Page 4 - 2018 Sulzer (Pumps Solutions) Benefit Guide
P. 4
Medical
For many of us, nothing is more important than our health and the
health of our family members. This is why Sulzer offers a robust medical
insurance program to our employees. We partner with BlueCross
BlueShield of Texas to offer this coverage.
Both plans cover preventive care at 100% and provide an extensive
network of doctors, hospitals, labs, and other providers who have agreed
to charge reduced fees.
Plan Features
X You do not need to select a primary care physician (PCP)
X You do not need a referral to see a specialist
X When you need medical care, you decide if you want to use an in-
network PPO provider or an out-of-network provider
X If you use an in-network provider, you will receive higher beneits and
will not be balance billed for any charges in excess of the discounted
rate
X You do not have to ile claim forms when you use an in-network
provider
In-Network vs. Out-of-Network
A network is a group of doctors, specialists, hospitals, labs, and
pharmacies your plan contracts with at negotiated or discounted rates.
These make up the providers in your “network.” This means you will
almost always pay less when you receive in-network care. Both plans
include access to the Blue Choice PPO network if you live in Texas and
the BlueCard PPO network throughout the country.
If you choose to see an out-of-network provider, you may be required
to submit your own claims. You may also be balance billed, which means
you will be responsible for charges above BlueCross BlueShield of Texas’
maximum allowable charge.
4 2018 Benefits Enrollment
For many of us, nothing is more important than our health and the
health of our family members. This is why Sulzer offers a robust medical
insurance program to our employees. We partner with BlueCross
BlueShield of Texas to offer this coverage.
Both plans cover preventive care at 100% and provide an extensive
network of doctors, hospitals, labs, and other providers who have agreed
to charge reduced fees.
Plan Features
X You do not need to select a primary care physician (PCP)
X You do not need a referral to see a specialist
X When you need medical care, you decide if you want to use an in-
network PPO provider or an out-of-network provider
X If you use an in-network provider, you will receive higher beneits and
will not be balance billed for any charges in excess of the discounted
rate
X You do not have to ile claim forms when you use an in-network
provider
In-Network vs. Out-of-Network
A network is a group of doctors, specialists, hospitals, labs, and
pharmacies your plan contracts with at negotiated or discounted rates.
These make up the providers in your “network.” This means you will
almost always pay less when you receive in-network care. Both plans
include access to the Blue Choice PPO network if you live in Texas and
the BlueCard PPO network throughout the country.
If you choose to see an out-of-network provider, you may be required
to submit your own claims. You may also be balance billed, which means
you will be responsible for charges above BlueCross BlueShield of Texas’
maximum allowable charge.
4 2018 Benefits Enrollment
