Retailers Insurance Company - EHB - 47638MI0010001 Health Insurance Plan

Retailers Insurance Company health insurance plan with the Plan ID 47638MI0010001. The plan is called Retailers Insurance Company - EHB.

Health Insurance Plan ID 47638MI0010001
Health Insurance Plan Year 2023
State Michigan
Health Insurance Issuer Retailers Insurance Company
Health Insurance Plan Variant 47638MI0010001-00
Provider Network(s) ['MIN001']
In Network Doctors

*The data available in our database based on Health Insurance Company Open Data (update: Tue, 01 Oct 2024 06:11 GMT).

Providers Michigan All US States
All N/A N/A
PCP N/A N/A
Allergy N/A N/A
OB/GYN N/A N/A
Dentists N/A N/A
Available Variants of the Health Plan

Standard Off Exchange Plan - 47638MI0010001-00

Last Plan Update Date Sun, 14 Aug 2022 00:00 GMT
Last Import Date Tue, 01 Oct 2024 06:11 GMT

Benefits of Retailers Insurance Company - EHB Health Insurance Plan, 47638MI0010001-00

Benefit Covered In Network Out Of Network
Accidental Dental
YES

Tier 1: 0.00%

Tier 2: 0.00%

0.00%
Basic Dental Care - Adult
YES

Tier 1: 50% Coinsurance after deductible

Tier 2: 50% Coinsurance after deductible

50% Coinsurance after deductible
Basic Dental Care - Child
YES

Tier 1: 20% Coinsurance after deductible

Tier 2: 40% Coinsurance after deductible

40% Coinsurance after deductible
Dental Check-Up for Children

Limit: 2.0 Visit(s) per Benefit Period

YES

Tier 1: 0.00%

Tier 2: 0.00%

0.00%
Major Dental Care - Adult
YES

Tier 1: 50% Coinsurance after deductible

Tier 2: 50% Coinsurance after deductible

50% Coinsurance after deductible
Major Dental Care - Child
YES

Tier 1: 50% Coinsurance after deductible

Tier 2: 50% Coinsurance after deductible

50% Coinsurance after deductible
Orthodontia - Adult
YES

Tier 1: 50.00%

Tier 2: 50.00%

50.00%
Orthodontia - Child
NO
Routine Dental Services (Adult)

Limit: 2.0 Visit(s) per Benefit Period

YES

Tier 1: 0.00%

Tier 2: 0.00%

0.00%

Retailers Insurance Company - EHB Health Insurance Plan Variant 47638MI0010001-00 Attributes

Plan Attribute Value
Begin Primary Care Cost-Sharing After Number Of Visits 0
Begin Primary Care Deductible Coinsurance After Number Of Copays 0
Business Year 2023
Child-Only Offering Allows Adult and Child-Only
Composite Rating Offered No
CSR Variation Type Standard High Off Exchange Plan
Dental Only Plan Yes
First Tier Utilization 25%
HIOS Product ID 47638MI001
Import Date 8/14/2022 20:00
Inpatient Copayment Maximum Days 0
Guaranteed Rate Estimated Rate
New/Existing Plan Existing
Issuer ID 47638
Issuer Marketplace Marketing Name Retailers Insurance Company
Market Coverage SHOP (Small Group)
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Not Applicable
Medical EHB Deductible, Combined In/Out of Network, Family Per Group $0 per group
Medical EHB Deductible, Combined In/Out of Network, Family Per Person $0 per person
Medical EHB Deductible, Combined In/Out of Network, Individual $0
Medical EHB Deductible, In Network (Tier 1), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 1), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 1), Individual Not Applicable
Medical EHB Deductible, In Network (Tier 2), Family Per Group per group not applicable
Medical EHB Deductible, In Network (Tier 2), Family Per Person per person not applicable
Medical EHB Deductible, In Network (Tier 2), Individual Not Applicable
Medical EHB Deductible, Out of Network, Family Per Group per group not applicable
Medical EHB Deductible, Out of Network, Family Per Person per person not applicable
Medical EHB Deductible, Out of Network, Individual Not Applicable
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual $375
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 2), Family Per Group $750 per group
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 2), Family Per Person $375 per person
Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 2), Individual $375
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Group per group not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family Per Person per person not applicable
Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual Not Applicable
Metal Level High
Multiple In Network Tiers Yes
National Network Yes
Network ID MIN001
Out of Country Coverage Yes
Out of Country Coverage Description Emergency Services Only
Out of Service Area Coverage Yes
Out of Service Area Coverage Description Same Benefit Level
Plan Effective Date 1/1/2023
Plan ID (Standard Component ID with Variant) 47638MI0010001-00
Plan Marketing Name Retailers Insurance Company - EHB
Plan Type PPO
Plan Variant Marketing Name Retailers Insurance Company - EHB
QHP/Non QHP Off the Exchange
Second Tier Utilization 75%
Service Area ID MIS001
Source Name SERFF
Plan ID 47638MI0010001
State Code MI

Copay & Coinsurance of Retailers Insurance Company - EHB Health Insurance Plan, 47638MI0010001

Drug Tier Pharmacy Type Copay amount Copay option Coinsurance rate Coinsurance option Mail Order

Frequently Asked Questions(FAQ) about Retailers Insurance Company - EHB, 47638MI0010001 Health Insurance Plan, 47638MI0010001

  • Does Retailers Insurance Company - EHB Health Insurance Plan, 47638MI0010001 support Mail Ordering?

    Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.

  • Does (47638MI0010001) Health Insurance Plan, Variant (47638MI0010001-00) have Out Of Country Coverage?

    Yes. Details: Emergency Services Only

    Does (47638MI0010001) Health Insurance Plan, Variant (47638MI0010001-00) have Out of Service Area Coverage?

    Yes. Details: Same Benefit Level

 

Disclaimer: This is based on the import(Date: Tue, 01 Oct 2024 06:11 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API