Agenda - Council - 11/22/1983 - Laserfiche WebLink

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TK~ ~ HOT A OOMPLIrl'B DBBCRIPTION OF BKKEPFF8o THE IfAHTER CONTRAC'F ~.L ~. ~ ~~~N OF ~ ~ COMPA~ON OF B~EF~ ~ GROUP HEALTH, PH~IC~NS HEALTH AND MEDCEN~ HEALTH PLANS (~f~tive J~uary 1, 1984) GROUP HEALTH PHYSICIANS HEALTH MEDCENTERS HEALTH PLAN PLAN PLAN I I- I ! I I I I I I I Definition of Dependents (Continued) Can coverage be converted upon termination of employment? (After 12 months continuation privilege. ) Can dependent ehildren convert to individual policy upon reaching age 19 (or 23 if fuU- time student)? Oth~ Exclami~ disability occurred while covered by the contract, Yes, provided you reside within GHP~ service area. Employees and depend- ants age 65+ may convert to a Medicare supplement policy or individual contract. Yes (J6H) Services of physician outside GHP unless arranged by GHP. Dental care, work comp cases, hospital confinement for diagnostic work when curative treat- ment is not rendered during confinement, home health services, speech therapy, genetic screening, custodial care, and experimental proced- ures not generally aeeepted by the medical profession. while covered by the contra, t: divorced spouse of the enrollee (until one or the other of the divorced PHP members remarries). H. Yes, provided you reside within PHP~ service area. Employees and depen- dents age 65+ may convert to a Medicare supplement policy or individual contract, I. Yes ({6H) Services not pre- scribed, recommended or approved by a PHP physician are excluded except in emergency situations; work comp eases, dental care, custodial care and experimental proce- dures not generally accepted by the medical profession are excluded. Out- of-plan referrals are excluded unless approved in advance in writing by the plan. Ho spouse of the enrollee (for up to 2 years or until one or the other of the divorced MCHP members remarries, whichever period is shorter). Yes, provided you reside within MCHP's service area. If you move outside their service area, you may choose from among several indemnity conversion options. Yes (#6H) Services not pre- scribed, recommended or approved by a MCHP physician are excluded except in emergency situations. Work comp cases, dental care, custodial care, and experimental procedures not gener- ally accepted by the medical profession are excluded.