/pages/newbiz/splash.twig

Benefits Proposal for Dharma Initiative

Effective Date: 06/21/2026

Broker: Jack Gordman
Prepared by: Morgan White Group

502 Court Street, Suite 241 • Utica, New York 13502

/pages/newbiz/details-fl.twig

Premium Saver Plan Dharma Initiative

Current Plan Integrated Health Plan

Deductible: $500 / Coinsurance: 90%/10% to $2,500

Current MM Rates # on Plan Total Monthly Premium
Employee $0.00 30 $0.00
E + Spouse $0.00 0 $0.00
E + Child(ren) $0.00 0 $0.00
Family $0.00 0 $0.00
Total     $21,579.59

Renewal Plan Integrated Health Plan

Deductible: $1,000 / Coinsurance: 80%/20% to $2,000

Renewal MM Rates # on Plan Total Monthly Premium
Employee $0.00 30 $0.00
E + Spouse $0.00 0 $0.00
E + Child(ren) $0.00 0 $0.00
Family $0.00 0 $0.00
Total     $21,579.59

Alternate Major Medical Plan lower cost high deductible plan by United Health Care

Deductible: $5,000 / Coinsurance: 100/0% to $1,250

Premium Saver AmFirst Insurance Company

Deductible: $500 per person
Coinsurance: 50% to $1,000
Benefit: $4,750
Office Copay: $30
Outpatient RX Benefit:
(see attached plan description)
Alternate Plan MM Rates Premium Saver Rates Total w/PS # on Plan Total New Monthly Premium
Employee $0.00 + $142.12 $142.12 30 $4,263.60
E + Spouse $0.00 + $278.89 $278.89 0 $0.00
E + Child(ren) $0.00 + $263.15 $263.15 0 $0.00
Family $0.00 $404.96 $404.96 30 $0.00
Monthly Totals $16,422.22 $4,263.60     $20,685.82

Total Monthly Savings

$893.77

Total Annual Savings

$10,725.24

1st Month PS Premium

$4,263.60

Alternate major medical rates could be an estimate. Actual rates are based on the major medical carrier's actual quote.

/pages/newbiz/explanation-fl.twig

Premium Saver Plan Dharma Initiative

How this plan works

Supplemental Plan Deductible and Coinsurance

Each insured person has a $500 annual deductible. After the deductible is met the insured person pays 50% until they pay $1,000 coinsurance. This plan wraps around your high deductible health plan and pays the amount applied to your major medical plan's Deductible, Coinsurance and Copayment until our payments reach the Maximum Benefit Amount.

Coverage

This plan covers all eligible expenses covered by your major medical plan.

Office Copay

After the insured person pays a $30 copay per office visit for the professional fee of a primary care physician or specialist in a doctor's office or medical clinic, this plan will cover the balance in full up to 6 visits per person per benefit year. The supplemental plan deductible and coinsurance described above apply to all charges except professional fee of a primary care physician or specialist in a doctor's office or medical clinic.

Prescription Drug Benefit (see attached plan description)

Max Benefit Amount

$4,750 is the maximum benefit amount payable for benefits described on this page during a benefit year for each Insured Person. The Prescription Drug Benefit described on attached page has a separate benefit amount.

Monthly Rates* (12 Mo Rate Guarantee)

Employee $142.12
E + Spouse $278.89
E + Child(ren) $263.15
Family $404.96

* Monthly rates include a non-commissionable $1.00 association fee for prescription drugs.

Participation requirements: All persons covered by the group major medical or comprehensive health plan must be covered by the Premium Saver Plan except when the HSA is funded.

This is a brief description of coverage, see policy for complete details.

/pages/newbiz/exclusions-fl.twig

Premium Saver Plan Dharma Initiative

Premium Saver Exclusions and Limitations

The Policy will pay no benefits for any expenses which result from:

  1. Professional fees for services performed in a doctor's office or medical clinic;
  2. Outpatient prescription drugs;
  3. Participation in a riot, civil commotion, civil disobedience, or unlawful assembly (This does not include a loss which occurs while acting in a lawful manner within the scope of authority.);
  4. Commission of a felony;
  5. An act of war, whether declared or undeclared while serving in the military service or any auxiliary unit attached thereto, or while performing police duty as a member of any military or naval organization. This exclusion includes Accident sustained or Sickness contracted while in the services of any military, naval, or air force of any country engaged in war. We will refund the pro rata unearned premium for any such period the Covered Persons is not covered;
  6. Accident or Sickness arising out of and in the course of any occupation for compensation wage or profit. This does not apply to sole proprietors not covered by Workers' Compensation;
  7. Any dental services, including treatment, surgery, extractions, or x-rays, unless: (a) Resulting from an Accident occurring while the Covered Person's coverage is in force and if performed within 12 months of the date of such Accident; or (b) Due to congenital disease or anomaly of a covered newborn child;
  8. Any expenses incurred for eye exams, eye refractions, eye glasses, contact lenses, or the fitting thereof, or elective surgery performed for the correction of vision;
  9. Routine examinations, such as health exams, periodic checkups, or routine physicals unless covered by an optional Rider;
  10. Any expense for which benefits are not payable under the Covered Person's Other Medical Plan;
  11. Any expense that does not meet the definition of Covered Charges;
  12. Expense or service that exceeds the Maximum Benefit Amounts, as shown in the Schedule of Benefits;

/pages/newbiz/payment-fl.twig

Premium Saver Plan Dharma Initiative

Claims Payment

The Premium Saver Plan pays the benefits directly to the provider. Paying the provider directly saves the insured time and it is the quickest way for the provider to receive payment.

Claims Submission (two methods)

Please note: Always give your Premium Saver insurance card to the provider.

A. The Medical Provider files the claim.

This is the easiest and best method to submit a claim.

Electronic Claims Submission

Claims can be filed electronically by the provider. This means no paperwork and quick payment of your claim to the provider. We are contracted with some of the largest claims clearinghouses in the country.

Email, Mail or Fax Claims Submission

Providers can email, mail or fax your claim information to us if they are not contracted with our clearinghouses. We will be glad to contact providers that want to contract with our clearinghouses.

B. The Insured will file the claim.

If the insured files the claim, they need to submit the two forms described below:

Major Medical EOB

The Explanation of Benefits is a form provided by your major medical carrier that describes the proc­edures covered, facility used, benefit paid and the amount applied to the insured's deductible or coin­surance.

Hospital form UB04 or Doctor form CMS 1500

These forms describe the procedures codes, provides us with the address and the provider's federal ident­ification number so we can pay the claim for you.


Contact Us

Physical Address:
AmFirst Insurance Company
500 Steed Road
Ridgeland, MS 39157
Statutory Home Office:
AmFirst Insurance Company
201 Robert S. Kerr Avenue, Suite 600
Oklahoma City, OK 73102
Phone: 1-888-888-2519
Email: claims@morganwhite.com

Administered by:

Underwritten by: