1. City of Phoenix Retiree Benefits Overview 2015

2. Today’s Topics
Rates
Employer Sponsored Medicare Part D

3. 2007 Changes
Before 2007, medical rates were the same for retirees and employees.
They were rated as one group.
To comply with GASB 45, retirees and employees were separated for medical rates beginning August 1, 2007.
30% increase to rates.

4. 2007 Changes
The Qualified City Contribution was created to reduce this rate increase.
Reduces the premium by $90 to $375 per month.
Includes a $50 per month reduction for family coverage.
A $15 million Retiree Rate Stabilization Fund was created for future retiree needs.

5. Setting Medical Rates
Trends
Claims
Costs
ACA
Stats

6. 2015 Medical Rates
Full Rate Increase recommended by Actuaries.
9.4%
Rate Increase after Health Care Reform costs are removed.
9.1%
After the Retiree Rate Stabilization Fund contributes 3%.
6.1%

7. 2015 Retiree Medical Rates Savers Choice Plan Cigna HMO BCBS PPO
Single – Not on Medicare
$605.57
$754.92
$708.90
Family – Retiree and 1 or more dependents not on Medicare
$1,672.81
$2,103.29
$1,970.61
Family – Retiree not on Medicare, all dependents on Medicare
$1,118.50
$1,408.33
$1,318.97
Single – On Medicare
$511.89
$638.38
$599.42
Family – Retiree on Medicare any dependent not on Medicare
$997.12
$1,258.46
$1,177.76
Family – Retiree and all dependents on Medicare
$968.72
$1,221.78
$1,143.77

8. 2014 to 2015 Monthly Medical Rate Change
Savers Choice Plan
Cigna
HMO
BCBS
PPO
Single – Not on Medicare
$40.85
$49.44
$46.80
Family – Retiree and 1 or more dependents not on Medicare
$117.73
$142.48
$134.85
Family – Retiree not on Medicare, all dependents on Medicare
$79.25
$95.92
$90.78
Single – On Medicare
$34.60
$41.88
$39.64
Family – Retiree on Medicare any dependent not on Medicare
$71.41
$86.43
$81.80
Family – Retiree and all dependents on Medicare
$69.20
$83.75
$79.27

9. Save $25 per month
Reduce your monthly premium by $25 each month when the retiree completes an online Health Risk Assessment.
Find information in your City of Phoenix Benefits Guide – in your mailbox around October 18th.

10. 2015 Retiree Dental Rates Dental HMO Dental PPO Single $27.44 $39.95
Plus One
$49.58
$88.78
Family
$87.38
$129.84
Retiree Dental Rates increase 5%
No plan changes

11. Legal Insurance
Enroll in the Legal Insurance Plan for $21.90 per month.
New in 2015! Identity Theft Services.
Enroll directly with ARAG at
Find information at AragLegalCenter.com
Access Code 16922phx

12. New on January 1, 2015
Employer Sponsored Medicare Part D Pharmacy Plan
Also called EGWP
(egg-whip)

13. New on January 1, 2015
The City will provide a self-insured group sponsored Medicare Part D plan to its Medicare eligible retirees.
The City will receive a direct subsidy from the Centers for Medicare and Medicaid Services (CMS) that will be larger than the retiree drug subsidy currently received.

14. Key Points
Medicare eligible retirees and their Medicare eligible dependents will automatically be enrolled in this employer provided Medicare Part D Prescription Drug Plan.
IMPORTANT REMINDER!
Retirees and their enrolled dependents are required to enroll in Medicare Part B as soon as they are eligible and provide a copy of the Medicare card to the Benefits Office.

15. DO NOT ENROLL in MEDICARE PART D!
Key Points
DO NOT ENROLL in MEDICARE PART D!
Your enrollment in the City of Phoenix medical and pharmacy drug coverage will automatically be considered to be Medicare Part D enrollment.
If you are enrolled in another Medicare Part D Plan or a Medicare Advantage Plan with or without prescription drug coverage, Medicare will disenroll you from the City’s plan.

16. Key Points You have the same co-pay structure: $10 Generic
$25 Preferred Brand Name
$40 Non-Preferred Brand Name
$40 Specialty Drugs
Your prescription drug list will be bigger than the standard Medicare Part D list.
There will be no “Donut Hole.”

17. Key Points CMS requirements may cause disruption with
1-2% of the current prescriptions. You will be notified by mail in late October if you are affected and alternatives will be identified.
If your spouse, qualified domestic partner or child is not eligible for Medicare, he or she will continue to be covered by the current Cigna prescription drug plan. They will receive a new ID card.

18. Don’t use your new card until January 1st
Key Points
You will get a new ID card from Cigna-HealthSpring in the mail in mid-December.
Don’t use your new card until January 1st

19. Key Points
You will have most of the same pharmacies in your current Cigna pharmacy network.
The VA Pharmacy is not permitted in the Medicare Part D network because you can receive benefits from only one government program at a time.

20. Current Cigna Pharmacy Cigna-HealthSpring Rx
Key Points
There will be no interruption in your coverage.
Through December 31st:
Current Cigna Pharmacy
January 1, 2015:
Cigna-HealthSpring Rx

21. Key Points
You continue to get your prescriptions filled at your local retail pharmacy or through the mail order pharmacy.
You can continue to get up a 90-day fill at a retail pharmacy.
Open and Read the information you receive from Cigna-HealthSprings Rx.

22. Note! CMS does not allow more than a 30-day transition fill.
Key Points
Get your prescriptions refilled in December through your current Cigna drug plan if possible.
Get a new prior authorization after January 1st if needed. You will receive a letter in late October if this affects you. Please act quickly to make a doctor’s appointment if needed.
Note! CMS does not allow more than a 30-day transition fill.

23. Prior Authorizations
Cigna will transfer existing Prior Authorizations from the current plan to the new plan for Medicare Part D medications.
Prior Authorizations will not transfer for non- Medicare Part D drugs such as ED drugs, Rx vitamins, weight loss or weight gain drugs.

24. You don’t have to do anything!
Coming in the Mail
Mid-October: A newsletter from the City of Phoenix Benefits Office introducing the Employer Sponsored Medicare Part D Plan.
Around October 20th: A packet from Cigna-HealthSprings Rx which includes a letter, a Summary of Benefits, and a List of Covered Drugs (Formulary).
You don’t have to do anything!

25. Coming in the Mail
The packet you receive from Cigna-HealthSpring Rx will tell you that you have the choice to opt-out of this plan per CMS requirements. We DO NOT RECOMMEND that you do this.
Your prescription drug coverage is part of your City of Phoenix Retiree Medical Plan. If you opt-out of the Cigna-HealthSprings Rx plan you will lose your medical coverage AND drug coverage.

26. Coming in the Mail
Mid-December: You will receive your new pharmacy ID card. Do not use this card until January 1, 2015.
Your covered dependents may also receive new ID cards.

27. Coming in the Mail
January 2015: You will receive a Welcome Kit from Cigna-HealthSprings Rx. This will include:
A pharmacy directory
Evidence of Coverage – details about the plan and your rights and responsibilities

28. Important Reminder
If you enroll in another Medicare Part D plan or a Medicare Advantage Plan with or without prescription drug coverage, Medicare will disenroll you from the City’s plan. This means you and your covered dependents will lose retiree medical and prescription drug coverage immediately.

29. Customer Service
Cigna-HealthSprings Rx Customer Service
8:00 a.m. to 8:00 p.m. AZ Time
Seven Days a Week
October 1, 2014 – February 14, 2015
After February 14, 2015 availability is Monday through Friday

30. Cigna Pharmacy On-site Representative
Kim Baker
(602)

31. Questions?