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T201 - Reply Memo Suport of Motions to Compel LDI and L&E - Buck - 2 9 21

https://ldi.la.gov/docs/default-source/documents/financialsolvency/receivership/louisiana-health-cooperative/lahc/t201---reply-memo-suport-of-motions-to-compel-ldi-and-l-e---buck---2-9-21.pdf?sfvrsn=39ba4c52_2

justification for noncompliance with the outstanding subpoenas. Presumably recognizing, of a privately owned company, put it out of business, [and] sue its officers for failing to run the company

Reg118-Cur-RequirementsInTheEve

https://ldi.la.gov/docs/default-source/documents/legaldocs/regulations/reg118-cur-requirementsintheeve.pdf?sfvrsn=c24a4c52_6

 INSURANCE Louisiana Administrative Code October 2021 500 2. The stop-loss or excess policies must contain provisions to cover incurred, unpaid claims liability in the event of plan termination. 3. The stop-loss or excess insurer shall bear the risk of coverage for any employer participating in the self-insurance plan that becomes insolvent with outstanding contributions due. 4, to out-of-network access to pharmacy services or prescriptions. AUTHORITY NOTE: Promulgated

MA Plan Jefferson Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-jefferson-parish-2017.pdf?sfvrsn=19527652_12

% Chemo Drugs 20% 20$ 20% 15%- 20% Out-of-Pocket Maximum $5,900/ $10,000 $6,700 $6,700 $6,700, and/or 25%- 51% Drugs not covered Chemo Drugs 15%- 20% 20%/ 19%- 25% 20%- 30% Out-of-Pocket Maximum, and/ or 40%- 51% $0- $15 and/ or 40%- 51% Chemo Drugs 20%- 30% 15% 15% 15% Out-of-Pocket Maximum, part C & D) $32.80 $0 $0 Health Plan Deductible $350 Out-of-network $0 PCP Co-pay $10 or 0-20% $25, in the Gap 40%- 51% 40%- 51% 40%- 51% Chemo Drugs 20% 20% 20% Out-of-Pocket Maximum $6,700 $6,700

MA Plan Iberville Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-iberville-parish-2017.pdf?sfvrsn=29527652_12

not covered Chemo Drugs 20% 20% 15%- 20% Out-of-Pocket Maximum $5,900/ $10,000 $6,700 $6,700, % Chemo Drugs 20% 20% 20%/ 19%- 25% Out-of-Pocket Maximum $6,700 $6,700 $6,700/ $10,000 Summary, % Chemo Drugs 20%/ 30% 20%/ 30% 15% 20% Out-of-Pocket Maximum $6,700/ $10,000 $6,700/ $10,000 $6,700, (includes part C & D) $0 $0 Health Plan Deductible $350 Out-of-network $0 PCP Co-pay $25 or 0-20, Drugs 20% 20% Out-of-Pocket Maximum $6,700 $6,700

MA Plan East Baton Rouge Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-east-baton-rouge-parish-2017.pdf?sfvrsn=30527652_12

and/or 40%- 51-% Drugs not covered Chemo Drugs $0 20% 20% 15%- 20% Out-of-Pocket Maximum $5,900, and/ or 26%- 51% $6- $100 and/ or 25%- 51% Chemo Drugs 20% 20% 20%/ 19%- 25% Out-of-Pocket Maximum, % 15% 15% Out-of-Pocket Maximum $6,700/ $10,000 $6,700/ $10,000 $6,700 $6,700 Summary, Deductible $350 Out-of- network $0 PCP Co-pay $10 0%- 20% $10- $25 0%- 20% $5 Specialist Co-pay, % 40%- 51% 40%- 51% Chemo Drugs 20% 20% 20% Out-of-Pocket Maximum $6,700 $6,700 $6,700

MA Plan St Charles Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-st-charles-parish-2017.pdf?sfvrsn=9f4f7652_12

) 20% (Part B) 20% / 30% (Part B) Out-of-Pocket Maximum $6,700 $6,700 / $10,000 $6,700 / $10,000, Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table (St, Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary, Plan Inc WellCare Health Plans HMO HMO-POS HMO $32.80 $0 $0 $166 annual deductible $350 Out, Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table (St. Charles Parish) Blue Advantage (HMO

MA Plan St Helena Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-st-helena-parish-2017.pdf?sfvrsn=9e4f7652_12

) Out-of-Pocket Maximum $6,700 $6,700 $6,700 2017 Medicare Advantage Plans Contract ID/Plan ID, Nursing Inpatient Hospital Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out, Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table (St Helena Parish, Hospital Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum, ) H5576-021 H2491-007 Vantage Health Plan Inc WellCare Health Plans HMO-POS HMO $0 $0 $350 Out

MA Plan St Tammany Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-st-tammany-parish-2017.pdf?sfvrsn=8e4f7652_12

% (Part B) 20% (Part B) 20% (Part B) Out-of-Pocket Maximum $5,900 / $10,000 $6,700 $6,700 2017, Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table (St Tammany, Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary, Drugs Out-of-Pocket Maximum AAA9 Vantage Capitol (HMO-POS) WellCare Value (HMO) H5576-021 H2491-007 Vantage Health Plan Inc WellCare Health Plans HMO-POS HMO $0 $0 $350 Out-of-Network

MA Plan West Baton Rouge Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-west-baton-rouge-parish-2017.pdf?sfvrsn=c3457652_6

coverage Yes Chemo Drugs 20% (Part B) 20% / 30% (Part B) 20% (Part B) Out-of-Pocket Maximum $6,700, Hospital Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum, Inpatient Hospital Annual Drug Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket, Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table (West Baton Rouge, Inc WellCare Health Plans HMO-POS HMO $0 $0.00 $350 Out-of-Network deductible $0 $25 or 0-20

MA Plan St Landry Parish 2017

https://ldi.la.gov/docs/default-source/documents/shiip/medicare-advantage-plans/ma-plan-st-landry-parish-2017.pdf?sfvrsn=fa427652_12

) Additional Coverage in Gap Yes Yes Yes Chemo Drugs 20% (Part B) 20% (Part B) 20% (Part B) Out, Out-of-Pocket Maximum Summary of Benefits Table (St. Landry Parish) HumanaChoice * (PPO without, Deductible Additional Coverage in Gap Chemo Drugs Out-of-Pocket Maximum Summary of Benefits Table, Health Plan Inc Local HMO HMO HMO-POS $0 $32.80 $0 $0 $166 annual deductible $350 Out-of-Network, Drugs Out-of-Pocket Maximum Summary of Benefits Table (St. Landry Parish) WellCare Value (HMO