Concordia Health Plan 2016 Enrollment Guide for Medicare Members

Transcription

1 c/o AmWINS Group Benefits 50 Whitecap Drive North Kingstown, RI Concordia Health Plan 2016 Enrollment Guide for Medicare Members S

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3 2016 Concordia Health Plan (CHP) Enrollment Guide for Medicare Members TABLE OF CONTENTS Introduction Letter CHP Group Medical Plan Options CHP Group Prescription Plan Options CHP Group Dental Program CHP Group Vision Program CHP Group Plan Options Monthly Cost Chart...10 Shopping for Individual Plans...11 Enrollment Instructions...12 CHP Enrollment Form...13 CHP Group Plan Provisions...15 Answers to your Questions for CHP Group Plan Options...16 Answers to your Questions for Individual Plans...17 This guide is for CHP Medicare supplemental coverage only. If you or your spouse are currently under the age of 65, or you are over 65 but do not have both Medicare Part A and Part B, you are not eligible to participate in this program. You will receive a separate communication for retired-member (non-medicare) plans directly from Concordia Plan Services. Page 1

4 WELCOME! Concordia Plan Services is pleased to announce our CHP Medicare supplemental coverage program now available to you and your Medicare-eligible spouse. On the first day of the month in which you turn 65, you will become Medicare-eligible. Once you (and/or your spouse) enroll in Medicare Parts A & B, you may be eligible to enroll in a Concordia Plan Services Medicare supplemental group plan administered by AmWINS Group Benefits, Inc. The Medicare supplemental health plan offerings are insured by The Hartford Life and Accident Insurance Company and the prescription drug plan is insured by Express Scripts. Optional benefits such as vision benefits through VSP and dental benefits through Ameritas are also available. This packet contains everything you need to activate your coverage: Enrollment Instructions Enrollment Form Benefit Summary Postage-Paid Return Envelope Please be sure to review the contents of this package and return your completed CHP Enrollment Form and a check for your first month s premium in the enclosed return envelope. If you are enrolling your eligible spouse, please be sure to include your spouse's information as well. If you or your spouse is younger than 65, please contact Concordia Plan Services at , ext to discuss enrollment provisions. We look forward to serving you and are pleased to offer you these new plans. We are confident this partnership will provide you with the quality and service you have come to expect from Concordia Plan Services. If you have any questions, please call AmWINS Customer Care Center at , Monday through Friday, 8:00 AM to 8:00 PM (EST). Concordia Plan Services Page 2

5 UNDERSTANDING YOUR OPTIONS With this new program, you can select from the CHP Group Plan Options (in this guide) or you can select from Individual Medical Plans. WHAT S THE DIFFERENCE IN THESE PLAN TYPES? The CHP Group Plan Options, developed by Concordia Plan Services, are supplemental to Medicare and include a Part D Prescription Drug benefit. The CHP Group Plan Options include SilverSneakers, a fitness program which provides a free, basic fitness membership to more than 13,000 gym/health club locations nationwide, as well as group exercise classes. Even if you don t have access to a SilverSneakers participating fitness club or class, you can still take advantage of wellness resources online at silversneakers.com/member. The CHP Options also include the opportunity to purchase dental and vision coverage. The Individual Medicare Plans are available in the open market from various insurance companies and may be suited to your geographic area and your budget. These plans are not sponsored by CHP since all Medicare members can enroll in them. CHP Group dental and vision programs are not available with the individual Medicare plans. Some individual plans may contract with SilverSneakers separately from Concordia Plan Services. HOW TO ENROLL CHP Group Plan Options (enclosed in this kit) Review the enclosed plan options carefully and make your selection(s). Contact an AmWINS Benefit Specialist at if you would like to discuss the plan options available. Complete the CHP Enrollment Form on both sides. Sign and return your paperwork in the enclosed postage paid envelope prior to your effective date along with a check for the first month s premium. Individual Medicare Plans (call AmWINS) Call an AmWINS Benefit Specialist at if you would like to discuss available plan options. A specialist will walk you through the enrollment process. Sign and return your enrollment form in the enclosed postage-paid return envelope prior to your effective date. Page 3

6 2016 CHP GROUP MEDICAL PLAN OPTIONS Insured by The Hartford Life Insurance Co. PREMIUM OPTION PLUS OPTION BASIC OPTION Annual deductible $166 Part B deductible $166 Part B deductible $166 Part B deductible Retiree coinsurance amount $0 20% 20% Annual out-of-pocket maximum $166 $500 $2,000 Annual plan maximums Unlimited Unlimited Unlimited Medicare (Part A) - hospital services - per benefit period* In general, Medicare Part A covers hospital care, skilled nursing care (even if received in a nursing home), and some health services. PREMIUM OPTION PLUS OPTION BASIC OPTION First 60 days $0 $0 $0 61 st through 90 th day $0 $0 $0 91 st through 150 th day (Reserve days) $0 $0 $0 Additional 365 days $0 $0 $0 Skilled nursing facility care * First 20 days $0 $0 $0 21st through 100th day $0 $0 $0 Blood First three pints $0 $0 $0 Additional amounts $0 $0 $0 Medicare (Part B) - medical services - per calendar year In general, Medicare Part B covers services such as lab tests, surgeries, doctor visits, and medical supplies considered medically necessary to diagnose or treat a disease or condition. PREMIUM OPTION PLUS OPTION BASIC OPTION First $166 of Medicare-approved amounts** $166 Part B deductible $166 Part B deductible $166 Part B deductible Remainder of Medicare-approved amounts $0 20% up to $500 Then $0 20% up to $2,000 Then $0 Part B excess charges $0 $0 $0 ⱡ The above plan options chart represents the amount you pay when an individual plan and Medicare are integrated to provide your coverage. *A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. **Once you have been billed $166 of Medicare approved amounts for covered services, your Medicare Part B deductible will be satisfied for the calendar year. This amount may change on January 1 of each year. Page 4

7 2016 CHP GROUP MEDICAL PLAN OPTIONS Insured by The Hartford Life Insurance Co. Blood PREMIUM OPTION PLUS OPTION BASIC OPTION First three pints $0 $0 $0 Additional amounts $0 $0 $0 Clinical laboratory services Blood tests for diagnostic services $0 $0 $0 Home health care Medically necessary skilled care services and medical supplies Durable medical equipment Remainder of Medicare-approved amounts Medicare Parts A & B PREMIUM OPTION PLUS OPTION BASIC OPTION $0 $0 $0 $0 Preventative services 20% up to $500 Then $0 20% up to $2,000 Then $0 Annual wellness exam $0 $0 $0 Other preventative services (per Medicare schedule) including cardiovascular screenings, cancer $0 $0 $0 screenings, flu shots, etc. Other benefits not covered by Medicare Foreign travel emergency*** Foreign emergency outside of USA Medicare Part D prescription coverage $250 deductible, then 20% up to $50,000 $250 deductible, then 20% up to $50,000 Included Medicare Part D prescription plan (summaries on next pages) $250 deductible, then 20% up to $50,000 PREMIUM OPTION PLUS OPTION BASIC OPTION Premium Rx Option Plus and Basic Rx Option ⱡ The above plan options chart represents the amount you pay when an individual plan and Medicare are integrated to provide your coverage. ***Foreign travel coverage deductible is a separate deductible and does not apply to the Part A or B deductible amounts. The summary of benefits described herein is for illustrative purposes only. In case of differences or errors the Group Policy governs. Page 5

8 2016 CHP GROUP PRESCRIPTION PLAN OPTIONS Administered by Express Scripts PREMIUM PRESCRIPTION PLAN OPTION INCLUDED WITH PREMIUM MEDICAL PLAN OPTION ONLY Annual Deductible: $0 Copay tier Retail (31 Days) Retail (90 Days) Mail Order (90 Days) Generic tier* $15 $45 $25 Preferred brand tier* $30 $90 $60 Non-preferred brand tier* $60 $180 $120 Coverage gap**: This option has NO coverage gap or Donut Hole. *May include specialty drugs **After your total yearly drug costs reach $3,310, you will pay 50% of the copay schedule for the Preferred and Non-preferred brand tier noted above. The copays shown do not already include the manufacturer discounts on brand name drugs by the Medicare Coverage Gap Discount Program. The Medicare Coverage Gap Discount Program provides manufacturer discounts on brand name drugs to Part D enrollees who have reached the coverage gap and are not already receiving Extra Help through a low income subsidy provided from Medicare. The amount discounted by the manufacturer counts toward your out-of-pocket costs as if you had paid this amount and moves you through the coverage gap. Catastrophic coverage begins once your total yearly drug costs reach $4,850. In this stage, copays will be $2.95 for generic prescriptions and $7.40 for brand name prescriptions. Specialty drug copays for the Premium Plan Option may be less if purchased from the specialty-drug mail order pharmacy specified by Express Scripts. Prescription drug coverage is administered by Express Scripts, a Prescription Drug Plan (PDP) with a Medicare contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact AmWINS. Limitations, copayments and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year. The formulary and/or pharmacy network may change at any time. You will receive notice when necessary. Page 6

9 2016 CHP GROUP PRESCRIPTION PLAN OPTIONS Administered by Express Scripts PLUS AND BASIC PRESCRIPTION PLAN OPTIONS INCLUDED WITH PLUS & BASIC MEDICAL PLAN OPTIONS Annual Deductible: $0 Copay tier Retail (31 Days) Retail (90 Days) Mail Order (90 Days) Generic tier $15 $45 $45 Preferred brand tier $40 $120 $120 Non-preferred brand tier $80 $240 $240 Specialty tier $100 $300 $300 Coverage gap*: Same copay schedule as above. This option has NO coverage gap or Donut Hole. *After your total yearly drug costs reach $3,310, you will pay the same copay schedule noted above. The copays shown already include the manufacturer discounts on brand name drugs by the Medicare Coverage Gap Discount Program. The Medicare Coverage Gap Discount Program provides manufacturer discounts on brand name drugs to Part D enrollees who have reached the coverage gap and are not already receiving Extra Help through a low income subsidy provided from Medicare. The amount discounted by the manufacturer counts toward your out-of-pocket costs as if you had paid this amount and moves you through the coverage gap. Catastrophic coverage begins once your total yearly drug costs reach $4,850. In this stage, copays will be $2.95 for generic prescriptions and $7.40 for brand name prescriptions or 5% of the cost of the drug, whichever is greater. Prescription drug coverage is administered by Express Scripts, a Prescription Drug Plan (PDP) with a Medicare contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact AmWINS. Limitations, copayments, and restrictions may apply. Benefits, premium and/or copayments/coinsurance may change on January 1 of each year. The formulary and/or pharmacy network may change at any time. You will receive notice when necessary. Page 7

10 2016 CHP GROUP DENTAL PROGRAM Insured by Ameritas Life Insurance Corp. Class A Preventative services Annual deductible per insured: $0 Initial & periodic exam 100% Two cleanings/year 100% Annual bitewing series 100% All other x-rays 100% Waiting period None Class B Basic services Annual deductible per insured: $50/year Fillings 80% Simple extractions 80% Oral surgery 80% Waiting period None Class C Major services NOT COVERED Maximum benefit per insured: $1,000 You must be enrolled in a CHP Group Plan Option to be eligible for the dental program. Page 8

11 2016 CHP GROUP VISION PROGRAM Insured by Vision Service Plan (VSP) Your Coverage with a VSP Doctor $15 Copay Every 12 months WellVision exam focuses on your eye health and overall wellness Every 12 months Prescription glasses Lenses Every 12 months Single vision, lined bifocal, and lined trifocal lenses Frame Every 24 months $150 allowance for wide selection of frames $170 allowance for featured frame brands 20% off the amount over your allowance OR Contacts (instead of glasses) Every 12 months Up to $60 copay for your contact lens exam (fitting and evaluation) Extra Discounts and Savings Glasses and Sunglasses Average 20-25% savings on all non-covered lens options 20% off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last WellVision exam Contacts 15% off cost of contact lens exam (fitting and evaluation) Laser vision correction Average 15% off the regular price of 5% off the promotional price. Discounts only available from contracted facilities. Your Coverage with Other Providers Visit vsp.com for details if you plan to see a provider other than a VSP doctor. Exam up to $45 Single vision lenses up to $30 Lined bifocal lenses up to $50 Lined trifocal lenses up to $65 Frame up to $70 Contacts up to $105 $150 allowance for contacts DOCTOR NETWORK: VSP CHOICE Please Note: You must be enrolled in a CHP Group Plan Option to be eligible for the vision program. Your coverage with a retail chain affiliate provider may be different than the coverage with a VSP doctor. Once your benefit is effective, visit vsp.com for details. VSP guarantees service from VSP doctors only. In the event of a conflict between this information and Concordia Plan Services contract with VSP, the terms of the contract will prevail. Page 9

12 2016 CHP GROUP PLAN OPTIONS MONTHLY COST CHART 2016 PLAN OPTIONS RETIREE ONLY RETIREE AND SPOUSE PREMIUM $365 $730 PLUS $309 $618 BASIC $260 $520 OPTIONAL DENTAL PROGRAM $39 $76 OPTIONAL VISION PROGRAM $9 $13 The above rates are effective from 1/1/2016 to 12/31/2016 and are subject to change each year on January 1. PAYMENT INFORMATION Monthly contributions for these plans can be deducted from your CRP monthly benefit or through an automatic deduction from your bank account (ACH). If you choose to have the premium deducted from your bank account, please complete the ACH Authorization which is located on the back of the enrollment form. You will have a choice of dates for payment deduction, which can coincide with your pension direct deposit date or Social Security payment date. Page 10

13 SHOPPING FOR INDIVIDUAL PLANS This guide contains everything you need to enroll in a CHP Group Plan. However, if these plans are not adequate for your needs, we can help you find and enroll in an Individual Plan. Prior to investigating Individual Plans, we recommend that you review the plan types below to familiarize yourself with the differences between Medicare Supplement and Medicare Advantage Plans. You will be required to purchase a Medicare Part D Prescription Plan as well. MEDICARE SUPPLEMENT PLANS These plans provide secondary coverage to traditional Medicare to fill in the "gaps." There are no restrictive provider networks and you can see any provider that accepts traditional Medicare. Your current plan and the CHP Group plan options offered in this guide are Supplemental Plans. MEDICARE ADVANTAGE PLANS These plans replace traditional Medicare and provide "first dollar" coverage from the Medicare Advantage insurance company. You will no longer use your Medicare card for these plans. Most Medicare Advantage plans require the use of restrictive provider networks, but can offer increased benefits for a lower monthly premium. Some Medicare Advantage plans offer additional benefits such as coverage for hearing aids, dental services, and gym memberships. MEDICARE PART D PRESCRIPTION DRUG PLANS Individual Part D plans typically have fewer benefits than the CHP Group Options contained in this guide. These plans usually have a coverage gap or "Donut-Hole," however, they can also have very low premiums. All Part D plans have a Formulary List or "covered" list of drugs. You will want to be sure that the plan you are considering has coverage for your current medications or you may be required to use an alternative medicine. When calling us to research an Individual Plan, we ask that you think about the following questions, which will assist in your decision-making process: What prescriptions do I take? Do I see multiple doctors? Do I see specialists? How important is "choice of providers" for me? Do I reside outside the state for a portion of the year? Do I travel frequently? ADDITIONAL NOTES ON INDIVIDUAL PLANS While enrolled in an Individual Plan, you will have a direct relationship with the insurance company. You will pay your Individual Plan premiums directly to the insurance company. Call AmWINS at with questions Page 11

14 ENROLLMENT INSTRUCTIONS HOW TO ENROLL IN A CHP GROUP PLAN OPTION 1 Review the enclosed plan options carefully and make your selection(s) 2 Call an AmWINS Benefit Specialist at if you would like to discuss available plan options 3 Complete the Enrollment Form 4 Return your signed Enrollment Form in the enclosed postage paid envelope prior to your effective date along with a check for the first monthly payment regardless of payment method selected HOW TO ENROLL IN AN INDIVIDUAL PLAN 1 Call an AmWINS Benefit Specialist at to discuss available plan options 2 Complete the Enrollment Form 3 Return your signed Enrollment Form in the enclosed postage paid envelope prior to your effective date Page 12

15 Effective Date: CHP ENROLLMENT FORM Member Information (Please Print Clearly in ink or type) First Name: Middle Initial: Last Name: Address: City, State, Zip: Social Security Number: Sex: M F Birth Date: Medicare ID Number (on Medicare Card): Phone Number: Address: Spouse Information (Please Print Clearly in ink or type only if enrolling) First Name: Middle Initial: Last Name: Sex: M F Birth Date: Medicare ID Number (on Medicare Card): Social Security Number: Address: CHECK DESIRED COVERAGE: MEMBER Plan Selection - Member and Spouse must elect the same plan. CHP PREMIUM OPTION CHP PLUS OPTION CHP BASIC OPTION INDIVIDUAL PLAN I/WE DECLINE THIS COVERAGE SPOUSE Dental/Vision Plan Selection (You must enroll in a CHP Group Plan Option enclosed in this kit to be eligible for dental or vision coverage.) CHECK DESIRED COVERAGE DENTAL PROGRAM VISION PROGRAM MEMBER SPOUSE Please Complete the Following Information: I/WE DECLINE THIS COVERAGE Do you currently have any Medicare Supplement policies or Medicare Advantage Policies in force (other than the current Concordia Health Plan coverage)? Member (if enrolling): Yes No Spouse (if enrolling): Yes No If YES, with which company? (Continue on Reverse) Page 13

16 CHP ENROLLMENT FORM Please be sure to sign, date, and return this completed Enrollment Form along with a check for the first monthly payment* to: AmWINS/Concordia Health Plan, 50 Whitecap Drive, North Kingstown, RI using the enclosed postage paid envelope. Member Signature: Spouse Signature: Date: Date: PAYMENT METHOD Monthly Pension Deduction (only available if your pension covers the full cost of your elections) Monthly ACH (please complete below) ACH AUTHORIZATION Name (Last, First, Middle Initial): Street Address: City: State: Zip: Type of Account: Savings Checking Please ensure the following: Select Monthly Withdrawal Date: 1st 8th 15th To deduct monthly from your checking account; A VOIDED check must accompany this signed authorization. (Starter checks are not accepted.) To deduct monthly from your savings account; A signed letter from your banking institution must accompany this signed authorization. Monthly payments are withdrawn on the first business day on or after the date you selected above. You will receive a confirmation from AmWINS Group Benefits that we have set up your account information to withdraw from your designated bank account. Note: Your monthly deduction will show as AmWINS on your bank statement. I authorize AmWINS to withdraw payment from my checking or savings account according to my agreed payment schedule. This authorization is to remain in force until AmWINS has received written notification from me of its termination in such time and manner as to afford AmWINS a reasonable opportunity to act on the request. If my account is erroneously charged, my financial institution will immediately credit the same amount to the account up to 15 days following issuance of the statement or 45 days after posting, whichever occurs first. Signature: Date: *Regardless of payment method elected, please return this completed form with a check for your first monthly payment. Page 14

17 CHP GROUP PLAN OPTION PROVISIONS Please review the below provisions for the CHP Group Plan Options: The Medical and Prescription Drug programs are only offered as a package. If you are enrolling your Medicare eligible spouse in a CHP Group Plan, you must both select the same plan option. Note: If you enroll together in a joint plan, you can t select separate elections later. Conversely, if you enroll separately, you cannot be in a joint plan later. You will NOT be able to elect a higher plan option in the future. You can reduce your coverage on January 1 of any year. If you decline or terminate coverage and choose to return to the plan in the future, you will only be offered the lowest plan option(s) available at that time. You must enroll in a CHP Group plan option to also elect the optional dental and/or vision program. If a member cancels coverage, the spouse s coverage will be cancelled too. If a member passes away, the surviving spouse can remain on the plan. If a member or spouse is not yet enrolled in Medicare, he/she will be able to join the same plan option as the Medicare-eligible participant when he/she becomes Medicare eligible in the future. If you are currently receiving a contribution from your former employer, you can work with them to continue any arrangement you have in place today. How to get more details about your prescription drug plan options More detailed information about Medicare plans that offer prescription drug coverage is available in the Medicare & You handbook, which you receive in the mail every year from Medicare. For more information about Medicare prescription drug coverage: Visit medicare.gov Call your State Health Insurance Assistance Program for personalized help (see the inside back cover of your copy of the Medicare & You handbook for their telephone number) Call 800.MEDICARE ( ), 24 hours per day, 7 days per week. TTY users should call Also, please note that you may have to pay a late enrollment penalty if within 63 continuous days after your current coverage with Concordia Health Plan ends: You do not enroll in another Medicare prescription drug plan (or a Medicare Advantage Plan with prescription drug coverage), or You do not have or obtain other coverage that is at least as good as Medicare prescription drug coverage (also referred to as creditable coverage ). Page 15

18 ANSWERS TO YOUR QUESTIONS FOR CHP GROUP PLAN OPTIONS Q: Who is the Hartford Insurance Company? A: The Hartford Insurance Company was founded in They are rated A Excellent, by A.M. Best (a financial services rating agency). Q: How do the Medical plans supplement Medicare? A: Medicare has coverage gaps which are the costs that you must pay, like coinsurance, copayments, and deductibles. These plans help cover those gaps. You may go to any doctor, specialist, or hospital that accepts Medicare. Medicare pays its share and then your plan pays based on the plan option you choose. Q: Will my doctors accept these plans? A: Yes, simply present your new ID card along with your Medicare ID card to any doctor, specialist, hospital, or healthcare provider that accepts Medicare and they will accept your supplemental Medicare health plan option. Q: What services are covered by these Medical plan options? A: Any service covered by Medicare is also covered by the enclosed plans. Services not covered by Medicare are not covered by these options. Please contact us or visit medicare.gov for the Medicare exclusion list. Q: When will I receive my ID Cards? A: ID cards will be sent prior to your effective date. Medical and prescription drug ID cards will arrive in two separate packages. Q: Do my prescription drug copayments count toward my medical plan deductible or out-ofpocket costs? A: No. Any copayments you make for prescription drugs do not count toward the deductible or out-of-pocket maximum amounts of your medical plan. Q: How do I get my prescriptions filled? A: Simply present your Express Scripts ID card and prescription to a participating pharmacy in the Plan network. You will also receive information about mail order prescriptions when you enroll. You can find more information about your prescription coverage by calling AmWINS Group Benefits at Q: Can I continue to use my pharmacy with this plan? A: Express Scripts has a national retail pharmacy network with more than 64,000 participating pharmacies. All major pharmacy chains participate; please call AmWINS to verify that your current pharmacy is part of the network. Q: Where can I get information about using Mail Order Services? A: Once you enroll in the Plan, you will receive a fulfillment kit in the mail which will include mail order information from Express Scripts. Please expect your package and materials to arrive shortly before your plan effective date. Q: How can I find out if my drugs are covered on the new plan option? A: You will receive a copy of the formulary (list of covered drugs) in your fulfillment packet once you enroll. Some covered drugs may have additional requirements or limits on coverage. You can find out if your drug has any additional requirements or limits by reviewing the formulary. If your drug is not included on the formulary, you should first contact us and ask if your drug is covered. Please contact AmWINS Customer Care toll-free at Q: How can I lower my drug expenses? A: Generic medications often cost less than brand-name counterparts. Talk to your doctor to determine if a generic is available. Page 16

19 ANSWERS TO YOUR QUESTIONS FOR INDIVIDUAL PLANS Q: What are "Individual" Insurance Plans? A: Individual plans are not established by Concordia Health Plan (like the custom group options in this kit), but instead are plans offered directly for sale from insurance companies to individuals who are on Medicare during Medicare's annual open enrollment period. These are the plans you typically see advertised on TV from companies like Humana and AARP (United Healthcare). Q: How do I shop for an Individual Plan that meets my needs? A: You may contact the AmWINS Customer Care Center and an agent will search for plans in your area and send you pertinent information on plans which may make sense for you. Q: What information should I have ready when I call the AmWINS Customer Service Center to help me search for Individual Plans? A: We recommend you have a list of all of your doctors, hospitals, and other providers you currently use. Also, you should have the name of your pharmacy and a list of your medications handy so that we can help you search for a plan that meets your needs. We will also ask you about any travel you do or "out-of-area" needs you may have. Q: Will my doctors, pharmacies, and other providers be covered by the Individual Plan I select? A: This will depend on the Plan you choose. Many Individual Plans have provider networks which you must use to receive coverage. AmWINS will help advise you on these networks during the search process. Q: How will I know what is covered by an Individual Plan? A: You will receive an insurance policy directly from the selected insurance company once you are enrolled. This policy will govern your plan's benefits. Q: Once enrolled in an Individual Plan, who provides service and help? A: Due to privacy laws, AmWINS will be limited in the service we can provide once you enroll in an Individual Plan. You will have a direct relationship with the insurance company you enroll with in the future. The insurance company will provide your policy documents, ID cards, billing, and answer your claims questions. If you contact AmWINS with questions on your Individual Plan, we will be happy to re-direct your call to customer service with your new insurance company. Q: How will I pay my monthly premium for an Individual Plan? A: You will pay your premium directly to the insurance company (usually on a monthly basis). Q: How are the annual renewals handled with an Individual Plan? A: You will receive an annual communication directly from your selected insurance company which will detail any policy or rate changes each year. Call AmWINS at with questions Page 17

20 Disclaimer: The benefit information contained in this brochure is subject to change at any time, and Concordia Plan Services reserves the unlimited right to make benefit plan changes at any time. Any changes to the benefit plans implemented by Concordia Plan Services will be considered effective, regardless of whether notice has been given, on the date set by Concordia Plan Services. If you are ever in doubt about your retiree medical benefits, please contact AmWINS Group Benefits at a-0416