An Industry First: Affordable Health Insurance Plans for Fitness Professionals
IDEA® introduces the industry’s first medical and dental health insurance program for fitness pros.
Do you have affordable healthcare coverage? If so, are your benefits meeting your and your family’s healthcare needs?
IDEA recognizes the challenges our members and customers have in finding affordable programs while working as contractors or small-business owners. We are excited to introduce a new program that provides customized and flexible options for fitness professionals.
Among the benefits:
- medical and dental plans
- fitness professional/individual and family plans
- affordable and flexible options
- custom plans for small-business owners and contractors
- year-round enrollment
- telehealth access
- mobile application for anytime access
“IDEA is elated to offer a health insurance program designed with fitness professionals in mind,” says Amy Boone Thompson, vice president and general manager of IDEA Health & Fitness Association. “The timing of this program couldn’t be better, as much of our industry has been impacted by a significant decrease in revenue and loss of jobs. We have reduced any barriers to getting coverage by extending low-cost options with year-round enrollment. IDEA membership is not required. We sincerely hope this program serves the needs of every fitness professional and business owner who is looking for affordable health care.”
As of May 1, 2020, enrollment is open until the 25th of each month for benefits eligibility at the start of the next month. You can enroll in any month of the year.
Frequently Asked Questions
What does this plan cover?
There are four medical plans and two dental plans available. For a more in-depth list of benefits, limitations and exclusions, refer to the Schedule of Benefits on the enrollment site.
Medical Plan #1: Well Premium. This base plan has a $0 deductible and is designed to encompass “everyday” needs.
- Well Premium helps cover primary care and specialist doctor visits, urgent care, labs, radiology, CT/MRI/MRA/PET scans, and prescription benefits for a predetermined copay based on the service.
- It is ACA-compliant, “guaranteed issue” with no preexisting-condition exclusion.
- It includes a mobile application that allows members to store their ID cards on their cellphones.
- Well Premium gives 24/7 on-demand access to board-certified medical providers for minor illnesses and injuries. Providers can call in prescriptions to your local pharmacy.
- It is a PPO plan, which means you can select your own doctor within the network.
- This plan gives access to two networks: Multiplan and First Health Network. For a more in-depth list of benefits, limitations and exclusions, refer to the Schedule of Benefits on the enrollment site.
Medical Plans 2, 3, 4: Medical Enhanced Plans. These three plans are buy-up options for the Well Premium plan. All benefits included in Well Premium are included in the Medical Enhanced plans.
Medical Enhanced plans are designed to cover the majority of medical needs that take place inside a facility. They help to cover hospitalization, in- and outpatient surgery, emergency room visits, dialysis and chemotherapy.
- The three plan options members can choose from are Medical Enhanced 2.5, Medical Enhanced 5.0 and Medical Enhanced 10.0.
- The different numbers (2.5, 5.0 and 10.0) define three different deductible levels.
- Medical Enhanced plans have a 12-month preexisting-condition clause and require preauthorization for some benefits.
To learn more about benefits coverage, limitations and exclusions for all of these plans, please refer to the Schedule of Benefits on the enrollment site.
There are two dental plans available. Each can be purchased in tandem with the medical plans or as a stand-alone dental plan.
- The two dental plans help to cover preventive dentistry at 100%, simple dentistry at 80% and complex dentistry at 50%.
- The percentages refer to how much the plans will pay for the types of service.
- The dental plans access the DenteMax network. To find a provider near you, refer to dentemax.com.
To learn more about benefits coverage, limitations and exclusions for these plans, please refer to the Schedule of Benefits on the enrollment site.
How much do the plans cost?
The pricing for the plans can be found on the enrollment site.
When can I enroll? What are the term requirements?
Members can enroll year-round through the enrollment site. Please note that the calendar-year deductible resets every January 1st.
Are there options, such as family versus individual plans?
Yes. There are four tiers of coverage: Member-only, Member and Spouse, Member and Child/Children, and Member and Family.
Can the policy be extended to IDEA business members and their businesses?
Yes. Anyone can join, including sole proprietors, employees and independent contractors.
Does this program offer vision or life insurance plans?
No. Vision, life and accident plans are not available at this time. We anticipate making them available to you in the near future.
How do the Medical Enhanced plans define a “preexisting” condition?
Any conditions treated 12 months prior to enrollment are excluded from coverage. The Medical Enhanced plans are not the correct options for individuals with a preexisting condition.
Is there a COBRA option?
Members can continue to pay a premium for as long as they wish. The program uses a direct ACH (soon to be credit card) billing system.
How does this option compare with a COBRA plan?
There are over 1,000 COBRA plans in the marketplace, so it is challenging to explain how our plans compare.
What is the likelihood of a premium increase? When would we likely see rate hikes?
If rates increase, it would be on the calendar year. The current pricing is very conservative. The goal is to keep prices flat or even decrease rates once we get a larger pool of participants to spread the risk.
How do I enroll, and when are the enrollment dates?
For more information and to enroll, just visit the enrollment site. Enrollment is open year-round, which means you can enroll at any time. You also can terminate your enrollment at any time throughout the year.
What if I need assistance selecting a plan or want to reach customer service once I sign up? Whom do I contact?
7 a.m.–6 p.m. (CST)
Do I need to be a member of IDEA to enroll for insurance?
No, anyone can join.
What if I am currently covered by another plan but want to choose one of these plans instead?
If you would like to enroll in one of the plans, you can do so. With regard to obtaining instructions on how to terminate your existing coverage, everyone is different, but we recommend reaching out to your human resources or insurance representative or calling the number on your ID card for more information.
What if I am laid off or furloughed? Am I still eligible to participate in these plans?
Yes. Your current job status does not matter. Anyone can join.
More Questions? Check Out This IDEA Webinar
To learn more about the various plans, benefits and enrollment options, watch this informative webinar, hosted by IDEA and our insurance partner.
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