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Sterling Benefit Solutions, a limited medical indemnity benefit plan, gives employers an opportunity to provide real, meaningful medical insurance to their employees without facing skyrocketing expenses.

See the Frequently Asked Questions (FAQ) section to get additional insight into the value of this program to you and your employees

By offering benefits with defined coverage limits at a fixed cost, Sterling Benefit Solutions plans provide a viable, affordable benefit to offer valuable employees. Consider just a few of these advantages:

FLEXIBLE

• Unlimited plans offering a range of coverage's.
• Self-funded plans available.
• Optional benefits like vision, dental and disability benefits
• GAP/HSA plans available.
• Customized plans available for large employees.

• Continuing inflation of medical cost
• Increasing prevalence of high deductible full coverage group medical insurance plans
• 42 million Americans who currently do not have medical insurance.

Inflation
Group medical premiums are doubling every four or five years because of inflationary effects of the medical sector.  Many companies and their employees are unable to absorb the increased costs of premiums, prompting them to drop out of group medical programs altogether, or to “carve out” previously eligible employees.

Rising Deductibles
Because of recent premium increases in full coverage group medical plans  insurers have applied higher deductibles in order to hold down the cost of insurance to the employer. Deductibles of $1,500 to $2,500 have become commonplace.

Uninsured Workers
There is also an increasing trend in the American workplace to hire “permanent part-time” employees to lower the costs of labor, since many such employees are not eligible for “benefits”. Rising demand for these employees forces employers to compete for them.

the Solution
The Sterling Benefit Solutions Plan mitigates these issues by giving employers an opportunity to provide medical insurance to employees affordably.  This strategy helps employers attract and retain a solid, permanent part-time workforce without facing the costs associated with catastrophic group plans.

Many companies struggle with providing insurance benefits to their employees, due to factors such as:

• Part-time, permanent part-time, and seasonal employees
• Ever-increasing Premiums
• Previously eligible employees are "classed out" of current coverage to cut costs
• Employees that can’t afford or are not eligible for core plans
• High deductibles that are rising each year to help contain cost

The Sterling Benefit Solutions Plan eliminates these issues by giving employers an opportunity to provide medical insurance to employees affordably. This helps companies:

• Attract and retain a solid, permanent part-time workforce
• Prevent the "classing out" of eligible employees
• Provide an alternative to employees who can’t afford core plans
• Save money by avoiding the costs associated with catastrophic group plans.

Our Plan is a perfect option for industries such as hotels, restaurants, nursing homes, retail chains, convenience stores, manufacturing, call centers, placement / staffing companies, distribution centers… not to mention for any company looking to save money.

Our list of plans and options allows a “custom fit” of benefits at a low, fixed cost with no deductible. Please review our Plan Options and Rate Page to learn more about how Sterling Benefit Solutions can help you.

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American Sterling plans are approved for each of the states indicated below.   For information about plans in states that are not approved, please Contact Us for available options.

What types of medical expenses are covered?
All Sterling Benefit Solutions Plans provide set coverage for benefits such as doctor’s office visits, wellness visits, hospitalization room & board, and more. To learn more about the variety of available plans, as well as expenses covered under each one, please visit our Plan Options page.

Do you have a list of doctors or hospitals that I must use?
Sterling Benefit Solutions allows employees to visit ANY licensed health care provider – there are no restrictions. Some plan designs are eligible for a national PPO discount if the Employer chooses to provide one.

Are pre-existing medical conditions covered?
Limitations on pre-existing conditions may be waived for groups with 25 or more covered employee's. Please see our Eligibility and Underwriting Guidelines.

Who is eligible for coverage?
Sterling Benefit Solutions has minimal and easy-to-understand eligibility requirements.  Review the Eligibility and Underwriting Guidelines document for more information.

Can insured users with separate health insurance use your plans?
Yes. Employees covered by Sterling Benefit Solutions receive the set amount listed on our Plan Options page in addition to any coverage provided by separate health insurance.

May I obtain coverage for my dependents?
Yes. Each plan can be customized to cover spouses, children and maternity.

How do I get reimbursed for my medical expenses?
Most healthcare providers will file a claim for their services. If the bill exceeds the set coverage amount, the employee will be billed for the difference. If the bill is for less than the coverage amount, the employee will be paid the difference. If the provider does not accept the assignment of benefits, the employee will be responsible for payment, and must personally file a claim with American Sterling.

How does enrollment work?
Typically, eligible employees can sign up for coverage during a 30-day enrollment period. Employees that request coverage after this 30-day period must provide evidence of insurability. Employees hired after this enrollment period must enroll within 30 days from the end of any waiting period after their date of hire.

When does coverage end?  Can an employee cancel coverage any time?
Coverage ends when any employee or dependent no longer qualifies for coverage, when the plan is cancelled, or when premium payments stop. An employee can cancel coverage at any time.

What about COBRA and HIPAA administration?
All Sterling Benefit Solutions Plans are exempt from HIPAA.  COBRA administration services are available if the employer has signed a COBRA services agreement with American Sterling Insurance Services.

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FORM INDEX:	New Group Approval Form	Employer Application Form	Employee Application Form
Medical Claim Form