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Ontario Professional Fire Fighters Conference April 6, 2016 Presented by: Holly Murphy
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Managing Health Care in Retirement Government Health Care – OHIP Services Private Insurance – MROO Retiree Benefits ENCON Administration – Personalized Client Services Today’s Presentation
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Municipal Retirees Organization (MROO) Advocate protecting the pensions and enhancing the quality of life for all OMERS pensioners since 1977 ENCON Group Inc. – MROO’s Insurance Program Manager MROO Retiree Insurance Program offers you health care benefits in retirement MROO and ENCON – Who We Are
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What is the biggest expense today for people in retirement? Medical Expenses Canadians expect to spend $5,391 a year out of pocket* Only 22% have a financial plan that includes expenses for health care** BMO Wealth Institute Survey, 2014* Sunlife -Ipsos Reid Survey 2014** Trending: Private Health Insurance
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While Working: OHIP Group Health Care Benefits – hospital, health, dental, travel What happens when your group benefits end? Managing Health Care in Retirement
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OHIP Covers Medically Necessary Services In Hospital Physician Benefits After Age 65 Limited Physiotherapy Annual Eye Exam Ontario Drug Benefit (ODB) You pay your first $100 prescription drugs and $6.11 dispensing fee per prescription OHIP Benefits are Limited
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2004 – Annual Eye Exams, Chiropractic Services 2005 – Physiotherapy Services 2008 – Antibiotic Drugs ODB 2010 – Vitamin D Testing August 1, 2016 – ODB Deductible from $100 to $170 Dispensing fee from $6.11 to $7.11 No guarantee OHIP will not change in the future Trends in Government Services – OHIP Cutbacks
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Retirement Health Care Options Government Health Care (OHIP) Personal Savings Private Insurance Personal Considerations: Current health care needs Future health care needs Finances – ability to pay out of pocket
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Employer paid benefits in retirement – Group Insurance to age 65 or 70 for life Health Care Spending Account – HCSA Use to pay health care expenses on an “as you go” basis OR Use to pay premium for private health insurance such as the MROO Health and Dental Care Plan Employer Benefits – Fire Fighters
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MROO Health, Dental, Annual Travel Insurance Designed Specifically for OMERS Retirees Start when Group Coverage Ends You and Your Spouse Benefits Not Covered by OHIP Rates are Not Age Related Affordable Coverage for Life
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Semi-Private Hospital Prescription Drugs Ambulance Vision Care Home Nursing Care Orthopedic Shoes Paramedical Services (8) Medical Supplies Accidental Dental Psychologist Hearing Aids Semi-Private Hospital Prescription Drugs Ambulance Vision Care Home Nursing Care Orthopedic Shoes Paramedical Services (8) Medical Supplies Accidental Dental Psychologist Hearing Aids Annual Travel Dental Health MROO – Your Choice of Benefit Plans Basic and Major Services Unlimited Trips of 30 to 180 days per trip
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MROO Annual Travel Benefit - RSA $1 million coverage per person per trip Choice of trip length: 30 to 180 days per trip Benefit can be changed from year to year Pre-existing condition clause; 3 months for high blood pressure 6 months for all other conditions Lifetime travel benefit MROO Annual Travel – Option with Health Care
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MROO Health Care Plan Discounts – Preferred Vision and Hearing Services Discounts for vision and hearing aids up to 20% Participating providers include:
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MROO Health Care Plan Discounts – Preferred Pharmacy Service Prescriptions covered 100% Free overnight delivery MedPack or vial dispensing Refill reminders
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MROO Health Care Plan Offers More – Caregiver Service Registered Nurses – offer expert care giving assistance coordinating homecare & eldercare For you, your family and loved ones
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If you have a Health Care Spending Account (HCSA) You may be able to use your HCSA to: Pay for health care expenses as you go OR Pay for MROO insurance premiums If you are financing your own insurance, MROO premiums are reasonably priced … MROO is An Affordable Option for OPFFA Retirees
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MROO Annual Rates 2016 Plans Retiree 2016 Retiree & Spouse 2016 Health Care$1,204.92$1,948.56 Health and Dental Care $2,029.68$3,483.72
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MROO Monthly Rates 2016 Plans Retiree 2016 Retiree & Spouse 2016 Health Care$100.41$162.38 Health and Dental Care $169.14$290.31 Premiums are tax deductible
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MROO Annual Travel Rates – Annually Travel Days Per Trip RetireeRetiree + Spouse 30$ 312$ 624 45$ 444$ 888 60$ 564$1,128 90$ 852$1,704 120$1,152$2,304 150$1,476$2,952 180$2,124$4,248
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MROO Annual Travel Rates – Monthly Travel Days Per Trip RetireeRetiree + Spouse 30$ 26$ 52 45$ 37$ 74 60$ 47$ 94 90$ 71$142 120$ 96$192 150$123$246 180$177$354
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HCSA $3,000 – MROO Maximum Coverage 2016 BenefitSingleCouple Health and Annual Travel Travel – 150 days per trip Travel – 60 days per trip Health and Dental CoveredYou pay $483.72 Health and Dental and Annual Travel Travel – 90 days per trip You pay $483.72 and Annual Travel
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When to Enroll? When Employer Health Benefits End Within 90 Days; Guaranteed Enrollment, No Medical After 90 Days; Medical Application No later than Age 75 Spousal Coverage Available
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Other MROO Insurance Plans
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RSA Travel Plans – Individually Priced Discounted rates Plans for any age Single Trip or Multi Trip Plans Trip Top Ups and Extensions 21 Day Vacation Plan, no medical Other MROO Travel Insurance Choices
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MROO Convalescent Care Cash Benefits per accident or illness Home Nursing Care – to $3000 Equipment Benefit – to $300 Fracture Benefit – to $700 Accidental Death Benefit – $5000 $18.43 Retiree / Month $35.18 Couple / Month
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MROO Guaranteed Issue Life Insurance Life Insurance – No Medical Coverage from $5,000 to $20,000 Living Benefit No Premium Increases Paid up Policy at Age 90
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Rates Not Age Banded Benefits for Life – all plans including Annual Travel Multiple choices for Annual Travel trips 30 – 180 days Spousal and Survivor Benefits Personalized Service, ENCON MROO Plan Highlights
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Your ENCON Client Service Specialists MROO Retiree Plans – Contact ENCON Reminder Service Plan Information Claims Questions 1-800-363-7861 mroo@encon.ca www.encon.ca/mroo
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ENCON and MROO - Questions?
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