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Prepaid Health Plan PHC & Discount Medical Plan DMPO . Form # 20061214 1 WHY WAS THIS COMPANY CREATED ? Because: 3.8 Million People Uninsured in Florida H.M.O. Premiums are Very High 50% Medicaid Recipients Disqualified Strict Underwriting Small Companies Stopped Offering Health Benefits Agents Don’t Have a Product to Meet their Client's Needs 2 What is….. 3 Is a Medical Plan created in 1998, Licensed by the State of Florida and NOW Accredited by the AAAHC which provides the following BENEFITS: • Access to Primary Care Physicians, which include Pediatricians, Internal Medicine & Family Practitioners for only $ 10.ºº a Visit • Plan does not require physical examination or Lab Tests to be approved and does not have age or weight limits, neither denies members for pre existing conditions, or any other cause • There are no Limitations or waiting Periods • Children alone are accepted in the Plan • Maternity at very convenient costs • Lab Tests with very low Co-payments • Radiology Tests are at very Reduced Rates • Prescriptions provided at all Major Pharmacies Nationwide by Tiers and by Mail Order including Diabetic Supplies. • Urgent Care Centers available at all three Counties • Very simple Application Form 4 HOW DOES THE PLAN WORK? The Plan has two licensed components: 1. One called Prepaid Health Plan “PHC”. 2. The other called Discount Medical Plan Organization “DMPO”. The Plan has Medical Centers in Miami-Dade, Broward and Palm Beach. The Plan has medical attention 24 hours a day with your PCP. 5 PREPAID HEALTH PLAN (PHC) CONCEPT: Doctor’s visit for only $ 10 Co-Pay A Family Doctor is assigned for each patient for a low monthly fee No age limit and all existing conditions are accepted. You may change doctors once per month. All these in your own language, and close to home or work. The Prepaid Plan offers: Primary Care Physician for adults at $ 10 per visit Pediatricians Gynecologists Laboratory Vaccines 6 DISCOUNT MEDICAL PLAN (DMPO) CONCEPT: Complementary service available for Members at fixed and pre-negotiated rates. This portion provides you with: Specialist’s at Fixed Reduced Rates Urgent Care Centers at fixed Costs Two Pharmacy Plans available at fixed costs for each product Diagnostic Centers Scheduled Hospitalizations: Surgeries and Maternity Maternity At two Maternity Centers at Total Cost of $ 3,600 plus other options Low Co-pay in Diabetic Supplies and Other Medical Services - Diabetic and Blood Glucose Testing Supplies. - Insulin products and meters. - Dental Plan at $ 6.00 per month per family. - Durable Medical Equipment 7 PHARMACY PLAN PAYMENT LEVELS Level 1 - $12 or less You pay up to $12 at participating pharmacies. Common examples include: Antibiotic Ditary Supplement Amoxillin Doxycycline Motronidazole (Flagyl) Sulfamethazole/TMP (Bactrim) Tetracycline Folic Acid Glaucoma Timolol (Timoptic) Gout Allopurinol (Zyloprim) Antidepressant Heart Amitriptilene (Elavil) Fluoxetine (Prozac) Nortriptyline (Pamelor) Trazodone (Desyrel) Atenolol (Tenormin) Captopril (Capoten) Doxasosin (Cardura) Enalapril ( Vasotec) Isosorbide Mononitrate (Isordil) Propranolol (Inderal) Anti-Inflammatory Ibuprofen (Motrin) Antifungal Hormone Nystatin Asthma Estradiol (Estrace) Medroxiprogesterone (Provera) Albuterol Inhaler Motion Sikness Blood Pressure Meclizine ( Antivert) Atenolol (Tenormin) Captopril (Capoten) Clonidine (Catapres) Doxasosin (Cardura) Enalapril ( Vasotec) Furosemide ( Lasix) Hydrochlorothiazide (Lasix) Lisinopril (Prinivil, Zestril) Metoprolol (Lopressor) Propranolol (Inderal) Triamterene/HCTZ (Dyazide) Pain Reliever Cough Acetaminophen/Codeine Hydrocodone/APAP ( Vicodin) Oxycodone/APAP (Percocet) Propoxyphene-N/APAP (Darvocet) Seizures Clonazepam (Klonopin) Steroid Prednisone Triamcinolone Acetonide Panic Disorders Clonazepam (Klonopin) Promethazine/Codeine (Phenergan/Cod) Thyroid Hormone Diabetes Levothyroxin Glipizide (Glucotrol) 8 Diabetic Patients are Welcomed to ProMedical Plan Yes, our Diabetic Members not only can be treated and prescribed for only $ 10 but also can have their medications at very low co-payments with Care Pharmacy Inc. Now Members can order conveniently from their homes and it will be delivered to their door without having to wait in long lines at the pharmacy. Orders will be shipped using the U.S. Post Office Priority Mail and delivery at no extra charge. We will send Members a METER AT NO CHARGE with their first 90 day supply so they can monitor their Blood Glucose for accurate and affordable control. We carry a wide range of products including Diabetic Testing Supplies, Lancets, Blood Glucose Test Strips, Glucose Control Solution Test, as well as other supplies needed by people with chronic illnesses. 9 MATERNITY PLAN The Plan offers complete maternity packages at: The MIAMI MATERNITY CENTER or HOLLYWOOD BIRTH CENTER, with the following benefits: Prenatal Vitamins (at Miami location) All Routine Labs Two Sonograms Vaginal Delivery at Birth Center (Home birth option available) One Home visit after Delivery Four Post Partum visits PKU Infant Screening & New Born Hearing Test Complete packages for only $ 2,800 In case C-Section is needed patient will be transferred to Parkway Hospital or North Shore Hospital from Miami Maternity Center or to Hollywood Memorial Regional from Hollywood Birth Center at an additional cost of $ 800. Miami Maternity Center Address: 140 NE 119 Street, Miami, Florida 33161 MOM Maternity Center Address: 3408 W. 84 Street, Hialeah, Florida 33018 Hollywood Birth Center Address: 2316 Hollywood Blvd., Broward, Florida 33020 10 MATERNITY SPECIAL RATES DADE CO U N TY HOSPITALS HOSPITAL NAME HIALEAH KENDALL PALMETTO JACKSON NORTH BROWARD MIAMI MATERNITY CENTER M.O.M. MATERNITY CENTER HOSPITAL RATES ** VAGINAL C-SECTION DELIVERY 2 DAYS 3 DAYS 3,300 5,250 3,000 2,200 4,900 7,250 3,600 4,500 DOCTOR'S NAME 1,600 1,600 1,600 1,600 1,500 1,900 1,900 1,900 1,900 1,900 $ $ $ $ $ $ $ 6,700 8,650 6,400 5,600 5,500 3,200 2,800 $ $ $ $ $ 8,600 10,950 7,300 8,200 8,200 C.B. SINGH C.B. SINGH C.B. SINGH ROBERT KLEIN ROBERT KLEIN BARRINGTON MURRAY 4,500 ROBERT KLEIN 1,925 1,925 1,600 1,600 1,600 1,800 1,800 1,925 1,800 2,425 2,425 2,000 2,000 2,000 2,300 2,300 2,425 2,300 $ $ $ $ $ $ $ $ $ $ 7,725 5,510 5,185 5,425 5,250 7,100 7,100 7,225 7,100 3,900 $ $ $ $ $ $ $ $ $ 10,225 8,215 7,790 8,855 8,300 8,600 8,600 8,725 8,600 5,000 RONALD THOMPSON 5,000 ISAAC HALFON 4,800 ISAAC HALFON 1,800 1,680 1,680 2,100 1,900 1,900 $ $ $ 5,400 6,980 6,880 $ $ $ 8,900 8,700 8,500 EDUARDO LAVADO EDUARDO LAVADO EDUARDO LAVADO EDUARDO LAVADO NABIL MATAR 4,000 1,785 6,000 BARRINGTON MURRAY 3,990 BARRINGTON MURRAY HOLY CROSS CORAL SPRINGS MEMORIAL MIRAMAR MEMORIAL WEST 2,025 1,850 3,500 3,500 5,055 4,500 4,500 4,500 HOLLYWOOD BIRTH CENTER WEST BOCA PALMS WEST WELLINGTON REGIONAL 1,800 3,500 3,400 4,500 TOTAL VAGINAL * C-SECTION DELIVERY DELIVERY REGULAR C-SECTION (2 DAYS) (3 DAYS) Costo Total *** (1) Costo Total *** (2) 3,500 Costo Total *** (3) TOTAL DOCTOR'S RATES PLANTATION BROWARD GENERAL MEMORIAL REGIONAL P. BCH. DOCTORS NOTES: * $ 1,800, has been included to TOTAL VAGINAL or C-SECTION COST to pay for: PEDIATRICIAN (NEONATOLOGIST) FEES, ANESTHESIOLOGY FEES and ANALYSIS (PATHOLOGY). ** RATES are for HEALTHY PREGNANCY and SUBJECT TO PRICE CHANGE AT ANY TIME WITHOUT PREVIOUS NOTICE. *** Packet for Vaginal Delivery at Maternities include: Total Prenatal Care; Prenatal Vitamins; All Routine Labs; Two Sonograms; Childbirth Classes. Vaginal Delivery at Birth Center; 1 Home visit after Delivery; 4 Post Partum Visits; PKU Infant Screening & New Born Hearing Test. (1) In case C-Section is needed, patient will be transferred to either Jackson South Hospital or North Shore Hospital. (140 NE 119 St. Miami, 33161). Web site: www.miamib 11 (2) In case C-Section is needed, patient will be transferred to either Jackson North or South. (3408 W 84 St.Ste 114. Hialeah, Fl 33018). Web site: www.MoMmaternitycenter. (3) In case C-Section is needed, patient will be transferred to Hollywood Memorial Regional. (2316 Hollywood Blvd. 33020). Web site: www.hollywoodbirthcenter.com Example of Costs on Labs & Diagnostics Services ProMedical Cost Occult Blood CBC TSH HIV Conventional PAP Urinalysis Profile Glucose Level Prostate Specif.Antigent Liver Panel Comprehe. Metabolic Panel Mammogram Chest X Ray Foot or Hand X Ray Abdominal Ultrasound Pelvic Ultrasound Tran rectal Ultrasound Electrocardiogram $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 10 10 30 25 50 10 10 25 20 15 50* 40 35 80 80 80 20 Regular Cost $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 45 45 100 70 120 50 35 60 55 60 150 100 80 330 230 190 85 Note: In every case the doctor will determined which lab services will be performed (*) Price in Palm Beach is $ 85. 12 URGENT CARE CENTERS Now with 30 Locations to better serve your needs: Miami-Dade (11) Locations • Miami • North Miami Beach • Hialeah • Aventura • Kendall Broward (13) Locations • Hallandale • Weston • Pembroke Pines • Fort Lauderdale • Lauderhill • Plantation • Tamarac • Coral Springs Palm Beach (6) Locations • Boca Raton • Delray Beach • Royal Palm Beach • Lake Worth • Wellington (See detailed addresses and phone numbers, as well as Hours of Operation and Fee Schedule on PCP Directory). 13 M o n t h l y R a t e s (Effective July 01, 2009) 1. Individual 1st. Person 2nd. Person 3rd. Person 4th. Person Additional Person 2. ProDental Plus 3. Application Fee: ProMedical Plan ProDental Plus Medical & Dental Plans Total $ $ $ $ $ Medical & Dental Plans Accumulated 65 44 15 15 15 $ $ $ $ 65 109 124 139 $ 10 Individual $ 13 Per Family $ 35 per Application $ 10 per Application The Dental Plan is included in the Medical Plan. When the dental Plan is sold alone, the Application Fee will, be $ 10. 14 Documentation Needed to Affiliate Members Individuals a. Application signed by the Member b. Bank draft form signed c. Credit Card or Debit Card number with expiration date d. Initial Payment IN EVERY CASE, A PAYMENT FOR THE FIRST TWO MONTHS SHOULD BE INCLUDED WITH EVERY APPLICATION. 15 SALES COMMISSIONS INDIVIDUALS or GROUPS 100 % of one monthly payment, PLUS 100 % of Application Fee, PLUS 5 % Bonus for Renewals, every month as long as the member remains in the Plan (*) 16 Compensation • Check disbursement: Applications should be submitted on a weekly basis, every Thursday before 12pm. The agents will receive their checks by mail one week after the date of submission. Commissions for renewals will be paid the 25th of every month, starting on the third month, this applies to overrides as well. • Last day of submission: The 25th of every month (or the last business day before the 25th,) is the last day to submit applications, so that the new members could become effective the 1st of the following month 17