To Secure Housing. A continuing employee and one (1) additional family member will be allowed up to three (3) round trips to a new official workstation for the purpose of securing housing. Travel, lodging, and food costs will be reimbursed up to a maximum of nine (9) days in accordance with the Standardized Travel Regulations.
To Secure Housing. A continuing employee and one (1) additional family member will be allowed up to three (3) round trips to a new official work station for the purpose of securing housing. Travel, lodging, and food costs will be reimbursed up to a maximum of nine (9) days in accordance with the Standardized Travel Regulations. HEALTH INSURANCE BENEFIT CHART P r e v e n t i v e S e r v i c e s State Health Plan PPO “SHP – PPO” Benefits HMO Plan “HMO” Benefits In-network Out-of-network Health maintenance exam Covered 100% 1 per year Not Covered Covered 100% Annual gynecological exam Covered 100% 1 per calendar year Not Covered Covered 100% Pap smear screening – laboratory services only 1 Covered 100% 1 per year Not Covered Covered 100% Well-baby and child care Covered 100% Not Covered Covered 100% Immunizations, annual flu shot & Hepatitis C screening for those at risk Covered 100% Not Covered Covered 100% Childhood Immunizations Covered 100% through age 16 Covered 80% Covered 100% Fecal occult blood screening 1 Covered 100% Not Covered Covered 100% Flexible sigmoidoscopy 1 Covered 100% Not Covered Covered 100% Prostate specific antigen screening 1 Covered 100% one per year Not Covered Covered 100% Mammography, annual standard film mammography screening (covers digital mammography up to the standard film rate) 1 Covered 100% Covered 80% after deductible Covered 100% Colonoscopy 1 Covered 100% Covered 80% after deductible Covered 100% 1 American Cancer Society guidelines apply P h y s i c i a n O f f i c e S e r v i c e s State Health Plan PPO “SHP – PPO” Benefits HMO Plan “HMO” Benefits In-network Out-of-network Office visits, consultations and urgent care visits and telemedicine2 Covered, $20 co-pay Covered 80% after deductible Covered, $20 co-pay Outpatient and home visits Covered 90% after deductible Covered 80% after deductible Covered, $20 co-pay E m e r g e n c y M e d i c a l C a r e State Health Plan PPO “SHP – PPO” Benefits HMO Plan “HMO” Benefits In-network Out-of-network Hospital emergency room for medical emergency or accidental injury Covered, $200 co-pay if not admitted Covered, $200 co- pay if not admitted Ambulance services – medically necessary Covered, 90% after deductible Covered, 100% after deductible D i a g n o s t i c S e r v i c e s State Health Plan PPO “SHP – PPO” Benefits HMO Plan “HMO” Benefits In-network Out-of-network Laboratory and pathology tests Covered 90% after deductible Covered 80% after deductible Covered 100% Diagnostic tests and x-rays ...
To Secure Housing. A continuing employee and one (1) additional family member will be allowed up to three (3) round trips to a new official work station for the purpose of securing housing. Travel, lodging, and food costs will be reimbursed up to a maximum of nine (9) days in accordance with the Standardized Travel Regulations. APPENDIX F Letter of Understanding—Article 26 The attached Rules for Network Use will be used by the parties in determining in- network and out-of-network benefits. In addition, the parties agree to set up a joint committee for the purpose of creating any additional guidelines and reviewing implementation. The committee will also be charged with identifying situations in which access to non-participating providers may be necessary and developing procedures to avoid balance billing in these situations. The parties have also discussed the fact that there are some State employees who do not live in Michigan. The following are procedures in place for persons living or traveling outside Michigan: Members who need medical care when away from Michigan can take advantage of the Third Party Administrator’s National PPO program. There is a toll-free number for members to call in order to be directed to the nearest PPO provider. The member is not required to pay the physician or hospital at the time of service if he/she presents the PPO identification card to the network provider. If a member is traveling he/she must seek services from a PPO provider. Failure to seek such services from a PPO provider will result in a member being treated as out-of-network unless the member was seeking services as the result of an emergency. If a member resides out of state and seeks non-emergency services from a non-PPO provider, he/she will be treated as out-of-network. If there is not adequate access to a PPO provider, exceptions will be handled on a per case basis. RULES FOR NETWORK USE Effective October 12, 2014, see Appendix G-2 for member costs. A member is considered to have access to the network based on the type of services required, if there are: Primary care -two primary care physicians (PCP) within 15 miles; Specialty care -two specialty care physicians (SCP) within 20 miles; and Hospital - one hospital within 25 miles. The distance between the member and provider is the center-point of one zip code to the center-point of the other. SHP PPO MEMBER COSTS ASSOCIATED WITHIN IN-NETWORK OR OUT- OF-NETWORK USE (for eligible employees hired prior to April 1, 2010 and ...
