City of Portland Health Insurance in Retirement Debi Danielson Benefits and Wellness Office Portland Building, 4th Floor (503)

Top 10 retirement decisions 1.When to retire 2.When to claim Social Security 3.Health Coverage 4.How much you can safely spend each year 5.How much investment risk 6.When to pay taxes on investments 7.Where to live 8.Whether your home should help finance retirement 9.Whether to keep working 10.What you will do US News and world report, Oct 2011

Health insurance in retirement City of Portland Health insurance in Retirement - Eligibility - Enrollment Process - Cost and Payment Options PERS health insurance Medicare Social Security Life Insurance Other questions?

When does City paid benefits coverage end? In General, City paid benefits will end on the last day of the month in which an employee terminates employment. 1. You notify your Bureau that you are retiring 2. An enrollment packet is sent to your home 3. You elect coverage (or not based on your situation)

COBRA vs. Retiree coverage COBRA vs. Retiree insurance Both offer continuation of the plan you are currently on COBRA (Federal requirement to offer continuation) ends after 18 months 2% admin fee is charged Retiree (State requirement to offer continuation, ORS ) available until Medicare eligibility When you retire you pay 100% of the premium. When you elect COBRA you pay 102% of the premium.

City of Portland Retiree self pay health insurance eligibility Eligible to receive retirement income from PERS (you don’t have to be actually receiving the PERS monthly pension) Tier 1 Unreduced benefit at age 58 (or 30 years) Or reduced benefit at age Tier 2 Unreduced benefit age 60 (or 30 years) Or reduced benefit at age OPSRP Unreduced benefit age 65 (58 with 30 years) Or reduced benefit at age if vested

Eligibility To be covered as a retiree, you must have been covered under the active employee health plans on a City-paid basis in the month prior to your retirement (or disability if considered disabled by PERS). If you currently opt-out of healthcare coverage, you will not be eligible for retiree coverage, as there are no plans for you to continue. If you know you want to opt in for retiree coverage, elect coverage the year you are planning to leave. As a retiree, if you elect medical and opt out of dental, you are not allowed to elect dental at a later date.

How do I enroll in the City’s retiree health insurance plan? You will receive an enrollment packet via certified mail. Packets are sent out once we receive information from your Bureau that you are retiring. The packet contains both COBRA and Retiree information. You must complete and return the retiree or COBRA election form within 60 days. Once we receive your enrollment form and payment we will notify the insurance company that you are covered. As a retiree you do not have access to the online system that active employees use.

enrolling continued Annual Enrollment – each June, retirees can change plans just like active employees. Retirees will receive a packet. If there are no changes, the default will be a roll over of existing elections and dependents. Please keep the Benefits Office updated with your current address, phone number, and address You may only continue the plans you were enrolled in when you retired unless you move out of the service area and/or network and change plans.

Moving out of area? If you move outside the Kaiser service area, you are no longer eligible to continue Kaiser coverage. See your benefit handbook for more information. Enrollment in CityCore would be your only option with the City. We do have a national network PHCS, through ODS, if you reside outside the local area.

Re-Enrollment Option You may re-enroll if you have remained covered under another employers group sponsored health plan. You will be required to provide proof of continued coverage from the point your coverage with the City terminated. If you go to an individual plan such as LifeWise or an individual Kaiser plan you cannot re-enroll at a later date. * Should this provision change in the future, it will change prospectively and participants will be provided notice.

Making monthly payments Auto Pay (monthly electronic withdrawal for savings/checking account) –This option requires that you complete and return a form authorizing us to automatically deduct your premium each month out of a checking or savings account. OR Pay by coupon –Payment coupons are sent to you by the Benefits Office and are to be included with your monthly check payable to the City of Portland

Premium payments Initial payment is due 45 days from date of election. No claims are processed until premium is paid in full. Payments are due 1 st of each month Grace period of 30 days If you pay after the 15 th of the month, you may have a delay in claims payment Premiums are subject to change during annual enrollment (July 1) of each year

Strategies to pay for coverage 1.Deferred Compensation Account 2.Personal Savings/IRA 3.IAP Account through PERS

City of Portland insurance Total monthly premium cost for medical/vision and dental Plan 7/1/12-6/30/13 1 Party2 PartyFamily CityCore Medical, VSP Vision $546.51$1,067.56$1, Kaiser NW Medical and Vision $563.84$1,117.44$1, ODS Dental $57.97$100.11$ Kaiser Dental $58.96$101.41$172.16

City of Portland Health Insurance Annual Cost Scenarios *Estimates are for planning and should be used as a guide. Actual costs will be determined on an annual basis. CityCore cost is based on 5% increase per year, Kaiser cost based on 8% increase per year. CityCore One party Two party Age 58 in 2012$6,279$12,159 Age 59 in 2013$6,592$12,766 Age 60 in 2014$6,922$13,405 Age 61 in 2015$7,268$14,075 Age 62 in 2016$7,632$14,779 Age 63 in 2017$8,013$15,518 Age 64 in 2018$8,414$16,294 $51,123$98,998 Kaiser One party Two party Age 58 in 2012$6,557$12,906 Age 59 in 2013$7,081$13,938 Age 60 in 2014$7,648$15,053 Age 61 in 2015$8,259$16,257 Age 62 in 2016$8,920$17,558 Age 63 in 2017$9,634$18,963 Age 64 in 2018$10,405$20,480 $58,506$115,157

PERS health Insurance rates Monthly Insurance premium cost See PERS for Eligibility rules Plan 1/1/13-12/31/131 PartyFamily ODS Medical Plan $937.42$1, Kaiser Medical Plan $713.33$1, ODS Dental $57.26$ Kaiser Dental $50.85$101.60

ABC’s -and D -of Medicare Medicare is health insurance for people age 65 or older, under 65 with certain disabilities, or any age with permanent kidney failure Part A Hospital coverage Part B Medical coverage These are “Original Medicare” coverage. Both of these plans pay 80%. Most people want something to the fill 20% gap.

Medicare Part A Medicare Part A (Hospital Insurance) Part A helps pay for hospital stays and some skilled nursing facility stays. Most people get Part A without having to pay for it. This is because you or your spouse paid Medicare taxes while working. You must enroll in Medicare Part A during your Initial Enrollment Period (when you first become eligible for Medicare) even if you are still working and receiving employer medical benefits. Initial enrollment period begins three months before your 65 th birthday, includes the month you turn 65, and ends three months after your birthday.

Medicare Part B,C & D Medicare Part B (Medical Insurance) Part B helps pay for doctor visits and outpatient services such as X-rays and physical therapy. Most beneficiaries pay a monthly premium that can change from year to year. -Standard Part B premium in 2013 is $ You may pay more if your income is above a certain amount Medicare began in 1966; Part B was $3.00 a month Starting in 2007 if you make more you pay a higher premium, based on income taxes Medicare Part C (Medicare Advantage plans) You need to elect parts A & B to elect part C, or Medicare supplement plan Medicare Part D (Prescription Drug Coverage) Part D helps pay for medications doctors prescribe for treatment

PERS health Ins. Medicare rates Monthly Insurance premium Jan 1, 2013-Dec 31, 2013 Dental is also available through PERS if you elect initially Medicare Plans * with RHIA Subsidy, see PERS handbook for more info 1 PartyFamily ODS Supplement Plan $169.46$ Kaiser Advantage Plan $155.46$ Providence Medicare Choice $153.15$ Pacific Source Medicare essentials $163.34$384.68

Oregon Medicare Supplement Plans Monthly Insurance premium Jan 1, 2013-Dec 31, 2013 Medicare Supplement Plans1 party ODS Advantage Plan $139 Kaiser Sr Advantage Basic Plan Kaiser Senior Advantage Plan $39 $99 Humana Gold Plus $0 Providence Medicare Extra $133 Regence MedAdvantage $53

Monthly insurance cost in Retirement at Medicare Part A$0 Part B$99.90 Part C$ Total$269.36

Medicare continued “Open enrollment” for Medicare plan changes is in the Fall of each year. You are allowed to make plan changes once a year. Attend a class on Medicare basics conducted by Multnomah County Aging and Disability Services or contact them with questions by phone at www.multnomah.or.networkofcare.org Medicare & you, publication Provides Basic Medicare plan information, as well as detailed plan comparisons Medicare plan finder at or.medicare.gov call Medicare

Age 65 (or under) Medicare eligibility If you are on the retiree health insurance plan and turn age 65… You are not able to continue on the same plan; When you become Medicare eligible you must transition to another plan. If you have a spouse/domestic partner under 65, the spouse/domestic partner may continue on the under 65 plan. The retiree transfers to a Medicare supplement plan through the City or can seek coverage outside of the City with a Medicare supplement or Advantage plan. As a PERS retiree you may be able to purchase a Medicare Supplement plan through PERS or an individual plan through another carrier Contact SHIBA (Senior Health Insurance Benefits Assistance) for more information at (800) in Oregon or (800) in WA

More on Medicare… You enroll in Medicare through Social Security Administration If you are receiving a monthly benefit from Social Security when you reach age 65 you are automatically enrolled into Parts A and B of Medicare (and Social Security deducts the premium from your SSA monthly benefit) If you are not receiving a monthly benefit from Social Security and you want to elect A and B you must go to the Social Security Office to enroll. If you are working past age 65 and have healthcare coverage under an employer sponsored group plan you will need to decide whether you want to enroll in Medicare Part B or not. You would likely want to elect Part A three months prior to turning age 65, even if you plan to defer Part B. SHIBA may be helpful as you make your decision. You are not penalized for late enrollment if the reason for late enrollment is because you were enrolled in an employer sponsored group health plan. If you have delayed Part B enrollment, the Social Security Administration will require you to bring an employer verification form to our office and the Benefit Office will complete the form verifying your dates of coverage.

Social Security Visit Social Security online at Not sure when to retire, try the retirement estimator at and enter different scenarios to come up with the best option for you You can apply online for retirement benefits in as little at 15 minutes at Contact Social Security with questions at Visit Social Security online at Not sure when to retire, try the retirement estimator at and enter different scenarios to come up with the best option for you You can apply online for retirement benefits in as little at 15 minutes at Contact Social Security with questions at

Life Insurance Supplemental Life All active employees can view rates and request changes to supplemental life insurance at any time during the year. All active employees can manage beneficiary information online If you have effective coverage (approved and paying the premium) you will have the opportunity to “port” your coverage and take it with you when you terminate employment with the City. This is term life insurance and ends at age 75 (provided you have continued to pay the premium to Standard Insurance). If you are eligible for portability, you will receive an enrollment form in your retirement/Cobra packet. You have 30 days to elect portability once your coverage ends. Basic Life Group life insurance is “convertible”. It can be changed to an individual rate/policy. You will receive a form in your packet

Questions?