Page 4 - Enrollment Guide Example
P. 4
2016 Benefits Enrollment
Medical
Medical coverage
provided by [Carrier] For many of us, nothing is more important than our health and the health
of our family members. This is why [Client Name] offers a robust medical
insurance program to our employees. We partner with [Carrier] to offer
this coverage.
You have the option of choosing one of four plans. All four plans
provide an extensive network of doctors, hospitals, labs, and other
providers who have agreed to charge reduced fees.
Features of All Four Medical Plans Include
You do not need to select a primary care physician (PCP)
You do not need a referral to see a specialist
When you need medical care, you decide if you want to use an in-
network PPO provider or an out-of-network provider
If you use an in-network provider, you’ll receive higher beneits and
you’ll pay a small copayment for many services
You do not have to ile claim forms when you use an in-network
provider
In-Network vs. Out-of-Network
A network is a group of doctors, specialists, hospitals, labs, and
pharmacies your plan contracts with at negotiated or discounted rates.
These make up the providers in your “network”. This means you will
almost always pay less when you receive care in-network.
If you choose to see an out-of-network provider, you may be required to
submit your own claims. You may also be balanced billed, which means
you will be responsible for charges above [Carrier]’ reimbursement
amount.
4
Medical
Medical coverage
provided by [Carrier] For many of us, nothing is more important than our health and the health
of our family members. This is why [Client Name] offers a robust medical
insurance program to our employees. We partner with [Carrier] to offer
this coverage.
You have the option of choosing one of four plans. All four plans
provide an extensive network of doctors, hospitals, labs, and other
providers who have agreed to charge reduced fees.
Features of All Four Medical Plans Include
You do not need to select a primary care physician (PCP)
You do not need a referral to see a specialist
When you need medical care, you decide if you want to use an in-
network PPO provider or an out-of-network provider
If you use an in-network provider, you’ll receive higher beneits and
you’ll pay a small copayment for many services
You do not have to ile claim forms when you use an in-network
provider
In-Network vs. Out-of-Network
A network is a group of doctors, specialists, hospitals, labs, and
pharmacies your plan contracts with at negotiated or discounted rates.
These make up the providers in your “network”. This means you will
almost always pay less when you receive care in-network.
If you choose to see an out-of-network provider, you may be required to
submit your own claims. You may also be balanced billed, which means
you will be responsible for charges above [Carrier]’ reimbursement
amount.
4
