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Broker 2018 Heli

Memorial Hermann Health Plan

By aligning care delivery, physicians and health insurance, Memorial Hermann has created an integrated health system unique to Houston.

We're committed to delivering better coordinated care, through technology, service, and experience at an unmatched price and value from one of the most trusted names in Houston healthcare.

A One-Sheet Guide to 2018

To help guide you as you plan for 2018, we have created this handy one-sheeter for your reference. It highlights important aspects of our 2018 plans and provides a Pharmacy Benefit update.

Eligibility Guide - Small Group

We're often asked about eligibility restrictions when quoting a new group. We hope these visual aids will help identify the plans that employers and their employees are eligible.



Discontinued Plans - Small Group

The following Small Group plans have been discontinued for 2018.



  • Select Silver 4000 H.S.A. HMO

  • Select Bronze 6550 H.S.A. HMO

  • All Small Group PPO plans with the exception of Select Gold 2000 PPO

New Plans for 2018 - Small Group

We're excited to introduce the following new Small Group plans for 2018.

BenefitsSelect Platinum 500 HMOSelect Gold 1000 HMOSelect Silver 3000 HSA HMO
In-Network Deductible$500$1,000$3,000
Family Deductible
(for display only)
$1,500$2,500$9,000
Out-of-Pocket Maximum (Individual)$1,500$4,750$4,500
Out-of-Pocket Maximum (Family)$4,500$9,500$9,000
Member Coinsurance10%20%0%
PCP$15$25No charge after deductible
Specialist$30$50No charge after deductible
Telemedicine/TelehealthNo chargeNo charge$40
Urgent Care$50$50No charge after deductible
Emergency Room$400 then 20% Coinsurance$400 then 20% CoinsuranceNo charge after deductible

Plan Grid - Small Group

A draft version of our Small Group Plan Grid is now available. This is a draft and is not yet approved by TDI.

Eligibility Guide - Large Group

We're often asked about eligibility restrictions when quoting a new group. We hope these visual aids will help identify the plans that employers and their employees are eligible.



  • Large Group - Headquarters is located within Harris, Montgomery or Fort Bend county.

  • Large Group - Headquarters is located within Brazoria, Galveston, Walker or Wharton county.

Discontinued Plans - Large Group

The following Large Group plans have been discontinued for 2018.



  • Select 5000-100 HMO

  • Select 002 PPO

  • Select 500–80 PPO

  • Select 2000–100 PPO

  • Select 2500–70 PPO

  • Select 3000–100 PPO

  • Select 5000–70 PPO

  • Select 5000–100 PPO

  • Select Standard Copay PPO

  • Select 3000-100 H.S.A. PPO

  • Select 5000-100 H.S.A. PPO

New Plans for 2018 - Large Group

We're excited to introduce the following new Large Group plans for 2018.

BenefitsSelect 500-80
HMO
Select 1000-80 HMOSelect 1500-80 HMOSelect 2000-80 HMO
In-Network Deductible$500$1,000$1,500$2,000
Family Deductible
(for display only)
$1,000$2,000$3,000$4,000
Out-of-Pocket Maximum (Individual)$3,500$4,000$5,000$5,000
Out-of-Pocket Maximum (Family)$7,000$8,000$10,000$10,000
Member Coinsurance20%20%20%20%
PCP$25$25$25$30
Specialist$50$50$50$60
Telemedicine/TelehealthNo chargeNo chargeNo chargeNo charge
Urgent Care$50$50$50$50
Emergency Room$250 then 20% Coinsurance$300 then 20% Coinsurance$300 then 20% Coinsurance$300 then 20% Coinsurance


BenefitsSelect 2500-80 HMOSelect 4000-80 HMOSelect 5000-80 HMOSelect 5000-100 HSA HMO
In-Network Deductible$2,500$4,000$5,000$5,000
Family Deductible
(for display only)
$5,000$8,000$10,000$10,000
Out-of-Pocket Maximum (Individual)$5,500$6,350$6,350$6,350
Out-of-Pocket Maximum (Family)$11,000$12,700$12,700$12,700
Member Coinsurance20%20%20%0%
PCP$30$35$35No charge after deductible
Specialist$60$70$70No charge after deductible
Telemedicine/TelehealthNo chargeNo chargeNo charge$40
Urgent Care$50$50$50No charge after deductible
Emergency Room$300 then 20% Coinsurance$350 then 20% Coinsurance$350 then 20% CoinsuranceNo charge after deductible

Plan Grids - Large Group

Draft versions of our Large Group HMO Plan Grid and Large Group PPO Plan Grid are now available. These documents are a draft and are not yet approved by TDI.


Best Practices

We've also pieced together a variety of Best Practices for New Business Submissions. These tricks and tips will help us achieve smoother on-boarding processes in 2018.


Applications

All HMO Group Applications must also complete the following Disclosure Form.


Pharmacy Resources


Other Important Documents

Finally, below are other important documents designed to help you get 2018 off to a great start.