Monthly Employee Contributions for 2008

USC Network Medical Plan
Employee:		$75.00
Employee + Adult:		$162.00
Employee + Child(ren):		$130.00
Employee + Adult + Child(ren):		$217.00

Network Referral to Non-Network Provider
If your Network Physician refers you to another physician or health care provider, it is your responsibility to verify that the physician or other provider is also a Network provider. If the physician or other provider is not a Network provider, benefits will be paid at the out-of-Network rate.

Want to find a USC physician or learn more about USC Care Medical Group? Visit their website at www.doctorsofusc.com.

The Doctors of USC at Downtown
The The Doctors of USC at Downtown is located in downtown Los Angeles. Faculty, Staff and their covered dependents can be seen at this site between the hours of 9:00 a.m. and 5:00 p.m., Monday through Friday. The The Doctors of USC at Downtown is located at:

Tier 2 Participating Providers - Nationwide Coverage
You have access to participating providers nationwide. What this means to you is that you are able to access a larger network of contracted physicians and hospitals within the state of California and across the United States (with the exception of vision and dental providers) and have benefits calculated at a negotiated contract rate.

You may look up the participating providers within California from the Blue Cross Prudent Buyer website at www.bluecrossca.com. For providers outside of California, you must go to the BlueCard program website at www.bluecares.com. When making an appointment with any of these providers, you must verify with their office that the provider continues to participate either in the Prudent Buyer or BlueCard program. Otherwise, benefits will be calculated at the non-contracted Network level if they no longer participate.

RxAmerica
Pharmacy benefits for the USC Network Medical Plan are managed by RxAmerica.

Prescription Copay Information
The retail Copayment for prescription drugs filled at a Network pharmacy is:

Generics - 15% of the cost of each prescription or refill, with a minimum Copay of $5.00. Maximum Copay of $100 per prescription per 30 day supply.

Brand Name - 20% of the cost of each prescription or refill, with a minimum Copay of $20.00. Maximum Copay of $100 per prescription per 30 day supply.

Brand Name with Generic available - 40% of the cost of each 30 day prescription or refill - No Maximum Copay.

A $0 Copay for over-the-counter (OTC) non-sedating antihistamines and proton pump inhibitors when dispensed pursuant to a prescription written by a Physician. (Not available through Mail Order.)

For medications dispensed in excess of a one month's supply at a retail pharmacy, multiple copayments will be charged.

For more information about Mail Service, please see www.rxamerica.com or call RxAmerica at (800)736-2774.

For prescriptions filled at a non-Network pharmacy, the plan will reimburse 50% of the Plan's RxAmercia contracted rate. Prescriptions filled at a non-Network pharmacy must be paid in full by the Covered Person at the time of service. The Covered Person must then submit a prescription claim form within 60 days of the fill to get reimbursed 50% of the Plan's contracted rate.

If you have any questions regarding pharmacies or outstanding prescription claims previously submitted by you, please call RxAmerica at (800)736-2774. Also, if you have prescription claims that need to be submitted for reimbursement please forward them within 60 days of the fill to: RxAmerica, L.L.C., Attn: Member Reimbursement, 221 Charles Lindbergh Dr., Salt Lake City, UT 84116.

Medical Claims Information
All inquiries regarding Explanation of Benefit correspondence or any medical bill in question should be directed to Delta Health Systems at (800) 418-5409, Monday-Friday, 8:30 a.m. -- 5:00 p.m. You can also view your paid claims information on Delta Health Systems' web site at www.deltahealthsystems.com. You must first register on their site as a member before you will be allowed to view your information (you must have Internet Explorer to access your information).

All medical claim forms, bills and receipts should be forwarded to:

Delta Health Systems
P.O. Box 780
Stockton, CA 95201-0780

Medical claim forms for submission to Delta Health Systems may be downloaded by going to www.usc.edu/dept/Benefits/forms.html.

ID Cards
USC Network Medical Plan ID cards are issued and mailed by RxAmerica, the Plan's pharmacy benefit manager. ID cards are mailed to your home address in a USC envelope with large words written across the envelope, "Member ID Card Enclosed." RxAmerica automatically sends a maxium of two (2) ID cards to subscribers with family coverage. If you have family coverage and need an extra ID card, you may request an additional card by contacting the Health Plans Office at (213)740-0035. It will take approximately two (2) weeks from the day you place your request to receive the ID card.

If you need a replacement card, there is a $5.00 charge. You may place your request by either mailing or dropping off a check made out to "USC" for $5.00 to USC Health Plans, 3500 S. Figueroa St., Suite 214, Los Angeles, CA 90089-8014. If you are mailing in a check, please enclose a note stating that the check is for an ID replacment card and verify your home address so that we can make sure that the ID card will be mailed to a valid home address.

Inpatient admissions, partial hospital (day treatment), residential tretement center and intensive outpatient visits require prior authorization and BC Life and Health should be contacted at (800) 274-7767.

Outpatient mental health claims should be mailed to: Delta Health Systems, P.O. Box 780, Stockton, CA 95201-0780. For benefit questions or concerns, please call Delta Health Systems at (800) 418-5409.

Vision Service Plan
Employees enrolled in the Network Medical Plan are automatically enrolled in Vision Service Plan (VSP). You can verify your eligibility, plan coverage and other information by clicking on their webpage at www.vsp.com. You must enter your Network Medical Plan ID number on their web site instead of your social security number to view your coverage.