Maintaining Your Edge

Okay, we admit it. Healthcare plans today are anything but simple. In fact, choosing one can be pretty complicated. So we're trying to help simplify your life and give you a little extra peace of mind by offering only the best options available. In fact, you can use our handy medical options comparison chart to compare your options.

Your healthcare options were designed to put you in the driver’s seat. You not only decide which plan works best for you and your family, but with both the PPO options, you have the flexibility of staying within a network or going outside the network. It’s up to you.

We’ll offer several different medical plans in most markets. The choices you’ll have will depend on where you live. Most employees will be able to choose from among the two PPO options and an HMO. In some locations, your choices may be limited to an HMO or the Out-of-Area Indemnity plan.
What's the difference between a PPO, an HMO, and an indemnity plan?

We’re even offering an optional supplemental medical plan to cover those treatments some insurance companies may not cover.

Oh, and if you’re covered under another plan, you can choose not to enroll in any medical coverage and get a $500 coverage waiver credit you can have paid to you in taxable cash during the year. That's pretty cool.

Basic Option Open Access Preferred Provider Organization (PPO) plan featuring:

No Primary Care Physician (PCP) selection required
$15 copay for in-network office visits
80% coverage for most other in-network care and 70% coverage for most out-of-network care
Not available in all areas

Premier Option Open Access PPO plan featuring:

No PCP selection required
$10 copay for in-network office visits
100% coverage for most other in-network care and 80% coverage for most out-of-network care
Not available in all areas

HMOs featuring:

$10 office visit copay
100% coverage for in-plan care
May require PCP selection
Not available in all areas

Out-of-Area Indemnity plan featuring:

90% coverage of office-visit charges and most other care
No PCP selection required
Available only if you live outside an Open Access PPO network and/or outside areas covered by an HMO

Prescription Drug Plan
Your prescription drug coverage depends on the options you choose. If you choose an HMO, your prescription drug coverage will be based on the individual HMO schedule of benefits.

If you choose the Basic or Premier Option Open Access PPO or the Out-of-Area Indemnity plan, your cost depends on how you get your prescriptions filled. For example, having your prescription filled with a generic drug costs less than having it filled with a brand-name counterpart. By law, both generic and brand-name drugs must meet the same standards for safety, purity, strength, and quality.

Formulary drugs are drugs that are listed in the prescription drug vendor’s formulary, which is a published listing of approved drugs. Formulary drugs are selected based on safety, efficacy, and cost. Different drug vendors have different formularies. Obviously, non-formulary drugs are those not listed in the prescription drug vendor’s formulary.

Your cost will also vary depending on where you get your prescription filled. At retail pharmacies, you pay:

$7.50 for 30-day generic drug supply
$15 for 30-day formulary drug supply
$25 for 30-day non-formulary drug supply

Through the money-saving mail order option, you pay:

$12 for 90-day generic drug supply
$20 for 90-day formulary drug supply
$30 for 90-day non-formulary drug supply

Medical Plus Plan
Not everyone’s situation is the same, so we’ve added the Medical Plus Plan to provide a little extra flexibility. The Medical Plus Plan can be purchased as a supplement to one of the regular medical plans to cover experimental and investigational treatments not normally covered by medical plans. Plan features include:

A maximum lifetime benefit of $500,000, including up to $10,000 for companion travel and $15,000 for professional air ambulance transportation.
If an approved facility is used, the plan pays 100% of expenses.
If a non-approved facility is used, the plan pays 80% of the negotiated rate, or the actual billed charges.
Because claims for the Medical Plus Plan are paid for by employee contributions held in a trust, at least 30% of Cingular employees and covered dependents must enroll in order for the plan to continue.

Long-Term Care
Long-term care insurance is designed to protect you and your family financially if you or an eligible family member need long-term care in a nursing home, your own home, or an adult day care center.

You pay for the coverage monthly through a convenient payroll deduction.
You can choose to cover yourself, your spouse or Registered Domestic Partner, parents, and parents-in-laws—including your Registered Domestic Partner’s parents. In some cases, retired employees and spouses of retired employees are eligible for coverage.

You can choose between Comprehensive Coverage and Nursing Home Only Coverage.

Nursing Home Only Coverage protects you against the high cost of care provided in a qualified nursing home or assisted living facility for the cognitively impaired.
Comprehensive Coverage also provides coverage in a qualified nursing home or an assisted living facility for the cognitively impaired, plus it provides coverage for home health care, adult day care, and even informal care.
Both plans include a daily maximum benefit and a lifetime maximum benefit.

After you choose your plan, you select the daily maximum benefit and the lifetime maximum benefit you want.

Vision
If you're eligible for benefits, you're covered under our Cingular Vision Plan, and there’s no monthly contribution. (Retired employees are not eligible for vision coverage, and part-time employee premium costs are based on scheduled hours.) See our chart for an overview of your coverage.

You can stay in the network and get a higher level of coverage, or, you can go outside the network for a lower coverage level.
You don’t have to decide at enrollment and live with your choice the rest of the year. It’s your choice each time you get care.
Coverage for you and your dependents includes an annual exam, new lenses every 12 months, and new frames every 24 months. Coverage also includes a second pair of glasses for a $30 copayment.
You and your eligible dependents will also have access to substantially discounted LASIK corrective eye surgery through a network of approved vendors. If you participate in the Cingular Healthcare Spending Account, you may also be able to set aside money before taxes to help pay for eligible out-of-pocket expenses related to this procedure.

Your Vision Coverage at a Glance

Vision Services/
Products In-Network
Coverage Out-of-Network
Coverage*

Examination $15 copayment; then 100% 100% up to $28

Single Lenses 100% 100% up to $30

Bifocal Lenses 100% 100% up to $52

Trifocal Lenses 100% 100% up to $72

Lenticular Lenses 100% 100% up to $80

Frames 100% up to plan allowance 100% up to $30

Medically Necessary Contact Lenses 100% 100% up to $75

Elective Contact Lenses Contact lenses can be chosen instead of lenses and frames, once every 12 months. 100% up to $75

*Employee pays the remainder in full after limits.

Dental
You have two Cingular Dental Plan choices—Basic and Premier.

Cingular fully covers the cost of the Basic Plan. You have no monthly contribution. Your cost includes a deductible—or first charges per year—and the applicable copayments. (Part-time employee costs are based on scheduled hours.)

For a small monthly contribution, we offer you the flexibility of upgrading your coverage to the Premier Plan.

With both plans, you can choose to see dentists inside the network and take advantage of negotiated rates or you can go outside the plan and see any dentist with no penalty.

Dental Option Comparison Chart

Plan Highlights Basic Plan Premier Plan

Deductible $30 per person up to $90 $25 per person up to $75

Annual Plan Maximum $1,400 $1,830

Orthodontia Lifetime Maximum $1,250 adult
$1,650 child $1,460 adult
$1,800 child

Preventive Care 100%, no deductible 100%, no deductible

Basic Care 60% of reasonable and customary costs, after deductible 80% of reasonable and customary costs, after deductible

Major Medical 60% of reasonable and customary costs, after deductible 80% of reasonable and customary costs, after deductible

Orthodontia 50% of reasonable and customary costs, after deductible 60% of reasonable and customary costs, after deductible

Healthcare Spending Account
Healthcare spending accounts help you make the most of every dollar you earn because they let you pay some of your eligible expenses in a way that reduces your taxes.

You can to contribute up to $5,000 before taxes to your account.

When you have eligible expenses for the Healthcare Spending Account, you can submit them to the service vendor and be reimbursed from your account.

Transitioning to the Edge
When you transition to the new Cingular medical, dental, and vision plans, you don’t have to worry about coverage limitations for any preexisting illnesses or conditions for you or your dependents.

Because your new health plan options provide broad doctor choice, you're likely to find your doctor(s) in your new plan. If your doctor is not in the new plan and you are in a course of ongoing treatment, Cingular will help you coordinate your ongoing care with your new doctor.

For some conditions, such as late-term or high-risk pregnancy, cancer or other serious medical conditions, Cingular and your medical plan will work with you to develop a transition of care plan to make the move to your new plan as stress-free as possible. For example, you may be able to continue seeing your current doctor through the course of your treatment even if he or she is not part of your new plan.

To ensure the smooth transition of your prescription drug coverage, Cingular and your prescription drug vendor will work with you to make sure your maintenance prescriptions continue without interruption.

Any money left in your Healthcare Spending Account under your parent company may be forfeited when you move to Cingular. You will have until March 31, 2002 to submit claims for eligible expenses provided before the move date.

What's the Difference Between a PPO, HMO, and Indemnity Plan?
The Basic and Premier Open Access PPO plans work like this:

Preferred Provider Organizations (PPOs) maintain networks of participating doctors and hospitals.
You don’t have to select a Primary Care Physician (PCP). While some PPO plans require you to choose a PCP to direct your care, the Basic and Premier Open Access PPO plans leave the decision entirely up to you.
Each time you get care, you have the choice of using in-network or out-of-network providers.
If you use in-network providers, you’ll receive the highest level of benefits and won’t have to file your own claims.
You can choose between two options. The Basic Option has lower coverage levels and higher deductibles with a lower employee contribution and the Premier Option has higher coverage levels and lower deductibles, with a higher employee contribution.

HMOs work like this:

Health Maintenance Organizations (HMOs), provide prepaid benefits for most healthcare needs, with no bills or claim forms.
First, you choose a Primary Care Physician (PCP) from a list of providers.
For your expenses to be covered—except in emergencies—you must receive care from your PCP or from a doctor or facility referred by your PCP.
If you receive care from a doctor other than your PCP, or without being referred by your PCP, you won't receive any coverage.

The Out-of-Area Indemnity plan works like this:

The Out-of-Area Indemnity plan is only available if you live in an area not covered by an HMO or an Open Access PPO plan.
An indemnity plan provides the same coverage no matter which doctor or hospital you use.
The plan reimburses you for covered services as long as the expenses are defined by the insurance company as reasonable and customary.
You—or your doctor—will need to file claim forms in order to be reimbursed.