LOS ANGELES POLICE RELIEF ASSOCIATION, INC.

Transcription

1 ITEM BA LOS ANGELES POLICE RELIEF ASSOCIATION, INC. 600 N. GRAND AVENUE, LOS ANGELES. CA (213) (888) FAX (213) December 21,2010 Dean Hansell President Board of Fire and Police Pension Commissioners 360 East Second Street, Suite 400 Los Angeles, CA Re: Out-of-State Members in HMO Dental Plans Dear Mr. Hansell: This letter is in response to your correspondence dated November 18, Since this was previously discussed by your Board and appeared as an item on your Benefits Committee's agenda, we would appreciate a copy of this response being shared with your full Board. The decision of our Board to change dental vendors, from Cigna to Anthem Blue Cross, was made after significant evaluation of products, pricing, network access and a comprehensive assessment of total member needs. Our Board's decision, which was conveyed to LAFPP staff in advance of our open enrollment beginning May 1 st, resulted in considerable improvement in benefits for retirees, nationwide access to dental providers and, for many, reduced out-of-pocket costs. Our new dental products were sowell received by retirees that I thought you and your Board may be interested in the following statistics: 1. Retiree enrollment in a LAPRA-sponsored dental plan increased from 2,719 members to 3,836 members, an increase of 1/117 retirees or 29.1% retirees, residing in Texas and Mississippi, now have access to PPO dental providers (not I previously available under Cigna) and, consequently, higher benefits. 3. Over 750 retirees experienced a reduction in monthly premium rates. 4. 3,463 retirees experienced the following significant benefit improvements (highlighted in yellow):

2 Dean Hansell December 21,2010 Page Two Individual Family DEDUCTIBLE WAIVED FOR Class I: PREVENTIVE/DIAGNOSTIC None $25 $25 $25 None $50 $75 $75 N/A dass 1 Class I No PPO Non-PPO PPO Non-PPO Cleaning * of Cleaning per Year Exams X-rays Sealants I Class II: BASIC SERVICES PPO Non-PPO PPO Non-PPO Extractions 9 7 Fillings 9 7 Root Canal 9 7 Oral Surgery 9 7 Class III: MAJOR SERVICES PPO Non-PPO PPO Non-PPO Crowns 4 Bridges 4 Dentures 4 Lifetime maximum $1,750 $1,000 Your letter infers that we did not take into consideration the fact that the Anthem Blue Cross HMO plan was not available to retirees residing outside of California. While we made every effort to accori1modate 10 of the retirees, we had to accept that the 1% of our retirees enrolled in the Cigna HMO, residing outside of California, would no longer have a dental HMO plan available to them. In light of this, we embarked on a strategic communication effort aimed at educating our retirees, a copy of which is attached to this letter. In addition, we sent a personalized statement to every retiree covered by our plans.

3 Dean Hansell December 21,2010 Page Three The decisions made by our Board were done so after thoughtful deliberations regarding the best interest of our overall membership. We appreciate the opportunity to provide you and your Board with this additional insight and invite any questions you may have. Sincerely, Kevin McCarthy President

4 LOS ANGELES POLICE RELIEF ASSOCIATION, INC. Retired Members

5 Breaking News: Plan Changes and Highlights Beginning July 1, 2010 Each year, we review our plans to ensure that they continue to keep pace with the needs of our retirees in ways that are cost effective and market competitive. Below are plan changes and highlights effective July 1, 2010: Anthem Blue Cross PPO Dental Plan A new Anthem Blue Cross PPO Dental Plan featuring a $2,000 calendar year maximum, $1,750 orthodontia lifetime maximum and three cleanings per year will replace the CIGNA PPO Dental Plan. Other new plan features include no deductible when you use PPO network providers, no deductible for Preventive services (network or non-network), and greater coverage for Basic and Major services. See page 4 for a side-by-side comparison of the new Anthem Blue Cross PPO Dental Plan, current CIGNA PPO Dental Plan and current League Delta Dental Plan. Monthly premium rates for the new PPO Dental Plan are $57.00 for single, $87.00 for 2-party, and $97.00 for family coverage, Refer to page 11 to determine your actual out-of-pocket premium cost, which varies depending on your subsidy eligibility. Anthem Blue Cross: Your One-Stop Shop for Service When you enroll in medical and dental coverage through Anthem Blue Cross, you receive one 10 card and access one web site to find medical and dental network providers, check the status of claims, and get detailed coverage and plan information. Count on Anthem Blue Cross as your convenient, one-stop shop for all medical and dental information and resources. Anthem Blue Cross HMO Dental Plan Anew Anthem Blue Cross HMO Dental Plan available only in California will replace the CIGNA HMO Dental Plan, Refer to the schedule of benefits on page 5 for plan details, Monthly premium rates for the new HMO Dental Plan will remain the same ($24,94 for single, $50,27 for 2-party, and $75.62 for family coverage). Refer to page 11 to determine your actual out-of-pocket premium cost, which varies depending on your subsidy eligibility. Anthem Blue Cross Prudent Buyer PPO Medical Plan The deductible will decrease from $400 per personi $800 per family to $250 per person/$500 per family. All retirees (in-california and out-of-california) enrolled in the Anthem Blue Cross PPO will now have access to the same nationwide network. The Fee-for-Service Plan and the Blue Card Plan will be replaced by the nationwide Blue Cross PPO Plan. A $25 co-pay will apply to the in-network benefit for routine physicals, (There is no out-of-network benefit for routine physicals.) The annual out-of-pocket maximum will go from $1,500 (PPO and non-ppo combined) to $1,500 PPO and $1,500 non-ppo. A $250 penalty will apply if you fail to obtain pre-authorization for certain medical services, Acupuncture benefits will have a limit of $30 per visit and 24 visits per year. Anthem Blue Cross CaliforniaCare Plus HMO Medical Plan The emergency room co-pay will increase from $50 to $75, Kaiser HMO Medical Plan There are no plan changes to the Kaiser HMO Medical Plan. Please note: Coverage limits will be removed from the mental health and chemical dependency benefits under all LAPRA medical plans to comply with new legislation.

6 Is Open Enrollment on Your Radar? Open Enrollment for All Points Benefits runs from May 1 through May 30, This is your annual opportunity to evaluate your medical, dental and vision needs and make coverage and/or dependent changes for the new plan year. Take the time to learn how the plans work so you can make informed decisions. Reviewing this Enrollment Guide will answer many of your questions, as it describes the key features and benefits of our Anthem Blue Cross PPO and HMO medical plans, Kaiser HMO, our new Anthem Blue Cross PPO and HMO dental plans, and the Vision Service Plan (VSP). Monthly contributions for begin on page 11. If you do not wish to make changes to your current medical or dental coverage and you have no changes to dependents, there is no need to re-enroll. Your medical coverage will automatically continue with your current plan selection (Anthem Blue Cross PPO, Anthem Blue Cross HMO or Kaiser HMO). If you are currently enrolled in the Anthem Blue Cross Fee-far-Service Medical Plan or Blue Card Medical Plan, your coverage will automatically transfer over to the Blue Cross PPO Medical Plan. If you are currently enrolled in the CIGNA PPO Dental Plan, your coverage will automatically transfer over to the new Blue Cross PPO Dental Plan. If you are currently enrolled in the CIGNA HMO Dental Plan, your coverage will automatically transfer over to the new Blue Cross HMO Dental Plan. If you are currently enrolled in the CIGNA HMO Dental Plan, and you live outside of California, your coverage will automatically transfer over to the new Blue Cross PPO Dental Plan. To enroll or make changes to your medical or dental coverage, update depe~dent information or ask questions about All Points Benefits, contact a LAPRA Benefits Representative by calling or

7 APB Dental The APB dental plans have a new shine and a new carrier-anthem Blue Cross. The plans cover preventive, basic, and major services, as well as orthodontia. lwo options are available: Anthem Blue Cross PPO Dental Plan Anthem Blue Cross HMO Dental Plan (available only to retirees living in California) Anthem Blue Cross PPO Dental Plan With the PPO Dental Plan you can visit any dentist and receive benefits; however, you will receive the greatest value for your dollar when you use PPO providers. PPO providers have contracted with the plan to provide services at reduced rates, so using these dentists will save you money. Deductibles do not apply with PPO providers. In addition, there is no deductible for non-ppo preventive and diagnostic services. Non-PPO providers are paid the customary and reasonable charge for professional services. This means you could be responsible for any differences between the "customary and reasonable" amount and actual charges, in addition to any deductible and/or coinsurance amounts. Anthem Blue Cross HMO Dental Plan The HMO Dental Plan offers comprehensive coverage designed to fit your family's budget. The Plan is only available in California and all services must be performed by an Anthem Blue Cross HMO Dental provider in order to be covered. Many services are covered at 10, while others require a co-pay. Each family member may choose a different dentist. Deductibles and calendar year maximums do not apply..~ Something to Smile About The new Anthem Blue Cross PPO Dental Plan is designed for individuals and families to promote good oral hygiene and offer convenient, affordable dental coverage. Highlights of the new plan include: No deductible with PPO network providers No deductible for Preventive and Diagnostic services (network and non-network) Greater coverage for Basic and Major services Calendar year maximum of $2,000 per person Lifetime maximum of $1,750 for orthodontia Three cleanings per year covered at 10 Access to dental care at discounted fees Freedom to choose any demust 3

8 LAPRA APB PPO Dental Options Comparison Take a look at how our new Anthem Blue Cross PPO Dental Plan compares to our current ClGNA PPO Dental Plan and the League's current Delta Dental PPO. Benefit Feature Non-PPO PPO Non-PPO Providers Providers Providers PPO Providers Non-PPO Providers Annual Deductible $25 per person $25 per person $75 per family $75 per family (waived for preventive & diagnostic) $25 per person $75 per family $75 per person $225 per family Calendar Year Maximum (excluding Orthodontia) 2,000 per person $1,500 per person $1,500 per person $ per person Preventive & Diagnostic Cleanings ~ Exams X-rays Sealants 10 (2/year) (2/year) (2/year) (2/year) l Basi~ Extractions Fillings Root Canal Oral Surgery Major Crowns & Bridges Dentures / Orthodontia (including adults and children under age 25) Orthodontia Lifetime Maximum Monthly Premium Rates* 1,7-50 per person Single: $ Party: $87.00 Family: $ $1,000 per person Single: 2-Partywithout ortho: 2-party with ortho: Family without ortho: Family with ortho:... $1,500 per person $50.60 Single: $76.00 $79 :65 2-Party: $ $8~.19 Family: $ $ $ * To calculate your cost for coverage, refer to page 11.

9 LAPRA APB HMO Dental Option At-a-Glance The table below shows the benefits under the new Anthem Blue Cross HMO Dental Plan. This Plan is only available in the state of California. Anthem Blue Cross HMO Dental Plan 07/01/10-06/30/11 Benefit Feature Annual Deductible.- HMO Dental Providers Only None I Calendar Year Maximum Preventive & Diagnostic - Cleanings -Exams - X-rays -Sealants Basic - Extractions - Fillings - Root Canal - Ora! Surgery Major - Crowns &Bridges - Dentures Orthodontia (including adults and children under age 25) Note: Services exceeding a 24~month treatment period will require additional co-pays. Monthly Premium Rates* None $10 per tooth $0-$180 per tooth $0-$200 per tooth $100-$200 per tooth $150-$200 per tooth $1,750 co-pay (child) $1,750 co-pay (adult) Single: $ Party: $50.27 Family: $75.62 How to Find an Anthem Blue Cross Dental Provider For the PPO 1. Go to 2. Click on "Find a Doctor," in the middle of the screen 3. Click on "All Dental Products" under "Dental Providers" 4. Select plan "Dental Blue Complete 100/200/300" 5. Select provider type "All Dental Blue" 6. Choose aspecialty if you want to narrow your search further 7. Click on "Next" 8. Enter your address or enter the county information 9. Click on "View Results" For the HMO 1. Go to 2. Click on "Find a Doctor," in the middle of the screen 3, Click on "All Dental Products" under "Dental Providers" 4. Select plan "Dental Net HMO" 5. Select a provider type of Primary Dentist' 6. Click on "Next" 7. Enter your address or enter the county information 8. Click on "View Results" 1 Specialty dentists can be seen as referred by your primary dentist. * To calculate your cost for coverage, refer to page 11. 5