Page 19 - 2019 CommScope AE
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Spine and Joint Solution
Is back, knee or hip pain changing how you live your life? A dedicated orthopedic team can review your treatment
options—if you choose surgery, the team can offer support before and after your procedure, so you can get back
to doing what you love. This new COE offers an enhanced in-network level of beneits, meaning a lower cost to
you, versus non-COE network providers.
Health and Investment Plan A
Plan Details In-Network Out-of-Network COE
Annual Deductible $3,000/$6,000 $6,000/$12,000 $3,000/$6,000
Inpatient Care 70% 60% 80%
Health and Investment Plan B
Annual Deductible $1,500/$3,000 $3,600/$7,800 $1,500/$3,000
Inpatient Care 80% 60% 90%
PPO Medical Plan
Annual Deductible $750/$1,500 $1,500/$3,000 $750/$1,500
Inpatient Care 80% 60% 90%
This COE may offer a travel beneit, rules and restrictions apply.
Cancer Support Program
If cancer touches your life, this personalized program may be available for you, your family and your support
system. Cancer COEs are designed for complex cancer cases, and not all cancers are best treated at a Cancer COE.
If eligible for this COE, a beneit to cover your travel costs for visiting the COE will be provided.
Health and Investment Plan A
Plan Details In-Network Out-of-Network COE
Annual Deductible $3,000/$6,000 $6,000/$12,000 $3,000/$6,000
Inpatient Care 70% 60% 70%
Travel Beneit Not available Not available Included
Health and Investment Plan B
Annual Deductible $1,500/$3,000 $3,600/$7,800 $1,500/$3,000
Inpatient Care 80% 60% 80%
Travel Beneit Not available Not available Included
PPO Medical Plan
Annual Deductible $750/$1,500 $1,500/$3,000 $750/$1,500
Inpatient Care 80% 60% 80%
Travel Beneit Not available Not available Included
You can easily access some of these services by
calling the number on your health plan ID card.
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Is back, knee or hip pain changing how you live your life? A dedicated orthopedic team can review your treatment
options—if you choose surgery, the team can offer support before and after your procedure, so you can get back
to doing what you love. This new COE offers an enhanced in-network level of beneits, meaning a lower cost to
you, versus non-COE network providers.
Health and Investment Plan A
Plan Details In-Network Out-of-Network COE
Annual Deductible $3,000/$6,000 $6,000/$12,000 $3,000/$6,000
Inpatient Care 70% 60% 80%
Health and Investment Plan B
Annual Deductible $1,500/$3,000 $3,600/$7,800 $1,500/$3,000
Inpatient Care 80% 60% 90%
PPO Medical Plan
Annual Deductible $750/$1,500 $1,500/$3,000 $750/$1,500
Inpatient Care 80% 60% 90%
This COE may offer a travel beneit, rules and restrictions apply.
Cancer Support Program
If cancer touches your life, this personalized program may be available for you, your family and your support
system. Cancer COEs are designed for complex cancer cases, and not all cancers are best treated at a Cancer COE.
If eligible for this COE, a beneit to cover your travel costs for visiting the COE will be provided.
Health and Investment Plan A
Plan Details In-Network Out-of-Network COE
Annual Deductible $3,000/$6,000 $6,000/$12,000 $3,000/$6,000
Inpatient Care 70% 60% 70%
Travel Beneit Not available Not available Included
Health and Investment Plan B
Annual Deductible $1,500/$3,000 $3,600/$7,800 $1,500/$3,000
Inpatient Care 80% 60% 80%
Travel Beneit Not available Not available Included
PPO Medical Plan
Annual Deductible $750/$1,500 $1,500/$3,000 $750/$1,500
Inpatient Care 80% 60% 80%
Travel Beneit Not available Not available Included
You can easily access some of these services by
calling the number on your health plan ID card.
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