Transamerica s Retiree Medical Insurance Program For employers, unions, and their group retirees

Transcription

1 For agent/broker use only Transamerica s Retiree Medical Insurance Program For employers, unions, and their group retirees Affinity Services

2 Retiree Medical Insurance coverage is specifically designed for retirees age 65 and older who are enrolled in Medicare Parts A and B. This coverage offers benefits that help cover the costs that Medicare may not such as co-insurance and deductibles to provide more protection. It enables employers to transition retirees to a defined contribution, fully-insured program while limiting an employer groups openended obligations, reducing health care expenses and other costs involved with the management of retiree coverage. A flexible retiree program for employer and union groups Find out how this Retiree Medical insurance program can work successfully for employers, unions, and their group retirees. Choice of high-quality benefit options Selection of contribution levels Minimal administration required by your organization Variable participation requirements Adaptable to your retiree group size Reduce FASB 106 and GASB 43/45 liabilities Co-payments options that can be used to reduce rates Opportunity to lower costs on active employee health plans Rates based on employers experiences An exceptional health care value for retirees Medical benefits that coordinate with Medicare Acceptance guaranteed No waiting period for full coverage if retiree is replacing coverage Automatic claim filing Freedom of choice and no networks Optional Medicare Part D prescription drug coverage made available Group-rated premiums Direct access to excellent customer service support Transamerica s Medicare Prescription Drug Plan Solution - Medicare GenerationRx TM Your client s Medicare-eligible retirees can take advantage of all the benefits a fully-insured 800-series Employer Group Waiver Plan has to offer, plus the high-level of choice, value, and service that will make your clients retirees happy. For agent/broker use only p. 2

3 CASE STUDY Transamerica s Retiree Medical Insurance Program Overview A Manufacturing Company in the Midwest had 1,000 retirees receiving self-funded benefits. With self-funded benefits, a portion of the money for benefits is deducted from active employee paychecks as well as retiree pension checks. The company is obligated to contribute the remaining portion of the funds for benefits. This money is then utilized to pay claims by both the active and retired employees. Problem As claims are submitted by both current employees and retirees, the self-funded money is deducted to pay the claims. However, since the retirees incurred more health care costs with increased doctors visits and claims, the employees and retirees quickly drained the pool of deposits. To continue funding the claims, the company was left with two options: 1) put an ever-increasing amount of funds into the pool from other company resources, or 2) deduct a higher percentage from employee paychecks and retiree pension checks. In addition, the retirees were receiving Medicare and the company was trying to coordinate the major medical benefits around the complex Medicare system. Solution Since retirees are consistently higher users of medical benefits than current employees, management wanted to remove the retirees from the self-funded plan. After careful consideration, this manufacturing firm decided to transfer their retirees to our Retiree Medical Program, a fully-insured option where the company can set their contribution level. Now, the company has a fixed cost for their Retiree Medical plan, since the financial risk is shifted to the insurance carrier - instead of the company - to fund all claims. Results This company now has a fixed liability per retiree, and it eliminated the confusion of coordinating a major medical plan around Medicare. In addition, the administrative burden of the retiree health benefits was alleviated from the company. With all retirees in our Retiree Medical Insurance Program, the self-funded plan of active employees should now consist of mostly healthy individuals which helps stabilize plan costs. *The case study illustrations are estimates and all situations are different based on the facts. p. 3

4 Experience counts, and we ve got it Transamerica Affinity Services, Inc. (hereinafter referred to as Transamerica ) is a leader in providing medical insurance protection to retirees across the nation. In fact, we ve helped to provide this type of coverage to over 50,000 private and public organization retirees since 1994, and we know the business inside and out. You can count on us to bring this experience to your clients organizations every step of the way. Stability counts, and we ve got that, too In addition to our name recognition and sound reputation for financial strength and stability around the globe, our underwriting carriers, Transamerica Life Insurance Company (Cedar Rapids, IA), Transamerica Premier Life Insurance Company (Cedar Rapids, IA), Stonebridge Life Insurance Company (Rutland, VT) and Transamerica Financial Life Insurance Company (Harrison, NY) have received some of the highest ratings* attainable from all of the leading insurance rating agencies. In a sometimes volatile market, it makes good sense to partner with a stable insurer your clients organizations and their retirees can depend on. Transamerica is a leader in providing Retiree Medical Insurance Programs across the U.S. Employers and their retirees can count on us now and in the years ahead You can rest assured that we are here for the long-term. We ve made our name in the Retiree Medical insurance business, and we ll be here when your clients organizations and their retirees need us. Just as vital... We understand the importance of treating retirees with respect. Our customer service professionals go through rigorous training to assure the highest quality of service. Retirees benefit from experiencing exceptional courtesy and professionalism whenever they have questions, concerns, or need assistance with claims. For agent/broker use only p. 4

5 Helping employers keep their promises. Our Retiree Medical Insurance Program can help relieve the pressure on employers as they look to fund the health care benefit promises they made to their retirees years ago. Between 2012 and 2050, the United States will experience considerable growth in its older population. In 2050, the population aged 65 and over is projected to be 83.7 million, almost double its estimated population of 43.1 million in The baby boomers are largely responsible for this increase in the older population, as they began turning 65 in By 2050, the surviving baby boomers will be over the age of 85. Source: 2014 Analysis of U.S. Census Bureau data by Administration on Aging An Aging Nation: The older Population in the United States (census.gov) Number of Older Americans The growth of the population age 65 and over affects many aspects of our society, by challenging policymakers, families, businesses, and health care providers, among others, to meet the needs of aging individuals Population, Relative Growth, and Ratio of Older Population to Working-Age Population by Age Group for the United States: 2012 to 2050 Population (in millions) 65 tp 84 years 85 years and over Note: Relative growth is calculated as the population in a projected year ( ) divided by the Population in Source: U.S. Census Bereau, 2012 Population Estimate and 2012 National Projections. p. 5

6 Easy Program Setup From the initial stages of putting this program in place, your Transamerica team makes every step as simple and easy as possible. We know the processes involved, from planning, data management and promotion, to efficiently get the Retiree Medical program up and running. Simplified Implementation Transamerica is equipped to handle all the details of switching retirees from another insurance program, or assuring a smooth transition to this coverage at retirement. Our simplified enrollment and promotional programs can easily be adjusted to the employers needs. Ongoing Administration Whether administration is handled through your broker relationship, or by Transamerica, we fully understand all the administrative requirements, such as enrollment, billing and claims. Our flexibility is key to implementing a successful Retiree Medical insurance program. We can handle every aspect of setting up and administering this program. Access to Your Transamerica Team at all Times At every stage of the Retiree Medical insurance program s administration, you will have direct access to a Transamerica team and leadership who are dedicated to the employer and their retirees. We are extremely accessible and responsive to ongoing needs. For agent/broker use only p. 6

7 A Sound Strategy Transamerica s Retiree Medical Insurance Program The employer-sponsored retiree health care market continues to rapidly evolve. Federal health care reform introduced both challenges and opportunities for entities sponsoring retiree health care programs. This is creating an impetus for change at a time when escalating health care costs and benefit liabilities threaten to crowd-out other mission-critical investments that plan sponsors need to make in the current economic and competitive environment. Many plan sponsors are finding that new strategies can create significant savings opportunities and allow them to effectively re-position their retiree medical insurance programs for the future. Source: Aon 2013 Retiree Health Care Survey An Overview of Retiree Health Insurance Program benefits. We agree Retirees deserve a more worryfree retirement. Retiree Medical Insurance coverage coordinates with Medicare such as coinsurance and deductibles to provide more protection. Here s an overview of what s also available: Hospitalization Coverage Part A deductible Part A hospital co-payments Part A hospital co-payments for each lifetime reserve day used 100% of Medicare-eligible hospital expenses per year Part A and Part B blood cost deductibles Medical Coverage Part B co-insurance amounts Skilled Nursing co-payments for 21st-100th day Excess Part B coverage of 80% or 100% At Home Recovery Foreign Travel Emergency Preventive Care annual physicals and various preventive tests and screenings Medicare Part D Prescription Drug Coverage Options Plan options are made available through Transamerica s Medicare Prescription Drug Plan Solution. All standard products include a broad formulary and clinical management. Group products offer the following advantages: A variety of deductibles and co-payments Flexibility to enhance the Standard Part D benefit plan Opportunity to implement clinical management programs for retirees through formulary and drug utilization review Reduced administrative burden of retiree drug subsidy filings and credible coverage communications Access to home delivery for reduced costs and extra convenience for retirees Extensive formularies p. 7

8 Transamerica s Medicare Prescription Drug Plan Solution Medicare GenerationRx SM Delivering Exceptional Value, Choice, and Coverage. Medicare GenerationRx SM is more than a drug plan. There is so much that goes into building and delivering the plan Customized Solutions cost saving opportunities with flexible benefit packages that can mirror your current plan designs (including Retiree Drug Subsidy) top-notch networks that will provide your client and their retirees with satisfying, safe, and secure experiences strict security and privacy providing members a carefully managed, highquality process that ensures member health and some peace of mind innovative technology provides a seamless enrollment and easy transition process for your clients and their retirees You can count on us for generations to come. Great Products precise processes providing members a carefully managed, high-quality experience that ensures member health and some peace of mind exceptional customer service that delivers personal and professional advice ensuring your clients and their retirees get top-priority treatment personal attention with patient-centered clinical programs to drive medication adherence and safety Great Company We are experts at implementing retiree medical insurance programs in an on-time and hassle-free manner. The underwriter, Stonebridge Life Insurance Company (a Transamerica company) and the pharmacy benefits manager, MedImpact Healthcare Systems, support your business with best-in-class processes that ensure accurate, timely implementation and ongoing support. Transamerica Affinity Services is a business unit of the Transamerica companies. We are a specialist in the direct marketing of supplemental insurance products through the affinity marketing channel, conducts its operations through ten insurance companies. The financial health and strength of our insurance companies are sources of great pride and of paramount importance to us. More importantly, it gives you, our partners, and your clients the security and some peace of mind you should expect from your insurance company. The Post-65 Retiree Medical insurance product is underwritten through Transamerica Premier Life Insurance Company, Cedar Rapids, IA and Transamerica Life Insurance Company, Cedar Rapids, IA (Transamerica Financial Life Insurance Company in Harrison, NY), depending on your state of residence. Transamerica Premier Life, Stonebridge, Transamerica and Transamerica Financial are AEGON companies. The 800-series EGWP Medicare Prescription Drug Plan, marketed under the name Medicare GenerationRx SM, is a group plan underwritten by Stonebridge Life Insurance Company (Rutland, Vermont), A Transamerica company. Stonebridge Life Insurance Company (a Transamerica company) is a PDP plan sponsor with a Medicare contract. *These carriers have all been rated A+ (Superior, 2nd of 16 rating categories) by A.M. Best Company as of October 20, Affinity Services 100 Light St., FL B1, MS 3239 Baltimore, MD Toll Free Plans may not be available in some states. Transamerica Affinity Services is a business unit of the following Transamerica companies: AT# /14