Service Benefit Plan Contract Change

     
     NOTE TO ALL SUPERVISORS:  Please ensure that a paper copy of this 
     memorandum is given to all employees without access to e-mail.
     
     
     May 31, 1996
     
     
     
     Memorandum
     
     To:        Employees Covered by the Blue Cross and Blue Shield Service 
                Benefit Plan
     
     Subject:   Service Benefit Plan Contract Change
     
     
     The Office of Personnel Management (OPM) has informed the Department 
     that there has been retroactive changes made to the Blue Cross and 
     Blue Cross Service Benefit Plan for Calendar year 1996.
     
     Prior to these retroactive changes,  allowable charges for services of 
     nonparticipating providers were based on the Medicare participating 
     fee schedule amounts for the geographic area in which the services 
     were provided or 60% of the billed charges if no equivalent Medicare 
     fee schedule amount.
     
     Under the new retroactive 1996 contract provision, allowable charges 
     will be based on the greater of -
     
        - the above provision; or,
     
        - 80% of the 1996 UCR amount for the service or supply in the       
          geographic area in which it was performed or obtained.
     
     For those employees covered by the Blue Cross and Blue Shield Service 
     Benefit Plan, we recommend you visit your servicing Personnel Office 
     and obtain a copy of the OPM Benefit Administration Letter that 
     describes the changes as well as the amendment to the contract.