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Thank you. All right. Hello everybody. Welcome to the Centivo webinar. My name is Jim Hedges. I’m the CEO of the health fund and happy to have you all here tonight. Thanks for taking time on a Thursday night to talk about this.

Our hope tonight is that we can give you some good information on the new medical plan offering, Centivo, and hopefully also answer some of your questions. But before we get into the Centivo presentation, I want to take you through just a couple of of slides on some information that we also think will be helpful related to open enrollment. So, Sheila, if we can go to the next slide.

So tonight on the webinar with you, I’m here. Jim Hedges, that’s me. And Willard Woods from the fund office is also here. He’s our COO. Happy to have him. And then from our partners from Centivo, Jerry Greenbomb is here. And Ellie Cogdoll will also answer questions and take you through the presentation.

And I’m happy to have also Jillian Dearus from Budgie Health here. And we’ll explain more what Budgie is in a moment. But that’s who’s here tonight to talk with you. Let’s go to the next slide. So new for 2027 is a new medical offering. You’ll have two choices for your medical plan. The first and it’s fully optional for you. The first is the Anthem PPO plan which is the same plan we’ve had for oh decades.

And next to that will be an option for you called the Centivo plan. That’s a brand new offering. So for Centivo, you may know a little bit about it, but it’s a narrow network, plan that includes in Los Angeles, UCLA, in New York, Mount Sinai. There are others that are also included. We’ll get into more detail on that in a minute. The premiums for Centivo are lower.

There’s no co-insurance, no deductible for in network care, free primary care visits. But I will point out that Centivo is not an option for Medicare age certified retirees. Those folks will stay with Anthem. Next slide, please.

So open enrollment will begin on November 11th and continue through December 15th. So that’ll be the window where you’ll select what medical plan is best for you and for your family. We have a couple of tools we’ve created to help you decide what’s best for you. The first is we’ve partnered with a company called Budgie and they will be able to help you do a cost comparison between the two.

If you had claims in 2025, those will have been loaded into Budgie. So you’ll have an actual live cost comparison between the two plans. If not, you’ll be able to set up what you expect will happen during the course of the year to give you kind of an estimated cost comparison on a sidebyside basis.

Throughout the course of open enrollment or before, you’ll have multiple ways to get your questions answered. The Budgie tool has a question answering process and to also has a micro site that’s set up already where you can get questions answered. And on our website we have FAQs that we continue to add to every day as we talk to more participants to make that a robust place where you can go and get your questions answered.

We’ll also do live events. We’ve done one health fair. We have a webinar tonight. There’ll be several more. I’ll show you a calendar of that in a moment. And then you can of course always call us at the fund office and we’ll be happy to answer any questions you might have. And to that end, we are staffing up to make sure that the waits are not long when you do call us to try to get answers.

Once you’re ready to enroll, you’ll go to our My Plans site. About 80% of our participants are already signed up on My Plans. That’s where you can go and see your contributions, run your pension calculations, and you’ll also have to go there to sign up during open enrollment. So, if you aren’t already enrolled in my plans, it takes about two minutes. You go there, sign up, and when open enrollment comes around, you’ll be you’ll be ready to go.

Okay, next slide, please. So, as I mentioned, there are a couple of resources we’ve created to help you. The first is on our website. We’ll have an open enrollment tool that’ll be accessible through our website. All members will need to use this tool as I mentioned to choose a medical plan either Anthem or Centivo. It’s up to you. You can elect any dependent to cover.

You set up autopay for your quarterly premiums. And then all of your other benefits, as I’ll mention in a moment, come along with your medical plan selection. In addition, you’ll have Budgie Health which will be available around the 1st of November or sooner if it’s available and that will have that sidebyside cost comparison that should help you as you make your decision. The Centivo Microite is up and available now and we’ll give you that URL in just a moment when they do their presentation.

It’ll also be on our website and I’ll mention that all of these presentation slides along with the recorded presentation will be available on our website. So the all this information will be up there for you to look at later. In addition, we have our health plan FAQs which I mentioned are also available on the website.

Next slide, please. So whether you pick Anthem or Centivo as your medical coverage, all of these other benefits that you’ve enjoyed under the Anthem plan are also available. They’re the same under Centivo and Anthem. So Express Scripts, Rula, Carrot, Hinge Health, Lantern, VSP for vision, and Delta Dental for dental care the same regardless of which plan you pick. So that’s not an impact in your choice.

It’s just medical that you’re deciding between Anthem and Centivo. All right, next slide, please. So, this is the calendar leading up to open enrollment. We have a health fair in person planned on November 14th. We had one on August 29th. We have the Zoom webinar tonight. We’ll have another one on November 10th. On the East Coast, we’ll have a health fair on October 20th.

I mentioned the Budgie decision tool will be available November 1st or sooner. The Centivo micro site is available now and the website is also available for to help you decide. So hopefully that’ll give you a lot of chances to get your questions answered. We’ll try to answer as many as we can tonight. I’m sure we won’t get to all of them. So you’ll have ample opportunity over the coming two months essentially a little bit longer to get your questions answered through these various means.

All right, that’s it from me. We’re going to move on to the Centivo folks to take you through their their presentation. Yeah, Ellie, sounds great. Thank you, Jim, and thank you for having us. We’re really excited to be partnering with you all and offering you a new health plan for this upcoming year. We can go to the next slide just to share a little bit about Centivo because we’re probably a new name to some of you.

I’m sure you recognize the Anthem name, but you might be thinking, hm, I haven’t heard of Centivo before. So, we were founded in 2017, and our mission is really to make healthc care easier to use, more affordable, and really our work is really on behalf of you as our our members and on behalf of PWGA. So we’ll share a little bit more about what makes this plan different.

If we go to the next slide, a couple of key things is really around the relationship and the ease of use of getting connected to primary care. So you’ll have access to inperson primary care in the Los Angeles area. We partner with UCLA that does include the industry health network clinics if you use one of those clinics today. And we also have our own virtual primary care team called Centivo Care that is an option for members who are interested in virtual primary care.

And we’ll talk a little bit more about that as well. Jim touched on some of this already, but the plan is a really great benefit to you. So, it’s really affordable in that it has no deductible. If you stay in network, you pay simple, predictable co-pays. And we’ll show you a sample of what all of that looks like in a few slides. And we’ve built a really great network of providers, you know, in the Los Angeles network.

You know, with UCLA. It does include some others which I’ll share. We have a network in the New York area with Mount Sinai. So, some really great providers many of which you might use today or are familiar with. We go to the next slide a little bit more around, you know, why we have kind of built a health plan that’s centered around making it easy to access primary care.

We’ve seen and we get great feedback from our members that when you have a trusted primary care doctor, it gives you a place to start when something comes up. We know health care can be complex and things come out of the blue. And so we want to really make it easy for our members to get established with a primary care doctor. You know, that’s really not only when you’re sick, but when you’re healthy as well, getting, you know, focused on your preventative care.

It’s also having a trusted partner when you do need to see a specialist helping you find, you know, what is the right specialist to go to for what’s happening. And we’ll talk more about that process, but that’s a really key component to the plan and the member experience that we’ve built. If we go to the next slide, I’ll share just a little bit more on, you know, what that looks like and what that process is for you as a member.

So, if you do decide to choose the Centivo plan, you’ll be able to download our Centivo app. You can also call our member care team to do these things as well. But one of the first steps that you’ll be presented is to choose a primary care doctor or to what we call activate. And we’ll ask you a few questions to make sure we’re gathering your preferences.

And we’ll help you find a primary care doctor that meets those needs. That includes in-person primary care. It can include virtual primary care with our Centivo care team if you are open to that. It also includes pediatricians for children as well. Once you have an established primary care doctor, the rest is honestly really simple. You’ll see that the plan design is really intended to remove some of those confusing things with health insurance, trying to predict what you’re going to pay.

You have predictable co-pays and we’re really just asking you to start with that primary care doctor and establish a relationship there. If we move to the next slide, I’ll talk a little bit more about our referral process. So, this is not intended to be a barrier or an additional step for you as the member. It really is around connecting you with a PCP and making sure that primary care doctor can help guide your care when you do need certain downstream care.

So, Centivo is the health insurance. We auto approve all referrals once we receive them. We don’t want to make this an additional step. And you can actually go into your Centivo app and see all the referrals that your provider has sent over to us and they’re going to be good for a full year. So, you don’t need to do that. Multiple times within the year. There are also some services that do not require a referral.

So, women’s health, OB/GYN, mental health, of course, urgent and emergency care. We want to make sure you can get the care that you need in those situations. And then a few other areas such as chiropractic care, labs, physical and occupational and speech therapy, and alternative medicine. Those do not require a referral. But for something like a, you know, you think you might have something going on with your knee, you think you might need to see an orthopedic specialist, we want you to, you know, have at least an exchange with your provider.

Could be a quick message. Doesn’t always have to be an in-person visit. If we go to the next slide, just a little bit more. Sometimes we get the question of this sounds too good to be true. Is there a catch? You know, what are what am I missing? And there really isn’t. I would say one of the things that we have been able to do to make this plan more affordable is that we’ve built this network on behalf of organizations like PWGA and we’re really driving some of those savings back into your pocket.

And so that’s one of the benefits and why the plan design looks really great. I think if there’s one thing that’s a little bit different in this plan compared to a more traditional plan is that we’re asking you to partner with a primary care doctor and have a trusted primary care doctor that you’re working with to guide your care.

We can go to the next slide. So, I’ve mentioned a few of these names, but more about our network in the greater Los Angeles area. So, we partner with UCLA Health. That includes, you know, all their brickandmortar facilities, but there are a number of providers as well, you know, in clinics that they have like the Industry Health Network clinics in the Orange County, Long Beach area.

We work with Memorial Care and then kind of more inland, we work with PIH Health. You can go to pwga.centivo.com or scan this QR code and it will take you to that site and we’ll have a tool where you can search by provider type, your zip code to really, you know, get a sense of what the network looks like and the providers in the network and we encourage you to do that.

We also welcome you to reach out to our team. Our information is on the website as well if you have any questions on providers in the network. If we move to the next slide, you know, we’re focused on the greater Los Angeles area given the webinar today, but we do have a network throughout the country and a few other key areas. So, we’ve mentioned kind of the New York area.

We work with Mount Sinai out there, Northwell Health, we have a pretty robust network out in the broader northeast area. And you can see a number of other markets. So, if you have a dependent that might live in one of these markets, they can access the network. And the other thing I will mention is if you’re traveling and you’re in a location that maybe doesn’t have an orange dot on this slide, you can of course access urgent care.

For example, if something were to come up and you have to go to the urgent care, you’ll pay an in-network copay for that. So you have access to urgent care or emergency care if something were happening if you were traveling outside of your home area.

If we go to the next slide, just a little bit more on Centivo Care, which is our virtual primary care team. I love this benefit. I’ve used it myself. I’m a Centivo member. And I would say one of the great things about Centivo Care is the convenience. So, you can text your provider. You can have a video visit. And what’s different than other virtual care solutions is it’s the same provider.

So, you’re getting to know your primary care doctor as if you were going in person with them, but it’s all done virtually. And we have the ability for you to, like you see on this, picture, do, you know, a video visit on your phone, making it really convenient for you. And it’s really a great option for folks who maybe they’ve been avoiding going to the primary care doctor cuz they don’t want to schedule an appointment, drive, sit in LA traffic, and then, you know, go go in.

This can be a great option because you can do so conveniently from home. And we can do a lot of things virtually these days. You know, I think, about 90% of care can be covered virtually. And for those things that have to be done in person, we’ll help guide you to an in-person provider to get those things done.

Let’s move to the next slide. So the plan design, I’ve mentioned this just to give you a sense of what this looks like. You know, if you stay in the network, you have a really great benefit. So no deductible, free primary care, predictable co-pays, you know, behavioral health co-pays of $25.

This is a great plan design. Probably one of the best ones I’ve seen out there. So, you have a great benefit when you stay in network and you have coverage if you go out of network. So, if you have a you know specialist that you want to continue to see that may not be in the network, you still have coverage and you can see them.

You’ll pay a little bit more if you go out of network, but you still have coverage for out of network situations if you do need to go out of network.

You can go to the next slide. As Jim mentioned, your benefit on pharmacy through Express Scripts is staying the same. So, we will partner, we partner with Express Scripts, and you’ll be able to access, you know, great benefits on generic preferred brands, non-preferred brand medications. You can see those co-pays listed here. Same kind of network of pharmacies that you have access to through the Express Scripts benefit today.

If we go to the next slide. So, a little bit more on, you know, maybe you’re starting to do, if you’re a math person, you’re kind of starting to add up, okay, what might this cost me if I pick the Centivo plan throughout the year? So, we just have a couple of examples here, you know, for someone who maybe has to go through a knee surgery experience.

You can see, you know, between a free primary care visit, obviously some specialist visits, MRI, potentially surgery, you know, you’re looking at an out-of- pocket cost of $620 allin. So, pretty affordable for a more, you know, involved procedure. The other example is if you’re expecting to have a baby. I actually went through this on the Centivo plan about a year and a half ago and paid something very very similar versus, you know, having to pay out of pocket thousands and thousands of dollars.

So, you know, really great benefit for, you know, a more kind of planned, you know, expensive year of healthcare. It doesn’t have to be that expensive in the Centivo plan. And you can see kind of for that scenario, you would pay about $790 out of pocket.

If we go to the next slide, this might help just as you’re thinking, is this potentially a good fit for me? You know, at the end of the day, we want to make sure we’re getting the right people into this plan and we know this his plan isn’t for everyone, but it can be a really good fit for many people. So, you know, for example, Shawn, let’s say he already uses doctors as part of the UCLA network and he wants to stay with those doctors, he can do so and he’s going to pay a lot, less if he picks the Centivo plan versus the Anthem plan.

And so, he’ll be able to, you know, save quite a bit, especially if he’s wanting to stick with those doctors. Sarah, you know, she maybe has a primary care doctor, but maybe she hasn’t built that loyalty with her primary care doctor and she is kind of weighing, you know, wanting a more affordable and a predictable plan. And she’s willing to switch providers. And one of the things that we will do is we’ll help you find a provider if you’re looking to find a new provider to switch to.

And we look very closely and make sure that our providers are accepting new patients and can get you in to be seen for the first time. So, we’re happy to help with that as well. Jen, you know, she has a a family and she covers, you know, kids who are getting ear infections and needing to go, you know, get to go to the pediatrician a bit more often.

This is going to be a great benefit for her and her family because every time you go to that pediatrician visit, it’s free for you. So that’s a really great benefit for those who might be covering a number of dependents and family members who are accessing care quite often. And then Miles you know he hasn’t actually gone through you know a process of finding a primary care doctor.

You know maybe he goes to the urgent care when things comes up because you know it’s convenient and that’s what he’s used to but he likes the idea of finding a primary care doctor or maybe even trying out our Centivo care team for a convenient option and we think this can be a great plan for him as well. So hopefully that helps, you know, if any of these examples resonate.

But we can move to the the next slide just to give you a little bit more information on where to go if you have questions. We’ll obviously answer some questions at the end of this presentation. But we have our member care team available. They’re answering questions already. So you can give us a call at this number between 5:00 a.m. To 5:00 p.m. Pacific time.

And we’re happy to talk to you. We’re happy to answer any questions that you might have. We know healthcare is a really personal decision and so you’re kind of probably thinking through all of the different questions and scenarios. We’re happy to talk with you one-on-one. You can also go to our website where you can find more information and reach out to us there as well.

So I think with that if we go to the next slide that wraps the you know key portion for Centivo. Like I said we’re really excited to be offering this new plan. I’ll be out in the Los Angeles area for the November Health Fair. So, happy to answer other questions in person and we’ll we’ll stay on here at the end to answer any questions you might have.

And with that, I’ll turn it over to Jillian. Thank you, Ellie. Great. Thank you, Ellie. Hi everyone. Super excited to to be here today and share a little bit more about Budgie Health. So I am Jill Demarz from the Budgie team. And here to talk about the new decision support tool that you’ll have available to you starting this open enrollment as Jim mentioned at the top of the call.

So we know that choosing a health plan can be overwhelming especially you know having choice for the first time this year and so Budgie is here to help you navigate that decision between the PPO and Centivo. And so today I’ll walk you through, you know, what Budgie is, what is decision support, and also give you a preview of how you’ll actually use Budgie during open enrollment.

So if you go forward to the next slide here. Thank you. So yeah, as I mentioned, Budgie is a decision support tool. And so in practice, what that means is that we’re here to help you understand the options that you have available this open enrollment between the Anthem PPO and Centivo. And really ultimately our goal is to help you feel confident in a choice that’s right for you and your family.

And so what our real ethos here when it comes to Budgie is that that confidence comes from your own data. So when you go through Budgie, you’ll have the option to connect your claims data and use that to evaluate your costs against each plan. Jim mentioned this at the top of the call, but if you don’t have any claims or if you choose not to connect your claims, you can easily build a claims profile that’s based on your anticipated utilization and the anticipated utilization of any dependents that you have or are planning to enroll.

And so, you know, either way, Budgie is here to crunch the numbers for you and summarize your anticipated costs on each plan. And in turn, what you’ll get is a sideby-side comparison of each of the plans, covering cost shares for common services, your deductibles on each plan, out-of- pocket max, as well as the premiums. And so, the goal here is really simple.

Make your options easy to understand, so that you can ultimately choose with confidence this year. The other piece I wanted to add to that that Jim mentioned at the top, we’re also here to support you. If you have any questions as you’re going through Budgie, you’ll have the option to type in any questions to us or to schedule time with our team to actually talk through those one-on-one.

So if you go forward onto the next slide, I’ll just share a little bit more about how you’ll actually use Budgie this year. So starting November 1st, you’ll have access access to Budgie. How you’ll do that is that you’ll v visit PWGA’s unique link. You’ll log in with your phone or email. You’ll get a onetime passcode either sent over email or text.

And then your account is already set up for you. So, you don’t have to go, you know, answer any crazy questionnaires. It’ll be super simple once you get logged in. And then you’ll just have the option to connect your claims. Or build a claims profile for anyone who doesn’t have claims and then ultimately see your sideby-side comparison, ask any questions to our team.

So again, you feel super confident in your choice this year. So just to wrap it up, more will be shared about Budgie in the the coming months here ahead of open enrollment. Oh and if you just go to the the last slide we have here and we’ll also be on site in New York on October 20th and in LA November 14th at the benefits fair.

So many more opportunities to chat with us, ask us any questions. And in the meantime, you can feel free to explore our website if you just want to learn more about Budgie, who we are at budgie-health.com.

All right, perfect. Thank you, Jillian. That’s great. We have a number of questions. So, how about if I kind of read through some of them and then let’s give an answer based on the folks that are here in attendance. The first question is I’ll read it. Hi, if we use the Budgie tool, who has access to the information we enter and how might it be used beyond our comparison?

It’s a great question. We made sure that any information we share is deidentified. So, it’s it’s essentially your a string with your WRX number in it. There’s no name attached. They don’t know who you are. So, that information is is protected that way. We we wanted to be certain for that reason that your your especially your personal health information is protected.

Anything else Jillian or or Ellie you want to add to that? Nope. That you nailed it. The only thing is that there it the data is not used beyond your your cost comparison. So just for that deidentified onetime poll. Great. Okay. The next question is, if you were to select Centivo, would it be possible to try the plan then switch back to Anthem in the future?

I’ll try to answer this and Ellie, you can help me. The answer is you can switch back, but not till the next open enrollment unless you have a life event, such as you get married, divorced, that sort of thing. I would not suggest getting divorced just to switch. But I hope that helps. Ellie, you want to add anything to that?

No, I think you answered it well, Jim. And I hope I hope we don’t have members feeling like they have to get divorced to switch and of course would want any feedback if if someone, you know, had any feedback and weren’t happy for their first experience. One other thing I’ll add is that if you do move your primary residence out of the Centivo footprint, we’ve made that a life event so that you could switch in the instance of of moving.

So, I hope that’s helpful as well. All right, the next question I’ll have Ellie help me with. Also, does Centivo offer care only at UCLA clinics or all doctors affiliated with UCLA? There’s an easy way to search to see if your doctor is in the Centivo.

Generally speaking, most of the UCLA, I don’t know if we can say all, but I would certainly check to be sure that your doctor’s in the Centivo network. And you can do that either on the Centivo website or on the Budgie website. There’s also links on our website for you to be able to do that. Or you could call your doctor and ask them, hey, are you in Centivo?

And hopefully they know. How do you do, Ellie? Yeah, that was great. They I would say majority of all UCLA providers are in our network, but you could have a provider that maybe is just admitting at one of their hospitals for one day. So, you always want to just check in our tool, but I would say majority are part of our network. Okay, sounds great. Next one also, Ellie, if you could help me with the current, it says, “Currently, LiveHealth Online is available for a $10 co-pay, which is a lot cheaper to use for mental health services than Rula, which is a percentage of co-insurance.”

Right? Rula is in network. Will LiveHealth Online still be available next year or do I have to switch to Rula? LiveHealth Online will still be available next year if you are in the Anthem network. So, anything on Centivo? Yeah. So, we actually have a pretty robust network of virtual behavioral health solutions even in addition to Rula. There’s some information that we can share and you can reach out.

But just a couple as an example is Array Takiatry. So, these are built into our network and if you are staying in network, you’re going to pay you know low cost. I think I said it was $25 copay for behavioral health. So, you’re not paying co insurance.

Okay, good. Hey Ellie, this is Will. We also mentioned in the FAQ a bit of documentation about MD LIVE. You might want to talk to that as well because they are Yes. And MD LIVE is a similar solution to LiveHealth Online and they offer behavioral health. So that in addition to some of those other virtual behavioral health solutions are available. So there’s a pretty wide array of solutions for behavioral health.

Great. Perfect. All right. Next question. Comes apparently from somebody in Palm Springs. Does Centivo have coverage in the Palm Springs Palm Desert area? And I think they’d have to go and check to make sure that Yeah, we have some providers, but I would say not a full robust network. So it depends on your situation. You know, if you’re comfortable with Centivo Care, that could be an option, but if you’re looking to get, you know, specialists in care, you know, community care right there in Palm Springs, it might not be quite enough.

So, just check the network tool and and see if you know it meets your needs, right? Yeah. Good good advice. Might not be the perfect fit if that’s where you live and there’s not enough of the kind of care you need in person there. Yeah. Good.

All right. I’m going to put my glasses on for the next one because it’s a long one. So, bear with me. A very important question that many of the membership have questions about from what I’ve seen online. What is your rate of approving prior authorization requests? Or when the insurance declines coverage at first, but then your physician appeals that it is medically necessary, what is your percentage of approving requests?

So maybe Ellie, you could take that one. Yeah. Yeah. So I would say one of the things that we’ve actually tried to do in our model is eliminate some of the unnecessary administrative burdens on the prior auth process. So we built this network of high-quality providers such as UCLA and we looked at the data on things that you know they were essentially recommending their patients to do that maybe previously required prior auth and they were getting approved like 99% of the time.

So we removed the requirement for prior auth on certain services like MRIs for example because we didn’t want to add that unnecessary barrier. There still is prior auth requirements on certain complex, you know, surgeries and things like that, but our goal is really not to be adversarial with the providers. You know, this whole model is intended to partner closer with providers. And we have a process, you know, if a prior auth were to get denied where it goes through a review and we work with the provider.

We also often times if that happens, it’s because we just didn’t get enough medical notes from the provider. So, we need more detail. And then if it needs to, it can go to a peer-to-peer discussion with the actual with another physician. And so we really try to make this quite easy for the provider and for you as the member. You know, we don’t want you to be stuck in a situation where your provider is recommending care and it’s not, you know, getting approved because of the health plan.

So we’ve tried to remove some of those barriers where possible. Okay, great. Just as a follow on to that, they asked, “Do we know what the rejection rate is at Centivo, an industry standard rejection rate of 12% similar to Anthem, which is quite good with these things. They’re worried about a high rejection rate for Centivo. So, I don’t know if you happen to know. I don’t have the stat memorized, but we can certainly follow up on that.

And like I said, our goal is for that process to be honestly much better than kind of the traditional carriers.” Yourself. Got it. Yeah. Thank you. Okay. The next question. I am 65 and signed up for Medicare Part A. I am not collecting retirement at PWGA. Does that mean that I’m not what you refer to as a certified retiree can still get Centivo?

The answer is no. Once you’re on Medicare, you’re not eligible for Centivo. Anything to add to that, Ellie? No. Great. Thank you. Okay. Then the next question is a question about traveling internationally and if they pick Centivo, how does that work? So Ellie, if you could address that. Yeah, if you’re traveling internationally and you were to need to go to, you know, emergency room or urgent care, you will have coverage.

You will typically have to submit those claims yourself because oftentimes international providers don’t know how to submit claims to, you know, a US-based insurance company, but we can handle those. Our member care team will get them to our claims team. So we have a process for that. You know if something were to come up and you’re traveling. If you’re going to be you know international for an extended period of time you might want to look into other options and coverage.

But for you know obviously emergencies if they come up you can submit those to the plan. Right. One thing I’ I’d note on that also is just make sure you keep all of your bills from the international whatever kind of international care you had. So you can submit those once you return back to the US. Yeah, that would be that’s how it’s similarly handled with the Anthem network as well.

So it’s not much different in that regard. Yep. Yeah. Thank you, Will. Perfect. Yeah. Okay, next question. My son is a is a dependent on the plan but lives in Chicago. What are the options for him if I choose Centivo? Yeah. Yeah, great question. And there’s probably other folks who are on the call who might have similar situations. So I think this is where every family’s different.

So, I’m going to answer more generally, but you have to make a personal decision for you and your family. But I would say we find many college kids, you know, they’re getting a lot of their routine care when they’re at home or our Centivo Care virtual primary care team is actually a perfect option for college kids if they’re over the age of 18 because it’s convenient. You know, allows them to schedule visits when they’re away from home.

They can prescribe, you know, if something were to happen and they got sick and they need to just pick up a prescription at the pharmacy. So, that’s a really great option. And then of course they have access to urgent and emergency care covered in person at an in network copay if something were to come up. And I would say many families find that that’s sufficient.

But if you had a dependent who had need for in-person specialists and other ongoing care in Chicago where we don’t have a network, you might want to consider the Anthem plan. So just depends on your personal family situation. Yeah. Perfect. And if so if they have to go to the ER or urgent care that’s covered. That’s covered. Don’t need to worry if it’s in network, out of network, just go.

Great. Yeah. Thank you. Okay. Next question is, will my Centivo primary care doctor stay the same if I already have one that’s in the Industry Health Network that I like? The answer is many or most of the industry health care network doctors are in the Centivo plan, but to be sure, you should check either on the Centivo site, call your doctor, go to our site, check it.

Just to be 100% certain. But but most if they’re part of the Industry Health Network, they’ll they’ll be in the network and you can continue to work with them. And if you don’t see them for whatever reason, that’s a great example to like write into us and we can research it. Like one detailed note, sometimes if providers have like a full panel, we might not show them in the directory because we don’t want a new member to pick them and then not be able to get seen.

So, that might be a reason why you don’t see them, but you can write into us and we can confirm and help you. Okay, sounds good. The next question is, does Centivo cover international travel as well as within the US? I think we’ve kind of answered that. So hopefully the participant that asked that question is is satisfied. If not, reach out to us, contact us and and we’ll get into more detail with it.

Okay, the next question I’ll just say is a bit of a loaded question. It says, “How much to have a baby?” Now, I have three kids, so that is a neverending pot of money you’re going to need to have a baby. But if you’re talking about just the initial birth of a baby, I think Ellie gave a compar $790.

And that was actually I’m reading it again. That was for a cesarean delivery, which is oftentimes a little bit more complex. So, obviously depends on every delivery can be different, but it it’s for that example, $790. Yeah, that’s great. And just to add on to that, I just I don’t know why I just thought of that. If they if you know the baby was in the NICU or something like that, how would that affect that cost?

It could be Yeah, that’s a great question. So an inpatient stay is a $600 co-pay. So even if the baby is, you know, needing to then be inpatient for even weeks or something, you’re going to just pay that 600 copay. So perfect. Yeah, that’ll be the least expensive part of having a baby. Yeah. Yeah.

All right. The next question is, a traveling question. If I’m traveling or on an extended stay overseas, I assume I can do a video visit, but what happens if they write a prescription? Can Express script express scripts mail overseas or can the prescription go to an overseas pharmacy?

Yeah, that would be similar with Anthem. You’re able to get a script overseas and get it filled that way. Anything you want to add to that, Ellie? No, I don’t think so. It would follow just whatever Express Scripts’ process is. So similar to the Anthem experience, right? No change. Yeah. No difference, I should say. Yeah.

Okay. Next question is, does the plan cover any all prescriptions doctors prescribe or can they be rejected as they can with Anthem? That would be the same. Express Scripts handles all of our pharmacy benefits. And so the rules are exactly the same whether you pick Anthem or Centivo related to pharmacy.

Okay. What about kids in college that are in places not on the map? Massachusetts specifically. I just want to say Massachusetts is on my map, but you might want to get yours updated. All right. So, it’s the same kind of the same thing we talked about earlier. Similar question that you do have the option of having them in Centivo and you can get care online.

But that might not be the best depending on what kind of care that child needs or your your student needs. That might not be the best alternative for you. So, anything else you want to add to that, Ellie? No, I think you answered it well. Yeah. Okay, sounds good.

All right, next one. I’ve heard that Centivo is extremely platform and visual-based. If there are issues or more in-depth requests, fixes or questions, how easy is it to work with someone rather than get spun around through an online platform? Yeah. Yeah, you can call our member care team and we love talking to members. Like our member care team wants to make sure we’re solving any issues.

So, if you prefer to talk to a live person, you can call us and we can, you know, talk to you about that specific issue. If we can’t resolve it on that call, if it’s very complex, we will follow back up with you to make sure we resolve that issue and we can also communicate in the member app. There’s a chat functionality where you can actually send things through the member app as well if you want to do that that way.

Great. I have heard that question a number of times from participants. And we’re all worried about that. You know, you get stuck in the the loop of of a AI answers and you can’t get to a live body. So, that’s that’s great to hear.

All right. Next question. Let’s see. With Centivo, are we required to use Express Scripts’ mail service? I prefer going to my local pharmacy. I find it more convenient than mail. Because I can usually receive my medicine the same day. That would be the same for Anthem or Centivo.

And you can go to the local pharmacy rather than do a 90-day fill for mail order under Express Scripts. It just cost you a little bit more as your as your co-pay.

All right, next question. Can you tell us more about how Centivo is similar and/or different from the Industry Health Network? Yeah, so the Industry Health Network is specific clinics within the UCLA network. I would say the key difference is our network is much broader. It includes all of the UCLA facilities, additional clinics, and so it’s going to include much more beyond just those specific clinics.

And you know, it’s one of the benefits, too, is because we’re including all of the facility care, the specialists, the primary care. You’re going to have a very connected experience when you work with a UCLA provider. And let’s say something comes up and they need to refer you to a specialist. They’re going to be all talking on the same platform. Like one of the benefits to the model is more of an integrated experience for you as the patient.

So that would be probably the the key difference. Yeah, that’s great. And TIHN was very geographically limited. So if you live sort of in San Fran Valley or LA kind of that area where a lot of our part participants do live then it worked great. But if you were in New York you didn’t even know what TIHN was. It just wasn’t an option for you. So this is a much broader footprint than than TIHN was.

Yeah. One of the one of the let me answer one quick thing on that, on TIHN there. One of the challenges we had historically was that referrals would end up going to UCLA physicians who weren’t part of the TIHN network. And so you’d get charged the Anthem PPO rate versus the TIHN rate for services. That won’t happen with Centivo. All of the referrals are within network in the Centivo network.

So it’ll be consistent in terms of the application of of services. So yeah, good. Thank you, Will. Yeah, good point. Sure. Okay. Next question is, if you have an an if you have an in-person primary care doctor, can you still use the virtual doctor?

So, you can, but we do want you to actively choose. So what you will probably do is go into your Centivo app and if you want to use virtual, you will switch to the Centivo care. The one thing I will mention is a lot of the UCLA providers also have access to virtual. So if you want kind of that hybrid, you might be better off choosing the UCLA provider and you can do some virtual visits with them.

I would say Centivo Care is best for someone who wants really that virtual primary care first experience. And you can always try that and if you feel like it doesn’t end up working out, you can switch to an inerson primary care doctor. Yeah. Great.

And the ability to switch your primary care physician, you can do it any day online. So, there’s no waiting period or anything like that. You can switch. So, I thought that was a it came up in the health fair. That’s a really great point on this. All right, let’s go to the next one. Can you talk a little bit about the continuity of prescription coverage?

Will our prescriptions under the current plan be covered? Will they require a reset? And how does the system handle ongoing prescriptions and physical medical equipment? So that would go through Express Scripts. Your primary care doctor will give a script for a certain number of prescriptions.

If that needs to get refilled once you’ve switched to Centivo, let’s say, you can you just have to have that new doctor or maybe it’s the same doctor. They’re just also in Centivo write out a refill for you, but it would since it’s under Express Scripts, it’s handled the same.

Okay, next question. Will eye benefits be the same as Anthem Blue Shield or will there be specific doctors? It’s the same. VSP is our vision care provider and whether you choose Anthem or Centivo, that is the same exactly the same as what you had.

Okay. Next question. We got a lot of folks traveling. When will will we have Centivo health coverage when traveling and abroad? So, I think yeah, so travel within the US if you’re in a state where we have a network, you can access not only urgent care, emergency care, but if you really wanted to travel, if you lived in LA and you really wanted to see a specialist in New York for whatever reason, you could do that.

If you went to a a market where we didn’t have a network, like I said, you have full access to urgent care, emergency care if something were to happen when you’re traveling. Same thing when you’re international. Great. Okay. Next question is, hi, is there any advantage for dual writer coverage, husband and wife writing teams with the Centivo plan? And I would, my response would be, it’s just less expensive.

Right. Right. So that would be that would be the advantage, but beyond that, no. Right, Will, anything you want to add to that? Yeah, I mean, you could have one of the writers, sign up for PPO and the other sign up for Centivo and and cover each other on each plan. So, you’re going to have the best of both worlds. It cost you more, but but you can certainly do that as a dual writer, right?

Yep. Okay. The next question is, do we have to cancel our Anthem service if enrolling in Centivo or is that not necessary? The answer is during open enrollment, you have to decide which one you want. You either choose Anthem or you choose Centivo. So if you do, you have Anthem now and you choose Centivo, then January 1, you’ll no longer have access to Anthem. You’ll you’ll be in the Centivo network.

Okay. Let’s see, next question. If I have a primary care provider from the Sautell Health Center, can I keep her and is she in network? We would want to check that one specifically. U, I I’m I don’t know. But again, yeah, I would suggest going to the pwga.centivo.com website and you can search by your provider name to see if they’re in network, right? Yeah.

Or you can always call their office and ask them to. Hopefully, the person answering knows. But you yeah those are great options for you to figure that out or call us and we’ll help you figure it out too. Yeah, we’re always happy to help you. Next, can you use Budgie to compare other health plans besides Centivo or Anthem? That’s interesting. Or is this benefit for us only comparing this the those two?

At this point it’s just comparing those two, Centivo versus Anthem but interesting question. We’ll think about that. Next one. I mostly have UCLA doctors, but the hospital right near me is not UCLA or covered by Centivo. What percentage would I have to pay if I needed to go to that ER and was admitted?

Yeah, that’s a great question. I think actually a really good example of I hear that I’m like this plan is potentially a really good fit for you. If you use mostly UCLA providers and if for whatever reason you had to go to the emergency room and they took you to that emergency room cuz it’s the closest nearby you’re going to pay the same co-ay amount. So it’s $300 regardless in network or out of network.

So you don’t need to worry about emergencies. I think the most important thing is plan for the things that you can plan for and if you’re comfortable with UCLA providers and using them already, this is a great option for you. Right. Good. Thank you. Next question is, can you expand upon mental health benefits? If I move to Centivo, will I need to drop my therapist?

What would the therapist be receiving dollar-wise from Centivo? Yeah, Ellie, you want to take that? I’ll start. And Will might want to chime on this one, too. I could see. So we do have, you know, a lot of, behavioral health therapists sometimes don’t participate in insurance networks. We know this is a common theme. So, you know, if they’re out of network, like I mentioned, you do have an out-ofnet network benefit on the Centivo plan, and you’re going to pay a little bit more, but you still have a benefit.

And there is a process through a partner that PWGA works with to help negotiate down the the price of those and get those at a reasonable price. So, I don’t know, Will, if you want to share anything on that. For, you know, behavioral health benefits, we if it’s out of network, we’re going to be paying at 150% of Medicare cost. Which is, you know, what we’re going to play on all out of network benefits.

As it pertains to in network though, it would be far less expensive for you if you went through Rula to get to an in-network provider or called Centivo directly to get an in-network provider. Yeah. Okay. Good. Thank you. Yeah, sure. Okay. Next question. At what level will out of network physical therapy be covered? And if we go out of network, does the quote no referral for PT unquote still apply?

Yeah, physical therapy across the board in network out of network does not require a referral. And then the cost share for out of network for pretty much all services except for emergency room is you pay if you’re covering yourself a $500 deductible first and then 40% co insurance or if you cover a family $1,500 deductible and then 40% co insurance.

Great. Thank you. Next question. If you get a bad illness, is that considered a life event? If so, how quickly can you switch to get PPO care? So you can switch back and forth once a year during open enrollment except for those life events that I mentioned which include moving your primary residence out of the Centivo network. At that point you could switch.

So generally no just having a bad illness wouldn’t be a life event where you could switch between one or the other. And I would just add like if if you’re the person who’s thinking of the what if scenarios like what if this happens? Will I get the care that I need? UCLA has like they’re actually like the top provider for more complex care. A lot of like complex burn cases get sent to UCLA if something like that were to happen.

So they have really great access. Let’s just say for whatever reason UCLA could not treat your particular situation and your provider is saying actually you get need to be flown to another state or something to get the care that you need, we cover that. So we will, you know, if that’s getting recommended by your provider team, we do what’s called a single case agreement. We negotiate that with the provider and we make sure you get the care that you need.

So, I wouldn’t worry, you know, if you’re I I know some people are a worrier when it comes to health care, but UCLA does have really great coverage for complex care. Yeah, good point. Yeah, we had a similar question at the health fair, somebody who had a very s serious illness and was kind of deep into treatment and had their doctors all lined up. In that case, you know, our our you know, what I would do if it was me or my family is I wouldn’t switch because I had all my doctors lined up and was getting care in a certain way.

But I agree with Ellie. UCLA care is is really pretty fantastic. Similar to Mount Sinai in New York, you know, really top-notch place to go. So, all right. Next question is, will my existing referrals via UCLA UCLA Health transfer over if I choose to switch to Centivo? It’s a good question. This is a great question actually. So, I’m glad that someone asked this. So they won’t automatically transfer, but UCLA is very familiar within the Centivo plan.

They do need to let Centivo know that there are referrals. So when you go to your first provider visit for the year in January or if you don’t have a, you know, visit set up, you could probably even send a message through, you know, your UCLA app to say, “Hey, I I switched insurance companies. I’m working with Centivo. They do require referrals. Can you please submit, you know, my referral for my cardiologists or whoever it will be?”

And they can do that on your behalf. So, it is a good reminder if you do have established specialists to ask your provider to do that on your behalf. Perfect. Yeah. Next question. If we switch to Centivo, do we have access to all of the other local networks nationwide or are we tethered to UCLA? You have access to all of them. So, if you split your time between New York and LA and you do want to use Mount Sinai providers when we’re in New York, you can absolutely do so.

So, you’ll have access to all of them. Yeah, good question. I told you our our participants would have great questions. They’re very smart. Yes. All right. Next question is, what percentage of prior authorization requests does Centivo deny? That’s a similar question that we had earlier. And when a physician appeals a denial based on medical necessity, what percentage of those appeals are approved? This can affect access to everything from specialy medications and MRIs to surgery and extended NICU care?

Yeah, like I said, I don’t have the exact percentage memorized, but I will say it’s pretty low in terms of denials and we’ve really tried to remove barriers on that front. And if there was a more complex case that needs to be reviewed, there are multiple avenues for your provider to share more information with us and we work really closely with them to really work to get it approved.

So that’s what I would say generally for that topic. Great. Thank you. And I I’ll just say if we if we do are able to get actual percentages, we’ll we’ll put those up on our website for our participants to see. Open enrollment will be every November. Should we should we want to switch plans? Yes, every year. Similar time we’ll do open enrollment.

So once a year this year it’s November 11th through December 15th. It’s actually compared to other plans, it’s a very long open enrollment window. Which is purposeful because this is the first time our participants have had to make a medical plan choice between Anthem that they know versus Centivo. So, we wanted to give a large window to be able to give folks a chance to make the right choice for them and their families.

But yes, every year we’ll do it in the same time frame. Okay, next question. Is it possible for my son who turns 26 in January? Congratulations. To remain with the UCLA PCP by paying for Centivo individually. That’s a good question. In other words, can they sign up for Centivo?

I think it would depend if they’re actually eligible and covered, right, as a a member under PWGA. If they were going to sign up not under your family plan, you can of course cover them you know on under the family plan, but I think that would be the biggest thing. Or if they work for an employer that offers Centivo separately.

Yeah. Perfect. Okay. All right. Next question. I’m already using the UCLA motion picture clinics. That’s the TIHN. Oh, the motion picture clinics. Okay. Maybe that’s the other through MPI. What’s the likelihood I can stay with the same exact primary care doctor?

That’s a good question. I think you’d have to check to be sure whether your doctor is in Centivo. But again we mentioned all the different sources you can do that in addition to talking to your doctor directly. Yeah.

Okay. Next question. When going to see a chiropractor, there is currently a cap $50 that Anthem will pay. How does this work for for Centivo? And before you answer, I’ll just say our FAQs that are on our website have a a lot of this kind of information available to you. We’ve tried to sort it in a way that it pops out pretty easy, easy to find stuff.

But Ellie, would you would you answer that for us? Sounds like that’s an out of network provider potentially from the way that the questions worded. So it’s going to follow a similar process for out of network on the reimbursement. Got it. Okay. And is in network? Yeah. 6040 for out of network.

And then if it’s in network, we have negotiated rates with you know chiropractors that are in network. So those are agreed on already with the provider. Okay. Okay. Great. Next question. You mentioned retired Medicare folks are not eligible. What happens if the WGA member is younger and working but the spouse is of retirement age? That’s interesting. So, you’re working a covered participant. Your spouse is retired on Medicare.

Are they able to sign up then for Centivo if one is Medicare covered by Medicare and one and the participant is not? Yeah. You could enroll at for individual coverage for yourself and your spouse could continue on Medicare in that situation. Yeah. Yeah. So in that case, they’d be they’d be on Medicare, not eligible for coordination of benefits essentially after the fact because we don’t we don’t cover Medicare under Centivo.

Yeah. Okay. All right. Next question. What if you live in a Centivo footprint area but have a dependent in college that’s not in one of the Centivo areas? Would you recommend staying on Anthem? We’ve had this question come up quite a few times and I think the answer is that you you do have the ability to use Centivo virtually for your college age dependent and then if they need to go to to urgent care or the ER that would be that would be covered.

A lot of colleges also, and I I’ve been through this. I’m older. My kids are through college. A lot of colleges also have, you know, a college plan where you pay 500 bucks a semester. It’s probably way more than that. You know, I’m older. But you can get coverage on campus also. But if if that doesn’t work for you, then again, it may not be the right fit for for you and your family.

Yeah. Ellie, anything you want to add to that? No, I think that that’s perfect. I’d say really just depends on your family situation and what coverage they need. But many college kids, I think, are perfectly fine with care at home when they’re at home and virtual primary care and coverage for urgent care if something were to come come up while they’re away. Right. Okay.

Excuse me. Next question. Who who qualifies as a primary does an endocrinologist qualify as a primary care physician? Yeah, an endocrinologist would not be considered a primary care physician. Oftentimes the primary care physicians are you know an MD you know I’m forgetting there’s another acronym off the top of my head, but you can search in our tool and actually filter by primary care doctors specifically versus specialty care.

Great. Yes, that’s great. Does Centivo reimburse my international health payments? I think we’ve answered that. Answer is you bring them back, submit them. Okay. Next question. You mentioned previous info sessions have taken place. Staff were not allowed to attend those. May we attend future sessions including the 1110 webinar. Well, it sounds like the show is a hit. So if you want to join us again and RSVP, it’s fine fine with us.

Yeah, it’d be great. The more the more the merrier. Just want to answer as many questions as we can and pass along as much information to help you make a good choice.

All right. I should probably read these first, huh? My dependent son will be living in Santa Cruz for the next four years. If I choose Centivo, can he select a Centivo primary care physician in Santa Cruz or does his PCP have to be within UCLA Health?

Yeah. So, we don’t have a network up in the Santa Cruz area. So, his options would be, you know, choosing a in-person PCP that’s in the LA area through UCLA when he’s home. They also allow virtual. Or he could choose Centivo Care and use the Centivo Care virtual primary care team while he’s away in Santa Cruz. Got it.

Okay. Here’s another travel related question. Slightly different maybe. If we’re if we’re on Centivo and we travel abroad or to another state, do we have any coverage?

Yeah, I think we’ve we’ve answered this one a couple times. So the answer is yes for emergency and urgent care services if you’re abroad and also all across the US. And then if you are traveling to a market where we have a network, you can access that network as well. Got it.

Okay. I know we’re past time, but let’s let’s get through a couple more if it’s okay with everyone. If you’ll hang out for a couple more minutes. The out-of- pocket maximum is 20,000. How does that work for say the example of going to the hospital and having a baby or other large expenses? Okay, we talked about the baby the example given during presentation which m was excuse me much less than 20,000 for out-of pocket.

How did that compute? Yeah. Do you want to maybe just I think they’re speak I think they’re speaking of out of pocket for out of network services. So having a baby is typically an in network service which would cost you that $790 if you right do it that way. Yeah. So have your baby in network or Right. Yeah. You have surgery in network definitely. Yeah.

Okay let’s see. Bear with me. Is the cost of care and/or premiums changing at all under the Anthem plan? Yes. There’s a fairly detailed chart on that on the frequently asked questions on our website. There there’s also FAQs that are very similar on the WGAW website related to the changes in the Anthem plan. So I it’s hard to talk through a chart, but yes, it is it is changing and I would I would ask you to please go look at the FAQs.

If you still want to go through it, give us a call and we’ll we’ll point you to it. Okay, next question. How long is the UCLA and Centivo relationship contracted for? Is there a chance of a change in relationship network in the near future?

No. One of the things I will say, and you see this in the news with other insurance carriers, is we really haven’t had a health system leave our partnership. They’ve chosen to work with us. You know, not not to say anything ill will on the other insurance carriers, but I think providers are sometimes frustrated working with some of the traditional insurance carriers and they view us as a way to really work closer with organizations like PWGA and their members.

And so we’ve been very fortunate in that we haven’t had health systems leave our partnership and our contracts at this point kind of autorenew. So, there isn’t really an expected change with that UCLA partnership. Great. Okay. Next question relates to Rula. The coverage for Rula is the same under Centivo. Question mark.

Yes, I believe I believe it is. Will can confirm if there’s any difference between Anthem, but I believe it’s the same. Yeah, exactly the same. Yes. Okay. This is an interesting question. We’ll have to think about this. What happens if you are relocated for a show to a place that does not have a robust Centivo network? Does that count as a life event?

I think the answer would be yes. If you’ve changed your your primary residence, I I know often times, you know, if you’re on a show, it can go for a long time and you have to move there to be on on set on location. And if that’s the case and you’ve moved your primary residence, the answer is yes, that that qualifies as a life event.

Okay. Let’s do maybe one more question. I know we’re past time. I just want to try to A lot of these are are very very similar to what we’ve already answered. So, I’m I’m scrolling through them. How much for dependence on Centivo?

So, the Centivo monthly premium is $25 for you, just the participant, $50 for you and your spouse. This is per month and $75 for you and your family on Centivo. That’s the That’s the monthly premium.

I’ll do maybe make this I’ll do two more. There’s one really good one. If you do one more, Jim, and then I there’s one that might be good to end on. So, go for the one that you were going to go to. Okay, perfect. That’s great. How much will prescriptions be covered if we use CVS rather than Express Scripts?

And the answer is you have to use Express Scripts. That’s our that’s our pharmacy benefit manager. So, you got to go through Express Scripts. But if you go to CVS and you give them your card with your number on it, they will they will honor that as as being part of Express Scripts. I know I’ve done it myself, so that does work.

Okay, Ellie, pick your Please pick. Okay. Okay. Yeah, I thought this was a good question. So the question is, “This plan seems great. Can you go through some of the major differences between Centivo and Anthem? Specifically, what are some of the, for lack of a better term, downgrades going from Anthem to Centivo?”

So I think this is a good question because you’re probably trying to compare, you know, some of the differences between the two plans. I I think if there’s any and I wouldn’t even necessarily call this a downgrade, but like the reality is the Anthem network is very broad. It includes many many providers. So it’s a very broad network. The Centivo network is more tailored and we’ve you know centered it around UCLA for very particular reasons because we’ve looked at their quality.

We’re able to get more affordable prices and so the network’s going to be a little bit more tailored compared to Anthem. But one of the benefits to that is because of the interconnectedness of it all being with UCLA is you’re going to have an experience where your providers are talking together versus it being more fragmented if you were going to a UCLA provider, a Cedar specialist, you know, another specialist somewhere else.

They’re not always talking together. So, that’s one of the benefits of why we’ve built it this way. And then I think the positives are the affordability. I mean, the benefits that we looked at earlier of having no deductible, free primary care, $25 co-pay for specialists, you know, less than $700 if you have a really serious procedure done. Most people are not paying that level you know, of out of pocket for expenses like that.

So, you are getting a a much richer benefit on the Centivo plan as well as lower contributions to what Jim shared as well. So, I would say those are probably some of the biggest differences between the two options, right?

I I’ll just second that that as the the board and the guild considered what to do, the primary reason Centivo was was we thought such a great second option is that the the groups inside of that network are terrific. UCLA is one of the top in the world. Mount Sinai similar Memorial if you’re in Long Beach or Orange County. So across the board you have these top-notch groups.

U as Ellie mentioned you have the the the difference is you have to stay within those those call it narrow networks force and versus a broad you know much broader network for Anthem. But you you pay more for Anthem. So you pay for that broad reach versus you know having these narrow networks like such as UCLA. So we you know we thought it was just a really great option for our participants to consider to have those those great networks inside of Centivo and to try to save a couple dollars also for our participants if they were willing to go into that UCLA environment or Mount Sinai in New York.

The second thing was in New York we haven’t had an option like this. There was no TIHN in New York. So if you were a writer in New York, you were in Anthem. There were no TIHN options. So that was also interesting and we felt important. So with that I think I think we’ll end. We’re at about 612.

So thank you all for Jim. I just wanted to make one more announcement before you ended. If we didn’t get to your questions or if any further questions come up, please email [email protected]. If you submitted an anonymous question to the Q&A, you’ll also need to email [email protected].

Great. And then we’ll we’ll respond to each of those. Thank you, Sheila. That’s great. Yeah, I’m glad you I’m glad you mentioned that. All right. Thank you, everybody. We’ll we’ll do another one of these on November 10th right before open enrollment begins. And we look forward to taking your calls and questions and hopefully the resources we’ve provided for you you find helpful as well. And thank you and good night everyone.

Appreciate it. Okay. Thank you. Good night.