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Company:
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Plans:
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Value
Advantage - HD Advantage
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The
Value Advantage plan is a basic
plan that offers protection against major medical expenses, at an
affordable rate.
If
you are looking for a World plan that can be used with a Health
Savings Account, please visit our HD
Advantage plan page for more details.
Value
Advantage Brochure 
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| World
Value Advantage plans at a glance:
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Features
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Value
Advantage 70
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Value
Advantage 50
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| Lifetime
Maximum |
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Choice
of $1 million or optional $5 million |
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Choice
of $1 million or optional $5 million |
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| Deductibles |
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Coinsurance
*
World pays/you pay |
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In-PPO:
70%/30% to $10,000
Out-of-PPO: 50%/50% to $10,000 |
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In-PPO:
50%/50% to $10,000
Out-of-PPO: 30%/70% to $10,000 |
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Out-of-Pocket
Max
Your maximum payment for eligible
charges after deductible. Copayments
for optional physician office visits,
drugs, access fees
and emergency room are not included
in maximum. |
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In-PPO:
$3,000
Out-of-PPO: $5,000 plus charges above usual and
customary. |
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In-PPO:
$5,000
Out-of-PPO: $7,000 plus charges above usual and
customary. |
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| Inpatient
Hospital |
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Subject
to deductible and coinsurance after a $500 access
fee per admission (maximum of four per covered person/per
calendar year).
See Benefit Increase option #3
below. |
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Subject
to deductible and coinsurance after a $500 access
fee per admission (maximum of four per covered person/per
calendar year).
See Benefit Increase option #3
below. |
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Outpatient
Medical
*Not applicable to chemo and
dialysis
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Subject
to deductible and coinsurance after a $250 access
fee per admission (maximum of 4 per covered person/per
calendar year)*.
See Benefit Increase option #3
below. |
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Subject
to deductible and coinsurance after a $500 access
fee per admission (maximum of four per covered person/per
calendar year).
See Benefit Increase option #3
below. |
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| Emergency
Room |
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Subject
to deductible and coinsurance after a $250 additional
copayment. Waived if patient is admitted directly
into hospital as inpatient. |
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Subject
to deductible and coinsurance after a $250 additional
copayment. Waived if patient is admitted directly
into hospital as inpatient. |
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Foreign
Travel Emergency
Emergency care that begins during first
60
days outside U.S. |
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Subject
to deductible and coinsurance; $100,000 lifetime
maximum. |
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Subject
to deductible and coinsurance; $100,000 lifetime
maximum. |
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| Physician
Office Visits |
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Not
covered. Discounts may be available at PPO
providers.
Diagnostic lab and x-ray subject to deductible and
coinsurance.
See Benefit Increase option #1
below. |
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Not
covered. Discounts may be available at PPO
providers.
Diagnostic lab and x-ray subject to deductible and
coinsurance.
See Benefit Increase option #1
below. |
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Prescription
Drugs
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Optional:
Benefit Increase Options
- Physician
Office Visits: This option provides a $40 copay for
PPO physician office visits. Out-of-PPO visits are still
subject to the deductible and coinsurance.
- Prescription
Drugs: After a separate $500 Rx deductible per year,
this option will provide a maximum benefit of $2,500 per
person, per calendar year:
- Generic
- $10, plus 20% of remaining charge
- Brand
Name (formulary) - $25, plus 50% of remaining charge
- Brand
Name (non-formulary) - $35, plus 50% of remaining
charge
State variations apply.
- Inpatient
and Outpatient: Waives the $500 Inpatient Access Fee
and $250 Outpatient Access Fee.
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This information
is presented only as a very brief overview of some of the benefits
of this plan, and is intended only for general education.
The amount of benefits provided depends on the plan selected.
Premium will vary with the type of benefits selected. These
plans contain exclusions from and limitations of coverage.
Please see the product brochure for more complete information,
as well as information about terms of renew ability, preexisting
conditions, out-of-network penalties, and notification requirements.
Plans are subject to health underwriting. To be considered
for reimbursement, expenses must qualify as covered expenses.
Expenses are also subject to reasonable and customary limits,
unless you use a network, and all other policy provisions, including
determinations of medical necessity.
Coverage
Synopsis:
Value
Advantage Plan
This plan
covers 50% or 70% of your first $10,000 in covered expenses, then
100% of covered expenses up to $1,000,000. Routine doctors
visits and outpatient prescription drugs are not covered, although
you may add optional benefits which will give you a $40 copay
for doctor visits.
The prescription
drug rider comes with a $500 annual deductible, after which generic
drugs would come with a copay of $10 (plus 20% of the remaining
cost of the drug); $25 for brand name (plus 50% of the cost of
the drug), or $35 for non-formulary drugs (plus 50% of the cost
of the drug). Emergency room visits are covered with a $250
access fee, which is waived if you are admitted into the hospital,
at which time your coverage would be subject to your deductible
and coinsurance.
Foreign travel
is also covered for 60 days, with a $100,000 lifetime limit.
See the WorldCARE
Advantage Series – Product Comparison chart to see
how this plan compares with the HD Advantage plan.
Optional
Riders:
Maximum
Benefit Option
Your Value
Advantage policy/certificate's lifetime coverage maximum is
$1 million per covered person. The Maximum Benefit Option
increases the lifetime maximum to $5 million. It also increases
the per-organ transplant maximum from $500,000 to $1,000,000 at
nationwide Centers of Excellence, facilities that specialize in
specific types of transplants and can provide you with quality
care on a cost efficient basis.
Term
Life Benefit Option
The Term Life
Benefit Rider provides you and/or your spouse with annually renewable
term life insurance coverage in benefit amounts of $10,000, $25,000
or $50,000. Plus, you also have the option of converting
your term-life policy to a World whole life policy. (Note:
Not available in Georgia, Ohio and Oklahoma.)
Outpatient
Accident Benefit Option
With the Outpatient
Accident Benefit Rider, your plan pays 100 percent of expenses
for a covered injury, not to exceed the amount you choose ($500,
$1,000, $1,500, $2,000, $2,500, $3,000 or $5,000) per calendar
year for treatment of injuries on an outpatient basis, with no
deductible or coinsurance. Additional benefits are subject
to your deductible and coinsurance. (Note: Not all levels
are available in all states)
Expenses covered
under this rider include:
- Services,
supplies, and physician's care;
- X-ray
and laboratory tests; and
- Treatment
or services received in a hospital emergency room, urgent care
center, physician's office, or ambulatory surgical center or
facility.
Rates:
This plan
comes with an initial 12 month rate guarantee.
Preferred
rates without riders are available on our instant
quote page. The quoted rates are for the $2 million
maximum benefit, and do not include optional benefits such as
term life, supplemental accident, maternity, and Rx riders.
They also do not include $7.50/month dues for membership in the
National Consumer Alliance Association (NCA), which endorses these
plans and gives members access to valuable products and services.
If you are
not replacing current coverage, you will be issued a policy with
standard rates, approximately 8% higher than preferred rates.
Please contact
us for rates on the optional benefits. Rates depend
on gender, smoking status, zip code, and health status.
The premium
can be paid via quarterly, semi-annual, or annual billing, or
a monthly bank draft or credit card. The bank draft will
occur on the premium due date each month. The initial premium
can be paid with a check or credit card.
The following
chart shows when you can expect payment to be deducted from your
credit card:
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App
Effective Date
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Credit
Card Charged
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1st
of the month
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1st
of month
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2nd
- 5th of month
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5th
of month
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6th
- 10th of month
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10th
of month
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11th
- 15th of month
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15th
of month
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16th
- 20th of month
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20th
of month
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21th
- 28th of month
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25th
of month
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PPO
Network:
World
Insurance Company recently signed an agreement with Great-West
Healthcare, a division of Great-West Life & Annuity Insurance
Company. Great-West Healthcare operates a substantial multi-state
(national) healthcare network that includes more than 4,200 hospitals
and 530,000 providers. It provides network and other services
to more than 2 million people. Find
a Doctor
Underwriting:
Underwriting
of your application with World normally takes two to four weeks,
though if medical records are ordered it could take longer.
World's underwriting seems fairly lenient, and often accept applicants
who may have been turned down by other companies.
It is standard
practice for them to request a Blood Pressure Inquiry if you are
currently being treated for or have recently discontinued treatment
for high blood pressure. Certain conditions may be waivered
with a temporary rider (usually for one to twos years), or an
indefinite rider.
Effective
dates:
The earliest
your coverage can go into effect is ten days after you have signed
your application. You may request an effective date any
time between 10 and 60 days after you sign your application.
Please note,
if you are requesting an effective date of less than 21 days from
the time you complete the application, you may not receive notification
of your approval until after your effective date. If you have
claims during this period, they will be eligible for coverage
if submitted after you have been approved.
Also note
that you will be billed starting on your requested effective date,
even if you have not yet been notified that you have been approved.
This is very good for someone who does not have any present coverage
and would like for their benefits to begin right away. For
those who are already covered, it is suggested that you maintain
your current coverage in force until you have received notice
from either ColoHealth
or directly from World Insurance
that your coverage has been approved and is in force.
About
World Insurance:
World
Insurance was founded in 1903 in Omaha, Nebraska, as
the World Accident Association. The company began hiring
agents in 1925 and became World Insurance Company in 1929.
The first general agency was established in Colorado in 1938.
In 1943, World mutualized and was authorized to sell life insurance
as well as accident and sickness policies.
By the late
1950s, World was licensed in 45 states with 500 agents nationwide.
The company's product portfolio included a wide variety of individual
hospital, life and disability policies.
Today, World
is licensed in 46 states and the District of Columbia. More
than 11,200 general agents and agents represent the company.
World
Insurance has been assigned a rating of A- (Excellent)
from the A.M.
Best Company, an independent insurance rating organization.
ColoHealth
is an independent authorized World agent in Colorado.
"I
truly appreciate that you are accessible and return calls
promptly."
I
just wanted to thank you for all of your efforts to successfully
resolve the administrative problem I was having with Anthem.
You had helped me switch from a PPO plan to an HSA plan,
when the billing got mixed up. It was no simple
matter and you managed to get through all of the red tape.
You
have been a terrific agent, always able to answer my questions
and having a thorough knowledge of your products.
And I truly appreciate that you are accessible and return
calls promptly.
Thank
you again for all of your hard work and diligence and
not to mention your personable demeanor.
Alaine
Ginocchio
Student
Boulder, CO
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