Schedule of Benefits
HDHP / Basic MEC Q & A
Q: Is this an insurance plan?
A: No, the HDHP is not an insurance product, but a self-funded plan
sponsored by the National Consumers Benefits Association (NCBA) in which
it’s members are eligible to participate
Q; What number do I can for member services?
A: For member services and question on benefits, claims, ID cards etc.:
Q; The HDHP, is it comprehensive or catastrophic coverage such as a HDHP would
be in the Marketplace?
A: No, there are only three items that count towards the deductible, those
services include Primary Care visits, Urgent Care visits and Lab services.
However, it does provide the framework to make it eligible for a Health
Savings Account (HSA)
Q: Does the plan include an HSA account?
A: No, with enrollment in the HDHP/Basic MEC you are eligible to open and
HSA Account at a financial institution of your choice. The maximum
contributions are as follows:
2018: Individual $3,450 / Family $,6,900
2019: Individual $3,500 / Family $7,000
For those age 55 and over, an additional $1,000 can be contributed
Q: Does the plan cover Preventive Care Services?
A: Yes, the plan provides 100% benefits, no, copays, no deductibles for the
following Preventive Care services:
• 21 Preventive Care services for Adults
• 28 Preventive Care services for Women
• 31 Preventive Care services for children
Q: Is there a network of doctors or physicians:
A: Yes, the plans access one of the largest physician networks in the country
Preferred Health Care Services (PHCS) with over 900,000 physicians
nationwide. There are no out-of-network benefits.
Q: What if I need catastrophic coverage?
A: The HDHP/Basic MEC plan can be paired with Sedera Health – Medical Cost
Sharing to provide a complete, comprehensive and affordable healthcare
solution for you and your family. By paring the HDHP/Basic MEC plan with
Sedera Health, members may save up to 50% of what they could purchase a
plan for on the Marketplace.