Benefit Rates Summary

Benefit Rates Summary

The Related SISC Anthem Blue Cross Plan Options Document is a brief summary of benefits
that is superseded by the plan Documents and is not all inclusive.

Remember it is the member's responsibility to verify provider participation in the correct PPO network prior to accessing services. Utilizing a non-contracted provider will result in greater out-of pocket expense for the member.

Prescription drug benefit plan is managed by Express Scripts.

Attached rate summary is for October 1, 2014 - September 30, 2015.

FRTA voted for a modified tiered rate. The rates posted under "FRTA Modified Rates" are the monthly out of pocket rates for FRTA members.

Website by SchoolMessenger Presence. © 2017 West Corporation. All rights reserved.