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Published byLouise Berry Modified over 9 years ago
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Updated | 5/9/2012 Retiree Choices New Choices Better Value New Coverage New Approach to Health Care Coverage
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What We’ll Cover Today Benito Cachinero, SVP, HR, DuPont Introducing Extend Health Understanding Supplemental Medicare Insurance Next Steps Questions & Answers 2
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Introducing Extend Health The Industry’s Largest Private Medicare Exchange
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Who is Extend Health? Independent company, dedicated to serving Medicare- eligible retirees Partner with 75+ health plan carriers to provide you coverage to fit your individual needs and budget Objective and Trusted U. S. –based licensed benefit advisors Focused on helping each participant make an informed and confident decision
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Why Extend Health? We are experienced in helping people just like you Our services are provided at no cost to you
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Plans & Partners All Medicare Plan Types Medicare Advantage Medigap Prescription Drug (Part D) Vision Dental Select Carrier Partners
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You will need to pay your first premium when you enroll… PART D PLAN MEDIGAP PLAN OPTION 1: Medigap Plan + Part D Plan MEDIGAP (Medicare Supplement) A Medigap plan fills the “gaps” in original Medicare Part A and Part B coverage (i.e., helps pay the difference between your costs and the amount original Medicare pays). These plans provide additional coverage for your doctor visits and hospital stays as well as other expenses not covered by original Medicare. PART D PLAN A Part D plan supplements Medigap to provide prescription drug coverage. These plans help pay for your prescription drug expenses.
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MEDICARE ADVANTAGE OPTION 2: Medicare Advantage Plan with Prescription Drug Coverage (MAPD)* MAPD PLAN An MAPD plan provides an all-in-one plan which bundles your Part A, Part B and prescription drug coverage together with additional benefits. These plans provide coverage for your doctor visits, hospital stays, and prescription drug expenses. * Note that Medicare Advantage plans are generally network based plans
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Educate Evaluate/Enroll Manage The Process
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Education Getting Started Guide Gather information Current prescriptions and preferred physicians Current coverage and health conditions* Give us a call toll-free at 1-855-535-7140 Visit us online www.extendhealth.com/dupont * Pre-existing conditions will not limit your plan selection - except end-stage renal disease
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Education Enrollment Guide Prepare for your for enrollment discussion Review Medicare basics Appointment confirmation letter
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Decision Support Tools Help Me Choose Prescription Profiler
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Extend Health’s Benefit Advisors 100% domestic workforce Objective advocacy Neutral compensation Extend University Certified and appointed Average age 43 Hours of Operation Monday – Friday 8 a.m. – 9 p.m. Eastern Time Call Extend Health Toll-Free at Evaluate and Enroll 1-855-535-7140
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Enrollment Process Benefit Advisors can discuss coverage options with anyone – need to speak to the participant to complete the enrollment Once you have made a coverage selection, enrollment is conducted via telephone 100% of calls are recorded
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Medicare & You
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Your Future Coverage Primary Coverage Medicare Parts A & B Additional Coverage ( Your Choice ) Medigap + Prescription Drug (PDP) or Medicare Advantage with Prescription Drug (MAPD) Optional Coverage ( Your Choice ) Dental and Vision
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Medicare Prescription Drug Coverage For 2013 (Part D Plan) Initial Coverage You pay * Deductible and Co-payments for your plan * Coverage for the first $2,970 in Actual Cost of medications Coverage Gap – Donut Hole You pay * 50% of Brand Drugs and 79% of Generics Until out of pocket costs reach $4,750 Catastrophic Coverage You pay * $2.65 for Generics and $6.60 for Brand Or 5% which ever is greater
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Health Reimbursement Arrangement (HRA)
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What Is An HRA? Tax-advantaged account used to reimburse you for eligible health care expenses You must meet DuPont’s eligibility requirements to qualify for HRA Your HRA funds will be available January 1, 2013
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Who is Eligible? You are eligible for a Health Reimbursement Arrangement (HRA) account if DuPont currently helps you pay for the cost of your group plan You received information on your HRA in your announcement package from DuPont You and your eligible spouse/dependent(s) will have a joint account
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Your HRA amount If you have Medical, Rx and Dental coverage or just Medical and Dental from DuPont TODAY* you’ll receive $1,400 annual allocation (prorated based on the retirees pension adjustment factor) Participants enrolled in a medical only plan TODAY* will receive $1,200 annual allocation (prorated based on the retirees pension adjustment factor) Participants enrolled in dental only TODAY* will receive $200 annual allocation (prorated based on the retirees pension adjustment factor) You must enroll in a plan through Extend Health in order to qualify for your HRA. Extend Health Benefits Advisors will confirm your HRA amount when you speak with them. *You must maintain coverage through 12/31/2012
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HRA Enrollment Kit Initial batch mailed in late December Ongoing will be mailed prior to beginning of month coverage begins Confirms HRA amount Describes eligible expenses Includes claim and direct deposit request form Reminder how to use HRA, where to get support, reminder of dedicated toll-free line Health Reimbursement Arrangement (HRA)
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DuPont allocates benefit dollars to HRA accounts of eligible participants Participant HRA Account Administered by Extend Health Participant works through Extend Health to enroll in individual coverage Participant is reimbursed for healthcare expenses using HRA benefit dollars Health Reimbursement Account: How It Works
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How to File a Paper Claim Participant pays plan premium Participant fills out claim form, attaches proof of payment Extend Health verifies receipt of payment and eligibility Extend Health reimburses customer
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EH HRA - Manual Claim Form
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How Auto-Reimbursement Works Participant pays plan premium to insurance carrier Insurance carrier forwards receipt of payment to Extend Health Extend Health verifies receipt of payment and eligibility Extend Health reimburses participant
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What is Auto-Reimbursement? Auto-Reimbursement (AR) allows retirees to be automatically reimbursed for monthly medical and prescription premiums without submitting a claim form or receipt Auto-reimbursement only applies to premiums paid, not out-of- pocket expenses like copayments, deductibles, coinsurance AR is NOT available on all plans Due to the timing of Auto-Reimbursement files AR is usually not the fastest way to get a reimbursement
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Next Steps
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Before Calling Extend Health Review Getting Started Guide Gather Medicare Card, prescriptions, & doctor information Call Extend Health Toll-Free at 1-888-535-7140
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Post Enrollment Customer Service Advocacy and support services: —Toll Free number to contact Extend Health representative —Direct support for claims issues, appeals and network questions Renewal process – ability to pick new coverage for future years – not locked into this year’s coverage choice forever —Enrollment elections are generally for a one year period Ongoing enrollment services as retiree or spouse turns age 65
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Retirees or Covered Spouses Who Are Not Yet Eligible for Medicare Dependents who are not yet eligible for Medicare do not need to take any action at this time DuPont-sponsored group programs for pre-Medicare retirees and eligible spouses remain available Once you or your spouse/dependents become eligible for Medicare, you will have access to the new individual program, including enrollment support offered through Extend Health 32
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What You Need To Do Action required by current participants in DuPont-sponsored group coverage! Enroll in Medicare Part B if not already enrolled Contact Extend Health Call 855-535-7140 Schedule a meeting with a benefit advisor Learn more about the individual coverage options available to you Benefit advisors available: Monday through Friday (Tip! Call on Thursday or Friday, and not on Monday morning) 8:00 a.m. to 9:00 p.m. Eastern Time 33
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Questions & Answers
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