[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-138590-en":3,"doc-seo-138590-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":4,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},138590,2336474466412,"\tJames","https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d",7,"Healthcare","Your Health Care Benefits Program - Certificate of Coverage","Certificate of Coverage outlines the terms under which Blue Cross and Blue Shield of Texas provides managed health care and pharmacy benefits to eligible employees (subscribers) and covered dependents. Coverage begins on the effective date shown on the identification card, subject to timely employer premium payments and the plan’s provisions. The booklet includes schedules describing in-network and out-of-network benefit percentages, deductibles, copayments, and payment maximums, plus required notices and complaint or appeal guidance through insurer and the Texas Department of Insurance.","Your Health Care Benefits Program  \nManaged Health Care Pharmacy Benefits  \nBlue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association  \nTX-G-P-2025  \nCERTIFICATE OF COVERAGE  \nBlue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association  \n(herein called “BCBSTX” or “Carrier”)  \nHereby certifies that it has issued a Group Managed Health Care, and Pharmacy Benefits Contract (herein called the “Plan”) . Subject to the provisions of the Plan, each Employee (Subscriber) to whom a Blue Cross and Blue Shield Identification Card is issued, together with his eligible Dependents for whom application is initially made and accepted, shall have coverage under the Plan, beginning on the Effective Date shown on the Identification Card, if the Employer makes timely payment of total premium due to the Carrier. Issuance of this Benefit Booklet by BCBSTX does not waive the eligibility and Effective Date provisions stated in the Plan. Any reference to“applicable law” will include applicable laws and rules, including but not limited to statutes, ordinances, and administrative decisions and regulations.  \nJames Springfield  \nPresident of Blue Cross and Blue Shield of Texas  \nThe Schedule(s) of Coverage enclosed with this Benefit Booklet indicate benefit percentages, Deductibles, Copayment Amounts, maximums, and other benefit and payment issues that apply to the Plan.  \nThe Schedule(s) of Coverage specify benefits for:  \nManaged Health Care (In-Network) and (Out-of-Network) coverage Pharmacy Benefit coverage  \nNOTICE OF SEPARATE AVAILABLE COVERAGE  \nThis notice is required by Texas legislation to be provided to you. It is to inform you, the Employee, that your Employer has selected this health benefit coverage. BCBSTX does not offer a rider or separate insurance contract through your Employer that would provide coverage in addition to the coverage under this Contract.  \nTHE INSURANCE CONTRACT UNDER WHICH THIS BENEFIT BOOKLET IS ISSUED ISNOT A CONTRACT OF WORKERS’ COMPENSATION INSURANCE. YOU SHOULD CONSULT YOUR EMPLOYER TO DETERMINE WHETHER YOUR EMPLOYER IS A SUBSCRIBER TO THE WORKERS’COMPENSATION SYSTEM.  \nTX-G-P-2025  \nHave a complaint or need help?  \nIf you have a problem with a claim or your premium, call your insurance company or HMO first. If you can't work out the issue, the Texas Department of Insurance may be able to help.  \nEven if you file a complaint with the Texas Department of Insurance, you should also file a complaint or appeal through your insurance company or HMO. If you don't, you may lose your right to appeal.  \nBlue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation  \nTo get information or file a complaint with your insurance company or HMO:  \nCall: Blue Cross and Blue Shield of Texas  \nToll-Free: 1-800-521-2227  \n[Email: BCBSTXComplaints@bcbstx.com](Email: BCBSTXComplaints@bcbstx.com)  \n[Mail: P. O. Box 660044](Mail: P. O. Box 660044), [Dallas](Dallas), TX 75266-0044  \nThe Texas Department of Insurance  \nTo get help with an insurance question or file a complaint with the state:  \nCall with a question: 1-800-252-3439  \n[File a complaint: www.tdi.texas.gov](File a complaint: www.tdi.texas.gov)  \n[Email: ConsumerProtection@tdi.texas.gov](Email: ConsumerProtection@tdi.texas.gov)  \n[Mail:](Mail: Consumer Protection)[ Consumer Protection](Mail: Consumer Protection), MC: CO-CP,  \nTexas Department of Insurance, PO Box 12030, Austin, TX 78711-2030  \n¿Tiene una queja o necesita ayuda?  \nSi tiene un problema con una reclamación o con su prima de seguro, llame primero a su compañía de seguros o HMO. Si no puede resolver el problema, es posible que el Departamento de Seguros de Texas (Texas Department of Insurance, por su nombre en inglés) pueda ayudar.  \nAun si uste","cbCaiiD6C9K0BQ94","https://ap.wps.com/l/cbCaiiD6C9K0BQ94","pdf",2704878,1,161,"English","en",105,"# Certificate of Coverage\n# Important Notice\n# Schedule(s) of Coverage\n# Introduction\n# Who Gets Benefits\n# How the Plan Works\n# Utilization Management","[{\"question\":\"When does coverage begin for employees and dependents?\",\"answer\":\"Coverage begins on the effective date shown on the identification card, provided the employer makes timely payment of the total premium due.\"},{\"question\":\"What does the Schedule(s) of Coverage provide?\",\"answer\":\"It lists benefit percentages, deductibles, copayment amounts, maximums, and other issues that apply to managed health care and pharmacy benefit coverage.\"},{\"question\":\"Where should a complaint or help request be submitted?\",\"answer\":\"Start with the insurance company or HMO. If needed, the Texas Department of Insurance may help, and complaints or appeals should also be filed through the insurer or HMO to avoid losing appeal rights.\"}]","Your Health Care Benefits Program - Certificate of Coverage | PDF",1787484347,406,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":86,"head_meta":88,"extra_data":90,"updated_unix":28},"your-health-care-benefits-program-certificate-of-coverage","",{"@graph":36,"@context":85},[37,54,68],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/your-health-care-benefits-program-certificate-of-coverage/138590/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":62,"encodingFormat":61,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-08-23",true,{"@type":65,"interactionType":66,"userInteractionCount":4},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71,77,81],{"name":72,"@type":73,"acceptedAnswer":74},"When does coverage begin for employees and dependents?","Question",{"text":75,"@type":76},"Coverage begins on the effective date shown on the identification card, provided the employer makes timely payment of the total premium due.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"What does the Schedule(s) of Coverage provide?",{"text":80,"@type":76},"It lists benefit percentages, deductibles, copayment amounts, maximums, and other issues that apply to managed health care and pharmacy benefit coverage.",{"name":82,"@type":73,"acceptedAnswer":83},"Where should a complaint or help request be submitted?",{"text":84,"@type":76},"Start with the insurance company or HMO. 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