New Individual Health Plans from Keystone & Personal Choice Effective 7-1-2010

1. Health Plans for The benefits you need...
at the price you can afford...
Individuals and Families from the name you know and trust

2. Contents
Why choose Blue?
Because we’re dedicated to improving the health and wellness programs, discounts on health and wellness products, and 24/7
of the communities we serve in Philadelphia, Montgomery, access to a Health Coach. You also get tools and resources to
Bucks, Delaware, and Chester counties. In fact, we’re the manage your benefits and make informed decisions about
region’s #1 HMO and PPO provider*. With an expansive network your health through our member website, ibxpress.com.
of more than 55,000 doctors and 100 hospitals to choose from, Copay plans . . . . . . . . . . . . . . . . . . 2
you can always find the care you need.
Need help choosing?
It’s all about predictability. Almost all of the in-network services you use are
We can help.
For more than 70 years, we’ve provided the best in quality, covered by a fixed dollar amount, known as a copay. Visiting your doctor for a
reliability, and service to Philadelphians. Choose Independence We offer three different types of plans – copay, deductible, check-up? Pay a copay. Need physical therapy? Pay a copay, and we take care
Blue Cross, the name you know and trust. and health savings account (HSA). All of our plans offer of the rest.
comprehensive coverage, but what you pay each month
Think a Blue plan is too expensive? depends on what you want to spend when you see the doctor
Think again. or go to the hospital. With our copay plans, you pay a set Deductible plans . . . . . . . . . . . . . . . 6
dollar amount for most services while our deductible and HSA
You have a wide variety of medically underwritten plans** to It’s all about affordability. With these plans, you still have copays or 100%
plans help reduce monthly costs by requiring a deductible
choose from at various prices. You’re bound to find a plan that coverage for the services you use most often, such as doctor visits, screenings,
and coinsurance for certain services. Use the chart below to
meets your needs without breaking the bank. That means you and immunizations. The in-network deductible, an amount you pay before
figure out what type of plan works best for you. Still not sure?
still have money left to catch a Phillies game, visit the zoo, or insurance kicks in, applies only to services such as hospital and emergency
Contact your broker for more information.
spend the weekend at the shore. care. After you pay your deductible, you’re responsible for coinsurance, a
percentage of the provider’s charge.
Plus, all of our plans include value-added extras such as
reimbursements for gym fees and weight management
HSA plans. . . . . . . . . . . . . . . . . . . . 10
Here’s an overview of the types of plans we offer It’s all about savings. With our health saving account (HSA) plans, you have
two ways to save. First, you save money by paying lower premiums each
$$$ Monthly Rate $ month. Then, you can invest your money in a tax-advantaged HSA to save for
deductibles and coinsurance. Plus, if you don’t use all of your HSA dollars, the
money is yours and can be rolled over year to year to pay for future expenses.
Copay Deductible HSA
Office visits Copay Copay Coinsurance after deductible
Value-added programs . . . . . . . . . .14
Preventive care Covered 100% Covered 100% Covered 100%
There are a lot of advantages to being an Independence Blue Cross member. We
HMO options: Copay
Emergency care PC options: Coinsurance Coinsurance after deductible Coinsurance after deductible want to make it easier for you to save money and make healthy choices. That’s
HMO options: Copay why we offer the programs, tools, and resources members need to get engaged
Inpatient hospital PC options: Coinsurance Coinsurance after deductible Coinsurance after deductible
in their health and make informed health care decisions.
HMO options: Copay HMO: Copay
X-ray PC options: Coinsurance PC: Coinsurance after deductible Coinsurance after deductible
Laboratory
HMO options: Covered 100% HMO: Covered 100% Coinsurance after deductible
Glossary . . . . . . . . . . . . . . . . . . . . . 18
PC options: Coinsurance PC: Coinsurance after deductible options
Prescription drugs Yes Yes Yes
Choosing a health plan doesn’t have to be difficult. Learn more about some of
the common terms and definitions, such as coinsurance, deductible, and referral.
Pair with a tax-free health
N/A N/A Yes
savings account (HSA)
Important information . . . . . . . . . . 20
Cost-sharing included in the chart above applies to in-network coverage only. For PPO out-of-network cost-sharing, Get a better understanding of our policies and guidelines and the steps
refer to the benefits summary charts in this brochure.
*According to a leading independent consumer magazine.
we take to help you receive appropriate care.
**Final rate quote and approval of coverage is dependent on medical underwriting. Approval is not guaranteed,
and some applications may not be approved based on medical conditions.
1

3. Copay plans
It’s all about predictability.
Whether paying for utilities, your phone bill, or groceries, it can be
hard to predict how much you’ll need to pay each month. But our
copay plans offer the predictability you need to control your budget
so that you aren’t surprised when your bill arrives.
Almost all of the services you use are covered by a fixed copay if you
use in-network providers. Visiting your doctor? Pay a copay. Need
physical therapy? Pay a copay. We’ll take care of the rest.
Here’s a look at what our copay plans include:
• office visits
• preventive care
• prescription drugs
• hospital stays
• emergency/urgent care
• X-rays
• laboratory services
• routine eye care (HMO plans only)
• maternity (HMO plans only)
Need help choosing between our Keystone
HMO and Personal Choice® PPO plans?
There are several key differences between our HMO and Personal
Choice plans. With our HMO plans from Keystone Health Plan East,
you select a primary care physician to coordinate all of your health
care needs and provide you with referrals to network specialists.
In comparison, our Personal Choice plans give you the flexibility to
receive care from doctors both in and out of network. There’s no
need to pick a primary care physician and you never need a referral.
Our Personal Choice plans also provide in-network coverage coast-
to-coast when you use BlueCard® PPO providers. While our Personal
Choice plans offer you freedom to access care directly, they do not
provide coverage for maternity and routine eye care, which are
included in our HMO options.
City skyline from steps of the Philadelphia
Museum of Art, Philadelphia County.
Our copay plans have predictable, set costs for most services. This
2 makes it easier for you to budget so that you can add in trips to the 3
movies, art museum, or any of the attractions that Philly has to offer.

4. Copay plans
HMO 20 Copay HMO 15 Copay HMO 10 Copay Personal Choice PPO 30 Copay
Benefits per calendar year You pay You pay You pay You pay in-network You pay out-of-network**
Deductible, individual/family None $5,000/$10,000
Coinsurance, after deductible 20% 50%
None None None
$5,000/$10,000 $10,000/$20,000
Out-of-pocket maximum, individual/family Includes coinsurance only Includes coinsurance only
Preventive services
Mammogram (no referral required) $0
50%, no deductible
Pediatric immunizations (subject to office visit copay) $0 $0 $0 $0
Nutrition counseling (6 visits per year‡) $0 50%, after deductible
Physician services
Primary care office visit $20 $15 $10 $30
50%, after deductible
Specialist office visit $50
Routine gynecological exam/Pap test (no referral required, 1 per year) $30 $25 $20 $30 50%, no deductible
Routine eye exam (once every two years) Not covered Not covered
Eyeglasses or contact lenses (once every two years) $35 benefit* $35 benefit* $35 benefit* Not covered Not covered
Spinal manipulations (20 visits per year‡) $50
$30 $25 $20 50%, after deductible
Physical/occupational therapy (30 visits per year‡) $50
Hospital/other medical services
Inpatient hospital services 20%/unlimited days 50%, after deductible/70 days
$400† $200† $100†
Maternity hospitalization Not covered Not covered
Emergency room (not waived if admitted) $100 $100 20% 20%, after in-network deductible
$100
Outpatient surgery $400 $200
Ambulance
$0 $0 $0
Outpatient lab/pathology
Routine radiology/diagnostic $30 $25 $20 20% 50%, after deductible
MRI/MRA, CT/CTA scan, PET scan $60 $50 $40
Biotech/specialty injectables $100 $75 $50
Durable medical equipment (HMO: up to $1,000 per year; PC: up to $2,000 per year, 50% 50% 50%
which includes up to $1,000 for diabetic equiptment and supplies)
Mental health/substance abuse/serious mental illness treatment Not covered Not covered Not covered Not covered Not covered
Prescription drug
Prescription deductible, individual/family $250/$750 $100/$300 $100/$300 None None
Generic formulary copay $15, after prescription deductible $15, after prescription deductible $15, after prescription deductible $10
Brand formulary copay $25, after prescription deductible $25, after prescription deductible $25, after prescription deductible $30 50%, no deductible
Non-formulary copay $35, after prescription deductible $35, after prescription deductible $35, after prescription deductible $50
Prescription mail order Available Available Available Available Available
Maximum prescription drug benefit, individual/family Up to $2,500/$5,000 per year Up to $2,500/$5,000 per year Up to $2,500/$5,000 per year Up to $2,500 per person per year ‡
*Paid-in-full benefit available with select group of frames at Davis Vision participating providers.
** It is important to note that all percentages are percentages of the plan allowance, not the provider’s actual charge. Out-of-network, non-participating providers may bill you for differences between
the plan allowance, which is the amount paid by Personal Choice, and the provider’s actual charge. This amount may be significant. Claims payments for out-of-network professional providers
(physicians) are based on Independence Blue Cross’s (IBC’s) own fee schedule. For services rendered by hospitals and other facility providers, the allowance may not refer to the actual amount paid by
Personal Choice to the provider. Under IBC contracts with providers, hospitals, and other facility providers, IBC pays using bulk purchasing arrangements that save money at the end of the year but do
not produce a uniform discount for each individual claim. Therefore, the amount paid by IBC at the time of any given claim may be more or it may be less than the amount used to calculate your liability.
† Amount shown reflects the copayment per day. There is a maximum of five copayments per admission.
‡ For PPO plans, maximums shown are combined for in- and out-of-network care.
4 Certain plan benefits may be enhanced in order to comply with health care reform legislation. 5

5. Deductible plans
It’s all about affordability.
Our deductible plans are a great way to lower your monthly costs.
Better yet, the in-network deductible applies only to services such as
hospital and emergency care. You still have copays or 100% coverage
for services such as doctor visits, screenings, and immunizations.
Here’s a look at what our deductible plans include:
• office visits
• preventive care
• prescription drugs
• hospital stays
• emergency/urgent care
• X-rays
• laboratory services
• routine eye care (HMO plans only)
• maternity (HMO plans only)
Why have insurance if I have to pay a deductible?
A deductible may seem like a lot of money to pay, but keep in mind,
it doesn’t apply to all services. Think of the cost if you don’t have
insurance. An unexpected accident or illness could result in medical
bills up to $50,000 or more. A deductible is much less, and probably
much easier to pay off.
Plus, when you show your card to a participating provider, your deductible
is based on our discounted rates. It’s typically a fraction of what
people without insurance pay. Once you reach the deductible, you’re
responsible for a percentage of the cost and we’ll take care of the rest.
Need help choosing between HMO and Personal Choice?
Turn to page 3.
Linvilla Orchards, Delaware County.
With a deductible plan, you get lower monthly rates and you
don’t have to pay for benefits you don’t use. That makes it
easier to enjoy hayrides through the fields, fishing in Orchard
6 7
Lake, and picking fresh fruit at Linvilla Orchards.

6. Deductible plans
HMO 5000 HMO 2500 HMO 1500 Personal Choice PPO 5000 Personal Choice PPO 2500
You pay You pay
Benefits per calendar year You pay You pay You pay You pay in-network out-of-network* You pay in-network out-of-network*
Deductible, individual/family $5,000/$10,000 $2,500/$5,000 $1,500/$3,000 $5,000/$10,000 $10,000/$20,000 $2,500/$5,000 $5,000/$10,000
Coinsurance, after deductible 30%, unless otherwise noted 30%, unless otherwise noted 30%, unless otherwise noted 20% 50% 20% 50%
$5,000/$10,000 $10,000/$20,000
Out-of-pocket maximum, individual/family $7,500/$15,000 $5,000/$10,000 $5,000/$10,000 $10,000/$20,000 $20,000/$40,000 Includes coinsurance only Includes coinsurance only
Preventive services
Mammogram (no referral required)
$0, no deductible 50%, no deductible $0, no deductible 50%, no deductible
Pediatric immunizations (subject to office visit copay) $0, no deductible $0, no deductible $0, no deductible
Nutrition counseling (6 visits per year†) $0, no deductible 50%, after deductible $0, no deductible 50%, after deductible
Physician services
Primary care office visit $30, no deductible $30, no deductible $30, no deductible $30, no deductible $30, no deductible
50%, after deductible 50%, after deductible
Specialist office visit $50, no deductible $50, no deductible $50, no deductible $50, no deductible $50, no deductible
Routine gynecological exam/Pap test (no referral required, 1 per year) $30, no deductible $30, no deductible $30, no deductible $30, no deductible 50%, no deductible $30, no deductible 50%, no deductible
Routine eye exam (once every two years) $50, no deductible $50, no deductible $50, no deductible Not covered Not covered Not covered Not covered
Eyeglasses or contact lenses (once every two years) $35 benefit* $35 benefit* $35 benefit* Not covered Not covered Not covered Not covered
Spinal manipulations (20 visits per year ) †
$50, no deductible $50, no deductible $50, no deductible $50, no deductible 50%, after deductible $50, no deductible 50%, after deductible
Physical/occupational therapy (30 visits per year†)
Hospital/other medical services
Inpatient hospital services/days 20%, after deductible/unlimited 50%, after deductible/70 20%, after deductible/unlimited 50%, after deductible/70
Maternity hospitalization Not covered Not covered Not covered Not covered
Emergency room (not waived if admitted) 20%, after in-network 20%, after in-network
30%, after deductible/unlimited 30%, after deductible/unlimited 30%, after deductible/unlimited 20%, after deductible 20%, after deductible
deductible deductible
Outpatient surgery
Ambulance
Outpatient lab/pathology $0, no deductible $0, no deductible $0, no deductible
Routine radiology/diagnostic $50, no deductible $50, no deductible $50, no deductible 20%, after deductible 50%, after deductible 20%, after deductible 50%, after deductible
MRI/MRA, CT/CTA scan, PET scan
$100, no deductible $100, no deductible $100, no deductible
Biotech/specialty injectables
Durable medical equipment (HMO: up to $1,000 per year; PC: up to $2,000 per 50%, after deductible 50%, after deductible 50%, after deductible
year, which includes up to $1,000 for diabetic equiptment and supplies)
Mental health/substance abuse/serious mental illness treatment Not covered Not covered Not covered Not covered Not covered Not covered Not covered
Prescription drug
Prescription deductible, individual/family None None None None None None None
Generic formulary copay $10 $10 $10 $10 $10
Brand formulary copay $30 $30 $30 $30 50%, no deductible $30 50%, no deductible
Non-formulary copay $50 $50 $50 $50 $50
Prescription mail order Available Available Available Available Available Available Available
Maximum prescription drug benefit, individual/family Each year you have coverage up Each year you have coverage up Each year you have coverage Up to $2,500 per person, per year†
Up to $2,500 per person, per year†
to $2,500/$5,000 to $2,500/$5,000 up to $2,500/$5,000
*Paid-in-full benefit available with select group of frames at Davis Vision participating providers.
** It is important to note that all percentages are percentages of the plan allowance, not the provider’s actual charge. Out-of-network, non-participating providers may bill you for differences between
the plan allowance, which is the amount paid by Personal Choice, and the provider’s actual charge. This amount may be significant. Claims payments for out-of-network professional providers
(physicians) are based on Independence Blue Cross’s (IBC’s) own fee schedule. For services rendered by hospitals and other facility providers, the allowance may not refer to the actual amount paid by
Personal Choice to the provider. Under IBC contracts with providers, hospitals, and other facility providers, IBC pays using bulk purchasing arrangements that save money at the end of the year but do
not produce a uniform discount for each individual claim. Therefore, the amount paid by IBC at the time of any given claim may be more or it may be less than the amount used to calculate your liability.
8 † For PPO plans, maximums shown are combined for in- and out-of-network care. 9
Certain plan benefits may be enhanced in order to comply with health care reform legislation.

7. HSA plans
It’s all about savings.
Finally, there’s a way to make the most of your health care dollars.
When you have one of our Personal Choice® HSA-qualified medical
plans, the savings are twofold. First, you save money by paying lower
premiums each month. Then, you can invest your money in a tax-
advantaged health savings account (HSA) to save for deductibles and
coinsurance. Plus, if you don’t use all of your HSA dollars, the money is
yours and can be rolled over year to year to pay for future expenses.
Here’s a look at what our HSA-qualified medical plans cover, both in
and out of network:
• office visits
• preventive care
• prescription drugs
• hospital stays
• emergency/urgent care
• X-rays
• laboratory services
Want to open a health savings account?
You can use our preferred vendor, The Bancorp Bank, an independent
company, to set up an HSA or you can pick any bank you like. To
set up a Bancorp HSA, simply check the box in Section A of the
application that reads: “Yes, I’d like an HSA account set up with
Bancorp.” Bancorp HSA features include:
• no application or account set up fees;
• no monthly maintenance fees1;
• ability to earn interest with first deposit2;
• free no-annual-fee Visa® Check Card;
• toll-free 24/7 customer service and online access;
• ability to invest HSA funds through National Financial Services
once balance reaches $2,500.
To learn more, visit the Bancorp website at www.mybancorphsa.com.
1
Standard banking fees apply, e.g. insufficient funds
2
Interest paid on balances over $1
Downtown West Chester, Chester County.
Our HSA plans help you save money, so you can spend
it on what you love most: grabbing a bite to eat with
friends or browsing local stores for that next great find.
10 11

8. HSA plans
Want to make the most of Personal Choice PPO 5000 HSA Personal Choice PPO 3000 HSA
your HSA plan? You pay in- You pay You pay
Benefits per calendar year network out-of-network* You pay in-network out-of-network*
Take the savings you get with your monthly
Deductible, individual/family $5,000/$10,000 $10,000/$20,000 $3,000/$6,000 $6,000/$12,000
premiums and open a health savings account (HSA).
Coinsurance, after deductible N/A 50% 20% 50%
You can use the money in your HSA to pay for
Out-of-pocket maximum, individual/family
deductibles and coinsurance. If you have money left (includes deductibles, copays, and coinsurance) $5,000/$10,000 $20,000/$40,000 $5,000/$10,000 $10,000/$20,000
over at the end of the year, it carries over into your
Preventive services
account for next year.
Mammogram
50%, no deductible 50% , no deductible
Pediatric immunizations (subject to office visit copay) $0, no deductible $0, no deductible
Monthly premium
Nutrition counseling (6 visits per year†) 50%, after deductible 50%, after deductible
Premium savings put into HSA
Physician services
Primary care office visit
$0, after deductible 50%, after deductible 20%, after deductible 50%, after deductible
Specialist office visit
Routine gynecological exam/Pap test (1 per year) $0, no deductible 50%, no deductible $20, no deductible 50% , no deductible
Routine eye care Not covered Not covered Not covered Not covered
Spinal manipulations (20 visits per year ) †
Want to see just how much you can save with an HSA? $0, after deductible 50%, after deductible 20%, after deductible 50%, after deductible
Physical/occupational therapy (20 visits per year†)
Let’s say each year you contribute $1,500 to your HSA and withdraw, on average, $500 for health care expenses.
Hospital/other medical services
With an interest rate of 3.5%, your savings will grow each year! Depending on how you invest your money in the
$0, after deductible/ 50%, after deductible/ 20%, after deductible/ 50%, after deductible/
account, your savings can be even greater. Inpatient hospital services/days unlimited days 70 days unlimited days 70 days
Maternity hospitalization Not covered Not covered Not covered Not covered
$0, after in-network 20%, after in-network
Balance at end of year 10 Tax savings Emergency room (not waived if admitted) $0, after deductible deductible 20%, after deductible deductible
$11,731.39 $5,314.02 Outpatient surgery
$14,000 Ambulance
Outpatient lab/pathology
$12,000 Routine radiology/diagnostic $0, after deductible 50%, after deductible 20%, after deductible 50%, after deductible
MRI/MRA, CT/CTA scan, PET scan
$10,000
Biotech/specialty injectables
$8,000 Durable medical equipment (up to $1,000 per year)
Mental health/substance abuse/serious mental illness treatment Not covered Not covered Not covered Not covered
$6,000
Prescription drug
$4,000 Prescription deductible, individual/family Integrated with
medical
Integrated with
medical Integrated with medical Integrated with medical
Generic formulary copay $10, after deductible
$2,000
Brand formulary copay $0, after deductible 50%, after deductible $30, after deductible 50%, after deductible
$0 Non-formulary copay $50, after deductible
1 2 3 4 5 6 7 8 9 10 Prescription mail order Available Available Available Available
Maximum prescription drug benefit†, individual/family None None None None
The above chart is for illustrative purposes only. With an annual deposit of $1,500 on the first day of each year, an annual percentage yield of 3.5% with all * It is important to note that all percentages are percentages of the plan allowance, not the provider’s actual charge. Out-of-network, non-participating providers may bill you for
earnings reinvested in the account, and $500 withdrawn for eligible medical expenses on the first day of each year. differences between the plan allowance, which is the amount paid by Personal Choice, and the provider’s actual charge. This amount may be significant. Claims payments for out-of-
network professional providers (physicians) are based on Independence Blue Cross’s (IBC’s) own fee schedule. For services rendered by hospitals and other facility providers, the allowance
The chart is not intended to be used as legal and/or tax advice. Please consult with your tax advisor and/or attorney for your particular situation. may not refer to the actual amount paid by Personal Choice to the provider. Under IBC contracts with providers, hospitals, and other facility providers, IBC pays using bulk purchasing
arrangements that save money at the end of the year but do not produce a uniform discount for each individual claim. Therefore, the amount paid by IBC at the time of any given claim
may be more or it may be less than the amount used to calculate your liability.
† Maximums shown are combined for in- and out-of-network care.
Certain plan benefits may be enhanced in order to comply with health care reform legislation.
12 13

9. Value-added
programs
A plan for
better health
We care about you and your health. We want to make it easier for
you to save money and make healthy choices. That’s why we offer
the programs, tools, and resources members need to get engaged in
their health and make informed health care decisions.
Enjoy big rewards with Healthy LifestylesSM
Our unique Healthy Lifestyles programs offer cash rewards,
discounts, and reminders designed to help you and your family
lead healthier lives.
Cash rewards – We believe you should be rewarded for taking
action to maintain and improve your health. Exercise regularly? We’ll
give you up to $150 back on your fitness center fees. Quit smoking
or lost weight? We’ll reimburse you up to $200 on your program
fees. We’ll even give you money back when you buy a bike helmet,
complete a CPR class, or go to a parenting class.
Valuable discounts – How about a discount on a massage
or fitness gear? Just show your card and you’ll earn a discount
at participating providers. From alternative health services like
acupuncture to yoga books and DVDs, you’ll enjoy the discounts that
come with an Independence Blue Cross membership. Our members
also get exclusive discounts on CorCell®, a program that preserves
your child’s umbilical cord blood - a resource that may help combat
a variety of life-threatening diseases.*
Important reminders – We’ll help you remember to schedule
those routine tests and screenings that always seem to slip your
mind. We’ll send you educational reminders for mammograms, Pap
tests, and colorectal screenings. You’ll also get special reminders
and resource mailings to keep the whole family up to date on
immunizations and vaccinations.
Healthy Lifestyles programs are value-added programs and services – they are not benefits under
the health care plan that you purchased and are therefore subject to change without notice.
*CorCell is an independent company offering a discount on cord blood preservation services to
Independence Blue Cross members. CorCell does not offer Blue Cross and/or Blue Shield products or
services. CorCell is solely responsible for its products and services.
Valley Forge National Historical
Park, Montgomery County.
Our wellness programs offer cash rewards and valuable discounts.
14 It’s just the motivation you need to go for a run, ride your bike, or 15
take a walking tour on the expansive grounds of this historical site.

10. Value-added
programs
Make informed decisions Take control of your health Receive personalized support
ibxpress.com also provides the tools you need to make lifestyle You don’t have to be alone when making
Our member website, ibxpess.com, provides tools and
changes – like losing weight or quitting smoking – by helping important decisions regarding your
resources to help you make informed health care decisions.
you get started, set reachable goals, and track your progress. health. Our ConnectionsSM Health
We’ve partnered with WebMD® to provide you with
Management Programs give you the
personalized tools and reliable information to help you make • Personal Health Profile (PHP) – This powerful
one-on-one support you need when
health decisions that are right for you. health assessment tool will give you a clear picture
facing significant treatment decisions or
• Provider Finder and Hospital Finder help you find of what you are doing right and suggest ways to stay
everyday health concerns. Your personal
the participating doctors and hospitals that are best healthy. After you complete the PHP, you’ll receive an
Health Coach is available 24/7 to answer
equipped to handle your needs. You can learn about accurate, confidential, and personalized action plan.
your questions and to help you make
where your doctors went to medical school, their board knowledgeable, confident decisions
• Lifestyle Improvement Programs – These
certification, languages spoken, and more. You can regarding your health care. Your Health
personalized, self-paced, step-by-step programs
also compare hospitals based on their experience, Coach can provide:
will help you improve your health. You’ll find
cost, patient satisfaction, and other factors you
several different programs, such as exercise, weight • information on everyday health
find important.
management, nutrition and smoking cessation, designed concerns, such as headaches and
• Symptom Checker provides a head-to-toe tool to to inspire and support your positive health changes. joint pain;
help you evaluate how serious your symptoms are – and These online programs combine proven tactics with the
what you should do about them. ultimate in privacy, security, and convenience. • help if you are facing a significant
medical decision, such as treatment
• Health Encyclopedia provides information on more • Health Trackers – Chart your progress over time options for back pain, breast or
than 160 health topics and the latest news on to help you stay motivated. Track blood pressure, prostate cancer, or surgery:
common conditions. cholesterol, body fat, and other health factors. Or,
customize the tool by adding a new health tracker for • personalized calls about your
• Treatment Cost Estimator helps you estimate your additional data you want to track – like test results, chronic condition or health
costs for hundreds of common conditions – including number of push-ups, etc. concerns;
tests, procedures, and health care visits – so you can
plan and budget for your expenses. • Personal Health Record – Use your Personal Health • information about what types of
Record to store, maintain, track, and manage your questions to ask your doctor.
health information in one centralized, private, and
Take a tour of our secure location. We’ll even update your Personal Health
Record for you each time we process one of your claims.
1
WebMD is an independent company offering online health
information and wellness education to Independence Blue
member website on
Cross members.
www.ibxpress.com.
Health information at your fingertips
No matter where you take your laptop, ibxpress.com
makes it easy for you to stay on top of your health.
16 17
1 1

11. Glossary
Choosing a health plan doesn’t have to be difficult. Learn more PPO - This stands for preferred provider organization. With a Precertification – This may also be called
about some of the common terms and definitions before you PPO plan, there’s no need to select a primary care physician. preapproval or prior authorization. Basically,
make a decision. You can visit any doctor or specialist in the network, without a you may need additional approval from
referral. You also have the freedom to choose doctors outside your health plan before you receive certain
Copay - It’s a set dollar amount you pay for a covered health
the network if you’re willing to pay more for their services. tests, procedures, or medications. It’s a way
service. If you have a $10 copay for a doctor’s visit, you simply
to make sure the services you’re getting
pay $10 and we cover the rest. Preexisting condition - It’s a health condition you received
are effective.
medical care or advice for before applying for insurance.
Coinsurance - Some plans require you to pay a percentage
All of our medically underwritten plans have exclusions for Rate guarantee - All of the plans in
of your medical costs. If you use a participating provider, your
preexisting conditions for the first 12 months of coverage, this brochure come with a six-month rate
costs are based on our discounted rate.
meaning that some conditions may not be covered for the first guarantee. This means that your final rate
Deductible – This is a fixed dollar amount that you must year. Under our HMO plans, we will look at any conditions that will remain the same for the first six months
pay before your insurance kicks in. If you use a participating you received services or advice for in the 90 days preceding of coverage. You will be notified in advance
provider, your costs are based on our discounted rate. your enrollment. For our PPO plans, the look back period is 12 of any rate increases approved by the
months. There are two ways that you can waive or reduce the Pennsylvania Insurance Department.
HMO - This stands for health maintenance organization. If preexisting condition exclusion period.
you pick an HMO plan, you’ll need to select a family doctor who Referral – If you have an HMO plan, your
can help you with general health concerns, or refer you to a • Blue-to-Blue transfer – If you’ve had active health family doctor (or PCP) will need to write
network specialist for care. coverage with a Blue Cross® or Blue Shield® plan for up you a referral before you see other network
to 12 months without a break in coverage prior to your providers, such as a dermatologist. No need
Health savings account (HSA) - A tax-advantaged savings requested effective date, you can receive credit for each to pick up a piece of paper, our referrals are
account that can be used to save for health care expenses. You month of prior coverage up to the entire exclusion period done electronically.
must be enrolled in an HSA-qualified high-deductible health of 12 months.
plan to be eligible to open an HSA. There is a maximum amount
that you can contribute to an HSA each year but if you don’t • Creditable Coverage – If you had active coverage with
use all of the money within your benefit period, it rolls over to another insurance carrier for at least 18 months without
the next year. a break in coverage of more than 63 days prior to your
current application, you can receive credit for the entire
Medically underwritten plan - All of the plans in this exclusion period of 12 months.
brochure are medically underwritten. Your health history and
If you qualify for a preexisting condition waiver, be sure to
current health will be reviewed to determine whether you
complete Section G of the application and provide any
qualify for enrollment. If approved, some health conditions may
required documentation.
require you to pay a higher premium.
Premium - This is the amount you pay for your health
Out-of-pocket maximum – This is the maximum amount insurance coverage. This is separate from costs you pay when
that you will have to pay under your plan. Once you hit your you use your benefits to get care, such as copays, deductibles,
out-of-pocket maximum, we’ll cover services requiring a and coinsurance.
deductible or coinsurance 100% for the remainder of the
Primary care physician (PCP) – This is just another term
benefit period. Check plan details to see what’s included in the
for your family doctor. HMO plans require you to pick a PCP to
out-of-pocket maximum calculation. Please note that none of
coordinate your health care and refer you to a specialist if needed.
the plans include balance billing by out-of-network providers in
the out-of-pocket maximum calculation. Frankenfield Covered Bridge,
Bucks County.
Riding your bike is a great way to get your health in gear –
18 and admire the foliage and covered bridges of Bucks County. 19
16 1