b'Blue Cross Blue Shield PPONETWORK NAMEParticipating Provider Organization (PPO)Plan Comparison:PLAN FEATURESNon-Medicare Traditional PPO. You may use any physician. Plan typically pays 80% PPO and 50% Non-PPO of allowed Eligible Members charges after the plan year deductible has been met.CONTACT INFORMATIONGroup number: P066751-800-331-8032 Customer Service1-800-851-7498 Mental Health1-800-423-1973 Pharmacy1-800-299-0274 Nurse Linewww.bcbsil.comHOW TO ENROLLComplete CTPF Form 350 (available in the center of this book or online at www.ctpf.org). Return with required documentation to CTPF.SERVICE AREANationwideFOREIGN TRAVELForeign travel emergency benefits available. Other foreign medical coverage may be available. Contact BCBS at 1-800-810-2583 for more information.PHYSICIAN SELECTIONEnhanced benefit level when you use aPPO hospital or physician.LIFETIME MAXIMUMNo lifetime maximumOUT-OF-POCKET MAXIMUMSIndividual:$2,400PPO$4,800Non-PPOFamily:$4,000PPO$9,600Non-PPOPrescription copays do not apply towardplan deductible.CTPF 2024 NON-MEDICARE HEALTH INSURANCE HANDBOOK CTPF 2024 NON-MEDICARE HEALTH INSURANCE HANDBOOK 11'