Dear Georgia Tech Retiree,

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1 Dear Gergia Tech Retiree, Open Enrllment is the ne pprtunity yu have each year t make changes t yur existing benefit cverage. The 2015 benefits Open Enrllment perid will be held Nvember 3, 2014 thrugh Nvember 14, T participate in this Open Enrllment, yu must have previusly elected t cntinue cverage int retirement. During this enrllment perid, eligible retirees and surviving spuses may nly make changes t their current medical, dental, r visin cverage. This includes electing a different plan, adding dependents up t age 26, drpping cverage, r reducing cverage levels. This year, the health care ptins frm the University System f Gergia (USG) are the same, but there are a number f plan design and rate changes. Due t variables in ur plan usage and general health care cst trends, yu will see rate increases fr mst f the medical plans and changes in deductibles/c-pays. It is imprtant that yu review the different plans and select what best fits yur expected needs fr The enclsed 2015 Health Care Basics: USG Cmparisn Guide prvides an verview f the plans that will be ffered fr A dedicated website is available fr retirees, with all infrmatin accessible at As yu review yur Open Enrllment packet and the nline resurces prvided, knw that the benefits team is here t guide and assist yu thrugh this prcess. Yu may reach us via at r by phne at GTHR (8627). In additin t this letter, enclsed yu will find: 2015 Open Enrllment Retiree Electin Frm 2015 Health Care Basics: USG Cmparisn Guide Persnalized Current Benefits Enrllment Statement USG Tbacc-Use Certificatin Frm Life Insurance Beneficiary Frm Silver Jackets Invitatin Return Envelpe Sincerely, Brandn Cnkle Directr, Ttal Rewards Office f Human Resurces 1

2 IMPORTANT INFORMATION If yu d nt wish t make any changes t yur existing insurance cverage fr 2015, yu d nt need t take any actin. Cverage will default t yur 2014 selectins if n changes are made during Open Enrllment. Yu may nly make changes t medical, dental, r visin cverage if yu are currently participating in a plan. Fr example, yu may nt enrll in a dental plan if yu currently d nt have dental cverage. Please review yur beneficiaries at the bttm f yur benefits statement. If yu wuld like t change yur beneficiary listing r allcatin, yu will need t cmplete the yellw Minnesta Life Beneficiary frm. Make sure yu prvide the Scial Security number fr all cvered dependents n yur electin frm. Per the Affrdable Care Act, we are prviding ntice that this will be yur last pprtunity t add child dependents, aged 19 25, during Open Enrllment. If yur dependents, aged 19 25, experience a qualifying family status change during the year, yu can make a change within the guidelines at that time. MEDICAL PLAN CHANGES The University System f Gergia will cntinue t ffer fur medical plan ptins. Tw f the plan names are changing: RATES 1. HSA Open Access POS will be Cnsumer Chice HSA 2. Open Access POS will be Cmprehensive Care 3. BlueChice HMO 4. Kaiser HMO Please refer t the 2015 Health Care Basics: USG Cmparisn Guide fr the new rates n Page 5. PLAN DESIGN CHANGES There are a number f plan design changes. Refer t Page 2 f the 2015 Health Care Basics: USG Cmparisn Guide. 2

3 NOTE: Tbacc Surcharge If yu are enrlled in a USG medical plan and yur tbacc status r that f yur dependents has changed since last year, yu must cmplete the enclsed USG Tbacc Certificatin frm fr yu and all ther enrllees aged 18 and lder. There will be a nn-refundable $75 per mnth surcharge per persn added t yur mnthly medical premiums fr any enrlled tbacc user. If yu d nt update yur tbacc status using the attached frm, yur tbacc status currently n file as well as that f yur dependents will be used as yur 2015 tbacc status. PHARMACY CHANGES The USG will intrduce a new pharmacy vendr fr all Blue Crss Blue Shield medical plans. Express Scripts will be replaced by CVS/Caremark. Over 60,000 retail pharmacies accept CVS/Caremark insurance. If yu are nt Medicare-eligible and are enrlled in the Blue Chice HMO r the Cnsumer Chice medical plan, yu will receive a Welcme Kit frm CVS/Caremark. If yu are Medicare-eligible and enrlled in the Cmprehensive Care plan, yu will receive a separate mailing t enrll in the new SilverScript Medicare Part D Prgram: Yu must enrll in the SilverScript plan; n ther plan is eligible. CVS/Caremark will mail a ntificatin t cnfirm yur autmatic enrllment in the SilverScript Medicare D prescriptin cverage. Yu will als have the ptin t pt ut f this cverage, but yu are encuraged nt t d s. Medicare Part D is a requirement upn enrllment in the Cmprehensive Care plan if yu are Medicare-eligible. N actin is required if yu want t remain enrlled. Prescriptin refills, including mail rders, will transfer t CVS/Caremark with the exceptin f narctics, cmpund, and specialty drugs. T crdinate refills, CVS/Caremark will directly cntact members wh have prir authrizatins fr the previusly mentined exceptin drugs. CVS/Caremark will be available t assist with general infrmatin and drug cst questins n r after Octber 27, The Custmer Care phne number is r MEDICARE MEDICARE AND COMPREHENSIVE CARE PLAN Medicare-eligible retirees nt enrlled: Current retirees wh are enrlled in the Cmprehensive Care medical plan and have nly Medicare A, will n lnger be grandfathered int the discunted premium plan: USG will cntact retirees nt currently enrlled in Medicare Part B fr assistance with Medicare enrllment in December

4 All Medicare-eligible retirees in the Cmprehensive Care medical plan must enrll in Medicare Part B during the Medicare Open Enrllment perid: January 1 March 31, USG will pay the late enrllment penalty fr retirees wh enrll during the abve-stated perid nly. The USG Cmprehensive Care medical plan will be secndary cverage nly as f July 1, Nn-Medicare-eligible retirees: When yu and/r yur spuse becme Medicare-eligible at age 65 (after January 1, 2014), yu are required t enrll in Medicare Part B during yur eligibility perid designated by the Scial Security Administratin. In 2015, USG medical plans will be Secndary Payer nly. Failure t enrll in Medicare B during yur eligibility perid will result in yu paying the ttal cst (USG/GT rate + retiree rate) fr medical insurance. The ttal cst f medical insurance can be fund n Pages 5 and 6 in the enclsed 2015 Health Care Basics: USG Cmparisn Guide. Once yu btain yur Medicare A & B card(s), yu must submit a cpy t the Gergia Tech Benefits Department: Mail: Gergia Tech Benefits, 500 Tech Parkway, Atlanta, GA Fax: MEDICARE AND HMOs Medicare-eligible retirees and/r dependents must have Medicare Parts A and B and must assign cverage t Kaiser t qualify fr the Kaiser Senir Advantage HMO Plan. The Kaiser Senir Advantage HMO prduct will serve as the member s nly health care plan. There will nt be secndary benefits frm Medicare. If yu fail t qualify fr participatin in the Kaiser Senir Advantage HMO Plan, yu will be required t enrll in the Cmprehensive Care Plan r the Cnsumer Chice HSA Plan. If yu are cvered by the BlueChice HMO plan, yu must chse anther plan when yu becme eligible fr Medicare. The BlueChice HMO des nt ffer a Medicare-eligible retiree health care plan. COMPREHENSIVE CARE PLAN MEDICARE PART D The USG created the SilverScript Medicare Part D plan fr Medicare-eligible participants in the Cmprehensive Care plan. Retirees in the Cmprehensive Care plan will be autmatically enrlled in the SilverScript Medicare Part D plan. If yu d nt want t enrll in the SilverScript Medicare Part D plan thrugh the Cmprehensive Care Plan, yu must either: 1. Chse anther USG health plan. OR 2. Drp health insurance cverage. Please nte, if yu drp health cverage thrugh the USG, yu will NOT be allwed t re-enrll at a later date. The SilverScript Medicare Part D custmer service phne number is

5 ID CARDS Every retiree enrlled in medical cverage will receive a new card fr the 2015 plan year. Pharmacy infrmatin will be n the back f the medical card fr the BlueChice HMO and Cnsumer Chice HSA plans. Medicare-eligible retirees enrlled in the Cmprehensive Care medical plan will receive a new medical and SilverScript card. NOTE: REVIEW YOUR BENEFICIARIES Due t the change in life insurance carrier, yu will need t review yur beneficiaries and allcatin amunts. Please update the enclsed Minnesta Life Beneficiary Frm and submit t the Benefits Department fr prcessing in the self-addressed envelpe that is included in this package. WAYS TO GET ASSISTANCE Benefits Fair Octber 23, a.m. 2 p.m. Student Center Ballrm Open Enrllment Website The website will include detailed plan infrmatin, FAQs, and vides that will address the majrity f yur questins. Benefits Help Line Octber 27 Nvember 14, a.m. 6 p.m. Scial Security CVS/Caremark SilverScript r On r after Octber 27,

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