Page 27 - 2022 DPR Construction Benefit Guide_Craft Employees

Generic Drugs Network Provider

Generic drugs are less expensive versions of brand name A provider who has a contract with your health insurer or
drugs that have the same intended use, dosage, effects, plan to provide services at set fees.
risks, safety and strength. The strength and purity of
generic medications are strictly regulated by the Federal These contracted fees are usually lower than the provider’s
Food and Drug Administration. normal fees for services.

Guaranteed Issue Open Enrollment

The amount of coverage pre-approved by the insurance A period of time (usually a few days to a few weeks) in
carrier regardless of health status. which companies allow employees
to choose their insurance coverage for the
Imputed Income coming year.

The IRS requires that the value of any paid Life insurance Out-of-Network Benefits
premiums for coverage above $50,000 be included in your
taxable income. This taxable income is known as “imputed The benefits applicable for the covered services of a
income” and will be reflected in your paycheck and non-network provider.
year-end W-2 form. Imputed income also applies to covering Out-of-Pocket Maximum
domestic partners as well. The employer portion of the
monthly premium attributed to domestic partners is subject The highest amount you’ll pay toward medical expenses in
to taxation. a year including deductibles, copays, and coinsurance, but
not monthly premiums. If the out-of-pocket-maximum is
In-Network met, any further qualified expenses will be 100% covered by

A designated list of health care providers (doctors, the insurance company for the remainder of the year.
dentists, etc.) with whom the health insurance provider Primary Care Physician (PCP)
has negotiated special rates.
Physician (generally a family practitioner, internist or
Using in-network providers lowers the cost of services for pediatrician) who provides ongoing medical care. A primary
you and DPR Construction. care physician treats a wide variety of health-related
Life Insurance conditions.
Preferred Provider Organization (PPO)
A specific amount of money paid to designated
beneficiaries in the event of the insured person’s death. A network of health care providers contracted to provide

Mail Order Pharmacy medical services to covered employees and dependents at
negotiated rates. You may seek care from either a network
Mail order pharmacies generally provide a 90-day supply or non-network provider, but network care is covered at a
of a prescription medication for the same cost as a 60-day higher benefit level and the employee is responsible for
supply at a retail pharmacy. Plus, mail order pharmacies a greater portion of the cost when using a non-network
offer the convenience of shipping directly to your door. provider.

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