Knowing which healthcare providers are in the PHN Employee Plan provider and pharmacy network is just as important as understanding your plan benefits. Keep your costs low by using the physicians, hospitals, pharmacies and other healthcare providers in the network. Use the Search Providers and Search Pharmacies buttons to find the provider or pharmacy you need.
It’s also important to know what prescription drugs are covered by PHN Employee Plan. Search Medications below to see what drugs the plan covers.
The PHN Employee Plan covers:
You might access this care during a medical emergency (when you have medical symptoms that require immediate medical attention to prevent loss of life, loss of limb, or loss of function of a limb). Examples of a medical emergency include an illness, injury, severe pain or a medical condition that is quickly getting worse.
You may access this care for an unforeseen medical illness, injury or condition that requires immediate medical care but is not a medical emergency. An unforeseen condition could be a flare-up of a condition you already know you have. You might also access urgent care for a minor injury or illness when primary care physician offices are closed. Examples of minor injuries or illnesses include cuts, sprains, flu-like symptoms, earaches, fever and minor burns. Click here to find an urgent care center in your parish.
PHN Employee Plan members can find an Optum provider by:
Optum customer service can also answer questions you have about your behavioral health benefit through PHN Employee Plan.
2018 Summary of Benefits and Coverage – Explains PHN Employee Plan coverage levels and costs when accessing health services and filling prescriptions.
Download 2018 Summary of Benefits and Coverage PDF
Plan Document and Summary Plan Description and Amendments – Information about plan benefits, membership, covered and noncovered services, and other important plan details. Includes amendments that explain changes in coverage effective June 1, 2017, and January 1, 2018. The main part of the Plan Document and Summary Plan Description remains unchanged from year to year and changes are made through amendments, which are at the beginning of the plan document. The amendments modify the terms of the plan document. Reference these amendments when using the plan document to confirm coverage information.
Download 2018 Plan Document and Summary Plan Description PDF
The Employee Retirement Income Security Act (ERISA) requires administrators and sponsors of pension and welfare plans to file a Summary Annual Report (SAR) with the U.S. Department of Labor. The report is essentially a summary of the filed annual tax return for employee benefit programs. Plan administrators are required to provide a copy of the report to each participant receiving benefits under a qualified plan.
Lincoln Financial Group provides coverage for routine eye examinations, eyeglasses frames and lenses, contacts, and laser vision surgery. Employees may also elect to cover their spouse or dependent children.
The Standard provides dental coverage, from routine cleanings to extensive procedures. Employees may elect to provide coverage for their spouse or dependent children.
Short-term disability is a supplemental insurance policy that provides up to 11 weeks of income replacement in the event an employee is unable to work due to a disability. It is equivalent to 60 percent of the first $1,250 of their weekly insured pre-disability earnings, reduced by deductible income, with a plan maximum benefit up to $750 per week. This insurance is provided through Lincoln Financial Group.
Peoples Health will match employee contributions dollar for dollar, up to 5 percent of their bi-weekly salary, for employees who have been with the company for one year.
Download 401(k) Summary Plan Description PDF – An overview of 401(k) plan administration, including details about contributions and distributions.
Download Summary of Material Modifications to Summary Plan Description PDF – A summary of changes to the Summary Plan Description (this document is a companion piece to the Summary Plan Description).