Page 14 - 2017 US Benefits Guide - for all Capgemni employees in the FS SBU
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Mental Health and Substance Abuse Get to know your PCP.
If you enroll in either of the Medical Plan options, you and your dependents have access to Having a good relationship with a primary
comprehensive mental health, substance abuse and lifestyle management treatment services care physician who knows you and your
through the Blue Cross Mental Health Unit. The Blue Cross Mental Health Unit has been health will make you more likely to receive
established to perform preadmission and length of stay review for your services for the treatment the care you need when you need it.
of Mental Illness and Substance Abuse Disorder. The Mental Health Unit is primarily stafed by
physicians, psychologists and registered nurses. These professionals are there to ensure you and Ask your doctor about
your dependents are getting the most efective care from our Medical Plan. For more information generic drugs.
about these services and your responsibility for satisfying preauthorization requirements, contact Generic drugs ofer the same safety and
the Mental Health Unit 24 hours a day, 7 days a week at 1-800-851-7498 . strength as their brand-name counterparts
Capgemini also ofers an Employee Assistance Program (EAP) to all beneit-eligible employees. at a lower cost.
The EAP is a free and conidential resource that can help you identify and resolve issues by
providing short term counseling services or directing you to resources in your community. For Women’s Health and
more information about the EAP, go to page 31. Cancer Rights Act of 1998
The Women’s Health and Cancer Rights
Terms You Should Know Act of 1998 requires that all group health
plans that provide medical and surgical
Semi-monthly Rates: Amount you pay to participate in the plan.
beneits with respect to a mastectomy
Annual Deductible: Amount you pay before the plan begins paying certain beneits. must provide coverage for:
Co-insurance: A percentage of your medical costs that the Company pays. ➤ Reconstruction of the breast on
Co-payment: A lat dollar amount you pay at the time you receive a service. which the mastectomy has been
performed
Out-of-Pocket Maximum: The Medical Plan’s out-of-pocket maximum is the total amount you
pay out of pocket (including deductibles, co-pays, co-insurance and prescription co-pays) in one ➤ Surgery and reconstruction of
plan year before the plan pays 100% of eligible expenses. the other breast to produce a
Primary Care Physician (PCP): A physician in general practice, family practice, pediatrics, or symmetrical appearance
obstetrics and gynecology whom you select to coordinate your care. ➤ Prostheses and treatment of
Specialist: A physician who provides specialty or subspecialty services (ophthalmologists, physical complications of all
oncologists, endocrinologists, cardiologists, etc.). stages of mastectomy, including
lymphedemas
Maximum Allowance: Amounts in which participating providers have agreed to accept as
payment in full for a particular covered service. If you receive care outside of the plan’s network, These services must be provided in a
with a non-participating provider, the Maximum Allowance will be the lesser of the provider’s manner determined in consultation with
billed charges or the non-contracting Maximum Allowance. the attending physician and the patient.
This coverage may be subject to annual
deductibles and co-insurance provisions
applicable to other such medical and
surgical beneits provided under the plan.
CAPGEMINI 2017 BENEFITS GUIDE 11
If you enroll in either of the Medical Plan options, you and your dependents have access to Having a good relationship with a primary
comprehensive mental health, substance abuse and lifestyle management treatment services care physician who knows you and your
through the Blue Cross Mental Health Unit. The Blue Cross Mental Health Unit has been health will make you more likely to receive
established to perform preadmission and length of stay review for your services for the treatment the care you need when you need it.
of Mental Illness and Substance Abuse Disorder. The Mental Health Unit is primarily stafed by
physicians, psychologists and registered nurses. These professionals are there to ensure you and Ask your doctor about
your dependents are getting the most efective care from our Medical Plan. For more information generic drugs.
about these services and your responsibility for satisfying preauthorization requirements, contact Generic drugs ofer the same safety and
the Mental Health Unit 24 hours a day, 7 days a week at 1-800-851-7498 . strength as their brand-name counterparts
Capgemini also ofers an Employee Assistance Program (EAP) to all beneit-eligible employees. at a lower cost.
The EAP is a free and conidential resource that can help you identify and resolve issues by
providing short term counseling services or directing you to resources in your community. For Women’s Health and
more information about the EAP, go to page 31. Cancer Rights Act of 1998
The Women’s Health and Cancer Rights
Terms You Should Know Act of 1998 requires that all group health
plans that provide medical and surgical
Semi-monthly Rates: Amount you pay to participate in the plan.
beneits with respect to a mastectomy
Annual Deductible: Amount you pay before the plan begins paying certain beneits. must provide coverage for:
Co-insurance: A percentage of your medical costs that the Company pays. ➤ Reconstruction of the breast on
Co-payment: A lat dollar amount you pay at the time you receive a service. which the mastectomy has been
performed
Out-of-Pocket Maximum: The Medical Plan’s out-of-pocket maximum is the total amount you
pay out of pocket (including deductibles, co-pays, co-insurance and prescription co-pays) in one ➤ Surgery and reconstruction of
plan year before the plan pays 100% of eligible expenses. the other breast to produce a
Primary Care Physician (PCP): A physician in general practice, family practice, pediatrics, or symmetrical appearance
obstetrics and gynecology whom you select to coordinate your care. ➤ Prostheses and treatment of
Specialist: A physician who provides specialty or subspecialty services (ophthalmologists, physical complications of all
oncologists, endocrinologists, cardiologists, etc.). stages of mastectomy, including
lymphedemas
Maximum Allowance: Amounts in which participating providers have agreed to accept as
payment in full for a particular covered service. If you receive care outside of the plan’s network, These services must be provided in a
with a non-participating provider, the Maximum Allowance will be the lesser of the provider’s manner determined in consultation with
billed charges or the non-contracting Maximum Allowance. the attending physician and the patient.
This coverage may be subject to annual
deductibles and co-insurance provisions
applicable to other such medical and
surgical beneits provided under the plan.
CAPGEMINI 2017 BENEFITS GUIDE 11
