BLUE CROSS PLANS	Blue Cross	Blue Cross
EFFECTIVE January 1, 2001	Basic Hospital PPO 1000	PPO Share 5000
Deductible per Person	$1,000	$5,000
Deductible Maximum per Family	$2,000	$10,000
Coinsurance Paid after Deductible	80%	70%
Your Coinsurance Percentage	20%	30%
NOTE: YOUR COINSURANCE PERCENTAGE IS BASED ON THE BLUE CROSS NEGOTIATED DISCOUNT, NOT THE PROVIDER'S BILLED CHARGES.
Your Maximum Out of Pocket Costs	$3,500 per Person/2 per Family	$7,500 per Person/2 per family
Lifetime Benefit	$5,000,000	$5,000,000
Pre-existing Conditions	6 month waiting period	6 month waiting period
(Credit is given on pre-existing condition waiting period if you had recent prior health coverage)
Office Visits-Adults	Not Covered until maximum is met	30% of negotiated fee - No Ded.
Office Visits-Well-Child Visits	Not Covered until maximum is met	50% of negotiated fee - No Ded.
Hospitalization-your portion	20% after Ded.	30% after Ded.
Maternity	Not Covered	$1,000 CoPay + 30% after Ded.
Outpatient Surgery	20% after Ded.	30% after Ded.
Laboratory & X-Ray	20% after Ded.	30% after Ded.
Ambulance	20% after Ded; $750 max/trip	30% after Ded.
Emergency Room	$30 + 20% after Ded. - In Network	$30 + 30% after Ded. - In Network
(CoPay waived if admitted	Out of Network: 20%+ any excess	Out of Network: 30%+ any excess
as an inpatient)	charges. After 48 hours, BC limits	charges. After 48 hours, BC limits
	payment to $650 per day.	payment to $650 per day.
Acupuncture	Not Covered	BC pays $25 per visit/24 visits/yr
		(Deductible Waived)
Chiropractic Care/ Physical Therapy	Covered during Inpatient Stay	30% after Ded; 12 visits/yr
PREVENTIVE CARE
Well Baby Care	See Office Visits above	50% of negotiated
Check Ups	Use Check Up Center for basic	discount-No Deductible
Check Ups	screening - $25 or $75 CoPay	Use Check Up Center for basic
	Deductible Waived	screening - $25 or $75 CoPay
Mammogram, Cancer Screening	20% - No Ded.	30% - No Ded.
OUT PATIENT Rx COPAYS		$10 Generic / *$35 Brand
(Retail or Mail Order)	Not Covered	*(Brand Name CoPay applies
		after a $750 Deductible)
		(2 Deductible max. per family)