Posts by resig
California Employers Required To Implement Workplace Violence Prevention Plan By July 1, 2024
Employers in California will be required to establish, implement, and maintain a written Workplace Violence Prevention Plan (WVPP), as mandated by California Labor Code Section 6401.9. It’s important to note…
Read More2024 Retiree Survey
As we strive to enhance our communication channels and keep you informed about the latest updatesand happenings within our organization as well as important benefits information, we would like toensure…
Read MoreMAJOR SERVICES
Complex or restorative dental work such as crowns, bridges, dentures, inlays and onlay.
Read MoreDIAGNOSTIC AND PREVENTIVE SERVICES
Generally include routine cleanings, oral exams, x-rays, and fluoride treatments. Most plans limit preventive exams and cleanings to two times a year.
Read MoreBASIC SERVICES
Dental services such as fillings, routine extractions, and some oral surgery procedures.
Read MorePREFERRED DRUG
Each health plan has a list of prescription medicines that are preferred based on an evaluation of effectiveness and cost. Another name for this list is a “formulary.” The plan may charge more for non-preferred drugs or for brand-name drugs that have generic versions. Drugs that are not on the preferred drug list may not be covered.
Read MoreGENERIC DRUG
A drug that has the same active ingredients as a brand name drug but is sold under a different name. For example, Atorvastatin is the generic name for medicines with the same formula as Lipitor. You generally pay a lower copay for generic drugs.
Read MoreBRAND NAME
A drug sold under its trademarked name. For example, Lipitor is the brand name of a common cholesterol medicine. You generally pay a higher copay for brand name drugs.
Read MoreOUT-OF-POCKET MAXIMUM
The most you would pay from your own money for covered healthcare expenses in one calendar year. Once you reach your plan’s out-of-pocket maximum dollar amount (by paying your deductible, coinsurance and copays), the plan pays for all eligible expenses for the rest of the plan year.
Read MoreIN-NETWORK / OUT-OF-NETWORK
Network providers (doctors, hospitals, labs, etc.) are contracted with your health plan and have agreed to charge lower fees to plan members, as negotiated in their contract with the health plan. Services from out-of-network providers can cost you more because the providers are under no obligation to limit their maximum fees. With some plans, such as HMOs and EPOs, services from out-of- network providers are not covered at all.
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