GAP
| GAP Premiums | |||
|---|---|---|---|
| Monthly Premium: | Ages 39 & Under | Ages 40 - 49 | Ages 50+ |
| Employee Only | $26.46 | $34.16 | $71.64 |
| Emp. + Spouse | $48.63 | $62.77 | $131.60 |
| Emp. + Child(ren) | $64.84 | $81.44 | $126.26 |
| Emp. + Family | $86.42 | $105.81 | $184.68 |
GAP* is a low-cost program designed to reduce your out-of-pocket expenses for hospitalization and listed outpatient services such as surgery.
- GAP pays up to $2,000 towards inpatient charges per covered individual, per plan year.
- GAP pays up to $1,000 towards outpatient charges, up to 3 times per plan year.
*The GAP plan is not available if you are contributing to an HSA.
Quick Links
Claim Submission:
Send Itemized Bill & EOB (Explanation of Benefits) to:
Administrative Concepts Inc.
PO BOX 4000
Collegeville, PA 19426
Customer service number:
888-346-9905
Contact
2023-24 Plan Year:
Chubb Group Customer Service:
(800) 36 CHUBB (24822)