Agents & Brokers
This section has resources for our Agent Broker Community. Agents and Agencies who would like more information on our plans and benefits.
Click on the link below that is appropriate for your needs.
Should you have further questions or wish to obtain additional information about Total Health Care USA, please do not hesitate to give a call to our Marketing Department at (313) 871-7888 or email us at marketing@thc-online.com
Selecting a Benefit Plan ...
Total Health Care USA offers a variety of benefit options for employers with 2 or more employees located in southeast Michigan. Our marketing staff is available to answer questions and to assist potential clients in selecting the best benefit option for the employer group. Employer groups receive an "adjusted community rate" (ACR) based on anticipated enrollment, industry, and the average age of the group. To generate a quote, we will need a current group census and the primary SIC for the covered population.
Below, you will find the Benefit Plan Descriptions for each series.
- 50 or fewer contracts. Total Health Care USA has pre-packaged and priced benefit plans for commercial groups with anticipated enrollment of 50 or fewer contracts. There are four series to select from, 321 Series, T300 Series, 521 Series or T500 Series. A Deductible benefit option is offered on each of the above series as well. An employer may select a dual option within the series for group coverage.
- 50 or more contracts. Commercial groups with anticipated enrollment of 50 or more contracts may select one of the pre-packaged plans, or reconfigure a benefit option to create an "employer specific" plan. One of our Account Executives will consult with the employer or agent-of-record, to tailor a benefit plan that complies with Michigan's Office of Financial and Insurance Services regulations, and is within the administrative capabilities of Total Health Care.
HMO 
Our Traditional Health Maintenance Organization (HMO) offers comprehensive health care to its members. Preventive and wellness services are emphasized. Each plan gives its members high quality care with an emphasis on prevention, while helping employers contain costs. Our Marketing Department will work with employers and Agents to design a benefit plan that best meets their needs.
HMO: Benefit Plan Descriptions – Grandfathered
HMO: Benefit Plan Descriptions – Non-Grandfathered
HMO Deductible – Grandfathered
- Deductible 521X Benefit Plan Series
- Deductible T-300 Benefit Plan Series
- Deductible 321X Benefit Plan Series
- Deductible T-500 Benefit Plan Series
HMO Deductible – Non - Grandfathered
- Deductible 521X Benefit Plan Series
- Deductible T-300 Benefit Plan Series
- Deductible 321X Benefit Plan Series
- Deductible T-500 Benefit Plan Series
HMO: Member Handbook, Certificates of Coverage - Grandfathered
HMO: Member Handbook, Certificates of Coverage - Non-Grandfathered
Select POS 
Employers and Agents who are looking for cost effective coverage with greater flexibility than our traditional Total Health Care plan, should consider Total Health Care Select. Select is a Point of Service Plan (POS) that combines the comprehensive benefits of our HMO plan with the flexibility of a POS plan. The plan eliminates the need for referrals and allows members to choose a provider at the time of service. Select members can seek medical treatment from within the Total Health Care network at a lower cost. The PPOM (Cofinity) and Out-of-Network options allow members the ability to see any provider, but at a greater out of pocket cost.
POS: Benefit Plan Descriptions – Grandfathered
POS: Benefit Plan Descriptions – Non-Grandfathered
POS: Member Handbook, Certificates of Coverage – Grandfathered
- Member Handbook
- Select HIGH09 Certificate of Coverage
- Select MID09 Certificate of Coverage
- Select LOW09 Certificate of Coverage
POS: Member Handbook, Certificates of Coverage – Non - Grandfathered
PPN (Physician Preferred Network) 
Employer Groups looking for lower out-of-pocket cost, cost effective premiums and still offers flexibility, now has the option in using a specialized point-of-service plan. PPN (Physician Preferred Network) is a high performance physician network composed of specialty physicians that offer members the choice of physicians who practice more efficiently and provides a higher-quality of care. The plan eliminates the need for referrals and allows the member to seek medical treatment within the Total Health Care Network, PPOM (Cofinity) and Out-of-Network.
PPN: Benefit Plan Descriptions – Grandfathered
PPN: Benefit Plan Descriptions – Non-Grandfathered
PPN: Member Handbook, Certificate of Coverage – Grandfathered
- Select/PPN Member Handbook
- HMO/PPN Member Handbook
- Select/PPN Certificate of Coverage
- HMO/PPN Certificate of Coverage
PPN: Member Handbook, Certificate of Coverage –
Non-Grandfathered
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Downloadable Forms
- Agent/Broker Agreement
- 2011 Commission Schedule
- Group Administration Form
- THC Underwriting Guidelines
- Total Health Care USA Employee Waiver Form
- New Group Exception Letter
- Group Administration Guide
- Group Status Verification Form
- Commission Agreement Form
- Member Enrollment/Deletion Form