PLAN NAME - "EMPLOYER GROUP PLANS"
HMO NGF Plan
Visit to Physician, Physician Assistant or Nurse Practitioner at a PPG.
Periodic health evaluations. Includes annual preventive physical examinations, preventive vision/hearing screenings, well-woman exam and
preventive laboratory tests and x-rays.
Vision examinations for refractive eye exams.
Specialist consultations (except podiatrist). Includes OB/GYN self-referral for
Podiatrist (all services)
Physician visit to member's home (at discretion of physician) .
Physician visit to hospital or skilled nursing facility (excluding care for mental
Other immunizations (except foreign travel/occupational-see below).
Immunizations for foreign travel/occupational purposes.
Allergy injection services (serum not included).
Injections related to infertility services.
Surgeon/assistant surgeon in hospital or PPG.
--Complex radiology (CT, SPECT, MRI, MRA, MUGA and PET).
Rehabilitation therapy (outpatient physical, speech, occupational and respiratory therapy). Provided as long as significant improvement is
Dental services (when medically necessary to properly monitor, control or treat a severe medical condition when excluded dental services are being
HMO NGF Plan
CARE FOR CONDITIONS OF PREGNANCY (professional services only)
Normal delivery, Cesarean section. Includes newborn inpatient care
provided by a member physician.
Complications of pregnancy, including medically necessary abortions.
FAMILY PLANNING (professional services only)
Depo-Provera Medication (contraceptive injection)
Infertility services (including professional services, inpatient and outpatient care, treatment by injection and prescription drugs, if applicable).
ALCOHOL/DRUG REHABILITATION and MENTAL DISORDERS
Administered by Managed Health Network (MHN)
Durable medical equipment.
Nebulizers, peak flow meters, face masks and tubing for the treatment of
asthma of dependent children under the age of 19 are covered with NO
COPAYMENT and not applicable towards annual benefit maximum.
Corrective footwear. Custom inserts and shoes.
Nuclear medicine (professional services only).
Organ and bone marrow transplants (non-experimental and noninvestigative.
Professional services only).
Chemotherapy/radiation therapy (professional services only).
Renal dialysis (professional services only).
HMO NGF Plan
HOSPITAL AND SKILLED NURSING FACILITY SERVICES
Unlimited days of hospital care in a semi-private room or ICU with ancillary
services. Excluding care for mental disorders.
Organ and Bone Marrow Transplants - inpatient. Travel expenses not
Confinement for infertility services.
Confinement in a skilled nursing facility (limited to 100 days a cal yr).
Maternity care. Includes routine nursery charges.
Outpatient services other than surgery.
Oupatient surgery at hospital or ambulatory surgical center
EMERGENCY SERVICES/URGENTLY NEEDED CARE
The copayment will not be required if the member is admitted as a hospital inpatient directly from the emergency room or urgent care center.
Use of emergency room (facility and professional services).
Use of urgent care center (facility and professional services).
OUT OF POCKET MAXIMUM
OTHER BENEFITS OR COVERAGE
MAIL ORDER (Administered by CVS Caremark)
VISION BENEFITS (Administered by Eyemed)
International Journal of Systematic and Evolutionary Microbiology (2009), 59, 2605–2609Marinobacter szutsaonensis sp. nov., isolated froma solar salternChung-Yi Wang, Chang-Chai Ng, Wen-Sheng Tzeng and Yuan-Tay ShyuDepartment of Horticulture, National Taiwan University, 140, Keelung Road, Section 4, Taipei 106,A Gram-negative, aerobic, non-spore-forming, halophilic bacterial strain, NTU-104T
Facials Deep Cleansing and Rebalancing Facial This facial is for combination/ oily skin types. It incorporates an exclusive Antibacterial Serum containing thyme, niaouli, tea tree, echinacea and rosemary to calm, heal, reduce bacteria, seal and rebalance hormonal skin problems. Duration: 60mins Beneficial Botanical Facial and Body Treatment Excellent for mature and sun damage