HEALTH INSURANCE POLICY
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- Lillian Lane
- 6 years ago
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1 BIGHORN HSA QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN EPO HEALTH INSURANCE POLICY This document provides a brief overview of the benefits offered under the Colorado HealthOP Bighorn HSA Qualified High Deductible Health Plan EPO Health Insurance Policy. Full information is available in the Certificate of Coverage. To request a copy of the Certificate of Coverage, call P1
2 BIGHORN HSA QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN EPO HEALTH INSURANCE POLICY BIGHORN HSA QUALIFIED HIGH DEDUCTIBLE HEALTH PLAN EPO PLAN AT A GLANCE The Colorado HealthOP Bighorn HSA Qualified High Deductible Health Plan EPO (Bighorn HSA EPO) is one of our gold-level Exclusive Provider Organization (EPO) health insurance plans. This plan includes the opportunity to open your own Health Savings Account (HSA). HSAs are a great way for you to save money for medical expenses. This account can be used to pay for your share of medical expenses, as well as services not covered under your plan (such as dental and vision care). In addition to helping you save for medical care, HSAs can save you money on taxes. To learn more about HSAs, visit Some key features of this plan include: LIMITED NETWORK OF HIGH-QUALITY PROVIDERS: Under Colorado HealthOP s Exclusive Provider Organization (EPO) plans, your healthcare is covered only when you use in-network healthcare providers and facilities (except in case of an emergency). If you choose to visit an out-of-network doctor, hospital or other healthcare provider, you will be responsible for the full cost of your services. FREE WELLNESS VISIT: You can go to your primary care doctor for an annual wellness visit. The visit is free and it s your chance to discuss your health survey, biometric screening and other health concerns with your doctor. NO COST FOR MANY COMMON PREVENTIVE GENERIC PRESCRIPTIONS: Some generic preventive prescription drugs (including some medications for cholesterol, diabetes, asthma/copd, high blood pressure and prenatal care) are covered at no cost to you. REWARDS FOR TAKING HEALTHY STEPS: When you complete three health actions, you ll get rewarded with: A lower out-of-pocket maximum A lower deductible Coverage for acupuncture and chiropractic services WHY COLORADO HEALTHOP? Colorado HealthOP is a nonprofit health insurance cooperative (CO-OP) that s focused on people, not profits. Here s what sets us apart: More Control Over Your Healthcare We re a CO-OP, which means you have a voice in how your health insurance company is run. Our members sit on the board of directors and weigh in on what s covered under our benefit plans. At Colorado HealthOP, all of our members are working together to take care of their own health and reduce the cost of healthcare for everyone. READ MORE ABOUT HOW TO GET REWARDED FOR TAKING HEALTH ACTIONS ON PAGE 4. A Focus on Preventive Care, Not Sick Care We think health insurance should help you stay healthy, not just take care of you when you re sick. Our benefits are designed to help you and your family catch healthcare issues early before they become major, expensive health problems. A No Surprises Philosophy We know health insurance is complicated, and we re committed to helping you understand your benefits. If we can serve you better, we want you to let us know, so we can improve our service for all of our members. P2
3 BIGHORN HSA EPO PLAN OVERVIEW GOLD BIGHORN HSA EPO Health Insurance Policy (Exclusive Provider Organization) Maximum Lifetime In-Network Benefits No Lifetime Maximum Annual Deductible (Aggregate) Individual Family Annual Out-of-Pocket Maximum $2,000 $4,000 Health Actions: (1) Health Survey (2) Biometric Screening (3) Wellness Visit $1,800 $3,600 Individual (Includes Deductible) $2,000 $1,800 Family (Includes Deductible) $4,000 $3,600 No Maximum Office Visits Annual Wellness Visit Additional Primary Care Office Visits to Treat an Injury or Illness (Exc. Well Baby, Preventive, and X-rays) Behavioral Health Specialist 100% Covered Acupuncturist or Chiropractor 100% Covered 2 Professional Services Lab & X-Ray Hospital & Facility Services Hospital Facility Hospital Physician Emergency Room Services Emergency Transportation Urgent Care Center Prescription Drugs 1 Retail and Mail Order Preventive: 100% Covered Generics: Preferred Brand: Other: Retail and Mail Order Preventive: 100% Covered Generics: Preferred Brand: Other: Pediatric Dental (Embedded) Included (Delta Dental PPO Network) 1 In an effort to offer cost-effective benefits, we have an additional prescription drug discount card. It is not insurance and doesn t coordinate with benefits. Visit our website to learn more about the CO-OP Discount Pharmacy Program. 2 This does not apply to your out-of-pocket maximum. P3
4 LOWER YOUR HEALTHCARE COSTS IN THREE STEPS As a Colorado HealthOP member, you will be upgraded from the standard version of your plan to the enhanced version when you complete three health actions. HOW TO COMPLETE YOUR HEALTH ACTIONS STEP 1: TAKE A HEALTH SURVEY Take a quick, confidential online health survey. It will give you and your primary care doctor a snapshot of your current health and risk for health issues. STEP 2: GET A BIOMETRIC SCREENING Schedule a visit at your primary care doctor s office, and get a biometric screening. This free and confidential test will screen for illnesses and identify your risk for certain health conditions. STEP 3: HAVE A WELLNESS VISIT WITH YOUR PRIMARY CARE PROVIDER Go to your primary care doctor for an annual wellness visit. The visit is free and it s your chance to discuss your health survey, biometric screening and other health concerns with your doctor. GET REWARDED! When you complete all three health actions, you ll be rewarded with: A lower out-of-pocket maximum A lower deductible Coverage for acupuncture and chiropractic services SEE PAGE 3 TO LEARN MORE. SHOULD MY SPOUSE AND/OR KIDS COMPLETE THE HEALTH ACTIONS? If you have a spouse and/or children who are covered by your plan, the entire family will be upgraded to the enhanced plan when you and your spouse complete the health actions. If you choose a child-only plan, your child(ren) will be upgraded to the enhanced plan when they complete a wellness visit. P4
5 HOW TO GET STARTED You can purchase the Colorado HealthOP Bighorn HSA EPO plan on Connect for Health Colorado, or on Colorado HealthOP s website: On Colorado HealthOP s website, you can: Compare your plan options Get a quote Sign up for your health insurance plan, plus your family s TAX CREDITS To receive a tax credit, you must purchase your plan through Connect for Health Colorado or through a licensed health insurance broker. To learn more, call us at HAVE QUESTIONS? CONTACT US! CALL: Our knowledgeable staff can help you figure out the right plan for you and sign you up over the phone. VISIT: WRITE: 8000 E. Maplewood Ave. Building 5, Suite 200 Greenwood Village, CO P5
BISON FLEX PPO HEALTH INSURANCE POLICY
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Anthem Blue Cross Your Plan: Lumenos HSA 2000/ /40 (LHSA2153) Your Network: Prudent Buyer PPO
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Anthem Blue Cross Your Plan: Modified Anthem PPO HSA-H 2000/ /40 Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Modified Anthem PPO HSA-H 2000/6000 20/40 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
You must pay all of the costs for these services up to the specific deductible amount before this plan begins to pay for these services.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-477-8768. Important Questions
Anthem Blue Cross Your Plan: Lumenos HSA 1500/ /30 (LHSA497H) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Lumenos HSA 1500/4500 10/30 (LHSA497H) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
Anthem Blue Cross Your Plan: Custom Anthem HSA /40 Embedded (HSA291) - Actives Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Custom Anthem HSA 2700 20/40 Embedded (HSA291) - Actives Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with
Anthem Blue Cross Your Plan: Anthem PPO HSA 2700/0 Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Anthem PPO HSA 2700/0 Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This summary
HealthEZ doesn t serve clients; we serve people. We are here to take care of you. We are here to serve you!
Benefit Overview Welcome! HealthEZ is proud to serve as your benefits administrator. We help companies all over the US provide custom, personalized benefits to their employees. We re here to make your
You can see the specialist you choose without permission from this plan.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.pibf.org or by calling 1-918-280-4800. Important Questions
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.crystalrunhp.com or by calling 1-844-638-6506. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by calling 1-888-294-1515. Important Questions Answers Why this
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Coverage Period: 08/01/ /31/2016
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 08/01/2015-07/31/2016
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-877-309-2955. Important Questions
Anthem Blue Cross Your Plan: Custom Classic PPO 500/20/20 (RX $5/$10/$25/30%) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Custom Classic PPO 500/20/20 (RX $5/$10/$25/30%) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you with the selection
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.pibf.org or by calling 1-918-280-4800. Important Questions
Tri-County Schools Insurance Group: Basic Plan Coverage Period: 01/01/ /31/2014
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.tcsig.com or by calling Delta Health Systems at 1-800-464-7627.
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.summacare.com or by calling 1-800-996-8701. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthscopebenefits.com or by calling 1-866-205-8702.
$0 See the chart starting no page 2 for your costs for services this plan covers.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthscopebenefits.com or by calling 1-800-398-0028.
Important Questions Answers Why this Matters: Network: $500 Individual / $1,000 Family Non-Network: $1,000 Individual / $2,000 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.healthscopebenefits.com or by calling 1-800-262-4772.
You can see the specialist you choose without permission from this plan.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.crystalrunhealthinsurancecompany.com or by calling 1-844-638-6506.
Yes. Some of the services this plan doesn t cover are listed on page 4
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.centuryhealthcare/com/user/login or by calling 1-877-685-2432.
Nationwide Life Insurance Co.: Oral Roberts University Coverage Period: 8/10/13 8/9/14
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.chpstudent.com or by calling 1-800-633-7867. Important
Some of the services this plan doesn t cover are listed on page 6. See your policy or plan Yes. plan doesn t cover?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.nslijcareconnect.com or by calling 1-855-706-7545. Important
University of New Hampshire Student Health Plan: Self-Funded Coverage Period: 8/24/13 8/22/14
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.chpstudent.com or by calling 1-800-633-7867. Important
City of Monroe: City of Monroe Medical Care Plan Coverage Period: July 1, 2016 June 30, 2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.tuckeradministrators.com or by calling 704 525-9666.
BLUE. Care. A classic, comprehensive health insurance plan for families and individuals who want more predictable health care costs.
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Medical Plan Summary: PPO Core Plan
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CHI Health Coverage Period: 01/01/ /31/2017 Employee Assistance Program
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Plan Type: (EAP) This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at https://eoc.anthem.com/eocdps/fi or by calling 1-800-542-9402.
$5,000 person. Does not apply to preventive care. Coverage for: Individual + Family Plan Type: PPO
Summary of Benefits and Coverage: What this Plan Covers & What it Costs This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
You must pay all of the costs for these services up to the specific deductible amount before the plan begins to pay for these services.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-800-552-9159. Important Questions
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by calling 1-816-737-5959. Important Questions Answers Why this
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.summacare.com or by calling 1-800-996-8701. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.crystalrunhp.com or by calling 1-844-638-6506. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.arcsvs.com or by calling 1-877-309-2955. Important Questions
Cost if you use an In-Network Provider. Cost if you use a Non-Network Provider. Covered Medical Benefits
Anthem Blue Cross Life and Health Insurance Company Your Plan: Solution PPO 1500/15/20 (Essential Formulary $5/$20/$40/$60/30%) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.nslijcareconnect.com or by calling 1-855-706-7545. Important
Anthem Blue Cross Your Plan: Anthem Elements Choice PPO 6500 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Anthem Elements Choice PPO 6500 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage,
You must pay all the costs up to the deductible amount before this plan. covered services after you meet the deductible.
Secure Choice Health Savings Account Partner Coverage Period: Beginning on or after 01-01-2016 Summary of Benefits and Coverage: What this Plan covers & What it Costs Coverage for: S, S+1, and Family coverage
$ 400 person/ $1,200 family; Waived for inpatient and outpatient hospital charges at Centers of Excellence and Hospitals of Distinction.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.mbpet.net or by calling 1-888-742-3380. Important Questions
HealthSpanOne for Individuals and Families Enrollment Guide
2015 for Individuals and Families Enrollment Guide for Individuals and Families Welcome to your for Individuals and Families Enrollment Guide. This guide will help you understand what health care means
Cost if you use an In-Network Provider. Cost if you use a Non-Network Provider. Covered Medical Benefits. $18,000 single / $36,000 family
Anthem Blue Cross Your Plan: Anthem Elements Choice EQ PPO 6000 (Essential Formulary $5/$20/$50/$65/30% $500 Deductible) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage,
Your Plan: Lumenos HSA Embedded Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Lumenos HSA Embedded Your Network: Prudent Buyer PPO City of Chico This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
You don t have to meet deductibles for specific services, but see the chart starting on page 2 for other costs for services this plan covers.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by calling 1-866-497-5711. Important Questions Answers Why this
In-network $1,000 person / $3,000 family Out-of-network $3,000 person / $9,000 family. What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.loomisco.com or by calling 1-800-367-3721. Important
AvMed In-Network Tier A Providers: $1,500 individual / $3,000 family AvMed In-Network Tier B Providers: What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-477-8768. Important Questions
Cost if you use a Non-Network Provider. Cost if you use an In-Network Provider. Covered Medical Benefits
Anthem Blue Cross Life and Health Insurance Company Student Health Plan: Samuel Merritt University Your Plan: Custom PPO 300/20/40/20 Your Network: Prudent Buyer PPO This summary of benefits is a brief
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
Anthem BlueCross BlueShield Premier Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2013-01/01/2014 Coverage For: Individual/Family Plan Type: PPO This is
Anthem Blue Cross Your Plan: Classic PPO 250/20/20 (Essential Formulary $5/$15/$30/$50/30%) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Classic PPO 250/20/20 (Essential Formulary $5/$15/$30/$50/30%) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you
You don t have to meet deductibles for specific services.
Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: 01/01/2019 12/31/2019 Highmark Delaware: Health Savings Embedded Blue EPO Silver 4450 HSA Coverage
You don t have to meet deductibles for specific services, but see the chart starting on page 2 for other costs for services this plan covers.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by email at info@healthplan.org or by calling 740.695.7902 or
Baptist Health System and HealthTexas Medical Group Network San Antonio, TX Medical plans at-a-glance for businesses with employees
Baptist Health System and HealthTexas Medical Group Network San Antonio, TX Medical plans at-a-glance for businesses with 2 100 employees Aetna Whole Health SM EPO Plans TX Gold AWH EPO 500 80/60 (2 50)
Quote Effective: 04/01/ /30/2019 Version Updated: 01/07/2019
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Senior Care Network: Blue Access PPO and Blue Access Choice PPO Coverage Period: 01/01/ /31/2016
Senior Care Network: Blue Access PPO and Blue Access Choice PPO Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016-12/31/2016 Coverage for: Individual/Family
Mandatory Online Open Enrollment November 9-23, 2015
Mandatory Online Open Enrollment November 9-23, 2015 MVPOE16 All enrollees eligible for coverage must enroll. If you want to keep your current coverage, you must enroll online. If you waive your insurance
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document by calling 1-585-343-0055 ext. 6415. Important Questions Answers
$ 200 family deductible per benefit year for Major Medical benefits. Only applies to out-ofnetwork. $ No
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.njcf.org or by calling 1-800-624-3096. Important Questions
Anthem BlueCross BlueShield St. Charles Community College Blue Access & Blue Access Choice PPO Coverage Period: 01/01/ /31/2016
Anthem BlueCross BlueShield St. Charles Community College Blue Access & Blue Access Choice PPO Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2016-12/31/2016
Companion Life Insurance Company: New England Culinary Institute Coverage Period: 7/1/14-7/1/15
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.chpstudent.com or by calling 1-800-633-7867. Important
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.tccba.com or by calling 1-800-815-3314. Important Questions
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com or by calling 1-855-333-5735. Important Questions
AvMed Network: $1,500 individual / $3,000 family Doesn t apply to preventive care. What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-376-6651. Important Questions
Important Questions. Why this Matters: For PPO Providers: $0 Member/$0 Family For Non-PPO Providers: $0 Member/$0 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/ca or by calling 1-800-759-5758. Important
Important Questions Answers Why this Matters: Network: $3,500 Individual $7,000 Family Non-Network: $10,000 Individual $20,000 Family
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.inhealthohio.org or by calling 1-800-580-8502. Important
Anthem Blue Cross Your Plan: Classic PPO 1000/35/20 (Essential Formulary $5/$20/$30/$50/30%) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Classic PPO 1000/35/20 (Essential Formulary $5/$20/$30/$50/30%) Your Network: Prudent Buyer PPO This summary of benefits is a brief outline of coverage, designed to help you
Highmark Delaware: Shared Cost Blue EPO 1000 Coverage Period: 01/01/ /31/2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.highmarkbcbsde.com or by calling 1-888-601-2242. Important
Anthem Blue Cross and Blue Shield Your Plan: Lumenos Health Savings Account (HSA-Compatible) Plan $ /20 Your Network: PPO
Anthem Blue Cross and Blue Shield Your Plan: Lumenos Health Savings Account (HSA-Compatible) Plan $3500 80/20 Your Network: PPO This summary of benefits is a brief outline of coverage, designed to help
Your Plan: Custom Premier PPO 300/20/20 (Medicare) Your Network: Prudent Buyer PPO
Anthem Blue Cross Your Plan: Custom Premier PPO 300/20/20 (Medicare) Your Network: Prudent Buyer PPO City of Santa Rosa This summary of benefits is a brief outline of coverage, designed to help you with
What is the overall deductible? Are there other deductibles for specific services?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.avmed.org or by calling 1-800-376-6651. Important Questions
Nationwide Life Ins. Co.: Cape Cod Academy Coverage Period: 9/1/13-8/31/14
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.chpstudent.com or by calling 1-800-633-7867. Important
Important Questions Answers Why this Matters: What is the overall deductible?
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.pibf.org or by calling 1-918-280-4800. Important Questions
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan
BlueCross BlueShield Healthcare Plan of Georgia Premier Plus POS Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 01/01/2013-01/01/2014 Coverage For: Individual/Family
Important Questions Answers Why this Matters: What is the overall deductible? Are there other deductibles for specific services?
Exclusive Care: Plan Coverage Period: 01/01/2019 12/31/2019 This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the Summary Plan Document at
Texas Annual Conference: High Deductible Plan Coverage Period: 01/01/ /31/2019
Texas Annual Conference: High Deductible Plan Coverage Period: 01/01/2019 12/31/2019 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type:
Important Questions Answers Why this Matters:
Anthem BlueCross BlueShield MMEBG Blue Access PPO Coverage Period: 07/01/2015-06/30/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type:
Important Questions Answers Why this Matters: $300 Single/$600 Family for Network Providers. $500 Single/$1,000 Family for Non- What is the overall
Bellefontaine City Schools: Blue Access (PPO) Coverage Period: 04/01/2015-03/31/2016 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: PPO
You can see the specialist you choose without permission from this plan.
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/ca/sisc or by calling 1-855-333-5730. Important
1199SEIU Greater New York Benefit Fund Summary of Benefits and Coverage: What This Plan Covers and What It Costs
1199SEIU Greater New York Benefit Fund Summary of Benefits and Coverage: What This Plan Covers and What It Costs Coverage Period: Beginning 09/01/2015 Coverage for: Medicare-Eligible Retirees with 25 Years
Anthem BlueCross BlueShield MMEBG HSA 2 Lumenos Health Savings Accounts (Blue Preferred Select) Coverage Period: 07/01/ /30/2017
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California State University Risk Management Authority
Anthem Blue Cross Your Plan: Custom Premier PPO 500/20/80/60 Your Network: Prudent Buyer PPO California State University Risk Management Authority This summary of benefits is a brief outline of coverage,
Regence BlueShield : HSA 2.0
Regence BlueShield : HSA 2.0 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 10/01/2016-09/30/2017 Coverage for: Individual and Eligible Family Plan Type: PPO This
Nationwide Life Ins. Co.: Rhode Island College Coverage Period: 8/15/13-8/15/14
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.chpstudent.com or by calling 1-800-633-7867. Important
Coverage for: Individual/Family Plan Type: PPO
This is only a summary: If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.medica.com or by calling 952-945-8000 (Minneapolis/St.
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This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document on www.myversobenefits.com or by calling 1-800-422-6103. Important
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This is only a summary: If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.medica.com or by calling 952-992-1814 (Minneapolis/St.
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