Health Insurance – Frequently Asked Questions (FAQs)

General

1. What health insurance options are available through Capital Group?
   Employees can choose from a range of plans, including PPOs, HMOs, High Deductible Health Plans (HDHPs), and plans paired with Health Savings Accounts (HSAs).

2. Why is health insurance offered through the benefits marketplace?
   Health insurance helps employees protect themselves and their families from unexpected medical costs, with the convenience of group pricing and payroll-deducted premiums.

3. Who is eligible for coverage?
   Typically, full-time employees are eligible, and coverage may also be available for spouses, partners, and dependents. Eligibility requirements are outlined in your employer’s benefits package.

Coverage

1. What does health insurance cover?
   Coverage varies by plan but generally includes doctor visits, hospital care, preventive services, prescription drugs, and wellness programs.

2. Does preventive care cost extra?
   No. Preventive services (like annual check-ups, vaccines, and screenings) are usually covered at no cost when using in-network providers.

3. Can I keep my current doctor?
   Yes, as long as your provider is in the plan’s network. You can check provider directories online or through the Capital Group portal.

4. What if I need care when traveling?
   Most plans include nationwide or emergency coverage when outside your home network area.

Costs & Enrollment

1. How much does health insurance cost?
   Costs depend on the plan you choose, your level of coverage (employee only vs. family), and whether your employer contributes to premiums.

2. Are premiums deducted from my paycheck?
   Yes. Premiums are typically deducted automatically through payroll, making payment simple.

3. What is the difference between a deductible, copay, and coinsurance?

• Deductible: The amount you pay before insurance begins covering major costs.

• Copay: A set fee for services (like a $20 doctor visit).

• Coinsurance: The percentage of costs you pay after the deductible is met.

Enrollment & Changes

1. When can I enroll?
   You can enroll during your employer’s open enrollment period or within 30 days of a qualifying life event (marriage, birth, adoption, loss of other coverage).

2. Can I change my plan mid-year?
   Only if you experience a qualifying life event. Otherwise, changes can be made during open enrollment.

3. Can I cover my family?
   Yes. Most plans allow you to enroll a spouse, partner, and/or dependents.

Support

1. How do I get help choosing a plan?
   Capital Group provides licensed benefits advisors and online tools to help compare plans and choose the best option for your needs.

2. Who do I contact with questions about claims or coverage?
   You can contact Capital Group customer support via phone, online portal, or mobile app for assistance.