Plan Options
How does SelecTEMP® Preferred Provider Health Insurance Plan (PPO) work?
Individuals can choose one, two, three, four, five or six months of benefit coverage and a $500, $1,000, $1,500, $2,000 or $2,500 deductible depending on their needs.
Individuals pay the selected benefit period deductible. Once the deductible is met, SelecTEMP PPO will pay 80 percent of the next $5,000 on in-network eligible expenses. The policyholder pays 20 percent of in-network eligible expenses, up to $1,000.
Then SelecTEMP PPO pays 100 percent of eligible charges for the rest of the benefit period up to $2,000,000 per participant.
When does SelecTEMP PPO coverage begin?
The Benefit Period begins on the latter of:
A) The requested effective date; or
B) The day after the postmark date affixed by the U.S. Post Office*
*If the envelope containing the application is not postmarked by the U.S. Post Office, or if the postmark is not legible, the effective date will be the latter of: a) the requested effective date; or b) the date received by Blue Cross and Blue Shield of Texas.
The following conditions MUST be met before SelecTEMP PPO coverage can begin:
- Applicant is a resident of Texas; and
- Applicant answered “NO” to all the health questions on the SelecTEMP PPO application; and
- The completed application and premium are received by Blue Cross and Blue Shield of Texas within 10 days of the signature date.
Need additional coverage?
If the individual needs coverage for an additional period of time, he/she may apply for a second non-renewable SelecTEMP PPO contract. Any condition which may have existed or occurred under the prior contract will be a pre-existing condition under the subsequent contract and will not be covered.
Extension of Benefits
If the individual is totally disabled on the expiration date of this contract, covered benefits will continue to be payable for any continuous illness or injury that began while this contract was in force and will continue during the continuous total disability of the participant until the earliest of:
- the date the individual is no longer totally disabled; or
- the payment of maximum benefits; or
- at the end of 90 days.
Instructions for an individual to complete the application
- Complete the application in blue or black ink.
- Determine the premium by using the rate worksheet on the back of the application.
- If applicant is not a U.S. citizen but has been a permanent resident for the past two years, he/she can apply for coverage. Applicant MUST submit a copy of their Alien Registration Receipt Card or “Green Card” along with the completed application and their premium.
Payment Options:
- If paying by Single Payment Plan, the check should be made payable to Blue Cross and Blue Shield of Texas and mailed with the application in the envelope provided. If the individual is selecting a one-month benefit period, he/she must select the Single Payment Plan.
- If paying by Monthly Bank Draft, the check should be made payable to Blue Cross and Blue Shield of Texas for the first month of premium, the Bank Draft Authorization Request Form needs to be completed, and a blank check marked “VOID” must be included with the application in the envelope provided. The Monthly Bank Draft option is available for two to six-month benefit periods.
- Once established, policyholder cannot cancel bank draft until selected benefit period is expired.
- SelecTEMP PPO premiums are non-refundable.