Page 15 - 2018 Capgemini Enrollment
P. 15
Terms You Should Know Women’s Health and
Cancer Rights Act of 1998
Semi-monthly Contributions: Amount you pay to participate in the plan.
The Women’s Health and Cancer Rights
Annual Deductible: Amount you pay before the plan begins paying certain beneits. Act of 1998 requires that all group health
Co-insurance: A percentage of your medical costs that the Company pays. plans that provide medical and surgical
Co-payment/Co-pay: A lat dollar amount you pay at the time you receive a service. beneits with respect to a mastectomy
must provide coverage for:
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 and co-insurance) in one plan year before the ➤ Reconstruction of the breast on
plan pays 100% of eligible expenses. which the mastectomy has been
Primary Care Physician (PCP): A physician in general practice, family practice, pediatrics, performed
or obstetrics and gynecology whom you select to coordinate your care. ➤ Surgery and reconstruction of
the other breast to produce a
Specialist: A physician who provides specialty or subspecialty services (ophthalmologists, symmetrical appearance
chiropractors, oncologists, endocrinologists, cardiologists, etc.).
➤ Prostheses and treatment of
Maximum Reimbursable Cost: Amounts determined by the insurance company based on fees
customarily charged by providers in your area for a given service. If you receive care outside of physical complications of all
the plan’s network, you are responsible for paying any fees your provider charges above the stages of mastectomy, including
maximum reimbursable cost. lymphedemas
These services must be provided in a
manner determined in consultation with
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 2018 BENEFITS GUIDE 12
Cancer Rights Act of 1998
Semi-monthly Contributions: Amount you pay to participate in the plan.
The Women’s Health and Cancer Rights
Annual Deductible: Amount you pay before the plan begins paying certain beneits. Act of 1998 requires that all group health
Co-insurance: A percentage of your medical costs that the Company pays. plans that provide medical and surgical
Co-payment/Co-pay: A lat dollar amount you pay at the time you receive a service. beneits with respect to a mastectomy
must provide coverage for:
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 and co-insurance) in one plan year before the ➤ Reconstruction of the breast on
plan pays 100% of eligible expenses. which the mastectomy has been
Primary Care Physician (PCP): A physician in general practice, family practice, pediatrics, performed
or obstetrics and gynecology whom you select to coordinate your care. ➤ Surgery and reconstruction of
the other breast to produce a
Specialist: A physician who provides specialty or subspecialty services (ophthalmologists, symmetrical appearance
chiropractors, oncologists, endocrinologists, cardiologists, etc.).
➤ Prostheses and treatment of
Maximum Reimbursable Cost: Amounts determined by the insurance company based on fees
customarily charged by providers in your area for a given service. If you receive care outside of physical complications of all
the plan’s network, you are responsible for paying any fees your provider charges above the stages of mastectomy, including
maximum reimbursable cost. lymphedemas
These services must be provided in a
manner determined in consultation with
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 2018 BENEFITS GUIDE 12
