What is the deductible for inpatient hospital for HMO Prime?
$300 per year.
100
What is it called when a member comes on THPMP from Tufts Commercial?
Aged In
100
What city do the Premium Bills go to?
Chelsea
100
What is the initial coverage amount for pharmacy?
$2830
200
Is there an Individual PDP Plan?
No
200
What is the chiropractor copay for HMO Value?
$20
200
What is the time frame for the OEP?
1/1-3/31
200
What is the due date for Premiums?
15th
200
How many tier levels are there for the Individual PDP?
4
300
Who is the primary insurance for the Med Supp Plan?
Medicare
300
What is the deductible for inpatient hospital for HMO Value?
$125 per day for days 1-5
300
What is the time frame for the AEP?
11/15-12/31
300
How often are premiums billed?
Monthly
300
What are the 3 rx options for the HMO plan?
No Rx, Rx, Rx Plus
400
What are the 3 PDP Plans
Standard, Premier, Enhanced
400
What is the copay for a PCP visit on the HMO Basic
$25
400
What is the name of the penalty if a member if a member signs up for part D after they were eligible for it?
LEP
400
How many months of non payment before a member is disenrolled?
3
400
Can a member have the Med Supp with the HMO group plan?
No
500
What HMO plan has a Out of Pocket Max
All of Them
500
How much would the copay be if the members sees a specialist and they did not get a referral?
The billed amount.
500
What is the one thing a member cannot have when joining THPMP?
ESRD
500
If a member says they sent a check and it's been more than 14 days and they tell you it's been cashed but it has not been posted in PBLGR what should you request the member to do?
Send us a copy of the cancelled check.
500
What is the name of the system that we will be using for pharmacy tomorrow?