Converting to an Individual Policy - Contact Anthem Blue Cross Directly

If while covered for benefits under the Indemnity Plan, your eligibility terminates under the Southern California IBEW-NECA Active Health Plan, you may apply for a medical conversion plan. If you are eligible for the conversion plan, it will be an insured plan offered by Anthem Blue Cross of California.

To qualify for an individual conversion plan, you must submit an application directly to Anthem Blue Cross within 31 days of the date your eligibility under the Southern California IBEW-NECA Indemnity Plan ends. If the application is submitted within 31 days, you will not be required to submit health evidence. You will also need to pay the required premium to Anthem Blue Cross when submitting your application.

For information on the individual conversion plan, you can call the 800 number on your Prudent Buyer identification card or write to Anthem Blue Cross directly at the address indicated below. Be certain to identify yourself as a participant under the Southern California IBEW-NECA Active Health Plan.

Anthem Blue Cross of California
21555 Oxnard Street
Woodland Hills, CA  91367

Or Contact Anthem Blue Cross At www.anthem.com/ca

You will not be eligible for an individual medical conversion plan under any of the circumstances indicated below.

1. You are not eligible for a conversion plan if you are eligible for health coverage under another group plan when your coverage ends.
2. You are not eligible for a conversion plan if you are eligible for Medicare coverage when coverage under the agreement ends, whether or not you have actually enrolled in Medicare.
3. You are not eligible for a conversion plan if you are covered under an individual health plan.
4. You are not eligible for a conversion plan if you were not covered for medical benefits under the Plan for three consecutive months immediately prior to termination of your coverage.

Important: The intention of medical conversion coverage is not to replace the coverage you have under this Plan, but to make available to you a specified amount of coverage for medical benefits until you can find a replacement. The medical conversion plan provides lesser benefits than this Plan and the provisions and rates differ.