2013 Employee Benefits Guidebook - Administration Home

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Ambulance Service 75% after deductible Note: Pre-authorization with the Claims Administrator will be required for non-emergent transport. Advanced Radiological Imaging (i.e., MRIs, MRAs, CAT Scans, PET Scans and Nuclear Medicine) 75% No deductible or copayment will apply Not Covered Diagnostic X-ray & Lab Testing 100% No deductible applies Not Covered Durable Medical Equipment 100% Not Covered No deductible or copayment will apply Home Health Care 75% after deductible Not Covered Home Infusion Therapy 75% after deductible Not Covered Hospice Care 75% after deductible Not Covered Note: A pre-authorization is required prior to services being rendered. Please see the Covered Charges section fo Bereavement Counseling 75% after deductible Not Covered Mental Disorders and Substance Abuse Treatment Inpatient Services Payable as any other Illness Not Covered Outpatient Visits 100% after $10 copayment Not Covered No deductible applies Morbid Obesity Benefit Payable as any other Illness Not Covered more information regarding this benefit. Nutritional Evaluation Outpatient Short-Term Rehabilitation Therapy and Chiropractic Services Payable as any other Illness 3 visits per Calendar Year maximum 100% after $20 copay per visit No deductible applies Not Covered Not Covered Includes: Cardiac Rehab, Physical Therapy, Speech Therapy, Occupational Therapy, Pulmonary Rehab, Cognitive Therapy and Chiropractic services. Multiple services provided on the same day constitute one visit, but a separate copayment will apply to the services provided by each Physician. Orthotics 75% after deductible Not Covered Note: See Covered Charges section for details. Prosthetics 100% Not Covered No deductible or copayment will apply Pregnancy * Initial visit (to confirm Pregnancy) 100% after $75 Specialist office visit copayment Not Covered 2013 Employee Benefit Guidebook Updated August 2013
All subsequent prenatal visits, postnatal visits, and Physician’s delivery charges (i.e., global maternity fee) Physician’s office visits in addition to the global maternity fee (when performed by an OB/GYN or specialist) Delivery – Facility charges (Inpatient Hospital, Birthing Center) Organ Transplants Transportation Benefit Maximum (Available only when using a COE facility) 75% after deductible 100% after $75 office visit copayment No deductible applies Payable per Inpatient Hospitalization benefit Payable as any other illness $10,000 Lifetime Maximum Not Covered Not Covered Not Covered Not Covered Note: See the Covered Charges section for more information regarding this benefit. Wigs 75% after deductible $1,000 Lifetime Maximum Note: Limited to the initial purchase of a wig when deemed Medically Necesssary due to temporary or permanen hair loss. See the Covered Charges section for more information regarding this benefit. All Other Eligible Charges 75% after deductible Not Covered 2013 Employee Benefit Guidebook Updated August 2013
Page 1 and 2: EMPLOYEE BENEFITS Open Enrollment G
Page 3 and 4: PHONE DIRECTORY Employment, Benefit
Page 5 and 6: IMPORTANT INFORMATION SUMMARY OF BE
Page 7 and 8: EMPLOYEE CONTRIBUTIONS AND POP: The
Page 9 and 10: MEDICAL, VISION AND DENTAL PLAN PRE
Page 11 and 12: Questions regarding which protectio
Page 13: (including ER Physician services) M
Page 17 and 18: Note: The copayment will apply as l
Page 19 and 20: Pregnancy * Initial visit (to confi
Page 21 and 22: Wellness Exams The County Employee
Page 23 and 24: Walgreens Health Initiatives now Ca
Page 25 and 26: Medication List (PML)/formulary is
Page 27 and 28: 2013 Employee Benefit Guidebook Upd
Page 29 and 30: Guardian DENTAL PLANS El Paso Count
Page 31 and 32: What is an FSA? FLEXIBLE SPENDING A
Page 33 and 34: You can only be reimbursed up to th
Page 35 and 36: VOLUNTARY TERM LIFE INSURANCE Volun
Page 37 and 38: DISABILITY BENEFITS SHORT TERM DISA
Page 49: 2013 Employee Benefit Guidebook Upd

2013 Employee Benefits Guidebook - Administration Home

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