COBRA Rates for Active Healthcare Coverage – Inside Wiremen & 9th District Sound & Communications Participants

Date: September 2011
To: Southern California IBEW-NECA Health Plan Participants
From: Southern California IBEW-NECA Administrative Trust Funds Office
Re: COBRA Rates for Active Healthcare Coverage - Inside Wiremen & 9th District
Sound & Communications Participants Effective October 1, 2011

Effective October 1, 2011, the COBRA continuation of coverage rates in the Active healthcare plan will change. Please refer to the other side of this memo for the new rates. If you are currently participating in COBRA, the new rates will automatically reflect on the October COBRA reminder notice.

The Health Fund offers three COBRA continuation of coverage programs:

• Core coverage includes medical/behavioral health, prescription drug benefits and Member Assistance Program (MAP) only.
• Core Plus coverage includes medical/behavioral health, prescription drug benefits, dental, vision and MAP.
• A Trust Funds Subsidized COBRA program is available to participants that qualify. This program allows you to pay a reduced rate for the first three consecutive months. If you do not qualify for the Trust Funds Subsidized COBRA program, non-subsidized COBRA rates are applicable for the entire COBRA coverage period.

For more information on the COBRA programs, please refer to the COBRA section (pages 18 to 24) of the Southern California IBEW-NECA Health Plan Summary Plan Description and Amendments 15, 16 and 26. You may also view this information on the Funds' website at www.scibew-neca.org.

Rolling 12-Month Open Enrollment
The Plan allows you to change health carriers after enrollment with the same carrier for 12 consecutive months (Active and COBRA participants alike). If you are eligible and interested in changing carriers, please contact the Administrative Trust Funds Office for more information. A carrier change may alter the amount of your COBRA continuation of coverage rate. If you have questions or require additional information on COBRA, please contact the Administrative Trust Funds Office at (323) 221-5861 or toll-free at (800) 824-6935 and ask to speak with a Membership Services Department representative. Our office hours are Monday through Friday from 9 a.m. to 5 p.m.

NON-SUBSIDIZED COBRA RATES (Monthly Rates)

CORE (Medical/Behavioral Health, Prescription Drug, Member Assistance Program)

Carrier	Current Rates through 9/30/11	New Rates 10/1/11-9/30/12
Kaiser Permanente HMO	$976	$1,036
United HealthCare HMO	$933	$1,078
Anthem Blue Cross PPO	$869	$1,061

CORE PLUS
If you choose CORE Plus, dental and vision coverage is also included with the United HealthCare and Anthem Blue Cross plans. For those enrolled in the Kaiser Permanente plan, vision is included in the medical coverage. Life insurance coverage is not included, but an "Individual Conversion Privilege" may be available directly with the Metropolitan Life Insurance Company. The Metropolitan's customer service telephone number is (800) 638-6420.

CORE Plus (Medical/Behavioral Health, Prescription Drug, Vision, Dental, Member Assistance Program)

Dental Carrier	Kaiser Permanente HMO	United HealthCare HMO	Anthem Blue Cross PPO
United Concordia PPO	$1,148	$1,207	$1,189
CIGNA DHMO	$1,090	$1,148	$1,130
Delta Dental DHMO	$1,080	$1,138	$1,121
MetLife DHMO	$1,078	$1,135	$1,118
United Concordia DHMO	$1,084	$1,141	$1,125

TRUST FUND SUBSIDIZED COBRA RATES
(First three consecutive months of COBRA coverage)

CORE: The monthly subsidized rate for CORE (medical and prescription drugs) coverage is $50.00 per month.

CORE Plus (Medical/Behavioral Health, Prescription Drug, Vision, Dental, Member Assistance Program)

Dental Carrier	Kaiser Permanente HMO	United HealthCare HMO & Anthem Blue Cross PPO
United Concordia PPO	$161	$161
CIGNA DHMO	$103	$103
Delta Dental DHMO	$93	$93
MetLife DHMO	$91	$91
United Concordia DHMO	$96	$96