Exhibit 1_2026 COLB Actives Benefit Guide.pdf

City of Long Beach 2026 Active Employee Benefits

2026 ACTIVE EMPLOYEES BENEFIT ELIGIBLE

YOUR LIFE, YOUR BENEFITS

CONTENTS

MEDICARE PART D NOTICE

If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage.

Please see the Important Plan Information section for more details.

GETTING STARTED

BENEFITS OVERVIEW 5

OPEN ENROLLMENT HIGHLIGHTS 6

HOW TO ENROLL AND MAKE CHANGES DURING OPEN

ENROLLMENT

WHO’S ELIGIBLE FOR BENEFITS? 8

YOUR MONTHLY BENEFIT COSTS 9

EMPLOYEE CONTRIBUTION SCENARIOS 10

CHANGING YOUR BENEFITS EXPLAINED 11

BENEFIT ENROLLMENT TIMETABLE 12

HEALTH ADVOCATE CONCIERGE SERVICES 15

MEDICAL, PHARMACY, DENTAL & VISION

ANTHEM MEDICAL PLAN OPTIONS 17

ANTHEM DEDUCTIBLE & COPAY OVERVIEW 18

KNOW WHERE TO GO 19

ANTHEM RESOURCES 20

PREVENTIVE CARE SCREENING BENEFITS 22

EMERGENCIES AND AMBULANCE SERVICES 23

CARRUM HEALTH SURGERY BENEFIT 24

PHARMACY 25

DENTAL PLANS 29

VISION PLANS 33

LIFE & DISABILITY

LIFE & DISABILITY HIGHLIGHTS

VOLUNTARY BENEFITS

HEALTHCARE FSA, DEPENDENT CARE FSA, LONG TERM

CARE INSURANCE, LONG BEACH CITY EMPLOYEES

FEDERAL CREDIT UNION, SCHOLARSHARE, WELLHUB,

AND PET INSURANCE

WELLBEING & BALANCE

ALLIANT MEDICARE SOLUTIONS, EMPLOYEE

ASSISTANCE PROGRAM (EAP), LIFEBALANCE

DISCOUNT PROGRAM, AND MENTAL HEALTH

RESOURCES

RETIREMENT

CALPERS, DEFERRED COMPENSATION PLAN, AND

RETIREMENT PLAN

IMPORTANT PLAN INFORMATION

PLAN CONTACTS AND ANNUAL NOTICES

GETTING

STARTED

Whether you are enrolling in benefits for the first time, nearing retirement, or somewhere in between, the City of Long Beach supports you with benefit programs and resources at every step.

This guide provides an overview of your healthcare coverage, life, disability, retirement benefits, and more.

You will find tips to help you understand your benefits coverage, save time and money on healthcare, and balance your work and home life. Review the coverage for all plans available to choose the benefit package that best aligns with your needs.

2026 BENEFITS

January 1, 2026 through December 31, 2026

IMPORTANT NOTE:

This is a summary overview and does not provide a complete description of all benefit provisions. While we have made every effort to make this overview comprehensive, it cannot provide a complete description of all benefits. Plan documents contain more details on relevant provisions, limitations, and determine how benefits are paid. If the information in this overview differs from the plan documents, the plan documents prevail.

Employment with the City of Long Beach may include the following benefits. Reference page 8 for employee eligibility.

Resources

Benefit Concierge Services

Health Advocate HealthAdvocate.com/

COLB

(866) 799-2691

Employee Assistance Program (EAP)

Health Advocate HealthAdvocate.com/

COLB

(866) 799-2691

Medicare Resource Alliant Medicare

Services AlliantMedicare Solutions.com

(877) 888-0165

Discount Program LifeBalance

COLB.LifeBalance Program.com

(888) 754-5433

Core Benefits

Medical Anthem Blue Cross

Anthem.com/CA/COLB

(844) 653-7399 Policy #: 276800

Dental Delta Dental

DeltaDentalins.com/COLB

Vision

VSP

VSP.com

(800) 877-7195

Policy #: 30069959

HMO

(800) 422-4234 Policy #: 78506

PPO

(800) 765-6003 Policy #: 3712

Pharmacy Benefit CVS Caremark Caremark.com

(855) 559-7919

PPO Surgery Benefit Carrum Health

Info.CarrumHealth.com/COLB

(888) 855-7806

Retirement Pension Plan CalPERS

CalPERS.CA.gov

(888) 225-7377

Supplemental Benefits

Basic Life and AD&D Insurance The Standard

Standard.BenSelect.com/COLB

(800) 628-8600

Policy #: 448651-G

Short-Term Disability The Standard

Standard.BenSelect.com/COLB

(800) 368-2859

Policy #: 448651-E

Long-Term Disability The Standard

Standard.BenSelect.com/COLB

(800) 368-1135

Policy #: 448651-F

Voluntary Benefits

Voluntary Life Insurance The Standard

Standard.BenSelect.com/

COLB

(800) 628-8600 Policy #: 448651-G

Long-Term Care Insurance

UNUM

UnumInfo.com/Cityof

LongBeach

(800) 421-0344

Dependent Care FSA Health Equity

Participant.WageWorks .com

(877) 924-3967

Healthcare FSA Health Equity

Participant.WageWorks .com

(877) 924-3967

Pet Insurance MetLife

Quote.MetLifePet Insurance.com

(866) 937-7387

Gym Access & Wellness Wellhub

Wellhub.com

529 College Savings Plan ScholarShare

ScholarShare.com

(562) 595-4725 ext. 2010

457(b) Plan MissionSquare MissionSq.org/

LongBeach

(202) 759-7122

BENEFITS OVERVIEW

http://www.healthadvocate.com/COLB http://www.healthadvocate.com/COLB http://www.healthadvocate.com/COLB http://www.healthadvocate.com/COLB https://www.alliantmedicaresolutions.com/ https://www.alliantmedicaresolutions.com/ https://colb.lifebalanceprogram.com/ https://colb.lifebalanceprogram.com/ http://www.anthem.com/ca/colb http://www.deltadentalins.com/COLB http://www.vsp.com/ http://www.caremark.com/ https://info.carrumhealth.com/colb/ http://www.calpers.ca.gov/ https://standard.benselect.com/enroll/Login.aspx?Path=colb https://standard.benselect.com/enroll/Login.aspx?Path=colb https://standard.benselect.com/enroll/Login.aspx?Path=colb https://standard.benselect.com/enroll/Login.aspx?Path=colb https://standard.benselect.com/enroll/Login.aspx?Path=colb http://www.unuminfo.com/CityofLongBeach http://www.unuminfo.com/CityofLongBeach http://www.unuminfo.com/CityofLongBeach https://participant.wageworks.com/MemberLogin?ReturnUrl=%2F https://participant.wageworks.com/MemberLogin?ReturnUrl=%2F https://participant.wageworks.com/MemberLogin?ReturnUrl=%2F https://participant.wageworks.com/MemberLogin?ReturnUrl=%2F https://quote.metlifepetinsurance.com/pet?partnerId=999999&cid=qal9w&utm_id=qal9w&utm_source=vanity&utm_medium=vanity&utm_campaign=g_pet_3q21_MetLife&utm_content=v_vanity_petquote&promoid=qal9w https://quote.metlifepetinsurance.com/pet?partnerId=999999&cid=qal9w&utm_id=qal9w&utm_source=vanity&utm_medium=vanity&utm_campaign=g_pet_3q21_MetLife&utm_content=v_vanity_petquote&promoid=qal9w http://www.wellhub.com/ http://www.scholarshare.com/ http://www.missionsq.org/longbeach http://www.missionsq.org/longbeach

OPEN

ENROLLMENT

HIGHLIGHTS

What’s changing in 2026?

New LifeBalance Discount Program

Starting January 1, we are excited to introduce our new discount program, LifeBalance! LifeBalance is no cost to you and your family members and works like an online coupon book, offering discounts at thousands of participating businesses nationwide. Discounts are available at health clubs, fitness studios, online retailers, sporting goods stores, amusement parks, movie theaters, hotels, ski resorts, and more.

New Medicare Solutions Resource

We are also pleased to introduce Alliant Medicare Solutions (AMS). We know that navigating Medicare, retirement, and Social Security decisions can feel overwhelming, but you do not have to do it alone. AMS is a no-cost resource available to you, your family, and friends. Experienced, licensed insurance agents can help you understand Medicare, explore enrollment options, coordinate benefits, and prepare for retirement.

Voluntary Life Insurance Guaranteed Issue Opportunity

During this year’s Open Enrollment, you have the opportunity to increase your voluntary life insurance coverage up to the newly increased guaranteed issue (GI) amount without providing evidence of insurability. The updated GI limit for employees is the lesser of three times your annual earnings or $350,000, and the spouse GI limit is $50,000. If you’ve been considering additional coverage for yourself or your family, now is a great time to review your options.

Increased Fertility Coverage Under Anthem HMO

As a result of California’s recently passed Senate Bill 729, members enrolled in the Anthem HMO plan will have expanded coverage for fertility treatments, including in vitro fertilization (IVF), effective January 1, 2026. We encourage you to review your plan documents for full details on these updates.

IRS Flexible Spending Account Limit Increase

The IRS has increased the Healthcare FSA contribution limit for 2026. You can now contribute up to $3,300 to your Healthcare FSA.

HOW TO ENROLL &

MAKE CHANGES

DURING OPEN

ENROLLMENT

DO I NEED TO COMPLETE OPEN

ENROLLMENT?

This is a passive Open Enrollment, so no action is required if you want to keep your current benefits for the 2026 plan year.

Please note Flexible Spending Accounts require re-enrollment each year. If you would like to re-enroll or enroll for the first time in a Healthcare or Dependent Care FSA, you must complete Open Enrollment on LifeViewHR.

LBNet

During Open Enrollment, you can enroll, waive, and/or make changes to your medical, dental, vision, and flexible spending account benefits on LifeViewHR. Changes to benefits not available on LifeViewHR must be made directly through the benefit provider.

LifeViewHR Website LifeViewHR is available on the City of Long Beach Intranet website at LBNet. LifeViewHR can only be accessed from a City issued computer. If you do not have access to a City issued computer, your Department Personnel/Payroll staff can provide a Benefits Selection Form and Open Enrollment Form.

Before you enroll

▪ Know the date of birth, social security number, and address for each dependent you will cover.

▪ Review your enrollment materials to understand your benefit options and costs for the coming year.

Getting started

1. When you are ready to make benefit changes, log into LifeViewHR using your Social Security Number (SSN) and password that you created. If you have forgotten your password, call the TI Helpdesk at (562) 570-6100.

2. If this is your first time logging into LifeViewHR, you will log in by typing your SSN into the Username field and “LVHR” (all capital letters) in the password field. From there, you will be prompted to change your password.

3. Once you have logged in, click on the Open Enrollment tab at the top of the page to make your selections. Look on the right-hand side of the screen for the link to LifeViewHR OE Instructions document.

4. Review your personal information and benefits selections.

Make changes as needed.

5. To add or delete dependent(s) during Open Enrollment, click on the link in the LifeViewHR Open Enrollment Page to download the Open Enrollment Form. Submit the completed form and any required documentation to your Department Personnel/Payroll staff for processing.

6. If re-enrolling in flexible spending accounts, enter the amount in the appropriate field corresponding to either healthcare and/or dependent care.

7. Once selections have been entered and verified, click “Submit” for your selections to be saved.

http://lbnet/

WHO’S ELIGIBLE FOR BENEFITS?

calgenrollintake@anthem.com

Eligible Dependents

▪ Your spouse – The person who you are legally married to under state law, including a same-sex spouse.

▪ Your registered domestic partner – The person (same or opposite sex, must be age 18 or over) who you have registered as a domestic partner with the California Secretary of State.

▪ Any premiums for your domestic partner paid for by the City of Long Beach are taxable income and will be included on your W-2. Any premiums you pay for your domestic partner will be deducted on an after-tax basis.

▪ Your child(ren) – Includes natural children, step-children, domestic partner’s children, adopted children, children fostered under legal custody, and/or children covered under legal guardianship that are:

▪ Under age 26. They do not have to live with you or be enrolled in school. They can be married and/or living and working on their own.

▪ Over age 26 ONLY if they are incapacitated due to a disability and primarily dependent on you for support. See below regarding Disabled Dependents for additional information.

▪ Named in a Qualified Medical Child Support Order (QMCSO) as defined by federal law.

▪ Disabled (Child) Dependent – Unlike other dependent children, a disabled dependent child may be eligible for health benefits beyond the age of 26. A disabled child dependent can remain a qualified dependent if the disability is certified by a physician and if it occurred prior to reaching age of 26.

Contact your Department Personnel/Payroll staff for the Disabled Dependent Certification Form. You can find your appropriate PPA contact on page 60.

▪ The Anthem Blue Cross Disabled Dependent Certification process must be completed within 60 days of the disabled dependent reaching the age of 26 and requires completion of the Disabled Dependent Certification Form. Once certified by a physician, the form must be forwarded to calgenrollintake@anthem.com for review and approval, to avoid coverage interruptions. Due to HIPAA, please be advised that the City is not involved in the review and/or approval of Disabled Dependency status.

▪ Pregnant (Child) Dependent – If you have a covered (child) dependent under your health insurance who is pregnant, the covered (child) dependent is responsible for obtaining health coverage for the baby. The City’s plan will only cover prenatal care and delivery for the covered (child) dependent.

▪ Please note that the health plan will not cover the children of your covered dependent (grandchildren) unless you have legal guardianship and/or custody.

Employees

▪ Permanent Full-Time City employees working 80 or more hours per pay period.

▪ Permanent Part-Time (PPT) employees are eligible to enroll in health coverage and flexible spending plan(s) only. In lieu of insurance benefits, employees holding permanent part-time positions shall be paid $2.529 for each hour worked (equivalent to $440 for every 174.0 hours worked). You can enroll in the flexible spending plans(s) whether you opt in or out of health plan enrollment.

mailto:calgenrollintake@anthem.com

VSP VISION PLAN

Single Monthly Payroll Deduction $0

Two-Party Monthly Payroll Deduction $0

Family Monthly Payroll Deduction $0

DeltaCare USA HMO Delta Dental PPO

Single Monthly Payroll Deduction $0 $10.00

Two-Party Monthly Payroll Deduction $0 $13.00

Family Monthly Payroll Deduction $0 $18.00

DENTAL

VISION

YOUR MONTHLY BENEFIT COSTS

In general, you pay for medical, vision, and dental coverage before federal, state and social security taxes are withheld. Please note the monthly premiums are paid a month in advance via bi-weekly check deductions.

In 2026, the City will continue to pay the full cost of coverage for Delta Dental HMO, VSP Vision, Basic Life Insurance and Accidental Death & Dismemberment (AD&D), and Short-Term and Long-Term Disability (STD/LTD)*. While the City pays most of the monthly premiums for Anthem HMO, Anthem PPO, and Delta Dental PPO, there is a shared cost component for employees: your share of the premium cost is listed below.

Voluntary benefits such as enrollment in a Flexible Spending Account(s), voluntary life insurance, long-term care insurance, and other voluntary benefits are paid for entirely by you.

If you experience a type of leave that results in being placed on a non-pay status, meaning there are not enough funds in your bi-weekly checks to capture your premium deductions, you will be responsible to pay for the continuation of insurance with our third-party administrator, Health Equity, until you return to a paid status.

*Some STD/LTD Classes can choose to self-pay premiums or opt-in and pay for Buy-Up.

Anthem HMO Plan Anthem PPO Plan

Single Monthly Payroll Deduction $269.00 $211.00

Two-Party Monthly Payroll Deduction $356.00 $300.00

Family Monthly Payroll Deduction $415.00 $359.00

MEDICAL

EMPLOYEE CONTRIBUTION SCENARIOS

PLAN

COMBINATIONS

Single Monthly Payroll

Deduction

Two-Party Monthly Payroll

Deduction

Family Monthly Payroll

Deduction

Anthem PPO Plan $211.00 $300.00 $359.00

Delta Dental PPO $10.00 $13.00 $18.00

VSP Vision Plan $0.00 $0.00 $0.00

TOTAL $221.00 $313.00 $377.00

Anthem PPO Plan $211.00 $300.00 $359.00

DeltaCare HMO $0.00 $0.00 $0.00

VSP Vision Plan $0.00 $0.00 $0.00

TOTAL $211.00 $300.00 $359.00

Anthem HMO Plan $269.00 $356.00 $415.00

Delta Dental PPO $10.00 $13.00 $18.00

VSP Vision Plan $0.00 $0.00 $0.00

TOTAL $279.00 $369.00 $433.00

Anthem HMO Plan $269.00 $356.00 $415.00

DeltaCare HMO $0.00 $0.00 $0.00

VSP Vision Plan $0.00 $0.00 $0.00

TOTAL $269.00 $356.00 $415.00

The below tables outline how much would be deducted from your paycheck based on plan selection and coverage requested.

CHANGING YOUR BENEFITS EXPLAINED

When can I make changes?

As a NEW HIRE, you have the opportunity to enroll in or waive benefits at the start of your onboarding process by completing the Benefits Selection Form. Based on the requested coverage start date on your form, benefits will start either the first of the month following your start date, or the first of the month following 30 days from your date of hire.

▪ Please note: If a Benefits Selection Form either waiving or enrolling in benefits, is not received within 30 days from date of hire, you will automatically be enrolled in the following plans as Employee Only.

Payroll deductions will apply: Anthem Blue Cross PPO, Delta Dental PPO, and VSP Vision.

As an ACTIVE EMPLOYEE, you can make changes to your benefits during the once-a-year Open Enrollment period or if you experience a mid-year qualifying life event (table below for reference).

How can I make changes?

During onboarding or a mid-year qualifying life event, your primary point of contact to complete a Benefits Selection Form is your Department Personnel/Payroll staff. Make sure to notify your Department Personnel/Payroll staff right away to make changes during the eligible enrollment timeframe.

During Open Enrollment, you can make changes to your benefits selection on LifeViewHR (reference page 7 for more information).

Qualifying Life Events Enrollment Timeframe Documentation

Verification

Birth or adoption of a baby or child

Within 60 days of QLE You may be required to provide proof of one or more of the following:

▪ Marriage Certificate or License

▪ State of California Domestic Partner Affidavit

▪ Birth Certificate

▪ Final decree of divorce

▪ Proof of gain/loss of coverage

▪ Court Documents showing legal responsibility for adopted/foster children

Marriage / Registered Domestic Partnership

Within 60 days of QLE

Gain or Loss of other healthcare coverage

Within 31 days of QLE

Gain or Loss of Medicaid or Children’s Health Insurance Program (CHIP)

Within 60 days of QLE

Divorce Within 31 days of QLE

BENEFIT ENROLLMENT TIMETABLE: CORE AND SUPPLEMENTAL

Benefit New Hire

Enrollment Deadline

New Hire Earliest Effective Date

Qualifying Event Timeframe

Open Enrollment Options

MEDICAL, DENTAL

AND/OR VISION

Eligibility:

• Permanent Full-time employee

• Permanent Part-time employee (Medical

Only)

• Seasonal Part-time employee (ACA eligibility - Medical

Only)

Must enroll or waive benefits within 30 days of employment to avoid default to single party PPO coverage as a late enrollee

• Elective: 1st of the month following date of hire

• Standard: 1st of the month following 30 days of employment

• Late Enrollee: 1st of the month following

30 days of employment

Request to either enroll, add or delete qualifying dependents within 31 days (60 for

Medicaid or CHIP) of the qualifying event date

• Adding a newborn requires retroactive enrollment to the date of birth

Enroll, add, or delete dependents, change health plans, and/or continue current enrollment

• Changes are effective

January 1 of the upcoming calendar year

BASIC LIFE AND

AD&D INSURANCE

(EMPLOYER-PAID)

Eligibility:

• Permanent Full-time employee

Enrollment is automatic for $20K coverage

1st of the month following 30 days of employment

Employee Status

Change (i.e., part-time to full-time status, etc.)

N/A

SHORT-TERM

DISABILITY (STD)

Eligibility:

• Permanent Full-time employee

Enrollment is automatic based on eligibility (see MOU)

1st of the month following 30 days of employment

Employee status change (i.e., non-career to permanent full-time employee) within 31 days of event

N/A

LONG-TERM

DISABILITY (LTD)

Eligibility:

• Permanent Full-time employee

Enrollment is automatic based on eligibility (see MOU)

1st of the month following 30 days of employment

Employee status change (i.e., non-career to permanent full-time employee) within 31 days of event

N/A

BENEFIT ENROLLMENT TIMETABLE: VOLUNTARY

Benefit New Hire

Enrollment Deadline

New Hire Earliest

Effective Date

Qualifying Event Timeframe

Open Enrollment Options

FLEXIBLE SPENDING

ACCOUNTS (FSAs)

Eligibility:

• Permanent Full-time employee

• Permanent Part-time employee

Must enroll or waive enrollment within 30 days of employment

• Elective: 1st of the month following date of hire

• Standard: 1st of the month following 30 days of employment

Request to either enroll, stop, start, or change annual deferral amount based on a qualifying event within

31 days of the qualifying event date

• Qualifying event options based on the plan type (i.e.

Healthcare FSA vs.

Dependent Care FSA)

Must declare re-enrollment during Open

Enrollment to confirm participation in the upcoming calendar year – continuation of enrollment is not automatic

• Enroll and select annual deferral amounts

• Changes are effective

January 1 of the calendar year

VOLUNTARY LIFE

INSURANCE

Eligibility:

• Permanent Full-time employee

Employees can exercise their option to enroll within 30 days of becoming benefits eligible based on The

Standard benefits effective date

1st of the month following 30 days of employment

Request to either enroll, add or delete qualifying dependents within 31 days of the qualifying event date

Employees can enroll, increase or decrease; add dependents

• Changes are effective

January 1 of the calendar year

LONG-TERM CARE

INSURANCE

Eligibility:

• Permanent Full-time employee

Employees can exercise their option to enroll within 31 days of their hire date

1st of the month following 31 days of employment

Employee status change (i.e., non-career to permanent full-time employee); marriage

(enrollment extended to spouse only) within

60 days of event

Employees can enroll and/or make changes;

medical questionnaire required

MISSIONSQUARE 457

DEFERRED

COMPENSATION

Eligibility:

• All employees

None; employee’s discretion

1st contribution can be set-up to be deducted from

1st paycheck

N/A – contribution amount can be changed via LifeViewHR per IRS regulations

N/A

SCHOLARSHARE 529

COLLEGE SAVINGS

Eligibility:

• All employees

None; employee’s discretion

1st contribution can be set-up from 1st paycheck

N/A – contributions are paid directly to

ScholarShare

N/A

METLIFE PET

INSURANCE

Eligibility:

• All employees

None; employee’s discretion

1st contribution can be set-up from 1st paycheck

N/A – premiums are paid directly to MetLife

Pet Insurance

N/A

WELLHUB

Eligibility:

• All employees

None; employee’s discretion

1st of the month following 30 days of employment

N/A – premiums are paid directly to Wellhub

BENEFIT ENROLLMENT TIMETABLE: PER MOU

Benefit New Hire

Enrollment Deadline

New Hire Earliest

Effective Date

Qualifying Event Timeframe

Open Enrollment Options

DEFERRED

COMPENSATION 401A

CONTRIBUTION

Eligibility:

• Per MOU

None; enrolled upon becoming eligible per

MOU

Varies based on

MOU

Employee status change (i.e., shift to classification within eligible union)

N/A

EXECUTIVE PHYSICALS

Eligibility:

• Per MOU

None; enrolled upon becoming eligible per

MOU

Varies based on

MOU

Employee status change (i.e., shift to classification within eligible union)

N/A

STD/LTD Buy-Up

Eligibility:

• Per MOU

None; enrolled upon becoming eligible per

MOU

1st of the month following 30 days of eligibility

Employee status change (i.e., shift to classification within eligible union)

Enroll, waive, or make changes to short-/long-term disability buy-up options (applies to certain groups); medical questionnaire may apply

ADDITIONAL LIFE

INSURANCE

Eligibility:

• Per MOU

None; enrolled upon becoming eligible per

MOU

1st of the month following 30 days of eligibility

Employee status change (i.e., shift to classification within eligible union)

N/A

RETIRED HEALTH

SAVINGS ACCOUNT

(RHS)

Eligibility:

• Sworn Fire and Police

None; enrolled upon retirement from the

City of Long Beach.

Retirement Date from the City of

Long Beach

Employee status change (i.e, change to a

Sworn classification)

HEALTH ADVOCATE

CONCIERGE

SERVICES

Get help from Health Advocate Health Advocate is a service that provides you and your entire family 24/7 access to confidential one-on-one benefit support at no additional cost to you! Health Advocate experts will answer your questions and take on virtually any healthcare issue, so you and your family get the right care at the right time.

Connect to all your benefits through a single toll-free number

▪ Health Advocate can answer questions about your entire benefits package.

▪ If you need to reach a specific benefit provider, Health Advocate can connect you right away.

Support for every medical condition

▪ Explain health conditions, diagnoses, and treatments;

research the latest treatment options.

▪ Arrange expert second opinions, transfer medical records, and coordinate care and services.

Health Advocate takes the hassle out of healthcare

▪ Find the right in-network doctors and make appointments.

▪ Review medical bills to find errors or duplicate charges;

resolve complicated claims and billing issues.

Help you stay on top of your health

▪ Health Advocate will identify and help you schedule any overdue care, tests, or screenings.

▪ Receive confidential reminders at home about getting the ongoing care you need.

Answers@HealthAdvocate.com

HealthAdvocate.com/COLB

CONTACT HEALTH ADVOCATE

Phone

(866) 799-2691

Email

Answers@HealthAdvocate.com

Website

HealthAdvocate.com/COLB

Registration Code

COLBEmployees

Visit the App Store or Google Play Store to download the Health Advocate app!

Click to play video mailto:Answers@HealthAdvocate.com http://healthadvocate.com/COLB https://www.healthadvocate.com/video/HealthAdvocacyAndNavigation.html https://www.healthadvocate.com/video/HA-M-2007022-Advocacy.html

MEDICAL

Medical insurance is a vital component of a comprehensive benefits package. It provides coverage for medical expenses, including doctor visits, hospital stays, and preventative care.

We offer two medical plans through Anthem: the Anthem HMO Plan and the Anthem PPO Plan.

OUR PLANS

ANTHEM HMO PLAN

ANTHEM PPO PLAN

Anthem.com/CA/COLB

CONTACT INFORMATION

Website

Anthem.com/CA/COLB

Phone

(844) 653-7399

App

Sydney Health App

ID Card

Yes

All About Medical Plans

Play the Health Lingo Game!

http://www.anthem.com/ca/colb https://vimeo.com/567584004/0fcc552ff7 https://vimeo.com/609859696/de011cdd18

ANTHEM MEDICAL

PLAN OPTIONS

HMO PLAN

When you enroll in the Anthem Blue Cross HMO plan, you agree to use only Anthem Blue Cross doctors, facilities and medical groups for all of your medical care. You must choose between a Participating Medical Group (PMG) or an Independent Physician Association (IPA), along with a Primary Care Physician (PCP) to manage your care. Anthem Blue Cross HMO covers most services at 100%, with no deductible, as long as you use providers who belong to your PMG/IPA. Office visit copayments are $20, and there are no claim forms. Any care you receive without approval from your PCP is not covered. Emergency room services require a $100 copayment per visit. This copayment is waived if you are admitted to the hospital.

PPO PLAN

The Anthem Blue Cross PPO plan offers you access to a large network of physicians who agree to discount their fees for services. Under this plan, you are not required to select a PCP, and you can access different physicians and specialists at your own discretion. While you may go to any doctor or hospital each time you need care, your copay or coinsurance will be lowest when you go to an in-network PPO provider. As long as you use providers who participate in the network, your care will be covered at the highest benefit level – 90% for most services after your deductible is met.

You also have the option to see an out-of-network PPO provider, but services are then covered at 50% of Usual, Customary, and Reasonable charges (UCR). Higher deductible amounts apply and claim forms are required. Some providers may also require payment in full at the time of service. Out-of-network benefits are paid based on 90th percentile of UCR charges, which means the plan pays charges for non-network providers based on fees charged by 9 out of 10 doctors in their geographic area. This means you could receive a bill for any charges over UCR. If the UCR amount is lower than the actual charge, the provider may take a loss or you, the patient, may be responsible for the difference.

Note: If you use non-network providers, Anthem will mail the reimbursement check to you (not to the non-network provider). It is your responsibility to reimburse non-network providers with the money you receive from Anthem.

ABOUT THE HEALTH CARE

PROVIDER GROUPS

Here are some things to keep in mind as you weigh your medical plan options:

1. Consider the location of your physician. They should be within a reasonable distance (about 30 miles) of your home or office.

2. You must select a PCP if you enroll in the Anthem Blue Cross HMO plan. You may choose different PCPs for yourself and each of your family members, if you wish.

3. The Anthem Blue Cross PPO plan has national networks of physicians and hospitals. Network providers are often available when you travel or if your dependents live in other areas.

4. The Anthem Blue Cross HMO plan covers urgent and emergency services outside your service area when you travel.

ANTHEM DEDUCTIBLE AND COPAY OVERVIEW

ANTHEM HMO PLAN ANTHEM PPO PLAN

In-Network Only In-Network Out-of-Network

Calendar Year Deductible1,2

Individual Family Embedded/Aggregate2

$0 $0

N/A

$150 $300

Embedded

$350 $700

Embedded

Calendar Year Out-of-Pocket Maximum1,3

Individual Family Embedded/Aggregate3

$1,000 $3,000

Embedded

$2,650 $5,300

Embedded

$0 $0

Embedded

Office Visit Primary Care Specialist

$20 copay $20 copay

$20 copay $20 copay

$40 copay then 50%5

Preventive Services No charge No charge 50%5

Chiropractic & Acupuncture $10 copay (up to 30 visits/year)

10%5 (up to 34 visits/year combined with Out-of-Network)

50%5 (up to 34 visits/year in/out combined with In-

Network)

Lab and X-ray $0 copay 10%5 50%5

Urgent Care $20 copay $20 copay $40 copay

Emergency Room (copay waived if admitted)

$100 copay $100 copay $100 copay

Inpatient Hospitalization $0 copay 10%5 $300 copay then 50%

Outpatient Surgery $0 copay 10%5 50%5

Mental Health & Substance Abuse Inpatient Facility Care Inpatient Physician Visits Outpatient Facility Care Outpatient Physician Visits

No charge6

No charge No charge

$20 copay per visit6

10%6

10%4

10% $20 copay per visit

$300 deductible then 50%4, 6

50%4

$300 deductible then 50%4, 6

$40 deductible then 50%4, 6

The chart below outlines deductible and copayment specifications of the Anthem HMO and PPO plans. You pay the copayments ($) outlined below. The coinsurance (%) listed in the PPO plan shows what you pay after the plan’s deductible.

1Deductibles and out-of-pocket maximums accumulate on a calendar year from January 1 though December 31.

2 An embedded family deductible means the plan begins to make payments for a member when they reach their individual deductible.

3An embedded family maximum means the plan will cover 100% for an individual member as soon as they reach their individual maximum.

4All covered expenses including your medical deductibles and prescription copays accumulate towards the out-of-pocket maximum.

5After deductible.

6Inpatient subject to utilization review; waived for emergency admissions; Outpatient Behavioral Health treatment for Autism or Pervasive Development disorders require pre-service review

KNOW WHERE TO GO

LiveHealthOnline.com

Anthem.com/CA

Anthem.com/CA

Anthem.com/CA

Anthem 24/7 NurseLine

Quick answers from a trained nurse

800-337-4770

▪ Identifying symptoms

▪ Decide if immediate care is needed

▪ Home treatment options and advice

24/7 $0

CVS

MinuteClinic

(Anthem PPO only)

Walk-in medical clinics with nurse practitioners and physician assistants who specialize in family health care

Visit a CVS

MinuteClinic

▪ Treat more than 125 minor illnesses & injuries

▪ Vaccines, physicals, screenings

▪ Write prescriptions, when medically appropriate

▪ Treat adults and children 18 months and older

Office

Hours

$0

LiveHealth Online

Many non-emergency health conditions

LiveHealthOnline.com

▪ Cold, flu, allergies

▪ Headache, migraine

▪ Skin conditions, rashes

▪ Minor injuries

▪ Mental health concerns

24/7 $0

Office visit Routine medical care and overall health management

Anthem.com/CA

▪ Preventive care

▪ Illnesses, injuries

▪ Managing existing conditions

Office

Hours

$20 copay*

Urgent care Non-life-threatening conditions requiring prompt attention

Anthem.com/CA

▪ Stitches

▪ Sprains

▪ Animal bites

▪ Ear-nose-throat infections

Office

Hours, or up to 24/7

$20 copay*

Emergency room

Life-threatening conditions requiring immediate medical expertise

Anthem.com/CA

▪ Suspected heart attack or

▪ stroke

▪ Major bone breaks

▪ Excessive bleeding

▪ Severe pain

▪ Difficulty breathing

24/7 $100 copay*

Where you get medical care can have a significant impact on the cost. Here’s a quick guide to help you know where to go, based on your condition, budget, and time.

*Additional costs may apply http://www.livehealthonline.com/ http://www.anthem.com/ca http://www.anthem.com/ca http://www.anthem.com/ca

ANTHEM

RESOURCES

LiveHealth Online

LiveHealth Online is your telemedicine vendor. You can video call with a board-certified doctor using your smartphone, tablet or computer with a webcam. Doctors are available 24/7/365 to assess your condition and, if it’s needed, they can send a prescription to your local pharmacy. Register online at LiveHealthOnline.com and make sure to download the mobile app.

LiveHealth Online also offers language lines to serve those who speak Spanish, Tagalog, Khmer, and more. To access the language line, indicate the preferred language when speaking to your provider. The provider will then connect to the line for language assistance.

Sydney Mobile App

Use Sydney Health to keep track of your health and benefits, all in one place. Access your plan details, member services, virtual care, and wellness resources. You can also set up an account at Anthem.com/CA/Register to access most of the same features from your computer.

The following programs are available through Sydney Health App:

▪ MyHealth Advantage - Anthem reviews medical history, pharmacy claims and doctor visits, and then connects the dots to find ways to help you avoid health problems, stay healthy, or save money. If they find something you could do to improve your health, you’ll get a MyHealth Note.

▪ Building Healthy Families - This program offers personalized, digital support through the Sydney Health mobile app or on Anthem.com/CA. This all-in-one program, at no extra cost to you, can help your family grow strong whether you’re trying to conceive, expecting a child, or in the thick of raising young children.

24/7 Nurse Line

24/7 NurseLine serves as your first line of defense for unexpected health issues. You can call a trained, registered nurse to decide what to do about a fever, give you allergy relief tips, or advise you where to go for care. For help, call 24/7 NurseLine at (888) 249-3820.

FINDING AN ANTHEM PROVIDER

To find a provider in your plan network, please visit Anthem.com/CA/Find-Care.

https://livehealthonline.com/ https://livehealthonline.com/ https://livehealthonline.com/ https://www.anthem.com/ca/register/ https://www.anthem.com/ca/register/ https://www.anthem.com/ca/register/ https://anthem.com/ca https://anthem.com/ca https://anthem.com/ca https://www.anthem.com/ca/find-care/ https://www.anthem.com/ca/find-care/

ANTHEM

RESOURCES

CONTINUED

ConditionCare

ConditionCare is a disease management program available to members at no cost. The program provides tools, resources and support with Asthma (pediatric or adult), Chronic obstructive pulmonary disease (COPD), Coronary artery disease, Diabetes, types 1 and 2 (pediatric or adult) or Heart failure. For more details and/or to join, call (866) 962-0957.

Rula

Rula makes it easy to find a virtual, in-network therapist who meets all of your needs. Getting started is easy, with four simple steps:

▪ Select Your Therapist – Visit the Rula.com/Anthem and input your therapist preferences so Rula can match you with the right provider.

▪ Complete Registration – Register within 12 hours of selecting your therapist. No changes will be made until after your first appointment (cancel anytime).

▪ Verify Your Benefits – Rula will work with Anthem on the backend and let you know your copay before your appointment.

▪ Confirm Your Appointment Time – You will receive a confirmation notice 1-2 days before your appointment along with a video call link.

FINDING AN ANTHEM PROVIDER

To find a provider in your plan network, please visit Anthem.com/CA/Find-Care.

https://www.rula.com/anthem/ https://www.rula.com/anthem/ https://www.rula.com/anthem/ https://www.anthem.com/ca/find-care/

You take your car in for maintenance.

Why not do the same for yourself?

Annual preventive checkups can help you and your doctor identify your baseline level of health and detect issues before they become serious.

What is Preventive Care?

The Affordable Care Act (ACA) requires health insurers to cover a set of preventive services at no cost to you, even if you haven not met your yearly deductible. The preventive care services you’ll need to stay healthy vary by age, sex, and medical history.

Visit CDC.gov/Prevention for recommended guidelines.

Preventive care is covered in full only when obtained from an IN-NETWORK provider.

Not all exams and tests are considered preventive Exams performed by specialists are generally not considered preventive and may not be covered at 100%.

Additionally, certain screenings may be considered diagnostic, not preventive, based on your current medical condition. You may be responsible for paying all or a share of the cost for those services.

If you have a question about whether a service will be covered as preventive care, contact Anthem at (844) 653- 7399.

PREVENTIVE CARE

SCREENING

BENEFITS

TYPICAL SCREENINGS FOR

ADULTS

▪ Blood pressure

▪ Cholesterol

▪ Diabetes

▪ Colorectal cancer screening

▪ Depression

▪ Mammograms

▪ OB/GYN screenings

▪ Prostate cancer screening

▪ Testicular exam https://www.cdc.gov/chronic-disease/prevention/preventive-care.html https://www.cdc.gov/chronic-disease/prevention/preventive-care.html https://www.cdc.gov/chronic-disease/prevention/preventive-care.html

EMERGENCIES AND

AMBULANCE

SERVICES

Emergencies In or out-of-network, our plans help pay for medically necessary emergency and urgent care services. If you go to an in-network facility (hospital or ambulatory surgery center), but later find out that a provider treating you, such as a radiologist, anesthesiologist, or pathologist, does not participate in your plan, the out-of-network provider will be reimbursed directly.

Ambulance Services Anthem covers ambulance services when one or more of these criteria are met and you are transported:

▪ By ground ambulance from your home, or from the scene of an accident or medical emergency, to a hospital.

▪ Between hospitals, including when you are required to move from a hospital that does not contract with the claims administrator to one that does.

▪ Between a hospital and a skilled nursing facility or other approved facility.

▪ By air or water ambulance from the scene of an accident or medical emergency, to a hospital.

Coverage includes medically necessary treatment of an illness or injury by medical professionals from an ambulance service.

Anthem will not cover ambulance services for non-emergency reasons.

Please note that ambulance services do not contract with health care providers, which means that ambulance services are covered at what is usual and customary.

Occasionally, employees may receive a bill from the ground ambulance service provider for remaining costs not covered by insurance. This does not apply to air ambulance services, as employees should never receive a direct bill for those. If a bill is received, it is recommended that employees contact Health Advocate at (866) 799 2691 for assistance and clarification regarding the charges.

For complete information on how ambulance services are covered under our plans, we encourage you to review your Summary Plan Description, located on Anthem.com/CA/COLB.

http://www.anthem.com/ca/colb http://www.anthem.com/ca/colb http://www.anthem.com/ca/colb

CARRUM HEALTH

SURGERY BENEFIT

WHERE CAN I GET MORE INFO?

Phone: (888) 855-7806

Web: Info.CarrumHealth.com/COLB

Mobile App: Search Carrum Health in the App Store or Google Play to download the app!

A surgery benefit that’s hard to believe!

When it comes to surgery or major medical treatment, you need to know you are getting the best care. That is why the City of Long Beach is sponsoring Carrum Health as a benefit to all Anthem PPO members. Carrum makes it easier, more enjoyable, and less expensive to get high-quality healthcare.

Covered surgeries include

▪ Knee

▪ Hip

▪ Elbow

▪ Oncology

▪ Spine

▪ Shoulder

▪ Cardiac (heart)

▪ Bariatric (weight loss)

How it works

▪ Activate your account Answer a few questions about your health history, read profiles of surgeons, and get a detailed estimate of out-of-pocket costs, if any.

▪ Meet your care specialist virtually A dedicated care specialist will reach out to walk you through the process, learn about you and your goals, and answer all of your questions.

▪ Relax as Carrum plans your surgery Your care specialist will gather your medical records, submit forms to your surgeon, and plan travel for you and your loved one, if necessary. You will also meet with your surgeon in person or virtually to ensure surgery is absolutely medically necessary.

▪ Receive world-class care You will be in the best hands on the day of your surgery and walk away feeling stronger and healthier.

▪ Never get a medical bill The Carrum Health benefit covers all of the medical costs related to your procedure, so you will not have any surprise bills.

Shape

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Click to play video https://info.carrumhealth.com/colb/ https://info.carrumhealth.com/colb/ https://info.carrumhealth.com/colb/ https://info.carrumhealth.com/colb/ https://info.carrumhealth.com/colb/ https://youtu.be/98ZUw7ATRhk https://youtu.be/98ZUw7ATRhk

OUR PLANS

CVS CAREMARK HMO PLAN

CVS CAREMARK PPO PLAN

PHARMACY

Prescription drug coverage provides a benefit that is important to your overall health.

The City offers a three-tier prescription drug program through CVS Caremark for employees enrolled in the Anthem Blue Cross HMO and PPO Plan.

Caremark.com

CONTACT INFORMATION

Website

Caremark.com

Phone

(855) 559-7917

App

CVS Caremark Mobile App

ID Card

No http://www.caremark.com/

PRESCRIPTION

DRUG PLAN

HIGHLIGHTS

Diabetes Management (Anthem PPO & HMO Members) Next-Generation Transform Diabetes Care is customized using your data, including medical and pharmacy claims, lab work and other biometric and demographic information to develop a personal plan based on your risk profile. The program identifies the next best health action you can take for the most positive impact on your A1C levels and overall health.

The Diabetic Bundling Program waives the cost of diabetic supplies when you purchase them on the same day as your insulin. Under this program, diabetic supplies such as syringes and needles would be at a $0 member cost share if purchased on the same day as the insulin and if the insulin claim is processed first.

Population Health The City of Long Beach employees are automatically enrolled in the CVS Population Health Program, which is a comprehensive approach to addressing RX and medical gaps.

The program’s goals include:

▪ Continuous review of pharmacy claims, medical claims and lab data for a broader view of member’s physician care plan.

▪ Establish a comprehensive member profile including both Rx and medical gaps.

▪ Identify potential gaps in care for over 100+ conditions

▪ Support members in all points of therapy, in accordance with their physician care plan.

MinuteClinic (Anthem PPO Members) MinuteClinic walk-in medical clinics are staffed by nurse practitioners and physician assistants who specialize in family health care. They care for children and adults, every day with no appointment needed, at $0 copay for Anthem PPO members and their eligible dependents!

While life happens, they can help you feel better.

MinuteClinic practitioners can:

▪ Treat more than 125 minor illnesses & injuries.

▪ Provide vaccines, physicals, screenings & more.

▪ Write prescriptions, when medically appropriate.

▪ Treat adults and children 18 months and older.

▪ Share records with your primary care provider, with your permission.

CVS PERKS

▪ Vaccines. Visit any CVS Pharmacy, including CVS Minute Clinic for approved vaccinations. No appointment necessary and no cost to you or your family.

▪ Cash Pay Services. See full list of services and pricing at CVS.com/MinuteClinic/Services/Pri ce-Lists includes physicals, malaria, TB test, Strep throat test, Typhoid, Urine collection, and more.

▪ Target. Members can get their 30-day or 90-day Maintenance Choice refills at any CVS or Target locations.

https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists https://www.cvs.com/minuteclinic/services/price-lists

View your COLB prescription drug benefits, including copay amounts for specific medications, your prescription drug history, and more by registering online at Caremark.com.

PPO members, please note that when you use an out-of-network pharmacy, you must file a claim form with CVS Caremark; benefit amount paid will be reduced.

1You must meet an annual out-of-pocket limit for your plan to cover benefits at 100%.

IMPORTANT: Brand Name vs. Generic If you request a brand-name drug when there is a generic equivalent, you must either purchase the generic drug or pay 100% of the difference between the brand-name price and the generic price, plus the generic copayment. The only exception to this rule is if your doctor writes “Dispense As Written,” or

“DAW,” on your prescription, in which case the brand-name drug will be dispensed at the brand name formulary or brand name non-formulary copay (depending on the drug).

Avoid paying 2x the cost for 30-day supply For prescriptions taken on a long-term basis, members will be allowed to obtain three fills of maintenance drugs at a retail pharmacy. For all subsequent fills of the same prescription, you must use CVS Caremark

Mail Service Pharmacy or a local retail CVS Pharmacy. If you continue to fill your long-term prescription at a retail pharmacy, you will pay 2x the retail copayment and receive a 30-day supply. Please talk to your doctor about obtaining a 90-day prescription in these cases.

HMO Plan PPO Plan

In-Network Only In-Network Out-of-Network

Annual Out-of-Pocket Limit1

Individual Family

$1,000 $3,000

$3,950 $7,900

Unlimited Unlimited

Retail- 30 Day Supply Generic Preferred Brand Non-Preferred Brand

$10 copay $25 copay $40 copay

$10 copay $25 copay $40 copay

Not Covered

Mail Order- 90 Day Supply Generic Preferred Brand Non-Preferred Brand

$10 copay $50 copay $80 copay

$10 copay $50 copay $80 copay

Not Covered

CVS CAREMARK PRESCRIPTION DRUG SUMMARY

http://www.caremark.com/

PRESCRIPTIONS

BREAKING YOUR

BUDGET?

Understanding the formulary can save you money If your doctor prescribes medicine, especially for an ongoing condition, do not forget to check your health plan’s drug formulary. It’s a powerful tool that can help you make informed decisions about your medication options and identify the lowest cost selection.

What is a formulary?

A drug formulary is a list of prescription drugs covered by your medical plan. Most prescription drug formularies separate the medications they cover into four or five drug categories, or “tiers.” These groupings range from least expensive to most expensive cost to you. “Preferred” drugs generally cost you less than “non-preferred” drugs.

Get the most from your coverage To get the most out of your prescription drug coverage, note where your prescriptions fall within your plan’s drug formulary tiers and ask your doctor for advice. Generic drugs are usually the lowest cost option. Generics are required by the Food and Drug Administration (FDA) to perform the same as brand-name drug equivalents.

To find out if a drug is on your plan’s formulary, visit Caremark.com or call the CVS customer service number at

(855) 559-7917.

CVS Caremark App The CVS Caremark app lets you refill mail service prescriptions, track order status, view prescription history and more. If you already use Caremark.com, your existing username and password will also work on the app. If not, you can register directly on the app and use your new username and password on the website.

Features include:

▪ Refill mail service prescriptions without registering or signing in (Easy Refill).

▪ Submit new mail order prescription.

▪ Check order status.

▪ Check drug costs and coverage.

▪ View prescription history.

▪ Find a pharmacy in your network.

▪ Identify unknown pills.

▪ Check potential drug interactions.

THE FORMULARY DRUG TIERS

DETERMINE YOUR COST

$ Generic Drug

$$ Brand Name Drug

$$$ Specialty Drug

Click to play video https://www.caremark.com/ https://www.caremark.com/ https://www.caremark.com/ http://www.caremark.com/ http://www.caremark.com/ https://vimeo.com/611574258/74169baef2

DENTAL

OUR PLANS

DELTA DENTAL DELTACARE USA HMO

DELTA DENTAL PPO

Dental insurance makes it easier and less expensive to get the care you need to maintain good oral health. Dental insurance covers four types of treatments: preventative, basic, major, and orthodontia.

We offer two dental plans through Delta Dental: the Delta Dental HMO and Delta Dental PPO.

DeltaDentalins.com/COLB

CONTACT INFORMATION

Website

DeltaDentalins.com/COLB

Phone

HMO: (800) 422-4234

PPO: (800) 765-6003

App

Delta Dental Mobile App

ID Card

Yes https://www1.deltadentalins.com/group-sites/colb.html

DELTA DENTAL

PLAN OPTIONS

DeltaCare USA HMO Plan

When you enroll, you choose a dentist who belongs to the DeltaCare USA HMO network of providers. DeltaCare USA HMO dentists are in most areas of California. When you use the dentist, you select at the time you enroll, treatments are covered at the stated copay. However, if you use any other dentist, you receive no benefits. Each dependent may choose a different dentist and claim forms are not required. The copay schedule is available on DeltaDentalins.com/COLB.

Delta Dental PPO Plan

The Delta Dental PPO plan allows you to use any dentist of your choice.