Managed Care
The "managed care" philosophy of EGP is to preserve individuals freedom to choose their medical providers while offering them incentives to select quality medical providers who have agreed to provide services at negotiated rates.
Our benefit plans emphasize the availability of quality medical care and resist the medical rationing which is prevalent in many managed care programs. All available managed care options have been developed to ensure that participants have access to quality health care at affordable costs.
Network arrangements focus on fee-for-service contracting and
generally do not require physician gatekeeper arrangements.
No medical or prescription protocols are issued. When employees
choose preferred providers, they benefit from reduced out of pocket
expenses and protection from balance-due billing while the plan
benefits in the form of reduced overall claims costs.
EGP can offer multiple physician and hospital network
arrangements, nationwide, which are available on a preferred
provider (PPO) basis or an exclusive provider (EPO) basis.
EGP is also an administrator for the Caremark Prescription Services
managed prescription drug programs. Managed indemnity and
traditional co-pay programs are available.
Geo-access studies are available to determine network adequacy based
upon employee demographics.
Refer to the BUSINESS PARTNERS page for direct links to select networks.
