HOSPITAL AND MEDICAL BENEFITS ( Public Medical Plan files - Private files available after Log In )
Network and Non-
One important aspect of the Plan is the use of a Preferred Provider Organization
(PPO). The Plan has contracted with the MultiPlan Network and Horizon Blue Cross
Blue Shield of New Jersey to make available a network of physicians, hospitals and
healthcare providers at a reduced cost to you and the Plan. The Plan has also contracted
with Caremark to manage the Plan's prescription drug program. Essentially, these
providers (or any other network the Plan may retain in the future) agree to accept
the reduced fees agreed upon with the network as payment in full for Covered Services.
You are responsible for a share of the agreed-
The arrangements between the Plan and the PPOs are flexible, meaning that there is no requirement that you go to a specific hospital, health care provider or pharmacy. You still may choose your hospital, health care provider or pharmacy at the time you receive care. However, as described in more detail below, you will save a significant amount of money if the hospital, health care provider or pharmacy you use participates in the applicable PPO.
In most cases, as described below, if you use network providers you will not pay
a deductible, and the cost will be covered with the exception of a nominal co-
You will receive a Horizon Blue Cross Blue Shield ID card, a MultiPlan ID card and a Caremark prescription ID card. The Horizon Blue Cross Blue Shield card is for the hospitals only; the MultiPlan card is for medical providers such as doctors, radiologists, labs, diagnostic centers and other similar providers; the Caremark prescription card is for retail pharmacies and the Mail Service Program for maintenance medication.
You will receive directories for the networks to assist you in locating network providers
in your area. Although the directories are updated periodically, please contact MultiPlan
THE MULTIPLAN NETWORK
$25.00 PER VISIT
Effective November 1, 2004, in addition to your current plan of benefits, you will
have the choice of saving healthcare dollars by using the MultiPlan® Network. When
you visit a Network doctor you will pay $25.00 per visit whether or not you have
satisfied your annual Major-
PAID IN FULL LABS
If you use MultiPlan® Network Labs and diagnostic facilities, your costs are covered
in full whether or not you have satisfied your annual Major-
YOUR BENEFITS REMAIN THE SAME
The Local 25 Medical Plan Benefits Program remain the same. If you choose not to
use the MultiPlan® Network doctors and labs, you are responsible for the annual $150.00
deductible, 20% co-
THE CHOICE IS YOURS
You may choose whether to use the MultiPlan® Network or "Out-
You and your eligible dependents now have the opportunity to save your healthcare dollars by choosing a doctor from the MultiPlan® Network. By using the Network, you will pay only $25 an office visit. If the doctors refer you for further tests or to another doctor, remember to ask him/her to use the Network if possible. Make sure to bring your identification card with you when you visit the doctor.
* REMEMBER , BY USING THE MULTIPLAN NETWORK, YOUR $150 DEDUCTIBLE IS WAIVED!.