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1、 Southern Medical & MobilityBenefit Sheet for 2004These benefits are offered to full time employees (30 or more hrs per week)Health Insurance by Health Spring of Alabama HMO SMM pays 70% of the employees premium. HealthSpring requires a certificate of coverage for the last 12 months of continuous co
2、verage. Drug Card Included. See the brochure for benefits applicable. Employee Premium $ 183.25 SMM pays 128.28 - Emp pays 25.37 per pay periodFamily Premium $ 487.82 SMM pays 128.28 - Emp pays 165.94 per pay Insurance by HealthSpring of Alabama Employee Premium $ 19.55 SMM pays 13.69 Emp pays 2.70
3、 per pay period Family Premium $ 59.39 SMM pays 13.69 Emp pays 21.09 per pay periodPatelco Credit Union Patelco provides employees with a credit union membership. Offering great deals on various financial & benefit services, such as: Loans & Insurances. Including: Health, Disability, Auto and Homeow
4、ners. Visa, MasterCard application and ShareBuilder Trading. www.patelco.org Working Advantage As an employee of SMM you are entitled to corporate discounts on Entertainment, Shopping, Vacations and lots more. Go to enter your SMM Member ID # 500153536. AFLAC Supplemental Insurance options for Sout
5、hern Medical & Mobility Employees. Let me know if you have any interest in making an appointment with our AFLAC representative. These are employee out of pocket premiums.We offer vacation, sick time, personal days and paid holiday benefits. All benefits are subject to a 90 day waiting period. Please
6、 see our website for the complete employee manual: http:/ . NOTE: These benefits are subject to change at any time. Schedule of Benefits for Southern Medical & MobilityPhysician & MedicalCost to MemberOffice Visits$20 per visit for Primary CareConsults & treatment specialists$30 per visitSecond Surg
7、ical Opinions$30Diagnostic lab and xrayNo charge if in conjunction with ovAllergy testing & treatmentNo charge if in conjunction with ovRadiation therapy and chemoNo charge if in conjunction with ovChiropractic 12 visits per contract yr$30Routine eye exam (1 per 24 months)$30Preventative ServicesWel
8、l Baby and immunizations$20Hearing screenNo charge if in conjunction with ovRoutine gyn exams$20 Periodic health assessments$20MammogramsNo chargeHospital (InPatient)Semi private room (unlimited days)$500+ $25 per day (days 3-10 * co pay per admission Intensive care and other special care unitscover
9、s each of these servicesSurgical and anesthesia svcsOperating and recovery rooms, oxygen, drugsand medicationsGneral NursingXray, lab and other diagnostic servicesPrescribed radiation therapy and short termPhysical therapyAdministration of whole blood or plasmaOutpatient CareOutpatient Surgery$300 p
10、er outpatient serviceAll necessary services and supplies (excludingNo ChargeDrugs) provided in connection with a hospitalOutpatient visitShort term Physical TherapyNo ChargeShort term Speech TherapyNo ChargeShort term Occupational TherapyNo ChargeEmergencyHospital emergency room and services$100 per
11、 occurrence, waived if hospitalized in 24 hrs(in an emergency as defined in the Certificate of CoverageAmbulance when approved in advance byNo ChargeHealth Spring of Al.Maternity CarePhysician and Medical Services for prenatal, No ChargeDelivery and postnatal servicesComplications of pregnancyNo Cha
12、rgeHospital services (as above), includingRoutine nursery care$500 +$25 per day (days 3-10) * per AdmissionMental HealthInpatient care (30 days acute care per contract yr. 50% copay* per admissionDay Care (See certificate of coverage)$50 copay per visitOutpatient care Short Term 20 1hr visits per $5
13、0 copay per visitContract yearAlcohol and Drug DetoxicationDrug and Alcohol detox svcs only50%* copay per admission for removal of toxic drug& alcohol levels from the blood *Maximum out of pocket expense For inpatient hospital services, there is a maximum out of pocket expense of $1000 per member pe
14、r contract year.*Maximum Benefit on durable medical equipment is $2000 per member per contract year.* Dependent cut off age is 19.Full time student cut off age is 23This is a summary onlythis is not a contract or a legal binding agreement.PrescriptionsGeneric Copay $15Preferred Brand $25Non Preferred $35Mental & Nervous 50%Participating pharmacy shall furnish the prescribed drug to the patient upon presentation of validid card and as long as the prescription meet
