Harper Resources, LLC

Home  Health Plan Compare  Group Health Plan Comp

HomeHealth Plan CompareGroup Health Plan Comp

Health Plan Choices Made Easy!

Thank you for filling out the form below. The field marked with (*) are required fields. * First Name * Last Name * Address Line 1 Address Line 2 * City State * Zip Postal Code * Telephone Number * Email Address Your Comments * What Type of Plan is this? [Select One]HMOPOSPPONo Network * What level of coverage are you considering? [Select One]SingleEmployee and Child(ren)Employee and SpouseFamily * Enter an amount in dollars and cents ($000.00) that will be with held from your pay check per pay period: * How often are you paid? [Select One]WeeklyEvery Two WeeksTwice per month (Usually on the 15th and 30th)Monthly * Enter the Amount of Copay Required for a visit to your primary care physician: [Select One]This is a no Copay Plan$5.00$8.00$10.00$12.00$15.00$20.00$25.00$30.00$35.00$40.00$45.00$50.00 * Enter the Amount of Copay Required for a visit to your specialist physician: [Select One]This is a no Copay Plan$5.00$8.00$10.00$12.00$15.00$20.00$25.00$30.00$35.00$40.00$45.00$50.00 * Does your prescription drug plan have a deductible? Yes No * Is the Rx deductible applied per person? Yes No * Is the Rx deductible separate from the Medical deductible? Yes, I have to satisfy an Rx deductible that is separate from the deductible for medical costs. No, the costs for drugs is applied to the overall deductible. * What is the amount of the Rx deductible? [Select One]$50$75$100$125$150$200$225$250$500$750$1,000 * What is the deductible for medical costs incurred? (These costs are not covered by copays.) [Select One]$100$200$250$300$400$500$750$1,000$1,200$1,500$1,700$1,750$1,800$2,000$2,250$2,500$3,000None of the above * Is the deductible applied per person in your family? Yes No * What is the maximum number of family members that can incur deductibles? 2 3 4 5 * What is the maximum amount of out of pocket medical costs that can be incurred by you after you have met your deductible? [Select One]$100$200$250$300$400$500$750$1,000$1,200$1,500$1,700$1,750$1,800$2,000$2,250$2,500$3,000None of the above * What is the maximum number of people in your family that can incur the maximum costs beyond the deductible? 2 3 4 5