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Patient Physician Cooperatives

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