GAP - Supplemental Medical Coverage

Health insurance has been one of the most effective both physical and financial wellness tools employers could offer employees by helping protect them from high medical costs. To manage rising premiums, employers have migrated to higher-deductible plans. While HDHPs can be a great solution, they have the potential to impact retention by exposing employees to higher medical out-of-pocket expenses.

Two Plans

GAP insurance can help.

Gap policies are secondary insurance designed to supplement medical coverage and help offset costs related to inpatient and outpatient medical care.

Kemper Health offers two types of GAP policies:
Our new Kemper GAP policy combines the inpatient and outpatient benefit for a straight-forward approach.

Our Signature GAP policy include two separate benefits for inpatient and outpatient care.

Employers have the freedom to choose policies that include inpatient hospital, outpatient care and other important benefit options.

Kemper Health GAP* - One Combined Benefit

The Kemper Health GAP policy offers a combined inpatient and outpatient benefit for employees and their covered dependents. Features include:

  • Straight-forward policy design that is easy to understand.
  • Benefit amounts up to $10,000.
  • Optional benefit for treatment of mental illness and/or substance abuse.

Signature GAP** - Two Separate Benefits

Features of the Signature GAP policy include:

  • Separate benefit amounts for inpatient and optional outpatient services.
  • Inpatient benefit maximums up to $7,000.

*Underwritten by Reserve National Insurance Company.

**Underwritten by Fidelity Security Life Insurance Company ® Kansas City, MO 64111

Policy Form No. M-9134/M-9135. Policy Nos. MG-158/MG-159/MG-160.

How it Works

Enrolled employees receive an ID card.

The employer receives the policy and a certificate.

Employees provide GAP ID cards to providers, along with their medical ID cards.

Benefits are paid to providers (when an assignment of benefits exists) or employees.

CASE STUDY - GAP Insurance

Joe is an engineer who has employee-only medical coverage. He needs arthroscopic surgery in January to repair a torn meniscus in his left knee.*
Since Joe has had no medical expenses this year, he will need to meet his full deductible.

Without Kemper Health GAP
Insurance - Combined Benefit

Joe must cover his full deductible before health insurance policy will begin to pay benefits. Plus, he’ll need to cover 20% of any remaining costs for coinsurance.

Joe must cover his full deductible before health insurance policy will begin to pay benefits. Plus, he’ll need to cover 20% of any remaining costs for coinsurance. Hospital Bill: $8.970 Joe’s Full Deductible: - $3,000 Remaining Hospital Bill after Deductible: $5,970 Health Insurance (80% of remaining bill): - $4,776 Joe’s Coinsurance Payment (20% of remaining bill): - $1,194 Joe’s Total Out-of-Pocket Costs: $4,194 This case study is a fictional example based on estimated costs. Please see Kemper Health GAP insurance Features and Benefits before making a decision.

With Kemper Health GAP
Insurance - Combined Benefit

The amount Joe would normally pay toward his deductible and coinsurance is reduced or covered completely by his GAP policy benefit which may help with costs related to either inpatient or outpatient medical care.

The amount Joe would normally pay toward his deductible and coinsurance is reduced or covered completely by his GAP policy benefit which may help with costs related to either inpatient or outpatient medical care.Hospital Bill: $8.970 Joe’s Kemper Health GAP Policy Pays Deductible: - $3,000 Remaining Hospital Bill after Deductible: $5,970 Health Insurance (80% of remaining bill): - $4,776 Joe’s Coinsurance Payment (20% of remaining bill): - $1,194 Joe’s Total Out-of-Pocket Costs: $1,194 This case study is a fictional example based on estimated costs. Please see Kemper Health GAP insurance Features and Benefits before making a decision.-	Joe’s policy will cover the deductible and coinsurance, up to the maximum benefit amount his combined benefit Kemper Health GAP policy includes for the policy year. Joe may have benefits left in his Kemper Health GAP policy. If so, his benefit is used to help cover coinsurance costs for inpatient or outpatient services, until the entire GAP plan benefit maximum has been paid for that policy year. Once Joe’s Kemper Health GAP policy benefit is entirely used, he’ll be responsible for any remaining amount. Some policies do not include outpatient services. Ask your employer for a copy of the plan certificate for policy and benefit details.
Doctor and Patient
  • Joe’s policy will cover the deductible and coinsurance, up to the maximum benefit amount his combined benefit Kemper Health GAP policy includes for the policy year.
  • Joe may have benefits left in his Kemper Health GAP policy. If so, his benefit is used to help cover coinsurance costs for inpatient or outpatient services, until the entire GAP plan benefit maximum has been paid for that policy year.
  • Once Joe’s Kemper Health GAP policy benefit is entirely used, he’ll be responsible for any remaining amount.

This case study is a fictional example based on estimated costs. Please see Kemper Health voluntary worksite Kemper Health GAP insurance Features and Benefits before making a decision.

Give employees the health insurance protection they deserve.

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