The Global Employer's Option - GEO Group

Worldwide employer-sponsored group health insurance

Summary of Benefits

The following benefits are offered to eligible insureds.

The plan charges for eligible medical expenses within the area of coverage.

All amounts are shown in US dollars and subject to applicable deductible and coinsurance.

Plan Information
 
Calendar Year Maximum Limit: 365 days
Lifetime Maximum Per Insured $50,000 - $8,000,000
Extension of BenefitsMaximum Limit beginning on the first day of Total Disability, temporary layoff or leave of absence: 180 days
Maximum Limit for a Spouse/or Dependent in the event of the Insured Person’s death: 60 days
Continuation of BenefitsMaximum Limit after termination of employment: 12 months
Refer to the Continuation Provision in this Certificate for complete qualification details
Medical Concierge
  • Non-emergency services only
The Medical Concierge Service is a proprietary service of IMG that helps an Insured Person navigate the United States healthcare system to identify the highest quality providers for scheduled Inpatient and certain Outpatient Treatments.
Refer to the MEDICAL CONCIERGE provision for further details.
Deductible/Coinsurance
 
Benefit LevelsUnited States
Medical Concierge
United States
In-Network
United States
Out-of-Network
International
International
Deductible $0 - $25,000
Deductible reduced by 50% or $2,500: PPO, Outpatient Treatment, Emergency Inpatient Treatment, Medical Concierge Provider
Family Deductible Maximum 3 Deductibles per Family
Coinsurance
  • In addition to Deductible
Plan pays 100%
Insured pays 0%
Plan pays 100%
Insured pays 0%
Plan pays 80%
Insured pays 20%
Plan pays 100%
Insured pays 0%
Out of Pocket Maximum$0 $0 $1,000 $0
Precertification
  • Transplants: No coverage if Precertification requirements are not met.
  • Interfacility Ambulance Transfer: No coverage if Precertification requirements are not met.
  • Maternity and Newborn care: 50% penalty if not Precertified within 60 days of delivery.
  • Emergency Medical Evacuation: No coverage if Precertification requirements are not met. Refer to the EMERGENCY MEDICAL EVACUATION provision for complete requirements and coverage.
  • All other Treatments & supplies: 50% reduction of Eligible Medical Expenses if Precertification requirements are not met.
  • Deductible is taken after reduction.
  • Coinsurance is applied to remainder of the reduced amount.
  • Refer to Precertification REQUIREMENTS provision for a complete list of services that require Precertification .
Inpatient/ Outpatient Services Subject to Deductible and Coinsurance unless otherwise noted; Eligible Medical Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Eligible Medical Expenses 100%100%80%100%
Physician Visits / Services 100%100%80%100%
Hospital Emergency Room
  • Injury: Not subject to Emergency Room Deductible
  • Illness: Subject to a $250 Deductible for each Emergency Room visit for Treatment that does not result in a direct Hospital admission
100%100%80%100%
Hospitalization / Room & Board
  • United States: Average private room rate
  • International: Average private room rate up to a maximum of 150% of the average semi- private room rate
  • Includes nursing services, miscellaneous and Ancillary Services
100%100%80%100%
Intensive Care 100%100%80%100%
Outpatient Surgical / Hospital Facility 100%100%80%100%
Laboratory 100%100%80%100%
Radiology / X-ray 100%100%80%100%
Pre-admission Testing 100%100%80%100%
Reconstructive Surgery
  • Surgery is incidental to and follows Surgery that was covered under the plan
100%100%80%100%
Assistant Surgeon
  • 20% of the primary surgeon’s eligible fee
100%100%80%100%
Anesthesia 100%100%80%100%
Pregnancy and Childbirth
  • After 10 consecutive months of coverage
100%100%80%100%
Pregnancy Complications
  • After 10 consecutive months of coverage
100%100%80%100%
Newborn and Congenital Disorders
  • Lifetime Maximum: $250,000
  • First 31 days of life
  • Eligible when the Newborn’s birth is covered under this plan
100%100%80%100%
Durable Medical Equipment
  • Prescribed by a Physician
100%100%80%100%
Chiropractic Care
  • Not subject to Deductible or Coinsurance
  • Maximum per visit: $25
  • Maximum visits: 20
  • Prescribed by a Physician
Not Applicable100%100%100%
Physical Therapy
  • Maximum Charge per Visit: $50
  • Prescribed by a Physician
Not Applicable100%80%100%
Extended Care Facility
  • Upon direct transfer from an acute care Facility
100%100%80%100%
Home Nursing Care
  • Provided by a Home Health Care Agency
  • Upon direct transfer from an acute care Facility
100%100%80%100%
Hospice
  • Terminally ill - 6 months to live
  • Inpatient Hospice Facility
  • Insured Person’s home
Not Applicable100%80%100%
Transplant
  • Lifetime Maximum: $1,000,000
  • Calendar Year Transplant Maximum: 1
  • Organ procurement & harvesting costs Lifetime Maximum: $10,000
  • Travel & lodging Lifetime Maximum expense: $5,000
  • Covered Transplants: cornea, heart, heart/lung, lung, kidney, kidney/pancreas, liver, allogeneic or autologous bone marrow
  • Subject to the TRANSPLANT Precertification provision and only when Treatment is provided within the Company’s approved independent Managed Transplant System Network
100%100%80%100%
Preventative Care NOT Subject to Deductible and Coinsurance unless otherwise noted; Eligible Medical Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Adult
  • Maximum Limit: $250
  • Refer to the PREVENTATIVE CARE provision for further details and requirements
Not Applicable100%100%100%
Child
  • Maximum Limit: $150
  • Refer to the PREVENTATIVE CARE provision for further details and requirements
Not Applicable100%100%100%
Prescription Drugs and Medication Subject to Deductible and Coinsurance unless otherwise noted; Eligible Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Maximum Limit per Calendar Year $250,000 per person$250,000 per person$250,000 per person$250,000 per person
  • All categories listed under the Prescription Drugs and Medication benefit accumulate toward the Lifetime Maximum Limit
  • Routine inoculations and vaccinations are not subject to this limit and fall under the Preventative Care benefit
Outpatient or Inpatient Medication
  • Subject to Deductible and Coinsurance
  • Received as part of a Treatment plan or general care
  • Not obtained through a retail pharmacy
100%100%80%100%
United States Retail Pharmacy
  • Not subject to Deductible and Coinsurance
  • Prescriptions $3,000 and higher will require Universal RX (URX) to obtain prior authorization from the Company
Universal RX (URX) Prescription Drug Card MUST be utilized for all Outpatient Prescription Drugs in the United States.
Retail Pharmacy Copayments:
Generic $5
Higher cost Generic and Brand 30%
Non-Preferred Brand Name $50 plus 30%
Copayments are per 30-day supply
Dispensing Maximum per prescription: 90 days
Expatriate Prescription Services Program
  • Prescriptions $3,000 and higher will require Universal RX (URX) to obtain prior authorization from the Company

Medication delivery to an international address when prescription is not available for purchase internationally.

GenericCopayment: $5
Non-Preferred Brand NameCopayment: $30

Copayment is per 30-day supply
Dispensing maximum per prescription: 180

Contact Information:
Mental or Nervous, Substance Abuse, Counseling Subject to Deductible and Coinsurance unless otherwise noted; Eligible Medical Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Lifetime Maximum$20,000$20,000$20,000$20,000
Inpatient Mental or Nervous / Substance Abuse
  • Maximum Limit: $10,000
  • After 12 consecutive months of coverage
100%100%80%100%
Outpatient Mental or Nervous / Substance Abuse
  • Maximum per visit: $100
  • Maximum visits: 52
  • After 12 consecutive months of coverage
Not Applicable50%50%50%
Bereavement Counseling
  • Not subject to Deductible or Coinsurance
  • Lifetime Maximum: $300
  • Counseling 6 months before or after a Family member’s death
Not Applicable100%100%100%
Emergency Services NOT Subject to Deductible and Coinsurance unless otherwise noted; Eligible Medical Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Emergency Local Ambulance
  • Subject to Deductible and Coinsurance
  • Injury
  • Illness resulting in an Inpatient Hospital admission
Not Applicable100%80%100%
Emergency Medical Evacuation
  • Maximum Limit: $1,000,000
  • Insured persons under age 65
  • Approved in advance and coordinated by the Company
Not Applicable100%100%100%
Emergency Reunion
  • Subject to Deductible and Coinsurance
  • Maximum Limit: $10,000
  • Day Maximum: 15 days
  • Meal Maximum: $25 per day
  • Reasonable and necessary travel costs and accommodations
  • Approved in advance by the Company
Not Applicable100%100%100%
Interfacility Ambulance Transfer
  • Transfer from one licensed health care Facility to another licensed health care Facility resulting in an Inpatient Hospital admission
Not Applicable100%100%100%
Political Evacuation and Repatriation
  • Lifetime Maximum: $10,000
  • Approved in advance by the Company
Not Applicable100%100%100%
Return of Mortal Remains
  • Maximum Limit: $25,000
  • Return of Insured Person’s Mortal Remains to Home Country
  • Approved in advance by the Company
$20,000100%100%100%
Other Services NOT Subject to Deductible and Coinsurance unless otherwise noted; Eligible Medical Expenses are limited to Usual, Reasonable and Customary amounts; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
BenefitMedical Concierge
(Non-emergency)
In-NetworkOut-of-NetworkInternational
Complementary Medical Services
  • Subject to Deductible and Coinsurance
  • Maximum Limits are per Insured Person
Acupuncture$150
Massage Therapy$150
Vitamin Therapy$100
Magnetic Therapy$75
Herbal Therapy$50
Aroma Therapy $50
Emergency Dental
  • Subject to Deductible and Coinsurance
  • Accident related
Not Applicable100%80%100%
Hospital Indemnity
  • International only
  • Inpatient Hospitalization only

Private Hospital

  • Overnight Maximum Limit: $400
  • Maximum Limit: $4,000

Public Hospital (state, government or charitable Hospital)

  • Overnight Maximum Limit: $500
  • Maximum Limit: $5,000

Treatment received by the Insured Person at a Public Hospital and no Charges are incurred by the Insured Person or the Company will be subject to the Public Hospital Maximum Limit.

Treatment received by the Insured Person at a Public Hospital and Charges are submitted to the Company for reimbursement will be subject to the Private Hospital Maximum Limit.

Supplemental Accident
  • Maximum Limit per Accident: $300
  • Once the Maximum Limit is satisfied, Charges will be subject to Deductible and Coinsurance and paid the same as any other Injury
Not Applicable100%100%100%
Vision Care
  • Benefit available every 24 months
  • Routine Eye Examination Maximum Limit: $100
  • Corrective Lenses (Contacts)/Frame Maximum Limit: $150

Dental Benefits

Coverage Limit / Maximum Amount for Eligible Dental Expenses
 
Calendar Year Maximum Limit $1,000 - $1,500
Lifetime Orthodontia Maximum Limit $1,000 - $1,500
Deductible
  • Applies to Minor and Major Restorative Services
$50
Family Deductible
  • Maximum Deductibles per Family: 3
$150
Routine Services NOT Subject to Deductible; Eligible Dental Expenses are limited to Usual, Reasonable and Customary; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
Benefit Coinsurance
Diagnostic and Preventative Services
  • Preventative visits and cleanings: 2
    (1 every 6 months)
  • Radiographic examinations: 2
    (including posterior bitewings; 1 every 6 months)
  • Fluoride Treatment Maximum Limit: 1
    (Children under 19 years of age)
Plan Pays 100%
Insured Pays 0%
Emergency Palliative Treatment Plan Pays 100%
Insured Pays 0%
Minor Restorative Services Subject to Deductible; Eligible Dental Expenses are limited to Usual, Reasonable and Customary; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
Benefit Coinsurance
Minor Restorative Services
  • Refer to the ELIGIBLE DENTAL EXPENSES provision for further details
Plan Pays 80%
Insured Pays 20%
Oral Surgery Plan Pays 80%
Insured Pays 20%
Endodontics Plan Pays 80%
Insured Pays 20%
Periodontics
  • Root planning Maximum Limit: 1 every 2 years
  • Periodontal Surgery Maximum Limit: 1 every 3 years
Plan Pays 80%
Insured Pays 20%
Radiographs
  • Maximum Limit: 1 every 3 years
  • Full mouth x-rays including panographic x-rays
Plan Pays 80%
Insured Pays 20%
Major Restorative Services Subject to Deductible; Eligible Dental Expenses are limited to Usual, Reasonable and Customary; Maximum Limits per Calendar Year or if indicated, per Lifetime
 
Benefit Coinsurance
Major Restorative Services
  • Crowns, Jackets, Inlays on same tooth Maximum Limit: 1 every 5 years
  • Adults and Children older than 12 years of age
  • Refer to the ELIGIBLE DENTAL EXPENSES provision for further details
Plan Pays 50%
Insured Pays 50%
Prosthodontics
  • Dentures / Bridge Maximum Limit: 1 every 5 years
  • Replacement of denture base material or reline Maximum Limit: 1 every 3 years
  • Refer to the ELIGIBLE DENTAL EXPENSES provision for further details
Plan Pays 50%
Insured Pays 50%

Disclaimer

This invitation to inquire allows eligible applicants an opportunity to inquire further about the insurance offered and is limited to a brief description of any loss for which benefits may be payable. Benefits are offered as described in the insurance contract. Benefits are subject to all deductibles, coinsurance, provisions, terms, conditions, limitations, and exclusions in the insurance contract. The contract does contain a pre-existing condition exclusion and does not cover losses or expenses related to a pre-existing condition.

 

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