Page 6 - Electric Ben Guide 08-18
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HMO MEDICAL PLANS

        With the Blue Shield Health Maintenance Organization (HMO) plans, you must choose a Primary Care Physician
        (PCP) or medical group. You may choose from the Trio ACO Network or the Access+ Full Network HMO plans.  All
        of your care must be directed through your PCP or medical group. Any specialty care you need will be coordinated
        through your PCP and will generally require a referral or authorization. You will receive benefits only if you use
        the doctors, clinics, and hospitals that belong to the medical group in which you are enrolled, except in the case
        of an emergency.

        HSA MEDICAL PLAN


        The Health Savings Account (HSA) plan through Blue Shield combines a high deductible PPO health plan (HDHP)
        with a special, tax-qualified savings account. You may use your HSA funds to pay for current medical expenses
        such as deductibles, copays and coinsurance or save toward future medical expenses. This plan works like the
        PPO plan by allowing you the freedom to go in and outside of the network for care.  Electric will contribute $1,000
        to individual and $2,000 to family bank accounts to be used towards the deductible. You have the opportunity to
        contribute a combined maximum of $3,450 for the individual and $6,900  for the family in 2018, and $3,500 for
        the individual and $7,000 for the family in 2019.

        PPO PLAN


        With the Blue Shield Preferred Provider Organization (PPO) plan, you are not limited to the physicians within the
        PPO network and you may self-refer to specialists. If you receive care from a physician who is a member of the PPO
        network, a greater percentage of the entire cost will be paid by the insurance plan. You may also obtain services
        using a non-network provider; however, you will be responsible for the difference between the covered amount
        and the actual charges.  You may also be responsible for filing claims.

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