Applications from all industries will be reviewed for eligibility. Some businesses or industries are subject to special rates or restrictions based on the specific requirements of the sponsoring carrier.
Eligible employees are defined as all full-time, who are paid a salary or earnings from which federal, state and Social Security taxes are withheld (may vary by State). There must be a bona fide employer-employee relationship. 1099 employees are not eligible unless permitted by the state. Eligible dependents include spouses and unmarried dependent children. Dependent children are eligible until they reach a limiting age which may vary by each state and/or specific carrier partner utilized by Lifestyle Health Plans.
Other Individuals Not Eligible
Other individuals typically not eligible for coverage include: nonresident aliens; employees not working at the employer’s regular place of business on a full-time basis; any consultant, directors & stockholders who are not physically working at the place of business; and retired, temporary, part-time or employed on a seasonal basis. Specific details and restrictions may vary by sponsoring carrier.
Employee participation will vary by size of employer and their respective number of eligible employees. Please see a Lifestyle Health Plans sales representative for details.
In the majority of circumstances, employer contributions for employee coverage are required for all enrolling employees. Specific details may vary by sponsoring carrier. Please see a Lifestyle Health Plans sales representative for details.
Deductible and Co-pays
Deductibles, other than specific service deductibles, accrue on a calendar year basis unless otherwise specified. Co-payments and ineligible expenses do not apply toward satisfaction of the calendar year deductible(s). Out of network plan deductibles may accrue separately based on the specific specifications of the sponsoring carrier.
Plan Provisions, Limitations and Exclusions
A complete list of plan limitations and/or exclusions is contained in the Certificate Booklet provided by the sponsoring carrier to each participating employee.