ADVANTAGE Health Solutions

ADVANTAGE Broker Solutions

ADVANTAGE
Broker Solutions

The following resources are presented in Portable Document Format (PDF) and require Adobe Reader to view and print. You can download a free pdf reader from the Adobe web page.

Broker Forms
Agent Agreement
Assignment of Commission/Agent of Record
Form W-9
Small Group (2-50) Checklist

FAQs
Broker FAQ
Chambers of Commerce Benefit Plan Information
Errors and Omission Coverage
Glossary of Health Coverage and Medical Terms
News About CVS

Group Forms
Application for Group Policy
Authorization of Health Information Release
Continuity of Care
Electronic Census Form
Enrollment/Change Application
Health Statement
Important ADVANTAGE Contact Information
Mail Service Order Form
Step Therapy

Benefit Summaries

2013 Generic Summaries – Final Summary of Benefits and Coverage (SBC) will contain complete up to date benefits per HealthCare Reform.

Marketing Materials
About ADVANTAGE
About ADVANTAGE Flyer
ADVANTAGE Brochure
ADVANTAGE 2-Tier Formulary
ADVANTAGE 3-Tier Formulary
ADVANTAGE 4-Tier Formulary
ADVANTAGE 2013 Benefit Matrix
ADVANTAGE-Choice Highlights
Care-ADVANTAGE® Brochure
Care-ADVANTAGE® Trifold
Member Quick Reference
Service Area Map
Tobacco Education
Underwriting Guidelines
What Does it Mean to Stay in Network

HMO
HMO 100
HMO 101
HMO 102
HMO 103
HMO 104
HMO 105
HMO 106
HMO 107
HMO 108
HMO 109
HMO F
HMO G
HMO H
HMO J
HMO K
HMO P
HMO Q
HMO R

POS
POS 100
POS 101
POS 102
POS 103
POS 104
POS 105
POS 106
POS 107
POS 108
POS 109
POS L
POS M
POS N
POS P
POS Q
POS R

HDHP
HDHP 1
HDHP 2
HDHP 3
HDHP 5
HDHP 6

Rider Summaries

Prescription Drugs No Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)

Prescription Drugs $100 Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)

Prescription Drugs $250 Deductible
Rx Plan 1 ($10/20/30)
Rx Plan 2 ($10/20/50)
Rx Plan 3 ($10/25/40)
Rx Plan 4 ($10/30/50)
Rx Plan 5 ($15/30/60)
Rx Plan 6 ($10/30/50%)
Rx Plan 7 ($10/20/50/50%)

Vision
Basic - Exam Plus (standard)
Enhanced - B20
Enhanced - B18

Morbid Obesity
Surgical Treatment for Morbid Obesity Option

Chiropractic Services Please note, Chiropractic Services are not available with High Deductible Health Plans
Chiropractic Services Rider