Medical
Your Medical plan is a Preferred Provider Organization (PPO) plan through the BlueCard® Nationwide Network. This means that benefits will be paid at a higher rate when you visit a network provider. See the back for instructions on finding a network provider.
As you know, the contracted rates or allowed rates are negotiated between Blue Cross and their network providers. These rates apply only to network services. When you use a network provider, you’re not responsible for paying any amount over the contracted rate, even if the provider bills a higher amount. The allowed amount is payable at the higher network benefit rate.
Non-network providers are subject to the “Reasonable and Customary (R&C) limits”. Any amount over R&C is not considered an eligible expense. The R&C amount is payable at the lower non-network benefit rate. If you use a non-network provider, you’re responsible for paying any amount over the R&C limit. For more information on coinsurance and Reasonable and Customary limits, please see the Summary Plan Description.
Mental Health
Occasionally we find ourselves facing a situation that seems to be more than we can deal with on our own. At such times, it may be helpful to talk with a professional counselor, to assist you through a difficulty or simply to provide you with another point of view. As a plan participant, you are eligible for mental health and chemical dependency benefits.
Enclosed you will find information on the mental health and chemical dependency benefits available through the Writers’ Guild-Industry Health Fund Plan (“Fund”). In reviewing the benefits chart, you will find that you will receive a higher level of benefits if you use a contracted provider.
Vision
VSP is a nationwide network of eye care and eyewear providers. All eligible participants will automatically be enrolled in the new VSP vision program. Make sure your vision provider uses your Health Fund ID number (WRXA), as we didn’t provide VSP with any social security numbers.
The vision program offers:
- The broadest array of “paid-in-full” coverage
- Low member out-of-pocket cost
- The highest benefit allowances compared with other standard vision plans
- Total member flexibility to:
- choose any frame at their provider’s office
- select the most popular lens options at significant savings
- visit any of their network providers at more than 35,000 points of access (retail or private practice)
- The highest use of “covered-in-full” frame coverage
Please take a moment to review the attached information. If you have any questions, feel free to contact the Participant Services Department at the Fund Office (818) 846-1015, or visit our website at www.wgaplans.org.
BlueCard®Network
How to Locate a BlueCard ® Provider
There are two ways you can find doctors and hospitals that participate in the PPO plan:
- You may call (800) 810-BLUE (2583) for assistance in finding a PPO physician or
hospital. Be sure to tell the Customer Service Representative that your three-digit
alpha prefix is WRX. - You may also use our website, www.wgaplans.org, and click on the Find
Participating Provider link to select a hospital network or physician in your area.
How to Locate a VSP Provider
There are two ways you can find a provider that participate in the VSP Vision plan:
- You may call 1-800-877-7195 for assistance in finding a VSP Provider.
Be sure to tell the Customer Service Representative that your that your three-digit
alpha prefix is WRX.
We have not provided VSP with social security number for your protection.
- You may also use their website www.vsp.com and fill in the desired zip code in the section “Find a VSP Doctor”.
Your ID# is 12 digits: a 3-digit alpha prefix (WRX) is followed by your unique ID# (A12345678). It is very important for your providers to use the entire 12 digit ID# on claims submission to all medical, mental health, vision and dental providers. Please be sure to follow the claim submission information that is located on the back of your new ID card.