LIFEGUARD’S FORMER WEB SITE CLOSES

LIFEGUARD’S FORMER WEB SITE CLOSES

Due to Lifeguard’s termination of health plan coverage as of midnight on December 31, 2002, our former Web site is no longer available. The following information will assist you if you have questions regarding claims for services rendered through December 31, 2002.

YOU NEED TO SCROLL DOWN TO READ THE TEXT OF THIS WEBSITE.

Note to Lifeguard Customers

Information on this Web page is organized into separate sections for Lifeguard, Inc. Health Maintenance Organization (HMO) and Point-of-Service (POS) benefit plans, and Lifeguard Life Insurance Company Preferred Provider Organization (PPO), Out of Area (OOA) and Exclusive Provider Organization (EPO) plans.

Information Regarding Lifeguard, Inc.

IMPORTANT UPDATE AND LEGAL FORMS

The California Department of Managed Health Care (DMHC) is responsible for regulating HMO and POS health plans like those previously administered by Lifeguard, Inc. On September 13, 2002, the DMHC appointed Richard K. Diamond as a Conservator over Lifeguard, Inc. Mr. Diamond announced soon thereafter that Lifeguard would cease providing HMO and POS health plan benefits effective at midnight on December 31, 2002.

Since that time, all Lifeguard groups and members have been transitioned off the plan and benefit coverage ended on December 31, 2002 (or earlier if the employer group terminated coverage prior to 12/31/02).

On January 16, 2003, the DMHC filed a Verified Complaint for Involuntary Dissolution of Lifeguard, Inc. under section 8510 of the California Corporations Code. On January 16, 2003, the DMHC also petitioned the Santa Clara County Superior Court to transition Mr. Diamond from a Conservator to a Receiver over Lifeguard, Inc. and this motion was approved.

On January 28, 2003, several additional motions were filed with the Santa Clara County Superior Court by both Lifeguard, Inc. and the DMHC. The following Orders were issued by the Court in response to these motions:

Approved Motions:

Order Authorizing Wind Up and Dissolution of Lifeguard, Inc. Order Granting Motion of Receiver for an Order Establishing Claims Procedures and Setting a Bar Date For Filing Claims Against Lifeguard, Inc. Order Granting Motion of Receiver for an Order Establishing Procedures for Creditors’ Obtaining Notice of Future Hearings Order Granting Application for Employment of Danning, Gill, Diamond & Kollitz, LLP as General Counsel for the Receiver

Pending Motions:

On March 25, 2003, the Receiver will be appearing before the Santa Clara County Superior Court, seeking approval for the following motion:

Motion for Order Authorizing Receiver to Enter Agreements on Behalf of Lifeguard, Inc. and For Approval of Agreements

On April 8, 2003, the Receiver will be appearing before the Santa Clara County Superior Court, seeking approval for the following motion:

Motion for Approval of Termination Agreements with Former Lifeguard Executives

On April 22, 2003, the Receiver will also be appearing before the Santa Clara County Superior Court, seeking approval for the following motion:

Motion To:

(1) Sell certain personal property
(2) Employ Ostrin & Ostrin Co. as Auctioneers
(3) Confirm Sale Qithout Further Hearing: and
(4) Abandon Personal Property.

Claims Bar Date and Proof of Claim Form

Pursuant to the Court’s Order Establishing Claims Procedures and Setting a Bar Date for Filing Claims Against Lifeguard, Inc., a bar date of June 6, 2003 was established for any and all claimants to bring a claim against the estate of Lifeguard, Inc. ("Claims Bar Date"). Claimants must have filed a Proof of Claim in the form set forth below, and in accordance with the following instructions, in order to be eligible for recovery against the estate of Lifeguard, Inc. Please note that Proof of Claim forms and all supporting documentation must have been filed to the Receiver’s Claims Agent as follows: Attention: Lifeguard Claims Manager, CPT Group, Inc. at 16630 Aston Street, Irvine, CA 92606 by no later than June 6, 2003.

HMO/POS Provider Claims for Dates of Service Prior to September 13, 2002

Upon his appointment, Mr. Diamond determined that payment for HMO and POS claims for services rendered prior to September 13, 2002 would not be paid at this time, but must be dealt with through the receivership proceedings.

HMO/POS Provider Claims for Dates of Service from September 13, 2002 through December 31, 2002

Providers should be aware that the June 6, 2003 Claims Bar Date applied to any and all claims against the Lifeguard, Inc. Receivership estate, including those with dates of service on or after September 13, 2002. If a provider disagrees with Lifeguard’s adjudication of a post 9/13/02 claim that is upheld on appeal and wishes to pursue a claim against the receivership estate, a Proof of Claim must have been submitted with the Receiver’s Claims Agent, CPT Group, Inc. by no later than June 6, 2003 (see section above entitled "Claims Bar Date and Proof of Claim Form").

If HMO/POS Members Receive a Bill From Their Lifeguard Provider

As noted above, all claims with dates of service prior to September 13, 2002 are being held in abeyance by the Lifeguard receiver. These claims will be reviewed and handled through the receivership proceedings.

By law, Lifeguard contracted providers cannot directly bill Lifeguard members who were eligible for covered services rendered under HMO or POS plans, require these members to pay up front for covered medical services, or sign a Financial Responsibility waiver for covered services.

Under HMO and POS Level One medical plans, eligible members are not responsible for payment of covered or authorized medical services received from contracting providers after the applicable copayment requirements have been met.

Providers that have submitted pre 9/13/02 claims to Lifeguard were notified of Lifeguard's non-payment and the process for submitting a Proof of Claim Form for review through the receivership proceeding. If you receive a bill directly from your Lifeguard contracted doctor, hospital or other contracting facility for covered HMO or POS services rendered while you were eligible for Lifeguard coverage, you should contact the doctor’s office to verify that the bill has been submitted to Lifeguard.

Services provided under POS Level Two are subject to a plan deductible and for services received from non-contracting providers, members may be balance billed for the difference between Lifeguard’s payment and the provider’s billed charges.

For Additional Information and Assistance

If you need further information or assistance, contact the DMHC HMO Help Center 24 hours a day, 7 days a week, at 1-888-HMO-2219, or log onto their Web site at www.hmohelp.ca.gov. Specific information for Lifeguard members is posted on the DMHC Web site.

Information Regarding PPO, OOA and EPO Claims for Lifeguard Life Insurance Company

The California Department of Insurance (CDI) is responsible for regulating PPO, OOA and EPO plans, which are administered by Lifeguard Life Insurance Company (LLIC), a subsidiary company of Lifeguard, Inc. As a result of the Conservation of Lifeguard by the DMHC, the difficulties associated with operating LLIC separate from Lifeguard, Inc., and to protect the interests of LLIC’s policyholders, the California Insurance Commissioner conserved Lifeguard Life Insurance Company on September 27, 2002.

The operations of LLIC are so intertwined with Lifeguard, Inc. that the wind down and liquidation of Lifeguard has caused a parallel reduction in LLIC's membership and, ultimately, will result in the wind down of LLIC's operations. All Lifeguard Life Insurance Company employer groups and members have been transitioned off the plan and benefit coverage ended at midnight on December 31, 2002 (or earlier if the employer group terminated coverage prior to 12/31/02).

While Lifeguard, Inc. has been declared insolvent, LLIC has a statutory surplus of funds. Following the execution and court approval of a series of Agreements between the Insurance Commissioner and Lifeguard, Inc.’s Receiver, which are designed to assure that all LLIC claims continue to be paid in full, on June 30, 2003 the court issued an order removing LLIC from Conservation and returning it to the control of the Receiver. The Commissioner will continue to monitor LLIC’s performance under the Agreements through an Administrative Supervisor.

Motion for Order Authorizing Receiver to Enter Agreements on Behalf of Lifeguard, Inc. and For Approval of Agreements

LLIC Claims and Grievances

Lifeguard Life Insurance Company PPO, OOA and EPO claims and grievances relating to services received prior to December 31, 2002 will continue to be paid and processed in the normal course of business.

Submit PPO, OOA and EPO ASAP

To ensure that your Lifeguard claims are processed in a timely fashion, please submit outstanding claims for covered services as soon as possible.

Process to Submit Claims

For Providers to submit a paper claim, providers should include:

Any supporting medical records and documentation
The patient’s name, address, identification number and group number from the member’s identification card.
Itemized bill

PPO, OOA and EPO Members may submit claims on Lifeguard paper claim forms. To submit a claim, be sure to include:

Copies of itemized bills
The patient’s name, address, identification number and group number from the member’s identification card.
Proof of payment (for members submitting claims for reimbursement of out-of-pocket expenses).

Type of Claim	Mail Claim to:
Provider Claims For medical services rendered to Lifeguard members covered under PPO, OOA or EPO plans through midnight on December 31, 2002	Lifeguard’s Claims Department, P.O. Box 5506, San Jose, CA 95150.
Provider Claims Disputes	Submit all correspondence in writing to Lifeguard’s Provider Services Department, P.O. Box 5506, San Jose, CA 95150.
Member Claims For bills received directly from Lifeguard participating doctors for covered services after applicable copayments, coinsurance and deductibles have been paid (include proof of payment). For out of area or non-network hospital or emergency care services where members have been billed directly Pharmacy Claims	Lifeguard’s Claims Department, P.O. Box 5506, San Jose, CA 95150.
Member Grievances	Submit all correspondence in writing to Lifeguard’s Grievance Department, P.O. Box 5506, San Jose, CA 95150.
Mental Health/Chemical Dependency Claims	MBC, 300 Continental Blvd, Suite 300, El Segundo, CA 90245. Attn: Clinical Director or Call 1-888-622-4543

If PPO, OOA or EPO Members Receive a Bill From their Doctor

Services provided under PPO and OOA plans are subject to a plan deductible, and for services received from non-participating providers, members may be balance billed for the difference between Lifeguard’s payment and the provider’s billed charges.

EPO plans are also subject to a plan deductible; however, members should not be billed for amounts above applicable plan deductibles, co-payments or coinsurance.

If you question a bill received directly from your doctor for covered services rendered under your Lifeguard insurance coverage, mail your written correspondence with a copy of the bill in question directly to Lifeguard’s Grievance Department, P.O. Box 5506, San Jose, CA 95150. If you have paid the bill, please provide proof of payment in the form of a cancelled check or credit card receipt.