IBM Medicare Coverage Overhaul

Transcription

1 IBM Medicare Coverage Overhaul Current IBM coverage for medical, dental & vision care will be discontinued 12/31/2013 IBM subsidy will continue through Health Reimbursement Arrangement (HRA) Must work with Extend Health and enroll in a medical plan or prescription drug plan to receive HRA No group plans - - retiree and spouse will enroll in individual plans Offers flexibility to sign up for a plan based on individual s health status However, adds to enrollment process Exception: Those currently enrolled in Aetna Medicare Plan A (HMO) and Aetna Medicare Plan B (PPO) can continue with these plans along with IBM offered dental and vision plans for up to two years with the option to convert at the end of Will not be eligible for HRA. Not need to return the Spousal Selection Form 1

2 Who is Extend Health? Largest private Medicare exchange serving over 500,000 Medicare retirees Acquired by Towers Watson in May 2012, will be renamed to Towers Watson come January 2014 Extend Health is now your primary contact for enrollment and ongoing support for your health care coverage for 2014 and beyond All benefit advisors are expected to be trained but there are growing pains Note: For more details on Extend Health, visit to see the presentation given by Extend Health speakers at select IBM sites. 2

3 All About Health Reimbursement Arrangement (HRA) A tax-free account which can be used to pay for eligible out-of-pocket health care costs: Premiums for medical, prescription, dental & vision care plans Deductibles, Co-Pays and Co-Insurance Medicare Part B Premiums IBM will contribute annually to your HRA if you were receiving subsidized group coverage If you and your spouse are both IBM retirees and Medicare-eligible, each of you are eligible for your own HRA. A joint account will be setup for the total amount unless otherwise requested HRA must be funded by IBM, you can not contribute to an HRA (IRS rules) If you don t use your annual HRA allocation, it will not roll over If you have an FHA account, it will be transferred into an HRA and will roll over year to year till all depleted Extend Health will serve as the administrator for your HRA account 3

4 All About Health Reimbursement Arrangement (HRA) (Continued) To receive your HRA contribution, you, the retiree (or surviving spouse), must enroll in medical and/or drug plan through Extend Health Once you enroll in a medical plan through Extend Health, it s not necessary for your spouse to enroll in a medical plan through Extend Health. You and your spouse can enroll in prescription, dental and vision plans on your own and submit claims for premiums and other medical expenses for reimbursement Non-Medicare eligible spouse/dependent can not enroll through Extend Health but is eligible to draw upon retiree HRA for medical, dental, vision care premiums and expenses, same as the retiree See presentation for Non-Medicare Eligible Spouse for more details Make sure your spouse/dependent is included in Extend Health database Reimbursements You will first pay all premiums and other out-of-pocket expenses Auto reimbursement for select medical plans Premiums will be withdrawn from your bank account Extend Health will reimburse you with a check Manual process for all other expenses. Submit claims with valid receipts, etc. till HRA is depleted IBM premiums were payable in arrears. You will be paying December 2013 premium out of your January 2014 pension payment. However, your premiums for new plans will be paid in advance and are due starting 1/1/

5 IBM Subsidy for HRA IBM aggregate contribution to HRA s will be consistent with prior years Retirement Date Without Surviving Spouse Option With Surviving Spouse Option Retiree Already Deceased Now Surviving Spouse Now Surviving Spouse Medicareeligible Surviving Spouse Before Jan. 1, 1992 On or after Jan. 1, 1992 $3,500 0 $2,600 $1,300 $1,300 $3,000 0 $2,374 $1,187 $1,187 - You must make your selection on Survivor Selection Form and return to reach IBM vendor by 12/16/ Default is Spousal Coverage meaning lower amount even if there is no spouse or dependent -30 day grace period (12/17/2013 to 1/16/2014) to make changes 5

6 Next Step Choose the best coverage while optimizing the use of available funds: Annual HRA (or FHA) Annual SHAP, if eligible 6

7 2013 Options vs Coverage 2013 Options Medicare Supplement Plans: -IBM Medical Supplement -IBM Medical/Prescription Drug Supplement -IBM Medical/Prescription Drug Supplement Plus No medical coverage until you reach max out-of-pocket 2014 Coverage Options for comprehensive Medical coverage and lower cost Flexibility with individual plans -Aetna Traditional Integration Plan A or Plan B (Medigap) Single: Lower cost for similar coverage Couple: Higher cost for similar coverage Medicare Advantage Plans: -Humana Medical Plan (HMO) Better Value with more options Choose a similar HMO Plan -United Healthcare of Florida (HMO/PPO) Better Value with more options Choose a similar PPO Plan -Aetna Medicare Plan A (HMO) Can stay up to 2 years (no HRA) May get better value by switching to a street HMO Plan -Aetna Medicare Plan B (PPO) Stay up to 2 years (no HRA) Excellent value PPO 7

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9 Medicare Plan Types Option 1 Medigap + Part D Rx Option 2 Medicare Advantage Plan Name Plan F, N, C, etc PPO, HMO, etc Medicare Supplement to Original Medicare Pays instead of Medicare (You assign your Medicare benefits to the insurance provider) Costs Pay Up Front Pay As You Go Premiums Higher Monthly Premium Zero to Low Monthly Premium Co-Pays $0 Co-pays (Plan F) Co-pays, Co-insurance Doctors/Medical Facilities Any Doctor/Facility that Accepts Original Medicare Networks, PCP Portability Benefits Travel with You Only Emergency Coverage When Out of Network Area 9