For payments, you have the flexibility to choose between Automated Clearing House (ACH) withdrawal or credit card deduction. Utilizing ACH withdrawal is straightforward, allowing for seamless monthly payments directly from your bank account without any additional fees. Alternatively, if you prefer to use a credit card, please be aware that a 3% processing fee will apply to each transaction. This ensures that you have options to suit your financial preferences while maintaining the convenience of managing your health benefits.

INDIVIDUAL ENROLLMENT (W2, 1099, Part-time) Enrollment for INDIVIDUAL is simple and can be completed in three steps on the AAFD Major Medical Health Benefits Program website: (link here) <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="1" data-aria-level="1"> Select your plan from the available options. <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="2" data-aria-level="1"> See your monthly premium to understand the financial commitment. <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="3" data-aria-level="1"> Enroll yourself and any dependents using the online enrollment process. ENROLL NOW: Click here to enroll Schedule a meeting with Steven Chapkin: https://calendly.com/simplhealth/30min GROUP ENROLLMENT: Available to groups with 2 or more enrolled employees (W2, 1099, Part-time) For groups with 2 or more enrolled employees, the employer submits a census with employee details, selects the plan(s) to offer, and sets the open enrollment date. This streamlined process ensures that all eligible employees can access the benefits efficiently. <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="4" data-aria-level="1"> Employer submits census with employee name, age, dependent tier selection. <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="5" data-aria-level="1"> Employer selects plan or plans to be offered. <li data-leveltext="%1." data-font="Aptos" data-listid="2" data-list-defn-props="{"335552541":0,"335559683":0,"335559684":-1,"335559685":720,"335559991":360,"469769242":[65533,0,46],"469777803":"left","469777804":"%1.","469777815":"hybridMultilevel"}" aria-setsize="-1" data-aria-posinset="6" data-aria-level="1"> Employer sets open enrollment date. GET A QUOTE: aafd.org/healthbenefits/hb-contact Schedule a meeting with Steven Chapkin: https://calendly.com/simplhealth/30min

FAQs – Legacy Group

Q: What is care coordination, and how does it work?

Care coordination is a valuable feature available with the COPAY 3500, 4500, and 8000 plans, exclusively offered through our partner, Clearwater Benefits. If a member permits a Clearwater Concierge Care Coordinator to choose their specialist, hospital, or facility, both the deductible is waived, and they can access services such as hospital stays, surgeries, and CT/MRI scans at no cost.

Q: Are there penalties for pre-existing health conditions?

There are no rate penalties for pre-existing health conditions, allowing members to access coverage without fear of increased costs due to their medical history.

Q: Who can I contact for plan-related inquiries?

For any inquiries related to your AAFD Major Medical Plan, you can schedule a meeting with Steven Chapkin : https://calendly.com/simplhealth/30min

Q: Are there any exclusions or limitations to the coverage?

While the plans provide extensive coverage, it's important to review individual plan documents for specific exclusions and limitations . T here are no rate penalties for pre-existing conditions.

Q: Can I add my family members to the Major Medical Plan?

Yes, you can enroll your dependents by selecting the appropriate dependent tier during the enrollment process.

Q: What services and benefits are covered under the plan?

The plans include a wide range of medical services and benefits. Unique to some plans, if you allow a Clearwater Concierge Care Coordinator to select your specialist, hospital, or facility, the deductible is waived, and the service (hospital, surgery, CT/MRI) is free.

Q: What is the plan year, and how does enrollment work?

All plans operate on a calendar year basis, running from January 1 to December 31. Members may enroll mid-year with a 60-day waiting period effective on the first of the following month. Additionally, an annual open enrollment period occurs during November and December, providing ample opportunity to update or change plans.

Q: Where are the plans available?

Our health plans are available in all 50 states, providing comprehensive coverage options for a diverse population .

Q: What is AAFD's Major Medical Plan and who is eligible?

The AAFD Major Medical Plan offers comprehensive health coverage that complies with ACA standards, powered by Clearwater B enefits and accessible to all members. Clearwater is the health benefits platform of choice for individuals, families, and small businesses nationwide, that gets members into the right plan, at the right price, with total transparency—even if it’s not one of the company’s exclusive offerings. Clearwater offers a full suite of health and benefit options resulting in better plans, better benefits, and better prices.

FAQs

FAQs

What is the process for filing a claim?

What is care coordination, and how does it work?

Are there penalties for pre-existing health conditions?

Who can I contact for plan-related inquiries?

Are there any exclusions or limitations to the coverage?

What is the process for filing a claim?

Can I add my family members to the Major Medical Plan?

What services and benefits are covered under the plan?

How do I pay?

How do I enroll?

What is the plan year, and how does enrollment work?

Where are the plans available?

What is AAFD’s Major Medical Plan and who is eligible?