ANTHEM BLUE CROSS I - INDEMNITY PLAN
This is a traditional indemnity plan available to eligible, retired LACERA members and their dependents.  An indemnity medical plan is fee-for-service health insurance.  Indemnity plans require an annual deductible amount before you are entitled to coverage by your medical plan.

Features of this plan are:

• You select doctor or hospital of your choice. Annual deductible and copayments for medical services. No annual benefit maximum amounts (except outpatient mental health, acupuncture & diabetes instruction program)
• The Lifetime Benefit Maximum for the LACERA-administered Anthem Blue Cross plans (except Anthem Blue Cross III) is $1 million
  • Any benefits paid under a prior LACERA's Anthem Blue Cross plan will reduce any maximum amounts eligible for the current Anthem Blue Cross plan
  • Contact Anthem Blue Cross for the Lifetime Benefit Maximum information and contact LACERA for a plan change six months before the lifetime Benefits end
• Utilization Review Program
• CVS/Caremark Prescription Drug Program (retail & mail order)
• Coordination with Medicare Quality Centers - medical facilities specializing in specific medical conditions, transplants & surgeries
• The hospital room & board benefits are limited

ANTHEM BLUE CROSS II - INDEMNITY PLAN
This is a traditional indemnity plan available to eligible, retired LACERA members and their dependents.  This plan offers more comprehensive hospitalization benefits than Anthem Blue Cross l.

Features of this plan are:

• You select doctor or hospital of your choice
• Annual deductible and copayments for most medical services
• Utilization Review Program
• CVS/Caremark Prescription Drug Program (retail & mail order)
• Coordination with Medicare
• Quality Centers - medical facilities specializing in specific medical conditions, transplants & surgeries
• Hospital PPO that provides reduced fees to participants admitted as inpatients

ANTHEM BLUE CROSS PRUDENT BUYER INDEMNITY PLAN
This is a traditional indemnity plan for both Medicare-eligible and non-Medicare-eligible retired members.  You will receive a Prudent Buyer Network Directory which lists all participating providers.  If you receive care outside of California your benefits are reduced.

Features of this plan are:

• Prudent Buyer Participating Provider Network - a California based PPO network of physicians and hospitals which offers discounted services to participants
• Annual deductible and copayments
• You decide to use a network provider or non-network provider
• Not necessary to submit claim forms if using network provider 
• WellPoint Next Rx (formerly WellPoint Pharmacy Management)

ANTHEM BLUE CROSS III - MEDICARE SUPPLEMENT PLAN
This is an indemnity plan available to retired members and their dependents

A T T E N T I O N  To maximize your benefit  you should choose a  physician who accepts  assignment of benefits  from Medicare.  If the  provider DOES NOT  accept assignment, you  must pay the difference  between the provider  charges and your plan´s  coverage.

that are enrolled in Medicare Parts A and B.  Medicare does not cover certain prescription drugs, copayments, annual deductibles or coverage outside of the US.  This plan supplements Medicare by paying many of these costs.

Features of this plan are:

• You select doctor or hospital of your choice
• Member premiums for Medicare Part B are reimbursed by the County on a tax-free basis
• No deductibles
• CVS/Caremark Prescription Drug Program (retail & mail order)
• Provides certain emergency benefits for life threatening medical conditions

Need more information?  Call LACERA for enrollment information and benefit changes.  Call the insurance carrier for plan booklets, claim forms, eligibility and billing questions.

5/29/09