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GENERAL QUESTIONS B. If a me.ber is out of the service area and is hospitalized the hospital may take assignment from TBP and if the hospital takes assignment from THP then the me.ber is only responsible for appropriate copayments. If the hospital does not accept assignment from THP then the me.ber may be responsible for a nominal downpayment which may later be submitted to TBP for reimbursement. C. The first step in the enrollment process is to distribute benefit information to each employee. The marketing brochures are available in both English and Spanish. Next, TBP will hold work site meetings for the employees briefly explaining the benefits followed by a questions and answer session. Teri Craig, Carolyn French and eight other Marketing Service Representatives are available to conduct the meetings. Each employee will be required to complete an enrollment form listing a Primary Care Physician for each member of his/her family. These forms may be submitted to the City of San Marcos Personnel Department and TBP will process within the necessary time limit. TBP then will issue a member card for each member. The member may use the inside copy (pink) of the enrollment form for proof of insurance until the member card is received. F. As requested, the enclosed rates are guaranteed for a twelve month period. G. The primary reason for offering Texas Health Plans is to give employees a choice in their health plan. The enclosed benefit package follows the requested level of benefits as closely as possible. However, THP will differ from an indemnity program such as Benefit Trust in several ways. TBP does not have deductibles or routine 80/20 co-insurance. Instead, the member receives his/her health care at. 100X coverage or in some instances a minimal copayment will be charge (i.e., $5.00 per office visit). Also, Texas Health Plan will pay for preventive health care such as well baby care, eye exams. gyneco~ogical exaas and periodic health assessments. All of these services are provided with no routine claim forms. The member is assured an unlimited lifetime maximum benefit for each family member. The predictability of cost and the lesser member out-of-pocket expenses are desirable benefits to most employees. Each member who joins THP will be required to pick a Primary Care Physican(PCP) from the enclosed list of physicans. This physican will be responsible for providing or coordinating all of the members care, including authorizing specialty care as needed. See next page for a more detailed comparison or refer to the schedule of benefits/riders provided in the contract specimen section.