INSURANCE

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP79-00639A000100060001-6
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 11
• Document Creation Date: November 16, 2016
• Document Release Date: April 26, 2000
• Sequence Number: 1
• Publication Date: December 23, 1963
• Content Type: DISP

Approved For Release 2000/06/07 : CIA-RDP79-00639A000100060001-6
Subject copy is on file in DDP/PC
Rm 1A11 , Hqs
ext 7274
Approved For Release 2000/06/07 : CIA-RDP79-00639A000100060001-6
 CLASSIFICATION
PROCESS( G ACTION
Rep,
IS PAT C
MARKED FOR INDEXING
TO 25X1A
All Chiefs
a
NO INDEXING REQUIRED
1NFO-
ONLY QUALIFIED DESK
CAN JUDGE INDEXING
FROM
Chief, 25X1 A
MICROFILM
ZLJBJECT
Insurance
ACTION REQUIRED ? REFERENCES
IMPS NKCE : 22 November 1963
25X1A 25X1A
1. ld about the announced increase for in -patient
hospitalization charges
as of 1 January 1964. As a result or this announcemen , the undo r o
Association Benefit Plan was asked to provide a schedule for reimbursement. The
underwriter has established the following schedule for reimbursement, applicable
only to hospitalization charges described above:
APPORTION) IT OF DAM CHAd OF $37.00 FOR IN-PATIENT 3IIRQITCAL
OR NON-d ICAL SERVICES
a. High Option
Plan will pay $20.00 per day as allowance for room and board
for up to 90 days.
Plan will. pay the first $202.50 of the difference between the
rate of $20.00 per day and the total charges for confinement.
Plan will pay 80% of additional charges above $202.50 up to
$$000.00 for each 90 day confinement.
The 20% in excess of the $202.50 may be applied to the major
medical benefits. ($100 deductible)
b. Low Option (NOTE: $20.00 of the $37.00 daily charge has been
~.~ established by the underwriter as the assessment
for room and board, i.e., as if there was a daily
charge for room and board of $20.00) r
Plan will pay $13.50 per day as allowance for room and board p
for up to 90 days. a
Toone. will pay $6.50 per day for room and board for up to
90 days. y m
Plan will pay the first $202.50 of the difference between
the rate of $20.00 per day and the total charges for confinement.
CROSS REFERENCE TO DISPATCH SYMBOL AND NUMBER
DATE 23 DEC
u
25X1A
CLAS (CATION
HQS FILE NUMBERNone. After the
' V% bgw~
dispatch has served its pur-
e r e 000 : CI -RDP79-0
~4(0$sY.~, d.
ADDroved For Rel
006
25X1 C
 Approved For Rele Tt7 P79-00639A000100060001-6
CONTINUATION OF
DISPATCH
Plan will pay 80,E of adatiaaal charges above $202.50 to
$5000.00 for charges repromented by the daily sharp ($37.00)
aims $20.00 tiles the nmiber of days baapitslisod for sash ceo-
fin~nt. The eaip1syes will pay the raaaJadar.
c. 1laterzdU Benefits (Normal Delivers)
(1) High 0ptiess
Plan will pay $16.00 per day v'p to 8 days for roan
and board.
Plan will pay up to $100.00 of the difference
between the above and the total hospital charges.
(2) I OLtien
Plan will pay $10.00 per. day up to 8 days for room
and board.
Plan will pay up to $100.00 of the difference
between the above and the total hospital charges.
N07Ss In case of Caesarean 3octioIor miscarriage, rates of
r` s +roasnt will be made as sloWm,,la and lb for surgical or
non-surgical services.
2. ZZLXn= s
a. assume 11 I*X3 IN 1i03PIltiL WILE OR WI4800i 3 0 I'm IV
HIGH OPTION WV OPTION
qLams 9.""
11 x $37.00 $WUM-00 11 z $37.00
Hoiaburseanmt Roiabur .ma*t
Roam & Beard Room & Board ailowaaoo
U z $20.00 $220.00 11 z $33.50
Hospital zztras 187.00 Rom & Board paid by os*loyso
$M nx $6.50
WAS" (Paid as hospital 187.
Tow l to be paid by e00le7e9 $ . 0
roEM
e?60 no
(4?)
.00
$148.50
Approved For Release 290 1:{9 FI k.k.0639A000100060001-6
497
25X1A
 Approved Fo. elease 2000/06/07 : CIA-RDP79K10639A000100060001-66
CONTINUATION OF
DISPATCH
-------------
20 a $37.00
Re jubprstraient
Room & Board
20 x $20.00
Halame
Hospital Extras
Hale
80% z $137.50
B.s-Q-"-T
Assume 20 a 18 IK BD3PIhL WITH OR 1CTAOUT SUB=
b
.
HIGH 0PTI0x
LOW -OPMEOR
charges
$740.00
$740.00
20 x $37.00
Refit
~s #Di35o
227000
170.00
340,00
202.5o
Ulan"
Hoard to be paid by
Roam &
1 0.00
13
enployee 20 x $6.50
..E
137
50
00
340
.
lalanae
.
!.x=00
Hospital Extras
202- JO
To be =plied by 6091070e
toward 100 dednotible # 2 0
25X1
Assmr 8IX 1UZ8 I11.PATIUT CL
E. OPSIOH
Balance
80% x $137.50
Hospital Iztras to be paid by
emloy"
Total to be paid by eerp1a s.
$222.00 6 x $37.00
6 : #3a.oo
I~,iba:*a.awt
6 a *16.00 96.00 6 :?QO
137.50
110.00
$222.00
$ 60.00
25X1A
100 00
8npplenaattal a7larana 10000 anpplamentsl alleWaiaoe
OW-M
To be.paid by esployee $_k2.. 0_0
To be by GM10 #a~00
4.14 sat u of an i1~?~ dependant are reinbarseable under
?
wk~ ha ape a is required to pay the first #35.00. If MNMM the the par+visiaos of is Plan and the hospital is in a
t is eo~-ered W the ?O?iat' am telteas s
the #35.00 will ~ 25X1 C4a
a. High Option the plan rill pay the $35.00
b. Law Optin - the. plan will p4 $28.50 and the WWI" Will
py #6.54
1kApproved.s v nwsv~ov.For^.RT ele10M?
=-m
 Approved For:Release 2000/06/07 : CIA-RDP
CLABBIFICATION DISPATCH SYMBOL AND NUMUM
CQNTINUATION OF
. DISPATCH
Advance Autherit~
subject to approval by
ce of official fiends
dv
t
,
an
as a
An employee may rsqu+ss
an authorised approving official, for hospitalisation and related expenses in an amount
not in exaess of that for which,, in the opinion of the approving official the e 1 ee
riate
t reimbursement under his health benefits plan. The approp
will be =roded to specifically' authorise this type of advance;
the issuance of such amendment this dispatch may be cited as authorisation for such
advances. Such advances oust be repaid by the employee proeptly upon his receipt of
notification that his claim has been settled. Authority for advances for hospitali-
satien and related expenses for which reinborsement, is due an employee under the pro-
visions of
25X1A
ypg ' 25X1A2d1
25X1A2e
FORM
b?so 53d USE PRKVIOUf EDITION.
(40)
cijs$IIFICATION
34 0 it IP-T
D CCWMNU=
25X1A
25X1A
25X1A
25X1A
ApprdMe or a ease 2000/06/07 CIA-RDP79-00639A0.00100060001-6-
 Approved For Release 2000/06/07 : CIA-RDP79-00
25X1A
TO All Chief
FROM Chief,
SUBJECT . Insurance
25X1A REFERENCE: - 22 November 1963
25X1A
25X1 C4a
25X1A2d1
told about the announced increase for
25X1A
25X1 C4a
in-patient hospitalization charges for
as of 1 January 1964. As a result of this announcement, the
underwriter of the Association Benefit Plan was asked to provide a schedule for
reimbursement. The underwriter has established the following schedule for
reimbursements Applicable only to hospitalization charges described above
APPORTIONMENT OF DAILY CHARGE OF $37. 00 FOR
IN-PATIENT SURGICAL OR NON-SURGICAL SERVICES
a. High Option
Plan will pay $20. 00 per day as allowance for room and board
for up to 90 days.
Plan will pay the first $202. 50 of the difference between the
rate of $20. 00 per day and the total charges for confinement.
Plan will pay 80% of additional charges above $202. 50 up
to $5000.00 for each 90 day confinement.
The 20% in excess of the $202. 50 may be applied to the major
medical benefits. ($100 deductible)
b. Low Option (NOTE: $20. 00 of the $37. 00 daily charge has
been established by the underwriter as the
assessment for room and board, i. e. , as if
there was a daily charge for room and board
Approved For Release 2600'769/6). CIA-RDP79-00639A000100060001-6
 Approved For Release 2000/06/07 : CIA-RDP79-006' 9A000100060001-6
Plan will pay $13. 50 per day as allowance for room and board
for up to 90 days.
Employee will pay $6. 50 per day for room and board for up to
90 days.
Plan will pay the first $202. 50 of the difference between the
rate of $20. 00 per day and the total charges for confinement.
Plan will pay 80% of additional charges above $202. 50 up to
$5000. 00 for charges represented by the daily charge ($37. 00) minus
$20. 00 times the number of days hospitalized for each confinement.
The Employee will pay the remainder.
c. Maternity Benefits (Normal Delivery)
(1) High Option
Plan will pay $16. 00 per day up to 8 days for room and
board.
Plan will pay up to $100. 00 of the difference between the above
and the total hospital charges.
(2) Low Option
Plan will pay $10. 00 per day up to 8 days for room and board.
Plan will pay up to $100. 00 of the difference between the above
and the total hospital charges.
NOTE: In case of Caesarean Section or miscarriage, rates of
reimbursement will be made as shown la and lb for surgical or
non-surgical services.
Approved For Release 2000/06/07 CIA-RDP79-00639A000100060001-6
2
 Approved For Release 2000/06/07 : CIA-RDP79-00 39A000100060001-6
2. EXAMPLES:
(a) Assume 11 DAYS IN HOSPITAL WITH OR WITHOUT SURGERY
HIGH OPTION
Charge s
11 x $37. 00
Reimbursement
Room & Board
11 x $20.00
Hospital Extras
LOW OPTION
Charges
11 x $37. 00 $407.00
QMMMNM~
$407.00
Reimbursement
Room & Board allowance $148. 50
11 x $13. 50
$220.00
Room & Board paid by employee
11 x $6. 50 71. 50
$220.00
187.00
$407.00
Balance (paid as hospital
extras 18 7. 0 0
$407.00
Total to be paid by employee
$ 71.50
qwrvm~
Approved For Release 2000/06/07 : CIA-RDP79-00639A000100060001-6
 Approved For Rel'rase 2000/06/07 : CIA-RDP79-00639A000100060001-6
(b) Assume 20 DAYS IN HOSPITAL WITH OR WITHOUT SURGERY
LOW OPTION
Charges
Charges
20 x $37. 00
$740. 00
20 x $37. 00
$740.00
Reimbursement
Reimbursement
Room & Board
Room & Board
20 x $20.00
400.00
20 x $13. 50
270.00
Balanc e
340. 00
Balance
Hospital Extras
202. 50
Room & Board to be paid by
employee 20 x $6. 50
130. 00
Balance
137. 50
Balance
340. 00
80% x $137. 50
applied
To be by employee
toward $100 deductible
110.00
$ 27. 50
Hospital Extras
Balance
80% x $137. 50
Hospital Extras to be paid by
employee
202. 50
137. 50
110. 00
$130.00
27. 50
Total to be paid by employee
Approved For Release 2000/06/07 : CIA-RDP79-00639A000100060001-6
9
 Approved For Re1Lsase 2000/06/07 : CIA-RDP79-00639A000100060001-6
(c) NORMAL DELIVERY MATERNITY BENEFITS
Assume SIX DAYS IN -PATIENT CARE
HIGH OPTION LOW OPTION
Charges Charges
6 x $37. 00 $222.00 6 x $37.00 $222. 00
Reimbursement Reimbursement
6 x $16. 00 $ 96.00 6 x $10.00 $ 60.00
Supplemental allowance 100. 00 Supplemental allowance 1 00.00
$196. 00
To be paid by employee $ 26. 00
25X1A
$160.00
To be paid by employee $ 62. 00
3. When hospitalization expenses of an eligible dependent are reimburseable
under the provisions of the employee is required to pay the
first $35. 00. If the dependent is covered by the Association Benefits Plan 25X1C4a
and the hospital is in the $35. 00 will be reimbursed as fol-
lows:
(a) High Option - the plan will pay the $35. 00
(b) Low Option - the plan will pay $Z8. 50 and the employee will
pay $6. 50
25X1A
4. Advance Authority
An employee may request an advance of official funds, subject to
approval by an authorized approving official, for hospitalization and related
expenses in an amount not in excess of that for whixh, in the opinion of the
approving official, the employee may expect reimbursement under his health
benefits plan. amended to specifically
Approved For Release 2000/06/07 CIA-RDP79-00639A000100060001-6
 Approved For Re1ase 2000/06/07 : CIA-RDP79-00639A000100060001-6
25X1A
authorize this type of advance; pending the issuance of such amendment this
dispatch may be cited as authorization for such advances. Such advances
must be repaid by the employee promptly upon his receipt of notification
that his claim has been settled. Authority for advances for hospitalization and
related expenses for which reimbursement is due an employee
, Overseas Medical Benefits, is now reflected in that
25X1A
c
Approved For Release 2000/06/07 : I R[7PJ9=000 AM00060001-6