Under 65 Participant Welcome Kit

Transcription

1 Under 65 Participant Welcome Kit This booklet contains important information on your health care coverage. *Services provided by Mercer Health & enefits Administration LLC. Mercer Marketplace 365SM* P.O. ox 14401, Des Moines, IA (toll-free) (TTY) (fax)

2 INCLUDED IN THIS KIT WHO S WHO...3 There are many people supporting you through this transition. This list will help you understand the roles and responsibilities of each group. WHAT YOU NEED TO KNOW...4 Knowing what to do and what to expect will help you prepare for a smooth transition. APPOINTMENT PREPARATION...5 Following these steps will help you get the most out of your consultation with a enefits Counselor. OVERVIEW OF PLANS...6 Understanding the four different plan types available to you, and what factors may help you make a decision. PREPARIN TO ENROLL...7 These are questions to answer to help you prepare to enroll and items you will need to have ready before you enroll. HEALTH CARE PROVIDER TRACKER...8 List your important health care providers to help determine what kind of plan will best meet your needs. PRESCRIPTION DRU TRACKER...9 ather your prescriptions in one place to give you a head start toward making a sound selection. HEALTH REIMURSEMENT ACCOUNT (HRA)...10 Important facts about your HRA. NOTES...11 Use this page to keep track of any items you wish to discuss when you talk to your enefits Counselor. Welcome to Mercer Marketplace 365. Having the right health care coverage to meet your needs and budget during retirement is important. That s why Motorola Solutions, Inc. ( MSI ) is partnering with Mercer Marketplace 365 to provide resources that will help you choose a plan from a variety of health care coverage options. You will shop for and enroll in your new coverage through Mercer Marketplace 365. You will have several options to choose from to meet your medical and prescription drug needs. Mercer Marketplace 365 and its enefits Counselors are ready to support you as you transition to retirement. They will help you understand the different individual plans offered to you, determine the best plan for you, and help you enroll. When you sign up for your new coverage through Mercer Marketplace 365, MSI will provide you with a subsidy to offset the cost of your health insurance. The subsidy will be placed in a Health Reimbursement Account ( HRA ) set up in your name. This is a special, tax-free account that you may use to reimburse yourself for insurance premiums. Page 10 provides more information about your Health Reimbursement Account. To be eligible for the subsidy, you must enroll for medical coverage through Mercer Marketplace 365. You will have a dedicated enefits Counselor from Mercer Marketplace 365. Your enefits Counselor will help you compare your medical, prescription drug, critical illness, dental, and vision coverage options. You can also visit our website to compare your options and learn more about Mercer Marketplace 365. Refer to page 5 for more information about connecting with your enefits Counselor. In the meantime, review this Welcome Kit. It contains tools and exercises to help you prepare for your consultation. Completing the information in this booklet will make it easy for you and your enefits Counselor to evaluate your options and get you enrolled. Our team is excited to serve you in this program. You may reach Mercer Marketplace 365 Monday through Friday, from 8:00 a.m. to 5:30 p.m. EST at toll-free (TTY ) to set up a consultation with our enefits Counselors who are available to support you during your enrollment period. Or, visit us online at at your convenience, 24 hours a day, seven days a week. For additional information about Mercer Marketplace 365, including our compensation and privacy practices, please see the enclosed documents. We look forward to working with you. Mercer Marketplace 365 PAE 2

3 Our enefits Counselors will help you through the change in health insurance and get the most out of your Health Reimbursement Account (HRA). Who s Who? You are not alone in this transition. MSI carefully evaluated the retiree health insurance market and selected a team of companies and individuals to support you throughout your enrollment and in the future. MSI values their retiree relationships and continues to work to provide access to comprehensive programs that support the needs of retirees and their families. MSI research determined that the robust individual health insurance market offers retirees choice and flexibility in coverage options to maximize the value of your HRA dollars. To best support retirees with the service and support necessary for this transition, MSI evaluated several potential partners and has assembled the following team: MERCER MARKETPLACE 365 Our enefits Counselors are licensed insurance professionals who are available to assist you with this transition. They will help you learn how to evaluate and compare plans to select a strategy that best fits your needs. When you have selected your plan(s), your enefits Counselor will help you through the enrollment process to ensure that all information is submitted accurately and timely to the insurance carrier(s). Once you have enrolled, your enefits Counselor continues to support you throughout the year with your reimbursement requests, HRA inquiries, and insurance advocacy. INSURANCE COMPANIES You will be able to enroll in individual health plan policies offered by leading health insurance companies. Once you enroll in your selected plan, a new health insurance card will be issued to you directly by your new insurance carrier. PAE 3

4 WHAT YOU NEED TO KNOW efore your call with Mercer Marketplace 365 KEEP TRACK OF YOUR HEALTH AND PRESCRIPTION DRU COSTS AND LIST YOUR PROVIDERS Start by keeping track of your individual health care expenses. This step will prepare you for your call with your enefits Counselor, and assist you in making sure you have a health care plan that is best for your situation. Use the Health Care Provider Tracker on page 8 to list your important providers. Use the Prescription Drug Tracker on page 9 to record your monthly prescriptions. Providing correct information in the trackers will help your enefits Counselor at Mercer Marketplace 365 analyze your health insurance needs. As soon as possible SCHEDULE A TELEPHONE CONSULTATION WITH YOUR ENEFITS COUNSELOR Call Mercer Marketplace 365 to schedule a one-on-one consultation with your enefits Counselor. During this call, you should notify your enefits Counselor if you will be opting-out of coverage. efore you select a health care plan CONSULT WITH YOUR ENEFITS COUNSELOR AND PREPARE TO ENROLL IN YOUR HEALTH PLAN Please take this opportunity to utilize your enefits Counselor and his or her health insurance expertise. He or she will present you with all of your options so you can feel confident about the decision you are making. To avoid a gap in your health care coverage ENROLL IN YOUR HEALTH PLAN Your coverage start date will not be retroactive, so please be sure to enroll in your health plan prior to your previous coverage ending. When you are ready to enroll in your new plan(s), call your enefits Counselor at or (TTY ). Post enrollment EXPECT YOUR ENROLLMENT PACKAE After submitting your enrollment, please watch for an enrollment package from your enefits Counselor. This package will provide details on when to expect your insurance card(s), how to access your HRA, how to submit claims and when you will receive reimbursements. Ongoing UTILIZE YOUR ENEFITS COUNSELOR Your enefits Counselor is your year-round advocate. Call your Mercer Marketplace 365 enefits Counselor whenever you have questions about any health insurance related matters. PAE 4

5 ACT QUICKLY for your new health care plan to be effective as NEXT STEPS Appointment Preparation Follow these steps to ensure that you are prepared for your phone consultation with a Mercer Marketplace 365 enefits Counselor. applicable. 1 Call Mercer Marketplace 365 Monday through Friday between 8:00 a.m. and 5:30 p.m. ET at to schedule your one-on-one consultation with a enefits Counselor. QUESTIONS FOR MY ENEFITS COUNSELOR Appointment Date Time enefits Counselor Phone 2 Prepare for your appointment. To help guide your decision, please see the Questions To Think About section on page 6. 3 Complete the Health Care Provider Tracker and Prescription Drug Tracker forms included in this kit. Please mail, fax, or this information days before your appointment. MotorolaSolutions.Retiree.Exchange@mercer.com Secure fax: Address: Mercer Marketplace 365 P.O. ox Des Moines, IA Write down your questions or concerns in the space on the left side of this page. Your enefits Counselor will take the time to explain your health care insurance options and answer any questions you have. Our goal is to help you select the health plan that best fits your needs. 5 If known, write down your current plan information below to discuss with your enefits Counselor during your consultation: Insurance Carrier Plan Name PAE 5

6 OVERVIEW OF PLANS Understanding Your Options Plans are tiered and named after metals: Platinum, old, Silver, and ronze. The cost sharing structure is different from tier to tier. ut keep in mind that all of the plans, regardless of tier, combine both medical coverage and prescription coverage under one plan. Higher Premium Lower Premium Lower out-of-pocket expense Higher out-of-pocket expense Platinum: typically, the premium payments are highest for this tier, but the expected out-of-pocket costs when seeking care are the lowest among the tiers. old: typically, the premium payments are lower than Platinum, but the expected out-ofpocket costs when seeking care are slightly higher. HOW IT WORKS Questions to Think About Silver: typically, the premium payments are lower than old and higher than ronze. The expected out-of-pocket costs when seeking care are slightly higher than old and lower than ronze. ronze: typically, the premium payments are the lowest for this tier, but the expected out-of-pocket costs when seeking care are the highest among the tiers. As you compare your health care insurance options, it is important to consider all the costs of the plan, not just the monthly premium. When determining your budget, remember to include other factors that go into your health care expenses, like prescriptions and provider visit co-payments. This will help you get a clear picture of the true cost differences among the insurance plans. elow are some questions you and all family members who are under age 65 should consider. These will help determine the best plan at a cost you can afford:. Who do you want to enroll (who are under 65) and what are their dates of birth?. How many times a year do you or your family visit the doctor? How many ongoing monthly prescriptions do you have? Are any other benefits such as children s dental or chiropractic care important to you? PAE 6

7 NEXT STEPS Preparing to Enroll When you have your consultation with your Mercer Marketplace 365 enefits Counselor, you will need to provide some of your basic household information. Use the checklist below to help you with some of the information you will need on your call: Your Social Security Number (or other document ID number if you re a legal immigrant). Current income: either a pay stub, your W-2 tax form, or your most recent tax return. ACT QUICKLY for your new health care plan to be effective as applicable. Other income information: this could include unemployment checks, child support, veterans payments, alimony, retirement income or other sources. People in your household: the number of people who you claim as dependents, whether or not they live with you. Current health plan information: the type of current health insurance coverage you have and other health plans you may _have access to in the year ahead. KEEP IN MIND When you Enroll After researching your health insurance plan options and gathering your basic household information as listed above, please keep in mind: You have options for coverage: you may elect a plan that provides coverage for your family, or each family member can enroll in an individual plan. You may have access to federal tax credits: when you call Mercer Marketplace 365, your enefits Counselor will walk you through your options. He or she will make you aware of any available tax credits for which you may qualify, and how that will impact any HRA, if applicable. PAE 7

8 NAME PHONE (PLEASE PRINT) Health Care Provider Tracker List your current health care providers on this sheet. Some health care plans like HMOs and PPOs use networks. athering your health care providers information here will help you and your enefits Counselor compare access to your current providers. You also can contact your providers and ask them which health care plans they accept. 1. PRIMARY CARE PHYSICIAN NAME PHONE ADDRESS athering your health care providers information will help determine if your providers accept the new health insurance you are considering. TIP Some providers do not participate in certain HMO and PPO plans. 2. SPECIALIST NAME PHONE ADDRESS 3. SPECIALIST NAME PHONE ADDRESS 4. OTHER NAME PHONE ADDRESS 5. OTHER NAME PHONE ADDRESS Please submit this worksheet days prior to your scheduled consultation. Mail, fax, or to: Mercer Marketplace 365 P.O. ox 14401, Des Moines, IA Fax: PAE 8

9 NAME PHONE (PLEASE PRINT) Prescription Drug Tracker (Please Print Clearly) In order to construct an accurate cost analysis, we will need your complete and accurate drug information. For example, it is important to indicate the name of the drug that you are taking, and whether you are taking a RAND or ENERIC version. Please note, over-the-counter medications, vitamins, and supplements are not covered by prescription drug plans and therefore are not required on this form. IF THE IF THE SUPPLY SUPPLY OF A OF PRESCRIPTION A MEDICATION DRU LASTS LASTS LONER LONER THAN THAN ONE ONE MONTH MONTH OR IS OR IS ONLY USED AS NEEDED (PRN), PLEASE TELL US HOW OFTEN IT IS ORDERED. NAME OF MEDICINE (Excluding vitamins and over the counter) RAND OR ENERIC FORM AND DOSAE PACKAE SIZE / QUANTITY MONTHLY (Quantities, number of packages) COST EXAMPLES: Simvastatin 20 mg tablet Timolol Maleate Opthalmic Sol 0.5% OP Sol 10 ml bottle 1 bottle per month Nasocort AQ AER 55 mcg/ac 16.5 gm inhaler 1 inhaler per month Ciclopirox el 0.77% gel 30 gm tube 1 tube per month Lantus Solostar INJ PAE ml 3 ml pen (pack of 5) 10 pens (2 packs of 5 pens per month) Please complete one Prescription Drug Tracker per person. Please mail, fax, or this worksheet days before your scheduled consultation to: Mercer Marketplace 365 P.O. ox 14401, Des Moines, IA Fax: MotorolaSolutions.Retiree.Exchange@mercer.com

10 Your HRA through Mercer Marketplace 365 MSI is providing an HRA for their retirees and eligible dependents. This HRA may be used for Individual Health, Prescription Drug, Dental, Vision, and Critical Illness plan(s). You will first pay your premiums directly to your insurance carriers, then be reimbursed by Mercer Marketplace 365 from your HRA account. ecause Mercer Marketplace 365 is administering these HRA reimbursements, you will have one place to call for all your insurance and reimbursement needs. Any change to the program will be provided via direct communication from MSI. > Who s covered? Pre-65 MSI retirees and their eligible dependents, if they elect health insurance coverage through Mercer Marketplace 365. > How can I use the HRA? You can be reimbursed for certain eligible health care expenses (for example, your monthly premiums, and other eligible outof-pocket expenses, including co-payments, coinsurance, and deductibles). ONLINE ACCESS OF YOUR HRA Once your eligibility has been confirmed by your employer, you will be able to access your HRA information 24/7 by taking the following steps: 1) Visit com/msiaccess In the far right box, outlined in red below, click LO IN. Use the primary account holder s information to log in to access your HRA. 2) Next, in the red box outlined below, enter your Social Security Number (omit any dashes) as your User Name, and your Date of irth (MMDDYYYY) as your password. You will be prompted to change your password after you complete this initial log in. (This is a secure site.) WHEN TO EXPECT REIMURSEMENTS FROM YOUR HRA Approved claims received Monday through 12 p.m. EST on Friday will be reimbursed Friday of the following week, excluding bank holidays. Direct deposits are made that Friday. Hard checks will be issued Friday and take approximately 3-5 business days to be delivered. 3) From your dashboard, shown below, you can: View your account balance Submit claims and check their status Set up or edit direct deposit Access many other convenient features PAE 10

11 NOTES AND QUESTIONS FOR A ENEFITS COUNSELOR PAE 11

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