Week 1

Plan Types

100

• INN only
• Referrals are required to see a specialist, PT, & medical equipment
• Most services require a copay

HMO

200

• Offers INN & OON
• No PCP or Referral required
• Most policies have a higher DED & Co-INS
• Usually paired with HSA

HDHP or CDHP

300

• Restrictive INN only
• Networks are usually regional (state or region w/ in a state)
• Has DED & Co-INS
• No PCP or Referral needed 

EPO

400

• Offers INN & OON
• No PCP or Referral required
• Most policies have a DED & Co-INS
• Premuims' are usually very high     

PPO

500

• Hybrid of HMO & PPO plan; INN only 
• PCP may be required
• No Referral required
• Premiums are typically lower than PPO

POS

Medical & Networks

100

This health care provider has a contract with the carrier to provide health care services at a pre-negotiated contracted rate 

INN provider

200

Another name for non-prescription medication.

OTC

300

Serves as a patient’s main point of contact for medical care. Also, known as the gatekeeper.

PCP

400

A provider that doesn't work with the insurance company, the member gets charged the full price or R&C for their services.

OON provider

500

I specialize in the care of elderly patients

Geriatrician

bswift Culture

100

I'm the CEO of bswift

Who is Ted Bloomberg

200

The place EE's call into to get information about their EE benefits.

Service Ctr.

300

Pursue Excellence 

Embrace Accountability

Deliver Superior Service

Be a Great Place to Work

Our Values

400

I consist of 

• Executives 
• Retirees
• Survivors
• Acquisitions
• Terminations

White Glove Service/Support

500

• Resolve escalated issues
• Set processes
• Design Programs
• Special handling

Client Service Team

Dental & Vision

100

I fill prescriptions for eyeglasses and contact lenses.

Opticians

200

Includes 

• Fluoride - is a substance applied to the teeth that aids in     hardening the enamel
• Sealants - Resin materials applied to the occlusal surfaces of a     permanent bicuspids and molars.
• Prophylaxis - routine cleaning
• Images (X-rays)
• Oral exams
• Space maintainers

Preventive

300

I exam the eye, diagnose visual defects, perform test to diagnose eye disorders, and dispense RX for glasses and contact lenses.

Ophthalmologist 

400

These procedures are necessary to recognize and find conditions of the mouth that are not normal.

Diagnostic services

500

Includes

• Fillings
• Oral Surgery
• Simple     Extractions
• Endodontics
• Periodontics

Basic Restorative Care

Systems & Resources

100

My status can be changed to many dispositions

What is Max Agent

200

Use me to locate plan resources and docs. 

Library 

300

I populate the EE's profile if the correct information is entered in the IVR. 

Unified Desktop (UD)

400

Use me to locate client rules and guides.

What is Expert Km. 

500

Click on me to process transactions

Impersonate