Please note that members covered under HMO plans are required to use the services of HMO providers and can only use the Fund's SMMP for co-payments or services not available under their HMO plan.
The SMMP also provides a hearing aid and audiometric examination benefit covering a maximum of up to $1,500 per hearing aid and 90% of Reasonable and Customary (R&C) allowances for audiometric examination. These benefits are not subject to the deductible.
Adult Wellness Benefit
The Adult Wellness Benefit covers annual and/or periodic physical and screening examinations that can result in early detection and intervention before a serious disease develops or advances. Some tests are age and gender-specific or related to health risk factors. Coverage is provided up to 100% of R&C and is not subject to the deductible.
The Plan is administered by Administrative Services Only, Inc. (ASO). For questions or inquiries on claims matters, a member may call ASO's customer service department toll-free at (877) 844-SMMP (877-844-7667).
Please refer to the Fund Booklet for complete details on the Superimposed Major Medical Plan.