Company Plan - Active Employees

Plan Name	CMP - Active (Salaried Non-Rep)	BC/BS/MM (Represented)	BC/BS/MM (Coatesville) (Represented)	BC/BS/MM - RR (Represented)
Member Services Number	1-800-345-3131 www.bluecares.com	1-800-345-3131 www.bluecares.com	1-800-345-3131 www.bluecares.com	1-800-345-3131 www.bluecares.com
Individual Lifetime Maximum Benefits	$1 Million	$500,000 Major Medical	$500,000 Major Medical	$50,000 Major Medical
Individual Annual Deductible	$200	Sparrows Point, Burns Harbor and Conshohocken $175 All Other Locations $100 (Rx Deductible - Brand Name $50)	$100	$75
Family Annual Deductible	$400	Sparrows Point, Burns Harbor and Conshohocken $350 All Other Locations $100 (Rx Deductible - Brand Name $100)	$200	$150
Coinsurance	20% except Hosp/Surgery	20% - Major Medical	20% - Major Medical	20% - Major Medical
Individual Out-of-Pocket Maximum Per Year	$1,000	$1,000 - Major Medical	$1,500 - Major Medical	None
Family Out-of-Pocket Maximum Per Year	$1,200	$2,000 - Major Medical	$3,000 - Major Medical	None
Precertification	Patient Responsibility	Patient Responsibility	Patient Responsibility	Patient Responsibility
Claims Filing	Yes	Yes	Yes	Yes
Inpatient Hospital	100% after deductible	100% up to 365 days per calendar. year	100% up to 365 days per calendar. year	100% up to 120 days per calendar year.
Physicians Services: PCP Office Visit	80% after deductible	80% after MM deductible	80% after MM deductible	80% after MM deductible
Emergency Care: In-area Hospital	80% after deductible	100% Covered	100% Covered	100% Emergency Accident Only
Outpatient X-Ray and Lab	80% after deductible	100% up to $1,500 per calendar year	100% up to $2,500 per calendar year	100% up to $75 per calendar year
Prescription Coverage: Generic Drug Copay	15%	15%	15%	10%
Prescription Coverage: Brand Name Drug Copay	25% when generic not available; 30% when generic available and medically necessary	25% when generic not available; 30% when generic available and medically necessary	25% when generic not available; 30% when generic available and medically necessary	20%
Prescription Coverage: Mail Order Copay	10% generic; 20% brand when generic not available; 25% brand when generic available and medically necessary	10% generic; 20% brand when generic not available; 25% brand when generic available and medically necessary	10% generic; 20% brand when generic not available; 25% brand when generic available and medically necessary	10% generic; 20% brand
Diabetic Benefits: Insulin	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit
Diabetic Benefits: Chem. Strips/Lancets	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit	Covered under Pharmacy Benefit
Home Health Care	80% after deductible up to 100 days per year	100% up to 100 visits/year	100% up to 100 visits/year	80% after deductible up to 100 visits per year
Durable Medical Equipment and Maximum	80% after deductible	80% after MM deductible	80% after MM deductible	80% after MM deductible
Mental Health: Inpatient Benefit and Maximum	80% after deductible; 30 days per calendar year*	100% up to 60 days per 12 month period*	100% up to 60 days per 12 month period	100% up to 30 days per 12 month period
Mental Health: Outpatient Benefit and Maximum	60 days per year; Maximum payments-first 30 visits, $50; second 30 visits, $30*	80% after Major Medical Deductible	80% after Major Medical Deductible	80% after MM Deductible
Substance Abuse: Inpatient Benefit and Maximum	100% after deductible; 28 days per confinement ( 33 with detox) - 2 course of treatment (inpatient and /or outpatient) per lifetime *	100% up to 56 days lifetime; detox up to 5 days of treatment; limit of 3 courses of treatment per lifetime	100% up to 56 days lifetime; detox up to 5 days of treatment; limit of 3 courses of treatment per lifetime	Not Covered
Substance Abuse: Outpatient Benefit and Maximum	Up to 30 visits and up to 5 days of detox - 2 courses of treatment ( inpatient and/or outpatient per lifetime*	Up to 90 days lifetime	Up to 90 days lifetime	Not Covered
Vision Care: routine Eye Exam	Not Covered	Not Covered	Not Covered	Not Covered
Vision Care: Eye Glasses and Contact Lenses	Not Covered	Not Covered	Not Covered	Not Covered
Hearing Care: Exam	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458
Hearing Care: Hearing Aids	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458	Provided by National Ear Care Plan (NECP) 1-800-999-1458
Dental Care: Basic Services	Not Covered	Not Covered	Not Covered	Not Covered
Dental Care: Major Services	Not Covered	Not Covered	Not Covered	Not Covered
Dental Care Preventive Services	Not Covered	Not Covered	Not Covered	Not Covered
Wellness Benefits	Mammograms, pap smear and PSA tests - 80% after deductible	Mammograms, pap smear and PSA tests - 80% after MM deductible	Mammograms, pap smear and PSA tests - 100% UCR	None
*Foot notes	The Mental Health and Substance Abuse Benefits for Burns Harbor, Pennsylvania Steel Technologies and Sparrow Point are administered by a separate Third Party Administrator and the benefits may be different then stated above. Note:* Pages 3-7 of the PIB should state (4) Diagnostic Benefits and (5) Major Diagnostic Benefits payable at 80% Current SPD incorrect at 100%	*The Mental Health and Substance Abuse Benefits for Burns Harbor, Pennsylvania Steel Technologies, Sparrow Point and Conshohocken are administered by a separate Third Party Administrator and the benefits may be different then stated above.