Introductions and Welcome USG Representative Karin Elliott, University System Office Aon Retiree Health Exchange Representative Proprietary & Confidential August 2015 2
Why We Are Here Today The purpose of this Retiree Information Meeting is to provide you with: A summary of health coverage changes in 2016 for retirees and dependents who are age 65 and older and are Medicare-eligible An overview of upcoming communications, resources and key steps A forum to answer your questions Learn Prepare Enroll Proprietary & Confidential August 2015 3
Agenda What is Changing for 2016? 2016 USG Funds to HRA Your Health Reimbursement Account The Aon Retiree Health Exchange Learn About Medicare Options for Enrolling Paying for Your Coverage Tools to Help You Enroll Timeline and Next Steps Questions Proprietary & Confidential August 2015 4
Coverage for Medicare Eligible Retirees In 2016, you ll enroll in your health care coverage and receive your retiree health care benefit in a new way 1. Medicare Part A and B will provide your primary coverage same as today 2. Supplemental Coverage will be provided through the Aon Retiree Health Exchange 3. USG will deposit money into a Health Reimbursement Account (HRA) to use towards premiums and other out of pocket health care expenses Proprietary & Confidential August 2015 5
To receive the money from USG into the HRA Must be enrolled in Medicare Parts A & B Must be enrolled in the USG Healthcare plan in 2015 Must purchase coverage through the Aon Retiree Health Exchange Spouse coverage: Medicare Eligible Pre-65 Medicare Eligible Pre-65 not Medicare Eligible Exchange with HRA USG Plan USG Plan Retiree must be enrolled in coverage for spouse to receive HRA contribution or coverage in USG plan Proprietary & Confidential August 2015 6
2016 USG Funds to HRA 2016 USG Funds to HRA $2,736 annually /$228 monthly Full Amount Available January 1 Retiree and Medicare Spouse will each receive $2,736 Proprietary & Confidential August 2015 7
Health Reimbursement Account (HRA) Funds will roll over from year to year Eligible reimbursement expenses will include Medicare Supplemental premium, Medicare Advantage premium, Part D premium, Part B premium, Vision/Dental premium, Out-of-Pocket Medical/Vision/Dental expenses Medicare income and late enrollment penalties Joint Accounts for retiree and spouse coverage share funding - each receive $2,736 Proprietary & Confidential August 2015 8 8
Comparison of Premiums Supplement Plan (Medigap) 2015 Premium range for the highest level of coverage $150 $250 per individual/month $1,800 $3,000 annually Part D Prescription Drug Plans 2015 Average premium $35.00 per individual/month $420 annually Proprietary & Confidential August 2015 9
Comparison of Premiums Medicare Advantage (Part C) 2015 Premium range $0 $100 per individual/month $0 $1,200 annually Proprietary & Confidential August 2015 10
Comparison of Premiums - Summary Medicare Advantage (Part C) (2015) $0 $100/month (or $0 $1,200 annually) Medigap & Part D Combined Total (2015) $185 $285/month (or $2,220 $3,420 annually) USG 2016 Deposit to HRA $228 per month (or $2,736 annually) 2015 single retiree premium $116 per month (or $1,392 annually) Proprietary & Confidential August 2015 11
Important Notes If you do not enroll in coverage through the Aon Retiree Health Exchange in 2016, you will not receive the USG deposit into the HRA in 2016 and will not be eligible for the USG HRA deposit going forward Your non-medicare or pre-65 spouse and dependents will remain enrolled in the USG plans until they turn age 65 or age out of the plan Proprietary & Confidential August 2015 12 12
The Aon Retiree Exchange Proprietary & Confidential August 2015 13
What is a Private Medicare Exchange? What it is: An insurance marketplace, where you can: Compare coverage, carriers and prices Coverage Get personalized, one-on-one support Choose the coverage option that best meets your needs Compare What it is not: Associated with the public exchanges established under the Affordable Care Act Insurance carriers Price Proprietary & Confidential August 2015 14
About the Aon Retiree Health Exchange The Aon Retiree Health Exchange is one of the nation s most trusted advisors in navigating Medicare it s advice you can count on We have a reputation for providing qualified, independent assistance to Medicare recipients who expect and deserve highquality health insurance coverage at an affordable price Proprietary & Confidential August 2015 15
The Aon Retiree Health Exchange Retiree focused solution Aon has served millions of employees, retirees, and their families for many years Offers broad range of health plan coverage options Provides robust tools and services to help you learn, prepare, and enroll Recommended by the National Council on Aging (NCOA) Proprietary & Confidential August 2015 16
Learn and Prepare Get Started Attend a retiree meeting presentation (or webinar) Read materials in the Personalized Education Kit Confirm your appointment Include Power of Attorney (if applicable) Prepare for your Appointment: Medicare card List of doctors List of medications Proprietary & Confidential August 2015 17
About the Aon Retiree Health Exchange Benefits Advisors help you learn, prepare and enroll Benefits Advisors serve you Licensed, certified and experienced in Medicarerelated insurance Not incentivized to steer to specific health insurance carriers and/or plans for you Dedicated to you throughout the entire process Proprietary & Confidential August 2015 18
Enroll Compare and Select Your Coverage Review and choose the right plan(s) with your Benefits Advisor Complete the Enrollment application Enroll online* or over the phone between [October 1 and December 31] * Voice signature required for all online enrollments Proprietary & Confidential August 2015 19
Take a closer look at Medicare Proprietary & Confidential August 2015 20
Current Plan Coverage Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Group Plan covers some of the costs Not covered by Medicare Parts A or B Company Sponsored Proprietary & Confidential August 2015 21
Medicare Insurance Plan Options Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Keep Medicare and add: Medicare Supplement Insurance (covers some or all of the costs not covered by Part A or B) Offered by Insurance Carriers Obtain Medicare (Part A & B) through a Medicare Advantage (combines Part A and B and may include prescription drug coverage) Medicare Part D (covers prescriptions) Medicare Part D Offered by Insurance Carriers Offered by Insurance Carriers Proprietary & Confidential August 2015 22
Medicare Part A & B Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Proprietary & Confidential August 2015 23
Medicare Part A Inpatient Hospital Care What Is Covered Part A covers part of the following services: Inpatient hospital care Inpatient care in a skilled nursing facility (not custodial or long-term care) Hospice care services Home health care services Blood What You Pay Enrollment in Medicare: Part A is automatic for those people who have worked 40 quarters in their lifetime and does not have a monthly premium. If you have not there could be a monthly premium. Deductible: per benefit period Benefit period: starts the day you leave the hospital after spending a night and lasts 60 days * 2014 Proprietary & Confidential August 2015 24
Medicare Part B Outpatient Hospital & Doctor Care What Is Covered Outpatient care: Doctors visits Outpatient hospital Blood Preventive care Mental health (outpatient) Ambulance Services Laboratory Services What You Pay Premium: Monthly Social Security determines the premium amount based on the last 2 years of taxable income Deductible: Annual Coinsurance: Medicare pays 80% Participant pays 20% Proprietary & Confidential August 2015 25
Medicare Supplement Plan Medigap Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Keep Medicare and add: Medicare Supplement Insurance (covers some or all of the costs not covered by Part A or B) Offered by Insurance Carriers Obtain Medicare (Part A &B) through a Medicare Advantage (combines Part A and B and may include prescription drug coverage) Medicare Part D (covers prescriptions) Medicare Part D Offered by Insurance Carriers Offered by Insurance Carriers Proprietary & Confidential August 2015 26
Medicare Supplement Medicare Supplements add onto the Medicare coverage you already have: Medicare remains your primary coverage Medicare Supplement is your secondary coverage Medicare Supplement plans DO NOT include Part D coverage With Medicare Supplement plans, as long as the doctor/medical facility accepts Medicare patients, you can go to: Any doctor Any medical facility in the country the service is Medicareapproved (similar to what you currently have) Proprietary & Confidential August 2015 27
Medicare Supplement Plan Medigap Plans are all regulated and must offer the same core plan benefits Prices and any extra features are the only differences between these plans Plans come with a range of coverage Plans A through N Plan F has highest level of coverage covering your deductibles and out-of-pocket expenses left over by Medicare Prices vary by company, age, and service area Some plans offer benefits for travel outside of the United States Proprietary & Confidential August 2015 28
Medicare Supplement Chart Features A B C D F G K L M N Medicare Part A Coinsurance and Hospital Costs (up to 365 days after Medicare Benefits are used up) Medicare Part A Deductible Skilled Nursing Facility Care Copay/Coinsurance Part A Hospice Care Coinsurance or Copayments Medicare Part B Deductible Medicare Part B Coinsurance (Generally 20%) Medicare Part B Excess Charges Blood (First 3 Pints) Foreign Travel Emergencies (up to Plan Limits) Proprietary & Confidential August 2015 29 50% 75% 50% 50% 75% 50% 75% 50% 75% 50% 75% For illustrative purposes only
Guaranteed Issue of Coverage For Medicare Supplement Plans Guaranteed issue means that during this Special Election Period for retirees, you re automatically accepted by most insurance carriers without having to answer medical questions You have guaranteed acceptance into most Medicare Supplement Plans, regardless of any pre-existing health conditions Proprietary & Confidential August 2015 30
Medicare Part D Prescription Drug Coverage Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Keep Medicare and add: Medicare Supplement Insurance (covers some or all of the costs not covered by Part A or B) Offered by Insurance Carriers Obtain Medicare (Part A &B) through a Medicare Advantage (combines Part A and B and may include prescription drug coverage) Medicare Part D (covers prescriptions) Medicare Part D Offered by Insurance Carriers Offered by Insurance Carriers Proprietary & Confidential August 2015 31
Medicare Part D Plans Prescription Drug Coverage Deductible 100% paid by Beneficiary (if applicable) Initial Coverage Level Beneficiary pays co-payments/coinsurance for each drug The Coverage Gap (donut hole) Beneficiary pays a percentage of the generic and brand name drug cost Catastrophic Coverage Beneficiary pays a small co-payment for each drug for the remainder of the year Proprietary & Confidential August 2015 32
Medicare Part C Medicare Advantage Plan Part A covers hospital stays Part B covers doctors and outpatient visits Government Sponsored Keep Medicare and add: Medicare Supplement Insurance (covers some or all of the costs not covered by Part A or B) Offered by Private Companies Obtain Medicare (Part A & B) through a Medicare Advantage (combines Part A and B and may include prescription drug coverage) Medicare Part D (covers prescriptions) Medicare Part D Offered by Private Companies Offered by Private Companies Proprietary & Confidential August 2015 33
Medicare Advantage Plans Part C Features Includes Medicare Parts A and B coverage Most include prescription drug coverage Network based plans HMO s PPO s May offer extra coverage Vision Hearing Dental Health/wellness programs What You Pay Medicare Advantage Plan premium (if any) Copays/coinsurance and deductibles Out-of-Pocket Max Proprietary & Confidential August 2015 34
Comparison for Choosing a Medical Plan Supplement Plan (Medigap) Pay Now option Can be higher premium/low to no cost on the back end Can go to any doctor or medical facility in the country that accepts Medicare Does not include prescription drugs Most plans include foreign travel emergency coverage Medicare Advantage (Part C) Pay Later option Low to no monthly premium/pay as you go Copays, coinsurance, and deductibles apply Out-Of-Pocket Max Network-based plans/hmos, PPOs Typically includes prescription drugs Coordinated Care Proprietary & Confidential August 2015 35
Options for Enrolling Proprietary & Confidential August 2015 36
Choosing a Medical Plan Each eligible person can choose a different medical or prescription drug plan Medicare Advantage Medicare Part D Retiree Selects Individual Coverage Spouse Selects Individual Coverage Medicare Supplement Proprietary & Confidential August 2015 37
Enrollment Periods 2015 Special Election Period: October 1 December 31, 2015 2016 Medicare Open Enrollment Period: October 15 December 7, 2016 Initial Enrollment Period: Eligible 3 months before, the month of, and 3 months after 65 th birthday Be sure to let your Benefits Advisor know if you have: Tricare or VA Coverage Proprietary & Confidential August 2015 38
Choices to Meet Your Needs Online Available 24/7; fastest method of Education and Enrollment Detailed summary of benefits information Plan comparison tools Online plan application collection Telephonic Enrollment Prefilled Application Benefits Advisor guides you You work with same Benefits Advisor throughout process All enrollments must be completed with telephonic signature Some individuals prefer to review printed materials before selecting Paper applications accepted via prepaid envelopes or fax Telephonic or online enrollments result in faster receipt of ID cards Proprietary & Confidential August 2015 39
Paying for your coverage Proprietary & Confidential August 2015 40
Conveniently Paying for Your Coverage Three Options 1. Pay your health insurance premium by check each billing period 2. Have your premium automatically withdrawn from a checking or savings account Most insurance providers allow automatic withdrawal as a convenient alternative to paper checks 3. Pay your premium by automatic deduction from your Social Security Option only available for Medicare Advantage and Part D plans Proprietary & Confidential August 2015 41
Health Reimbursement Account (HRA) Other Highlights You ll continue to be reimbursed for your insurance premiums and eligible out-of-pocket expenses until the HRA amount is depleted Any remaining balance in your HRA at the end of the year will roll over to be used in future years Catastrophic HRA (CHRA) If retiree or dependent reaches catastrophic drug coverage, they can receive reimbursement for the 5% Out-of-Pocket cost for the remainder of the 2016 CHRA account is independent of HRA account Survivorship Rules Note: For those who are eligible to receive an HRA. Proprietary & Confidential August 2015 42
How the HRA Will Work $ Participant Pays health insurance premiums directly to insurance carrier Insurance Carrier Reports medical/part D premium payments to the Aon Retiree Health Exchange $ Participant Pays for eligible out-of-pocket expenses, e.g., copays or coinsurance, and submits reimbursement claims Participant HRA Reimburses participant for premiums and other eligible out-of-pocket expenses $ Proprietary & Confidential August 2015 43
Tools to help you Proprietary & Confidential August 2015 44
Advocacy Services Access to additional assistance after Enrollment We help with: Access to care and prescription drugs Claim denials and incorrect payments Billing disputes Authorization and referrals Medicare coordination Our Advocates Pioneered service in 1999 400 clients 3.6 million participants Advocates average 18 years of industry experience Months: Transition event Decades: Ongoing support Proprietary & Confidential August 2015 45
Medicare Advocacy Examples Problem Root Cause Solutions Erroneous billing code Unexpected bills from rheumatologist Provider miscoded diagnosis and CPT code; as a result, charges were not eligible for Medicare Advocate worked with provider to correct and reprocess bill. After bill was reprocessed, advocate communicated accurate liability to retiree Incorrect Medicare claim denial Medicare denied claim, indicating Medicare was not primary Retiree did have additional coverage; however, Medicare was primary Advocate facilitated refiling claim with Medicare, then forwarded EOBs to health plan for secondary payment Access to wheelchair Denied a retiree s request for a wheelchair Medicare denied claim as not medically necessary Advocate collected medical records and forwarded them to Medicare Once approved, Advocate made arrangements for home delivery of wheelchair Proprietary & Confidential August 2015 46
Website After you have received your Education Kit, visit the website On the website you can : Confirm your Enrollment appointment Confirm your phone number/address Add your prescriptions to Medicine Cabinet Compare plans and add to Shopping Cart HRA Link available once plans are active Proprietary & Confidential August 2015 47
Website If no access to website you can: Call to confirm your Enrollment appointment Call to confirm your phone number/address Call to add your prescriptions to Medicine Cabinet Work with your Advisor to compare plans and plans mailed to your home Talk to your Advisor regarding the HRA process and balance information0151available once plans are active Proprietary & Confidential August 2015 48
Timeline and Next Steps Proprietary & Confidential August 2015 49
Enrollment Timeline for your 2016 Coverage Eligible Participants Aug/Sep Mid September Pre-Communications/Retiree Meetings Receive Aon Retiree Health Exchange Letter and Education Kit October November December Telephonic Appointment With a Benefit Advisor HRA Welcome Kits Mailed From Your Spending Account Enroll for 2016 Benefits Proprietary & Confidential August 2015 50
Recap: What Do I Need to Do? Learn Prepare Ongoing: Review the Medicare Eligible Retiree Guide Today: Attend a retiree meeting presentation (or webinar) September: Review your Education Kit and confirm your Enrollment Appointment Enroll October 1 December 31: Complete your Enrollment Appointment Proprietary & Confidential August 2015 51
Checklist Receive and Read Welcome Letter and Educational Package Activate Account Online (optional) Add Plans to Cart Add Drug Information Confirm Appointment (online or calling number provided) Gather Prescription Drug and Doctor Information Appointment with Benefits Advisor Discuss Plan Options Enroll in plan(s) by December 31, 2015 Aon Retiree Health Exchange 1-866-212-5052 Monday Friday 9:00 a.m. 9:00 p.m. ET Proprietary & Confidential August 2015 52
Thank you for coming! Additional Resources: Aon Retiree Health Exchange at 1-866-212-5052 (TTY 711 Relay), 9:00a.m. to 9:00 p.m. Eastern Time, Monday through Friday Aon Retiree Health Exchange Information website: www.usg-retireehealthexchange.com USG HR/Benefit Teams USG Retiree Benefits website: http://www.usg.edu/hr/benefits/retiree_benefits Proprietary & Confidential August 2015 53