Page 20 - 2019 CommScope
P. 20
Medical Travel Option
We are offering a non-U.S. based health provider network for all three medical plan options, giving patients the
option of traveling abroad for certain elective surgeries. This program is managed by IndusHealth, a global medical
travel program administrator. Surgeries are performed by leading specialists at Joint Commission International (JCI)
accredited top-tier hospitals in San Jose, Costa Rica. Patients must be pre-approved and meet certain requirements
to avoid undue health risks imposed by travel or the inability to coordinate care with local providers.
Condition-Specific Care is Available For:
Hip/knee replacement (uni/bilateral) Hernia Repair
Rotator cuff repair Hysterectomy
Lumbar Discectomy/Fusion Gastric Bypass/Sleeve
Once Approved, Patients Are Eligible For The Following Enhanced Benefits:
Cost of travel and stay covered for the patient and one companion
Dedicated IndusHealth nurse case manager to help with the process of evaluation, pre-approval, travel,
treatment and follow-up
Dedicated team of destination patient coordinators
Employee receives a cash payment of $5,000, subject to income taxes
Health and Investment Plan A
Plan Details In-Network Out-of-Network
Annual Deductible $3,000/$6,000 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
Health and Investment Plan B
Annual Deductible $1,500/$3,000 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
PPO Medical Plan
Annual Deductible $750/$1,500 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
* Taxable Income
20 ANNUAL ENROLLMENT GUIDE BENEFITS 2019
We are offering a non-U.S. based health provider network for all three medical plan options, giving patients the
option of traveling abroad for certain elective surgeries. This program is managed by IndusHealth, a global medical
travel program administrator. Surgeries are performed by leading specialists at Joint Commission International (JCI)
accredited top-tier hospitals in San Jose, Costa Rica. Patients must be pre-approved and meet certain requirements
to avoid undue health risks imposed by travel or the inability to coordinate care with local providers.
Condition-Specific Care is Available For:
Hip/knee replacement (uni/bilateral) Hernia Repair
Rotator cuff repair Hysterectomy
Lumbar Discectomy/Fusion Gastric Bypass/Sleeve
Once Approved, Patients Are Eligible For The Following Enhanced Benefits:
Cost of travel and stay covered for the patient and one companion
Dedicated IndusHealth nurse case manager to help with the process of evaluation, pre-approval, travel,
treatment and follow-up
Dedicated team of destination patient coordinators
Employee receives a cash payment of $5,000, subject to income taxes
Health and Investment Plan A
Plan Details In-Network Out-of-Network
Annual Deductible $3,000/$6,000 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
Health and Investment Plan B
Annual Deductible $1,500/$3,000 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
PPO Medical Plan
Annual Deductible $750/$1,500 Not Available
Inpatient Care 100% after deductible Not Available
Cash Bonus* $5,000 Not Available
Travel Beneit Covered 100% Not Available
* Taxable Income
20 ANNUAL ENROLLMENT GUIDE BENEFITS 2019
