Montebello Teachers Association Contact Newsletter.

918 West Whittier Blvd Montebello, California 90640
(323) 722-5005 e-mail: montebello_teachers@earthlink.net

Montebello Unified School District

Anthem Blue Cross Insurance Survey 

(Please fill out the survey below)

 
 

Active Members Survey

Current Plan (cost will increase 30%)

Preferred Provider (PPO)                                              Non Preferred

$0 Deductible                                                               $200 deductible (max $600 deductible per family per year)     $10 office visit copay                                                   $10 office visit copay                                    $4,000 max out of pocket cost                                     $4,000 max out of pocket cost      _combined PPO and non PPO                                         combined PPO and non PPO                      100% hospital coinsurance                                           80% hospital coinsurance                             $0 inpatient copay                                                        $250 inpatient copay

Pharmacy: generic ($10), brand name ($20), and brand name non-formulary ($20) - Retail 30 days & mail service 90 days. Member pays copay plus 50% of max allowed & costs in excess of max amount.

Modified Plan (cost will increase 14.4%)

Preferred Provider (PPO)                                              Non Preferred

$200 Deductible                                                           $400 deductible                                                                             $20 office visit copay                                                   $20 office visit copay                                    $2,000 max out of pocket cost                                     $3,000 max out of pocket cost      _combined PPO and non PPO                                         combined PPO and non PPO                      90% hospital coinsurance                                             70% hospital coinsurance                             $0 inpatient copay                                                        $250 inpatient copay                                    $75 emergency room copay (waived if admitted)                                         $75 emergency room copay (waived if admitted)

Pharmacy: generic ($15), brand name ($25), and brand name non-formulary ($30) - Retail 30 days & mail service 90 days. Member pays copay plus 50% of max allowed & costs in excess of max amount.