City of Long Beach 2026 Retiree Benefits

2026 EARLY & MEDICARE ELIGIBLE RETIREES

YOUR LIFE, YOUR BENEFITS

GETTING STARTED

BENEFITS OVERVIEW 5

OPEN ENROLLMENT HIGHLIGHTS 6

WHO’S ELIGIBLE FOR BENEFITS 7

RETIREMENT RATES 8

CHANGING YOUR BENEFITS 9

PREVENTIVE CARE SCREENING BENEFITS 10

EMERGENCIES AND AMBULANCE SERVICES 11

HEALTH ADVOCATE 24/7 CONCIERGE SERVICE 12

MEDICAL, PHARMACY, DENTAL & VISION

ANTHEM MEDICAL PLAN OPTIONS 14

MEDICAL PLANS - RETIREES UNDER 65

AND NOT ELIGILBE FOR MEDICARE

KNOW WHERE TO GO 17

ANTHEM RESOURCES 18

CARRUM HEALTH SURGERY BENEFIT 20

PHARMACY 21

PRESCRIPTION DRUG PLAN HIGHLIGHTS 22

CVS CAREMARK PRESCRIPTION DRUG SUMMARY 23

PRESCRIPTIONS BREAKING YOUR BUDGET? 24

RETIREES 65+ RETIREES ELIGIBLE FOR MEDICARE

(MUST HAVE PARTS A & B)

MEDICARE COSTS AND HIGHLIGHTS 26

MEDICARE ADVANTAGE PLANS 27

UHC MEMBER RESOURCES 30

SCAN MEMBER RESOURCES 31

ANTHEM BLUE CROSS MEDICARE SUPPLEMENT PLAN 32

DENTAL PLANS 35

VISION PLANS 39

WELLBEING & BALANCE

ALLIANT MEDICARE SOLUTIONS, FITNESS PROGRAMS,

DEFERRED COMPENSATION PLAN, AND LONG TERM

CARE INSURANCE

IMPORTANT PLAN INFORMATION

BENEFIT COSTS, PLAN CONTACTS, ANNUAL NOTICES

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

Throughout your retirement, the City of Long Beach supports you with benefit package and resources to help you thrive today and prepare for tomorrow.

This guide provides an overview of your retirement insurance benefits.

You will find tips to help you understand your benefits, save time and money on healthcare, and balance your retirement. Review the coverage and tools available to you to make the most of your benefits package.

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've 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.

City of Long Beach 2026 Retiree Benefits 5

Participants enrolled in the City’s retiree benefits may have access to the following plans. Reference page 7 for eligibility.

Resources

Benefit Concierge Services Health Advocate

HealthAdvocate.com/

COLB

(866) 799-2691

Medicare Resource Alliant Medicare Services

AlliantMedicare Solutions.com

(877) 888-0165

Core Benefits

Medical Anthem Blue Cross

Anthem.com/CA/COLB

(844) 653-7399 Policy #: 276800

Medical UnitedHealthcare UHCRetiree.com

(877) 714-0178 Policy #: 15647

Medical

SCAN

SCANHealthPlan.com/COLB

(877) 305-7226

Policy #: 119

Dental Delta Dental

DeltaDentalins.com/COLB

Vision

VSP

VSP.com

(800) 877-7195

Policy #: 30069959

Pharmacy Benefit CVS Caremark Caremark.com

(855) 559-7919

HMO

(800) 422-4234 Policy #: 78506

PPO

(800) 765-6003 Policy #: 3712

Other Benefits*

*Some of these benefits are only accessible if you had an account when you were an active City of Long Beach employee.

Long-Term Care Insurance

UNUM

UnumInfo.com/Cityof LongBeach

(800) 421-0344

457(b) Plan MissionSquare MissionSq.org/

LongBeach

(202) 759-7122

Retirement Pension Plan

PARS

PARS.org

(800) 540-6369

Retirement Pension Plan

CalPERS CalPERS.CA.gov

(888) 225-7377

BENEFITS OVERVIEW

http://www.healthadvocate.com/COLB http://www.healthadvocate.com/COLB https://www.alliantmedicaresolutions.com/ https://www.alliantmedicaresolutions.com/ http://www.anthem.com/ca/colb http://www.uhcretiree.com/ http://www.scanhealthplan.com/COLB http://www.deltadentalins.com/COLB http://www.vsp.com/ http://www.caremark.com/ http://www.unuminfo.com/CityofLongBeach http://www.unuminfo.com/CityofLongBeach http://www.unuminfo.com/CityofLongBeach http://www.missionsq.org/longbeach http://www.missionsq.org/longbeach http://www.pars.org/ http://www.calpers.ca.gov/

OPEN

ENROLLMENT

HIGHLIGHTS

What is changing in 2026?

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 don’t 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. Get started by calling 877-888-0165 or review your Benefit Guide for more details.

New Medicare Part D Catastrophic Coverage Limit The Medicare Part D Catastrophic Coverage Limit has increased from $2,000 to $2,100 for 2026. This is applicable to SCAN and UHC members’ coverage.

WHO’S ELIGIBLE FOR BENEFITS?

Retirement@LongBeach.gov

CalgEnrollIntake@Anthem.com

Eligible Dependents

Eligible dependents are those you either enrolled in your plans at the time of retirement or added for the first time during retirement due to a qualifying life event.

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

▪ Your registered domestic partner (same or opposite sex, must be age 18 or over)

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

• 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 HR-Employee Benefits at Retirement@LongBeach.gov or at (562) 570-6303 for the Disabled Dependent Certification Form.

• 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 dependent (grandchildren) unless you have legal guardianship and/or custody.

For additional information, please refer to the plan documents for each benefit.

IMPORTANT NOTE: If you cancel your insurance, you nor your dependents will be able to re-enroll.

Retirees

▪ Early retirees less than age 65, those not eligible for Medicare, and retired from full time employment as well as retirees 65+ and those eligible for Medicare (must have Medicare Parts A & B) and enrolled in City Benefits prior to retirement.

mailto:retirement@longbeach.gov mailto:calgenrollintake@anthem.com

2026 RETIREMENT RATES

PLAN MONTHLY COST

Medical – Anthem Blue Cross PPO

Single Retiree $1,386.98

Retiree with 1 Dependent $1,733.75

Retiree with 2 or More Dependents $1,822.24

Medical – Anthem Blue Cross Medicare Supplement (Must have Medicare Parts A & B)

One Medicare (Single) $958.18

One Medicare & One Anthem PPO Non-Medicare Dependent $1,733.75

One Medicare & Two/More Anthem PPO Non-Medicare Dependents $1,822.24

Two Medicare (Retiree & Spouse) $1,915.89

Two Medicare & One Anthem PPO Non-Medicare Dependent $2,805.79

Two Medicare & Two or More Anthem PPO Non-Medicare Dependents $3,372.35

Medical – Anthem Blue Cross Premier HMO – CA ONLY

Single Retiree $1,109.75

Retiree with 1 Dependent $1,997.57

Retiree with 2 or More Dependents $2,170.50

Medical – Anthem Blue Cross Classic HMO – CA ONLY

Single Retiree $907.84

Retiree with 1 Dependent $1,225.60

Retiree with 2 or More Dependents $1,344.33

Medical – UnitedHealthcare Group Medicare Advantage PPO (Must have Medicare Parts A & B)

One Medicare (Single) $739.49

Two Medicare (Retiree & Spouse) $1,478.98

One Medicare & One Anthem Premier HMO Non-Medicare Dependent $1,849.24

Two Medicare & One Anthem Premier HMO Non-Medicare Dependent $2,588.73

One Medicare & Two Anthem Premier HMO Non-Medicare Dependents $2,737.06

One Medicare & Three/More Anthem Premier HMO Non-Medicare Dependents $2,909.99

One Medicare & One Anthem Classic HMO Non-Medicare Dependent $1,647.33

Two Medicare & One Anthem Classic HMO Non-Medicare Dependent $2,386.82

One Medicare & Two Anthem Classic HMO Non-Medicare Dependents $1,965.09

One Medicare & Three or More Anthem Classic HMO Non-Medicare Dependents $2,083.82

Medical – SCAN Health Plan Medicare Advantage – CA ONLY (Must have Medicare Parts A & B)

One Medicare (Single) $370.75

Two Medicare (Retiree & Spouse) $741.50

One Medicare & One Anthem Premier HMO Non-Medicare Dependent $1,480.50

Two Medicare & One Anthem Premier HMO Non-Medicare Dependent $1,851.25

One Medicare & Two Anthem Premier HMO Non-Medicare Dependents $2,368.32

One Medicare & Three/More Anthem Premier HMO Non-Medicare Dependents $2,541.25

One Medicare & One Anthem Classic HMO Non-Medicare Dependent $1,278.59

Two Medicare & One Anthem Classic HMO Non-Medicare Dependent $1,649.34

One Medicare & Two Anthem Classic HMO Non-Medicare Dependents $1,596.35

One Medicare & Three/More Anthem Classic HMO Non-Medicare Dependents $1,715.08

Dental – Delta Dental of California PPO

Retiree with or without Dependent(s) $105.03

Dental – DeltaCare USA HMO

Retiree with or without Dependent(s) $38.67

Vision – VSP Vision

Retiree with or without Dependent(s) $13.92

Vision – VSP Vision Voluntary 65+ Only

65+ Retiree Only $9.14

65+ Retiree with One Dependent $18.29

65+ Retiree with Two or More Dependents $21.49

Note: Other combinations of health plan enrollments may be available for non-Medicare retirees with Medicare-eligible dependents, or

Medicare-eligible retirees with non-Medicare dependents. Please contact HR-Employee Benefits at Retirement@LongBeach.gov or (562) 570-

6303 for additional information.

mailto:retirement@longbeach.gov

CHANGING YOUR

BENEFITS

When can I enroll?

Coverage for new retirees begins on the 1st of the month following their retirement date. New retirees must advise HR- Employee Benefits of their enrollment selections prior to retirement. If you do not inform HR-Employee Benefits of your selections, you will not receive coverage.

Once enrolled, your benefits will remain unchanged until the next open enrollment period, unless a qualifying life event occurs. Make sure to notify HR-Employee Benefits right away if you have a qualifying life event and need to make a change.

If you cancel enrollment You can cancel at any time with at least a 30-day notice from the 1st of the month by contacting HR-Employee Benefits.

Once you cancel enrollment in one or more of the City’s benefit plans, you cannot re-enroll at a future time. If you cancel your insurance, you nor your dependents will be able to re-enroll.

Contact Information Contact HR-Employee Benefits at Retirement@LongBeach.gov or (562) 570-6303.

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

▪ Court Documents showing legal responsibility for adopted/foster children

▪ Provide Medicare Number and Effective Date

Marriage Within 60 days of QLE

Divorce Within 31 days of QLE

Medicare Within 3 months of your 65th birthday; or Upon becoming Medicare eligible mailto:retirement@longbeach.gov

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 have not met your yearly deductible. The preventive care services you will 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 percent.

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 http://www.cdc.gov/prevention/ http://www.cdc.gov/prevention/ http://www.cdc.gov/prevention/

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, retirees 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 retirees should never receive a direct bill for those. If a bill is received, it is recommended that retirees 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

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 – RETIREES UNDER 65

AND NOT ELIGIBLE FOR MEDICARE

OUR PLANS

ANTHEM CLASSIC HMO PLAN – CA

ONLY

ANTHEM PREMIER HMO PLAN – CA

ONLY

ANTHEM PPO PLAN

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 three medical plans through Anthem: Anthem Classic HMO, Anthem Premium HMO, and Anthem PPO.

Anthem.com/CA/COLB

CONTACT INFORMATION

Website

Anthem.com/CA/COLB

Phone

(844) 653-7399

App

Sydney Health App

ID Card

Yes

ANTHEM MEDICAL

PLAN OPTIONS

HMO Plans – CA Only When you enroll in one of the Anthem Blue Cross HMO plans, you agree to use only Anthem Blue Cross doctors, facilities, and medical groups for all of your medical care. You must choose a Participating Medical Group (PMG) or Independent Physician Association (IPA), and Primary Care Physician (PCP) to manage your care. Anthem Blue Cross 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. Both HMO Plans utilize the Anthem California Care HMO Network. The Premier HMO plan features a lower Out-of-Pocket Maximum and lower copays for chiropractic, acupuncture, and mental health care than the Classic HMO plan.

PPO Plans The 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 one of the Anthem Blue Cross HMO plans. 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 plans cover urgent and emergency services outside your service area when you travel.

ANTHEM DEDUCTIBLE AND COPAY OVERVIEW

ANTHEM CLASSIC HMO PLAN

(CA ONLY)

ANTHEM PREMIER HMO PLAN

(CA ONLY)

In-Network Only In-Network Only

Calendar Year Deductible1,2

Individual Family Embedded/Aggregate2

$0 $0

N/A

$0 $0

N/A

Calendar Year Out-of-Pocket Maximum1,3,4

Individual Family Embedded/Aggregate3

$1,500 $4,500

Embedded

$1,000 $3,000

Embedded

Office Visit Primary Care Specialist

$20 copay $20 copay

$20 copay $20 copay

Preventive Services No charge No charge

Chiropractic & Acupuncture $15 copay (up to 30 visits/year $10 copay (up to 30 visits/year)

Lab and X-ray $0 copay $0 copay

Urgent Care $20 copay $20 copay

Emergency Room (copay waived if admitted)

$100 copay $100 copay

Inpatient Hospitalization $250 copay $0 copay

Outpatient Surgery $0 copay $0 copay

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

$250 copay + 20%5 No charge No charge

$20 copay per visit5

No charge5

No charge No charge

$20 copay per visit5

The chart below outlines the copayment specifications for the Anthem Classic & Anthem Premier HMO plans. You pay the copayment amounts listed below.

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.

5Inpatient subject to utilization review; waived for emergency admissions; Outpatient Behavioral Health treatment for Autism or Pervasive Development disorders require pre-service review

ANTHEM DEDUCTIBLE AND COPAYMENT OVERVIEW CONTINUED

ANTHEM PPO PLAN

In-Network Out-of-Network

Calendar Year Deductible1,2

Individual Family Embedded/Aggregate2

$150 $300

Embedded

$350 $700

Embedded

Calendar Year Out-of-Pocket Maximum1,3,4

Individual Family Embedded/Aggregate3

$2,650 $5,300

Embedded

$0 $0

Embedded

Office Visit Primary Care Specialist

$20 copay $20 copay

$40 copay then 50%5

Preventive Services No charge 50%5

Chiropractic & Acupuncture 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 10%5 50%5

Urgent Care $20 copay $40 copay

Emergency Room (copay waived if admitted)

$100 copay $100 copay

Inpatient Hospitalization 10%5 $300 copay then 50%

Outpatient Surgery 10%5 50%5

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

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 for the Anthem PPO plan. 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 is 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 will 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 are 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 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/

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 won’t have any surprise bills.

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

OUR PLANS

CVS CAREMARK HMO PLAN

CVS CAREMARK PPO PLAN

PHARMACY – RETIREES UNDER 65

AND NOT ELIGIBLE FOR MEDICARE

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 retirees enrolled in the Anthem Blue Cross HMO and PPO Plan.

Pharmacy details for the SCAN and UHC plans can be found on page 29 of this guide.

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

CVS CAREMARK PRESCRIPTION DRUG SUMMARY

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%.

2Combined with medical.

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 Plans (Premier & Classic) PPO Plan

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

Annual Out-of-Pocket Limit1

Individual Family

Premier: $1,0002 / Classic: $1,5002

Premier: $3,0002 / Classic $4,5002

$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

PRESCRIPTIONS

BREAKING YOUR

BUDGET?

Understanding the formulary can save you money If your doctor prescribes medicine, especially for an ongoing condition, don’t 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

MEDICAL – RETIREES 65+ AND

THOSE ELIGIBLE FOR MEDICARE

(MUST HAVE PARTS A & B)

Medicare is health insurance for people aged 65 or older, under age 65 with certain disabilities, and any age with End- Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant).

Medicare has:

▪ Medicare Part A (Hospital Insurance)

▪ Medicare Part B (Medical Insurance)

▪ Medicare Part C (Combines Part A and Part B Coverage)

▪ Medicare Part D (Prescription Drug Coverage)

The City of Long Beach offers you a total of three choices; two Medicare Advantage Plans and one Medicare Supplement Plan. The two Advantage plans offered are the UnitedHealthcare Group Medicare Advantage (PPO) plan and the SCAN Medicare Advantage (HMO) plan. We also offer the Anthem Blue Cross Medicare Supplement plan. Medicare eligible retirees must have Medicare Parts A & B.

Note: Details regarding our plans for Medicare eligible retirees can be found on the following pages. For the most current Medicare rates and information, please visit Medicare.gov.

OUR PLANS

SCAN MEDICARE ADVANTAGE

UNITEDHEALTHCARE MEDICARE

ADVANTAGE PPO

ANTHEM MEDICARE SUPPLEMENT

https://www.medicare.gov/ https://www.medicare.gov/ https://www.medicare.gov/

MEDICARE COSTS

AND HIGHLIGHTS

Medicare Advantage Plans (Part C) are another way to get your Medicare benefits. They combine Part A, Part B, and, sometimes, Part D (prescription drug) coverage. Medicare Advantage Plans are managed by private insurance companies approved by Medicare. These plans must cover medically necessary services.

However, plans can charge different copayments, coinsurance, or deductibles for these services. The City of Long Beach offers two Medicare Advantage Plans, UnitedHealthcare Group Medicare Advantage (PPO) and SCAN Health Plan. To participate in a Medicare Advantage plan you must be enrolled in Original Medicare, Part A & B.

Medicare Part D is a prescription drug option run by Medicare-approved private insurance companies to help cover the cost of prescription drugs. How it works: Each year, the member is required to meet a deductible (not more than $615 in 2026) before their Prescription Drug Plan begins to pay its share of covered drugs (some Medicare drug plans don’t have this deductible). After you reach your full deductible (if your plan has a deductible), you’ll pay 25% of the cost as coinsurance for your generic and brand-name drugs until your out-of-pocket spending on covered Part D drugs reaches $2,100 in 2026 (including your deductible and certain payments made on your behalf, like through the Extra Help program). Then, you’ll automatically get “catastrophic coverage.” You won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.

You will receive enrollment information from Medicare in the months prior to you turning 65. If you are covered by the Anthem Blue Cross Medicare Supplement Plan, you do not have to enroll in Medicare Part D, however you have the option to enroll. You should notify HR-Employee Benefits at (562) 570-6303 or at Retirement@LongBeach.gov to let them know you now have a Medicare Part D plan. Once you have enrolled in a Medicare Part D and wish to change plans, the enrollment period is October 15th through December 7th of each year.

Note: When you enroll in either the SCAN Health Plan or UnitedHealthcare Group Medicare Advantage (PPO), you DO NOT need to enroll in Medicare Part D through Centers for Medicare & Medicaid Services (CMS), as SCAN or UnitedHealthcare will automatically enroll you in Medicare Part D upon completion of the SCAN or UnitedHealthcare Retiree application.

Note Regarding Medicare Part B: For each 12-month period you delay enrollment in Medicare Part B, you will have to pay a 10% Part B premium penalty.

Medicare Part A helps cover inpatient care in hospitals, skilled nursing facilities, hospice, and home health care. You must meet certain conditions to get these benefits. Cost: You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. For 2025, you pay up to $518* each month if you don’t get premium-free Part A. If you pay a late enrollment penalty, this amount is higher.

In most cases, if you choose to buy Part A, you must also purchase Part B and pay monthly premiums for both.

Medicare Part B helps cover doctors’ services, hospital outpatient care, and home health care. Medicare Part B is optional. You must elect to enroll in Part B and pay a monthly premium. Your monthly premium depends on your income. Part B also covers some preventive services. Cost:

Most people pay the standard premium amount ($185.00* each month in 2025).

However, if your modified adjusted gross income as reported on your IRS tax return from two years ago (the most recent tax return information provided to Social Security by the IRS) is above a certain amount, you could pay more. Premium amounts can change each year depending on your income. Your 2025 Medicare Part B premium amounts* are listed below.

File Individual

Tax Return

File Joint

Tax Return

You Pay

Each

Month*

$106,000 or less $212,000 or less $185.00

Above $106,000 up to $133,000

$212,000 -

$266,000 $259.00

Above $133,000 up to $167,000

$266,000 -

$334,000 $370.00

Above $167,000 up to $200,0000

$334,000 -

$400,000 $480.90

Above $200,000 up to $500,000

$400,000 -

$750,000 $591.90

$500,000 or more

$750,000 or more $628.90

*As of release of this guide, 2026 limits and/or amounts have not been announced.

mailto:retirement@longbeach.gov

MEDICARE

ADVANTAGE PLANS

SCAN Health Medicare Advantage (HMO) Plan The SCAN Health Plan Medicare Advantage Plan offers a network of Primary Care Physicians, specialists, and hospitals.

You must use plan providers, except in emergency or urgent care situations or for out-of-area renal dialysis. If you obtain routine care from out-of-network providers neither Medicare nor SCAN Health Plan will be responsible for the costs. Eligible members must use network pharmacies to access their prescription benefit except under non-routine circumstances.

UnitedHealthcare Group Medicare Advantage (PPO) Plan The UnitedHealthcare Group Medicare Advantage (PPO) plan is a Medicare Advantage plan that delivers all the benefits of Original Medicare (Part A & B), includes prescription drugs (Part D), and offers additional benefits and features.

With the Medicare Advantage PPO plan, you are not required to select a Primary Care Provider (PCP) and there is no referral needed to see a specialist. The plan also offers you access to a large network of participating providers who accept Medicare assignments and will submit claims directly to UnitedHealthcare for payment, not Medicare.

LOG IN TO CARRIER WEBSITES

FOR ADDITIONAL INFORMATION

▪ SCAN Members:

SCANHealthPlan.com/COLB

▪ UnitedHealthcare Members:

UHCRetiree.com http://www.scanhealthplan.com/COLB http://www.uhcretiree.com/

SCAN AND UNITEDHEALTHCARE DEDUCTIBLE AND COPAY OVERVIEW

SCAN Health Plan Medical Advantage Plan

UnitedHealthcare Group Medicare Advantage Plan

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

Calendar Year Out-of-Pocket Maximum

$3,400 Unlimited Unlimited

Office Visit Primary Care Specialist

$5 copay $5 copay

No charge No charge

Preventive Services No charge No charge 50%5

Chiropractic $5 copay (up to 20 visits/year) No charge1 No charge1

Acupuncture Not covered No charge1 No charge1

Lab and X-ray No charge No charge No charge

Urgent Care $25 copay No charge No charge

Emergency Room (copay waived if admitted)

$50 copay/visit No charge No charge

Inpatient Hospitalization No charge No charge No charge

Outpatient Surgery No charge No charge No charge

Mental Health & Substance Abuse

Inpatient Outpatient

No charge3

$5 copay/visit No charge3

No charge No charge3

No charge

Routine Dental Benefits

Provided through the DeltaCare network.

$0 copay/exam (1 per year) $0 copay/cleaning (2 cleanings/year) $0 copay dental x-ray (1 x-ray/6 months)

Not Included. Dental benefits are limited to what is covered by Medicare

Not Included. Dental benefits are limited to what is covered by Medicare

Routine Vision Benefits

Provided by EyeMed.

$3 copay/exam (1 per year) $0 copay/glasses or contacts (1 pair/2 years) $100 allowance for frames or $130 allowance for contacts (every 2 years)

No Charge (coverage for Medicare-covered eye exam and routine eye exam refraction only)

No Charge (coverage for Medicare-covered eye exam and routine eye exam refraction only)

Routine Hearing Benefits

$5 copay/routine exam (1 per year) $5 copay/hearing aid fitting evaluation (3 visits within the first year of purchase) $2,000 hearing aid allowance (every 2 years)

$0 copay/exam (1 per yr) $500 routine hearing aid combined device allowance (every 3 yrs)

Not Included

The chart below outlines deductible and copayment specifications of the SCAN and the UnitedHealthcare plans. You pay the copayments ($) outlined below.

1Medicare-covered Chiropractic/Acupuncture Visits only 2 You may have to pay part of the cost for drugs and respite care. Hospice is covered outside of our plan.

3 Limited to a lifetime of 190 days in a Medicare-participating psychiatric hospital

SCAN AND UNITEDHEALTHCARE PRESCRIPTION DRUG COVERAGE

SCAN Health Plan Medicare Advantage Plan

Pharmacy Tier 1: Preferred Generic $7 copay Tier 2: Generic $7 copay Tier 3: Preferred Brand1 $14 copay Tier 4: Non-Preferred Brand $14 copay

Tier 5: Specialty $40 copay

Supply Limit 30 days

Mail Order

Tier 1: Preferred Generic $14 copay

Tier 2: Generic $14 copay

Tier 3: Preferred Brand $28 copay

Tier 4: Non-Preferred Brand $28 copay

Tier 5: Specialty Not Offered

Supply Limit 100 days

UnitedHealthcare

Group Medicare Advantage (PPO) Plan

Pharmacy Tier 1: Generic $10 copay

Tier 2: Preferred Brand $25 copay

Tier 3: Non-Preferred Drugs $40 copay

Tier 4: Specialty $40 copay

Supply Limit 30 days

Mail Order

Tier 1: Generic $20 copay

Tier 2: Preferred Brand $50 copay

Tier 3: Non-Preferred Drugs $80 copay

Tier 4: Specialty $80 copay

Supply Limit 90 days

SCAN members can save on 100-day supply

Get a 3-month supply (100 days) of Tiers 1, 2, 3, and 4 drugs at either a Retail Pharmacy or SCAN Mail-Order Pharmacy and only pay for 2 months. This network offers SCAN members lower copayments for many drugs.

Save on Maintenance Medications

If you take maintenance medications for conditions such as high blood pressure or diabetes, you can save money by purchasing your prescriptions through mail order. For two copays, you receive a 90-day supply rather than a 30-day supply.

If you reach the Catastrophic Phase, then you will pay the following for prescription drugs:

▪ $0 for generics and brand name.

Once you've spent $2,100 out-of-pocket in 2026, you're out of the coverage gap. Once you get out of the coverage gap (Medicare prescription drug coverage), you automatically get "catastrophic coverage." This assures you only pay a small coinsurance amount or copayment for covered drugs for the rest of the year. Go to Medicare.gov for more information.

1Select brand medications for diabetes and heart conditions are covered at an $11 copay.