Text Box: EPO stands for Exclusive Provider Organization Plan. The MBPET plan is modeled after an HMO type plan. Under the EPO Plan you receive the listed benefits only if you use network providers. For medical care if you go outside of the network, the EPO plan pays nothing. For hospital care, you must use Natividad Medical Center. Natividad is paid at 100%. Network doctors and providers are paid at 80% after the calendar year deductible of $100.00. In any calendar year the maximum our of pocket for covered expenses is $500.00. Out of area emergencies are paid under the regular benefit schedule but must be true emergencies. 1.) Hospitals of Distinction Level of coverage: 100% of contracted rates. (Natividad Medical Center, George L. Mee Hospital, Hazel Hawkins Memorial Hospital, Dominican Hospital of Santa Cruz, Watsonville Community Hospital) 2.) Centers of Excellence Level of coverage: 100% of contracted rates Must be pre-approved by Pacific Health Alliance (Stanford Medical Center, Sequoia Hospital, O’Conner Hospital, University of California—San Francisco Medical Center and other pre-approved facilities for specialized procedures and/ or treatments.) 3.) Out Of Area Referral Hospitals Level of Coverage:80% of contracted rates 4.) Regional Network Hospitals Level of Coverage:NONE Salinas Valley Memorial Hospital is not in the EPO Plan 5.) Regional Non-Network Hospitals Level of coverage: NONE Community Hospital of the Monterey Peninsula (CHOMP) is not in the EPO Plan

Hospitals of Distinction

Centers of Excellence

Hospitals of Distinction (Power Point Slide Show)

Centers of Excellence (a Power Point slide show)

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EXCLUSVE PROVIDER ORGANIZATION HOSPITAL OPTIONS