Microsoft Word - Secure Choice 2018 PPO Plus Plan SBC HM Hmong.doc

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1 Ntsiab Lus tawm Cov Txiaj Ntsig thiab Kev Pab: Yam uas lub koos haum Plan no Pab & Yam uas yuav raug nyiaj Lub Sij Hawm Qhov Kev Pab: 01/01/ /31/2019 Secure Choice: PPO Nrog Qhov kev pab rau: Ib leeg, Ib leeg kheej, and Tsev neeg Hom Kev Pab: PPO Qhov no tsuas yog qhov tseem ntsiab xwb: Yog hais tias koj xav tau qhov tseeb ntxiv txog ntawm koj qhov kev pab thiab cov nqi, koj tuaj yeem hu dawb tau rau Cov Lus Nug Tseem Ceeb Cov Lus Teb Vim Li Cas Qhov No Ho Muaj Teeb Meem: Hauv pab pawg Tawm ntawm pab koom ua ke* pawg koom ua ke** $1,500 Ib tug neeg $4,000 Ib Tug Neeg $3,000 ib leeg kheej $8,000 ib leeg kheej $3,000 Tsev neeg $8,000 Tsev neeg Kev lov nqi tag nrho yog dab tsi? Puas muaj cov kev pab cuam ua ntej yuav txiav nyiaj? Puas muaj lwm qhov kev txiav nyiaj rau tej yam kev pab cuam tshwj xeeb? Dab tsi yog qhov nyiaj them rau qhov kev pab no? Dab tsi uas tsis muaj rau hauv qhov nqi them rau kev kho mob? Koj puas yuav tau them tsawg yog koj siv xam nyas? Paub. Saib cov kev pab "Saib Xyuas Tiv Thaiv/Tshuaj Xyuas/Tshuaj txhaj". lwm cov kev txiav nyiaj rau cov kev pab cuam tshwj xeeb. Them rau cov kws kho mob sab hauv $6,600 ib tug neeg / $13,200 tsev neeg; them rau cov kws kho mob nyob sab nrauv tuaj $12,700 ib tug neeg / $25,400. paj ntsig them kev kho mob,kev them nqi sau se, thiab kev saib xyuas kam noj qab haus huv uas qhov kev pab cuam no tsis muaj. Paub. Hais txog cov npe xam nyas, saib hauv los sis hu dawb tau rau Koj yuav tsum them kom tag nrho cov nqi los ntawm cov muab kev pab cuam kom txog tus nqi txiav tawm ua ntej qhov kev pab cuam no pib them rau cov kev pab uas muaj. Tshuaj xyuas tsab cai los sis qhov ntaub ntawv kom pom lub sij hawm qhov nqi txiav tawm pib (muaj feem ntau, tiam sis yuav tsis muaj tas li, Lub 1 Hlis Hnub Tim 1). Saib cov ntawv qhia pib ntawm nplooj 2 seb koj them nyiaj rau cov kev pab uas tau them tom qab koj them tiav cov nqi txiav tawm. Qhov kev pab no muaj ib qho nqi tshaj nyob rau hauv. Qhov kev pab yuav pib them cov txiaj ntsig uas yuav tsum tau them tus nqi sib faib rau thawj tus neeg hauv tsev neeg uas ua tau raws li qhov kev txiav nyiaj tuaj rau - ib leeg. Tsev neeg them yus tus kheej yuav tsum tau ntsib kom tau tsev neeg ib leeg los yog coob dua no thiab tag ntawv qhov kev pab them yuav pab rau tag nrho cov neeg hauv tsev neeg. Qhov kev pab no duav qhee yam thiab qee qhov kev pab cuam txawm koj tsis tau txiav nqi them. Tiam sis yuav tau siv nyiaj los sis kev kho mob ua ke. Koj tsis tag yuav tau txiav nqi rau cov kev pab tshwj xeeb, tiam sis saib daim ntawv qhia pib ntawm nplooj 2 hais txog them nqi rau lwm yam yam kev pab uas muaj nyob hauv no. Qhov nqi rau kev kho mob yog tag nrho qhov koj tuaj yeem them nyob rau ib lub xyoo twg rau cov kev pab cuam. Yog tias koj muaj lwm tus neeg hauv tsev neeg nyob rau hauv qhov kev pab cuam no, lawv yuav tau them cov nyiaj rau kev kho mob ntawm lawv tus kheej kom txog thaum them tag qhov nyiaj rau kev kho mob ntawm tsev tsev neeg txhua tus. Txawm koj them cov nqi no tag, tsis tau suav nrog qhov nqi them rau kev kho mob. Yog tias koj siv ib tug kws kho mob neeg sab hauv los sis los sav nrauv los, qhov kev pab cuam no yuav pab them rau qee qhov los sis them tag nrho cov nqi pab cuam. Qhia paub tias, koj tus kws kho mob sab hauv los sis lub tsev kho mob yuav siv ib tug kws kho mob sab nrauv los pab qee qhov. Cov kev pab cuam yuav siv lub caij nyoog, qhov kev nyiam, los sis kev koom tes pab rau cov muab kev pab cuam 1 ntawm 5

2 Koj puas xav tau kev qhia mus cuag tus kws kho mob? Puas muaj cov kev pab uas tsis muaj nyob rau hauv no? Tsis paub. Paub. nyob rau ntawm lawv lub luag hauj lwm. Saib qhov lus qhia pib ntawm nplooj ntawv 2 hais txog qhov kev pab no them nqi rau cov neeg muab lwm yam kev pab cuam. Koj tuaj yeem ntsib tau tus kws kho mob uas koj xaiv yam tsis tag tso cai los ntawm lub koos haum no. Qee cov kev pab uas tsis muaj nyob rau hauv qhov kev pab no raug teev cia rau hauv nplooj 4. Saib koj qhov cai los sis cov ntaub ntawv kev pab kom paub ntxiv txog cov kev pab cuam uas tsis muaj. OMB Control Numbers , , and Released on April 6, ntawm 8

3 Cov nqi them yog them ua nyiaj ntsuab (piv txwv, $15) koj yuav tau them rau qhov kev saib xyuas kev noj qab haus huv, txhuas zaus uas koj tau txais txoj kev pab. Qhov nqi them rau kev kho mob yogkoj qhovkev faib peev ntawm ib qho kev pab, muab xam ua feem pua ntawm pob uas them rau txoj kev pab. Piv txwv, yog koom haum plan pob peev uas them rau nqi pw tsev kho mob yog $1,000, qhov nqi koj yuav them yog 20% raug li $200. Qhov no yuav muaj kev hloov yog tias koj tsis tau txiav koj li nqi dua. Qhov peev uas lub koos haum plan them rau cov kev pab cuam them raws li pob peev muab. Yog tias them nqi rau cov muab kev pab cuam tuaj sab nrauv tuaj ntau dua pob peev muab lawm, koj yuav tau them rau qhov tshaj ntawv. Piv txwv, yog tias lub tsev kho mob sab nrauv yuav nqi $1,500 rau kev pw ib hmos hos qhov nqi them yog $1,000 koj yuav tau them qhov tshaj $500 ntawv. (Qhov no hu ua kev sau nqi tshaj.) Lub koos haum no tuaj yeem txhawb koj los siv cov neeg muab kev pab cuam Sab Hauv kom koj tau them nqi tsawg, cov nqi them thiab cov peev them rau kev kho mob. Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj mus cuag ib tug kws kho mob qhov chaw hauj lwm saib xyuas kev noj qab haus huv los sis qhov chaw kho mob Yog koj txais kev tshuaj xyuas Cov Kev Pab Uas Tej Zaum Koj Xav Tau Kev mus cuag kev saib xyuas ua ntej los mus kho tus raug mob los sis mob mus cuagtus kws kho mob tshwj xeeb Kev saib xyuas Tiv thaiv/kev tshuaj xyuas/ Cov Tshuaj Txhaj Kev tshuaj xyuas kom tau tus mob (x-ray, kev ua hauj lwm ntawm cov ntshav) Yees duab ( Siv CT/PET tsom, MRIs) Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) $25 tus nqi them/ib zaug. Tsis siv kev txiav nyiaj. $35 tus nqi them/ib zaug. Tsis siv kev txiav nyiaj. Saib xyuas 100% rau Kev Saib Xyuas Tiv Thaiv uas tsim nyog uas cov kws kho mob teeb ua qhov kev tiv thaiv. Saib SPD cov ntsiab lus. 20% nqi koom them 20% nqi koom them Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb 3 ntawm 8

4 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj xav tau tshuaj los kho koj qhov mob los sis qhov ceev kav Kev paub ntxiv hais txog cov tshuaj uas muaj nyob hauv daim ntawv yuav mus saib tau ntawm Yog hais tias koj muaj tus neeg sab nrauv phais mob Yog koj xav tau kev pab tshuaj sai Cov Kev Pab Uas Tej Zaum Koj Xav Tau Txhua yam tshuaj (Qib 1) 90 hnub Rx: Txhua yam tshuaj (Qib 1) Hom tshuaj uas nyiam (Qib 2) 90 hnub Rx: Hom tshuaj uas nyiam (Qib 2) Hom tshuaj tsis nyiam (Qib 3) 90 hnub Rx: Hom tshuaj tsis nyiam (Qib 3) Cov tshuaj tshwj xeeb (Qib 4) Nqi chaw nyob (Piv txwv, qhov chaw phais mob rau cov sab nrauv) Cov nqi Kws Kho Mob/Kws Phais Chav saib xyuas thaum muaj kam ceev Kev xa tshuaj thaum muaj kam ceev Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) $10 nqi them/ntawv yuav tshuaj rau kev muag ntau yam tshuaj ua ke. Tsis siv kev txiav nyiaj. $25 Siab dua tus nqi them ntawm $40 los yog 20% txog rau qhov kawg nkaus ntawm $80. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $100 los yog 20% txog rau qhov kawg nkaus ntawm $200. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $60 los yog 50% txog rau qhov kawg nkaus ntawm $120. Tsis siv kev txiav nyiaj. Ntau dua $150 cov nqi koom them los sis 50% txog rau qhov siab kawg nkaus ntawm $300. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $75 los yog 20% txog rau qhov kawg nkaus ntawm $150. Tsis siv kev txiav nyiaj. 20% nqi koom them 20% nqi koom them 20% nqi koom them 20% nqi koom them Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. 4 ntawm 8

5 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog koj tau pw hauv tsev kho mob Yog tias koj xav tau kev pab cuam teeb meem kev xav, kev coj tus cwj pwm, los sis kev quav yeeb tshuaj Yog hais tias koj xeeb me nyuam Yog tias koj xav tau kev pab kom zoo tu qab los sis xav tau lwm yam kev noj qab haus huv Cov Kev Pab Uas Tej Zaum Koj Xav Tau Kev kho mob kom tau sai Tus nqi chaw nyob (piv txwv, chav pw tsev kho mob) Cov nqi Kws Kho Mob/Kws Phais Cov kev pab cuam tus neeg mob sab nrauv Cov kev pab rau tus neeg mob sab hauv Kev saib xyuas tom tsev thiab hnub yug tom qab Kev xa tawm thiab cov kev pab cuam rau tus neeg mob sab hauv kev pab tu hauv tsev Cov kev pab kev kho dua Cov kev pab cuam kev kho dua Kev pab muaj tus kws tu neeg mob Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) $25 tus nqi them/ib zaug. Tsis siv kev txiav nyiaj. 20% nqi koom them 20% nqi koom them 20% nqi koom them 20% nqi koom them 20% nqi koom them kev pov hwmrau cov kev pab cuam uas tsis tiv thaiv, 0% nqi koom them rau kev pov hwm uas muaj kev tiv thaiv 20% nqi koom them 20% nqi koom them Them nqi $25 / mus saib chaw hauj lwm ib zaug / kho ib zaug. Tsis siv kev txiav nyiaj. Them nqi $25 / mus saib chaw hauj lwm ib zaug / kho ib zaug. Tsis siv kev txiav nyiaj. 20% nqi koom them Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb * Cov kev pab cuam rau kev sib yuav/kev pab tswv yim ntawm khub niam txiv tsis muaj rau hauv no. Mus saib tau ntau kawg nkaus yog 100 zaus ntawm txua qhov chaw hauj lwm. siv tau siab kawg nkaus 90 hnub rau txhua qhov chaw ua hauj lwm. 5 ntawm 8

6 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj cov me nyuam xav tau kev saib xyuas hniav los sis qhov muag Cov Kev Pab Uas Tej Zaum Koj Xav Tau Cov Khoom Siv Tau Mus Ntev Rau Tus Mob Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) 20% nqi koom them Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Kev pab cuam kev nyab xeeb 20% nqi koom them Tshuaj xyuas kev pom kev cov Pab cuam 100% hnub noog nqis dua 6 xyoo Tsom iav Me Nyuam Yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. Thuaj xyuas hniav me nyuam yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. 6 ntawm 8

7 Cov kev pab cuam uas tshem tawm thiab Lwm Yam Kev Pab Cuam: Cov Kev Pab Cuam Koj Lub Koos Haum TSIS MUAJ Pab (Tshawb xyuas koj qhov cai los sis qhov ntaub ntawv koos haum txhawm rau kom paub meej thiab ib co npe ntawm lwm yam kev pab cuam uas tshem tawm.) Kev Phais Kho Kev Zoo Nkauj Kev Saib Xyuas Ncua Ntev Kev kho qhov muag (Neeg loj) Kev kho hniav Cov laj txheej pab kev yuag Kev Siab Xyuas Ko Taw Lwm Yam Kev Pab Cuam Uas Muaj (Qhov no tseem muaj cov npe tsis tau tag. Thov saib koj lub koos haum qhov ntaub ntawv rau lwm yam kev pab cuam uas muaj, cov kev txwv, thiab cov nqi rau cov kev pab cuam no.) Kev nruab koob ( qhov ntsiab lus rau cov kev Kev Zaws Lub Cev txwv ntawm kev saib xyuas Cov kev pab rau kev hnov lus (siv sab nrauv xwb Kev kho kev muaj me nyuam nyuaj Kev phais kom lub cev me thiab nyob rau cov kev txwv ntawm kev tuav tswj Koj Cov Cai txhawm rau kev tswj: Cov cai lij choj ntawm Tsoom Fwv thiab Lub Nroog yuav pab muab kev tiv thaiv ua kom koj khaws tau koj qhov kev siv kev pov hwm kev noj qab haus huv no kom ntev li ntev tau uas koj tseem them tau koj cov nyiaj paj ntsig pov hwm. Muaj cov kev tshwj tseg, txawm li cas los xij peem, yuav muaj xws li: Koj tsim kev dag ntxias Lub chaw nres kev muab cov kev pab cuam hauv Lub Xeev Koj tsiv tawm ntawm qhov chaw saib xyuas. Kev paub ntxiv, nyob rau hauv koj cov cai los siv qhov kev pab, hu rau lub chaw pov hwm tau Lwm cov kev pab them nqi kho mob kuj yuav muaj rau koj, xws li yuav ib qho ntawv kho mob ntawm tus kheej los ntawm Qhov Chaw Pov Hwm Kam Noj Qab Haus Huv Qhov Chaw Muag. Kev paub ntxiv hais txog Qhov Chaw Muag, mus saib tau hauv los sis hu rau Koj Cov Kev Tsis Txaus Siab thiab Kev Hais Kev Cai: Muaj cov chaw hauj lwm uas tuaj yeem pab tau yog koj muaj kev tsis txaus siab rau koj lub koos haum plan rau qhov kev tsis kam lees ntawm ib daim ntawv foob. Qhov tsis txaus siab no yog hu ua kev tsis txaus siab los sis rov hais dua. Cov lus nug hais txog ntawm koj cov cai, tsab ntawv qhia, los sis qhov kev pab no, koj tuaj yeem hu tau: Tus Thawj Coj Neeg Ua Hauj Lwm hu rau tus xov tooj hu dawb Qhov kev pab no puas yog muab kev pab cuam tau Tsawg Kawg Nkaus Ntawm Qhov Kev Pab Cuam Uas Tsim Nyog? Yog. Yog koj tsis muaj Qhov Kev Pab Uas Tsawg Kawg Nkaus Uas Tsim Nyog li ntawm ib lub hlis, koj yuav tsum tau them nyiaj thaum koj ua koj cov ntaub ntawv them se tshwj tsis yog tias koj tsim nyog tau txais kev zam los ntawm qhov yuav tsum tau muaj koj qhov kev pab them nqi kho mob rau lub hlis ntawd. Puas yog tias qhov kev pab no ua tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus? Yog. Yog koj lub koos haum pab ua tsis tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus, tej zaum koj yuav tsim nyog rau ib qho nqi se them rov qab pab koj them rau ib ua kev pab them rau ntawm Qhov Chaw Muag. Kev Pab Cuam Kev Txhais Lus: Lus Spanish (Español): Para obtener asistencia en Español, llame al Tagalog (Tagalog): Kung kailangan ninyo ang tulong sa Tagalog tumawag sa Lus suav ( 中文 ): 如果需要中文的帮助, 请拨打这个号码 Dinek ehgo shika at ohwol ninisingo, kwiijigo holne Saib cov piv txwv ntawm seb qhov kev pab no yuav them li cas rau qhov piv txwv ntawm kev kho mob, saib nqe lus tom ntej. 7 ntawm 8

8 Hais txog Cov Piv Txwv Kev Pab Cuam no: Qhov no tsis yog tus nqi khwv yees. Cov kev kho uas muab los no tsuas yog ua cov piv txwv ntawm qhov kev pab no qhov kev saib xyuas kev kho mob xwb. Koj cov tseem nqi yuav sib txawv nyob ntawm qhov kev saib xyuas koj tau txais, cov nqi uas koj cov kws kho mob rub, thiab muaj ntau yam. Tsom rau cov nqi sib koom nqi txiav, nqi koom them kev kho mob thiab nqi koom them rau kev pov hwm) thiab cov kev pab uas raug tshem tawm hauv qhov kev pab. Siv cov ntaub ntawv no los sib piv cov nqi ntawm cov nqi uas koj them tau raws li cov kev pab kho mob. Thov nco tias cov piv txwv kev pab cuam them nqi kho mob no yog ua raws li cov kev pab cuam nkaus xwb. Peg muaj me nyuam mos (9 lub hlis ntawm cov koom hauj lwm hauv tsev saib xyaus me nyuam ua ntej yuav yug thiab ib Cov nqi txiav tag nrho ntawm qhov kev pab $1,500 Tus kws kho mobthem ntxiv $35 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag Tus Kws Kho Mob qhov chaw hauj lwmkev saib xyuas kev xeeb tub hauv plab Kev Pab Cuam Uas Muaj Txeej Teg Siab Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev Pab Cuam Chaw Nyob Ntawm Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev tshuaj ntsuam xyuas tus mob (mloog suab thiab cov tshav khiav) Kev mus cuag Kws Kho Mob (tshuaj loog) Qhov Nqi Piv Txwv Tag Nrho $12,800 Nyob hauv qhov piv txwv no, Peg yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,500 Cov nyiaj koom them $700 Nqi koom them $2,000 Yam uas tsis muaj pab Kev txwv los sis kev cais $60 Tag nrho cov nqi uas Peg yuav tau them yog $4,260 Tswj Joe's hom Ntshav Qab Zib 2 (ib xyoos uas saib xyuas kev kho ntawm cov ua hauj lwm feem sab hauv ntawm qhov kev ua tib Cov nqi txiav tag nrho ntawm qhov kev pab $1,500 Tus kws kho mobthem ntxiv $35 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag tus kws kho mob lub chaw ua hauj lwm (nrog rau kev kawm kab mob) Kev tshuaj ntsuam xyuas tus kab mob (kev ntshav ua hauj lwm) Ntau ntawv yuav tshuaj Cov cuab yeej siv kho mob (tus ntsuas piam thaj) Qhov Nqi Piv Txwv Tag Nrho $7,400 Hauv qhov piv txwv no, Joe would tau them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,500 Cov nyiaj koom them $1,100 Nqi koom them $370 Yam uas tsis muaj pab Kev txwv los sis kev cais $55 Cov nqi tag nrho uas Joe yuav them yog $3,025 Mia qhov pob txha tawg (mus cuag cov neeg koom hauj lwm lub chav siv thaum muaj hauj lwm ceev and ua raws kev Cov nqi txiav tag nrho ntawm qhov kev pab $1,500 Tus kws kho mobthem ntxiv $35 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: lub chav siv saib xyuas thaum muaj mob nyhav (muaj tshuaj siv nrog tib si) Kev ntsuas tus kab mob (x-ray) Cov cuab yeej siv kho mob (pas nrig) Cov kev pab cuam kho dua tus mob (kho mob lub cev) Qhov Nqi Piv Txwv Tag Nrho $1,900 Hauv qhov piv txwv no, Mia yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,150 Cov nyiaj koom them $250 Nqi koom them $300 Yam uas tsis muaj pab Kev txwv los sis kev cais $0 Cov nqi tag nrho uas Mia yuav them yog $1,700 Ceeb toom: Cov zauv no xav tias tus neeg mob tsis koom nrog txoj hauj lwm pab kev noj haus. Yog koj koom tes hauv txoj kev pab hauv txoj kev pab cuam kev noj haus, koj tuaj yeem txo koj cov nqi. Kev paub ntxiv txog ntawm lub laj txheej pab kev noj haus, thov hu rau QHOV CHAW TXAIS NEEG hu tau tus xov tooj los sis HRConnect@taylorcorp.com. Qhov kev pab yuav saib xyuas lwm cov nqi them ntawm cov kev pab cuam PIV TXWV no. 8 ntawm 8

9 Ntsiab Lus tawm Cov Txiaj Ntsig thiab Kev Pab: Yam uas lub koos haum Plan no Pab & Yam uas yuav raug nyiaj Lub Sij Hawm Qhov Kev Pab: 01/01/ /31/2019 Secure Choice: PPO Kev Pab rau:ib leeg kheej, Ib leeg nkaus xwb, thiab Ib Tse Neeg Hom Kev Pab:PPO Qhov no tsuas yog qhov tseem ntsiab xwb: Yog hais tias koj xav tau qhov tseeb ntxiv txog ntawm koj qhov kev pab thiab cov nqi, koj tuaj yeem hu dawb tau rau Cov Lus Nug Tseem Ceeb Kev lov nqi tag nrho yog dab tsi? Puas muaj cov kev pab cuam ua ntej yuav txiav nyiaj? Puas muaj lwm qhov kev txiav nyiaj rau tej yam kev pab cuam tshwj xeeb? Dab tsi yog qhov nyiaj them rau qhov kev pab no? Dab tsi uas tsis muaj rau hauv Qhov nqi them rau kev kho mob? Koj puas yuav tau them tsawg yog koj siv xam nyas? Cov Lus Teb Hauv pab pawg koom ua ke* $2,500 Ib Tug Neeg $5,000 ib leeg kheej $5,000 Tsev Neeg Tawm ntawm pab pawg koom ua ke** $5,000 Ib Tug Neeg $10,000 ib leeg kheej $10,000 Tsev Neeg Paub. Saib cov kev pab "Saib Xyuas Tiv Thaiv/Tshuaj Xyuas/Tshuaj txhaj". lwm yam kev txiav nyiaj rau cov kev pab cuam. Them rau cov kws kho mob sab hauv $6,600 ib tug neeg / $13,200 tsev neeg; them rau cov kws kho mob nyob sab nrauv tuaj $12,700 ib tug neeg / $25,400. Paj ntsig them kev kho mob,kev them nqi sau se, thiab kev saib xyuas kam noj qab haus huv uas qhov kev pab cuam no tsis muaj. Paub. Hais txog cov npe xam nyas, saib hauv los sis hu dawb tau rau Vim Li Cas Qhov No Ho Muaj Teeb Meem: Koj yuav tsum them kom tag nrho cov nqi los ntawm cov muab kev pab cuam kom txog tus nqi txiav tawm ua ntej qhov kev pab cuam no pib them rau cov kev pab uas muaj. Tshuaj xyuas tsab cai los sis qhov ntaub ntawv kom pom lub sij hawm qhov nqi txiav tawm pib (muaj feem ntau, tiam sis yuav tsis muaj tas li, Lub 1 Hlis Hnub Tim 1 ). Saib cov ntawv qhia pib ntawm nplooj 2 seb koj them nyiaj rau cov kev pab uas tau them tom qab koj them tiav cov nqi txiav tawm. Qhov kev pab no muaj ib qho nqi tshaj nyob rau hauv. Qhov kev pab yuav pib them cov txiaj ntsig uas yuav tsum tau them tus nqi sib faib rau thawj tus neeg hauv tsev neeg uas ua tau raws li qhov kev txiav nyiaj tuaj rau - ib leeg. Tsev neeg them yus tus kheej yuav tsum tau ntsib kom tau tsev neeg ib leeg los yog coob dua no thiab tag ntawv qhov kev pab them yuav pab rau tag nrho cov neeg hauv tsev neeg. Qhov kev pab no duav qhee yam thiab qee qhov kev pab cuam txawm koj tsis tau txiav nqi them. Tiam sis yuav tau siv nyiaj los sis kev kho mob ua ke. Koj tsis tag yuav tau txiav nqi rau cov kev pab tshwj xeeb, tiam sis saib daim ntawv qhia pib ntawm nplooj 2 hais txog them nqi rau lwm yam yam kev pab uas muaj nyob hauv no. Qhov nqi rau kev kho mob yog tag nrho qhov koj tuaj yeem them nyob rau ib lub xyoo twg rau cov kev pab cuam. Yog tias koj muaj lwm tus neeg hauv tsev neeg nyob rau hauv qhov kev pab cuam no, lawv yuav tau them cov nyiaj rau kev kho mob ntawm lawv tus kheej kom txog thaum them tag qhov nyiaj rau kev kho mob ntawm tsev tsev neeg txhua tus. Txawm koj them cov nqi no tag, tsis tau suav nrog qhov nqi them rau kev kho mob. Yog tias koj siv ib tug kws kho mob neeg sab hauv los sis los sav nrauv los, qhov kev pab cuam no yuav pab them rau qee qhov los sis them tag nrho cov nqi pab cuam. Qhia paub tias, koj tus kws kho mob sab hauv los sis lub tsev kho mob yuav siv ib tug kws kho mob sab nrauv los pab qee qhov. Cov kev pab cuam yuav siv lub 1 ntawm 5

10 Koj puas xav tau kev qhia mus cuag tus kws kho mob? Puas muaj cov kev pab uas tsis muaj nyob rau hauv no? Tsis paub. Paub. caij nyoog, qhov kev nyiam, los sis kev koom tes pab rau cov muab kev pab cuam nyob rau ntawm lawv lub luag hauj lwm. Saib qhov lus qhia pib ntawm nplooj ntawv 2 hais txog qhov kev pab no them nqi rau cov neeg muab lwm yam kev pab cuam. Koj tuaj yeem ntsib tau tus kws kho mob uas koj xaiv yam tsis tag tso cai los ntawm lub koos haum no. Qee cov kev pab uas tsis muaj nyob rau hauv qhov kev pab no raug teev cia rau hauv nplooj 4. Saib koj qhov cai los sis cov ntaub ntawv kev pab kom paub ntxiv txog cov kev pab cuam uas tsis muaj. OMB Control Numbers , , and Released on April 6, ntawm 8

11 Cov nqi them yog them ua nyiaj ntsuab (piv txwv, $15) koj yuav tau them rau qhov kev saib xyuas kev noj qab haus huv, txhuas zaus uas koj tau txais txoj kev pab. Qhov nqi them rau kev kho mob yogkoj qhovkev faib peev ntawm ib qho kev pab, muab xam ua feem pua ntawm pob uas them rau txoj kev pab. Piv txwv, yog koom haum plan pob peev uas them rau nqi pw tsev kho mob yog $1,000, qhov nqi koj yuav them yog 20% raug li $200. Qhov no yuav muaj kev hloov yog tias koj tsis tau txiav koj li nqi dua. Qhov peev uas lub koos haum plan them rau cov kev pab cuam them raws li pob peev muab. Yog tias them nqi rau cov muab kev pab cuam tuaj sab nrauv tuaj ntau dua pob peev muab lawm, koj yuav tau them rau qhov tshaj ntawv. Piv txwv, yog tias lub tsev kho mob sab nrauv yuav nqi $1,500 rau kev pw ib hmos hos qhov nqi them yog $1,000 koj yuav tau them qhov tshaj $500 ntawv. (Qhov no hu ua kev sau nqi tshaj.) Lub koos haum no tuaj yeem txhawb koj los siv cov neeg muab kev pab cuam Sab Hauv kom koj tau them nqi tsawg, cov nqi them thiab cov peev them rau kev kho mob. Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj mus cuag ib tug kws kho mob qhov chaw hauj lwm saib xyuas kev noj qab haus huv los sis qhov chaw kho mob Yog koj txais kev tshuaj xyuas Cov Kev Pab Uas Tej Zaum Koj Xav Tau Kev mus cuag kev saib xyuas ua ntej los mus kho tus raug mob los sis mob mus cuagtus kws kho mob tshwj xeeb Kev saib xyuas Tiv thaiv/kev tshuaj xyuas/ Cov Tshuaj Txhaj Kev tshuaj xyuas kom tau tus mob (x-ray, kev ua hauj lwm ntawm cov ntshav) Yees duab (Siv CT/PET tsom, MRIs) Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Kev Saib Xyuas Ua Ntej: $40 nqi kho mob/ib zaug. Tsis siv kev txiav nyiaj. $60 tus nqi them/ib zaug. Tsis siv kev txiav nyiaj. Saib xyuas 100% rau Kev Saib Xyuas Tiv Thaiv uas tsim nyog uas cov kws kho mob teeb ua qhov kev tiv thaiv. Saib SPD cov ntsiab lus. 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them ntawv tuav pov hwm Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) ntawv ntawv ntawv ntawv ntawv Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb 3 ntawm 8

12 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj xav tau tshuaj los kho koj qhov mob los sis qhov ceev kav Kev paub ntxiv hais txog cov tshuaj uas muaj nyob hauv daim ntawv yuav mus saib tau ntawm Cov Kev Pab Uas Tej Zaum Koj Xav Tau Txhua yam tshuaj (Qib 1) 90 hnub Rx: Txhua yam tshuaj (Qib 1) Hom tshuaj uas nyiam (Qib 2) 90 hnub Rx: Hom tshuaj uas nyiam (Qib 2) Hom tshuaj tsis nyiam (Qib 3) 90 hnub Rx: Hom tshuaj tsis nyiam (Qib 3) Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) $10 nqi them/ntawv yuav tshuaj rau kev muag ntau yam tshuaj ua ke. Tsis siv kev txiav nyiaj. $25 Siab dua tus nqi them ntawm $40 los yog 20% txog rau qhov kawg nkaus ntawm $80. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $100 los yog 20% txog rau qhov kawg nkaus ntawm $200. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $60 los yog 50% txog rau qhov kawg nkaus ntawm $120. Tsis siv kev txiav nyiaj. Siab dua tus nqi them ntawm $150 los yog 50% txog rau qhov kawg nkaus ntawm $300. Tsis siv kev txiav nyiaj. Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. Yog hais tias koj muaj tus neeg sab nrauv phais mob Yog koj xav tau kev pab tshuaj sai Cov tshuaj tshwj xeeb (Qib 4) Nqi chaw nyob (Piv txwv, qhov chaw phais mob rau cov sab nrauv) Cov nqi Kws Kho Mob/Kws Phais Chav saib xyuas thaum muaj kam ceev Kev xa tshuaj thaum muaj kam ceev Kev kho mob kom tau sai Siab dua tus nqi them ntawm $75 los yog 20% txog rau qhov kawg nkaus ntawm $150. Tsis siv kev txiav nyiaj. 20% nqi koom them ntawv 20% nqi koom them ntawv tuav pov hwm ntawv ntawv 20% nqi koom them 20% nqi koom them $40 tus nqi them/ib zaug. Tsis siv kev txiav nyiaj. ntawv Siv xa tau txog 30-hnub (Tus nqi muag tuam); tsis muaj rau kev xa tshuaj los ntawm cov kws kho mob sab nrauv. 4 ntawm 8

13 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog koj tau pw hauv tsev kho mob Yog tias koj xav tau kev pab cuam teeb meem kev xav, kev coj tus cwj pwm, los sis kev quav yeeb tshuaj Yog hais tias koj xeeb me nyuam Yog tias koj xav tau kev pab kom zoo tu qab los sis xav tau lwm yam kev noj qab haus huv Cov Kev Pab Uas Tej Zaum Koj Xav Tau Tus nqi chaw nyob (piv txwv, chav pw tsev kho mob) Cov nqi Kws Kho Mob/Kws Phais Cov kev pab cuam tus neeg mob sab nrauv Cov kev pab rau tus neeg mob sab hauv Kev saib xyuas tom tsev thiab hnub yug tom qab Kev xa tawm thiab cov kev pab cuam rau tus neeg mob sab hauv kev pab tu hauv tsev Cov kev pab kev kho dua Cov kev pab cuam kev kho dua Kev pab muaj tus kws tu neeg mob Cov Khoom Siv Tau Mus Ntev Rau Tus Mob Kev pab cuam kev nyab xeeb Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them kev pov hwm rau cov kev pab cuam uas tsis tiv thaiv, 0% nqi koom them rau kev pov hwm uas muaj kev tiv thaiv 20% nqi koom them ntawv tuav pov hwm 20% nqi koom them ntawv tuav pov hwm Them nqi $40 / mus saib chaw hauj lwm ib zaug / kho ib zaug. Tsis siv kev txiav nyiaj. Them nqi $40 / mus saib chaw hauj lwm ib zaug / kho ib zaug. Tsis siv kev txiav nyiaj. 20% nqi koom them ntawv tuav pov hwm Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) ntawv ntawv ntawv ntawv ntawv ntawv ntawv ntawv ntawv ntawv Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb * Cov kev pab cuam rau kev sib yuav/kev pab tswv yim ntawm khub niam txiv tsis muaj rau hauv no. Mus saib tau ntau kawg nkaus yog 100 zaus ntawm txua qhov chaw hauj lwm. 20% nqi koom them 20% nqi koom them ntawv tuav pov hwm ntawv siv tau siab kawg nkaus 90 hnub rau txhua qhov chaw ua hauj lwm. 5 ntawm 8

14 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj cov me nyuam xav tau kev saib xyuas hniav los sis qhov muag Cov Kev Pab Uas Tej Zaum Koj Xav Tau Yam Uas Koj Yuav Tau Them Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Tshuaj xyuas kev pom kev cov hnub noog nqis dua 6 xyoo Pab cuam 100% Tsom iav Me Nyuam Yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. Thuaj xyuas hniav me nyuam yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. Cov kev pab cuam uas tshem tawm thiab Lwm Yam Kev Pab Cuam: Cov Kev Pab Cuam Koj Lub Koos Haum TSIS MUAJ Pab (Tshawb xyuas koj qhov cai los sis qhov ntaub ntawv koos haum txhawm rau kom paub meej thiab ib co npe ntawm lwm yam kev pab cuam uas tshem tawm.) Kev Phais Kho Kev Zoo Nkauj Kev Saib Xyuas Ncua Ntev Kev kho qhov muag (Neeg loj) Kev kho hniav Cov laj txheej pab kev yuag Kev Siab Xyuas Ko Taw Lwm Yam Kev Pab Cuam Uas Muaj (Qhov no tseem muaj cov npe tsis tau tag. Thov saib koj lub koos haum qhov ntaub ntawv rau lwm yam kev pab cuam uas muaj, cov kev txwv, thiab cov nqi rau cov kev pab cuam no.) Kev nruab koob ( qhov ntsiab lus rau cov kev Kev Zaws Lub Cev txwv ntawm kev saib xyuas Cov kev pab rau kev hnov lus (siv sab nrauv xwb Kev kho kev muaj me nyuam nyuaj Kev phais kom lub cev me thiab nyob rau cov kev txwv ntawm kev tuav tswj Koj Cov Cai txhawm rau kev tswj: Cov cai lij choj ntawm Tsoom Fwv thiab Lub Nroog yuav pab muab kev tiv thaiv ua kom koj khaws tau koj qhov kev siv kev pov hwm kev noj qab haus huv no kom ntev li ntev tau uas koj tseem them tau koj cov nyiaj paj ntsig pov hwm. Muaj cov kev tshwj tseg, txawm li cas los xij peem, yuav muaj xws li: Koj tsim kev dag ntxias Lub chaw nres kev muab cov kev pab cuam hauv Lub Xeev Koj tsiv tawm ntawm qhov chaw saib xyuas. Kev paub ntxiv, nyob rau hauv koj cov cai los siv qhov kev pab, hu rau lub chaw pov hwm tau Lwm cov kev pab them nqi kho mob kuj yuav muaj rau koj, xws li yuav ib qho ntawv kho mob ntawm tus kheej los ntawm Qhov Chaw Pov Hwm Kam Noj Qab Haus Huv Qhov Chaw Muag. Kev paub ntxiv hais txog Qhov Chaw Muag, mus saib tau hauv los sis hu rau Koj Cov Kev Tsis Txaus Siab thiab Kev Hais Kev Cai: Muaj cov chaw hauj lwm uas tuaj yeem pab tau yog koj muaj kev tsis txaus siab rau koj lub koos haum plan rau qhov kev tsis kam lees ntawm ib daim ntawv foob. Qhov tsis txaus siab no yog hu ua kev tsis txaus siab los sis rov hais dua. Cov lus nug hais txog ntawm koj cov cai, tsab ntawv qhia, los sis qhov kev pab no, koj tuaj yeem hu tau: Tus Thawj Coj Neeg Ua Hauj Lwm hu rau tus xov tooj hu dawb ntawm 8

15 Qhov kev pab no puas yog muab kev pab cuam tau Tsawg Kawg Nkaus Ntawm Qhov Kev Pab Cuam Uas Tsim Nyog? Yog. Yog koj tsis muaj Qhov Kev Pab Uas Tsawg Kawg Nkaus Uas Tsim Nyog li ntawm ib lub hlis, koj yuav tsum tau them nyiaj thaum koj ua koj cov ntaub ntawv them se tshwj tsis yog tias koj tsim nyog tau txais kev zam los ntawm qhov yuav tsum tau muaj koj qhov kev pab them nqi kho mob rau lub hlis ntawd. Puas yog tias qhov kev pab no ua tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus? Yog. Yog koj lub koos haum pab ua tsis tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus, tej zaum koj yuav tsim nyog rau ib qho nqi se them rov qab pab koj them rau ib ua kev pab them rau ntawm Qhov Chaw Muag. Kev Pab Cuam Kev Txhais Lus: Spanish (Español): Para obtener asistencia en Español, llame al Tagalog (Tagalog): Kung kailangan ninyo ang tulong sa Tagalog tumawag sa Chinese ( 中文 ): 如果需要中文的帮助, 请拨打这个号码 Navajo (Dine): Dinek'ehgo shika at'ohwol ninisingo, kwiijigo holne' Saib cov piv txwv ntawm seb qhov kev pab no yuav them li cas rau qhov piv txwv ntawm kev kho mob, saib nqe lus tom ntej. 7 ntawm 8

16 Hais txog Cov Piv Txwv Kev Pab Cuam no: Qhov no tsis yog tus nqi khwv yees. Cov kev kho uas muab los no tsuas yog ua cov piv txwv ntawm qhov kev pab no qhov kev saib xyuas kev kho mob xwb. Koj cov tseem nqi yuav sib txawv nyob ntawm qhov kev saib xyuas koj tau txais, cov nqi uas koj cov kws kho mob rub, thiab muaj ntau yam. Tsom rau cov nqi sib koom nqi txiav, nqi koom them kev kho mob thiab nqi koom them rau kev pov hwm) thiab cov kev pab uas raug tshem tawm hauv qhov kev pab. Siv cov ntaub ntawv no los sib piv cov nqi ntawm cov nqi uas koj them tau raws li cov kev pab kho mob. Thov nco tias cov piv txwv kev pab cuam them nqi kho mob no yog ua raws li cov kev pab cuam nkaus xwb. Peg muaj me nyuam mos (9 lub hlis ntawm cov koom hauj lwm hauv tsev saib xyaus me nyuam ua ntej yuav yug thiab ib Cov nqi txiav tag nrho ntawm qhov kev pab $2,500 Tus kws kho mobthem ntxiv $60 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag Tus Kws Kho Mob qhov chaw hauj lwmkev saib xyuas kev xeeb tub hauv plab Kev Pab Cuam Uas Muaj Txeej Teg Siab Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev Pab Cuam Chaw Nyob Ntawm Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev tshuaj ntsuam xyuas tus mob (mloog suab thiab cov tshav khiav) Kev mus cuag Kws Kho Mob (tshuaj loog) Qhov Nqi Piv Txwv Tag Nrho $12,840 Nyob hauv qhov piv txwv no, Peg yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $2,500 Cov nyiaj koom them $1,140 Nqi koom them $2,000 Yam uas tsis muaj pab Kev txwv los sis kev cais $60 Tag nrho cov nqi uas Peg yuav tau them yog $5,700 Tswj Joe's hom Ntshav Qab Zib 2 (ib xyoos uas saib xyuas kev kho ntawm cov ua hauj lwm feem sab hauv ntawm qhov kev ua tib Cov nqi txiav tag nrho ntawm qhov kev pab $2,500 Tus kws kho mobthem ntxiv $60 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag tus kws kho mob lub chaw ua hauj lwm (nrog rau kev kawm kab mob) Kev tshuaj ntsuam xyuas tus kab mob(kev ntshav ua hauj lwm) Ntau ntawv yuav tshuaj Cov cuab yeej siv kho mob (tus ntsuas piam thaj) Qhov Nqi Piv Txwv Tag Nrho $7,400 Hauv qhov piv txwv no, Joe would tau them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,500 Cov nyiaj koom them $1,300 Nqi koom them $400 Yam uas tsis muaj pab Kev txwv los sis kev cais $55 Cov nqi tag nrho uas Joe yuav them yog $3,255 Mia qhov pob txha tawg (mus cuag cov neeg koom hauj lwm lub chav siv thaum muaj hauj lwm ceev and ua raws kev Cov nqi txiav tag nrho ntawm qhov kev pab $2,500 Tus kws kho mobthem ntxiv $60 Tsev Kho Mob (qhov chaw) kev kho mob koom 20% Lwm yam kev kho mob koom 20% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: lub chav siv saib xyuas thaum muaj mob nyhav(muaj tshuaj siv nrog tib si) Kev ntsuas tus kab mob (x-ray) Cov cuab yeej siv kho mob (pas nrig) Cov kev pab cuam kho dua tus mob (kho mob lub cev) Qhov Nqi Piv Txwv Tag Nrho $1,900 Hauv qhov piv txwv no, Mia yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,150 Cov nyiaj koom them $420 Nqi koom them $300 Yam uas tsis muaj pab Kev txwv los sis kev cais $0 Cov nqi tag nrho uas Mia yuav them yog $1,870 Ceeb toom: Cov zauv no xav tias tus neeg mob tsis koom nrog txoj hauj lwm pab kev noj haus. Yog koj koom tes hauv txoj kev pab hauv txoj kev pab cuam kev noj haus, koj tuaj yeem txo koj cov nqi. Qhov tseeb ntxiv hais txog qhov laj txheej pab kev noj haus, thov hu rau feem txais hauj lwm hu tau los sis HRConnect@taylorcorp.com Qhovkev pabyuav saib xyuas lwm cov nqi them ntawm cov kev pab cuam PIV TXWV no. 8 ntawm 8

17 Ntsiab Lus tawm Cov Txiaj Ntsig thiab Kev Pab: Yam uas lub koos haum Plan no Pab & Yam uas yuav raug nyiaj Lub Sij Hawm Qhov Kev Pab: 01/01/ /31/2019 Secure Choice: HSA plan Qhov kev pab rau: Ib leeg, Ib leeg nkaus xwb, thiab Tsev neeg Hom Kev Pab: PPO Qhov no tsuas yog qhov tseem ntsiab xwb: Yog hais tias koj xav tau qhov tseeb ntxiv txog ntawm koj qhov kev pab thiab cov nqi, koj tuaj yeem hu dawb tau rau Cov Lus Nug Tseem Ceeb Kev lov nqi tag nrho yog dab tsi? Puas muaj cov kev pab cuam ua ntej yuav txiav nyiaj? Puas muaj lwm qhov kev txiav nyiaj rau tej yam kev pab cuam tshwj xeeb? Dab tsi yog qhov nyiaj them rau qhov kev pab no? Dab tsi uas tsis muaj rau hauv Qhov nqi them rau kev kho mob? Koj puas yuav tau them tsawg yog koj siv xam nyas? Cov Lus Teb Hauv pab pawg koom ua ke* $6,600 Ib Tug Neeg $13,200 Ib leeg kheej $13,200 Tsev neeg Tawm ntawm pab pawg koom ua ke** $12,700 Ib Tug Neeg $25,400 Ib leeg kheej $25,400 Tsev neeg Paub. Saib cov kev pab "Saib Xyuas Tiv Thaiv/Tshuaj Xyuas/Tshuaj txhaj". lwm cov kev txiav nyiaj rau cov kev pab cuam tshwj xeeb. Them rau cov kws kho mob sab hauv $6,600 ib tug neeg / $13,200 tsev neeg; them rau cov kws kho mob nyob sab nrauv tuaj $12,700 ib tug neeg / $25,400. Paj ntsig them kev kho mob,kev them nqi sau se, thiab kev saib xyuas kam noj qab haus huv uas qhov kev pab cuam no tsis muaj. Paub. Hais txog cov npe xam nyas, saib hauv los sis hu dawb tau rau Vim Li Cas Qhov No Ho Muaj Teeb Meem: Koj yuav tsum them kom tag nrho cov nqi los ntawm cov muab kev pab cuam kom txog tus nqi txiav tawm ua ntej qhov kev pab cuam no pib them rau cov kev pab uas muaj. Tshuaj xyuas tsab cai los sis qhov ntaub ntawv kom pom lub sij hawm qhov nqi txiav tawm pib (muaj feem ntau, tiam sis yuav tsis muaj tas li, Lub 1 Hlis Hnub Tim 1). Saib cov ntawv qhia pib ntawm nplooj 2 seb koj them nyiaj rau cov kev pab uas tau them tom qab koj them tiav cov nqi txiav tawm. Qhov kev pab no muaj ib qho nqi tshaj nyob rau hauv. Qhov kev pab yuav pib them cov txiaj ntsig uas yuav tsum tau them tus nqi sib faib rau thawj tus neeg hauv tsev neeg uas ua tau raws li qhov kev txiav nyiaj tuaj rau - ib leeg. Tsev neeg them yus tus kheej yuav tsum tau ntsib kom tau tsev neeg ib leeg los yog coob dua no thiab tag ntawv qhov kev pab them yuav pab rau tag nrho cov neeg hauv tsev neeg. Qhov kev pab no duav qhee yam thiab qee qhov kev pab cuam txawm koj tsis tau txiav nqi them. Tiam sis yuav tau siv nyiaj los sis kev kho mob ua ke. Koj tsis tag yuav tau txiav nqi rau cov kev pab tshwj xeeb, tiam sis saib daim ntawv qhia pib ntawm nplooj 2 hais txog them nqi rau lwm yam yam kev pab uas muaj nyob hauv no. Qhov nqi rau kev kho mob yog tag nrho qhov koj tuaj yeem them nyob rau ib lub xyoo twg rau cov kev pab cuam. Yog tias koj muaj lwm tus neeg hauv tsev neeg nyob rau hauv qhov kev pab cuam no, lawv yuav tau them cov nyiaj rau kev kho mob ntawm lawv tus kheej kom txog thaum them tag qhov nyiaj rau kev kho mob ntawm tsev tsev neeg txhua tus. Txawm koj them cov nqi no tag, tsis tau suav nrog qhov nqi them rau kev kho mob. Yog tias koj siv ib tug kws kho mob neeg sab hauv los sis los sav nrauv los, qhov kev pab cuam no yuav pab them rau qee qhov los sis them tag nrho cov nqi pab cuam. Qhia paub tias, koj tus kws kho mob sab hauv los sis lub tsev kho mob yuav 1 ntawm 5

18 2 ntawm 8 Koj puas xav tau kev qhia mus cuag tus kws kho mob? Puas muaj cov kev pab uas tsis muaj nyob rau hauv no? Tsis paub. Paub. siv ib tug kws kho mob sab nrauv los pab qee qhov. Cov kev pab cuam yuav siv lub caij nyoog, qhov kev nyiam, los sis kev koom tes pab rau cov muab kev pab cuam nyob rau ntawm lawv lub luag hauj lwm. Saib qhov lus qhia pib ntawm nplooj ntawv 2 hais txog qhov kev pab no them nqi rau cov neeg muab lwm yam kev pab cuam. Koj tuaj yeem ntsib tau tus kws kho mob uas koj xaiv yam tsis tag tso cai los ntawm lub koos haum no. Qee cov kev pab uas tsis muaj nyob rau hauv qhov kev pab no raug teev cia rau hauv nplooj 4. Saib koj qhov cai los sis cov ntaub ntawv kev pab kom paub ntxiv txog cov kev pab cuam uas tsis muaj. OMB Control Numbers , , and Released on April 6, 2016

19 3 ntawm 8 Cov nqi them yog them ua nyiaj ntsuab (piv txwv, $15) koj yuav tau them rau qhov kev saib xyuas kev noj qab haus huv, txhuas zaus uas koj tau txais txoj kev pab. Qhov nqi them rau kev kho mob yogkoj qhovkev faib peev ntawm ib qho kev pab, muab xam ua feem pua ntawm pob uas them rau txoj kev pab. Piv txwv, yog koom haum plan pob peev uas them rau nqi pw tsev kho mob yog $1,000, qhov nqi koj yuav them yog 20% raug li $200. Qhov no yuav muaj kev hloov yog tias koj tsis tau txiav koj li nqi dua. Qhov peev uas lub koos haum plan them rau cov kev pab cuam them raws li pob peev muab. Yog tias them nqi rau cov muab kev pab cuam tuaj sab nrauv tuaj ntau dua pob peev muab lawm, koj yuav tau them rau qhov tshaj ntawv. Piv txwv, yog tias lub tsev kho mob sab nrauv yuav nqi $1,500 rau kev pw ib hmos hos qhov nqi them yog $1,000 koj yuav tau them qhov tshaj $500 ntawv. (Qhov no hu ua kev sau nqi tshaj.) Lub koos haum no tuaj yeem txhawb koj los siv cov neeg muab kev pab cuam Sab Hauv kom koj tau them nqi tsawg, cov nqi them thiab cov peev them rau kev kho mob. Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj mus cuag ib tug kws kho mob qhov chaw hauj lwm saib xyuas kev noj qab haus huv los sis qhov chaw kho mob Cov Kev Pab Uas Tej Zaum Koj Xav Tau Kev mus cuag kev saib xyuas ua ntej los mus kho tus raug mob los sis mob mus cuagtus kws kho mob tshwj xeeb Kev saib xyuas Tiv thaiv/kev tshuaj xyuas/ Cov Tshuaj Txhaj Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Yam Uas Koj Yuav Tau Them Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Saib xyuas 100% rau Kev Saib Xyuas Tiv Thaiv uas tsim nyog uas cov kws kho mob teeb ua qhov kev tiv thaiv. Saib SPD cov ntsiab lus. Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Yog koj txais kev tshuaj xyuas Kev tshuaj xyuas kom tau tus mob (x-ray, kev ua hauj lwm ntawm cov ntshav) Yees duab ( Siv CT/PET tsom, MRIs)

20 4 ntawm 8 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Cov Kev Pab Uas Tej Zaum Koj Xav Tau Muag Tuam: Txhua yam tshuaj (Qib 1) Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Yam Uas Koj Yuav Tau Them Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb Yog tias koj xav tau tshuaj los kho koj qhov mob los sis qhov ceev kav Kev paub ntxiv hais txog cov tshuaj uas muaj nyob hauv daim ntawv yuav mus saib tau ntawm Yog hais tias koj muaj tus neeg sab nrauv phais mob Yog koj xav tau kev pab tshuaj sai Yog koj tau pw hauv tsev kho mob 90 hnub Rx: Txhua yam tshuaj (Qib 1) Kev muag tuam: Hom tshuaj uas nyiam (Qib 2) 90 hnub Rx: Hom tshuaj uas nyiam (Qib 2) Kev muag tuam: Hom tshuaj uas tsis nyiam (Qib 3) 90 hnub Rx: Hom tshuaj tsis nyiam (Qib 3) Cov tshuaj tshwj xeeb (Qib 4) Nqi chaw nyob (Piv txwv, qhov chaw phais mob rau cov sab nrauv) Cov nqi Kws Kho Mob/Kws Phais Chav saib xyuas thaum muaj kam ceev Kev xa tshuaj thaum muaj kam ceev Kev kho mob kom tau sai Tus nqi chaw nyob (piv txwv, chav pw tsev kho mob) Cov nqi Kws Kho Mob/Kws Phais Cov neeg koom nrog them nqi them tag nrho cov nqi muag tshuaj rau cov ntawv sau txog kev txiav tawm Cov neeg koom nrog them nqi them tag nrho cov nqi muag tshuaj rau cov ntawv sau txog kev txiav tawm Cov neeg koom nrog them nqi them tag nrho cov nqi muag tshuaj rau cov ntawv sau txog kev txiav tawm Pab cuam 100% tom qab txiav nqi Tsis tau txais kev pab kev faj seeb kho mob rau kev xa tshuaj tuaj ntawm cov kws kho mob sab nrauv.

21 5 ntawm 8 Yam ib txwm tshwm sim Hais Txog Kev Kho Mob Yog tias koj xav tau kev pab cuam teeb meem kev xav, kev coj tus cwj pwm, los sis kev quav yeeb tshuaj Yog hais tias koj xeeb me nyuam Yog tias koj xav tau kev pab kom zoo tu qab los sis xav tau lwm yam kev noj qab haus huv Yog tias koj cov me nyuam xav tau kev saib xyuas hniav los sis qhov muag Cov Kev Pab Uas Tej Zaum Koj Xav Tau Cov kev pab cuam tus neeg mob sab nrauv Cov kev pab rau tus neeg mob sab hauv Kev saib xyuas tom tsev thiab hnub yug tom qab Kev xa tawm thiab cov kev pab cuam rau tus neeg mob sab hauv kev pab tu hauv tsev Tus Neeg Muab Kev Pab Cuam (Koj yuav tau them tsawg tshaj plaws) Yam Uas Koj Yuav Tau Them Tus kws kho mob nyob tawm sab nraud ntawm pab pawg koom hauj lwm ua ke (Koj yuav tau them tag nrho) Cov kev txwv, Kev lees tau, & Lwm Yam Kev Paub Uas Tseem Ceeb * Cov kev pab cuam rau kev sib yuav/kev pab tswv yim ntawm khub niam txiv tsis muaj rau hauv no. Mus saib tau ntau kawg nkaus yog 100 zaus ntawm txua qhov chaw hauj lwm. Cov kev pab kev kho dua Cov kev pab cuam kev kho dua Kev pab muaj tus kws tu neeg mob Cov Khoom Siv Tau Mus Ntev Rau Tus Mob Kev pab cuam kev nyab xeeb Tshuaj xyuas kev pom kev cov hnub noog nqis dua 6 xyoo Tsom iav Me Nyuam Yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. Thuaj xyuas hniav me nyuam yaus Tsis tau txais kev pab Tsis tau txais kev pab kev pab cuam. siv tau siab kawg nkaus 90 hnub rau txhua qhov chaw ua hauj lwm.

22 6 ntawm 8 Cov kev pab cuam uas tshem tawm thiab Lwm Yam Kev Pab Cuam: Cov Kev Pab Cuam Koj Lub Koos Haum TSIS MUAJ Pab (Tshawb xyuas koj qhov cai los sis qhov ntaub ntawv koos haum txhawm rau kom paub meej thiab ib co npe ntawm lwm yam kev pab cuam uas tshem tawm.) Kev Phais Kho Kev Zoo Nkauj Kev Saib Xyuas Ncua Ntev Kev kho qhov muag (Neeg loj) Kev kho hniav Cov laj txheej pab kev yuag Kev Siab Xyuas Ko Taw Lwm Yam Kev Pab Cuam Uas Muaj (Qhov no tseem muaj cov npe tsis tau tag. Thov saib koj lub koos haum qhov ntaub ntawv rau lwm yam kev pab cuam uas muaj, cov kev txwv, thiab cov nqi rau cov kev pab cuam no.) Kev nruab koob ( qhov ntsiab lus rau cov kev Kev Zaws Lub Cev txwv ntawm kev saib xyuas Cov kev pab rau kev hnov lus (siv sab nrauv xwb Kev kho kev muaj me nyuam nyuaj Kev phais kom lub cev me thiab nyob rau cov kev txwv ntawm kev tuav tswj Koj Cov Cai txhawm rau kev tswj: Cov cai lij choj ntawm Tsoom Fwv thiab Lub Nroog yuav pab muab kev tiv thaiv ua kom koj khaws tau koj qhov kev siv kev pov hwm kev noj qab haus huv no kom ntev li ntev tau uas koj tseem them tau koj cov nyiaj paj ntsig pov hwm. Muaj cov kev tshwj tseg, txawm li cas los xij peem, yuav muaj xws li: Koj tsim kev dag ntxias Lub chaw nres kev muab cov kev pab cuam hauv Lub Xeev Koj tsiv tawm ntawm qhov chaw saib xyuas. Kev paub ntxiv, nyob rau hauv koj cov cai los siv qhov kev pab, hu rau lub chaw pov hwm tau Lwm cov kev pab them nqi kho mob kuj yuav muaj rau koj, xws li yuav ib qho ntawv kho mob ntawm tus kheej los ntawm Qhov Chaw Pov Hwm Kam Noj Qab Haus Huv Qhov Chaw Muag. Kev paub ntxiv hais txog Qhov Chaw Muag,mus saib tau hauv los sis hu rau Koj Cov Kev Tsis Txaus Siab thiab Kev Hais Kev Cai: Muaj cov chaw hauj lwm uas tuaj yeem pab tau yog koj muaj kev tsis txaus siab rau koj lub koos haum plan rau qhov kev tsis kam lees ntawm ib daim ntawv foob. Qhov tsis txaus siab no yog hu ua kev tsis txaus siab los sis rov hais dua. Cov lus nug hais txog ntawm koj cov cai, tsab ntawv qhia, los sis qhov kev pab no, koj tuaj yeem hu tau: Tus Thawj Coj Neeg Ua Hauj Lwm hu rau tus xov tooj hu dawb Qhov kev pab no puas yog muab kev pab cuam tau Tsawg Kawg Nkaus Ntawm Qhov Kev Pab Cuam Uas Tsim Nyog? Yog. Yog koj tsis muaj Qhov Kev Pab Uas Tsawg Kawg Nkaus Uas Tsim Nyog li ntawm ib lub hlis, koj yuav tsum tau them nyiaj thaum koj ua koj cov ntaub ntawv them se tshwj tsis yog tias koj tsim nyog tau txais kev zam los ntawm qhov yuav tsum tau muaj koj qhov kev pab them nqi kho mob rau lub hlis ntawd. Puas yog tias qhov kev pab no ua tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus? Yog. Yog koj lub koos haum pab ua tsis tau raws li Cov Cai Teev Yam Tsawg Kawg Nkaus, tej zaum koj yuav tsim nyog rau ib qho nqi se them rov qab pab koj them rau ib ua kev pab them rau ntawm Qhov Chaw Muag. Kev Pab Cuam Kev Txhais Lus: Spanish (Español): Para obtener asistencia en Español, llame al Tagalog (Tagalog): Kung kailangan ninyo ang tulong sa Tagalog tumawag sa Chinese ( 中文 ): 如果需要中文的帮助, 请拨打这个号码 Navajo (Dine): Dinek'ehgo shika at'ohwol ninisingo, kwiijigo holne'

23 Saib cov piv txwv ntawm seb qhov kev pab no yuav them li cas rau qhov piv txwv ntawm kev kho mob, saib nqe lus tom ntej. 7 ntawm 8

24 Hais txog Cov Piv Txwv Kev Pab Cuam no: Qhov no tsis yog tus nqi khwv yees. Cov kev kho uas muab los no tsuas yog ua cov piv txwv ntawm qhov kev pab no qhov kev saib xyuas kev kho mob xwb. Koj cov tseem nqi yuav sib txawv nyob ntawm qhov kev saib xyuas koj tau txais, cov nqi uas koj cov kws kho mob rub, thiab muaj ntau yam. Tsom rau cov nqi sib koom nqi txiav, nqi koom them kev kho mob thiab nqi koom them rau kev pov hwm) thiab cov kev pab uas raug tshem tawm hauv qhov kev pab. Siv cov ntaub ntawv no los sib piv cov nqi ntawm cov nqi uas koj them tau raws li cov kev pab kho mob. Thov nco tias cov piv txwv kev pab cuam them nqi kho mob no yog ua raws li cov kev pab cuam nkaus xwb. Peg muaj me nyuam mos (9 lub hlis ntawm cov koom hauj lwm hauv tsev saib xyaus me nyuam ua ntej yuav yug thiab ib lub tsev kho mob yug me nyuam) Cov nqi txiav tag nrho ntawm qhov kev pab $6,600 Tus kws kho mobthem ntxiv $0 Tsev Kho Mob (qhov chaw) kev kho mob koom 0% Lwm yam kev kho mob koom 0% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag Tus Kws Kho Mob qhov chaw hauj lwmkev saib xyuas kev xeeb tub hauv plab Kev Pab Cuam Uas Muaj Txeej Teg Siab Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev Pab Cuam Chaw Nyob Ntawm Kev Yug Me Nyuam/Pab Kev Yug Me Nyuam Kev tshuaj ntsuam xyuas tus mob (mloog suab thiab cov tshav khiav) Kev mus cuag Kws Kho Mob (tshuaj loog) Qhov Nqi Piv Txwv Tag Nrho $12,800 Nyob hauv qhov piv txwv no, Peg yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $6,600 Cov nyiaj koom them $0 Nqi koom them $0 Yam uas tsis muaj pab Kev txwv los sis kev cais $60 Tag nrho cov nqi uas Peg yuav tau them yog $6,660 Tswj Joe's hom Ntshav Qab Zib 2 (ib xyoos uas saib xyuas kev kho ntawm cov ua hauj lwm feem sab hauv ntawm qhov kev ua tib t j) Cov nqi txiav tag nrho ntawm qhov kev pab $6,600 Tus kws kho mobthem ntxiv $0 Tsev Kho Mob (qhov chaw) kev kho mob koom 0% Lwm yam kev kho mob koom 0% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: Kev mus cuag tus kws kho mob lub chaw ua hauj lwm (nrog rau kev kawm kab mob) Kev tshuaj ntsuam xyuas tus kab mob (kev ntshav ua hauj lwm) Ntau ntawv yuav tshuaj Cov cuab yeej siv kho mob (tus ntsuas piam thaj) Qhov Nqi Piv Txwv Tag Nrho $7,400 Hauv qhov piv txwv no, Joe would tau them: Qhov nyiaj sib pab them Cov nyiaj txiav $6,600 Cov nyiaj koom them $0 Nqi koom them $0 Yam uas tsis muaj pab Kev txwv los sis kev cais $55 Cov nqi tag nrho uas Joe yuav them yog $6,655 Mia qhov pob txha tawg (mus cuag cov neeg koom hauj lwm lub chav siv thaum muaj hauj lwm ceev and ua raws kev ib Cov nqi txiav tag nrho ntawm qhov kev pab$6,600 Tus kws kho mobthem ntxiv $0 Tsev Kho Mob (qhov chaw) kev kho mob koom 0% Lwm yam kev kho mob koom 0% Qhov kev tshwm sim UA PIV TXWV no yuav muaj kev pab cuam xws li: lub chav siv saib xyuas thaum muaj mob nyhav (muaj tshuaj siv nrog tib si) Kev ntsuas tus kab mob (x-ray) Cov cuab yeej siv kho mob (pas nrig) Cov kev pab cuam kho dua tus mob (kho mob lub cev) Qhov Nqi Piv Txwv Tag Nrho $1,900 Hauv qhov piv txwv no, Mia yuav them: Qhov nyiaj sib pab them Cov nyiaj txiav $1,900 Cov nyiaj koom them $0 Nqi koom them $0 Yam uas tsis muaj pab Kev txwv los sis kev cais $0 Cov nqi tag nrho uas Mia yuav them yog $1,900 Ceeb toom: Cov zauv no xav tias tus neeg mob tsis koom nrog txoj hauj lwm pab kev noj haus. Yog koj koom tes hauv txoj kev pab hauv txoj kev pab cuam kev noj haus, koj tuaj yeem txo koj cov nqi. Kev paub ntxiv txog ntawm lub laj txheej pab kev noj haus, thov hu rau QHOV CHAW TXAIS NEEG hu tau tus xov tooj los sis HRConnect@taylorcorp.com. Qhovkev pabyuav saib xyuas lwm cov nqi them ntawm cov kev pab cuam PIV TXWV no. 8 ntawm 8