Broadcast Union News: Entertainment Industry Flex Plan

Lot's of folks have asked about the Entertainment Industry Flex Plan, here is some information on the plan as available in New York. Coverage varies from State to State, so check their website for more info at www.flexplan.com. We welcome comments from people who have participated in this program.

Blue Cross - National Blue Card Plan 80 (NY) (2008)

The Blue Card Program by Blue Cross provides access to the National Blue Cross/Blue Shield Network. The dual option feature of this plan allows you to go to your own doctor or hospital and be eligible to receive the full benefits of the comprehensive coverage.

If the network providers are used, no claim forms need to be completed and payment is made directly to the provider. This plan provides $5,000,000 lifetime maximum.

This extensive network of quality providers considerably reduces carrier transition issues, as most employees will find their physician is a participant of the network.

You may search for providers on the Flex Plan website (insurance options). National Blue Card Plan 80 is the default option.

Additional Benefit Information: Generally, co-payment amounts are not subject to plan deductibles. Percentages shown are paid by Blue Cross AFTER $750 deductible (max 2 per family) has been satisfied.

Emergency room visits are subject to a $100 fee, plus deductible, then co-insurance paid at the amounts shown below.

Network Participation:: US Hospitals 90%; US Physicians 85%

Out of Pocket Maximum (after deductible) In Network: $3,000
Out of Network: $6,000

Deductible (max 2 per family) $750

Hospital (after deductible) In Network: *80%
Out of Network: $500 fee plus *60% of U+C

Emergency Room ⁺*80% after $100 fee (waived if admitted)

Doctor Visits, X-ray, & Labs In Network: $30 co-pay
Out of Network: *60% of U+C

Pregnancy & Maternity Paid as any other condition

Prescriptions In Network: $20 Generic $30 Name Brand $45 Non-Formulary Brand
Out of Network: In Network co-pay plus any amount over fee schedule.

Pre-existing Conditions: Excluded for 6 months for that specific condition.
Credit given for previous insurance.

* After deductible is satisfied
⁺ Refer to Evidence of Coverage for definition of emergency
U+C = Usual and Customary Charges

Monthly Rates through 12/2008 (Includes $2.50 administration fee)