Sue Fudge Health Plan Director (208) 472-0455

Healthy Employees  Healthy Business
Operating a successful construction business requires the right resources to get the job done. This means healthy, able employees who come to work ready to work. With Idaho AGC  Health Plans, you have an effective, affordable resource for providing comprehensive health benefits for your workers. The Idaho AGC Advantage gives your business affordable access to cost effective medical, dental, vision and life benefits for employees and their families. With a variety of plans to choose from, your business can enjoy highly competitive medical plan rates that keep employees healthy and productive. Coupled with dental and vision benefits, Idaho AGC gives you the resources your business needs to succeed. Contact Sue Fudge, Idaho AGC Health Plan Director, to enroll - (208) 344-9755.

"Health benefits designed for AGC member businesses"
The Idaho AGC Health Plan offers:

• Competitive, affordable rates
• Broad provider choice through Blue Cross of Idaho’s networks of participating doctors
• Comprehensive dental plans through Delta Dental
• Underwritten financially by stable carriers Blue Cross of Idaho and MetLife Assurance Company
• Responsive customer service and administration by Idaho AGC COBRA Administration
• HIPAA Compliant
• Hour bank option available
• $500 first dollar wellness benefit
• Rx1—$7 generic, 30% brand formulary, 50% nonformulary with $5,000 out-of-pocket limit $1,000 Deductible Plan — Blue Cross of Idaho
• Rx2—$250 deductible on forumulary and non-formulary brand name - $10 generic, $30 brand forumulary, $50 non-forumulary.

AGC 2010 Health Plan Offering

Basic: Medical/Life/STD — Blue Cross of Idaho/Metlife

• $750 individual/$1,500 family deductible
• $30 Primary Care/$45 Specialist office visit copay
• 75%/25% coinsurance in-network
• 55%/45% coinsurance out-of-network
• $3,000 individual/$6,000 family out-of-pocket maximum in-network
• $4,500 individual/$9,000 family out-of-pocket maximum out-of-network
• Rx—$5 generic, 25% brand formulary, 50% nonformulary with $5,000 out-of-pocket limit $1,000 Deductible Plan — Blue Cross of Idaho

• $1,000 individual/$2,000 family deductible
• $30 Primary Care/$45 Specialist office visit copay
• 75%/25% coinsurance in-network
• 55%/45% coinsurance out-of-network
• $3,000 individual/$6,000 family out-of-pocket maximum in-network
• $4,500 individual/$9,000 family out-of-pocket maximum out-of-network 

• $1,500 individual/$3,000 family deductible
• $30 Primary Care/$45 Specialist office visit copay
• 75%/25% coinsurance in-network
• 55%/45% coinsurance out-of-network
• $3,000 individual/$6,000 family out-of-pocket maximum in-network
• $4,500 individual/$9,000 family out-of-pocket maximum out-of-network

• $2,500 individual/$5,000 family deductible
• $30 Primary Care/$45 Specialist office visit copay
• 75%/25% coinsurance in-network
• 55%/45% coinsurance out-of-network
• $3,000 individual/$6,000 family out-of-pocket maximum in-network
• $4,500 individual/$9,000 family out-of-pocket maximum out-of-network

• $5,000 individual/$10,000 family deductible
• $30 Primary Care/$45 Specialist office visit copay
• 75%/25% coinsurance in-network
• 55%/45% coinsurance out-of-network
• $3,000 individual/$6,000 family out-of-pocket maximum in-network
• $4,500 individual/$9,000 family out-of-pocket maximum out-of-network

This is not a policy. Please refer to the actual policy for complete benefits, exclusions, limitations and other general provisions. To learn more about the benefits of working with AGC or obtain a list of brokers, contact the Idaho AGC at (208) 344-9755.

Life Insurance - Met Life

• Short-Term Disability $100 weekly benefit 14/14/13 wk
• $25,000 life insurance
• $25,000 accidental death and dismemberment life insurance
• $5,000 dependent life

AGC Deluxe Plans - Basic Medical/Life/STD with added option of Dental and Vision benefits

Dental — administered by Delta Dental

• $50 Deductible, $150 Family applies to Basic & Major Services
• 100%/80% Preventive Services for 2 exams/cleanings per year (In/Out)
• 80%/80% Basic Services (In/Out)
• 50%/50% Major Services (In/Out)
• $1,000

Vision — administered by Vision Service Plan

• $10 copay for exam
• $20 copay for materials, one set of lenses every 12 months and frames once every 24 months

The Idaho AGC dental and vision plans are self-funded, not insurance and do not participate in the state guaranty association.

All deductibles are effective January 1 through December 31.

Retirement Plans offered by ING

Terms and Conditions

Groups of 2–50 eligible employees are able to purchase health care coverage regardless of health status. An eligible employee is an employee who works at least 30 hours per week. “Family” as mentioned herein refers to dependent coverage. A dependent is:

• a legal spouse
• an unmarried child under the age of 21 years
• an unmarried child who is a full-time student under the age of 25 years and who is financially dependent upon the parent.
• an unmarried child of any age who is medically certified as disabled and dependent upon the parent

Initial premium is established based on expected claims costs as determined by the underwriting information provided by the group. Blue Cross of Idaho’s Underwriting Department may adjust renewal premium for past or expected future utilization. Premium will change for the group as the age and/or number of enrolled members change.
Policies shall be in force and guaranteed renewable unless terminated due to the following:

• termination by the employer without cause with 30 days written notice
• nonpayment of premium
• fraud or intentional misrepresentation of material fact by the employer
• noncompliance of minimum participation requirements set forth by Blue Cross of Idaho

Waiting periods for preexisting conditions will be credited for employees and their dependents who were enrolled under previous qualifying coverage. This is contingent upon the previous qualifying coverage ending not more than 63 days prior to the effective date under this coverage. New enrollees without previous qualifying coverage will be subject to a 12-month waiting period for preexisting conditions. Benefi ts for preexisting conditions may be denied until the member has been enrolled for coverage on this policy for a continuous 12-month period. This waiting period shall not apply to newborn children who shall be covered from the moment of birth or to adopted children or children in the process of adoption who have been placed with the enrolled employee. Preexisting condition means a physical or mental condition, regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received within six (6) months prior to the effective date of this coverage. Genetic information shall not be considered a preexisting condition in absence of a diagnosis of the condition related to such information. A pregnancy existing on the effective date of coverage will not be considered a preexisting condition.

Contact Sue Fudge, Idaho AGC Health Plan Director, to enroll - (208) 344-9755.