Page 2 - Aegion PPO SPDs
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BENEFIT BOOKLET
This Benefit Booklet has been prepared by the Claims Administrator to help explain Your health benefits.
This document replaces and supersedes any Benefit Booklet or summary that You have received
previously.
Please refer to this Benefit Booklet whenever You require health services. It describes how to access
medical care, what health services are covered by the Plan, and what portion of the health care costs You
will be required to pay.
This Benefit Booklet should be read and re-read in its entirety. Since many of the provisions of this Benefit
Booklet are interrelated, You should read the entire Benefit Booklet to get a full understanding of Your
health benefits.
Many words used in the Benefit Booklet have special meanings. These words appear in capitals and are
defined for You. Refer to these definitions in the Definitions section for the best understanding of what is
being stated.
Your Employer has agreed to be subject to the terms and conditions of Anthem’s provider
agreements which may include precertification and utilization management requirements, timely
filing limits, and other requirements to administer the benefits under this Plan.
This is a Preferred Provider Organization (PPO) Plan for all Members except residents of Missouri;
Members residing in MO are part of a Point of Service (POS) Plan, and must use the appropriate
POS Network Provider in Missouri to receive Network benefits. If You are a Member in a state
outside of Missouri that participates in an Advantage Network arrangement, please call the Member
Services number on Your Identification Card to locate participating Providers.
This health Benefit Booklet also contains Exclusions, so please be sure to read this Health Benefit Booklet
carefully.
Important: This is not an insured benefit plan. The benefits described in this Benefit Booklet or
any rider or amendments hereto are funded by the Employer who is responsible for their payment.
The Claims Administrator provides administrative claims payment services only and does not
assume any financial risk or obligation with respect to claims.
Si usted necesita ayuda en español para entender este documento, puede solicitarla gratuitamente
llamando a Servicios al Cliente al número que se encuentra en su tarjeta de identificación.
If You need assistance in Spanish to understand this document, You may request it for free by
calling Member Services at the number on Your Identification Card.
Identity Protection Services
Identity protection services are available with Your Employer’s Anthem health plans. To learn more
about these services, please visit www.anthem.com/resources.
2
This Benefit Booklet has been prepared by the Claims Administrator to help explain Your health benefits.
This document replaces and supersedes any Benefit Booklet or summary that You have received
previously.
Please refer to this Benefit Booklet whenever You require health services. It describes how to access
medical care, what health services are covered by the Plan, and what portion of the health care costs You
will be required to pay.
This Benefit Booklet should be read and re-read in its entirety. Since many of the provisions of this Benefit
Booklet are interrelated, You should read the entire Benefit Booklet to get a full understanding of Your
health benefits.
Many words used in the Benefit Booklet have special meanings. These words appear in capitals and are
defined for You. Refer to these definitions in the Definitions section for the best understanding of what is
being stated.
Your Employer has agreed to be subject to the terms and conditions of Anthem’s provider
agreements which may include precertification and utilization management requirements, timely
filing limits, and other requirements to administer the benefits under this Plan.
This is a Preferred Provider Organization (PPO) Plan for all Members except residents of Missouri;
Members residing in MO are part of a Point of Service (POS) Plan, and must use the appropriate
POS Network Provider in Missouri to receive Network benefits. If You are a Member in a state
outside of Missouri that participates in an Advantage Network arrangement, please call the Member
Services number on Your Identification Card to locate participating Providers.
This health Benefit Booklet also contains Exclusions, so please be sure to read this Health Benefit Booklet
carefully.
Important: This is not an insured benefit plan. The benefits described in this Benefit Booklet or
any rider or amendments hereto are funded by the Employer who is responsible for their payment.
The Claims Administrator provides administrative claims payment services only and does not
assume any financial risk or obligation with respect to claims.
Si usted necesita ayuda en español para entender este documento, puede solicitarla gratuitamente
llamando a Servicios al Cliente al número que se encuentra en su tarjeta de identificación.
If You need assistance in Spanish to understand this document, You may request it for free by
calling Member Services at the number on Your Identification Card.
Identity Protection Services
Identity protection services are available with Your Employer’s Anthem health plans. To learn more
about these services, please visit www.anthem.com/resources.
2
