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Your Emeriti Retirement Health Plan

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Presentation on theme: "Your Emeriti Retirement Health Plan"— Presentation transcript:

1 Your Emeriti Retirement Health Plan
2018 Benefits Your Emeriti Retirement Health Plan

2 Welcome to Emeriti’s Open Enrollment
Helping you make the most of your healthcare choices Manageable choice, easy to understand information, personalized support Welcome to this year’s open enrollment. Emeriti and Aetna are here to help you make the most of your healthcare choices in in 2018.

3 PRESCRIPTION DRUG PLANS DENTAL PLAN
What’s new in 2018? SRM PLANS K & L Return of the ACA-mandated Health Insurance Provider Fee (HIF). MEDICARE ADVANTAGE PLANS Aetna eliminating SRM plans in Default current enrollees to the Medicare Advantage Premium Plan. HIF is an ACA-related federally mandated fee that all insurer’s must apply to 2018 premium rates. Federal law enabled a one year suspension of the fee in 2017 – however, the fee will be in effect for Review bullets on page. PRESCRIPTION DRUG PLANS DENTAL PLAN No premium increase. Rx Premium 12.1% Rx Plus -16.6% Rx Standard -1.2%

4 Diabetic prevention program
What’s new in 2018? Diabetic prevention program SilverSneakers® fitness program replaces Silver & Fit There are a few new and important programs available in CMS is requiring that all plans provide a diabetic prevention program. There will be no limit on the number of physical exams you can have during the benefit year, if they are medically necessary. SilverSneakers replaces Silver Fit. New Resource for Living program available – providing consultants who can help you find caregiver support, household services, eldercare services, and more. Physical exams, whenever medically necessary Resources for Living program

5 Aetna’s Medicare Advantage Plans
Aetna provides 4-star rated group Medicare Advantage health plans. Aetna leads national competitors with 87% of members in 4+ out of five (5) star plans. Aetna offers Medicare Advantage plans that are 4-star rated.

6 Aetna is your primary insurance Your costs are simplified
How Medicare Advantage Plans Work Aetna is your primary insurance Aetna provides Medicare Parts A & B benefits You use one Aetna card You still get your Medicare card & you still pay Part B premium Your costs are simplified No plan deductibles and no Medicare Parts A & B deductibles You get extra benefits Annual eye & hearing exams, SilverSneakers, Resources for Living Here’s how they work – Aetna is your primary insurance. You use one Aetna card. Your costs are simplified – no Medicare deductibles and no plan deductibles. And – you get extra benefits – this year, annual eye and hearing exams, SilverSneakers and Resources for Living. Benefits available to employee (retiree), spouse and eligible dependents

7 Plan 2018 Medical Plans CHOOSE ONE MEDICAL PLAN Plus Standard Plus
Aetna Medicare Advantage Premium ESA Aetna Medicare Advantage Plus PPO/ESA-PPO Standard Aetna SRM Plan L Plan K Plan Deductible $0 in- and out-of-network $0 Medicare Deductible 25% of Part A 100% of Part B 50% of Part A Primary Care $15 copay * 15% coinsurance (in-network) 25% (out-of-network) $15 copay (in-network) 30% coinsurance (out-of-network) 25% coinsurance 50% coinsurance Specialist $40 copay Hospital 100% by the Plan $500 per admission (in-network) 25% per admission $200 per day (1-7) (in-network) 30% per admission. Preventive Care Covered 100% $0 after Medicare 50% after Medicare Out-of-Pocket Limit $2,000 * $2,750 (in-network) $5,500 (out-of-network) $6,700 (in-network) $10,000 (out-of-network) $2,480 $4,960 2018 Medical Plans CHOOSE ONE MEDICAL PLAN 1 2 3 Medicare Advantage Premium Medicare Advantage Plus Standard Plan Deductible $0* Medicare Deductible $0 Primary Care $15 copay * 15% coinsurance in-network $15 copay in-network Specialist $40 copay in-network Hospital Covered 100% $500 per admission in-network $200 per day (1-7) in-network Preventive Care Out-of-Pocket Limit $2,000 * $2,750 (in-network) $5,500 (out-of-network) $6,700 (in-network) $10,000 (out-of-network) Review items on slide *In- and out-of-network NOTES: The ESA-PPO Plan has the same benefits as the In-Network PPO Plan.

8 2018 Part D Drug Plans Rx Premium Plan Rx Plus Plan Rx Standard Plan
Open 2 Formulary GRP B2 Formulary $100 deductible $310 deductible Initial Coverage Limit: Coinsurance: 15% generic, 25% preferred brand, 40% non-preferred brand 50% non-preferred brand 25% preferred brand Coverage Gap: Same coverage at same coinsurance level 15% copay for Tier 1 generic drugs, 45% brand 58% generic, 45% brand Catastrophic Coverage: 100% coverage 95% coverage 2018 Part D Drug Plans CHOOSE ONE Rx PLAN 1 2 3 Rx Premium Rx Plus Rx Standard Open Formulary GRP B2 Formulary Deductible: $100 Deductible: $310 Initial Coverage Limit: 15% generic, 25% preferred brand, 40% non-preferred brand 50% non-preferred brand 15% generic, 25% preferred brand Coverage Gap: Same coverage, same coinsurance level 15% copay for Tier 1 generic drugs, 35% brand 44% generic 35% brand Catastrophic Coverage: 100% coverage, you pay nothing 95% coverage, you pay 5% Review items on slide The Medicare Coverage Gap Discount Program will continue to provide manufacturer discounts on brand name drugs to Part D beneficiaries who reach the Coverage Gap and are not already receiving “Extra Help.” A 50% discount on the negotiated price of preferred and non-preferred brand drugs (excluding the dispensing fee) will be available from manufacturers that have agreed to provide the discount. 2018 Standard drug plan deductible on the individual market: $405, Initial Coverage limit: $3,750, True-Out-Of-Pocket Threshold: $5,000

9 2018 Dental Plan – Optional Preventive Service 100% coverage
Annual Deductible (basic and major services) $100 Basic Services Coverage (fillings, standard crowns, extractions) 50% Major Services Coverage (root canal therapy, surgical removals, dentures) Annual Benefit Maximum $1,500 NOTES: Twelve month waiting period applies for major services, but may be waived with evidence of continuing coverage. One-time only opt-in opportunity. Dental is only available when you enroll in a combination Medical/Rx coverage, or elect the stand-alone Rx Standard Plan Please note: in the states of CA, OR, WA, the stand-alone Dental plan may be elected if the participant is enrolled in a Kaiser Permanente MAPD Plan, and with evidence of existing coverage. Dental not available in MD.

10 Choosing Your Coverage
Jim has a chronic medical condition. He takes 3 brand drugs, sees a specialist twice a year, and is sometimes in the hospital. Consider: Medicare Premium Plan Rx High Plan Let’s take a look at two different scenarios that illustrate how someone might choose their plans. Review information on slide. Mary is generally pretty healthy. She takes 2 generic drugs, gets her annual check-ups, and sees a specialist once a year for allergies. Consider: Medicare Standard Plan Rx Standard Plan For illustration purposes only. Emeriti does not provide advice about health insurance plans.

11 CURRENTLY ENROLLED IN SRM PLAN K OR L?
Next Steps CURRENTLY ENROLLED IN SRM PLAN K OR L? DO NOTHING & BE DEFAULTED INTO MEDICARE ADVANTAGE PREMIUM PLAN - OR – ENROLL IN THE MEDICARE ADVANTAGE PLAN OF YOUR CHOICE Your next steps - review items on slide CURRENTLY ENROLLED IN MEDICARE ADVANTAGE? You have some important decisions to make DO NOTHING & BE DEFAULTED INTO THE SAME PLAN YOU HAVE RIGHT NOW - OR – ENROLL IN THE MEDICARE ADVANTAGE PLAN OF YOUR CHOICE WE’RE HERE TO HELP YOU EVERY STEP OF THE WAY

12 Not Sure What Plan Is Best For You?
CALL AETNA SPECIALISTS FOR PERSONALIZED COUNSELING If you’re unsure about which plans to choose – call Aetna specialists who will provide personalized counseling for you and your dependents.

13 Providing choice, convenience and flexibility
National group plans follow you wherever you live in the U.S. Private, one-on-one counseling services help you choose the plan that’s right for you Easy online and telephone enrollment Emeriti and Aetna are working to provide you with choice, flexibility and convenience. Go through the list on this slide. Plans available with no network restrictions Keep or choose any doctor who accepts Medicare and Aetna Medicare Advantage Change plans each year without paying more or getting turned away because of a pre-existing condition

14 Emeriti’s Open Enrollment Timeline
Early October Retiree newsletter mailed Early November Here are some timeframes to keep in mind during this year’s open enrollment: look for your newsletter in the mail in early October. Look for your insurance kit in the mail in early November. Keep in mind that this year’s open enrollment period is Nov 13 – Dec 6. That is when you can change your plans and enroll for your 2018 coverage. Insurance enrollment kit mailed Nov 13 – Dec 6 Open enrollment

15 EMERITI SERVICE CENTER READY TO PROCESS YOUR ENROLLMENT
When to Enroll EMERITI OPEN ENROLLMENT DATES EMERITI SERVICE CENTER READY TO PROCESS YOUR ENROLLMENT Remember – this year’s open enrollment dates are Nov 3 – Dec 6 NOV 13 – DEC 6

16 1-866-363-7484, press #1 MyEmeritiBenefits.org How To Enroll
Call the Emeriti Service Center , press #1 You can enroll and change plans by calling the Emeriti service center or going online at MeEmeritiBenefits.org Enroll online MyEmeritiBenefits.org

17 Visit The New Emeriti Website
EmeritiHealth.org Visit The New Emeriti Website Built on TIAA’s platform Easier to navigate Easily download materials & calculate premiums The Emeriti website is always available – and we’re happy to announce that we have a new website. We invite you to check it out – it’s a great resource with additional information.

18 Working Together Emeriti and TIAA are working together to connect health and financial well-being As we close – we want to remind you that Emeriti and TIAA are working closely together to connect health and well-being for you and your dependents.

19 ThankYou FOR JOINING US Thank you. Do you have additional questions?

20 Addendum

21 How Primary Care Charge Works
Medicare Advantage Premium Medicare Advantage Plus Standard Primary Care Charge $200 Medicare Pays $0 Aetna Pays $185 $170 You Pay $15 copay (in- and out-of-network) $30 coinsurance (in-network) Review items on slide, if necessary.

22 Emeriti, TIAA, CBIZ Savitz, Aetna Life Insurance Company, and HealthPartners are independent corporations and are not legally affiliated. The full name of Emeriti Retirement Health Solutions is The Emeriti Consortium for Retirement Health Solutions, an Illinois Nonprofit Corporation. Emeriti Retirement Health Solutions is not an insurance company, insurance broker or insurance provider. The Emerti Program is delivered in collaboration with TIAA, CBIZ Savitz, Aetna Life Insurance Company, and Health Partners.CBIZ Savitz is Emeriti’s disbursement record keeper for Emeriti group insurance administration and Emeriti medical expense reimbursement processing. CBIZ Savitz is a Philadelphia company with more than forty years of experience in full-service benefits services supporting employees and retirees in organizations nationwide. Teachers Insurance and Annuity Association of America (TIAA) is Emeriti’s accumulation record keeper, trust services provider, and investment manager. TIAA is based in New York and has nearly one century of distinguished service to the non-profit community for financial services supporting retirement income security. Aetna Life Insurance Company is the primary health insurer for the Emeriti Program, providing fully insured medical insurance and health-related products. For over 150 years, Aetna has been an innovator in the delivery of insurance solutions and is a nationwide provider of Medicare-approved Part D prescription drug services. For Minnesota institutions and their Minnesota-resident retirees, HealthPartners provides participants with medical insurance and health-related products. HealthPartners is the largest consumer-governed nonprofit health care organization in the nation.

23 Interests in any retiree healthcare plan discussed herein are offered solely by the employer.
Teachers Insurance and Annuity Association of America (TIAA) will provide services to the plan and may issue plan communications on behalf of the plan sponsor, in its capacity as a plan record keeper. TIAA Individual & Institutional Services, LLC serves as a broker-dealer with respect to underlying mutual funds only, and does not offer, market or sell interests in such plans or otherwise provide broker-dealer services with respect to the interests in such plans. TIAA products may be subject to market and other risk factors. See the applicable product literature, or visit TIAA.org for details. Investment, insurance and annuity products are not FDIC insured, are not bank guaranteed, are not deposits, are not insured by any federal government agency, are not a condition to any banking service or activity, and may lose value. TIAA group of companies cannot and does not provide tax or legal advice and recommends that plan sponsors consult their own legal and tax advisors for such advice. By communicating the information contained in this material, neither TIAA nor Emeriti are providing impartial investment advice or giving advice in a fiduciary capacity regarding any investment by, or other transaction of, the plan(s). TIAA and Emeriti are acting solely in a sales capacity with respect to an arms-length sale, purchase, loan, exchange or other transaction related to the investment of securities or other investment property. FOR INSTITUTIONAL INVESTOR USE ONLY. NOT FOR USE WITH OR DISTRIBUTION TO THE GENERAL PUBLIC. 273347


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