## **CHANGES AFTER MAILING:** 

These are changes we made to the pattern [after the May transmittal
letter went out]{.underline}. [NOTE]{.underline}: To find these changes
in the brochure pattern, Word search for the date, e.g., for the latest,
search for \"*RV: 8-21*\". All changes from May 31 to now also have red
brackets to the right and are highlighted in [blue]{.mark}.

-   8-21-01 \-- ALL plans. OPM Logo on cover. Earlier, we posted the
    logo bitmap image on the web page to download for your brochure
    covers. But forgot to put it on our own. Today, we replaced the OPM
    logo. Probably will not mean plans have to change anything \-- if
    you downloaded from web page.

-   8-21-01 -- ALL Plans. Plain Language section. We added an address at
    OPM where enrollees can submit comments or suggestions.

-   8-21-01 -- ALL Plans. Section 2. How we change for 2002 section has
    been revised

-   8-21-01 -- ALL Plans. Section 4. Out-of-pocket maximum heading has
    been revised to "Your [catastrophic protection]{.underline}
    out-of-pocket maximum..."

-   8-21-01 -- ALL Plans. Section 5(a). Under Home health services
    section, Not covered, an exclusion has been revised.

-   8-21-01 -- ALL Plans. Section 5(e). the Preauthorization and Network
    limitation paragraphs have been revised.

-   8-21-01 -- ALL Plans. Section 9. The words "a Medicare + Choice plan
    that is" have been deleted from The Original Medicare Plan section

-   8-21-01 -- FFS and New Plan. Section 12 has been revised to Section
    11 in footer.

-   8-21-01 -- ALL Plans. Section 11. The words "Temporary continuation
    of coverage (TCC)" have been spelled out in the heading.

-   8-21-01 -- ALL Plans. Long term care section. We have added an
    alternative short version of the long term care section to the
    brochure.

-   8-21-01 -- ALL Plans. Long term care section. We revised two typos
    an italicized two sentences in the long version of the Long term
    care section.

-   8-21-01 -- ALL Plans. DoD/FEHB Demonstration Project section. The
    words "Temporary Continuation of Coverage (TCC)" have been spelled
    out in the heading.

-   7-26-01 \-- ALL plans. Long Term Care section. Change \"\...meet the
    state\'s poverty guidelines\....\" to \"\...meet their state\'s
    poverty guidelines\...\"

-   7-18-01 \-- ALL plans. Table of Contents. After \"Plan Language\",
    ADD entry for \"Inspector General Advisory.\"

-   7-18-01 \-- ALL plans. Table of Contents. After \"Group Health
    Coverage\" REMOVE entry for \"Inspector General Advisory\" that is
    now earlier.

-   7-18-01 \-- ALL plans. Table of Contents. Before Department of
    Defense Demonstration Project, ADD entry for long term care.

-   7-18-01 \-- ALL plans. After \"Plain Language\" before Section 1,
    add in the Inspector General Advisory that is edited/moved from
    Section 11.

-   7-18-01 \-- ALL plans. Section 2. Remove the \"Program changes\"
    paragraph about all enrollments being effective January 1. (This
    program change has been postponed; see carrier letter 2001-22.)

-   7-18-01 \-- ALL plans. Section 2. Add bullet about long term care to
    program-wide changes.

-   7-18-01 \-- ALL plans. Section 4. In the \"Deductible\" block, STET
    the deductible carry-over paragraphs and DO NOT ADD the paragraph
    that was meant to replace them.

-   7-18-01 \-- ALL plans. Section 11. Replace the \"When benefits and
    premiums start\" (AND the first replacement) with new language.

-   7-18-01 \-- ALL plans. Section 11. Language changes to the block
    called \" Getting a Certificate of Group Health Coverage.\"

-   7-18-01 \-- ALL plans. Section 11. Remove Inspector General
    Advisory, which is being moved to the front of the brochure.

-   7-18-01 \-- ALL plans. After Section 11, add NEW section for long
    term care.

-   7-18-01 \-- ALL plans. On Department of Defense demonstration
    project page, change January 1, 2001, to January 1, 2002.

-   7-18-01 \-- ALL plans. INDEX. Add back in \"Treatment therapies\"
    which we removed in error.

-   ~~6-19-01 - ALL plans. Clarify the Section 11 paragraph \"When
    benefits and premiums start\" to show mid-year changes are not
    effective January 1.~~ (Change reversed above.)

-   6-5-01 - ALL plans. Changes page. Move the clarification that blood
    lead testing is not for adults from program-wide change to a plan
    change since it was wrong in 2001 and needs to be fixed for only a
    few plans.

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-   6-1-01 - ALL plans - Cover. Change accreditation block to include
    logos and text for all accreditations the plan has.

-   5-31-01 - [ALL]{.underline} plans - Department of Defense
    Demonstration project page. Editorial correction in next to last
    paragraph from bottom. \"Your coverage will begin January 1, 2002.
    If you\....\"

-   5-31-01 - [HMO]{.underline} plans - Section 5(e). Replace 1^st^
    paragraph in Important section. (FFS paragraph picked up before;
    error).

## 

## **How the FFS brochure pattern changes for 2001 (as of April 30, 2001):**

## **Footers (throughout):** Change dates from 2001 to 2002

**Cover:**

-   Change dates -- 2 places

-   Add logo for accreditation, if any.

-   Information about logos (size, etc) follows the last page of the
    brochure (don't typset that information). For instance, the OPM logo
    has changed.

# Table of Contents 

-   Change 2001 to 2002

-   Under entry for 5(g), list flexible benefits option as your first
    special feature.

-   Under entries for 5(h), (i), and (j), added new instructions to
    plan.

### Introduction

-   Change 2001 to 2002---2 times

### Plain Language

-   Delete text and insert new updated text.

**Section 1.**

-   We also have Preferred\... \-- Clarified paragraph.

**Section 2. How we change...**

-   Date change from 2001 to 2002.

-   List of changes for 2001 deleted.

-   List of changes for 2002 added.

#### Section 3. How you get care

-   Medically underserved areas\-- Clarified language and added plan
    instruction/reminder.

-   Covered facilities\-- Bullet style change.

-   What you must do to get covered care\--

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-   Clarified 1^st^ paragraph.

-   Transitional care \-- Clarified (replaced) Specialty care.

-   Moved Hospital care heading to margin.

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-   How to get approval for your hospital stay\-- Editorial change in
    2^nd^ paragraph.

-   How to precertify\...\-- Bullet style change.

-   New Maternity care heading in margin, just before \"If your hospital
    stay needs to be extended.\"

-   If your hospital stay needs to be extended\-- Clarified who can do
    that.

-   What happens when you do not follow\...\-- Bullet style change.

-   Exceptions\-- 3^rd^ bullet\-- add bold face to \"do\".

**Section 4. Your costs for covered services**

-   Copayments\-- clarified copay description.

-   Deductible\-- Bullet style change.

-   Removed deductible carry-over language because effective dates now
    all 1/1. Replaced with other situations only.

-   Differences between our allowance and the bill\-- Clarified PPO
    providers paragraph.

-   Your out-of-pocket maximum\...\-- clarified your instructions.

-   When you are age 65 or over and you do not have Medicare\--

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-   Editorial changes in 2^nd^ and 3^rd^ blocks.

-   Boldface a word in \"If you physician\"

-   Editorial change in last block.

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-   When you have the Original Medicare Plan\--

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-   Clarified 1^st^ paragraph to help members understand original
    medicare.

-   Editorial changes paragraph 2.

-   The Note (5^th^ paragrpah)\-- editorial changes.

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-   When you have a Medicare Private Contract\-- Clarifications to help
    members understand and editorial changes.

#### Section 5. Benefits -- OVERVIEW

-   In the list for 5(a), added Chiropractic -- for the new benefit
    section.

-   In list for 5(c), editorial change.

-   Under entry for 5(g), list flexible benefits option as your first
    special feature.

-   Under entries for 5(h), (i), and (j), added new instructions to
    plan.

### Section 5(a) Medical services...

-   IMPORTANT section\--

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-   Add to explain non-PPO are the standard benefits.

-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

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-   Benefit Description gray band\-- added parens this way: "(No
    deductible)".

-   Preventive care, adult\-- in 1^st^ block,

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-   Remove blood lead level from the list of preventive services for
    adults because it is typically a test for children.

-   Remove age limit for blood cholestrerol.

-   Change the style of the bullets

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-   Preventive care, children\--3^rd^ block change the style of bullets.

-   Maternity care\-- clarification

-   Family planning\-- in 1^st^ block,

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-   added introductory line and instructions to plan about how to
    present the benefits in this block.

-   Added examples for clarification.

-   Added diaphragms.

-   Added a cross reference to prescription drugs for contraceptives.

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-   In 1^st^ block under Infertility services, changed the style of
    bullets.

-   Inferility services\-- In "Not covered" block,

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-   Changed the style of bullets.

-   Added 3 to sample list of exclusions.

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-   Reminder: Unless we've indicated otherwise, you may/should edit the
    benefit sections for your benefits.

-   Allergy care\-- 2^nd^ block, editorial change

-   Treatment therapies\-- in 1^st^ block, add a cross reference for
    Growth hormone.

-   Rehabilitative therapies\--

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-   Change heading to Physical and occupational therapy because speech
    therapy is being moved to new, separate block.

-   1^st^ block, left side, remove now-unnecessary introductory line.

-   remove speech therapists from list;

-   1^st^ block, right side, new plan instruction

-   removed speech therapy from the Note about short-term .

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-   Add new Speech therapy section. See call letter and brochure cover
    letter for details.

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-   Orthopedic and prosthetic devices\-- changed your instructions to
    show last bullet in our not-covered list is Plan-specific.
    {Reminder: Unless noted, everything in 5 is plan specific)

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-   Home health services\-- clarified language in 2^nd^ bullet in our
    not-covered list to remove indication that it\'s intended only for
    care by nurses.

-   Chiropractic\-- Moved chiropractic services from Alternative
    treatments and added new section.

-   Alternative treatments\-- Remove chiropractic services (and move to
    new section).

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-   Educational classes and programs\-- To smoking cessation bullet,
    added information about call letter instructions to you.

**Section 5(b). Surgical\....**

-   IMPORTANT section\--

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-   added parens this way: "(No deductible)".

-   Add to explain non-PPO are the standard benefits.

-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

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-   Benefit Description gray band\-- added parens this way: "(No
    deductible)".

-   Surgical procedures\--

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-   1^st^ block, added an introductory line and

-   editorial changes from singular to plural .

-   editorial change in last bullet in our list

-   Bullet change in multiple surgical procedures block.

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-   Reconstructive surgery\-- 1^st^ and 2^nd^ blocks, bullet style
    change.

-   Organ/tissue transplants\--

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-   Corrected typo.

-   Add intestinal transplants (per brochure letter).

-   Added plan instruction to clinical trial description.

**Section 5(c). Services provided by a hospital\....**

-   IMPORTANT section\--

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-   Clarified calendar year deductible paragraph. We did not make the
    paragraph exactly like other sections because we want to emphasize
    that the deductible isn\'t described the same in this section.

-   Added paragraph to explain non-PPO are the standard benefits.

-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

-   editorial change in the next bullet.

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-   Benefit Description gray band\-- added parens this way: "(calendar
    year deductible applies)".

-   Inpatient hospital\-- Not covered block; removed extended care
    facilities which, in our example benefits is listed as a benefit
    later.

-   Outpatient hospital\...\-- Right side; editorial change.

-   Hospice care\-- right side; editorial changes.

-   Ambulance\-- right side; editorail changes.

**Section 5(d). Emergency services/accidents**

-   IMPORTANT section\--

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-   Added paragraph to explain non-PPO are the standard benefits.

-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

-   added parens this way: "(No deductible)".

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-   Accidental injry\-- 2^nd^ block, right side; editorial changes

-   Medical emergency; right side; editorial changes

-   Ambulance; 1^st^ block; editorial changes

**Section 5(e). Mental health and substance abuse benefits**

-   Made several changes to change language from 1^st^ year introductory
    to on-going.

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-   IMPORTANT section\--

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-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

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-   In the Benefit Description gray band, added parens this way: "(No
    deductible)".

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-   Removed limitations that are not consistent with the call letter.

**Section 5(f). Prescription drug benefits**

-   IMPORTANT section\--

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-   added parens this way: "(No deductible)".

-   Added paragraph to explain non-PPO are the standard benefits.

-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

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-   Important features\-- Added introductory paragraph.

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-   We have an open formulary\-- Added text we moved from the
    not-covered section AND from below.

-   These are the dispensing limitations\-- Added text moved from below.

-   Add new Why use generic drugs? section. Included on next page some
    sample language various plans provided that you may use to build
    your language.

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-   Benefit Description gray band\-- added parens this way: "(No
    deductible)".

-   Covered medications and supplies \--

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-   1^st^ block, editorial clarification.

-   Removed text to add back above.

-   Added page of samples to answer the question Why use generic drugs?
    Do not typeset the language.

**Section 5(g). Special features**

-   Flexible benefits option - Edited instructions to show we want you
    to include this feature which is typical in all plans.

-   24 hour nurse line \-- added instruction to show this is not a
    required feature.

**Section 5(h). Dental benefits.**

-   Heading \-- added instruction.

-   IMPORTANT section\--

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-   edited the bullet paragraph that begins "Be sure to read" by putting
    comma after "Your costs for covered services".

**Section 5(i). Point of service benefits**

-   Heading \-- added instruction.

**Section 5(j). Non-FEHB benefits\....**

-   Added border to set page off from FEHB benefits.

-   Heading - added instruction.

**Section 6. General exclusions\....**

-   Clarified your instructions.

**Section 8. The disputed claims process**

-   Step 4\-- Clarified language.

-   Step 6 \-- Clarified language.

-   Note at end \-- Changed bullet style.

**Section 9. Coordinating benefits\....**

-   What is Medicare? \--

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-   Changed bullet style.

-   Added language to describe and help members better understand Part A
    and Part B.

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-   The Original Medicare Plan \--

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-   Added language to describe and help members better understand
    Original Medicare.

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-   We waive some costs\-- Added plan instruction.

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-   Primary payer chart \--

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-   Item A3(b) \-- editorial change.

-   Item C(1) \-- add (c) and (d) \-- to describe two
    frequently-occurring FEHB-Medicare coverage situations that aren\'t
    already described.

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-   Medicare managed care plan \--

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-   Editorial change in what is now: This Plan and another plan\'s
    Medicare managed care plan.

-   Editorial changes in Suspended FEHB coverage.

-   Private contract\-- clarification and editorial change.

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-   Enrollment in Medicare Part B \-- Clarified to include Part A.
    (Title changes to If you do not enroll in Medicare Part A or Part
    B).

-   Tricare\-- editorial change.

-   Workers\' Compensation. Language clarifications in 1^st^ bullet and
    last paragraph.

**Section 10. Definitions\....**

-   Coinsurance moved up to put sample list in alphabetical order.

-   Custodial care\-- Clarified your instructions.

-   Experimental or investigational services\-- Clarified your
    instructions

**Section 11. FEHB facts**

-   Where you can get information\...\-- Editorial change to underline
    URL.

-   Your medical and claims records are confidential\-- editorial change
    bullet 2 to remove comma.

-   When you lose benefits\-- Change bullet style.

-   TCC \--

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-   Clarification paragraph 1.

-   Add heading to 3^rd^ paragraph and add clarifying text.

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-   Converting\...\-- Change bullet style.

-   Getting a Certificate of group health plan coverage\-- Added
    clarifying language in 1^st^ paragraph and added a 2^nd^ paragraph
    to help members understand why certificate is important.

**Department of Defense/FEHB Demonstration Project**

-   Updated dates in several places.

**Index**

-   Introductory paragraph\-- Clarified.

-   Added sample entry.

-   Removed Rehabilitative therapies.

-   Updated date.

**Summary of benefits**

-   Changed dates.

**Rate Information**

-   Changed dates.

**Your instructions for using the pattern brochure**

-   Instructions follow the brochure. Do not typeset the instructions.