Business Benefits

Cost Savings

The variety of options offered by MCS allows you to choose the product that fits your company’s financial needs.

Personalized Service

If you want to integrate new options, our highly qualified sales executives are ready to assist you with the integration process.

Broad Provider Network

Our network includes more than 13,000 physicians, dentists, laboratories and hospitals in Puerto Rico. In addition, we offer more than 980 pharmacies throughout the island. Our affiliate network in the U.S. also provides emergency services and procedures not available in Puerto Rico.

Healthcare Plan Strength and Experience

With more than 30 years in the healthcare market, MCS continuously adapts to serve all kinds of businesses. Currently, MCS is the health plan of choice for more than 1,500 companies in Puerto Rico.

Essential Health Benefits Included in Our Basic Coverage

The Affordable Care Act (ACA) requires that, starting in 2014, all medical plans offered in the individual market and for groups of 50 employees or less, include comprehensive service coverage known as Essential Health Benefits.

Emergency Services
Hospitalization
Outpatient Services
Maternity and Newborn Care
Mental Health and Substance Abuse, including behavioral healthcare treatment
Prescription Drugs
Rehabilitation, Habilitation and Medical Equipment Services
Laboratory Services
Preventive Wellness Services and Chronic Disease Management
Pediatric Services, including dental and vision care

Pharmacy

As part of the essential health benefits, all our offerings for the small and medium-size business segment (PYMES) include pharmacy and dental benefits that are integrated into your medical benefits.

The MCS Global Premium products have an EHB drug formulary and a Special Pharmacy Network with more than 500 pharmacies throughout the island.

The MCS Global Essential products have an EHB drug formulary and a Essential Pharmacy Network with more than 300 pharmacies throughout the island.

	Basic Pharmacy Coverage
	The categories contemplated in our formulary are: Preferred Generics, Non-Preferred Generics, Preferred Brand Drugs, Non-Preferred Brand Drugs, Preferred Specialty Drugs and Non Preferred Specialty Drugs.	Special Network that Includes: Walmart, Walgreen, Kmart y Sams

Basic Dental and Vision

Our MCS Global Premium and MCS Global Essential products integrate Dental 100, which covers diagnostic and preventive services. For MCS Global Elite, basic coverage includes Dental 200.

All our products include vision benefits.

	Basic Dental Coverage
	Children Covered Dental Services for children under 21: two (2) dental exams and cleanings per policy year (every six months), bite and periapical radiographs, no more than one game every three (3) years and fluoride treatment covered as funamental benefit for the insured under the age of nineteen (19) years.	Adults: Two (2) dental exams and two (2) cleanings per policy year (every six months). One (1) complete set of intraoral radiographic images every thirty-six (36) months.

Dental Option

For an additional minimum cost to the basic essential benefits coverage, you can add various options for dental, vision and life insurance.

Coverage	Co-insurance
Dental 200*	Diagnostic Preventive 0% Space Maintainers 20% Restorative 20% Oral Surgery 20%
Dental 300	Diagnostic Preventive 0% Space Maintainers 20% Restorative 20% Oral Surgery 20% Endodontics 20% / 50% Periodontics 20% / 50% Prosthodontics 50%
Dental 400	Diagnostic Preventive 0% Space Maintainers 20% Restorative 20% Oral Surgery 20% Endodontics 20% / 50% Periodontics 20% / 50% Prosthodontics 50%
Note: Service received from dental specialist (endodontist, periodontist, prosthodontist) apply fifty percent (50%) of coinsuarance.

Life Insurance Option

Life
$10,000

Double indemnity coverage for death applies only to the principal isured prior to turning 65. The monthly premium is only $1.30.

The difference between MCS Global Elite, MCS Global Premium and MCS Global Essential

MCS Global Elite has 3 Pharmacy Access Models:

Preferred Drugs List (PDL) and Pharmacy Network (PPO)
Drugs form EHB and Pharmacy Special Network
Preferred Drugs List (PDL) and Pharmacy Special Network

MCS Global Elite includes the following benefits:

Vaccines against Allergies
Devices and Orthotics
Gynecomastia
Rhogam Injetions
Epidural
Respiratory Therapy Machine
60 Home Healthcare Visits
Reimbursed U.S. Services, incluiding air and ground ambulance
Additional Durable Medical Equipment
Hospice
Nutritionist
Internal and External Prosthesis
Providers Outside the Network
Shoes for Diabetics
Unlimited Services in the Following Benefits:
- CT Scan
- MRA
- MRI
- PET Scan
- Allergy Tests
- Collateral and Group Mental Health Visit
- Skilled Nursing Facility
- Intra-articular injections

For more information, contact your insurance agent or call 787.758.2500 ext. 5173

A New life experience for your employees

Promoting a healthy lifestyle among your employees helps maintain optimum productivity.

Russ Newman, Executive Director of the American Psychologists Association (APA), guarantees that employers who recognize the link between an employee’s health and physical well-being are better able to develop a high-performance workforce.

This also gives companies a competitive advantage in the market.

Physical exercise done regularly also helps one become more alert, and reduces stress, workplace accidents, fatigue, aggression, anger, anxiety and depression.

For that reason, our Wellness Programs are a positive investment in your employees. By developing exercise programs, recreational activities and health education for your employees, you can:

Increase Productivity
Generate Company Loyalty
Minimize Lateness
Reduce Dsabilities
Reduce Employee Turnover

For more information, contact your insurance agent or call 787.758.2500 ext. 5173

To learn about our rates, press here.