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LEOFF1 Disability Board Benefits

Effective January 1, 2016, the City will provide all post 65 LEOFF1 retirees healthcare coverage administered by AmWINS Group Benefits and is underwritten by United American Insurance Company. This is a MEDIGAP Plan based on utilizing Medicare as primary coverage and a supplement to pay the deductible and co-insurance. Post 65 LEOFF1 retirees are also being enrolled in a prescription drug coverage plan with Precise RX Care.  

The City will also provide healthcare coverage to pre 65 LEOFF1 retirees through the Employer's Healthcare Coalition of Washington, through the Premera network.

If you are eligible for Medicare it is your secondary health insurance after Medicare, for those ineligible for Medicare it is your primary insurance. First submit all medical claims to Medicare (if applicable) and Premera. If there are any medical expenses still due after Medicare and/or Premera payments have been issued, you can submit the City of Mount Vernon LEOFF1 Board Medical Claim Reimbursement Form with receipts or the Medicare/Premera Explanation of Benefits (EOB) forms for payment verification. Submitting out-of-pocket medical expenses to the LEOFF1 Board does not guarantee payment. All claims for medical expense reimbursement must comply with the City of Mount Vernon LEOFF1 Disability Board Rules, Policies, and Procedures.

Insurance Plans

Pre-65 Insurance Change Notification Letter
Post 65 Insurance Change Notification Letter

LEOFF1 Retirees not eligible for Medicare:
2016 LEOFF1 Plan A Summary

For LEOFF1 Employees on Medicare:
2016 LEOFF1 Medigap Summary Your vision benefit is through VSP. If you see a VSP provider they will bill MedicareAdvantage directly for the hardware/exam. If you see a non-VSP provider, use the VSP Member Reimbursement Form to submit the exam/hardware claim. To find a VSP provider: Vision Service Plan (VSP) or call 800-877-7195.

Contacts

AmWINS Group Benefits Customer Service Line: 1-888-883-3757
Premera Customer Service Line: 1-800-722-1471


Your Medicare Coverage Phone: 1-800-medicare
Medicare Claim Form
Medicare Appeals Form
Apply online for Medicare



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