September 6, 2010
  TABLE OF CONTENTS
  4.1.3 Specified Office Surgical Procedures - 100% Coverage
  The Plan will pay 100% of covered charges in connection with and on the day of the following operations if they are performed in a Physician’s office, regardless of whether the Physician is an HMO, PPO, Non-Network or Out of Area provider.

Excision of Chalazion Myringotomy
Rubber Band Treatment of Internal Hemorrhoids Drainage of Perirectal Abscess
Drainage of Pilonidal Abscess Evacuation of Thrombosed Hemorrhoids
Removal of Diseased Toenails Repair of Lacerations of Skin
Vasectomy  


If these operations are performed anywhere other than a Physician’s office, they will be subject to the Deductible (Inpatient or Outpatient, whichever is applicable), applicable HMO Co-pay and a reduced reimbursement rate. All other operations will be subject to the applicable Deductible and HMO Co-pay and a reduced reimbursement rate regardless of where they are performed, even in the Physician’s office.
  TABLE OF CONTENTS
  St. Louis Graphic Arts Joint Health & Welfare Fund
14323 South Outer Forty Rd. - Suite S106
Chesterfield, Missouri 63017
Fund Office: (314) 878-1579
twesthues@slgahw.org
Fax: (314) 275-2640
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