Empire Plan Changes Effective January 1, 2007

Benefit

2006 Benefit Level

2007 Benefit Level

Network Hospital (BC)

 

 

Emergency Room

$50 copay

$60 copay

Outpatient Physical Therapy

$15 copay

$18 copay

Par Provider (UHC)

 

 

Office Visit, Surgical Procedures, Radiology and Diagnostic/Lab

$15 copay

$18 copay

Managed Physical Medicine (MPN)

 

 

Physical/Occupational Therapy and Chiropractic Care

$15 copay

$18 copay

Managed Mental Health  (ValueOptions)

 

 

Outpatient Mental Health Visits

$15 copay

$18 copay

Outpatient Substance Abuse Visits

$15 copay

$18 copay

Emergency Room

$50 copay

$60 copay