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 Health Insurance - PPO and POS

 


Eligible Shelby County Government employees and retirees may enroll in health coverage.  Available options include a Preferred Provider Organization (PPO) or a Point of Service (POS) plan.  There are specific guidelines regarding the timeframe in which you and your eligible dependents must enroll.  In addition, participants are also offered the opportunity to withdraw from the County's health insurance coverage.  To review a comparison of some common features for the healthcare options, please refer to the appropriate Medical Benefits Summary. 
 

Preferred Provider Organization (PPO)

The PPO is administered by United Healthcare (UHC).  Under the PPO, participants choose a network provider or a non-network provider.  A network provider accepts a pre-negotiated fee.  The participant is responsible for a percentage of the maximum allowable charge and an annual deductible.  Should the participant utilize a non-network provider, service is paid at a percentage of the allowable charge, after deductible, and charges above the maximum allowable are the patient's responsibility.  Annual out-of-pocket maximums apply.

Participating hospitals are Methodist, St. Francis and LeBonheur Children's Hospital.  For complete hospital listings visit the United Healthcare website, www.myuhc.com.  (Please be aware that some of the information provided on this website is not applicable to Shelby County's PPO plan.)  Employees may change their address, request ID cards, view medical claims activity, and locate providers on the website.

United Healthcare Member Services:  1-866-204-6094 


 

Point of Service (POS)

The POS is administered by CIGNA Healthcare.  Participants use in network providers who have agreed to accept a fixed copayment for most services.  The use of out-of-network providers is covered at a percentage of the allowable charge.  Charges above the maximum allowable amount are the patient's responsibility.  There are no deductibles or out-of-network maximums if you use network providers.  All care is coordinated through your primary care physician (PCP).  Female participants are allowed direct access to a participating provider for obstetric/gynecology services.

Participating Hospitals are Methodist, St. Francis and LeBonheur Children's Hospital.  Please visit our CIGNA Healthcare website, http://provider.healthcare.cigna.com/SCG.html, for more information on hospitals.  Employees may also change their address, request ID cards, view medical claims activity, and locate providers on CIGNA's website. 

CIGNA Healthcare Member Services:  1-800-244-6224