Supplemental GAP Group
Plan is an employer-sponsored group supplemental insurance plan which is
designed to help reduce the cost of group medical coverage. Combining
the GAP Plan with certain major medical plans can deliver coverage groups
want and can afford.
does the GAP Plan pay claims? It’s simple!
Plan follows the major medical plan. The GAP Plan pays off of the
underlying major medical plan EOB, and it pays benefits directly to the
subscriber. When the insured goes in-network they always receive the carrier’s
coverage does the GAP Plan provide?*
plans have a supplemental deductible and co-insurance per insured
person. After the insured’s deductible has been satisfied, the GAP
Plan pays the benefits described in the policy until the payments reach the
Maximum Benefit Amount.
for Hospital and Outpatient Expenses
Plan pays the amount applied to your major medical deductible and
co-insurance. It covers the same expenses as your major medical plan,
with the exception of charges for professional fees in a doctor’s office or
medical clinic or for outpatient prescription drugs.
GAP Plan designs are available?
group can choose the plan design and benefit amount to achieve the maximum
overall premium savings for their group. The GAP Plan is extremely
Benefit Amount Options are any amount from $1,000 to $9,500 per person per
Options range from $250 to $3,000 (higher deductible available upon
Options are 0%, 90/10%, 80/20%, 70/30%, 50/50% from $0 to $10,000
there any participation requirements or waiting periods?
(employees and dependents) enrolled on the group’s major medical plan must
be enrolled with the GAP Plan. On the GAP Plan effective date,
everyone covered by the group’s major medical plan will be covered by the
are the underwriting guidelines?
are no excluded groups. The minimum group size is 10.
a brief description of coverage. See policy for complete details.
Available in Pennsylvania only.
application(s) available for download are in Portable Document Format
(PDF). In order to download and view these files you must have a
version of Adobe Acrabat Reader. Click here to download Adobe Acrobat
Premium Savings Example
Frequently Asked Questions