Preferred Provider Organization "PPO"

UNC has selected a Preferred Provider Organization (PPO) so covered persons will receive benefits at the "negotiated allowance". Preferred providers allow the covered person to maximize the benefits offered under this plan. For Hospital, Doctor, ancillary and other health care, you should seek treatment from a PPO provider.

• In-Network Providers for Student Health Plan

  GWH-Cigna PPO Network - Covered expenses are reimbursed at 80% of maximum allowable charges unless otherwise noted. View the list of Preferred Providers, or call 888-308-7320. Provider information is available 24 hours a day.

• Local Hospitals in PPO Network

  North Colorado Medical Center (NCMC). Located at 1801 16th St. Greeley, CO 80631. 
  Note: Out patient Emergency Room care is subject to a $150 copay for each ER visit. Ambulance benefit paid at 70% of "Usual & Customary" charges

• Out-Of-Network - Non Preferred Providers

  Covered expenses are reimbursed at 50% of "Usual & Customary" charges unless otherwise stated. Treatment provided by Out-Of-Network providers is subject to usual and customary charges. Any charges in excess of these charges are not covered under this plan. Non-Preferred Providers have not agreed to any prearranged fee schedules, so you will incur increased out of pocket expenses with these providers. Charges in excess of the insurance payment and amounts above reasonable and customary are your responsibility.

• Cost Savings with PPO

  You will always save money by going to a Preferred Provider. Preferred Providers are Physicians, Hospitals, and other health care providers who have contracted to render specific medical care at negotiated prices. "PPO Allowance" means the reduced allowance that a Preferred Provider will accept as payment in full.

  For an example of savings when you use a PPO, see the chart below:

  Physician's Charges

  PPO - $500

  Non PPO - $500

  Discount

   PPO discount - $100

   Non PPO discount - $0

  Net Charge

  PPO - $400

   Non-PPO - $500

  Coinsurance - What you pay after insurance payment

  PPO - 20%

  Non-PPO - 50%

  Your Cost -  After deductible has been met

  PPO - $80

  Non-PPO - $250