UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON...

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UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000 PER PERSON $4,000 MAXIMUM PER FAMILY 100% FOR REMAINDER OF CALENDAR YEAR WHEN SERVICES ARE IN BCBS NETWORK

Transcript of UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON...

Page 1: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN

$2,000,000 Lifetime Maximum

DEDUCTIBLE

$300 PER PERSON

$900 MAXIMUM PER FAMILY

ANNUAL OUT-OF-POCKET LIMIT $2,000 PER PERSON

$4,000 MAXIMUM PER FAMILY

100% FOR REMAINDER OF CALENDAR YEAR WHEN SERVICES ARE IN BCBS NETWORK

Page 2: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

PREVENTIVE CARE CHARGES

IMMUNIZATIONS

ROUTINE PHYSICAL EXAMINATIONS

EYE/HEARING EXAMINATIONS

100% COVERAGE - NO DEDUCTIBLE $750 per person per plan year

Page 3: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

HOSPITAL CHARGES

• Inpatient Surgery

• Outpatient Surgery

• Maternity Delivery

• Hospital Stay

90% COVERAGE AFTER DEDUCTIBLE

Page 4: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

NON-HOSPITAL CHARGES

AMBULANCE SERVICE

OFFICE VISITS

PREADMISSION TESTING

80% COVERAGE AFTER DEDUCTIBLE

Page 5: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

MEDCALL

Emergency Room Referral Surgical Services 90% UCR paid when

referred by MedCall.80% without referralNon-Surgical 80% UCR70% without referral

Page 6: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

HOME HEALTH CARE/HOSPICE CARE INPATIENT PSYCHIATRIC TREATMENT MATERNITY ADMISSIONS

SUBSTANCE ABUSE TREATMENT SURGERY ADMISSIONS (inpatient & outpatient) DIAGNOSTIC TESTS

UNICARE, INCORPORATED 1-800-233-5765UNICARE, INCORPORATED 1-800-233-5765

UnicareMedical Utilization Review

Page 7: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

PHARMACY PROGRAM

Network of Retail Pharmacies

Services Outside of Network

90 Day Maximum Drug Supply

$10 co-payment for generic $25 co-payment for preferred brand name 20% of non-preferred brand name cost

($40 min. and $100 max.)

Page 8: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

VISION CARE PROGRAMVISION CARE PROGRAM BLUE CHOICE VISION PROVIDERS LensCrafters Independent Optometrists Independent Ophthalmologists

VISION DISCOUNTS LensCrafters Preset Vision Packages ~Silver, Gold, and Blue Choices~ 30% Off Eyeglasses/Frames/Lenses/Lab Fees 25% Off Non-Prescription Sunglasses Low Fixed Prices on Contact Lenses

Page 9: UNIVERSITY SYSTEM OF GEORGIA INDEMNITY PLAN $2,000,000 Lifetime Maximum DEDUCTIBLE $300 PER PERSON $900 MAXIMUM PER FAMILY ANNUAL OUT-OF-POCKET LIMIT $2,000.

MEDICAL SERVICE

UNIVERSITY SYSTEM OF GEORGIA COVERAGE ANYWHERE IN THE WORLD

(Subject to Balance Billing effective 01/01/2003) HEALTH MAINTENANCE ORGANIZATIONS

ONLY ACUTE CARE AND LIFE THREATENING EMERGENCIES

COVERED OUTSIDE OF SERVICE AREA

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UNIVERSITY SYSTEM OF GEORGIACOST PER MONTH

-Employee- $140.62

-Employee/Spouse $295.20

-Employee/Child $253.00

-Family $407.64


Benefits Covered for Children under the Age of 21 …...tooth 0-20 Teeth 1-32, A-T No Maximum of four (4) teeth per day; Maximum two (2) applications per year per tooth; Maximum lifetime

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Benefits Atlas Group · 2019-05-21 · Atlas Group International Travel Medical Insurance Benefits Policy Maximum $50,000, $100,000, $250,000, $500,000, $1,000,000 or $2,000,000

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Penn State AE Senior Capstone Project · 14 Savannah State 5,000 (2,000,000) (1,995,000) 39900 Direct BIM Savings ($) Net BIM savings ($) BIM ROI (%) Minimum 120,000 36,640 44 Maximum

Penn State AE Senior Capstone Project · 14 Savannah State 5,000 (2,000,000) (1,995,000) 39900 Direct BIM Savings ($) Net BIM savings ($) BIM ROI (%) Minimum 120,000 36,640 44 Maximum

2,000,000 Horas sin Accidentes - Ing.Meniolí Alvarez

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Maximum Frequency Per Day Policy, Professional · Maximum Frequency Per Day Policy, Professional IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission

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$2,200,000$2.2M $2,100,000 $2,000,000 $2.0M $1,900,000 ...

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User Manual - Central Bank of India · 1. Maximum limit per transaction is Rs. 10,000 per transaction 2. Maximum limit per day is Rs. 20,000 There is limit of 20 transactions per

User Manual - Central Bank of India · 1. Maximum limit per transaction is Rs. 10,000 per transaction 2. Maximum limit per day is Rs. 20,000 There is limit of 20 transactions per

2020...$1,000 per person $3,000 per family Coinsurance (amount plan pays after deductible) 100% 100% 100% Out-of-Pocket Maximum (maximum amount you'll pay) $3,000 per person $6,000

2020...$1,000 per person $3,000 per family Coinsurance (amount plan pays after deductible) 100% 100% 100% Out-of-Pocket Maximum (maximum amount you'll pay) $3,000 per person $6,000

Triple-Channel Digital Isolators Data Sheet ADuM1300/ADuM1301 · 1.2 mA per channel maximum at 0 Mbps to 2 Mbps 3.5 mA per channel maximum at 10 Mbps 32 mA per channel maximum at

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Buy-to-Let Lending Criteria... · 2020. 9. 10. · Landbay Lending Criteria 08/2020 | 8 • Minimum property value - £120,000 • Maximum property value - £2,000,000 • Maximum

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Carlsbad Home Sales $999,000 to $2,000,000

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BUGETUL PE TITLURI DE CHELTUIELI, ARTICOLE SI …...interne directe 64 65 TITLUL IV SUBVENTII 40 27,235,372 0 27,235,372 2,000,000 0 2,000,000 4003 27,235,372 0 27,235,372 2,000,000

BUGETUL PE TITLURI DE CHELTUIELI, ARTICOLE SI …...interne directe 64 65 TITLUL IV SUBVENTII 40 27,235,372 0 27,235,372 2,000,000 0 2,000,000 4003 27,235,372 0 27,235,372 2,000,000

PERIOD PER WEEK CREDITS MAXIMUM MARKS THEORY …

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THE AGFA image processing MUSICA SCALE · THE MUSICA SCALE +2,000,000 MUSICA images read per day +8,000 hours diagnostic reading per day with MUSICA +10TB of MUSICA diagnostic information

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OCTOBER...capable of producing 2,000,000 bottles per month (30 capsules per bottle). Pre-Rolled Joints Ascent is developing a fully automated pre-roll line, capable of producing more

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Since 1833, we’ve made 2,000,000 GUITARS · Since 1833, we’ve made 2,000,000 GUITARS and not one compromise. Two Millionth

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Nearly 2,000,000 Per Year - Police Reform Organizing ...

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PowerPoint Presentation · 2018. 9. 28. · Total Rehospitalization Cost per 2,000 CHF Discharges $7,000,000 494 Patients at a cost of 13K per — $6.42 Million $4,000, 000 $2,000,000

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CERTIFICATE OF INSURANCE...de la santé et des services sociaux DARSSS-2020-2021-RC+RCP-RVLRR $2,000,000. per loss and per resource including Tenant’s legal liability: $1,000,000.

CERTIFICATE OF INSURANCE...de la santé et des services sociaux DARSSS-2020-2021-RC+RCP-RVLRR $2,000,000. per loss and per resource including Tenant’s legal liability: $1,000,000.

11 - archive.lib.msu.eduarchive.lib.msu.edu/tic/golfd/page/1979aug11-20.pdf · grass can run as high as 2,000,000 seeds per pound contrasted with approxi-mately 1,000,000 seeds per

11 - archive.lib.msu.eduarchive.lib.msu.edu/tic/golfd/page/1979aug11-20.pdf · grass can run as high as 2,000,000 seeds per pound contrasted with approxi-mately 1,000,000 seeds per