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© 2006 Texas Mutual Insurance Company PowerPoint Presentation
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© 2006 Texas Mutual Insurance Company

© 2006 Texas Mutual Insurance Company

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© 2006 Texas Mutual Insurance Company

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  1. © 2006 Texas Mutual Insurance Company

  2. Employee Benefits • Timely access to • Treating doctors • Specialty care • Quality doctors who will get you well and back to work • You have a choice of treating doctors in the network

  3. Changing Doctors • You may change your treating doctor once without approval • You will need to get approval if you change doctors a second time

  4. Employee Requirements • If you’re hurt on the job • Follow company procedures • If emergency care is needed, get it! • Report your injury as soon as possible • Select your treating doctor from the network list • www.texasmutual.com • (800) 381-8067 • If you go to a non-network doctor, you may be responsible for payments to the doctor © 2006 Texas Mutual Insurance Company

  5. Exceptions You do not have to go to a network treating doctor if • it is an emergency • you use your HMO primary care doctor* • you are referred to a specialist by your treating doctor • you live outside the “service area” * - applies only if employer offers HMO coverage

  6. Service Area • Where network health care is available and accessible • If you live in a service area, you must choose a network treating doctor • “Live” means • Principal residence (NOT a P.O. Box) • Temporary residence required by employment • Temporary residence for receiving help with daily activities © 2006 Texas Mutual Insurance Company

  7. Network Notice • Rules to help you get care from the network • You will receive a copy of the notice now and if you have an injury • You must sign a form stating that you have received and read the network notice

  8. Questions? © 2006 Texas Mutual Insurance Company