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Alliance Secondary Plan

What is Alliance?

Alliance Secondary Plan is a product that complements a comprehensive major medical plan with a supplemental health insurance product that is administered by MWG Administators and underwritten by AmFirst Insurance Company under the brand name Alliance Secondary Plan. This product can be customized to work in conjunction with any primary health insurance provider in the marketplace.  Alliance Secondary Plan is not a replacement for your primary coverage, but rather a supplement to your primary carrier’s health plan. Simply put, Alliance Secondary Plan pays the member’s portion of an eligible medical claim (i.e., copays, deductibles, and coinsurance) up to annual maximum benefit. Benefits are may be directly to the healthcare providers upon submission of the patient’s Itemized Bill or HCFA and the Primary Carrier’s EOB.

Alliance Secondary Plan is one of the few benefits that an employer can provide, which is universally beneficial. When implemented with the help of an Alliance consultant, your organization’s overall health insurance premiums should decrease and your employees will experience a dramatic reduction in their out-of-pocket expenses.

Alliance Secondary Plan also provides numerous advantages with regards to Healthcare Reform, including reducing the burden of compliance within the “Affordability Clause” of the PPACA by allowing employers to reduce single and family rates, all the while strengthening their health plans. Alliance is also helping employers large and small achieve premium stability by allowing great flexibility when picking a primary insurance plan design and by reducing the company’s claims experience with their primary provider.

 

Carrier Information

AmFirst

Since 1998 AmFirst has stood strong, stable and secure in both good and difficult economic times, ready to meet the needs of its policyholders. AmFirst continues to make outstanding strides in the supplemental market and has increased market share year after year. AmFirst Insurance Company is a wholly owned subsidiary of AmFirst Holdings, Inc. 

Financial Strenth Rating:

A.M. Best – A-/stable

Zurich

Zurich Insurance Group maintains an interactive rating relationship with Standard & Poor’s (S&P), Moody’s and A.M. Best. The table below lists the current financial strength ratings of some key subsidiaries.

Financial Strenth Rating:

S & P – AA/stable
Moody’s – Aa3/positive
A.M. Best – A+/stable

Transamerica

  • Licensed in all states (except New York) and the District of Columbia
  • Providing insurance products since 1961
  • State Domiciled: Iowa; NAIC Number 86231

Financial Strenth Rating:

A.M. Best – A/stable

Frequently Asked Questions

What is Alliance Secondary Plan?
Alliance Secondary Plan is secondary or supplemental health insurance. It pays the member’s portion of a qualified medical event, in which the primary insurance carrier does not cover (i.e., copays, deductibles, and coinsurance) up to a predetermined amount per calendar year.
What is a qualified medical event?
The determination of a qualified medical event, is based on your primary carrier’s definition of an eligible medical expense. In other words, if the primary provider deems the medical procedure or service to be a covered item, then Alliance Secondary Plan will also deem it a covered item that is eligible for benefits (excluding Preventative Care and Prescriptions).
Who files and pays the claims?
The medical providers file all of the claims. Members simply have an additional insurance card that allows providers to file claims electronically on their behalf and be paid directly by the insurance company.
Is Alliance Secondary Plan intended to replace my current health plan or provider?
No. It is NOT intended to replace your current provider or health plan, but rather it works in conjunction with any plan or provider in the marketplace.
Does Alliance Secondary Plan have a restrictive network?
No. Alliance Secondary Plan does not have a specific network. In fact, the network will mirror your current provider’s network. In other words, if a doctor (or facility) is in your major medical provider’s network, then he or she will also be in the Alliance Secondary Plan network.
Is Alliance Secondary Plan a HSA, FSA, or HRA plan?
No, but Alliance Secondary Plan is similar to those plans in that it is funded with pretax dollars and pays for members’ out-of-pocket medical expenses. However, with HSA’s, FSA’s, and HRA’s, for every $1 you contribute you have $1 of benefit, where as Alliance Secondary Plan funding operates on a premium and typically a $1 contribution equals $6 to $8 of benefit.
How is Alliance Secondary Plan affected by the PPACA (||Obamacare||)?
In short, it is not subject to PPACA oversight because it is not a major medical plan. In fact, Alliance Secondary Plan gives companies the ability to improve their overall plans while reducing major medical premiums and claims experience, thereby helping companies stay in compliance with the PPACA’s “Affordability Clause” and increase the potential for rebates under the MLR provision.
Will Alliance Secondary Insurance increase the cost of our health insurance?
No. Even with the additional Alliance Secondary Insurance premium, your overall health premiums should go DOWN!
Are preexisting conditions excluded?
No.
Who underwrites and administers Alliance Secondary Plan?

Alliance Secondary Plan is administered by MWG Administators and underwritten by AmFirst, Zurich, or Transamerica Insurance Companies. 

What is needed for an initial analysis?
(1) Current Summary of Plan Description;

(2) Current rates;

(3) Census of employees on your plan;

(4) Amount of HSA, HRA, or FSA employer contributions (if any);

(5) A meeting with an Alliance consultant.