Health Care Benefits
"Company" Defined
Throughout this section, unless otherwise stated, reference to "Company" or "PG&E" means Pacific Gas and Electric Company.
The Company gives you a choice of health care benefits so you can elect the coverage that best meets your needs. This section describes the available medical (including mental health and prescription drugs), dental and vision coverage provided pursuant to the Pacific Gas and Electric Company Health Care Plan for Active Employees (as used in this section, "the Plan.")
This section is organized into subsections and chapters, to help you find the information you want. These are:
Additional Information
In addition to the information in this section, there is also important information about your benefits in other parts of this Handbook. Be sure to review the About this Handbook section, the Benefits at a Glance section, the What If… section, and the Rules, Regulations & Administrative Information section.
Responsibility for Your Health Care
While the Company has contracted with reputable health care plans to provide health care services, neither the Company or any participating employer nor the Plan can ensure the quality of care you receive. The health care vendors contract with the providers in their networks; the Company does not contract with any of the network doctors, hospitals or other providers directly.
Health plan participants always have a choice in the services they receive and who provides those services, regardless of what the health care plan covers or pays. Members of HMOs always have the right to change primary care physicians, subject to the limitations outlined in the HMOs' Evidences of Coverage (EOCs). You can access copies of the HMOs' EOCs by visiting the Benefit Plan Documents section of the PG&E@Work intranet or by contacting the HMOs directly.
Plan Documents and Administration
The plan document for The Pacific Gas and Electric Health Care Plan for Active Employees (the "Health Care Plan") incorporates the terms of this Summary of Benefits Handbook which pertain to the Health Care Plan, the documents that are Summaries of Material Modifications to the Health Care Plan, which may include Open Enrollment guides, and the Health Maintenance Organization and Employee Assistance Program Evidences of Coverage. If a conflict exists between these Health Care Plan documents and any other communications or documents, the terms of these Health Care Plan documents shall govern the operation of the Health Care Plan.
The Employee Benefit Committee of PG&E Corporation is the Plan Administrator of the Health Care Plan and has the discretionary authority to interpret and construe the terms of the Health Care Plan, to resolve any conflicts or discrepancies between documents and to establish rules which are necessary or desirable for the administration of the Health Care Plan.