Page 9 - IPsoft 2018 Benefits Guide

9
Comprehensive and preventive healthcare coverage
is important in protecting you and your family from
the nancial risks of unexpected illness and injury. A little prevention usually goes a long way – especially in healthcare. Routine Exams and regular preventive care provide an inexpensive review of your health. Small problems can potentially develop into large expenses. By identifying problems early, often they can be treated at little cost.
IPSoft, Inc. offers you the option to choose one of
two Open-Access Managed Choice (OAMC) medical plans through Aetna. With Aetna OAMC Plans, you have access to a national network of participating providers. You also have the ability to select where you receive your medical services as you have access to out-of-network bene ts. No referrals to specialists are necessary under either plan.
HEALTH
OAMC EPO*: This plan delivers in-network only bene ts in which you must seek care from participating providers, except in the case of a life- or limb-threatening emergency.
OAMC POS: This plan allows you to seek care from any in- or out-of-network doctor at the time of service.
* We encourage you to strongly consider the EPO plan if you and your family members seek care from Aetna participating providers, as the in-network bene t levels are comparable under both plans and the cost of your monthly contribution is less.
It is important to understand that if you use contracted providers, your costs will be less because when
you stay in network, you avoid balance billing (other
than applicable deductibles, coinsurance and/or copayments). When visiting a non-participating provider (or out-of-network provider) there is no contract between the plan and the provider. The non-participating provider is not obligated to accept the plan’s allowance as “reasonable and customary” and may bill the member for any remaining balance.
If a child cannot support himself/herself due to intellectual disability or physical handicap, the age limitation requirement for such a child is waived provided that the disability or handicap arose prior to attaining the limiting age and the child is chie y dependent upon the subscriber for economic support and maintenance. Proof of such incapacity and dependency must be furnished to Aetna.
KB to confrim the use of this video: https://vimeo.com/redbrickhealth/review/248899182/4bf8457cf6
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