#7802: St. Joseph Montessori School Draft

Final Proposals Due 7/4/25 Plan Effective 8/1/2025 Census Used Census St Joseph Motesorri.xlsx (71 members)

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  • Stop Loss
  • Employee Benefit Plans
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Policy dates and deadlines
Policy Effective Date
The start date of the benefit plan.
Policy Termination Date
The end date of the benefit plan.
Final Proposals Due
Indicates when final proposals are due to your organization.

Please choose from the following networks or repricing:

Requested Stop Loss Plan Designs
Change Stop Loss Options
Prescription Drug Coverage Options
Specific Includes Rx Coverage? - Yes
Aggregate Includes Rx Coverage? - Yes
Plan Name Spec Deductible Spec Contract Aggregating Spec Deductible Agg Contract Agg Corridor Commission
Plan 1 $35,000 12/12 $0 12/12 1.20 0.00%
Plan 2 $35,000 12/18 $0 12/18 1.20 0.00%
Plan 3 $35,000 12/18 $0 12/12 1.20 0.00%
Plan 4 $50,000 12/12 $0 12/12 1.20 0.00%
Plan 5 $50,000 12/18 $0 12/18 1.20 0.00%
Plan 6 $50,000 12/18 $0 12/12 1.20 0.00%
Plan 7 $60,000 12/12 $0 12/12 1.20 0.00%
Plan 8 $60,000 12/18 $0 12/18 1.20 0.00%
Plan 9 $60,000 12/18 $0 12/12 1.20 0.00%
Plan 10 $75,000 12/12 $0 12/12 1.20 0.00%
Plan 11 $75,000 12/18 $0 12/18 1.20 0.00%
Plan 12 $75,000 12/18 $0 12/12 1.20 0.00%
Plan 13 $25,000 12/12 $0 12/12 1.20 0.00%
Plan 14 $25,000 12/18 $0 12/18 1.20 0.00%
Plan 15 $40,000 12/12 $0 12/12 1.20 0.00%
Plan 16 $40,000 12/18 $0 12/18 1.20 0.00%
Change Stop Loss Coverage Type
Stop Loss Coverage Type
Stop Loss Prescription Drug Coverage

Level Funded Stop Loss

About stop loss options

Use this section to choose specific and/or aggregate stop loss coverage and indicate if prescription drug coverage is included. Also indicate if you want to see a level-funded option.
Note: not all carriers or MGUs have level-funded options available.

Requested Employee Benefit Plans
Plan Name Deductible Coinsurance OOP Maximum OOP Includes
Deductible?		 Rx Copay
Generic		 Rx Copay
Formulary		 Rx Copay
Non-Formulary		 Rx covers
specialty?		 Rx copay
specialty
Fusion Platinum EPO: In: $7,500
Out: - 		In: 100%
Out: - 		In: $7,500
Out: - 		In: Yes
Out: No 		$0 $35 $75 No $0
Fusion Platinum PPO: In: $7,500
Out: $15,000 		In: 100%
Out: 50% 		In: $7,500
Out: $15,000 		In: Yes
Out: Yes 		$0 $35 $75 No $0
Plan 7: In: $0
Out: $2,000 		In: 100%
Out: 75% 		In: -
Out: - 		In: Yes
Out: Yes 		$10 $25 $50 Yes $200
Purust Platinum EPO: In: $9,200
Out: - 		In: 100%
Out: - 		In: $9,200
Out: - 		In: Yes
Out: No 		$0 $25 $70 No $0
Purust Platinum PPO: In: $9,200
Out: $18,400 		In: 100%
Out: 50% 		In: $9,200
Out: $18,400 		In: Yes
Out: No 		$0 $35 $75 No $0
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Quote Request Recipients
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Quoting Partner Networks or Repricing
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  • First Choice Health Plans of Mississippi
Fees
The fees listed below will be added to the proposal.
Fee Type Amount
TPA, PPO, PBM, Service Providers PEPM This fee is editable
Broker Fee PEPM This fee is editable