Health Insurance Network Providers – LG Health

Why Use Eliance Preferred Network(Tier 1) Providers?
The primary care physicians and specialists in the Eliance Preferred Network deliver to you and your family, the most convenient and cost-effective provider option. Eliance providers follow high quality protocols driven by advanced clinical initiatives that have been shown to improve medical outcomes and reduce health-related costs.

For employees using the Eliance Network co-pays and out-of-pocket expenses are reduced. The vast majority of services are available; however, if a service is not available within the Eliance Network, employees may access additional networks at the Tier 2 benefit level.

Which Providers Participate in the Eliance Preferred Provider Network?
The Eliance Network includes all providers employed by Penn Medicine Lancaster General Health, as well as, the University of Pennsylvania Health System and the Children’s Hospital of Philadelphia.

Where do I find Care? This simple tool can help you find the most appropriate Lancaster General Health Provider based on your location.

Tier 2 Providers

Employees may also access additional providers that include the following networks:

To determine if a provider is Tier 1 or Tier 2, or if you have other questions about the provider networks, please call Capital Blue Cross (CBC) at 1-833-584-1828 (24 hours a day/7 days a week). You can also view claims information, print or order ID cards and access insurance-related forms online, by logging onto Capital Blue Cross.

Note: A $5,000 copayment will be applied for non-life threatening inpatient visits at the following hospitals: Penn State Milton S. Hershey Medical Center, WellSpan York Hospital, Well Span Ephrata Community Hospital, Reading Hospital, UPMC Lititz, Penn State Health St. Joseph Medical Center, UPMC Harrisburg, Lebanon VA Medical Center, Nemours Children’s Hospital, WellSpan Good Samaritan Hospital and Penn State Health Lancaster Medical Center.

Note: LGHealth Insurance plan year from July 1 – June 30

LG Consumer Health Insurance Plan – Eligibility: 0.5 FTE effective on first of the month coinciding with the current month

Group Number 71-5942S

The LG Consumer Health Insurance Plan is a High Deductible Health Plan (HDHP) that provides you with the opportunity to participate in a Health Savings Account (HSA). You have significant power and responsibility for your health care decisions when you participate in a HSA-qualified health plan. The LG Consumer Plan requires no employee cost sharing – this means no health insurance premiums will be deducted from your pay! Without the expense of bi-weekly healthcare premiums with this Plan, you are able to deposit money in your HSA. Where you can save on taxes and have flexibility and control over your health care costs. The money in your HSA remains yours, even if you terminate employment, switch health plans or retire.

What Does High Deductible Health Plan (HDHP) Mean?

In a HDHP, your medical and prescription drug expenses must exceed the amount of your deductible in order to receive reimbursement from the Plan. In other words, the Plan pays for all covered expenses incurred after you have met the annual deductible amount and out-of-pocket expense maximum limits for individual and/or family (depending on the elected coverage level).

Benefits of a Healthy Lifestyle

As a participant in the LG Consumer Plan, all of your Preventive Care visits are covered 100% without having to meet your annual deductible.

Note: To be considered “preventive care”, the claim must be coded as a wellness visit and the service must be performed by an in-network provider. Preventive Care visits include annual checkups and screenings for each enrolled member of your family.

Am I Eligible to Participate in the LG Consumer Plan and/or HSA?

Employees who elect to participate in the LG Consumer Plan will be automatically enrolled in the HSA (although you will not be required to contribute to the HSA), and can increase, decrease, start and stop contributions as often as they like. Therefore, you must be eligible to own a HSA before you may participate in the LG Consumer Plan. The IRS has strict guidelines to determine who is eligible to own and contribute to a HSA – see below for further detail:

Individuals eligible to own a HSA:

May not also be covered under any health plan that isn’t a qualified HDHP
Must not be enrolled in Medicare
May not be eligible as a dependent on another individual’s tax return

Who are Eligible Dependents?

Quick Links:
Health Savings Account

LG Consumer Summary of Benefits and Coverage
LG Health Consumer At A Glance

LG Select Health Insurance Plan – Eligibility: 0.5 FTE effective on first of the month coinciding with the current month

Group Number 71-5942S

The LG Select Health Insurance Plan is designed for employees who want the lowest possible deductible, low co-insurance, are willing to pay a bi-weekly premium for their Health Insurance Plan and prefer co-payments for physician office visits and prescription drugs.

See below for some highlights of the LG Select Health Insurance Plan:

This plan has co-payments (no deductible) for primary care providers and specialist office visits.
At LG Health Outpatient Facilities, employees and families will have zero out-of-pocket expenses for related professional and facility charges for diagnostic tests.
LG Health inpatient co-payments are $200. LG Health hospital provider services are subject to the annual deductible* and co-insurance.

*When enrolled members of a family incur covered expenses that are subject to the deductible and they are equal to, or greater than, the dollar amount of the family deductible, then the family deductible will be considered satisfied for all family members for that calendar year. Any number of family members may help to meet the family deductible amount, but no more than each person’s individual deductible amount may be applied toward satisfaction of the family deductible by any family member.

Benefits of a Healthy Lifestyle

Preventive Care is covered 100% without having to meet your annual deductible when participating in the LG Select Plan.

Paying for Qualified Medical Expenses

Employees enrolling in the LG Select Plan are eligible to enroll in a Health Care Flexible Spending Account (FSA) for out-of-pocket expenses associated with deductibles, co-payments, and co-insurance. See Flexible Spending Accounts [link to Flexible Spending Accounts page] for further information on FSAs.

Who are Eligible Dependents?

Quick Links:
Flexible Spending Accounts

LG Select Summary of Benefits and Coverage
LG Select At A Glance

Plan Comparison

View Plan Comparison Here

Penn Medicine OnDemand – Eligibility: Employees and Dependents (14+) enrolled in either the LG Select health plan or LG Consumer health plan

Penn Medicine Lancaster General Health offers a virtual health care service, known as Penn Medicine OnDemand, to employees and dependents 14+ currently enrolled in either the LG Select or LG Consumer health insurance plan.

OnDemand is offered to LG Select participants at no cost. OnDemand is offered to LG Consumer participants for $49 / visit until the deductible is met; following deductible satisfaction, a $20 copayment is required per visit.

This service provides virtual visits for minor illnesses and injuries, such as sore throat, pink eye, urinary tract infections, rashes and headache. The service, managed by a nurse practitioner, can be reached 24 hours a day, seven days a week by calling 717-544-2222. To facilitate a video visit, employees are encouraged to download the MyChart app, available at MyLGHealth.org, prior to calling.

Infertility Services

Infertility services ($30,000 lifetime maximum) are only available through a Tier 1 provider, in LG Health’s medical programs. This includes service providers from LG Hospital, WBH and Penn Fertility Care (includes HUP, PA Hospital, Penn Presby Medical Center and CHOP).

More infertility plan information can be found in the Health Insurance Summary Plan Description, here.