Assembling the Puzzle. Welcome!

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1 Assembling the Puzzle Welcome! Thank you for joining us. The webinar will start momentarily. If you have not yet dialed in to the audio portion of the webinar, please click on Info Tab above, and follow the instructions in the box. License No Innovative Solutions. Enduring Principles.

2 Assembling the Puzzle Medicare 101 & Kaiser Permanente Senior Advantage Karyn Goodsite, Sr. Account Manager Sylvia Weathers, Sr. Service Representative Keenan & Associates Guest Speaker: Maria Harlan, Medicare Retiree Consultant Kaiser Permanente License No Innovative Solutions. Enduring Principles.

3 Agenda Welcome & Introductions Medicare 101 Age-In Campaign Monthly Billing & Medicare Activity Report Q & A License No Innovative Solutions. Enduring Principles.

4 License No Innovative Solutions. Enduring Principles.

5 Group Medicare Lesson One: The Basics of Medicare 5

6 What is Medicare? Federally funded national health program that pays for Seniors Disabled Individuals with end-stage renal (kidney) disease (ESRD) Part of President Lyndon Johnson s Great Society Initiative Signed into law in 1965 Administered by the Centers for Medicare & Medicaid Services (CMS) 6

7 Medicare eligibility Beneficiaries include: Seniors: Individuals 65 or older If they or their spouse are eligible for Social Security Disabled: Individuals under 65, but disabled If eligible for Social Security disability After two-year waiting period Individuals with end-stage renal disease (ESRD) After diagnosis 7

8 Closer look at Medicare Part A Purpose: Provides inpatient insurance Hospital, Skilled Nursing Facility (SNF), Hospice, Home Health Eligibility Cost First day of the month that retiree turns 65 Two years after becoming disabled Soon after renal dialysis begins No premium if beneficiary or spouse have worked 40 quarters of Medicare-covered employment If beneficiary worked less than 40 quarters, monthly premium, set by Medicare formula 8

9 Closer look at Medicare Part B Purpose: Provides outpatient insurance Physician services (inpatient and outpatient), outpatient surgery, lab, radiology, durable medical equipment (DME), dialysis, etc. Enrollment Optional plan: Individuals responsible for their own enrollment Enroll with Social Security Administration Individuals can enroll over a 7-month period that starts 3 months before their 65th birthday 9

10 Closer look at Medicare Part B Monthly premium, usually deducted from Social Security Premium goes up 10% for each 12-month period that individual declines coverage Known as Late Enrollment Penalty (LEP) Not imposed if individual continues to work for, and receives his or her health coverage from, a Group plan of 20 or more eligibles If initial enrollment is missed, they can enroll during Medicare s Open Enrollment Period (January 1 to March 31 with coverage effective July 1 In 2009, Part B premium will range from $96.40 to $308.30, depending on income Most beneficiaries will continue to pay $

11 2009 Monthly Premiums for Medicare Part B You Pay If Your Yearly Income is Single Married Couple $96.40 $85,000 or less $170,000 or less $ $85,001-$107,000 $170,001-$214,000 $ $107,001-$160,000 $214,001-$320,000 $ $160,001-$213,000 $320,001-$426,000 $ Above $213,000 Above $426,000 You Pay If You Are Married but You File a Separate Tax Return From Your Spouse and Your Yearly Income is $96.40 Under $85,000 or less $ $85,001-$128,000 $ Above $128,000 11

12 When to purchase Medicare Part B Option 1 A person over 65 actively working can postpone purchasing Part B until they decide to retire. There would be no Late Enrollment Penalty (LEP) if the member postpones enrollment in Part B due to primary coverage through an employer group. Option 2 A person, still working, can purchase Part B. This is where Medicare becomes secondary payer. This person does not assign their Medicare to Kaiser Permanente, instead uses providers that accept Medicare. This may be more expensive for the individual. Option 3 A person still working, can purchase Part B. This is where Medicare becomes secondary payer. But this time the person assigns their Medicare over to Kaiser Permanente and enrolls in the Senior Advantage plan. This person will be still be designated as "active" paying the active rates under the Working Aged contract option. This will result in richer benefits such as $0 copayments. 12

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16 Medicare Advantage (aka Medicare Part C) Legislation: Balanced Budget Act (BBA) of 1997 Purpose: Expanded the role of managed care plans Created private plan options for how beneficiaries receive Medicare coverage Option One: Original Medicare Plan through the Centers for Medicare & Medicaid Services (CMS) Option Two: Original Medicare Plus Medicare Supplement Plans Medigap Option Three: Through a private insurer plan, such as an HMO These plans were first known as Medicare Risk plans Then renamed Medicare + Choice plans Today they are known as Medicare Advantage plans 16

17 65, retired, has Medicare A & B Option 1: Original Medicare: I can go to any doctor, specialist that accepts Medicare. (Deductibles and Coinsurance apply) Option 2: Original Medicare plus Medicare Supplement Plans (Medigap): I can go to any doctor, specialist that accepts Medicare and purchase Medigap Plans A-L to help pay for my deductibles and coinsurances. Option 3: Medicare Advantage (Part C) Plans: I can assign my Medicare to private companies approved by Medicare (i.e. HMO, PPO, PFFS). How am I going to use my Medicare?

18 Medicare Part C: Relationship between CMS and Medicare Advantage plans MA plans are at risk plans, as opposed to cost plans that are guaranteed to be paid their costs CMS pays the insurer a monthly capitation Based on the beneficiary s county of residence Amount is adjusted over time, based on: Fee-for-service national per capita growth rates update the county rates Payments to plans based on their bids relative to the county rates In order for the insurer to be paid capitation by CMS, the member must exclusively assign his or her benefits to the insurer Member is locked into the plan s providers. CMS will not pay any other provider for this member 18

19 Medicare Part D Legislation: Medicare Modernization Act (MMA) of 2003 Purpose: Provides outpatient prescription drug coverage This prescription drug benefit became available to eligible individuals beginning January 1, Options for enrollment in Part D: Private insurer plan, like Kaiser Permanente Prescription Drug Plan (PDP): A new plan type (created by the legislation) that offers prescription drugs only Unlike Parts A and B, members enroll in Part D directly with the plan, not CMS 19

20 Enrollment in Part D Periods when members are eligible for initial enrollment: Age-in: When member turns 65 (7-month period) Late Enrollment Penalty (LEP) Like Part B, beneficiaries must obtain Part D as soon as they are eligible or be charged a penalty LEP is 1% per month that enrollment is deferred 20

21 Low-income subsidy (LIS) - extra help For those with limited income and resources Provides help with Part D premiums and outpatient drug copayments Degree of help depends on income and resources Additional facts about LIS: Apply at Social Security or through CMS Administered by the member s plan, for CMS Beneficiaries must be enrolled in a Part D plan to receive assistance 21

22 Group Medicare Lesson Two: Kaiser Permanente Senior Advantage 22

23 Medicare Plans and Products Kaiser Permanente Senior Advantage (KPSA) KPSA for Groups KPSA for Individuals 23

24 Kaiser Permanente Senior Advantage Kaiser Permanente s offering for the Medicare Advantage (MA) program enabled by Part C May be offered with a Part D component (MA-PD) Available to both Group and Individual Plan members Individual Plan members must have Parts A and B to join Group Plan members must have Parts A and B to join. Some Group plans will accept members with Part B only entitlement Members must reside in a CMS-approved service area 24

25 Senior Advantage: CMS Reimbursement Members lock-in their benefits with KP Assign their Medicare benefits to KP KP at risk for all medical services CMS pays a monthly capitation to KP Member Carrier CMS Reimbursement Kaiser Permanente $ Monthly capitation, based on: Demographic characteristics Diagnosis history Location 25

26 Group Medicare Lesson Three: Age-in Campaign 26

27 Age-in strategy Our campaign includes a series of six mailings that are sent over the year between members 64 th and 65 th birthdays. Both individual and group plan members are targeted. 27

28 64 years old When Kaiser Permanente members turn 64, we send them a birthday card wishing them good health. We use this opportunity to introduce the Senior Advantage name and to let members know that they ll be hearing from us. 28

29 64 and 4 months At 64 and 4 months, members receive a letter and a fact sheet that introduce them to Medicare and to our Senior Advantage plan. 29

30 64 and 7 months At 64 and 7 months, members are sent a self-mailer that lists key information about Medicare, and highlights the advantages of staying with Kaiser Permanente. We also send a handy refrigerator magnet with our phone number, so details are only a phone call away. 30

31 64 and 9 months: complete enrollment packet At 64 and 9 months (the age at which most members can enroll in Medicare), members receive a complete Senior Advantage enrollment packet, specific to their service area or employer / trust fund plan benefits. Our staff of Senior Advantage Conversion Specialists follow up by phone to make sure members who want to enroll do so in time. 31

32 THANK YOU Maria Harlan Medicare Retiree Consultant Kaiser Permanente For further information, please contact your Keenan & Associates Representative 32

33 Assembling the Puzzle Kaiser Permanente Monthly Medicare Activity Report License No Innovative Solutions. Enduring Principles.

34 Assembling the Puzzle Kaiser Monthly Medicare Activity Report Examples of changes that can impact premiums are: Change From: Change To: Impact: Under age 65 Under age 65 Retired over age 65 enrolled in Senior Advantage Over age 65 retired enrolled in Senior Advantage Over age 65 retired not enrolled in Senior Advantage Retired over age 65 disenrolled from Senior Advantage Lower Senior Advantage premium Higher over age 65, non- Medicare premium Higher over age 65, non- Medicare premium **For customers who have composite premiums, the number of over 65 non-medicare retirees will affect premiums at renewal. License No Innovative Solutions. Enduring Principles.

35 MONTHLY MEDICARE ACTIVITY REPORT PID: XXXXXXXXX Enrollment Unit(s): All Section 1 SUMMARY OF MEMBER STATUS CHANGES Section 2: MEMBERS CURRENTLY IN THE SENIOR ADVANTAGE SOLICITATION PROCESS 13 Members turning age 64 years and 9 months next month 2 Members turning age 64 years and 10 months next month 2 Members turning age 64 years and 11 months next month 5 Members turning age 65 years next month 4 Section 3A: NEWLY ENROLLED MAPD SENIOR ADVANTAGE MEMBERS 11 Section 3B: NEWLY ENROLLED MAPD SENIOR ADVANTAGE MEMBERS WITH PART D LATE ENROLLMENT 0 PENALTY Section 3C: MAPD SENIOR ADVANTAGE MEMBERS NEWLY ENTITLED TO LOW INCOME SUBSIDY 0 Section 3D: NEWLY ENROLLED MA SENIOR ADVANTAGE MEMBERS 0 Section 3E: NEWLY ENROLLED DOUBLE COVERED NON PLAN OF RECORD COMMERCIAL MEMBERS ERS 0 Section 4: MEMBERS WHO HAVE NOT ENROLLED IN SENIOR ADVANTAGE 6 Section 5: SENIOR ADVANTAGE DENIALS AND SENIOR ADVANTAGE COST DISENROLLMENTS 6 Section 6: DECEASED MEMBERS 0 Section 7: MEMBERS AGE 64 YEARS AND 10 MONTHS LIVING OUTSIDE OF THE KAISER PERMANENTE CALIFORNIA 0 SERVICE AREA Section 8: MEMBERS WHO HAVE TURNED 65 LIVING OUTSIDE OF THE KAISER PERMANENTE CALIFORNIA 0 SERVICE AREA Section 9: MEMBERS OVER 65 NOT ENROLLED IN A MEDICARE PLAN 93 Section 10: PART D LATE ENROLLMENT PENALTY MEMBERS 0 Section 11: LOW INCOME SUBSIDY MEMBERS 2 Section 12: DOUBLE COVERED NON PLAN OF RECORD COMMERCIAL MEMBERS 1 License CONFIDENTIAL No Innovative Solutions. Enduring Principles. Monthly Medicare Activity Report: Page 1 of 22 Thursday, August 6, :32:22 PM

36 Assembling the Puzzle Kaiser Monthly Medicare Activity Report Section 9 MEMBERS OVER 65 NOT ENROLLED IN A MEDICARE PLAN PID: XXXXXXXXXX Enrollment Unit(s): All ACTION REQUIRED: This is a comprehensive list of all members over the age of 65 who are not enrolled in a Medicare plan (including members appearing in Sections 4, 5, 6 and 8 of this month s report). The customer will continue to incur the over 65, non-medicare premium for retired members. Retired members can enroll in a Medicare plan, or the customer can terminate their membership or pay the substantially increased premium. Please verify working status shown. If a member continues to work for the customer after age 65, there will be not impact on the customer s premium. Enrl Unit Name Date of Birth Age Street City State Zip Phone Member MRN Deceased OOA Part Working Status Empoyee SSN Employee Name License No Innovative Solutions. Enduring Principles.

37 Assembling the Puzzle Medicare 101 & Kaiser Senior Advantage Questions? License No Innovative Solutions. Enduring Principles.

38 Assembling the Puzzle Information & Resources or Medicare ( ) Health Insurance Counseling & Advocacy Program (HICAP) Kaiser Permanente Conversion Specialist Team Kaiser Permanente Senior Advantage Member Services License No Innovative Solutions. Enduring Principles.

39 Assembling the Puzzle Medicare 101 & Kaiser Senior Advantage Disclaimer ~ Keenan & Associates is an insurance brokerage and consulting firm. It is not a law firm or an accounting firm. We do not give legal advice or tax advice and neither this presentation, the answers provided during the Question and Answer period, nor the documents accompanying this presentation constitutes or should be construed as legal or tax advice. You are advised to follow up with your own legal counsel and/or tax advisor to discuss how this information affects you. License No Innovative Solutions. Enduring Principles.

40 Thank you for your participation! Innovative Solutions. Enduring Principles. License No Innovative Solutions. Enduring Principles.

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