md-employee-benefit-guide-epo
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md-employee-benefit-guide-epo
State of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO C md-employee-benefit-guide-epo CFMl GHMSIEPO POS COMP (Custom 1/17)CareFirst of Maryland, Inc.doing business as CareFirst BlueCross BlueShield 10455 Mill Run Circle Owings Mills. MD 21117-5559A private not-for-profit health sen ice plan incorporated under the laws of the State of Maryland An independent licensee of the Blue Cross md-employee-benefit-guide-epo and Blue Shield AssociationEVIDENCE OF COVERAGEThis Evidence of Coverage, including any attachments, amendments and riders. IS a part of the Group Comd-employee-benefit-guide-epo
ntract issued to the Group through which the Subscriber is enrolled for health benefits, bl addition, the Group Contract includes other provisions thaState of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO C md-employee-benefit-guide-epo CareFirst and the Group.CareFirst provides administrative claims payment services only and does not assume any financial risk or obligation with respect to those claims.The Group reserves the right to change, modify, or terminate the Plan, in whole or in part. Members have no benefits after a Plan t md-employee-benefit-guide-epo ermination or partial Plan termination affecting them, except with respect to covered events giving rise to benefits and occurring prior to the date omd-employee-benefit-guide-epo
f Plan termination or partial Plan termination and except as otherwise expressly provided, in writing, by the Group, or as required by federal, state State of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO C md-employee-benefit-guide-epo rst has provided this Evidence of Coverage, including any amendments or riders applicable thereto, to the Group in electronic format. .Any errors, changes and or alterations to the electronic data, resulting from the data transfer or caused by any person shall not be binding on CareFirst. Such error md-employee-benefit-guide-epo s, changes and or alterations do not create any right to additional coverage or benefits under the Group’s health benefit plan as described in the heamd-employee-benefit-guide-epo
lth benefit plan documents provided to the Group in hard copy format.Group Name:State of Maryland_____________________________________________________State of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO C md-employee-benefit-guide-epo COMP (Custom 1 17)State of Mary land. 01/01/17Table of ContentsDEFINITIONS 5ELIGIBILITY AND ENROLLMENT 15MEDICAL CHILD SUPPORT ORDERS 20TERMINATION OF COVERAGE 22CON I IN I Al ION OF COVERAGE 24COORDINATION or BENEFITS; SITIROG ATĨON 26now TĨĨE PLAN WORKS 32REFERRALS 36UTILIZATION MANAGEMENT REQUIR md-employee-benefit-guide-epo EMENTS 38INTER-PLAN ARRANGEMENTS DISCLOSURE 44INTER-PLAN PROGRAMS ANCILLARY SERVICES 47BENEFITS FOR MEMBERS ENTITLED TO MEDICARE _____________________md-employee-benefit-guide-epo
48DESCRIPTION OF COVERED SERVICES _______________________________52EXCLUSION s 94ELIGIBILITY SCHEDULE FOR NON-MEDICARE OPTION 102SCHEDULE OF BENEFITS State of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO CState of MarylandExclusive Provider Option with Vision Care Benefits AndExclusive Provider Option with -Medicare Option with Vision Care BenefitsASO CGọi ngay
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