LOCKTON INSURANCE BROKERS, INC.
(213) 689-0065
Dear Retired Member:
Our records show that you are a newly retired member of the Pari-Mutuel Employees Guild - Local 280. Following
is a brief outline of the group health benefits through the Local 280.
LIFE INSURANCE (Retiree
Only)
American Medical Security
Life Insurance Company (a PacifiCare company) $1,000 Benefit
Group #14408
PRESCRIPTION BENEFITS (Retiree & Spouse)
NMHC
(PCN) and POSTAL PRESCRIPTION SERVICES $7,500 Lifetime Benefit
Group
#700
NMHC (retail) 1-800-777-0074
You must go to a NMHC Pharmacy to receive benefits;
up to 31 days supply or 100 units, whichever is greater
$25.00
co-payment for Brand name drugs
$15.00
co-payment for Generic drugs.
PPS (mail order) 1-800-552-6694
Mail
order service for maintenance drugs; up to 90-day supply
$10.00 co-payment for Brand name drugs
$ 5.00
co-payment for Generic drugs.
DENTAL BENEFITS (Retiree Only)
Delta Dental of
Group #4602-5555
To
receive maximum benefits; you must use a Delta dentist. Delta dentists have claim forms in their
office.
To find
a Delta dentist in your area, please call Delta Directory Service at 1-800-427-3237.
For benefit or claim questions, please
call Deltas Member Services at 1-888-335-8227.
VISION BENEFITS (Retiree & Spouse)
Vision Service Plan (VSP) $20 Co-pay Exam & Lenses Each
Calendar Year
Group #412802A Frames every other Calendar Year
In order to get maximum benefits; you
must use a VSP Provider.
To find a VSP doctor, please call VSP at 1-800-877-7195.
Enclosed are booklets and pamphlets describing the above mentioned plans. If you have any additional questions, please call Barbara Morey at (213) 689-0065.
Enclosures