510 N. Main
Wichita, KS 67203
2015 Benefits Book
Understanding Our New Benefits: 2014 Open Enrollment Meeting
October 23 – November 9 Open Enrollment
through Employee Self Service
2015 Health Insurance Changes Fact Sheet
2014 Benefits Book
Whether you use your medical coverage for planned, unexpected or catastrophic
expenses, everyone needs some level of medical care protection. REMEMBER: Choose
the plan that best fits your medical needs. Review the medical comparison chart
below to help you understand the coverage levels and plan designs.
Health System website lists the participating doctors in the plan's network.
PPK PHS/Coventry makes every effort to answer all of your questions, but if you have additional
questions about a health plan, have a service problem, or need provider
(316) 609-2390 (Wichita) or 1-800-660-8114
You have the following medical plan choices:
Summary of Plan Cost
Single Per Pay Period
2-Person Per Pay Period
Family Per Pay Period
Preferred Health Systems offers a telephone triage/medical advice line called
Preferred Advice Line (PAL). The service helps members who are experiencing
signs of illness or injury assess whether they need to go to the emergency room,
visit their doctor, or begin self care at home. Members can call1-866-221-6515
to receive toll free access to medical advice from a registered nurse 24 hours a
day, 7 days a week. To ensure coverage, call your family physician or PAL before
seeking care for urgent conditions.
With Preferred Health Systems’ insurance, you
are covered for emergency care when illness or injury strikes you or your
covered family members. However, it is important to know the difference between
an emergency medical condition and urgent care so that you can maximize your
health care benefits.
An urgent care situation is an unexpected
illness or injury that needs prompt medical attention, but is not an immediate
threat to your life. Examples include headaches, back or joint pain, flu
symptoms or earaches. These are times when care is necessary but not critical.
Medical conditions that are not an emergency should be treated in your family
physician’s office or at a contracting urgent care center. Talk to your
physician about what to do if you or a family member experiences a non-life
threatening situation that needs prompt attention. They may be able to give you
instructions over the phone. Physicians are available 24 hours a day to help you
get the care you and your family need. Their office will instruct you on how to
reach them. In most cases, non-emergent care is not covered when received in a
hospital emergency room.
If you have an emergency medical condition
such as difficulty breathing, suspected heart attack, uncontrolled bleeding,
unconsciousness or severe burns, try to use a contracting hospital emergency
room (Wesley Medical Center or Via Christi) to maximize your benefits.
Delta Dental of Kansas - Group 90192
Delta Dental is the leading and largest
group dental coverage provider in the United States. You are free to go to any
dentist of your choosing; however, there will be a difference in payment if the
dentist is not a participating dentist with Delta Dental. This dental plan has
no deductibles. It offers employees a preventative care service at 100 percent
(two checkups and cleanings annually and one set of x-rays). To encourage
employees to take responsibility for their health, a preventive care incentive
is included. Basic services, such as cavity fillings. Basic services are
covered up to 80 percent for employees who receive annual dental exams.
Basic services will be covered only at 50 percent for employees who do NOT
receive annual exams. Major services or orthodontia are covered at 50
percent. The maximum annual benefit per person is $1,000. Adult and dependent
orthodontia expenses are covered up to a lifetime maximum of $1,500.
(316) 264-4511 or toll free 1-800-234-3375.
You may elect to opt-out of dental coverage without other
dental coverage. However, you will not be permitted to elect a dental plan until
the next open enrollment period, unless you have a qualifying family status
Superior Vision - This vision plan has a $10 co-pay, in-doctor
network amount for eye examinations. Full exams and prescription lenses or
contact lenses are covered in full every 12 months, and frames are covered up to
$130 every 24 months. Covered lenses are covered up to $150 every 12 months. If
you decide not to see a Superior Vision doctor, you will receive a reduced
benefit and typically pay more out of pocket. For out-of-network providers, you
are required to pay the provider in full at the time of your appointment and
submit a claim to Superior Vision for partial reimbursement. If you have any
questions about the plan or you decide to see a provider outside the network,
call Superior Vision customer service at 1-800-507-3800 or visit their website
Mission: To assure quality public services that provide for the present and future well-being of the citizens of Sedgwick County.
© Copyright 2014
and Notice of Privacy Practices Regarding Medical Information.