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The Real Problem with Health Care

Patient/Physician Cooperatives (PPC) was established in 2005 by TBT. It is a non-profit association. The Association gets fair prices for its members on health-related products and services. It is not insurance. Health Care and Fitness Providers work together to give members access to affordable, basic health care and health club services through cooperation and mutual support. Health Care, Health Clubs and Association Group Insurance are all included. Association Membership Benefits Prescription Drug Discounts save up to 15%-80% on prescription drugs. Accepted at over 60,000 pharmacies. Lab Tests: PPC partners exclusively partners Clinical Pathology Laboratories (CPL) or Quest depending on the member’s choice. The payment plan from these laboratories covers 100%. Their retainer is included in the basic membership services. Patient Advocacy PPC will allow you peace of mind by providing Patient Advocacy to properly guide you through the system by mediating and negotiating reduced medical bills and expenses on your behalf. Indemnity and Stop Loss Insurance Provided to Association Members that Participate in Executive Plan the Physician Association that contracts with PPC purchases a stop loss agreement from Partner’s Re that covers 90% medical and hospital expenses excess of $50,000 up to a maximum of $5,000,000. PPC members may elect to be covered under that policy. Also, an indemnity policy from Pan American Life is included to cover hospital expenses, medial accident, accidental death and life insurance. The details of the policy are in the Pan American state approved brochure. Health Club Membership Assistance The Downtown Club and the Met are included for access to fitness and exercise programs. Both clubs are part of a national network owned by Club Corp which includes over 200 clubs in the United States. PPC members have an option to upgrade to a O.N.E. membership with Club Corp for access to their national network for golf, tennis, dining and extensive travel benefits. These are among the best clubs in the world. Concierge Primary Care and Imaging Services PPC will establish a monthly payment plan with your selected primary care provider and imaging clinic so that there are no added charges when you use their services. Specialist Retainer Services PPC will establish a monthly payment plan with specialists that the member may need to see: Cardiology, Pulmonology, Ophthalmology, General Surgery, Podiatry, Physical Therapy. Many additional benefits are included in the Basic Plans: Dental, Vision, Hearing, Durable Medical Equipment discounts nationwide 24/7/365 Teladoc nationwide 24/7/365 Road Service nationwide Basic Membership Basic Membership in PPC Nationwide Includes: Affordable Healthcare; Dental, Affordable Healthcare; Vision, Hearing, Roadside Assistance, Teladoc: Telemedicine Services Simplesave RX: Drug Plan PPC: Patient Advocacy Quest or Clinical Pathology Laboratories CPL): Lab tests Health Club ( Downtown Club and The Met) Primary Care Retainer Monthly Payment Plan Specialist Care Retainer Monthly Payment Plan Diagnostic Imaging Retainer Monthly Payment Plan Roadside Assistance Association Group Insurance Pan American Life Indemnity Coverage 0-50,000 Partner’s Re Stop Loss Coverage After 50,000 up the $5,000,000 with a 10% Coinsurance Plan Options (This is not Insurance) $20 one-time enrollment fee per application 1. Basic Membership in PPC Includes: PPC Provider Network Doc Wellbee: Dental discount plan Affordable Healthcare; Vision, Hearing & Roadside Assistance Teladoc: Telemedicine Services Simplesave RX: Prescription discount plan PPC: Patient Advocacy Quest or Clinical Pathology Laboratories CPL): Lab tests Health Club Membership Cost: Adult Child Monthly $40.00 $20.00 2. Concierge Plan: The Basic Membership with Primary Care at $0 copay. Cost: Adult Child Monthly $89.00 $50.00 3. Concierge Plus Plan: The Basic Membership with Primary Care at $0 copay. +Medical Imaging at $0 copay. Cost: Adult Child Monthly $109.00 $75.00 4. Concierge Plus+ Plan: The Basic Membership plus Primary Care at $0 copay +Medical Imaging at $0 copay. +Specialist Clinics at $0 copay Cost: Adult Child Monthly $180.00 $125.00 Association Group Insurance Pan American Life Summary of Indemnity Coverage Policy Number 98210 Inpatient first 20 Days $2,000 each day Intensive care up to 10 Days $4,000 each day Substance Abuse up to 10 Days $1,000 each day Mental Illness up to 20 Days $1,000 each day Skilled Nursing up to 17 days $1,000 each day Inpatient Major Surgical Benefit $3,000 Inpatient Anesthesia Benefit $750 Outpatient Surgical Benefit $1,500 Outpatient Anesthesia $375 Outpatient Surgical Facility up to 2 days $500 each day Outpatient Lab $25 for 3 days Outpatient X-ray $70 for 2 days Outpatient Advanced Studies $300 for 2 days Emergency Room Sickness $200 for 1 day Medical Accident with $100 deductible up to $2,500 Group Term Life Member $5,000 Spouse $2,500 Children $1,250 Infant $200 Accidental Death or Dismemberment $10,000 Cancer $25,000 Cost: Monthly: $96 per person (Maximum charge per family is $288) Partner’s Re Stop Loss Coverage Policy Number 11835 Deductible $50,000 per year Coinsurance 10% Maximum Benefit $5,000,000 per year Cost: Monthly $42 per person Association Group Plans The PPC benefits are used with Association Group Health Plans to lower cost and bring protection against unexpected high costs of hospital and surgical expenses. The hospital indemnity policy is written by Pan American Life and the catastrophic Stop Loss policy is written by Partner’s Re. Both companies are A rated and nationwide. Neither policy has pre-existing conditions exclusions. The retainer plans are $0 copays for primary care and lab. Specialist’s services are at discounted rates like those paid by Medicare or can be on a monthly retainer plan at specific clinics with $0 copay. The Stop Loss Policy from Partner’s Re has a 10% Coinsurance. Employer Sponsored ERISA Trusts (MVP) (The Most Comprehensive Plan)* Hospital Copay $500 Per Day Specialist Copay $25 per encounter Coinsurance 0% Out-of-Network Copay $250 Maximum Benefit Unlimited Pharmacy Copay- $5 Copay generic $50 Copay Brand based on Formulary Cost of Basic Membership and Group Insurance Cost: Member Member & Spouse Member & Children Family Monthly $ 414 $ 828 $ 800 $ 1,365 Bi-Weekly $ 192 $ 384 $ 370 $ 630 Weekly $ 96 $ 192 $ 185 $ 315 Includes Basic Membership and Group Indemnity and Stop Loss Insurance