This page contains a Flash digital edition of a book.
By John Jacobsen I


t’s a perfect time of year to start doing some new things. The weather is getting nicer and being outside after a long winter is wonderful! I say this like I’ve been hibernating somewhere in


the Arctic Circle, but you get the gest. Sometimes the slight sea- sonal changes we have in California are enough to kick start some new activities. All of us, like most people, have a lot going on in our lives.


Often that means that you are paying attention to everybody and everything besides yourself. If that is the case, this is for you. Each of us have people in our lives that depend on us. It is important to remember that taking care of yourself and being as healthy as you can means that you can get more done, and feel better doing it. You have heard it before, but it doesn’t hurt to get a reminder that can keep you on the top of your game. Try eating better, get some sort of physical activity in everyday and do something enjoy- able to melt the stress away. I know this sounds like a government sponsored health ad, but the truth is these few simple things are the drivers of our well-being. In the not so recent past, several local hospitals declared that


they would no longer be a part of the Anthem Blue Cross PPO net- work. This was of a great concern for a large portion of our mem- bers that rely on these hospitals for all of their family’s needs. The hospital group (HCA) and Anthem Blue Cross could not come to terms on several contractual issues. Some of you asked the Relief Association to fix this problem


- as if we had an ability to do so! But we did come up with a very temporary patch - to extend the period of time (90 days) before the “PPO” level benefit was discontinued, which would hopefully al- low some planning for alternatives. The Board made this decision with only your best interest in mind. No other healthcare plan that was affected by this would dream of doing such a thing for their members. I would hope that this is recognized by all as just one of the many reasons you belong to the LAFRA Medical Plan. The hospitals and facilities that are recognized as a “PPO” are


only such because of the agreement or contract that they have with Anthem Blue Cross. We pay Anthem a fee for our ability to access this gigantic network of doctors and facilities, and also to receive the tremendous discounts on the fees charged. Simply put, if An- them doesn’t have a contract in place, than we don’t have the ability to access these hospitals at the negotiated rates. I know every one of you has read some of the particulars sur-


rounding healthcare and the continuation of its rising cost. Take a look at one of your “Explanation of Benefits” (EOB) and really look at what was charged and what was paid. It is staggering. This is the key component as to why we are still able to deliver the level of benefits you deserve at the lowest cost possible. You may ask, “Aren’t there other PPO networks out there that we could contract with?” Yes, but on average they don’t come any-


where close to the depth of discount or the number of participat- ing doctors/facilities as Anthem provides. We consistently evaluate what else is out there with some of the key questions being: What would be the financial impact to our Medical Plan? What would be the disruption to the members? How does this fit our needs for our diverse geographical footprint? None of these have a perfect set of answers, but I hope your trust in the Board to consistently provide the best we can would ease some of your concern. Just when you thought the healthcare narrative was over, I need


to bring another subject to light. Many of you have read in the pa- per about Medco, our Prescription Benefit Manager, and Express Scripts working on a deal to combine and/or merge. Well, the two have reached an agreement and now Express Scripts (with Medco) is the largest PBM in the country - and by their words, “the world.” ::::: ::::: ::::: ::::: ::::: ::::: ::::: ::::: :::::


Some of you asked the Relief Association to fix this


problem - as if we had an ability to do so! ::::: ::::: ::::: ::::: ::::: ::::: ::::: ::::: :::::


What does this mean to us? At this point in time absolutely


nothing will change for our plan. Our contract that spells out where our people can go for retail pharmacy prescriptions will not change. Your mail order prescriptions will operate exactly the same as they have been. The website will remain labeled as Medco. Some of you might have seen the rift between Express Scripts


and Walgreens, where someone with an Express Scripts drug plan could not utilize Walgreens to get their medicine. This has no bear- ing on our Plan and you may continue to use any of the pharmacies you have been using. We have been told that within a year or so we will start to see the Medco branding removed and replaced with Express Scripts. We will ensure that anything changing in this arena will be communicated to you as early as possible. I wanted to relay a special thank you to Bruce Galien, Craig


White and all of you who worked your tails off putting together another great family weekend. The Hook and Ladder Enduro was another great success and brought a very healthy contribution to our Widows, Orphans and Disabled Firemen’s Fund. I hope everyone who attended enjoyed themselves. Great job guys! Hope for Firefighters is June 7th and we hope to see you there.


Respectfully,


John E. Jacobsen President@lafra.org (323) 259-5200


May 2012 • 5


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64