How do you determine which EPO or HMO medical plan best meets your needs? Check out our Plan Comparison Chart (pdf) to see how our benefit summaries work for you. Please note, the benefit summaries outlined in the comparison chart only highlight offered benefits. For official in-depth information, refer to the Summary Plan Document.
New to Exclusive Care is the Select Point of Service (POS) Plan for active employees and retirees is a plan that gives you the flexibility like a Preferred Provider Organization (PPO). This plan offers three tiers of coverage. Each time you need medical care, you get to decide which of the following tiers is best for you:
Tier 1: The Exclusive Care Network (In-Network) - This tier offers the highest benefits and lowest out-of-pocket costs. It also provides comprehensive coverage through a focused network of physicians, medical groups and hospitals that have contracted with Exclusive Care.
Search for a Tier 1 Doctor or Facility below to see what is available in your area.
Tier 2: National Provider Network - This tier provides comprehensive, affordable benefits for members who live or travel outside the Exclusive Care network. Our National Provider Network provides excellent coverage throughout the state, as well as coverage anywhere in the country. If there are no Tier 1 providers in your area, Tier 2 will be your preferred provider network.
Tier 3: Non-Network Providers - are covered by the plan as long as they are licensed providers. Keep in mind your out-of-pocket costs will be higher, as these providers do not offer discounted rates.
Click here for a sample Exclusive Care Select POS membership card (jpg)
The Summary Plan Document (SPD) will be the primary governing document for all plan coverage decisions and will be the basis for the final determination for the provision of benefits.
Information on plans such as the Exclusive Care Out-of-Area Dependent Coverage Plan can be found in Section 4 of the EPO Summary Plan Document below.
This Health Plan is intended to comply with all laws and regulations that are applicable whether or not specifically described in the Summary Plan Document. If you have any questions about your benefits under this plan, contact Member Services.
Click here for the EPO Summary Plan Document (pdf)
Click here for the Select Medicare Coordination Summary Plan Document (pdf)
Click here for the Select Medicare Supplement Summary Plan Document (pdf)
Click here for the Select POS Summary Plan Document (pdf)