General Benefits

In-Network Benefits	Out-Of-Network Benefits
Preferred Provider Health Insurance Plan (PPO) Select Value^® Care^SM pays 50 percent and the policyholder pays 50 percent of eligible expenses.	Preferred Provider Health Insurance Plan (PPO) Select Value^® Care^SM pays 50 percent and the policyholder pays 50 percent of eligible expenses.
Physician office visits paid at 50/50 coinsurance.	Physician office visits paid at 50/50 coinsurance.
Network providers will preauthorize your medical care.	Policyholder must preauthorize hospital admissions and certain services.
There are usually no claim forms to file.	Policyholders may have to submit claims for reimbursement.
Emergency room visits within 48 hours of accident paid at 50/50 coinsurance.	Emergency room visit within 48 hours of accident paid at 50/50 coinsurance.