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The Basic Small Group Health Plan was created as a result of legislation intended to provide an insurance option for small group employers regardless of their employees' health status or claims experience.
- Coverage. Eligible services are covered 100 percent at our allowance, less any coinsurance and/or copayments. There is no coverage
out of network, except for the initial treatment for accidents and medical emergencies.
- Participating network. The Basic Small Group Health Plan network includes all hospitals in Rhode Island and approximately 98 percent of
all Rhode Island providers. The Basic Small Group Health Plan uses the national pharmacy network.
- BlueCard Program. With our BlueCard PPO Network, a member's Blue Cross card is recognized at any Blue Cross participating PPO
provider nationwide. In most cases, claims are filed by the provider and paid based on the local plan's allowance. Members will not be balance billed beyond applicable copayments. The Preferred Blue network is Blue Cross & Blue Shield of Rhode Island's (BCBSRI)
designated BlueCard PPO Network.
Providers participating directly with Blue Cross & Blue Shield of Rhode Island will obtain all preauthorizations for our members. Members should obtain preauthorizations when using Blue Card PPO providers from other Blue Cross plans. Failure to obtain preauthorization
may result in members being responsible for all charges deemed by us not to be medically necessary.
For benefit details on this plan option, please refer to the "Comparison of Health Plans" benefit matrix within your renewal packet.
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