Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.
Primestin Care is a complete primary care solution with membership options that include virtual and in-person care. Their mission is to deliver compassionate, patient-centered healthcare that can be seamlessly integrated and tailored for individual patients. Primestin Care Memberships Primestin offers three membership options as outlined below. Virtual Care Unlimited access to virtual primary and mental health resources, along with care coordination.
The IRS decision to lower employer shared responsibility penalties in 2025 is a rare move. However, it comes alongside increased penalties for missed reporting deadlines. Take this opportunity to optimize your benefits strategy and make sure you are avoiding the penalties altogether.
Offering a High-Deductible Health Plan (HDHP) with a Health Savings Account (HSA) is a powerful way to support your employees’ financial and health goals. With the 2025 updates to HSA contribution limits, there are new opportunities to enhance these benefits while maximizing tax advantages.
No. An employer can set up deposits into an HSA at whatever bank an employee desires.
PlanstinRx is a robust, discount prescription program that provides its members more ways to save and convenient support for all their prescription needs. Members with access to PlanstinRx simply register at planstinrx.com using their Member ID and Group ID.
Follow the steps below. 1.) Visit planstinrx.com 2.) Click “login with member/group ID” 3.) Enter your credentials: Member Number and RxGrp code from your ID card 4.) Click “Log In” to update your profile and create a new password 5.) Start saving on your prescription needs
Your prescription benefits are listed on your ID card.
With PlanstinRx, members can get affordable access to the medications they need—even specialty meds that may typically be cost prohibitive. Not only does the program make prescriptions more affordable, it makes getting them more convenient.
Most Planstin-managed health plans do not use a provider network . That means you are free to work with any provider with out fear of any out-of-network penalties. Very few Planstin-managed health plans still use a provider network. In this case, your health plan uses the PHCS network of providers. Fair-priced healthcare & care coordination The majority of Planstin-managed health plans use an innovative healthcare pricing strategy called fair-priced healthcare. This strategy does not require the use of a provider network, and instead relies on a care coordination team to help you work with your provider, make appointments, and locate providers that work well with your benefits. To learn more about fair-priced healthcare, click here . To learn more about care coordination click here .
All Planstin-managed health plans now feature care coordination services as a part of a fair-price healthcare strategy. The Planstin Care Coordination team will help match members with providers that work best with their plan.
Fair-price healthcare is a no-network, proactive pricing strategy that relies on a care coordination team to match members with providers that work best with their plan. If your health plan uses fair-priced healthcare, it will try to determine what the most fair price is for a service in any given area by examining average prices, cash prices, or using other reference points, such as the Medicare rates.
Maybe. Preventive Basic, Preventive HSA, and Preventive Copay plans do not cover maternity. However, all Care+ health plans do include coverage for maternity care. Additionally, many members with a preventive health plan also become Zion HealthShare members. A Zion HealthShare membership is designed for larger, medical needs like maternity.
Maybe. Preventive Basic, Preventive HSA, and Preventive Copay plans do not cover maternity. However, all Care+ health plans do include coverage for maternity care. Additionally, many members with a preventive health plan also become Zion HealthShare members. A Zion HealthShare membership is designed for larger, medical needs like maternity.
No. You are not required to enroll in a health plan. You can enroll in Zion HealthShare only if you prefer. However, we do recommend pairing a preventive health plan with a Zion HealthShare Membership if possible for a more well-rounded solution.
Using a HealthShare membership and a preventive health plan together is an alternative to traditional insurance that can effectively meet many, if not most of your healthcare needs. The key to using these two pieces together is to understand what each one is for and when to use it. Your Preventive Health Plan The main part of your healthcare solution focuses on your routine needs like an annual checkup, medications, immunizations, and preventive screenings. Your HealthShare Membership The other part of your healthcare solution works best for bigger medical concerns, such as emergency care, maternity, and hospitalization for planned or unplanned surgery.
Zion HealthShare defines a pre-existing condition, or what they call a “pre-membership medical condition,” as any medical issue for which a member has received treatment, taken medication, or experienced symptoms in the 24 months leading up to their enrollment. There is a one-year waiting period before such conditions become eligible for sharing within the community. However, there are exceptions for certain conditions like diabetes, high cholesterol, and high blood pressure. If an employee has not been hospitalized for these conditions in the past 12 months and can manage them through medication or diet, they will not be classified as pre-membership medical conditions.
Maybe. Preventive Basic, Preventive HSA, and Preventive Copay plans do not cover maternity. However, all Care+ health plans do include coverage for maternity care. Additionally, many members with a preventive health plan also become Zion HealthShare members. A Zion HealthShare membership is designed for larger, medical needs like maternity.
If you have a health plan that covers preventive care, it may depend on how the doctor bills for your visit. For example, if you discuss specific health issues during an annual preventive visit, your doctor might bill an additional appointment for an office visit or sick visit, leading to a copay or full payment required for the additional visit. Also, it is important to note that n ot all procedures or tests recommended by your doctor will qualify as preventive care under the Affordable Care Act (ACA).
Most likely. If you have Preventive series or Care+ series health plan it covers preventive services as outlined by the Affordable Care Act. If you do not have a Planstin-managed health plan and you have questions about your benefits, contact a Benefit Advocate at 888-920-7526 .
Maybe. Preventive Basic, Preventive HSA and Preventive Copay plans do not cover ER visits. However, all Care+ health plans do include coverage for ER visits. Additionally, many members with a Preventive health plan also become Zion HealthShare members. A Zion HealthShare membership is designed for larger, unexpected medical needs like trips to the emergency room.
Yes. If you have a Planstin-managed vision plan, in most cases, vision service providers may ask you to pay up front. If you do pay out-of-pocket for vision services, you can get reimbursed upon submission of an itemized receipt. This receipt needs to include the Patient's Name, Member Number, Group Number, and the Date of Services and/or Purchase. To claim reimbursement, attach a detailed invoice to an email and send it to claims@planstin.com .
Follow the steps below 1. Go to: planstin.com 2. Highlight over “Resources” 3. Click “Vision Claim Form” and follow the steps Or click below
Any licensed provider is acceptable. There is no network. To avoid paying copays, you can go to Costco, Sams Club, or Walmart.
Yes. Please refer to the plan outlines linked below to see the out-of-network coverages. Standard Dental: click here Enhanced Dental: click here Why Stay In-Network? Using in-network providers allows your plan to keep rates low and directs members to high-quality dental care.
Primestin Care is a complete primary care solution with membership options that include virtual and in-person care. Their mission is to deliver compassionate, patient-centered healthcare that can be seamlessly integrated and tailored for individual patients. Primestin Care Memberships Primestin offers three membership options as outlined below. Virtual Care Unlimited access to virtual primary and mental health resources, along with care coordination.
Yes. You can enroll in Amaze by itself, and they can work with any insurance plan you have. Need help setting up the App or getting started? Visit: amazehealth.com/support/ Call: 720-577-5251
Attention: Do your benefits include a Teladoc Health membership? If you are unsure, call Planstin’s Benefit Advocacy team at 888-920-7526 for more help understanding your plan details. You can register on Teladoc.com or using the Teladoc Health app on your phone (see the steps below). You must register with the information that you provided to us upon enrollment (i.e. name, zip code, DOB, and email address). Once registered, you will enter medical information and then you can request a visit with a provider. Please note: A spouse cannot register for the primary employee. You will need to add your spouse and children to the account after you have already registered. Register for Teladoc Health Step 1 Click HERE and complete the online form Select your health plan—confirm the Planstin option Create username, password, and security questions Click “Complete Registration” Helpful Tips Wait 24 hours after receiving your Planstin welcome email to register for Teladoc Health. If you have difficulty registering online, try registering with the mobile App. Step 2 Complete your registration using the same information you used to enroll in your health plan. Make sure you use the primary subscriber information—not a dependent’s information. Step 3 You will be automatically matched with a benefits provider, simply confirm the selection and click “continue.” If you experience issues, please contact a Benefit Advocate at 888-920-7526 . There’s an App for that! You can enroll through the Teladoc Health mobile app. Simply download the Teladoc Health app through the Google Play Store or App Store. The registration process is the same as the online Teledoc Health registration.
Maybe. Some Care+ plans come with Amaze Health telemedicine and concierge services. However, most Care+ plans do not automatically include telemedicine services. Rather, virtual care services may be available to you through a different, add-on benefit. If you are unsure whether or not you have access to telemedicine or virtual care, contact a Benefit Advocate at 888-920-7526 . You can also check your plan details by clicking on "Plan Documents" and searching for your plan name (as found on your member ID card).
Preventive Core is a health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Core health plan, click here and select your specific plan name.
Preventive Basic health plans are now known as Preventive Core health plans. Click here to visit the Preventive Core article.
Preventive HSA is an HSA-qualified health plan that focuses on preventive care. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive HSA health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive HSA health plan, click here and select your specific plan name.
To make contributions to a Health Savings Account (HSA), enrollment in a High Deductible Health Plan (HDHP) is required. Thus, the Preventive HSA plan is designed accordingly. Under this plan, the deductible applies only to specific services such as sick or primary care office visits, specialist office visits, and lab tests. If a member meets the deductible through these services, they will then be subject to a copay for sick office visits and labs. This copay is only applicable after meeting the deductible. Note: For employees who are also members of Zion HealthShare, they will work with their IUA when using their HealthShare membership for medical expenses not covered by their health plan.
Preventive Copay is a health plan that focuses on preventive care. The plan provides limited access to select healthcare services through copays. These services may include lab work, imaging, and office visits. This health plan meets ACA requirements for minimum essential coverage (otherwise known as MEC). Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Care coordination Preventive Core health plans have no network restrictions and include care coordination services to help you make appointments and locate providers that work well with your benefits. To learn more about care coordination click here . To view information about your Preventive Copay health plan, including what services are available with a copay, click here and select your specific plan name.
Care+ Core is a comprehensive coverage, anywhere plan that covers essential medical needs and does not restrict you to a provider network. This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . For more information about your Care+ Core health plan, click here and then select your specific plan name.
Care+ HSA is a comprehensive coverage, anywhere plan that covers essential medical needs and does not restrict you to a provider network. This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . To view information about your Care+ HSA health plan, click here and select your specific plan name.
Care+ Copay is a comprehensive coverage, anywhere plan that covers essential medical needs and does not restrict you to a provider network. Fair-priced healthcare This health plan uses an innovative healthcare pricing strategy called fair-priced healthcare. To learn more about fair-priced healthcare, click here . Copays Care+ Copay provides access to some healthcare services with copays. For these services the deductible is waived.