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Congratulations to Labtopia Staffing for reaching this company milestone! Thank you to our wonderful employees for helping us earn this achievement!

 


Insurance Application & Plan Information - All Employees MUST fill out Sections 2 & 9


Accepting Coverage- Please complete Sections 2, 3, 4, 5, 7, & 9

Accepting Coverage Screen Shot Example

Plan Coverage Screen Shot

You are to choose between Blue Advantage HMO and BlueChoice PPO.

HMO Plan-

If you decide to enroll in the HMO plan, please note you MUST pick a Primary Care Physician at the time of enrollment. Please indicate your PPO in Section 4 of application.

To determine which doctors are eligible with this plan utilize the following instructions: 

Go to https://public.hcsc.net/providerfinder/search.do?corpEntCd=TX1 > through my employer or my spouse’s employer > I am a member > medical > Texas > Blue Choice PPO > to find a specific doctor enter last name only and zip code for best results.

Important Note about the HMO Plan

You must stay In Network as there are no Out Of Network benefits. MD Anderson and TX Children’s Hospitals are not In Network facilities.

PPO Plan-

Should you choose to enroll in the PPO Plan you will not need to list a Primary Care Physician or get referrals to a specialist.  You have In Network and Out of Network benefits. MD Anderson and TX Children’s Hospitals are In Network.


Declining Coverage-Please complete sections 2, 8, & 9 of the application only. Please include the reason for declining coverage. We must have your paperwork back even if you are declining coverage!

Declining Coverage Screen Shot Example

Important Note about Declining Benefits -

  • If you decline Benefits due to current coverage and you lose that coverage, you can enroll in one of Labtopia's plans within 30 days of previous coverage ending.
  • If you decline benefits due to any reason other than having current coverage, you must wait until next open enrollment period (December 2019)

All questions, comments, & concerns can be directed to ktyer@labtopiainc.com or 281-619-2600