LAPRA 2018 Legally Required Notices

3 Medicare Part D In 2003, the Federal Government voted to expand Medicare coverage to include Pharmacy coverage known as Medicare Part D. This became effective January 1, 2006. If enrolled in a LAPRA medical plan, you and your covered dependents already have pharmacy benefits provided by LAPRA through Anthem Blue Cross and Kaiser that are much better than those available through Medicare Part D. Therefore, the Federal Government has encouraged plans such as ours to continue to provide pharmacy coverage. Notice Regarding Women’s Health & Cancer Rights Act In compliance with the Women’s Health and Cancer Rights Act of 1998, the plans offered under the Los Angeles Police Relief Association, Inc. provide for mastectomy-related services, including reconstruction and surgery to achieve a symmetrical appearance, prostheses and services in connection with physical complications at all stages of mastectomy, including lymphedemas. Benefits for these services will be provided in a manner determined in consultation with the attending physician and the patient. If you have any questions regarding these benefits, please call Anthem Blue Cross PPO at 800-289-2250, Anthem Blue Cross CaliforniaCare Plus HMO at 800-289-2250 or Kaiser HMO at 800-464-4000. Notice Regarding Newborns’ and Mothers’ Health Protection Act This notice is required by the Newborns’ and Mothers’ Health Protection Act of 1996 (NMHPA). Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child not less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending physician, after consulting with the mother, from discharging the mother and her newborn earlier than the 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or issuer for prescribing a length of stay that does not exceed 48 hours (or 96 hours). Notice of Special Enrollment Rights If you decline enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in a plan offered by LAPRA if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 31 days after the other coverage ends or after the employer stops contributing toward the other coverage (60 days if you are requesting enrollment due to loss of eligibility for Medi-Cal or Healthy Families Program coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your eligible dependents. However, you must request enrollment within 31 days of the marriage, birth, adoption, or placement for adoption.