The following list provides a very brief description of each plan and vendor that has been contracted with or approved by Tyoga CareNet (TCN). More detailed information; including payor descriptions, provider reimbursement, and contact information, can be provided by contacting us directly or reviewing the Business Office Manual.

EMPLOYER HEALTH PLANS

ATHENS SCHOOL DISTRICT

Athens Area School District (AASD) is located in the Appalachian Highlands, a region in Bradford County known as the Endless Mountains of Northern Pennsylvania. AASD comes to us through our relationship with the Pennsylvania Public School Health Insurance Trust (Trust). TCN has a contract with the Trust for provider services at contracted rates. The Trust is making this relationship available to AASD. The Trust has relationships with other provider networks to provide access to services outside of this region.

The Loomis Company is the third party administrator for Athens Area School District and is also providing access to utilization management services.

Provider Network Options:

The Trust is using a somewhat complicated combination of provider networks and, at this time, they have not fully developed their system for locating in-network providers other than TCN. For issues associated with TCN providers, you can always refer to the TCN website (www.tyogacarenet.com). We cannot as yet provide guidance as to how to identify providers accessed through other networks.

Contacts:

For other provider issues related to claims and reimbursement, please contact the Loomis Company – Tonya Conrad at 610.374.4040, Ext. 2451

Tyoga CareNet
570.723.0560

INSURED HEALTH PLANS

EDUCATORS MUTUAL LIFE

In 1910, Educators Mutual Life Insurance Company began by providing policies to teachers to insure them against loss of income. Over the years, our experience has helped us to understand that employers have different group insurance needs and budget limitations.Recently, Educators Mutual has announced it is pulling out of the health insurance business. You can expect to see less and less volume from them in the future.

Provider Network Options:

TCN contracts with Educators Mutual through other preferred provider networks. This carrier uses multiple preferred provider networks based on the wishes of the employer. Each Tyoga CareNet provider will send claims for covered services as directed by the payor via the member identification card. Please send claims only to the address on the patients’ identification card. This address will vary from payor to payor.

Contacts:

Tyoga CareNet
570.723.0560

EMPLOYERS INSURANCE PROGRAM (EIP)

The Employers Insurance Program (EIP) has been developed by AmeriHealth in combination with the West Branch Manufacturer’s Association (based in Williamsport), Inter-County Health Plan, and Gettysburg Insurance. The health plan previously went under the Inter-County Health Plan name and will be sold throughout this region.

TCN has a contract with AmeriHealth in support of this payor. This includes participation in the AmeriHealth PPO.

Provider Network Options:

TCN has a contract with AmeriHealth for institutional services only.

TCN does not have a contract with AmeriHealth for physician services. AmeriHealth uses the Blue Shield of Pennsylvania network for physician services.

Contacts:

EIP Customer service
800.492.2385

www.ichphealth.com

Tyoga CareNet
570.723.0560

FIDELITY INSURANCE COMPANY (FIC)

FIC offers a fully-insured, indemnity PPO plan with basic in and out of network incentives and a variety of plan options. We have had employers report service problems with Fidelity. You may want to take this into account if considering their products. Bear in mind, there are many insurance companies that use “fidelity” as a component of their name.

Provider Network Options:

The primary network options in this area are InterGroup and Devon. The TCN logo will not appear on the identification card.

Contacts:

None.

JOHN ALDEN HEALTH (JAH)/FORTIS HEALTH (FH)

JAH/FH is a fully-insured, indemnity PPO plan with basic in and out of network incentives and a variety of plan options. This product is popular with many employers.

Provider Network Options:

The primary network options in this area are InterGroup and Devon. The TCN logo will not appear on the identification card.

Contacts: 

None.

LAUREL HEALTH SYSTEM (LHS)

LHS provides health benefits for its employees through a self-funded health plan using a provider network provided by TCN. The plan incorporates strong financial incentives to steer patients to in-network providers. The program operates with “Tiers” based on where the beneficiary resides. Each beneficiay is designated a Tier 1 or primary network. Generally, basic services have to be provided by a Tier 1 provider or the service is not covered.

Third-party administration is provided by The Loomis Company. The service and support provided by Loomis has been excellent.

All pertinent information is included on the beneficiary’s identification card. This includes claims payment procedures, contact numbers, and provider networks.

Provider Network Options:

The LHS health benefit plan uses the TCN network in combination with PPHN, Beech Street and Devon. The TCN logo will not appear on the beneficiary’s identification card because TCN providers are enrolled under the PPHN Network.

Contacts :

Laurel Health System 
570.723.0106

The Loomis Company
P.O. Box 7011
Wyomissing, Pa 19610-6011
866.229.0299

Tyoga CareNet
570.723.0560

For complete plan information please refer to the web page provided for Laurel Health System (just click on the Laurel logo on the Tyoga CareNet home page).

TAPCO INTERNATIONAL CORPORATION

TAPCO provides health benefits for its employees through a self-funded health benefit plan. The plan incorporates basic financial incentives to steer patients to in-network providers.

Third-party administration is provided by Weyco, Inc. The service and support provided by Weyco has been excellent.

All pertinent information is included on the beneficiary’s identification card. This includes claims payment procedures, contact numbers, and provider networks.

Provider Network Options:

The TAPCO health benefit plan uses TCN, in combination with the Devon Health Services network. The TCN logo will appear on the beneficiary’s identification card.

Contacts:

Weyco, Inc.
830.748.0003

Tyoga CareNet
570.723.0560

PARKER HANNAFIN CORPORATION (PHC)

PHC is one of the world’s leading diversified manufacturers of motion and control technologies and they are based in Bradford County. They have instituted a basic self-funded program for their employees.

Provider Network Options:

The health plan uses United Healthcare Choice Plus Network as its provider network. The TCN logo will not appear on the identification card

Contacts:

United Healthcare Choice Plus Network
888.780.4376

PHILADELPHIA AMERICAN LIFE INSURANCE (PALI)

This is a fully-insured, indemnity PPO plan with basic in and out of network incentives and a variety of plan options.

Provider Network Options:

The only network option supported by TCN is InterGroup. The TCN logo will not appear on the identification card.

Contacts:

InterGroup Services
570.537.9389

PRINCIPAL

The Principal Financial Group (The Principal) is a diversified family of insurance and financial services companies. The company has served the employer community over 120 years in the insurance industry and over 60 years offering quality group medical insurance products.

Provider Network Options:

TCN contracts with The Principal through other preferred provider networks. This carrier uses multiple preferred provider networks based on the wishes of the employer. Please refer to the member identification card, which will state to which address the claim should be sent.

Contacts:

Jim Dowrick, Vice President
Group Benefits
Three Radnor Corporate Center
100 Matsonford Road
Suite 312
Radnor, PA 19087
888.891.7033 or 610.225.0145.

Tyoga CareNet
570.723.0560

STARMARK

Starmark was founded in 1985 with a sole focus on the small employer (2-50 employees). Starmark serves this group with quality health and life benefit products. All Starmark products are fully insured by the Trustmark Insurance Company, a leading mutual company for over 90 years. Starmark provides flexible plans and nationwide networks to serve the small employer group.

Provider Network Options:

TCN contracts with Starmark through other preferred provider networks. This carrier uses multiple preferred provider networks based on the wishes of the employer. Each Tyoga CareNet provider will send claims for covered services as directed by the payor via the member identification card.

Contacts:

Customer service can be reached at: 800.522.1246.

Tyoga CareNet
570.723.0560

TRUSTMARK

Trustmark history dates back to 1913. They began when four enterprising railway workers decided that “passing the hat” no longer adequately provided for an injured or disabled co-worker. They formed a small fraternal organization, offering insurance benefits. Since that pioneering, one-desk beginning, Trustmark has been a company uniquely linked with the people it serves and offering a broad choice of customizable services including health care coverage.

Provider Network Options:

TCN contracts with Trustmark through other preferred provider networks. This carrier uses multiple preferred provider networks based on the wishes of the employer. Each Tyoga CareNet provider will send claims for covered services as directed by the payor via the member identification card.

Contacts:

Tyoga CareNet
570.723.0560

UNITED HEALTHCARE INSURANCE (UHI)

UHI is a fully-insured, indemnity PPO plan with basic in and out of network incentives and a variety of plan options. UHI is particularly attractive in that they typically do not medically underwrite.

UHI is licensed in the states of New York and Pennsylvania; however, UHI has not yet decided to quote rates for employers based in the Tioga County area. We expect them to become an important payor when they do start marketing in the area. Their primary client in the area is Corning, Inc. in Corning, NY.

Provider Network Options:

UHI uses their own provider network. The TCN logo will not appear on the identification card.

Contacts:

Provider Services
800.842.3585
www.uhc.com

Tyoga CareNet
570.723.0560

UNITED WISCONSIN LIFE INSURANCE COMPANY/AMERICAN MEDICAL SECURITIES

United Wisconsin Life Insurance Company is part of American Medical Security (AMS), a company founded on value. The company has grown successfully by sharing that value with individuals and small businesses, marketing health insurance benefit solutions that meet specific needs.

Provider Network Options:

TCN contracts with United Wisconsin through other preferred provider networks. This carrier uses multiple preferred provider networks based on the wishes of the employer. The primary network. options in this area will be InterGroup and Devon. The Tyoga CareNet logo will not appear on the identification card. Each Tyoga CareNet provider will send claims for covered services as directed by the payor via the member identification card.

Contacts:

American Medical Security 
570.420.6877

Tyoga CareNet
570.723.0560

UNIVERSITY OF PITTSBURGH MEDICAL CENTER (UPMC)

UPMC provides a combination of network, indemnity, and HMO products. They have been primarily based in western Pennsylvania; however, they are now seeking statewide coverage.

UPMC has been exceedingly professional and competent in their dealings with TCN and the local providers. We anticipate UPMC will be a significant payor in this market and strongly recommend them to all potential purchasers.

Provider Network Options:

UPMC uses their own provider network. The TCN logo will not appear on the identification card.

Contacts:

Ed Klein
717.571.4180

WARD MANUFACTURING MEDICAL PLAN (WMMP)

Ward Manufacturing provides health benefits for its employees through a self-funded health benefit plan. The plan incorporates basic financial incentives to steer patients to in-network providers. Ward employs approximately 1,000+ employees; about 790 covered under the health plan, which translates into about 2,109 total covered lives.

The Ward Manufacturing Third Party Administrator will be the Loomis Company. Each TCN provider will send claims for covered services to the address listed on the Ward Manufacturing member IDENTIFICATION CARD.

Provider Network Options:

Access to in-network providers is primarily through the PPHN/Tyoga CareNet network. Wrap networks, available as in-network choices, will include PPHN, Devon and Beech Street. There is no referral needed to in-network providers.

Contacts:

The Loomis Company 
PO Box 7011
Wyomissing, PA 19610-6011
866.410.1088

Tyoga CareNet
570.723.0560

For complete plan information please refer to the web page provided for Ward Manufacturing (just click on the Ward logo on the Tyoga CareNet home page).

The following list provides a brief description of vendors that have been contracted with or approved by the Network. For more detailed information, please contact us directly.

AMERICAN BENEFIT SERVICES
John Stratton
570.538.9711

ASSOCIATED PLAN ADMINISTRATORS
Cindy Sonnen 
614.545.1580

BOB OAKES AGENCY
Ken Gardopee
570.258.5618

C & N FINANCIAL SERVICES
Thomas L. Rudy, Jr.
570.724.0286

GALEONE FINANCIAL
Linda Galeone
570.724.2852

INTERGROUP SERVICES 
570.537.9389

JIM COLLINS INSURANCE
Jim Collins 
570.673.3622

NORTH AMERICAN HEALTH PLANS
570.828.6922

RICHAR INSURANCE AND FINANCIAL
Susan Richar
570.435.8128

PAUL WALKER & ASSOCIATES
Paul Walker
610.565.6477

THE LOOMIS COMPANY
Gerry Blaum
866.203.3930

TYOGA CARENET
Ronald J. Butler
570.723.0503

WEYCO, INC.
Harry Dalsey
570.748.0003

WILKINSON DUNN COMPANY
Bob Klein
570.724.3232