UBA'S OPTIONAL ACA SUPPLEMENTAL PLANS CATEGORY
DESIGNED TO SUPPLEMENT ACA BRONZE PLANS.

TRUGAP COMPREHENSIVE

Designed to Supplement
Bronze ACA Plans.

Group Supplemental Medical Insurance

INDIVIDUAL PLAN YEAR BENEFIT MAXIMUM
$7,500 per Covered Person per Plan Year
Plan Year Benefit Maximum per Family - 2 times the Individual Maximum

DEDUCTIBLE - $1,000 per Covered Person
Combined Inpatient Hospital & Outpatient Plan Year Deductible
Maximum Deductible per Family - 2 times the Individual Deductible

• INPATIENT OR OUTPATIENT
• SICKNESS OR ACCIDENTS
• 30 DAY WAITING PERIOD

This supplemental insurance pays for pre-existing conditions and is guaranteed issue. TruGap Comprehensive is designed to fill in the gap and cover 100% of a $7500 Bronze ACA deductible for covered medical expenses (after TruGap's $1000 deductible is met¹).

You must have a comprehensive ACA Bronze Plan in order to enroll in this supplemental plan.

¹Some coverage amounts or coverage availablity may vary by state. Always review the state specific Certificates of Insurance for the supplemental insurance plan to determine coverage benefits, availability, terms, conditions, limitations & exclusions. If there are any discrepancies between the descriptions above and the Certificate, the Certificate will govern. Prescription coverage and Physician office visits are not covered with TruGap. Coverage ends for covered member upon turning 65.

Group Supplemental Medical Insurance is underwritten by SiriusPoint America Insurance Company.

Turn a Bronze ACA Plan into a Gold ACA plan
with TruGap Comprehensive

If you select a Bronze Plan with a $7500 deductible and then you add TruGap Comprehensive which pays a $7500 benefit with a $1000 deductible for inpatient and outpatient covered medical expenses, you will have an out-of-pocket deductible expense of only $1000 which is the deductible offering of most Gold ACA plans.

Subject to covered expenses, schedule of benefits, terms, definitions, provisions, limitations & exclusions of the Policy & Certificate of Insurance. There are four metal level plans with ACA: Bronze, Silver, Gold & Platinum. To learn more about all your options for Affordable Care Act (ACA) plans or to enroll in ACA coverage, go to healthcare.gov or contact your insurance agent.

NO Network Restrictions with TruGap

Visit any lab, outpatient clinic, or hospital with TruGap Comprehensive.

HOW DO CLAIMS WORK?

• Present both cards at Provider's office. (Your ACA or Group Major Medical card & your Supplemental TruGap ID Card).
• Provider files a claim with your ACA or Group major medical primary insurance provider carrier.
• Your primary insurance carrier sends provider payment and explanation of benefits (EOB).
• Provider files claim with TruGap claim's administrator. TruGap claim's administrator sends payment to provider and EOB statement to Member.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP SUPPLEMENTAL MEDICAL INSURANCE
UNDERWRITTEN BY:
SiriusPoint America Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

^{*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).}

THE INSURANCE PORTIONS OF THIS MEMBERSHIP PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER GROUP SUPPLEMENTAL MEDICAL INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by SiriusPoint America Insurance Company^*. Your overall total association membership dues for the optional supplemental TruGap Comprehensive plan also include these monthly insurance rates:

^*Under Age 55:
$134.19 (Member), $256.72 (Member+Spouse)
$240.23 (Member+Child(ren)), & $344.75 (Family)

^*Age 55+:
$201.28 (Member), $398.54 (Member+Spouse)
$259.24 (Member+Child(ren)), & $439.92 (Family)


Read the Certificate(s) of Insurance carefully. This is a brief description of one of the various group association insurance membership plans and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Supplemental Medical Insurance is underwritten by SiriusPoint America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Coverage for Group Supplemental Medical Insurance ends at age 65. Membership plan cost for TruGap Comprehensive plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this membership plan.

United Business Association, SiriusPoint America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-GAP-1000

• CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  • 
    Alabama

    ---

  • Arizona

    ---

  • California

    ---

  • Florida

    ---

  • Georgia

    ---

  • Illinois

    ---

  • Indiana

    ---

  • Michigan

    ---

  • Ohio

    ---

  • Tennessee

    ---

  • Texas

    ---

  • Wyoming
  
  

While TruGap Comprehensive plan does not cover prescriptions, with your TruGap plan, you will receive a FREE Paramount RX^® Prescription Discount Card to use at retail pharmacies and for your pets! Learn more by viewing the details below.

SiriusPoint America Insurance Company does not offer and is not affliated with the discount programs offered in connection with Paramount RX^® or membership in United Business Association.

SiriusPoint America Insurance Company, Paramount RX^®, HealthyAmerica, & United Business Association are separate legal entities and have sole financial responsibility for their own products.

There is no cost to the member for this FREE prescription discount card. Read the guide carefully. This is a brief description of a prescription discount program through Paramount RX® and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.

TRUGAP HOSPITAL

Designed to Supplement
Bronze ACA Plans.

Group Supplemental Medical Insurance

INPATIENT INDIVIDUAL PLAN YEAR BENEFIT MAXIMUM
$7,500 per Covered Person per Plan Year
Plan Year Benefit Maximum per Family - 2 times the Individual Maximum

DEDUCTIBLE - $1,000 per Covered Person
Inpatient Hospital Plan Year Deductible
Maximum Deductible per Family - 2 times the Individual Deductible

• INPATIENT HOSPITAL ONLY
• SICKNESS OR ACCIDENTS
• 30 DAY WAITING PERIOD

This supplemental insurance pays for pre-existing conditions and is guaranteed issue. TruGap Hospital is designed to fill in the gap and cover 100% of a $7500 Bronze ACA deductible for covered inpatient hospital medical expenses (after TruGap's $1000 deductible is met¹).

You must have a comprehensive ACA Bronze Plan in order to enroll in this supplemental plan.

¹Some coverage amounts or coverage availablity may vary by state. Always review the state specific Certificates of Insurance for the supplemental insurance plan to determine coverage benefits, availability, terms, conditions, limitations & exclusions. If there are any discrepancies between the descriptions above and the Certificate, the Certificate will govern. Prescription coverage and Physician office visits are not covered with TruGap. Coverage ends for covered member upon turning 65.

Group Supplemental Medical Insurance is underwritten by SiriusPoint America Insurance Company.

Turn a Bronze ACA Plan into
a Gold ACA plan with TruGap Hospital

If you select a Bronze Plan with a $7500 deductible and then you add TruGap Hospital supplemental plan which pays a $7500 benefit with a $1000 deductible for inpatient hospital covered medical expenses, you will have an out-of-pocket deductible expense of only $1000 which is the deductible offering of most Gold ACA plans.

Subject to inpatient hospital covered expenses, schedule of benefits, terms, definitions, provisions, limitations & exclusions of the Policy & Certificate of Insurance. There are four metal level plans with ACA: Bronze, Silver, Gold & Platinum. To learn more about all your options for Affordable Care Act (ACA) plans or to enroll in ACA coverage, go to healthcare.gov or contact your insurance agent.

NO Network Restrictions with TruGap

Visit any hospital with TruGap Hospital.

HOW DO CLAIMS WORK?

• Present both cards at Hospital. (Your ACA or Group Major Medical card & your Supplemental TruGap ID Card).
• Provider files a claim with your ACA or Group major medical primary insurance provider carrier.
• Your primary insurance carrier sends provider payment and explanation of benefits (EOB).
• Provider files claim with TruGap claim's administrator. TruGap claim's administrator sends payment to provider and EOB statement to Member.

ASSOCIATION BENEFITS
PROVIDED BY:

GROUP SUPPLEMENTAL MEDICAL INSURANCE
UNDERWRITTEN BY:
SiriusPoint America Insurance Company

BILLING, FULFILLMENT &
CUSTOMER SERVICE PROVIDED BY:

^{*Billing is administered through the Third Party Administrator
of H A Partners, Inc. or HealthyAmerica (depending on state).}

THE INSURANCE PORTIONS OF THIS MEMBERSHIP PLAN PROVIDE LIMITED COVERAGE. THEY DO NOT PROVIDE COMPREHENSIVE MAJOR MEDICAL INSURANCE. COVERAGE IS PROVIDED UNDER GROUP SUPPLEMENTAL MEDICAL INSURANCE ONLY POLICIES.

The following monthly insurance rates apply to coverage underwritten by SiriusPoint America Insurance Company^*. Your overall total association membership dues for the optional supplemental TruGap Hospital plan also include these monthly insurance rates:

^*Under Age 55:
$31.00 (Member), $59.30 (Member+Spouse)
$55.49 (Member+Child(ren)), & $79.64 (Family)

^*Age 55+:
$46.49 (Member), $92.06 (Member+Spouse)
$59.88 (Member+Child(ren)), & $101.62 (Family)


Read the Certificate(s) of Insurance carefully. This is a brief description of one of the various group association insurance membership plans and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Group Policy and Certificate(s) of Insurance. Coverage may vary or may not be available in all states. You’ll find complete coverage details in the Certificate(s) of Insurance. Group Supplemental Medical Insurance is underwritten by SiriusPoint America Insurance Company, New York, NY. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act. Coverage for Group Supplemental Medical Insurance ends at age 65. TruGap Hospital plan is only for inpatient hospital covered expenses and does not cover any outpatient medical expenses. Membership plan cost for TruGap Hospital plan does not include the separate $10 UBA Membership dues. You must be a member of the United Business Association in order to purchase this membership plan.

United Business Association, SiriusPoint America Insurance Company, and HealthyAmerica are separate legal entities and have sole financial responsibility for their own products.

HASA-GAP-1000

• CHOOSE STATE TO VIEW CERTIFICATE OF INSURANCE
  
  (Limitations & Exclusions)
  • 
    Alabama

    ---

  • Arizona

    ---

  • California

    ---

  • Florida

    ---

  • Georgia

    ---

  • Illinois

    ---

  • Indiana

    ---

  • Michigan

    ---

  • Ohio

    ---

  • Tennessee

    ---

  • Texas

    ---

  • Wyoming
  
  

While TruGap Hospital plan does not cover prescriptions, with your TruGap plan, you will receive a FREE Paramount RX^® Prescription Discount Card to use at retail pharmacies and for your pets! Learn more by viewing the details below.

SiriusPoint America Insurance Company does not offer and is not affliated with the discount programs offered in connection with Paramount RX or membership in United Business Association.

SiriusPoint America Insurance Company, Paramount RX^®, HealthyAmerica, & United Business Association are separate legal entities and have sole financial responsibility for their own products.

There is no cost to the member for this FREE prescription discount card. Read the guide carefully. This is a brief description of a prescription discount program through Paramount RX® and is not an insurance contract. This is not a qualified health plan under the Affordable Care Act (ACA). Some services may be covered by a qualified health plan under the ACA. This plan does not meet the minimum creditable coverage requirements under M.G.L.c. 111M and 956 CMR 5.00. This is not a Medicare prescription drug plan. The plan provides discounts at participating providers for services. The plan does not make payments directly to providers. The plan member is obligated to pay for all services but will receive a discount from participating providers. The range of discounts will vary depending on the type of provider and services. Not all services are available in all states.