Operating Engineers Health & Welfare Fund

Blue Cross

IMPORTANT NOTICE

 

 

TO:                  ALL CALIFORNIA RESIDENTS

 

SUBJECT:       NEW CONTRACT PROVIDER NETWORK IN CALIFORNIA

 

Effective April 1, 2008, Blue Cross of California will begin doing business as Anthem Blue Cross.

Effective April 1, 2005 the Fund will no longer contract with Affiliated Health Funds (AHF) in CaliforniaThe new Preferred Provider Organization (PPO) for California residents will be the Blue Cross Prudent Buyer Plan.

Your freedom of choice is retained with this arrangement.  You may continue to select the doctors and hospitals of your choice.  However, choosing doctors and hospitals from the Blue Cross Prudent Buyer participating network will result in less out-of-pocket expense to you. 

The Trustees have incentives in the plans to encourage participants to use contract providers. These are the same incentives that were in effect when AHF was the contracted network - your deductibles and co-payments will remain the same. Please refer to your Benefit Booklet for more information.

If you live in Nevada, you should continue to use AHF providers where available.

If you live outside California but come to California for health care, you should continue to use providers in the AHF network.

If the Health & Welfare Fund provides the secondary benefits for you because of Medicare or other group insurance coverage, Blue Cross benefits will not be available.  Your claims will be paid in accordance with Plan rules relating to coordination of benefits.

The Blue Cross program is not a mandatory program and you are not prohibited from using the services provided by any physician or hospital.  You still have the freedom of choice.  You do not need to enroll or sign any application.  You may use a Blue Cross provider at any time.

Should you need to find the most current contracting provider information, please visit Blue Cross’ website at www.anthem.com/ca or you can contact the Fund Office for a directory.

 If you should have any questions, please contact the Fund Office.