Page 4 - 2017 Benefits Enrollment
P. 4
Medical
For many of us, nothing is more important than our health and the health of our
family members. This is why Sulzer offers a robust medical insurance program to our
employees. We partner with BlueCross BlueShield of Texas to offer this coverage.
You have the option of choosing one of 3 plans.* All 3 plans cover preventive care
at 100% and provide an extensive network of doctors, hospitals, labs, and other
providers who have agreed to charge reduced fees.
Features of All 3 Medical Plans
X You do not need to select a primary care physician (PCP)
X You do not need a referral to see a specialist
X When you need medical care, you decide if you want to use an in-network PPO
provider or an out-of-network provider
X If you use an in-network provider, you’ll receive higher beneits and will not be
balance billed for any charges in excess of the discounted rate
X 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 BlueCross BlueShield of Texas’ maximum allowable
charge.
* Only those enrolled in Medicare are eligible to enroll in the PPO 1000 plan.
Sulzer
4
For many of us, nothing is more important than our health and the health of our
family members. This is why Sulzer offers a robust medical insurance program to our
employees. We partner with BlueCross BlueShield of Texas to offer this coverage.
You have the option of choosing one of 3 plans.* All 3 plans cover preventive care
at 100% and provide an extensive network of doctors, hospitals, labs, and other
providers who have agreed to charge reduced fees.
Features of All 3 Medical Plans
X You do not need to select a primary care physician (PCP)
X You do not need a referral to see a specialist
X When you need medical care, you decide if you want to use an in-network PPO
provider or an out-of-network provider
X If you use an in-network provider, you’ll receive higher beneits and will not be
balance billed for any charges in excess of the discounted rate
X 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 BlueCross BlueShield of Texas’ maximum allowable
charge.
* Only those enrolled in Medicare are eligible to enroll in the PPO 1000 plan.
Sulzer
4
