Primary Care Physicians

The Group Life and Health Benefits Plan for Employees of Participating AMR Corporation Subsidiaries generally allows the designation of a primary care provider. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members as patients. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact the plan administrator.

OB/GYN visits

You do not need prior authorization from the Group Life and Health Benefits Plan for Employees of Participating AMR Corporation Subsidiaries or from any other person (including a primary care provider) to access obstetrical or gynecological care from a health care professional in our network who specializes in obstetrics or gynecology. The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan or following procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact the plan administrator.

Women's Cancer Rights Act

ANNUAL BENEFITS NOTICE UNDER THE WOMEN'S CANCER RIGHTS ACT

December 15, 2013

In compliance with the Women's Cancer Rights Act, this annual notice provides you with information about the coverages available to participants and their eligible dependents under the following employee benefit plans:

  • Group Life and Health Benefits Plan for Employees of Participating AMR Corporation Subsidiaries (referred to as the "Plan")
  • Group Life and Health Benefits Plan for Retirees of Participating AMR Corporation Subsidiaries (referred to as the "Retiree Medical Plan")
  • Supplemental Medical Plan for Employees of Participating AMR Corporation Subsidiaries
  • TWA Retiree Health and Life Benefits Plan.

These plans provide coverage for reconstructive surgery, as follows:

  • Reconstruction of the breast on which a mastectomy was performed;
  • Surgery or reconstruction of the other breast to produce a symmetrical appearance;
  • Services in connection with other complications resulting from a mastectomy, such as treatment of lymphedemas; and
  • Prostheses.

This information is also available in your Employee Benefits Guides and Retiree Benefits Guides – in both the CD-ROM version (if applicable to your work group) sent to you in December, 2012, and via Jetnet on e-HR.

NMHPA

Newborns' and Mothers' Health Protection Act

December 15, 2013

Health plans and insurance carriers generally may not, under federal law, restrict a mother's or newborn's benefits for a hospital length of stay that is in connection with childbirth to less than 48 hours following a vaginal delivery or 96 hours following a delivery by cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and insurance carriers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours as applicable). This is presented for your information in general.

TO EMPLOYEES OF AMR CORPORATION SUBSIDIARIES ELIGIBLE TO PARTICIPATE IN THE GROUP LIFE AND HEALTH BENEFITS PLAN FOR EMPLOYEES OF PARTICIPATING AMR CORPORATION SUBSIDIARIES

CHIP

Premium Assistance Under Medicaid and the Children's Health Insurance Program (CHIP)

August 15, 2012

If you or your children are eligible for Medicaid or CHIP and you are eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for these programs, but also have access to health insurance through their employers. If you or your children are not eligible for Medicaid or CHIP, you will not be eligible for these premium assistance programs.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, you can contact your state Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your state Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the state if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must permit you to enroll in your employer plan if you are not already enrolled. This is called a "special enrollment" opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.dol.gov or by calling toll-free 1-866-444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2012. You should contact your state for further information on eligibility.

State Assistance Contact Information

STATE AGENCYWEBSITEPHONE
ALABAMA
MEDICAID
www.medicaid.alabama.gov1-855-692-5447
ALASKA
MEDICAID
http://health.hss.state.ak.us
/dpa/programs/medicaid/
Outside
Anchorage:
1-888-318-8890

In Anchorage:
907-269-6529
ARIZONA
CHIP
www.azahcccs.gov/applicantsIn Maricopa
County:
602-417-5437

Outside Maricopa
County:
1-877-764-5437
COLORADO
MEDICAID
www.colorado.govIn Colorado:
1-800-866-3513
Outside Colorado:
1-800-221-3943
FLORIDA
MEDICAID
www.flmedicaidplrecovery.com1-877-357-3268
GEORGIA
MEDICAID
http://dch.georgia.gov/
Click on Programs, then Medicaid,
then Health Insurance Premium
Payment (HIPP)
1-800-869-1150
IDAHO
MEDICAID & CHIP
Medicaid:
www.accesstohealthinsurance.idaho.gov

CHIP:
www.medicaid.idaho.gov
Medicaid:
1-800-926-2588

CHIP:
1-800-926-2588
INDIANA
MEDICAID
www.in.gov/fssa1-800-889-9949
IOWA
MEDICAID
www.dhs.state.ia.us/hipp/1-888-346-9562
KANSAS
MEDICAID
http://kdheks.gov/hcf1-800-792-4884
KENTUCKY
MEDICAID
http://chfs.ky.gov/dms/default.htm1-800-635-2570
LOUISIANA
MEDICAID
www.lahipp.dhh.louisiana.gov1-888-695-2447
MAINE
MEDICAID
www.maine.gov/dhhs/ofi/
public-assistance/index.html
1-800-977-6740

TTY:
1-800-977-6741
MASSACHUSETTS
MEDICAID & CHIP
http://mass.gov/MassHealth1-800-462-1120
MINNESOTA
MEDICAID
www.dhs.state.mn.us/
Click on Health Care,
then Medical Assistance
1-800-657-3629
MISSOURI
MEDICAID
www.dss.mo.gov/mhd/
participants/pages/hipp.htm
573-751-2005
MONTANAmedicaidprovider.hhs.mt.gov/
clientpages/clientindex.shtml
1-800-694-3084
NEBRASKA
MEDICAID
www.ACCESSNebraska.ne.gov1-800-383-4278
NEVADAhttp://dwss.nv.gov/1-800-992-0900
NEW HAMPSHIRE
MEDICAID
www.dhhs.nh.gov/oii/
documents/hippapp.pdf
603-271-5218
NEW JERSEY
MEDICAID & CHIP
Medicaid:
www.state.nj.us/humanservices/
dmahs/clients/medicaid


CHIP:
www.njfamilycare.org/index.html
Medicaid:
1-800-356-1561

CHIP:
1-800-701-0710
NEW YORK
MEDICAID
http://nyhealth.gov/health_care/medicaid/1-800-541-2831
NORTH CAROLINA
MEDICAID
www.ncdhhs.gov/dma919-855-4100
NORTH DAKOTA
MEDICAID
www.nd.gov/dhs/services/
medicalserv/medicaid/
1-800-755-2604
OKLAHOMA
MEDICAID & CHIP
www.insureoklahoma.org1-888-365-3742
OREGON
MEDICAID & CHIP
In English:
www.oregonhealthykids.gov

En Español:
www.jihossaludablesoregon.gov
--
PENNSYLVANIA
MEDICAID
www.dpw.state.pa.us/hipp1-800-692-7462
RHODE ISLAND
MEDICAID
www.ohhs.ri.gov401-462.5300
SOUTH CAROLINA
MEDICAID
www.scdhhs.gov1-888-549-0820
SOUTH DAKOTA
MEDICAID
dss.sd.gov1-888-828-0059
TEXAS
MEDICAID
www.gethipptexas.com/1-800-440-0493
UTAH
MEDICAID & CHIP
http://health.utah.gov/upp1-866-435-7414
VERMONT
MEDICAID
www.greenmountaincare.org/1-800-250-8427
VIRGINIA
MEDICAID & CHIP
Medicaid:
www.dmas.virginia.gov/rcp-HIPP.htm

CHIP:
www.famis.org
Medicaid:
1-800-432-5924

CHIP:
1-866-873-2647
WASHINGTON
MEDICAID
http://hrsa.dshs.wa.gov/
premiumpymt/Apply.shtm
1-800-562-3022

Ext. 15473
WEST VIRGINIA
MEDICAID
www.dhhr.wv.gov/bms1-877-598-5820
HMS Third
Party Liability
WISCONSIN
MEDICAID
www.badgercareplus.org/
pubs/p-10095.htm
1-800-362-3002
WYOMING
MEDICAID
http://health.wyo.gov/
healthcarefin/equalitycare
307-777-7531

For more information...

To see if any more states have added a premium assistance program since July 31, 2012, or for more information on special enrollment rights, you can contact either:
United States Department of Labor
Employee Benefits Security Administration
www.dol.gov/ebsa
1-866-444-EBSA, (Ext. 3272)
United States Department of Health and Human Services
Centers for Medicare and Medicaid Services
www.cms.hhs.gov
1-877-267-2323, (Ext. 61565)

MEDICARE PART D

MEDICARE PART D—NOTICE OF CREDITABLE COVERAGE

October 10, 2012

Important Notice from American Airlines, Inc. About
Your Prescription Drug Coverage and Medicare

This notice applies to health coverage for active employees under the Group Life and Health Benefits Plan for Employees of Participating AMR Corporation Subsidiaries (herein referred to as the "Plan" or "AA health coverage" or "AA health plan").

You and your eligible dependents may or may not be eligible/enrolled in this Plan; therefore, you should check your personal benefit enrollment records to determine your eligibility and whether or not you are enrolled.

THIS NOTICE DESCRIBES YOUR COVERAGE UNDER THE PLAN AS OF OCTOBER, 2012. Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with American Airlines, Inc.-sponsored health plans ("AA health plan") and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are two important things you need to know about your current coverage and Medicare's prescription drug coverage:

  1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
  2. American Airlines, Inc. ("AA") has determined that the prescription drug coverage offered by the Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join A Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th through December 7th.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current AA health coverage will be affected. You may keep your AA health coverage, even if you elect Medicare Part D; however your AA health coverage will coordinate benefits with Part D coverage. If you do decide to join a Medicare drug plan and drop your current AA health coverage, you may later reenroll in AA health coverage, either during annual enrollment or if you experience a Life Event.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

You should also know that if you drop or lose your current health coverage with AA and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later.

If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join.

For More Information About This Notice Or Your Current Prescription Drug Coverage…

For further information, visit the Benefits page on Jetnet, and Chat with HR Services at www.jetnet.aa.com.

NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through AA changes. You also may request a copy of this notice at any time.

For More Information About Your Options Under Medicare Prescription Drug Coverage…

More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:

  • Visit www.medicare.gov
  • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help
  • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

Disclaimer

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).