Getting started with COHO's health plan

Important information for COHO Members

Effective January 1, 2013, Samaritan Health Plan Operations will no longer be the administrator of the COHO managed health care plan for Chinook Winds Casino employees and their families, and members of the CTSI in Oregon.

Samaritan Health Plan Operations will handle claims payment for dates of service through December 31, 2012. For questions about benefits or claims for services with dates prior to January 1, 2013, please contact our Customer Services.

For 2013 plan or enrollment changes, please contact your Human Resources department. For 2013 plan or benefit questions, please contact your new plan:

Medical: Healthcare Management Administrators Group 020326 P.O. Box 85016 Bellevue, WA 98015	Dental: Guardian Group Dental Claims Group 481822 P.O. Box 2459 Spokane, WA 99210-2459

Your benefits

Your member materials are important documents that describe your health insurance benefits in detail. Your member materials include:
2011 COHO Summary Plan Description-Medical
2011 COHO Medical Plan Summary of Benefits
2011 COHO Summary Plan Description-Dental
2011 COHO Dental Plan Summary of Benefits
Privacy Notice

Your 2012 benefits & Plan changes

Your member materials are important documents that describe your health insurance benefits in detail. Your 2012 benefits and plan changes documents are now available below:
2012 COHO-Confederated Tribes of Siletz Indians (CTSI) benefits changes memo: This document provides a list of changes to your premiums (Medical, Pharmacy and Vision coverage) and benefits, effective Jan. 1, 2012.
2012 COHO- Chinook Winds Casino Resort (CWCR) benefits changes memo: This document provides a list of changes to your premiums (Medical, Pharmacy and vision coverage) and benefits, effective Jan. 1, 2012.
2012 COHO Medical Summary Of Benefits
2012 COHO Dental Summary Of Benefits
2012 COHO Summary Plan Description-(Medical-Pharmacy and Vision):
2012 COHO Summary Plan Description-Dental:

P R I O R A U T H O R I Z A T I O N
Coverage of certain medical services and surgical procedures requires COHO Benefit of CTSI's written authorization before the services are performed.
2011 Prior Authorization List
2012 Prior Authorization List

Your pharmacies and covered drugs

Prescription drugs can be obtained from a pharmacy in the HealthTrans Pharmaceutical Network or any other licensed pharmacy. Plan members who are enrolled in any federally recognized Indian tribe may be able to obtain services from the Siletz Community Health Clinic Pharmacy. For more information or questions regarding this benefit please visit HealthTrans website: www.healthtrans.com or call HealthTrans' member services department at 1-800-950-9120.

Vision Benefits

Vision Benefits are provided through VSP. For more information or questions regarding this benefit please visit VSP's website: www.vsp.com or call VSP's member services department at 1-800-877-7195.

Your network providers

COHO Benefits of CTSI has an extensive provider network for your needs. Please note that provider information may change at any time. We recommend that you confirm your provider's network status and level of coverage PRIOR TO SEEKING SERVICE.
COHO Provider Directory

Your member forms

Member reimbursement:
Use this form to request reimbursement when you have paid for a covered service. to properly process your claims, COHO Benefit of CTSI needs periodic updates regarding your other health insurance coverage.

Coordination of Benefits Form: To properly process your claims, COHO Benefit of CTSI needs periodic updates regarding your other health insurance coverage.

Authorized Representative Form:
Use this form to confirm permission for COHO Benefits of CTSI Plans to discuss or disclose your protected health information to a particular person who acts as your Authorized Representative.

Member Request For Health Plan Records:
You are required to complete and send this form to the Health Plan at the address indicated when requesting any documentation from Samaritan Health Plan Operations.

COHO Appeal Request Form:
Request a medical appeal with COHO.

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