MPN Implementation Notice - DOC

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					                          MPN Implementation Notice


Date




Dear Employee,


We are implementing a Medical Provider Network (MPN) through our workers’ compensation insurance
carrier, Berkshire Hathaway Homestate Companies (Oak River Insurance, Redwood Fire and Casualty or
Cypress Insurance). This MPN is called Berkshire Hathaway Homestate Companies MPN.

Unless you pre-designate a physician or medical group, your new work injuries arising on or after
2/16/2005 will be treated by providers in the Berkshire Hathaway Homestate Companies MPN.

If you have an existing workers’ compensation injury, you may be required to change to a provider in the
new MPN. Please check with your claims adjuster first.

More information about the MPN can be found on the ‘Covered Employee Notification of Rights Material’
document or by asking us.


Sincerely,



Employer Name




                                                                                                           PS 06-28-11

				
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