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New Participant Portal
You can enroll for the new Participant Portal experience. Click here for instructions on how to access the new Participant Portal.
Register for New Participant PortalRetiree 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.
Anthem Blue Cross Retiree Programs
Participants on Medicare Parts A & B who elect the Anthem Medicare Preferred Plan for Retirees have benefits as described below.
General Features
| Calendar Year Deductible | None |
| Maximum Benefits | Unlimited |
| Annual Co-Payment Maximum | $6,700 |
| Hospital Benefits | No charge |
| Emergency Services Co-payment waived if admitted |
$20 co-payment |
| Urgently Needed Services Medically Necessary services required outside geographic area service by Primary Medical Group |
$10 co-payment |
| Pre-existing Conditions | All Medically Necessary conditions are covered provided they are a covered benefit. |
Inpatient Hospital Benefits
| Alcohol, Drug or Other Substance Abuse Detoxification | No charge |
| Mental Health Services As required by law, coverage includes treatment for Severe Mental Illness (SMI) of adults and the treatment of Serious Emotional Disturbance (SED) |
No charge |
| Physician Care | No charge |
| Reconstructive Surgery | No charge |
| Rehabilitative Care Including physical, occupational and speech therapy |
No charge |
| Skilled Nursing Facility Up to 100 Consecutive Days from the first treatment per disability |
No charge |
Outpatient Benefits
| Alcohol, Drug or Other Substance Abuse Detoxification | $10 co-payment |
| Ambulance | $50 per trip |
| Durable Medical Equipment | 5% co-payment |
| Mental Health Services As required by law, coverage includes treatment for Severe Mental Illness of adults and the treatment of Serious Emotional Disturbance |
$10 co-payment |
| Outpatient Medical Rehabilitation Therapy at a Participating Free-Standing or Outpatient Surgery Facility | $10 co-payment |
| Outpatient Surgery at a Participating Free-Standing or Outpatient Surgery Facility | No charge |
| Periodic Health Evaluations Physician, laboratory, radiology and related services as recommended by the American Academy of Pediatrics, Advisory Committee on Immunization Practices and U.S. Preventive Services Task Force and authorized through the patient's primary care physician |
No charge |
| Well-Woman Care Office Visit Includes PAP smear by PCP or an OB/GYN in Primary Medical Group and a referral by the Primary Medical Group for screening mammography as recommended by the U.S. Preventive Services Task Force |
No charge |
Prescription Drugs
Participants who elect UnitedHealthcare® Group Medicare Advantage receive their prescription drug benefit through UnitedHealthcare® Group Medicare Advantage Prescription Drug Program.
| Retail Pharmacy: Generic Drugs | $5 co-payment Up to a 30-day supply |
| Retail Pharmacy: Brand Retail Drugs | $15 co-payment Up to a 30-day supply |
| Mail Order: Generic Drugs | $10 co-payment Up to a 30-day supply |
| Mail Order: Brand Name Drugs | $30 co-payment Up to a 30-day supply |
2024 Self-Pay Rates
| Plan | Early Retiree | Medicare Eligible | One Early Retiree & One Medicare |
| UnitedHealthcare HMO–Traditional | |||
| Retiree Only | $187 | Not Applicable | Not Applicable |
| Retiree and Spouse | $391 | ||
| Anthem Medicare Preferred PPO | |||
| Retiree Only | Not Applicable | $85 | Not Applicable |
| Retiree and Spouse | $170 | ||
| Retiree & Spouse | Not Applicable | Not Applicable | $271 |
| UnitedHealthcare HMO–Harmony | |||
| Retiree Only | $128 | Not Applicable | Not Applicable |
| Retiree and Spouse | $269 | ||
| Anthem Medicare Preferred PPO | |||
| Retiree Only | Not Applicable | $85 | Not Applicable |
| Retiree and Spouse | $170 | ||
| Retiree & Spouse | Not Applicable | Not Applicable | $213 |
Additional Information
| Member Customer Service Number | (800) 457-8506 | (833) 848-8730 |
| Website | www.uhcretiree.com | www.anthem.com/ca |