Your Retiree Health Care Travel Guide

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1 SPECIAL EDITION for Individuals Not Yet Eligible for Medicare Your Retiree Health Care Travel Guide 2010 Enrollment for BorgWarner Pre-Medicare Health Care Coverage Welcome to 2010 Pre-Medicare enrollment! You and your qualifying dependents are eligible to continue BorgWarner medical and prescription drug coverage until reaching age 65 as members of the Pre-Medicare Retiree Plan. This brochure reviews coverage for retirees and qualifying dependents who are not yet eligible for Medicare. It gives you an overview of the plans available, what you should consider before making your decisions, Cost-Sharing Approach The dollar amount of the retiree contributions is shown on the 2010 Open Enrollment Form included in this packet. The monthly contribution amount is calculated on a per member basis (retiree, spouse, children are separate members). Premium Collection BorgWarner has established a retiree premium service center to administer the collection of health care premiums. Premium options, including Direct Debit Authorization and payment coupons, will be mailed to you after Thanksgiving. Payments are due on the first of each month for that month s coverage. For example, payment for coverage for the month of January is due by January 1, Payments for partial months will not be accepted. You may prepay for future months up to the end of the calendar year. If you don t pay by the first of the month, your coverage will be suspended for 30 days; however, your coverage will be retroactively reinstated if your payment is received during the 30-day grace period. If payment is not received by the end of the grace period, your coverage will be cancelled and cannot be reinstated. YOU MUST ENROLL Before November 16 Don t miss the chance to have health care coverage for 2010! You MUST complete and submit the enrollment form by November 16 or you and members of your household who are not eligible for Medicare will not have health care coverage for Take the Wheel For Pre-Medicare Retirees current

2 Take the Wheel Deductible= + Two Options for Medical Coverage You can choose from two medical plans for 2010: 1. PPO Plan 2. Choice Health Fund PPO Plan Under the PPO Plan, you can use any doctor or hospital you wish but if you use innetwork providers, you pay less and do not have to file claim forms. When you visit the doctor, you pay your copay at the time you receive the service the plan pays the rest of the bill. After you meet your annual, the plan covers 80% for in-network expenses (60% for out-of-network expenses), up to your out-ofpocket maximum. Then the plan pays the rest of your eligible medical expenses for the remainder of the year. Choice Health Fund This medical option gives you the flexibility and choice to manage your own health care spending. It works like most medical plans with one very important difference. The Choice Health Fund features a company-paid Health Reimbursement Account (HRA). Each year, BorgWarner credits an amount equal to half the cost of your to your HRA account. You determine how your fund dollars are spent and stretch your fund by seeking the most cost-effective care. This could mean choosing an in-network provider rather than an out-of-network provider, seeking treatment on an out-patient basis instead of in-patient. The wiser your health care choices are, the more money you may save. If you don t use all the credit in Preventive Care How the Choice Health Fund Works Company pays after you reach the Out-of-Pocket Maximum You and the company pay Medical Plan Coinsurance You pay the Member Deductible Gap Company pays for the Health Reimbursement Account * * For medical expenses only. Cannot be used for prescription drugs. + Includes member gap. your HRA during the year, it automatically rolls over to help pay for your expenses next year. It s like a savings account for health care. If you spend all the money in the HRA, you pay the remaining before plan benefits begin. See page 4 for examples. In-network preventive care covered at 100% with no. BorgWarner credits a sum to your Health Reimbursement Account each year ($750 single or $1,500 family). Use the HRA to pay for your medical expenses, including your. Once you spend all of the money in the HRA, you pay the remaining member gap ($750 single or $1,500 family in-network). After you meet your, you and the company pay coinsurance (80% / 20% in-network). Once you meet the out-of-pocket maximum ($3,750 single or $7,500 family in-network), the plan pays 100% of your eligible medical expenses. Page 2 October 2009 Pre-Med Current

3 Highlights of 2010 Medical Coverage 2010 PPO PLAN 2010 CHOICE HEALTH FUND In-network Out-of-network In-network Out-of-network Deductible Per person / per family $400 / $800 $800 / $1,600 $1,500 / $3,000 $3,000 / $6,000 Company-paid HRA Per person / per family None $750 / $1,500 Member Gap (Deductible HRA) Not Applicable Not Applicable $750 / $1,500 $2,250 / $4,500 Per person / per family Out-of-Pocket Maximum Per person / Per family $3,000 / $6,000 $6,000 / $12,000 $3,750 / $7500 $6,750 / $13,500 (offset by HRA) Lifetime Maximum Unlimited Unlimited Coordination of Benefits Office Visit Doctor Specialist Preventive Care Inpatient Services Outpatient Services ER & Urgent Care (1) Physician Office (2) Hospital ER (3) Urgent Care Center Maintenance of Benefits Plan pays up to the CIGNA allowed amount $20 / visit $40 / visit 100% (1) No charge after copay (2) (3) $40 copay, then 80% no 100% Same as In-network (1) (2) and (3) Paid 80% after Maintenance of Benefits Plan pays up to the CIGNA allowed amount Same as In-network Chiropractic Care $500 per calendar year maximum Mental Health/ Substance Abuse October 2009 Pre-Med Current Page 3

4 Take the Wheel Important Terms Coinsurance: The percentages you and the company pay toward your medical expenses. For example, 80% / 20% coinsurance means the company pays 80%; you pay 20%. Consumer-driven health plan: Works like a traditional medical plan but encourages participants to take a more active role in health care purchasing decisions by offering health, cost and quality information plus an HRA to help pay the. Our Choice Health Fund is an example. Copay: A flat dollar amount you pay for office visits. Deductible: Dollar amount you pay before coinsurance begins. Copays and prescription drugs do not count. Health Reimbursement Account (HRA): Company-paid credit to help you pay for your. Only available with the Choice Health Fund. Member gap: The portion of the you pay under the Choice Health Fund. Out-of-pocket maximum: The most you will pay each year for eligible plan expenses above any premium contribution required. Watch Your HRA Grow The Choice Health Fund is called a consumer-driven health plan for good reason. It puts you in the driver s seat when it comes to spending health care dollars. Under other plans, you may not even know how much your health care costs. But with the Choice Health Fund, you get a companypaid Health Reimbursement Account (HRA) that not only helps you pay for your health care, but tracks your costs as well. Every month, plan participants get statements showing their fund balance and how they ve spent their HRA dollars. That s important, because if you spend your HRA fund wisely, you could end up rolling money over to help pay for your expenses next year. For example, let s say you enroll in family coverage under the Choice Health Fund. During your first year, you use only $1,220 of your HRA. That leaves $280 to add to your annual $1,500 BorgWarner credit the next year. At the end of your second year, you have a $710 balance to roll over for a total of $2,210 to spend your third year. If you were then to have a major medical expense, your larger HRA balance would go a long way toward meeting your and paying your medical bills. Balance Your Cost HRA Year 1 Year 2 Year 3 BW contribution $1,500 BW contribution $1,500 Rollover + $280 $1,780 BW contribution $1,500 Rollover + $710 $2,210 Physical $0 Physical $0 Physical $0 9 office visits $720 9 office visits $720 Surgery $5,000 Urgent care $200 X-ray $150 Fund pays $2,210 Therapy $300 2 specialist visits $200 You pay remaining member gap $790 Fund pays $1,220 Fund pays $1,070 20% coinsurance $400 Rollover $280 Rollover $710 Balance $0 Crunching the Numbers How do you estimate how much your expenses will be next year? A good place to start is your medical bills from this year. Look at your old receipts or the Explanation of Benefits you received from your plan administrator. You can also find this information as well as a handy plan comparison and cost estimator tools at Page 4 October 2009 Pre-Med Current

5 Prescription Drug Coverage When you enroll in a medical plan, you re automatically enrolled in the prescription drug program. The same plan design applies regardless of what medical plan you choose and the administrator manages both. That means you can use your medical ID card for prescriptions, too. The prescription drug program does not have a. Your coverage begins with your first prescription. The coinsurance and copays under the prescription drug program do not count toward your medical or out-of-pocket maximum. There are two ways to get your prescriptions filled: at a network pharmacy or through mail order. The table below shows how much you pay for each prescription, depending on the type of prescription drug you buy. Retail Network Pharmacy Use a retail pharmacy any time you need a prescription filled right away. Simply show your medical ID card at a network pharmacy, and pay your portion of the cost. The pharmacist will file your claim for you. Most national pharmacies are in the network. Mail-Order Service If you use a maintenance drug for high blood pressure, for example use the convenient mail-order service. Order up to a 90-day supply for one copay, and your drugs are delivered directly to your home for free. You can order refills over the phone or online. Generic Drugs Save Money Using generic drugs can save money for everyone. That s why your prescription benefit is designed to be most costeffective for you when you elect a generic medication. You always have the option to purchase brand-name prescriptions; however, you will pay more out-of-pocket. Generic medications are lessexpensive copies of brand-name medications. They contain the same active ingredients and have the same quality, strength and purity as the brand-name medications they copy. When your doctor prescribes a medication, always ask if a generic alternative is available. Generic: Chemically equivalent, lower-cost version of a brand-name drug Formulary: Lower-cost, yet highly effective brand-name prescription drugs Non-Formulary: Generally higher cost and no more effective than the generic equivalents Specialty Pharmacy Specialty Rx Formulary: Typically used to treat arthritis and other conditions (does not include insulin) Specialty Rx Non- Formulary: Generally higher cost injectable drugs Retail Pharmacy 30-day supply Mail Order 90-day supply $8 $16 $8 + 30% 30% up to $150 per Rx $8 + 50% 50% Mail Order Only 30% up to $50 per Rx every 30 days 50% up to $100 per Rx every 30 days October 2009 Pre-Med Current Page 5

6 Take the Wheel Specialty Drugs Injectable drugs used to treat conditions like rheumatoid arthritis, cancer, multiple sclerosis or anemia are covered under our prescription drug program. Your first 30-day supply can be purchased at a retail pharmacy. Subsequent refills must be ordered through the specialty pharmacy mailorder service and will be dispensed in 30-day intervals. In addition, you can take advantage of the specialty pharmacy patient advocate service. You may contact them for guidance and support, as well as self-care information and helpful educational materials about your condition. Call and ask for the pharmacy area. Step Therapy and Prior Authorization With the wide variety of maintenance drugs available, it s sometimes difficult to find the one that works for you. Through step therapy, your pharmacist works with your doctor to find the most cost-effective and safest treatment plan for you. The goal is to find the most cost-effective and safest step one drug for treatment of your condition. More costly step two brand-name drugs are prescribed only if necessary. If you take a proton pump inhibitor (such as Nexium or Prevacid), cholesterollowering drug (like Lipitor), or ACE/ARB drugs (like Avapro) this program will apply to your prescriptions. If prescribed a step two brand-name drug, the pharmacy s system automatically checks to determine whether or not you ve used the costly step two brand-name prescription drug before. If you have a history of taking this drug, it pays the claim. However, if the brand-name drug is a new prescription, the pharmacist can fill your first prescription only. In about a week, you and your doctor will receive a letter explaining the Step Therapy process. To ensure that your future prescriptions are covered, work with your doctor to identify a generic drug in the same class. Alternatively, your doctor can provide information to CIGNA pharmacy indicating that the brand name drug is medically necessary for you and your future brand-name prescriptions are filled. Our prior authorization system works with the specialty pharmacy and step therapy to ensure that your drug therapy is appropriate. If you take medications for acne, weight management, hypertension or emphysema, your pharmacist will automatically call your doctor for a diagnosis before filling your prescription. How to Make the Most of Your Health Care Coverage Be sure to take advantage of the other resources included in your BorgWarner retiree health benefits: Web-based decision support tools offer health and pharmacy information, a symptom checklist, blogs by specialist physicians and a place to store personal medical information. One-on-one health care decision support lets you talk to a nurse who can explain health issues and treatment options. Health advocacy support helps you understand your health needs and get assistance with chronic conditions. To use these resources, contact CIGNA s 24-hour nurseline at or visit Page 6 October 2009 Pre-Med Current

7 Looking Ahead: What to Expect When You Become Eligible for Medicare As in past years, when a retiree or eligible dependent of a retiree becomes eligible for Medicare, Medicare becomes the primary coverage for that individual. This is coverage that was earned through the FICA contributions you and BorgWarner made every year during your employment. BorgWarner no longer provides coverage to supplement Medicare. Instead, the company will provide funds to help retirees pay for supplemental coverage now available from Medicare and private insurance companies. The decision to change the way benefits are provided to individuals who are Medicareeligible responds to changes in legislation and the marketplace that now provide more and better options for coverage. And the tax-free Retiree Reimbursement Account (RRA) that BorgWarner will provide, makes it possible for you to receive full value from BorgWarner s contributions. In addition to funding an account for you, BorgWarner also provides United Healthcare (UHC) as a Retiree Health Plan Coordinator to help you choose and enroll in Medicare supplement coverage. To contact your coordinator, call or visit Enrolling in Medicare About three months before your 65th birthday, you ll receive a comprehensive package of information about your Medicare options and your RRA from UHC At that time, you ll have the opportunity to work with the Retiree Health Plan Coordinator to explore the many plans that will be available to you. Timetable for Medicare Now until age 65 3 months before you turn 65 Age 65 Medicare eligibility will begin the first day of the month that includes your 65 th birthday, and BorgWarner will begin making credits to your RRA that same month. Your BorgWarner pre- Medicare coverage will end the last day of the month prior to your 65 th birthday. Because there are penalties for enrolling late in Medicare and these penalties can cause a delay in coverage or require you to pay higher premiums for the rest of your life you ll want to be ready Talk with others about their Medicare decisions. Contact the Retiree Health Plan Coordinator with Medicare questions. Keep up-to-date on changes in the marketplace. Receive your Medicare information packet from BorgWarner s Retiree Health Plan Coordinator (currently United Healthcare). Apply for Medicare Parts A & B if you delay signing up for Part B, you will pay more for your required Part B premiums, based on the time period you were eligible for Medicare coverage and did not pay Part B premiums. Talk with the Retiree Health Plan Coordinator for assistance with determining the type of medical and prescription drug coverage that is best for you. Enroll in the Medicare supplement medical and prescription drug coverage you choose. BorgWarner medical and prescription drug coverage ends; Medicare coverage begins. BorgWarner begins making a monthly credit to your Retirement Reimbursement Account (RRA). If you are married, credits to your spouse s account begin when he or she becomes eligible for Medicare. October 2009 Pre-Med Current Page 7

8 Take the Wheel Who Can You Contact for Assistance? General Enrollment Visit or call: Active Location Retirees: Closed Location Retirees: CIGNA Medical and Prescription Drug Coverage Provider, claim and health information: hour Nurseline: Page 8 October 2009 Pre-Med Current

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