You have the choice of receiving medical benefits through PPO Network providers or
out-of-network providers. PPO network benefits are provided through a network of
physicians and hospitals that has contracted with the Plan to offer medical care at
discounted rates through a Preferred Provider Organization (PPO).
You may also obtain care from an out-of-network physician or hospital. A non-network
physician or hospital is one that does not belong to the PPO.
When you use the services of network providers, the Plan may pay a higher percentage,
sometimes 100% of your covered expenses after you make a small copayment for
certain services, or the Plan may pay a percentage of your covered expenses after your
deductible, but not 100%. When you use out-of-network providers, the percentage paid
by the Plan is generally lower than the percentage the Plan pays for PPO providers. Your
service provider options and the percentages paid by the Plan are listed in your
schedule of benefits that accompanies this booklet.