Employer Compliance
Contributions determine your client’s Pension and Health benefits. Be proactive; send the PWGA’s Employer Compliance Department a copy of your client’s contract as soon as it is available. That way, we can determine whether the services are reportable and monitor when contributions are due and expected to be remitted. Missing contributions can cause problems for writers, and with your help, we may be able to avoid a problem before it becomes a problem!
A writer needs to be paid before contributions can be made on his/her behalf by the employer. Let us know when your client has been paid for covered services and send us copies of their check stubs, and we can monitor them on your client’s behalf. We can also initiate a bill to the employer should the deadline for payment pass and the contributions become delinquent. By doing this proactively, your client can avoid the complications of delayed health coverage or missing pension contributions.
For more information, please contact Employer Compliance at: (818) 846-1015 ext. 603 or email us at: [email protected]
Eligibility
The PWGA Open Enrollment period is when covered Participants can make dependent changes, COBRA Plan Changes, Extended Coverage Plan Changes and Dental Plan Changes (California residents only).
If your client DOES NOT need to make any changes to dependent coverage, health or dental coverage then no action is required from you!
If you would like to make changes please go directly to OpenEnrollment. Select the appropriate packet (based on your client’s coverage type), and follow instructions
IMPORTANT: You must complete and submit all Open Enrollment forms by December 31, 2017.
For more information, please contact Eligibility at: (818) 846-1015 ext. 605 or email us at: [email protected]
Claims (Participant Services)
Beginning January 1, 2018, there is a significant increase in cost for Participants who elect to use Out-of-Network providers.
The chart below sets forth the change details:
| Out-of-Pocket Maximum | PPO Plan | Low Option Plan | ||
|---|---|---|---|---|
| In-Network Providers | Out of Network Providers | In-Network Providers | Out of Network Providers | |
| Plan Maximum | $1,000/person (coinsurance only) |
$20,000/person (coinsurance only) |
$4,500/person (coinsurance only) |
$20,000/person (coinsurance only) |
| ACA Maximum | ACA $7,350/person $14,700/family/year (includes deductible, coinsurance & copays) |
N/A | ACA $7,350/person $14,700/family/year (includes deductible, coinsurance & copays) |
N/A |
To locate or verify if a doctor you are currently seeing is one of many network providers available through Anthem Blue Cross of California/Blue Card, visit our Find a Participating Provider page and follow the provided links, or look at the back of your medical ID card, and call Anthem at: (800) 810-2583.
For more information, please contact Participant Services at: (818) 846-1015 ext. 602 or email us at: [email protected]