Twitter_Logo_Blue

Members

TRANSPARENCY IN COVERAGE

The transparency in coverage section of this website is intended to provide general information concerning our plans to aid in the understanding of common health insurance concepts; but in all cases, the specific language of a member’s policy and related documents will always control over the more general descriptions outlined here.

Impacted Insurer and Plans

Insurer Name (HIOS Issuer#)
USAble Mutual Insurance Company (75293)

Individual Plans

Plan Name HIOS Product ID
Gold 500 with PCP/Rx Copays 75293AR1200001
Gold 1000 with PCP/Specialist/Rx Copays 75293AR1200002
Silver 1500 with PCP/Rx Copays 75293AR1200003
Silver 2500 with PCP/Rx Copays 75293AR1200005
Silver 3500 with PCP/Specialist/Rx Copays 75293AR1200004
Silver 3600 HSA 75293AR1200006
Bronze 6350 PCP/Rx Copays 75293AR1200007
Bronze 6400 HSA 75293AR1200008
Catastrophic 75293AR1200009

Multi-State Plans

Plan Name HIOS Product ID
Gold 500 MSP 75293AR121-0001-01
Silver 3000 MSP with PCP/Specialist/Rx Copays 75293AR121-0002-01
Bronze 6200 MSP 75293AR121-0003-01

Group SHOP Plans

Plan Name HIOS Product ID
SHOP Gold 1500 75293AR1220031
SHOP Silver 2000 75293AR1220032
SHOP Silver 4350 75293AR1220033
SHOP Bronze 3500 75293AR1220034

Individual Dental Plans

Plan Name HIOS Product ID
Pediatric 75293AR1230001
Dental Silver 75293AR1230002
Dental Gold 75293AR1230003
Dental Gold Plus Vision 75293AR1230004
  1. Out-of-network liability and balance billing
  2. Member claims submission
  3. Grace periods and claims pending policies during the grace period
  4. Retroactive denials
  5. Member recoupment of overpayment
  6. Medical necessity and prior authorization timeframes and member responsibilities
  7. Drug exceptions time frames and member responsibilities
  8. Information on explanation of benefits (our personal health statements)
  9. Coordination of benefits (COB)

The transparency in coverage section of this website is intended to provide general information concerning our plans to aid in the understanding of common health insurance concepts; but in all cases, the specific language of a member’s policy and related documents will always control over the more general descriptions outlined here.

Impacted Insurer and Plans

Insurer Name (HIOS Issuer#)
USAble Mutual Insurance Company (75293)

Individual Plans

Plan Name HIOS Product ID Form#
Gold Plan 1 7523AR1200019-00 17-309
Silver Plan 1 7523AR1200003-01 17-310
Silver Plan 2 7523AR1200014-01 17-310
Silver Plan 3 7523AR1200018-00 17-310
Silver Plan HSA1 7523AR1200006-01 17-310
Silver Plan AW1 7523AR1200004-01 17-311
Silver Plan AW1A 7523AR1200017-04 17-311
Bronze Plan 1 7523AR1200007-01 17-313
Bronze Plan HSA1 7523AR1200008-01 17-313
Bronze Plan 2 7523AR1200015-00 17-313

Multi-State Plans

Plan Name HIOS Product ID Form#
Gold Plan HSA M1 7523AR1210005-01 17-315
Silver Plan AWM1 7523AR1210002-01 17-316
Silver Plan AWM1A 7523AR1210004-01 17-316
  1. Out-of-network liability and balance billing
  2. Member claims submission
  3. Grace periods and claims pending policies during the grace period
  4. Retroactive denials
  5. Member recoupment of overpayment
  6. Medical necessity and prior authorization timeframes and member responsibilities
  7. Drug exceptions time frames and member responsibilities
  8. Information on explanation of benefits (our personal health statements)
  9. Coordination of benefits (COB)