Assurant has announced they are leaving the health insurance market after 2015.
Frequently Asked Questions and press release regarding Assurant’s exit from health insurance.
Assurant Health is the brand name for products underwritten and issued by Time Insurance Company, John Alden Life Insurance Company, and Union Security Insurance Company. Assurant Health plans are offered throughout California. They do not offer health plans through Covered California that would be eligible for ACA tax credits.
Assurant California Individual and Family Health Plans
One of Assurant Health’s big selling features is their large network of providers. They have contracted with Aetna Signature Administrators to offer possibly the largest network of doctors and hospitals throughout California with most of their health plans. The large provider network reduces the potential for receiving health care services from an out-of-network provider which invariably costs more money. All of the Assurant plans are Preferred Provider Organization or PPO plans.
Standard Benefit Designs
While Assurant offers a standard benefit design health plans that mirror health plans found on Covered California (Bronze, Silver, Gold and Platinum), they also offer different variations upon the standard metal tier levels. In addition to the standard benefit designed health plans, Assurant offers five other Bronze plans and three other Silver plan benefit designs.
Alternate Benefit Designs
But don’t expect is big premium discount on the alternate plan designs as they still have to meet the actuarial value of their respective metal tier levels. However, there may be some variations with the alternate plan designs that can be helpful for certain health care situations such as the Bronze 4 and 5 Assurant plans which include a separate pharmacy deductible and set copayments for Brand name prescriptions.
Summary of Benefits and Plan Documents
The plan documents are provided for reference only. For a complete listing of benefits, exclusions and limitations, refer to the issued contract. In the event there are discrepancies with the information in the plan documents, the terms and conditions of the issued contract will govern. Summary of Benefits and Coverage (SBC) reflects the Aetna Signature Administrators PPO network. Additional networks may be available in some markets. View your quote summary and policy details for PPO information specific to your plan.
File name nomenclature
Assurant Metal Tier Plan Number Deductible/Copay
- Metal Tier level of Bronze, Silver, Gold, or Platinum
- Plan number 1 – 6
- If present, a large number such as 6000 indicates the deductible.
- A split number such as 5000/25 represents the deductible followed by either the office copayment amount or office visit coinsurance amount.
- Gold and Platinum plans followed by 20, 25, or 30 represents the office visit copayment or coinsurance amount.
Assurant Summary of Benefits
- Assurant Bronze 1 6000 (520.0 KiB)
- Assurant Bronze 2 5000/35 (478.8 KiB)
- Assurant Bronze 3 2600 (473.0 KiB)
- Assurant Bronze 4 5000/25 (517.7 KiB)
- Assurant Bronze 5 3500 (708.9 KiB)
- Assurant Bronze 6 4500 (441.7 KiB)
- Assurant Gold 2 - 25 (452.9 KiB)
- Assurant Gold 3 - 30 (434.6 KiB)
- Assurant Platinum 2 - 25 (435.8 KiB)
- Assurant Platinum 3 - 20 (434.6 KiB)
- Assurant Silver 1 3500 (457.8 KiB)
- Assurant Silver 2 2000/30 (436.7 KiB)
- Assurant Silver 3 1250 (434.5 KiB)
- Assurant Silver 4 1850 (438.8 KiB)
- Assurant Silver 5 2000/45 (435.9 KiB)
Assurant Plan Documents
The Plan Documents are similar to the Evidence of Coverage, Certificate of Coverage, Member Agreement for other carriers. The documents give the general outline of the plan, restrictions, exclusions, plus right and responsibilities of the plan members.
- Assurant Bronze 1 6000 Plan Document (1.1 MiB)
- Assurant Bronze 2 5000/35 Plan Document (1.1 MiB)
- Assurant Bronze 3 2600 Plan Document (1.1 MiB)
- Assurant Bronze 4 5000/25 Plan Document (1.1 MiB)
- Assurant Bronze 5 3500 Plan Document (1.1 MiB)
- Assurant Bronze 6 4500 Plan Document (1.1 MiB)
- Assurant Gold 2 25 Plan Document (1.1 MiB)
- Assurant Gold 3 30 Plan Document (1.1 MiB)
- Assurant Platinum 2 25 Plan Document (1.1 MiB)
- Assurant Platinum 3 30 Plan Document (1.1 MiB)
- Assurant Silver 1 3500 Plan Document (1.1 MiB)
- Assurant Silver 2 2000/30 Plan Document (1.1 MiB)
- Assurant Silver 3 1250 Plan Document (1.1 MiB)
- Assurant Silver 4 1850 Plan Document (1.1 MiB)
- Assurant Silver 5 2000/45 Plan Document (1.1 MiB)
Some plans are no longer marketed for 2015. Those include: Bronze Plan 001 One Deductible, Bronze Plan 002 One Deductible, Gold Plan 001, andPlatinum Plan 001.
Children’s Dental and Vision
All plans come with embedded pediatric dental and vision for dependent children under 19 years old.
Assurant Drug Formulary
The Assurant Health prescription drug coverage is slightly different from some of the other health plans. Instead of numeric tier level, Assurant groups prescription drugs into
- Generic (G)
- Preferred Brand name (P)
- Non-Preferred Brand name (N)
- Medical (MED)
Medical drugs are subject to the medical deductible and coinsurance, regardless of plan type. Copays do not apply to these drugs. For example, Orencia for the treatment of moderate to severe rheumatoid arthritis is a MED level drug. Because Assurant uses this drug formulary across different categories of health plans, the copayments are listed on the member’s ID card. Assurant uses CVS/Caremark pharmacy benefits manager.
Assurant Dental Indemnity Plans
For additional information and summary of Assurant dental plans for individuals and families please visit by Dental Page.
- Assuranct Level 1 DOOC CA (104.6 KiB)
- Assurant Claim Form Dental (96.2 KiB)
- Assurant Dental Indemnity Comparison (375.5 KiB)
- Assurant Level 2 DOOC CA (104.6 KiB)
- Assurant Level 3 DOOC CA (109.9 KiB)
- Assurant Summary Dental Benefits (91.9 KiB)
- Dental Rate Sheet (73.6 KiB)
Additional files pertaining to Assurant Health Savings Accounts, qualifying events for special enrollment periods, California plan variations.
- Asssurant Childrens Dental Vision 2015 (466.9 KiB)
- Asssurant Drug Step Therapy (393.2 KiB)
- Assurant CA Metal Plan Summaries 2015 (1.5 MiB)
- Assurant CA Metal Variations (119.0 KiB)
- Assurant CA Plan Variations (99.0 KiB)
- Assurant Drug Formulary 2015 (6.7 MiB)
- Assurant HSA Qualified Expenses (101.1 KiB)
- Assurant OTC Claim Form (72.7 KiB)
- Assurant QLE SEP 2015 Guide (505.3 KiB)
- Assurant Qualifying Life Event List (51.7 KiB)
For a quote on Assurant health insurance please visit this line: Assurant Health Plan Quote