The PPO Program is an indemnity health insurance plan that utilizes most of the major
hospitals, pharmacies, and many doctors as Preferred Provider Organizations (PPO).
This plan provides 90% coverage, after deductibles, when the plan member uses a PPO
provider. If a plan member uses a non-provider when a PPO provider is available, the
coverage is 70% after deductibles. If there is no PPO provider available the coverage
is 80% after deductibles. There is a $500.00 deductible per family member with a maximum
of $1500.00. Blue Cross/Blue Shield uses a utilization review company to review all
hospitalizations and some outpatient surgeries. Failure to notify the utilization
review company will result in a penalty incurred against the plan member (maximum
penalty to $2000.00). A list of PPO providers is available from the Human Resources
Office. Coverage for non PPO services for plan members who reside out of state willbe
90%(subject to plan year dedcutible and/or co-insurance. Member pays difference between
billed amount and fee schedules).
For current rates, click here to go to the rate table.