Dual deductible plans. Separate in- and out- of-network deductibles apply.
  • Deductibles and copays do not apply to coinsurance maximum.
  • Separate copays for primary care physician office visits and specialist office visit.
  • PPO Primary Care and Specialist Physician Visit $ Limit - For plans with a copay, PPO physician visit limited to $500 per visit at 100% after copay; amounts in excess of $500 subject to deductible and in-network coinsurance. For plans without a copay, PPO Physician Visit subject to deductible and plan coinsurance.
  • Emergency room and Urgent Care copays are optional.

Enhanced Value Plan

Enhanced Value Plan

We know customers sometimes find it difficult to balance employee benefit needs with limited financial resources. That's why we developed Enhanced Value Plans....plan designs that can meet both of these goals.

  • Dual deductible plans.
  • Plans with or without copays are available.
  • Physician Office Charges - For plans with a copay, certain charges subject to deductible and coinsurance rather than 100% after copay (outpatient surgery, equipment other than DME, supplies, TMJ, dental services, anesthesia).
  • PPO Physician Visit $ Limit - For plans with a copay, PPO physician visit limited to $500 per visit at 100% after copay; amounts in excess of $500 subject to deductible and in-network coinsurance. For plans without a copay, PPO Physician Visit subject to deductible and plan coinsurance.
  • EVP Basic = separate deductibles for in and out of network and are NOT included in out of pocket.
  • EVP Plus = separate deductibles for in and out of network and ARE included in the out-of-pocket.

PPO

PPO

We know what customers are looking for in a health care plan: Convenience, affordability, and support. By choosing a Preferred Provider Plan from Nippon Life Benefits, you'll enjoy all three.

  • Single or dual deductible plans.
  • Out-of-pocket maximum includes deductible, but not copays. Plans with or without copays are available.
  • PPO Physician Office Charges -- For plans with a copay, charges for certain PPO services received in a physician's office, clinic or ambulatory care center paid at 100% after copay.
  • PPO Physician Visits -- For plans with a copay, PPO physician's office or clinic services paid at 100% after copay. For plans without a copay, PPO physician's office or clinic services subject to deductible and plan coinsurance.

High Deductible Health Plan (HDHP) / Health Savings Account (HSA)

High Deductible Health Plan (HDHP) / Health Savings Account (HSA)

High Deductible Health Plans (HDHPs) offer high-quality, cost-effective coverage with innovative preventive care programs.

Once an employee is covered under our HDHP, he or she can contribute to a portable Health Savings Account (HSA) and the funds deposited will accumulate tax-free. The employee may withdraw funds from the account without any tax penalties and apply them toward the deductible or any qualified medical expense. If an employee chooses to pay deductible costs or other medical care out-of-pocket, he or she can leave the money in the account for future use on a tax-advantaged basis.

HSAs are portable. When an employee leaves his/her employer a rollover must be completed within 60 days after the employee's last day.


Flexible Spending Account (FSA) and/or Limited Flexible Spending Account

Flexible Spending Account (FSA) and/or Limited Flexible Spending Account

If employers are looking to give their employees more control over their health care expenses, a Flexible Spending Account (FSA) may be the best choice. Nippon Life Benefits offers two FSA options -- Health and Dependent Care. Both are tax-advantaged savings accounts that provide employees the ability to manage their own cost-savings.

Limited FSAs are a savings option for those employees enrolled in an HSA. Eligible expenses for reimbursement are vision and dental expenses. Both types of FSAs are available for clients with 50+ employees.

Note: Plan offerings vary by state.

 

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