2015 Health Care Enrollment Medicare Eligible Retirees and Medicare Eligible Dependents Henrico County General Government and Schools

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1 2015 Health Care Enrollment Medicare Eligible Retirees and Medicare Eligible Dependents Henrico County General Government and Schools Frequently Asked Questions - OneExchange Q1: Why is the County sponsoring retiree coverage through the individual market for Medicare eligible retirees? A1: With our UnitedHealthcare contract ending on December 31, 2014, we are seeing changes in the health care industry, uncertainties about federal subsidies that have supported the type of Medicare Advantage program you have today, and some providers no longer accepting our coverage. We also have heard from retirees who are concerned about the rising cost of our group plan. In fact, the premium cost has more than doubled in the past five years. Henrico County s goal is to offer valuable health coverage in a way that meets the varied needs of our Medicare eligible retirees. In today s health care market, the best federal subsidies are in the individual market which offers a broad range of plans to meet different coverage needs and household budgets. We also know that comparing the numerous plans available, making an informed enrollment decision and completing the enrollment process can be a daunting experience. A dedicated and licensed OneExchange benefit advisor will listen to your specific needs and preferences and will help you find the health coverage that works best for you. A OneExchange benefit advisor will personally enroll you over the telephone for the coverage you select. Later, if you have claims or billing concerns, your OneExchange benefit advisor will facilitate a resolution for you. You may also contact OneExchange each fall during the Medicare Annual Enrollment period to evaluate new enrollment options for the upcoming year. Q2: I like my current coverage with UnitedHealthcare. May I keep my current coverage in 2015? A2: No, you cannot keep your current coverage with UnitedHealthcare in Your current coverage will end on December 31, Your OneExchange benefit 1

2 advisor will help you find the best plan for comparability and to meet your unique health and budget needs Q3: Is Henrico County dropping retirees? A3: No, Henrico County is providing a new way for Medicare eligible retirees to enroll for health care coverage in 2015 and beyond. The current UnitedHealthcare Medicare Advantage group plan will end on December 31, To provide continued coverage in an individual plan that works best for each retiree s health and budget needs, Henrico County has contracted with OneExchange to personally assist each retiree and Medicare eligible dependent with enrollment for 2015 health care coverage. Q4: Is Henrico County making this change to save money? A4: No, Henrico County will not save money by making this change. Retirees, however, will have increased choice in selecting a health care plan and the opportunity to spend less for coverage. Q5: Will coverage through OneExchange cost more? A5: It is likely that most retirees will not pay more for coverage. Retirees will have an opportunity to spend less for coverage, so a retiree s costs will depend on the coverage selected and services used. Q6: Who will be impacted by this change? A6: This change will impact Medicare eligible retirees and Medicare eligible dependents of Henrico County General Government and Schools who are enrolled in the County s group UnitedHealthcare Medicare Advantage plans. This change will not impact pre-medicare retirees and retiree dependents who are currently covered on Henrico County s Anthem plan. These pre-medicare retirees will continue with Anthem coverage and will receive information in the mail from Henrico County before their open enrollment period November 3 November 26,

3 Q7: My spouse is covered under the Anthem plan. What will happen when he/she becomes Medicare eligible at age 65? A7: If you enroll in a plan through OneExchange, your spouse s Anthem coverage will continue until he/she reaches age 65. Several months prior to his/her 65 th birthday, OneExchange will send your spouse information in the mail about his/her upcoming opportunity to transition to coverage through OneExchange. Q8: Will I have to choose a Medicare Advantage plan? A8: No. You can choose to enroll in another Medicare Advantage plan, or because you will be losing your group plan, you will be eligible at this one time to enroll in a Medigap (Medicare supplement) plan on a guaranteed issue basis. If you select a Medigap plan you must also enroll in a separate Prescription Drug Plan. Your OneExchange benefit advisor will assist you in choosing the best coverage for you. Q9: Will the individual plans available through OneExchange be part of the Affordable Care Act public health care exchange? A9: No. OneExchange offers post-65 retirees enrollment in a broad range of health plans through their privately operated exchange and has no affiliation with government-run exchanges created under the Affordable Care Act. Q10: I have a pre-existing health condition. Will I have coverage for claims related to my pre-existing condition? A10: Yes. Because you will be losing coverage on a group plan effective December 31, 2014, during this initial enrollment period, a plan will not be able to refuse to cover you and can t require that your rate be based on your health condition provided you enroll by December 31, Q11: Can I use the same doctors and hospitals? A11: Your OneExchange benefit advisor will ask you about the doctors and hospitals that you want to utilize so that you may select from health care plans that offer the access that is important to you. 3

4 Q12: What if I am in the hospital or undergoing a treatment program in late December 2014 through early January 2015 when we are making this coverage transition? A12: If you are in the hospital at the time the transition takes place from your UnitedHealthcare group Medicare Advantage plan to your new plan through OneExchange, UnitedHealthcare will continue to cover your claims expenses until you are discharged from the hospital. Once your hospital stay is over, the new carrier/new plan that you have selected through OneExchange will take over your care. If you have a hospital admission in 2014 that is likely to continue into 2015, it is important to let your newly selected plan know as soon as possible - ideally BEFORE your new coverage becomes effective so your new carrier can coordinate ongoing care. Any other treatments that are in progress at the time of the transition must be covered by your new carrier (under your new plan) beginning January 1, You should talk with your OneExchange benefit advisor about any treatments that are in process or which you will be undergoing that are expected to continue beyond January 1, Q13: I won t be able to attend a retiree information session. Will I still be able to enroll for 2015 coverage? A13: Yes! While we encourage you to attend a meeting, the meetings are for information purposes only and not for enrollment. Each retiree will schedule a phone appointment with a OneExchange benefit advisor to select health coverage and to enroll. In addition, you will have the opportunity to learn about the enrollment process through information sent by OneExchange to your home and also by calling the OneExchange/Henrico County toll-free number at During your phone appointment, you will be able to ask your benefit advisor any questions you have and can call later with questions as well. Q14: I am hearing impaired and have difficulty with phone calls. Can I enroll online or with a paper form? A14: OneExchange does offer online enrollment from a variety of carriers; however the carrier best suited for you may NOT be available online. TTY service 4

5 is available, however. Paper applications are not accepted by OneExchange due to the potential for errors in completion which could delay your coverage start date. Q15: My daughter/son/friend helps me with my financial decisions and handling bills. May this person participate in the phone call with the OneExchange benefit advisor when we discuss my plan options and enroll? A15: Yes! Please share your appointment time with the person(s) you would like to participate in your phone appointment. The OneExchange benefit advisor can set up a conference call to include the person(s) you choose to participate. Remember, however, that you alone can complete your enrollment, unless the person participating with you during your calls to OneExchange has a Power of Attorney (POA) for you. Q16: Who should I contact with questions about this new enrollment process and coverage? A16: You may call the OneExchange/Henrico County toll-free number at A benefit advisor for Henrico County will answer your questions. Q17: Why must I call now since enrollment doesn t begin until October? A17: OneExchange encourages you to call now so you can begin to build a profile in their system. They will also schedule your enrollment appointment during the Annual Election Period. Beginning on or about October 1, you will be able to see 2015 rates and benefits online at the OneExchange/Henrico County Website: medicare.oneexchange.com/henrico. Q18: How can I find the premium costs for plans available through OneExchange? A18: Your OneExchange benefit advisor will provide you with information about premium costs and out-of-pocket costs, such as copayments, coinsurance, deductibles and out-of-pocket maximums during your enrollment appointment. Most enrollment appointments will be scheduled between late October and mid- December. You may also check premium costs by visiting the OneExchange website after October 1. Prior to October 1 you may still visit the website to create your online profile, but rates will not be available until early October. To 5

6 avoid selecting a plan based solely on the premium costs, your OneExchange benefit advisor will guide you in considering both premium costs and out-ofpocket costs in order to find the plan that will work best for you. Q19: I have a Henrico County Health Care Supplement. Will I continue to receive this supplement after I enroll for coverage through OneExchange? A19: Yes! However, for those retirees eligible for a Henrico County Health Care Supplement, the funds will be available to you in a different way. Currently, Henrico pays your supplement directly to UnitedHealthcare and you pay the difference in premium. In 2015, you will pay your full premium directly to the insurance carrier you select for coverage. Henrico will provide your same monthly supplement through a Health Reimbursement Account (HRA) from which you can receive reimbursement for the amount of your monthly supplement. Your OneExchange benefit advisor will discuss this process with you in your phone appointment. Also, OneExchange will send you more detailed information on the reimbursement process in late December Q20: I receive a Health Insurance Credit (HIC) from the Virginia Retirement System (VRS). How will this be affected? A20: Some retirees are eligible to receive this state health insurance credit based on the position they held (such as teachers, constitutional officers and their employees) and their length of service. VRS includes your HIC with your monthly benefit deposit as an eligible retiree. The amount of your HIC is based on your years of service and will not exceed the amount of your health and dental premiums. You must notify VRS whenever there is a change in your coverage and premium. After selecting your new plan for 2015, complete VRS Form 45 (available from VRS at or ) to notify VRS of your new coverage and premium effective January 1, Submit the form directly to VRS in order to receive your proper HIC. General Government: HR Benefits, Schools: Schools Benefits Office,