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What is Supplemental Medical GAP Insurance?

What is Supplemental Medical (GAP) Insurance?

With the high costs of medical care, employers and hardworking employees are looking for ways to save money. A supplemental medical group insurance plan (known as GAP) is a company sponsored benefit that enhances the company’s high deductible health plan (HDHP). GAP benefits work in conjunction with HDHP and cover deductibles, co-pays, and coinsurance.

GAP reimburses eligible out-of-pocket medical expenses incurred under the group’s HDHP, such as deductible, copays, and coinsurance.

GAP has practical purposes for both employees and employers:

  1. It is an insurance plan that can provide first dollar coverage for employees and their out-of-pocket medical expenses.
  2. Incentivizes employee retention as an added health benefit.

Offer Your Employees Voluntary Benefits

Our benefits are fully-customizable and tailored to help address groups' specific needs.

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“Only 39% of US adults say they could cover the cost of a $1000 emergency room visit using savings.”

Easy enrollment

When a business decides to offer GAP as a benefit available to its employees, it is a great opportunity for people to sign up easily without the usual requirements individual GAP enrollment requires.

GAP under a group plan has different features as part of the benefit.2

  • It is guaranteed issue - as group coverage there are no limitations on who is eligible.
  • There are no medical questions - pre-existing health conditions are accepted.
  • There may be optional dependent coverage - adding your spouse and/or children.
  • Simplified administration - usage of the plan is easy and directly reimburses either the provider or employee.

For an employer to provide GAP to employees, they must provide major medical insurance.

Offer Your Employees Voluntary Benefits

Our benefits are fully-customizable and tailored to help address groups' specific needs.

Explore Our Solutions 

In consideration of providing GAP to your employees, count the costs of offering your employees a great benefit, and count the benefit of saving money.

How Gap Insurance Works

Major Medical Plan Benefits

Charges

Hospital: $7,105
Office Visit: $435 (not eligible for reimbursement under Gap plan)

Patient Responsibility
(what patient owes after major medical health insurance has paid)

Deductible: $1,200
Co-Insurance: $1,902
Office Visit Co-Pay: $50
Total Patient Responsibility: $3,152

Gap Plan Benefits

Without Gap Benefit

With Gap Benefit

Inpatient: $5,000
Outpatient: $3,000

Gap reimbursement

$0

$3,102

Net out-of-pocket cost
(paid by insured)

$3,152

$50