The CMM Plan is a Capital Blue Cross traditional fee-for-service comprehensive major medical plan that allows covered individuals to see any health care provider they choose. Charges for services are submitted to the plan and the plan determines what it will pay — based on defined coverage levels. Unpaid balances are the employee’s responsibility. The plan is designed to pay the cost of treating and caring for participants when they are ill. It does not cover wellness care, except for a limited number of items listed below. This plan provides the greatest freedom of choice but also exposes employees to the greatest out-of-pocket cost, including deductibles, coinsurance, and balance billing from physicians who do not participate with the Capital Blue Cross network.
Preauthorization is required for hospital stays and many elective surgeries.
Covered wellness testing is limited to annual gynecological exams, annual pap smears, screening mammograms, sigmoidoscopies, and PSA tests - the availability of which is governed by generally accepted medical protocols.
Also provided under the CMM Plan:
The highlights of this medical plan, pre-authorization procedures, and preventive care services can be found in the 2013 Flexible Benefits Enrollment & Reference Guide.
To view the Capital Blue Cross certificate of insurance for this plan, log on to the Campus Portal, select the "Employee" tab, and select Comprehensive Major Medical Plan within the Human Resources channel.