©2019 by Blue Heart Health Plans.

FREQUENTLY ASKED QUESTIONS

DO EMPLOYEES HAVE TO PURCHASE THE GAP PLAN? DO THEY HAVE TO PARTICIPATE IN THE POP/WELLNESS PLAN?

The GAP and the POP plan are completely voluntary, meaning employees may elect to enroll or decline to enroll.  Employees who do not enroll simply may have a high deductible health plan if they choose.

IS THE GAP PLAN ‘FREE’ TO EMPLOYEES?

The GAP plan will have no cost to employees by taking advantage of pre tax contributions and if necessary, to keep take home pay intact, a direct monthly EFT reimbursement if they participate in the Wellness/POP Health Plan.

IF AN EMPLOYEE FAILS TO MEET THE POP HEALTH GUIDELINES IS THE GAP PLAN REIMBURSEMENT STOPPED?

Yes, but each employee has a ‘Coach’ contacting them to insure they meet very reasonable requirements.  Lapses are rare and reimbursed when employee gets back on track.

DO MEMBERS/EMPLOYEES HAVE TO SUBMIT CLAIM FORMS TO COVER THE DEDUCTIBLE AND COINSURANCE?

No, like a Medicare Supplement, these costs are paid seamlessly.  The health plan submits a claim or EOB (Explanation of Benefits) to the GAP plan and the GAP plan pays the medical provider directly.  This defines a fully 'Integrated' GAP plan.