For Minnesota Higher Education and Its Retirees A NEW APPROACH to your retiree medical benefits
AGENDA Program Overview Emeriti Insurance Options – In Minnesota Emeriti Insurance Options – Out Of State Enrollment Planning Enrollment Process Additional Resources
SECTION 1 PROGRAM OVERVIEW Who are Emeriti’s collaborators? How does the Emeriti Program work?
About Emeriti Retirement Health Solutions First-ever, comprehensive retiree medical benefits program Not-profit consortium serving the higher education community Forty-one current member institutions and growing Generous grant support from The Andrew W. Mellon Foundation Headquartered in Hudson Valley, New York State Commitment to education and integrated retirement planning Source: This information is provided by Emeriti ® Retirement Health Solutions as of September 1, 2006.
5 ABOUT HEALTHPARTNERS Largest consumer-governed, non-profit health care organization in the nation 630,000 medical members and 210,000 dental members in Minnesota and Wisconsin Integrated health care organization delivering medical, dental, pharmacy, and group insurance products Largest contracted network in Minnesota with more than 15,000 physicians at nearly 40,000 clinics, including HealthPartners Clinics Headquartered in Bloomington, Minnesota Commitment to seamless integration and delivery of Emeriti Program This information is provided by HealthPartners as of June 30, 2006.
ABOUT AETNA Oldest and leading insurance company in the United States 15.4 million medical members and 10.2 million pharmacy members Delivery of integrated medical, dental, pharmacy, group insurance products Certification to offer Medicare-approved Part D plans in all fifty states Headquartered in Hartford, Connecticut Commitment to seamless integration and delivery of the Emeriti Program This information is provided by Aetna as of June 30, 2006.
ABOUT FIDELITY Largest provider of workplace savings plans in the United States Management of $1.3 trillion in assets on behalf of 22 million individuals* Leading mutual fund company with goal of solid long-term performance Service to 900 higher education clients with 840,000 participants** Headquartered in Boston, Massachusetts Commitment to seamless integration and delivery of the Emeriti Program This information is provided by Fidelity *as of 7/31/2006 ** as of 8/31/2006
Comprehensive Benefit Paradigm Emeriti Health Insurance Options Portable group health insurance options wherever you decide to live in retirement Emeriti Reimbursement Benefits A tax-free method for you to pay for other qualified out-of- pocket medical expenses not covered by Medicare or Emeriti Emeriti Health Accounts A tax-advantaged way for you to invest and accumulate assets exclusively to help meet future retiree medical expenses
Distributions For Health Care In Retirement
Distributions for Insurance Coverage in Minnesota COMPREHENSIVE PLANS (2) Very Enhanced D Rich MedicalStandard D RX ONLY PLANS (2) Enhanced D No MedicalStandard D
Distributions For Reimbursement Benefits Payment of Medicare premiums and cost shares Payment of supplemental insurance deductibles, coinsurance, and copayments Payment of vision, dental, hearing care Payment of long-term care insurance Payment of medical expenses associated with nursing or in-home health care services Payment of over-the-counter pharmaceuticals Payment of other insurance (if Emeriti coverage not elected) A wide range of health care expenses apply for tax-free reimbursement as long as they satisfy the requirements of Section 213 (d) of the IRS Code.
The Value of Emeriti’s Comprehensive Benefits Range of group insurance designs coordinating with Medicare National access to insurance Flexibility of the reimbursement benefit for other medical expenses Opportunities to set aside tax-advantaged savings for health care
The Flexibility of Emeriti’s Coverage Options Go to any doctor or facility accepting Medicare Choose from various levels of prescription drug benefits Make an annual choice from the available insurance options Secure your retirement assets through catastrophic insurance protection Have access to short-term international coverage Take advantage of preventive services for good health
SECTION 2 IN MINNESOTA Two Comprehensive Insurance Options Underwritten by HealthPartners Two Prescription Drug Only Options Underwritten by Aetna
Emeriti Coverage through HealthPartners ® Freedom Plans Must maintain permanent residence in Minnesota Must have Medicare Parts A and B ELIGIBILITY
A Medicare Cost contract offered by HealthPartners > where Medicare is Primary for Part A > where HealthPartners is Primary for Part B Use Original Medicare benefits > out-of-network within Minnesota Medicare Part D benefits also apply PRODUCT DETAILS Emeriti Coverage through HealthPartners ® Freedom Plans
More than 25,000 doctors in the network No referral required (You can see any provider that is within the network) Includes Mayo specialists without a referral OPEN ACCESS NETWORK Emeriti Coverage through HealthPartners ® Freedom Plans
PLAN 1PLAN 2 Doctor Visits$15 co-pay$20 co-pay Inpatient Hospital$100 co-pay per benefit period Emergency Room$50 co-pay Urgent Care$15 co-pay$20 co-pay Routine Preventive Care (physical, hearing, and eye exams) 100% coverage Annual Out-of-Pocket Limit$1,500$3,000 * See Summary of Benefits for additional details. MEDICAL BENEFIT HIGHLIGHTS * Emeriti Coverage through HealthPartners ® Freedom Plans
INITIAL COVERAGE TIERS YOU PAY: $12 copay for generic drugs $24 copay for brand-name drugs 25% coinsurance for specialty drugs PLAN PAYS:The Balance CATASTROPHIC TIER YOU PAY:$2.15 for generic $5.35 for brand-name or 5% whichever is greater PLAN PAYS:The Balance $3,850 annual out-of-pocket requirement PRESCRIPTION DRUG BENEFIT HIGHLIGHTS: PLAN 1 ► NOTE: Through Mail Order, a 3-month supply for 2 copays Emeriti Coverage through HealthPartners ® Freedom Plans $0 deductible ►
INITIAL COVERAGE TIER YOU PAY: $10 copay for generic drugs $31 copay for brand-name drugs 25% coinsurance for specialty drugs PLAN PAYS:The Balance CATASTROPHIC TIER YOU PAY:$2.15 for generic $5.35 for brand-name or 5% whichever is greater PLAN PAYS:The Balance $3,850 annual out-of-pocket requirement PRESCRIPTION DRUG BENEFIT HIGHLIGHTS: PLAN 2 ► NOTE: Through Mail Order, a 3-month supply for 2 copays Emeriti Coverage through HealthPartners ® Freedom Plans SECOND COVERAGE TIER “Gap” YOU PAY:100% for drugs PLAN PAYS:$ 0 ► $2,400 limit ► $0 deductible
IMPORTANT NOTICE HealthPartners INCLUDES Medicare Part D in your comprehensive Emeriti insurance coverage. You DO NOT need to enroll in a separate Medicare prescription drug plan. HealthPartners will AUTOMATICALLY enroll you in enhanced Part D drug coverage through the Freedom Plans. Emeriti Coverage through HealthPartners ® Freedom Plans
1. Extended Absence Benefit 2. Fitness Club Benefit 3. Dedicated Call Center Emeriti Coverage through HealthPartners ® Freedom Plans ADDED SERVICES AT NO ADDITIONAL COST
When you travel domestically, you take your health plan with you. You receive your plan’s level of coverage while you are away from Minnesota for up to 9 months Within the U.S, simply call Member Services to activate: (952) Local (800) Toll free When you travel abroad, your health plan covers urgent and emergency care You must keep your receipts for reimbursement. EXTENDED ABSENCE BENEFIT INTERNATIONAL COVERAGE Emeriti Coverage through HealthPartners ® Freedom Plans
It’s easy to join. Here’s how: Step 1: Select fitness club (YMCA or YWCA) Step 2: Sign-up at the club and take a tour Step 3: Workout at least 8 times in a month and HealthPartners pays that month’s dues IN FULL. FITNESS CLUB BENEFIT Emeriti Coverage through HealthPartners ® Freedom Plans
PLAN 1PLAN Premium $218.30$ Premium $204.85$ PREMIUM RATES IN MINNESOTA FOR POST-65 RETIREES NOTE: These rates are on a per person per month basis and apply to all Minnesota-resident, Medicare-eligible retirees and their Medicare-eligible spouses from Minnesota institutions.
Other Emeriti Coverage in Minnesota through Aetna’s PDP Plans If you want only Medicare prescription drug benefits, you may select from two Aetna drug plans: > enhanced prescription drug plan with an open formulary > a standard precription drug plan with a closed formulary NOTE: These plans provide Medicare Part D benefits only, and do not include Medicare Part A and B coverage. PRESCRIPTION DRUG ONLY OPTIONS
PLAN 3PLAN 4 COVERAGE LEVELStand-alone drug enhanced benefit Stand-alone drug standard benefit PHARMACY ONLY Your Deductible$125$265 Your 1st Cost Tier15% - 25% - 35%$5 - $35 – 25% Your 2nd Cost Tier100% Your 3rd Cost Tier5% Formularyopenclosed Plan Pays52-54%51.5% NO MEDICALNot applicable Other Emeriti Coverage in Minnesota through Aetna’s PDP Plans PRESCRIPTION DRUG BENEFIT HIGHLIGHTS
PLAN 3PLAN Premium $57.50$ Premium $56.20$33.60 Other Emeriti Coverage in Minnesota through Aetna’s PDP Plans 2007 Rx ONLY PREMIUM RATES FOR POST-65 RETIREES NOTE: These rates are on a per person per month basis and apply to all Minnesota-resident, Medicare-eligible retirees and their Medicare-eligible spouses from Minnesota institutions.
SECTION 3 OUT OF STATE Emeriti Insurance Options Underwritten by Aetna
COMPREHENSIVE PLANS (3) Very Enhanced D Rich MedicalEnhanced D Standard D RX ONLY PLANS (2) No MedicalEnhanced D Standard D MEDICARE ADVANTAGE (1) Private Fee-for-Service PlanStandard D Please note that Emeriti coverage through the Aetna plans may not be available everywhere. Please ask for the summary of benefits. Emeriti Coverage Options for Residents Outside of Minnesota
PLAN 1PLAN 2PLAN 3PLAN 4PLAN 5 PFFS * Total 2007 Premium $238.00$185.80$124.80$53.30$29.80$ Premium $245.00$194.00$140.00$52.10$30.40N.A. Emeriti Coverage Options for Residents Outside of Minnesota NOTE: These rates are on a per person per month basis and represent national average premiums for entry 65-year-olds. Rates will vary by residential location PREMIUM RATES FOR POST-65 RETIREES
SECTION 4GET READY FOR ENROLLMENT
Educate Yourself Read the Emeriti enrollment kit Come to Emeriti workshops Visit the Emeriti website also Phone the Emeriti toll-free call center EMERITI
Think Strategically about Your Health Needs Check your Plan’s definitions of “vesting” and “retirement eligibility” Be sure that you are enrolled in Medicare Parts A and B Consider the Emeriti insurance coverage right for you Identify which dependents get access to Emeriti benefits Calculate your contributions for premiums / other out-of-pocket medical expenses Review which investment options are appropriate for you, if you decide to add periodic lump sums to the Health Account
Make a Decision about Insurance Currently enrolled participants Do nothing if you want to stay in the current plan Call if you want to change to another plan Newly eligible participants Call to enroll and select your insurance option
Important Deadlines for Your Enrollment Your Window for Enrollment: Currently insured participants > by December 31, 2006 Newly eligible participants > by March 31, 2007
Organize Materials for Your Call Have your Medicare Parts A and B cards Have your social security number Have dates of birth of any eligible dependents Have social security numbers for eligible dependents Have your bank account number for electronic transfers (ACH)
SECTION 5NOW TAKE ACTION AND ENROLL
How to Enroll in Emeriti Coverage through the HealthPartners ® Freedom Plans Easy 3-Step Process: Step 1: Phone the Emeriti Call Center at EMERITI ( ) Step 2: Complete, sign and date the HealthPartners enrollment form (You and your spouse must each complete a separate enrollment form) Step 3: Return your completed enrollment form to HealthPartners Medicare Sales in the enclosed postage-paid envelope
EMERITI CALL CENTER 1-(866)-EMERITI Available Monday – Friday 8 a.m. to 12 a.m. (Midnight) EASTERN HEALTHPARTNERS MEMBER SERVICES (952) or 1-(800) Medical plan questions (Monday – Friday) 8 a.m. to 6 p.m. Medicare prescription drug questions (seven days a week) 8 a.m. to 8 p.m. CENTRAL Dedicated Call Center for Emeriti Participants
Paying for Emeriti Insurance Coverage Where You Have a Continuing Employer Subsidy Pays employer’s share automatically from the Health Account Pays your premium share electronically (ACH) from your bank account each month AND you may add lump sum amounts electronically (ACH) to the Health Account periodically Where There Was No Prior Employer Subsidy Pays your premium electronically (ACH) from your bank account each month AND you may add lump sum amounts electronically (ACH) to the Health Account periodically With Emeriti, there are no checks to write; set it up; the record-keeper does the rest.
Program Fees in Retirement Recordkeeping Fee ($6.25 per month) Participant Account Fee ($4 per month) Reimbursement Benefit Processing Fee ($6 per bundled set of claims) NOTE: Fees and expenses associated with Fidelity investment options also apply. Please request a mutual fund prospectus for more information about these fees.
SECTION 6 ADDITIONAL RESOURCES
Find Information with Emeriti Tools Read the latest articles on the Emeriti website ( Use the Emeriti online premium rate guide ( Conduct searches on the HealthPartners website for retirees living in Minnesota ( Visit Aetna’s Navigator website for retirees living in other states ( Explore the performance of Fidelity Freedom Funds (www. fidelity.com)
Do Independent Research Read Medicare and You from the Centers for Medicare and Medicaid Services Visit Medicare’s website for retirees ( Get independent views from the Kaiser Family Foundation ( Review research at the Employee Benefit Research Institute (
Legal Notices Summary Plan Description This presentation is intended to provide you with a brief summary of some of the details of your Employer’s Emeriti Plan and the Emeriti Program generally. It is not a Summary Plan Description (“SPD”) and does not summarize all the terms of your Employer’s Emeriti Plan. For a full summary of the terms of your Employer’s Emeriti Plan you must consult the SPD, which will be provided to you upon enrollment or upon request. Important Information about Emeriti The full name of Emeriti Retirement Health Solutions is The Emeriti Consortium for Retirement Health Solution, an Illinois Not-for-Profit Corporation. Emeriti Retirement Health Solutions is not an insurance company, insurance broker or insurance provider. Major Contributors to the Emeriti Benefit Program Emeriti Retirement Health Solutions, HealthPartners (in Minnesota), Aetna (other US regions), Fidelity Investments, and Acclaris are independent organizations and are not legally affiliated.
Investment Adviser Status Emeriti Retirement Health Solutions is a registered investment adviser for purposes of selecting the range of investment options for the Emeriti Program, selecting the investment manager for employer and voluntary employee contributions, and providing these and other impersonal educational materials to plan participants. Emeriti does not provide advice to participants about their individual investment selections. The participation interests in the voluntary employee contribution VEBA trusts associated with the Emeriti plans (the “Interests”) may be treated as securities under various state securities laws. The offering of these Interests is subject to compliance with any applicable state law. For residents of Georgia, the Interests are being offered in reliance on paragraph 13 of Code Section of the Georgia Securities Act of 1973, as amended (the “Georgia Act”). The Interests may not be sold or transferred except in a transaction which is exempt under the Georgia Act or pursuant to an effective registration under the Georgia Act.
Investment Decisions It is your responsibility to select and monitor your investments to make sure they continue to reflect your financial situation, risk tolerance and time horizon. Most investment professionals suggest that you reexamine your investment strategy at least annually or when your situation changes. In addition, you may want to consult an investment adviser regarding your specific situation. Recordkeeping and shareholder services for the Emeriti Program are provided by Fidelity Investments Tax-Exempt Services Company, a division of Fidelity Investments Institutional Services Company, Inc. Before investing in any mutual fund, please carefully consider the investment objectives, risks, charges and expenses. For this and other information, call or write Fidelity for a free prospectus. Read it carefully before you invest. ©2005 FMR Corp. All rights reserved Fidelity Investments Institutional Services Company, Inc. 82 Devonshire St., Boston, MA 02109