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 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)