Health Plans Case Managed by EAN

HEALTH PLANS CASE MANAGED BY EAN AFTER JANUARY 1, 2011

(Client’s Portion of Charges – Out-patient visits) Rev. 07/01/11

Biltmore Company Insurance – Wells Fargo – TPA, P O Box 3262, Charleston, WV 25331-3262, Attn: Donna Bean, 1-800-624-8605, FAX: 304-353-7636 (Co-pay Indiv-$25, Group-$10) – Group #5321

Blue Ridge Regional Hospital – Insurance – HealthSCOPE, P O Box 99005, Lubbock, TX 79490-9005, Phone: 877-226-2058, CDH Plan – $3,000 Ded., 70% (May have money in HRA account to pay); PPO Plan - $30 co-pay – Group MHS

CarePartners Health ServicesAsheville Specialty Hospital – Insurance – Wells Fargo – TPA, P O Box 3262, Charleston, WV 25331-3262, Attn: John Whitley, 1-800-624-8605, FAX: 304-353-7636 (No Ded; Indiv.- $30 co-pay; Grp-$20 co-pay) - Group #6045

City of Asheville – Insurance – Coresource, Inc., P O Box 2920, Clinton, IA 52733-2920, 1-866-433-0318, Base Plan: - (HRA $600 — Ded. $1500 then 80%); Base Plus Plan:  - ($25.00 co-pay); Enhanced Plan:  ($20.00 co-pay) - Group #5027

Grove Park Inn Resort & Spa – Insurance – Primary Physician Care, Inc., P O Box 11088, Charlotte, NC 28220-1088 Attn: Jeri Poucher, 1-800-446-5439, FAX 704-945-1161 ($35 co-pay per visit) - Group #175

MAHEC – Insurance – Wells Fargo – TPA, P O Box 3262, Charleston, WV 25331-3262, Attn: Donna Bean, 1-800-624-8605, FAX: 304-353-7636 – 2 Plans – Gold Plan$1,000 Ded., Indiv-$25 Co-pay + 20 % of approved amount; Platinum Plan-$300 Ded., Indiv-$25 Co-pay + 20 % of approved amount - Group #5561

McDowell Hospital – Insurance – HealthSCOPE, P O Box 99005, Lubbock, TX 79490-9005, Phone: 877-226-2058, CDH Plan – $3,000 Ded., 70% (May have money in HRA account to pay); PPO Plan - $30 co-pay – Group MHS

Mission Hospitals – Insurance – HealthSCOPE, P O Box 99005, Lubbock, TX 79490-9005, Phone: 877-226-2058, CDH Plan – $3,000 Ded., 70% (May have money in HRA account to pay); PPO Plan - $30 co-pay – Group MHS

Pardee Memorial Hospital – Insurance – Wells Fargo – TPA, P O Box 3262, Charleston, WV 25331-3262, Attn: Donna Bean, 1-800-624-8605, FAX: 304-353-7636 ($400 Ded.; OP MH & SA-20%; of approved amount) - Group #5355

Transylvania Regional HospitalInsurance – Wells Fargo – TPA, P O Box 3262, Charleston, WV 25331-3262, Attn. Donna Bean, 1-800-624-8605, FAX: 304-353-7636 ($500 Ded.; 20% of approved amount) - Group #5485