Pension and Health Plans' News
May 2013
Our Office is Moving
This summer, we will be moving.
Our new address will be:
DGA–Producer Pension and Health Plans
5055 Wilshire Blvd, 6th Floor
Los Angeles, CA 90036
Our office hours will be:
Monday to Friday
8:30am to 5:00pm Pacific Time
The move is tentatively scheduled for Friday, June 21.
Why are we moving?
The move will result in reduced occupancy costs and allow us to consolidate our entire operation from the current four-floor configuration onto a single floor. This new space will enable us to focus on our core business of providing pension and health benefits and to increase efficiency, which will, in turn, help us in our primary mission: serving our participants.
The new location is centrally located near the corner of Wilshire and Highland. Free parking will still be provided to all participants who meet with representatives at our office.
How will the move affect mail you send us?
After the move, any mail that would have been sent to 8436 West Third Street should be addressed to:
5055 Wilshire Blvd, 6th Floor
Los Angeles, CA 90036
Will this affect the claims submission process?
No. Those addresses have not changed. See here for detailed instructions for submitting health claims.
Will our phone numbers change?
No.
As we get closer to the move date, we will provide you with more information both here and in our summer issue of Spotlight on Benefits.
April 2013
Reminder: New Claims Submissions Process
Starting January 1, 2013, a new claims submission process went into effect for all medical claims. This new process includes two important changes.
Claims must now be submitted to your local Anthem Blue Cross office. Claims submitted to the Health Plan office may result in delayed processing. If you have experienced a delay in the processing of a health claim, please make sure the claim was sent to the correct address. For a list of claims addresses by state, please click here.
Additionally, in December every Health Plan participant was issued a new Health Plan ID card. Your new card includes our new medical group number. To prevent delays in processing your claims, please show your new ID card to your providers, to ensure that they include the new medical group number with your claims.
If you have experienced a claims processing delay, please make sure that your claim was submitted to the correct address and included the new medical group number.
Due to our new claims system, our Participant Services Department is experiencing higher than normal call volume. Be assured that we are handling each call as quickly as possible, and we apologize for any delays. If you call us and are unable to hold, follow the prompts to leave a message. A representative will return your call by the next business day.
January 2013
Health Plan Changes Effective January 1
Effective January 1, 2013, the Health Plan expanded its medical deductible to cover mental health and chemical dependency benefits. This move will bring medical and chemical dependency into full parity with medical benefits. As a result of this change, the Plan’s grandfathered status under the Affordable Care Act will end, and it will be required to make several additional changes to bring it into full compliance with the law.
The following briefly summarizes the Health Plan changes effective January 1, 2013:
- Mental Health and Chemical Dependency Benefits. Services for mental health and chemical dependency will count towards your annual medical deductible.
- Adult Dependent Child Coverage. Adult dependent children under age 26 will be eligible for Health Plan coverage regardless of their eligibility for employer-provided coverage.
- Preventive Care/Wellness Services. Preventive Care Services will replace the Plan’s wellness benefit. Preventive care from a network provider under the DGA Choice and DGA Premier Choice plans will be paid at 100%, with no deductible. Click here for a list of covered preventive care services.
- Emergency Services. You will be charged the network co-payment or co-insurance for hospital emergency services regardless of whether provided by a network or non-network hospital.
- Revised Appeal Process. The Health Plan’s appeals process will expand the notice provided to participants upon claim denial, adhere to stricter claim review requirements, and, in certain cases, offer an external review by an independent review organization for denied claims.
- Claims Submission Process for California Participants. Effective January 1, domestic health claims from California participants will be processed by the local Blue Cross office. For more information on submitting claims, click here. For the new CA health claims submission address click here.
For more detailed information on these changes, please refer to the Health Plan Booklet Updates available here.