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November
1, 2007
SAMBA
Standard Option Health Benefit Plan
Dear Member:
Your 2008 SAMBA Health Benefit Plan
Brochure and other materials are
enclosed.
There will be no change in your Standard
Option Health Plan premium for 2008.
| 2008
Standard Option Premium |
Employee
Biweekly |
Annuitant
Monthly |
| Self
Only |
$45.91 |
$99.47 |
| Self
& Family |
$104.85 |
$227.18 |
New for
2008 – SAMBA members will have access
to the extensive CIGNA Nationwide PPO
Network. The CIGNA PPO Network replaces
the CareFirst Blue Cross Blue Shield network
in Delaware, the District of Columbia,
Maryland, and Virginia; and replaces the
First Health and Beech Street networks in
all other states.
The CIGNA Nationwide PPO Network has more
than 800,000 in-network medical providers,
including most of the same doctors,
hospitals and other providers that our
members are now using. In view of the change
to the much larger CIGNA PPO network, the
out-of-network area benefit (for members not
previously served by a PPO network) and
Homelink, offered through First Health, will
no longer be available. Visit our website at
www.SambaPlans.com, or call
1-800-564-7642, to confirm that your
provider participates with CIGNA or to
locate a CIGNA provider in your area!
Medco will continue as our
Prescription Drug Benefit Manager. There
will be no change to the Plan's
prescription drug benefit for 2008. You will
continue to enjoy the same comprehensive
drug benefits.
Quest Diagnostics – When you use a
Quest Diagnostics facility, SAMBA will pay
for all covered outpatient laboratory
services at 100%. The use of Quest
Diagnostics is optional. Visit our website
or call 1-800-377-8448 to find a Quest
Diagnostics facility near you. Members who
use other labs will continue to pay
coinsurance (but no deductible) for
outpatient laboratory services.
The calendar year deductible will no
longer be applied to PPO benefits for
outpatient hospital and ambulatory surgical
centers or adult routine immunizations.
Benefits have been added for
screenings, testing, diagnostic evaluations,
and treatment by licensed hearing
professionals (including hearing aids) for
dependent children up to the age of 22.
In December, new Identification Cards
(ID cards) will be mailed to all members. It
is important that you use your new ID cards
starting January 1, 2008 to assure no
disruption in medical services or claims
processing.
- Non-Medicare covered members and
families, and "split"
families with at least one person
not covered by Medicare, and all
members with only Medicare Part A
coverage will receive two
different ID cards:
1) a CIGNA PPO ID card for use when
visiting health care providers, and
2) a Medco Prescription Drug ID card
for use when purchasing medications.
- Medicare covered members with
both Part A and Part B (member
or member and spouse) will receive
only one ID card:
1) a combination Medical and Medco
Prescription Drug ID card for use in
obtaining health care services and
for use when purchasing medications.
Online services – SAMBA's website, www.SambaPlans.com,
offers several helpful online services such
as finding a PPO provider, ability to review
your prescription drug and medical claims
history, ability to order prescription
refills, plus much more. SAMBA has recently
added more new services:
- Treatment Cost Estimator:
estimates out-of-pocket medical
costs, displaying PPO versus non-PPO
average costs, for over 350 common
conditions, procedures, tests and
visits. Search results include
related encounters, tests, and other
medical items that comprise the
total cost of an episode of care.
- Hospital Quality Tool:
provides diagnosis and procedure
specific comparisons of hospitals.
You can compare selected hospitals
quality ratings according to
evidence-based measures deemed
important for their analysis. The
tool offers an array of quality
outcomes and ratings (such as;
patient volume, severity adjusted
length of stay, severity adjusted
complications and mortality rates).
- Health Risk Assessment Tool:
provides advanced health profiling
risk assessments that scores an
individual's health status,
calculates risk levels, and provides
recommendations for personal health
improvement actions and behavior
changes. You simply supply answers
to a questionnaire that is put
through more than 5,000 calculations
that screen for 21 clinical risk
factors.
We pledge to you our best effort to deliver
the benefits and services you have come to
expect. If you ever have any questions,
please contact us at 1-800-638-6589, or
email us at feedback@sambaplans.com.
Sincerely yours,

Walter E. Wilson
Executive Director
Enclosures
Visit
our Web SIte at www.sambaplans.com |