The City of Plano offers a supplemental limited benefit medical expense insurance policy – or GAP plan offered through American Fidelity up to age 65.
You must be enrolled in the City’s medical plan to be eligible for this coverage.
If enrolling in Hospital GAP for the first time or making a change, you are required to complete an enrollment form on the Benefits website: plano.gov/benefits. The completed form must be returned to Human Resources.
Three Primary Benefits
- Inpatient – payable for covered out-of-pocket expenses up to the maximum benefit selected per confinement
- Out-Patient – payable for the difference between actual outpatient expenses incurred and the amount paid by the primary medical plan for out-of-pocket covered charges up to the maximum outpatient benefit of $200 for outpatient treatment
- Physician Outpatient Treatment – pays $25 per visit for up to five visits per family per calendar year for outpatient treatment due to sickness, injury or accident.
Claims can now be filed online or with the AFmobile app. Log onto americanfidelity.com/claims or download AFmobile to your Android or iPhone.
Hospital GAP Plan Monthly Rates
| Hospital GAP Plan Monthly Rates |
| Under 55 | $500 | $1,000 | $1,500 |
| Employees Only | $14 | $17 | $20 |
| Employees & Spouse/Domestic Partner | $26 | $31 | $37 |
| Employees & Children | $25 | $28 | $32 |
| Family | $37 | $42 | $49 |
| Under 55 To 59 | $500 | $1,000 | $1,500 |
| Employees Only | $20 | $24 | $30 |
| Employees & Spouse/Domestic Partner | $37 | $43 | $54 |
| Employees & Children | $31 | $35 | $42 |
| Family | $48 | $54 | $66 |
| Age 60 And Over | $500 | $1,000 | $1,500 |
| Employees Only | $31 | $36 | $46 |
| Employees & Spouse/Domestic Partner | $56 | $65 | $83 |
| Employees & Children | $42 | $47 | $58 |
| Family | $67 | $76 | $95 |
