Group Benefits from The Hartford. The Hartford s Group Retiree Health Plans. The Hartford Employer Group Insurance Trust Program.

Transcription

1 Group Benefits from The Hartford The Hartford s Group Retiree Health Plans The Hartford Employer Group Insurance Trust Program.

2 Group Benefits from The Hartford Are you struggling to manage your retiree health benefits? Is it becoming harder to offer a retiree plan with rising medical costs? Maybe it s time to review your retiree group benefits. Undivided attention and experience from The Hartford. Medicare's benefit structure leaves beneficiaries with significant out-ofpocket costs. 2 The Hartford Employer Group Insurance Trust Program provides a wide range of insurance services that help your retirees and keep costs down. With The Hartford 1, you get over 20 years of industry experience and a dedicated staff exclusively committed to the group retiree health business. The Hartford trust program consists of a fully insured group medical plan for the post-65 retiree, which integrates with Medicare. No employer is too small. Our trust groups include employers with as few as two lives. And with several prepackaged plans to choose from, you can find a medical plan that meets your retirees medical needs.

3 Medical Plan features: Freedom to choose any doctor or hospital within the U.S.; no networks. Guaranteed Issue no medical underwriting required. Acceptance into the plan is guaranteed this means your retirees will not be asked to take a medical exam or answer medical questions at the time of enrollment, insurance benefits payable are subject to the policy s pre-existing conditions limitation. Opportunity to pool together to provide group rates for small businesses. Plans designed to cover, in part or in full, many of the medical expenses not covered by Medicare. Possible reduction in Financial Accounting Standards (FAS) Board 106/General Accounting Standards Board (GASB) 43 liability. Electronic claims processing; payment cross-over with Medicare. Prescription Plan features: Claims handled at point of service, no forms to complete. Nationwide network of pharmacies. Competitive formularies (approved prescription drug lists). Options for both Medicare and non-medicare styled pharmacy plans. Non-Medicare plan designs eligible for Retiree Drug Subsidy (RDS) program. Caring and knowledgeable senior specialists. Your plan includes Customer Service Representatives specially trained to serve the senior segment. They understand the common concerns retirees face about their health care, finances, and coverage features, and are keenly sensitive to the anxieties associated with changes in a retiree s health plan.

4 Sample Medical Plan* Benefit Description Medical Option 1 Calendar Year Deductible $250 Inpatient Hospital Part A Deductible 100% Part A Coinsurance: 100% (days 61-90;) (days ) Additional Hospitalization (365 days) 100% Skilled Nursing Facility (days ) 100% Part B Coinsurance after the Part B Deductible 80% of the remaining balance after Medicare pays; 100% once the OOP is met Part B Out of Pocket Maximum (OOP) $500 Part B Deductible Not covered Total Out of Pocket (Deductible + OOP) $500 Part B Excess 100% Part A & B Blood Deductible (1st 3 pints) 100% Hospice (Inpatient respite care, drugs) 100% Foreign Travel Emergency ($250 Deductible / 100% 80% coinsurance /$50,000 Lifetime Maximum) At-Home Recovery ($40/visit not to exceed 7 Not covered visits per week up to a $1,600 Calendar Year Maximum) Preventive Care Cancer Screening Benefit 100% (one mammography, cervical, & prostate cancer screening per calendar year)

5 Sample Fully Insured Outpatient Prescription Drug Benefits* Fully-Insured Outpatient Option 1 Benefit Description Retail Mail Order Calendar Year Deductible** $150 Calendar Year Maximum ** Unlimited Generic Co-Pay $10 $20 Preferred Brand Co-Pay $25 $50 Non-Preferred Brand Coinsurance 50% 50% Sample Prescription Drug Plan* PDP Option 1 Benefit Description Retail Mail Order Calendar Year Deductible** $0 Preferred Generic Co-Pay $5 $8 Generic Co-Pay $10 $15 Preferred Brand Co-Pay $25 $56 Non-Preferred Brand Co-Pay $60 $165 Specialty Coinsurance 33% Not covered Coverage Gap Full Coverage * Certain state restrictions may apply. We will provide state availability information at the time of quote. ** These are combined retail and mail order deductible maximum benefit amounts. The individual retiree is responsible for the calendar year deductible and co-pay or coinsurance amounts. The plan pays after the calendar year deductible and co-pay or coinsurance has been met, up to the calendar year maximum if applicable. Please note: We will not cover the difference between the cost of a brand name drug and its less expensive generic equivalent (including preferred drug) regardless of any Dispense as Written (DAW) instruction from a doctor.

6 In its 2008 estimate, Fidelity Investments said the average 65-year-old couple would need $225,000 to pay costs not covered by Medicare. 3

7 The trust increases your purchasing power. We understand that you want to keep your commitment to your retirees. That's why, The Hartford Employer Group Insurance Trust pools together all participating firms under the trust to make offering group retiree health benefits affordable to you and your retirees. Because you belong to the trust, you and your retirees can enjoy the purchasing power of group rates. Whether your retirees contribute to the premium cost, pay all of the premium cost or none of the cost, we have billing options to accommodate your situation. List bill, direct bill, or a combination of list and direct bill options are available. Individuals have the option to receive a paper bill or have funds auto-deducted from their bank account. Billing can be done monthly or quarterly under the trust. The right plan for you. Various billing options. Group rates and pooled claim experience. Administrative freedom. HIPAA compliance. Your choice of contributory and non-contributory plans. And experienced people who understand retirees needs and concerns. That s what you get when you join The Hartford s Group Retiree Health plans. To learn more about The Hartford s solutions for retiree health benefits, please contact The Hartford sales contact line at

8 1 The Hartford is The Hartford Financial Services Group, Inc. and its subsidiaries, including issuing companies Hartford Life Insurance Company and Hartford Life and Accident Insurance Company. Policies sold in New York are underwritten by Hartford Life Insurance Company. Home Office of both companies is Simsbury, CT. All benefits are subject to the terms and conditions of the policy. Policies underwritten by the issuing companies listed above detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in force or discontinued. 2 Source: Fishman, Eliot, Ph.D., Tamang, Suzanne, M.S., and Shea, Dennis, Ph.D. Medicare Out-of-Pocket Costs: Can Private Savings Incentives Solve the Problem? The Commonwealth Fund, Vol 87. March 24, Available: m?doc_id= November 12, Source: Salisbury, Dallas. Crunching the numbers, Human Resource Executive Online, LRP Publications, September 2, Limitations & Exclusions: The Hartford s Insurance Plan does not cover any expense that is not a Medicare Eligible Expense or beyond the limits imposed by Medicare for such expenses or excluded by name or specific description by Medicare, except as specifically provided in the policy. Any part of a covered expense to the extent paid by Medicare; benefits payable under one benefit of the policy to the extent covered under another benefit of the policy; or expense incurred after coverage terminates, except as stated in the Extensionof-Benefits provision of the policy. This brochure/presentation explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this brochure and the policy, the terms of the policy apply. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy as issued to the policyholder. Benefits are subject to state availability. The Hartford s Group Benefits Division is proud to print on Forest Stewardship Council certified paper. FSC certification ensures that the paper we print on contains fiber from well-managed and responsibly harvested forests that meet strict environmental and socioeconomic standards (1/09) Printed in the U.S.A The Hartford, Hartford, CT 06115