Augustana College
Note: This is a Summary of Benefits; please refer to the Plan Document for a full description of benefits, limitations and maximums. Medical Expense Benefits Limitations and Maximums In-Network Out-of-Network Annual Deductible: Annual Out-of-Pocket Maximum: (includes Co-Insurance) Does not include Deductible, Drug Co-Pays, penalties for failure to pre-certify services, amounts exceeding usual and customary fees, or ineligible expenses Medical Expense Benefit Lifetime Maximum: Benefits Covered Expenses In-Network Out-of-Network Limitations Hospital Services
Includes room & board, special care units,
ancillary services, emergency room services
Physician Services Emergency Room Ambulance Services Physical, Occupational and Speech Therapy Durable Medical Equipment Chiropractic Care/Spinal Manipulation Laboratory, X-ray and Diagnostic Testing Home Health Care Hospice Care Mental Health/Substance Abuse Treatment Transplant Services Preventative Care
(please refer to Plan Document for list of covered services)
Maternity and Newborn Care Skilled Nursing Facility All other covered expenses Augustana College Preferred Provider Networks
This Plan has entered into an agreement with certain Hospitals, Physicians and other health care providers, which are called
Participating Providers, or In-Network Providers. Because these Participating Providers have agreed to charge reduced fees to
persons covered under the Plan, the Plan can afford to reimburse a higher percentage of their fees.
Therefore, when a Covered Person uses a Participating Provider, that Covered Person will receive a higher benefit percentage
from the Plan than when a Non-Participating, or Out-of-Network, Provider is used. It is the Covered Person’s choice as to which
Provider to use. The PPO networks for this Plan are:
Quad City Community Health Care - www.qcchealth.com or call 888-498-7224 Outside of the Quad City Area: PHCS - www.multiplan.com or call 866-680-7427 Precertification If these services are not pre-certified with QCCH, benefits payable will be reduced by $300 per Covered Individual per incident. The reduction in benefits does not apply to the Annual Deductible or Out-of-Pocket Maximum.
- All non-emergency inpatient admissions must be pre-certified prior to the service; emergency inpatient admissions must be
reported within two business days of admission
The following services are recommended:
- Durable Medical Equipment purchase over $300 and any rental of durable medical equipment
- All chemotherapy, radiation therapy, home health care and dialysis
Outpatient Prescription Drugs In-Network
Certain over the Counter Medication to include Claritin, Prilosec, Zantac, and Zyrtec - $10 Co-pay per 30 day supply
PARADIGM TALENT AGENCY Attn: Frank Balkin 360 North Crescent Drive Beverly Hills, CA 90210 CRESCENZO NOTARILE, A.S.C. T: (310) 288-8000 DIRECTOR OF PHOTOGRAPHY F: (310) 288-2000 EM:FBalkin@ParadigmAgency.com FEATURES TIME COP 2: THE BERLIN DECISION Universal Prod: Mike Elliot Dir: Steve Boyum TURNAROUND Strange Fruit Prods Prod: Regina King, D’Angela S
Present Research Activity and Publications (2007-continuing…) Conferences: 1. Sanghamitra Pradhan, National workshop on Nano-materials as Nano-catalyst, January 2 . Sanghamitra Pradhan, 77th National Workshop on Radiochemistry and applications of radioisotopes, 28th November – 6th December 2011, Bhubaneswar, India. 3. Sanghamitra Pradhan , Delivered a talk on Stereochemical a