UpDate - Vol. 12, No. 2, Page 8                                
September 10, 1992                                             
Health Care Benefits                                           
Lab and imaging provider network established                   
                                                               
     Effective July 1, the state of Delaware initiated significant   
cost containment measures for employees, dependents and  retirees in 
the state health care group. A network of lab and imaging providers  
for those enrolled in traditional coverage programs was established  
throughout the state. In addition, a new diabetes education benefit  
was offered to those enrolled in the state health care group.        
                                                               
Preferred providers for outpatient lab and imaging services, effective        
July 1                                                               
     When your doctor directs you to get outpatient imaging or       
laboratory services, remind your doctor that you will receive higher 
coverage if you go to a network provider. See the complete list of   
preferred provider networks for lab and imaging services below.      
     Although you are not required to use the Network, doing so can  
save you money by lowering the amount of medical costs you'll have to
pay. Using the network provider means you'll receive higher benefit  
levels.                                                              
                                                               
How are outpatient lab and imaging services paid?                    
     If your plan covers these services, benefits are paid as follows:        
       * Imaging Services, such as x-ray, mammography, CAT scan, or MRI,      
         will be covered 100 percent from a network provider and 65  
         percent by an out of network provider.                      
       * Lab services, such as blood tests, throat cultures and      
         urinalysis, will be covered 100 percent by a network provider        
         and 50 percent by an out of network provider.               
                                                               
Exceptions for outpatient lab and imaging benefits                   
     The following outpatient diagnostic lab and imaging services when        
rendered and billed by an out-of-network provider are paid according 
to the benefit level described in your benefit booklet. Out-of-network        
hospitals noted in the last two bullets of this section refer to     
hospitals whose outpatient imaging and/or laboratory departments are 
not network providers. You will be receiving updated benefit booklets
which describe more fully how these benefits work.                   
        * Machine Testing such as electrocardiogram,                 
          electroencephalogram, electromyogram (EMG) (Please note,   
          Machine Testing is not a covered benefit under the Basic Plan.)     
        * Services rendered and billed by out-of-state providers.    
        * Services directly related to outpatient emergency care.    
          Emergency care is treatment required as a result of a sudden,       
          serious and unexpected condition or illness.               
        * Services for taking and reading diagnostic x-rays for oral 
          surgery for bony impacted wisdom teeth.                    
        * Services rendered and billed as part of the hospice program
          and home health care benefits.                             
        * Services rendered and billed for in vitro fertilization.   
        * Diagnostic laboratory and imaging preadmission tests that  
          are required by an out-of-network hospital to be performed by       
          them before admitting you. However, services performed by a
          provider other than the admitting hospital or the network  
          provider will be paid at the applicable out-of-network payment      
          level.                                                     
        * Diagnostic laboratory and imaging services performed in the
          course of a surgical procedure in the outpatient department of      
          an out-of-network hospital. However, preoperative diagnostic        
          laboratory and imaging services for surgery performed in the        
          doctor's office or an ambulatory surgical center must be done       
          at the network provider or benefits will be paid at the    
          applicable out-of-network payment level.                   
                                                               
Diabetes education                                                   
     This benefit is covered at 100 percent of the allowable charge  
for one course per calendar year if you complete the course. For now,
you can obtain the names and locations of approved providers by      
calling Blue Cross Blue Shield of Delaware Customer Service or       
Principal Health Care of Delaware at the numbers below.              
     Blue Cross Blue Shield of Delaware Customer Service Dedicated   
Unit: In New Castle County: (302) 428-6080 In Kent and Sussex        
Counties: (800) 242-3861                                             
     Principal Health Care of Delaware Member Service Dedicated Unit:
In New Castle County: (302) 322-4700 In Kent and Sussex Counties:    
(800) 833-7423                                                       
     After Sept. 1, a list of approved providers will be published.  
Starting Oct. 1, you must use only those approved providers.         
                                                               
How can I qualify for the program?                                   
     You qualify for diabetes education if:                          
        * You are a newly diagnosed diabetes patient, or are a       
          previously diagnosed patient with changing needs, and      
        * You have been referred by your attending physician for     
          assessment and education.                                  
                                                               
What is an "approved" program?                                       
     The diabetes program must be:                                   
        * An approved course. This means it must be conducted by a   
          diabetic educator certified by the National Board of Testing.       
        * 8-12 hours in length and held over a period of up to 8     
          weeks. You are limited to one course per calendar year. You
          must complete the course for it to be covered. Courses must
          focus on diet, meal planning, blood glucose monitoring, insulin     
          usage and/or oral medications for diabetes, and foot care. After    
          completion of the course, you are entitled to two additional        
          visits per calendar year to clarify methods necessary for you to    
          manage the disease or to focus on skills required by your  
          changing needs.                                            
     For diabetics diagnosed with gestational diabetes:        
        * Under traditional plans, the course is covered by the High 
          Risk Maternity program, which helps to ensure that you will
          have a healthy baby.                                       
        * In the course of the program your educator may recommend   
          that you purchase specialized equipment, such as a home glucose     
          monitoring system. Before you make any purchases of this kind,      
          you should keep in mind that devices are categorized as durable     
          medical equipment. As such, they are subject to the durable
          medical equipment provisions, outlined in your benefit booklet.     
          Please review these durable medical equipment coverage     
          limitations.                                               
        * In addition, before purchasing such equipment, you must    
          obtain proper approval. This means that if you are a member of      
          The HMO of Delaware, Total Health Plus, or Principal Health
          Care of Delaware, you need to receive approval from your   
          primary care physician. If you have traditional coverage, you       
          must receive approval through Intracorp.                   
                                                               
How is the diabetes education benefit paid?                          
        * You must complete the course first. Then, upon receiving a 
          bill, you submit it on a customer claim form to your insurance      
          carrier, either Blue Cross Blue Shield of Delaware or Principal     
          Health Care of Delaware.