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Retiree Health Plan Benefit Tabs™

This is a summary of benefits and not a substitute for the Southern California IBEW-NECA Retiree Health Plan Summary Plan Description, and to the extent it differs from the SPD, the terms of the SPD will govern.

Overview
 

The Out of Area Retiree Plan is an alternative arrangement designed to offer coverage for those retirees who do not live in the HMO service areas that cover the Southern California IBEW-NECA Health Trust Fund.

Early Retirees and Medicare Eligible Retirees and their eligible spouses who reside outside of the HMO Service Areas may elect to be covered under this arrangement.

The Out of Area Retiree Plan provides the same level of benefit to retirees who live outside of the Plan's HMO Service Areas as received by those retirees who reside in the Plan's HMO Service Areas. A summary of the benefits to be provided to the Early Retirees and Medicare Retirees under the Out of Area Retiree Plan is provided below.

Self-Pay Rates - 2024
(1/1/24-12/31/24)

Note: Effective January 1, 2024, the Medicare eligible retirees option is through Anthem Medicare Preferred PPO
 
Out of Area Retiree Plan Early Retiree Medicare Eligible One Early Retiree & One Medicare
UnitedHealthcare
(California/Out of Area)
Retiree Only
Retiree and Spouse


$353
$740


$85
$170


N/A
$438
UnitedHealthcare
(Out of State)
Retiree Only
Retiree and Spouse


$627
$1,372


$85
$170


N/A
$711
Additional Information
 
Member Customer Service Number (800) 457-8506
Website www.uhcretiree.com
Evidence of Coverage (EOC)  
Medicare Eligible UnitedHealthcare Group Medicare Advantage Out of Area Plan - UnitedHealthcare Medicare Advantage Plan (Group #13601)