ACME Corporation Health Insurance Programs
ACME corporation offers employees a choice of several group health plans. Most of these plans incorporate a managed care strategy in their approach. The options vary in the amount of choice and level of benefits. You may choose from WellCare, a point-of-service plan; HMO coverage; and Catastrophic Plan.
WellCare is a point-of-service medical plan that combines the advantages of a health maintenance organization (HMO) with the option to use the physician of your choice. When you join, you choose a primary care physician (PCP) from the plan network. If you receive care provided by, or authorized by, your PCP you receive the highest level of coverage (100%) with a small co-payment. This is called In-Network. If you obtain care not provided or authorized by a network PCP, you would receive a lower level of benefits (80%).
In most locations, we offer a local HMO. When you join the HMO, you select a primary care physician for yourself and each covered family member. For treatment, you see your PCP. Most Services are covered in full and you pay only a small co-pay. Except in an emergency, services received outside the network are not covered.
The Catastrophic Plan offers you an alternative if you are in excellent health and rarely need medical services and feel that you don't need or use the services that the full plan offers. This plan provides financial protection against the high cost of an unexpected catastrophic illness or accident. It is not designed to help pay for routine care or basic medical services. |
