2015 Retiree Open Enrollment benefits information seminar

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2 2015 Retiree Open Enrollment benefits information seminar Purpose to provide you with information and the resources needed for you to make an informed decision in selecting your benefits for 2015 Process provide an overview of the available benefits, who you can call to get more information and a Medicare plan assessment and how to enroll in your benefits. The benefit providers will present details about their benefit plans. Payoff our goal is that you leave here today with the knowledge you need to enroll for your 2015 benefits.

3 Open Enrollment Facts- January 1 st December 31, 2015 Cigna Healthcare plans continue to be offered to retirees and dependents that are Under Age 65 and NOT eligible for both Medicare Parts A & B. Your current Cigna Healthcare coverage, along with your dependent(s) coverage, will continue. Plan design changes and premiums will automatically be adjusted effective January 1, This is a mandatory enrollment for your Flexible Benefits. Your current Flexible Benefits will terminate on December 31, 2014; therefore, in order to continue your participation in your Flexible Benefits, you must re-enroll during this enrollment period.

4 Open Enrollment Facts Miami-Dade County Public Schools (M-DCPS) has joined the Florida School Retiree Benefit Consortium (FSRBC) FSRBC is an organization that assists school districts with benefit and retirement-related initiatives for retirees and eligible dependents Over Age 65 or Under Age 65 eligible for both Medicare Parts A & B.

5 2015 Cigna Healthcare Plans offered to Under 65 retirees and dependents not Medicare Eligible

6 OAP 10 Coverage In-Network OON In-Network OON Deductible (Individual/Family) $500/$1,000 $1,000/$2,000 $500/$1,000 $1,000/$2,000 Co-insurance 20% 40% 20% 40% Maximum Out of Pocket (co-pays, deductibles & co-insurance ) $3,750/$7,500 $3,500/$7,000 $3,750/$7,500 $7,500/$15,000 Primary Care Physician $30 40% $30 40% CCN Specialist Office Visit $50 40% $50 40% Non-CCN Specialist $70 40% $70 40% Physical, Speech & Occupational Therapies $50 40% $50 40% Convenience Care Centers $15 40% $15 40% Urgent Care $70 $70 $70 $70 Emergency Room $350 / $175 (JMH) $350 / $175 (JMH) Prescription Drug Benefits (no out-of-network coverage) Prescription Drug Deductible (Ind/Fam) N/A N/A Retail Drug Network Walgreens, Wal-Mart, Publix, Navarro & some Independents Walgreens, Wal-Mart, Publix, Navarro & some Independents Generic $20 $20 Brand $50 $50 Non-Preferred Brand You pay 50% ($105 min/ $160 max) You pay 50% ($105 min/ $160 max) Mail Order Prescription (90-day supply) Generic $40 $40 Brand $100 $100 Non-Preferred Brand You pay 50% ($210min/ $320 max) You pay 50% ($210 min/ $320 max)

7 OAP 20 Coverage In-Network OON In-Network OON Deductible (Individual/Family) $750/$1,500 $1,500/$3,000 $750/$1,500 $1,500/$3,000 Co-insurance 30% 50% 30% 50% Maximum Out of Pocket (co-pays, deductibles & co-insurance ) $4,000/$8,000 $8,000/$16,000 $4,000/$8,000 $8,000/$16,000 Primary Care Physician $30 50% $30 50% CCN Specialist Office Visit $50 50% $50 50% Non-CCN Specialist $70 50% $70 50% Physical, Speech & Occupational Therapies $50 50% $50 50% Convenience Care Centers $15 50% $15 50% Urgent Care $70 $70 $70 $70 Emergency Room $350 / $175 (JMH) $350 / $175 (JMH) Prescription Drug Benefits (no out-of-network coverage) Prescription Drug Deductible (Ind/Fam) N/A N/A Retail Drug Network Walgreens, Wal-Mart, Publix, Navarro & some Independents Walgreens, Wal-Mart, Publix, Navarro & some Independents Generic $15 $15 Brand $45 $45 Non-Preferred Brand You pay 50% ($105 min/ $160 max) You pay 50% ($105 min/ $160 max) Mail Order Prescription (90-day supply) Generic $30 $30 Brand $90 $90 Non-Preferred Brand You pay 50% ($210 min/ $320 max) You pay 50% ($210 min/ $320 max)

8 LOCALPLUS PLAN Coverage 2015 In-Network OON In-Network OON Deductible (Individual/Family) $750/$1,500 $1,500/$3,000 $750/$1,500 $1,500/$3,000 Coinsurance 30% 50% 30% 50% Maximum Out of Pocket (co-pays, deductibles & co-insurance) $4,000/$8,000 $8,000/$16,000 $4,000/$8,000 $8,000/$16,000 Primary Care Physician $20 50% $20 50% CCN Specialist Office Visit 50 for all 50% 50 for all 50% Non-CCN Specialist N/A 50% N/A 50% Physical, Speech & Occupational Therapies $50 50% $50 50% Convenience Care Centers $10 50% $10 50% Urgent Care $70 $70 $70 $70 Emergency Room $300/ $150 $300/ $150 Prescription Drug Benefits (no out-of-network coverage) Prescription Drug Deductible (Ind/Fam) N/A N/A Retail Drug Network Walgreens, Wal-Mart, Publix, Navarro & some Independents Walgreens, Wal-Mart, Publix, Navarro & some Independents Generic $15 $15 Brand $40 $40 Non-Preferred Brand Mail Order Prescription (90-day supply) You pay 50% ($100 min/ $150 max) You pay 50% ($100 min/ $150 max) Generic $30 $30 Brand $80 $80 Non-Preferred Brand You pay 50% ($200min/$300max) You pay 50% ($200 min/ $300 max)

9 HOW TO ACCESS LOCALPLUS PROVIDERS If you Access Care LocalPlus Provider OAP Provider Non Par Provider in LP or OAP In LocalPlus Network Area In-Network Benefits Apply Out-of-Network (OON) benefits Out-of-Network (OON) Primary Care Physician Office Visit $20 Specialist Office Visit $50 Meet OON Deductible Individual $1,500 Family $3,000 OON Coinsurance Applies 50% Balance Billing May Occur Meet OON Deductible Individual $1,500 Family $3,000 OON Coinsurance Applies 50% Balance Billing May Occur Away from Home in an Area with No LocalPlus Network Does Not Apply In-Network Benefits Apply Primary Care Physician Office Visit $20 Specialist Office Visit $50 Out-of-Network Meet OON Deductible Individual $1,500 Family $3,000 OON Coinsurance Applies 50% Balance Billing May Occur

10 MAXIMUM OUT-OF-POCKET (MOOP) SAVINGS OUT-OF-POCKET MAXIMUM ADJUSTMENT: Medical co-pays Rx co-pays Deductibles and co-insurance Your medical co-pays, Rx co-pays and deductibles and co-insurance count toward your annual Out-of-Pocket (OOP) Maximum. Once your Out-Of- Pocket maximum and in-network expenses are reached, there are no other costs to pay. You are covered 100 percent.

11 CIGNA CARE NETWORK Specialists in the Cigna Care Network (CCN) are identified by Cigna to have demonstrated the best outcome in patient care. These specialists are easily identified by symbol in the online directory. You pay a lower co-pay when you utilize any of the CCN specialty physicians. To learn more and make more informed health care decisions, log-in to (Find Docs & Services).

12 Network pharmacies Which pharmacies are in the narrow pharmacy network? Walgreens Wal-Mart Navarro Publix Independent Pharmacies in rural areas. Log-in to for list of independent pharmacies.

13 EXCLUSIVE HOME DELIVERY HOW DOES IT WORK? This program is for individuals who take prescription medications on a regular basis, such as prescriptions to treat diabetes, asthma, heart conditions, high blood pressure, birth control and more. A letter is sent after the first prescription is filled at a retail pharmacy explaining how the benefit works and what action must be taken. Cigna Home Delivery Pharmacy program allows three (3) refills at a pharmacy, allowing plenty of time to switch to Cigna Home Delivery Pharmacy. Log-in to for a list of maintenance medications.

14 HOW CAN I GET THE MOST OUT OF MY PHARMACY BENEFITS PLAN? HOW CAN I GET THE MOST OUT OF MY PHARMACY BENEFITS PLAN? Learn what drugs are covered Use Participating Pharmacies Use Cigna Home Delivery Pharmacy Use mycigna.com Save money by reviewing the covered drug list on mycigna.com to know which drugs are generic or preferred and cost less. Learn which drugs are maintenance drugs. Have your prescription filled in-network at: Walgreens, Wal-Mart, Publix or Navarro. Switch your maintenance medications to Home Delivery Pharmacy and take advantage of savings. Call Quick Switch to get started today! Gives you 24/7/365 access to pharmacy claim history, benefit details, drug and pharmacy comparison tools and a pharmacist to answer your questions.

15 What Happens if You Don t Enroll for 2015 Benefits? The M-DCPS Humana Group Plan is ending as of 12/31/2014. If we do not receive enrollment information from UnitedHealthcare or Cigna (Leon Medical Centers) by 12/31/14, we will send you a letter notifying you that your Medicare Plan enrollment has not been received. You will have an additional enrollment period until 12/31/2014.

16 What types of Medicare plans are offered for 2015? Medicare Supplement Plans sold by private companies can help pay some of the costs that Original Medicare does not cover like copayments, coinsurance and deductible. All Supplement Plans must offer the same basic benefits, the difference is the added value features that differ from company to company. Medicare Part D Prescription Drug Plans (sometimes called PDP) - sold by private companies - adds coverage to Original Medicare and some other Medicare Plans. If you select a Medicare Supplement Plan, the addition of a Prescription Drug Plan will provide coverage for prescriptions. Medicare pays first, the Supplement and PDP pays secondary.

17 What types of Medicare plans are offered for 2015? Medicare Advantage Plans - A Medicare Advantage Plan is a type of Medicare health plan offered by a private company that contracts with Medicare to provide you with ALL your Medicare Part A and Part B benefits. If you re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren t paid for under Original Medicare. Most Medicare Advantage Plans offer Prescription drug coverage.

18 What s New in Plan Year 2015 Healthcare Benefits for Over Age and/or Medicare eligible? Three Medicare Advantage Plans: Cigna (Leon Medical Centers) UnitedHealthcare (UHC) two plans Three UHC Medicare Supplement Plans: (A, F & N) Two UHC Part D Pharmacy Plans: Comprehensive and Premier

19 Medicare Advantage Plans UnitedHealthcare Medicare Advantage Low Premium National PPO Comprehensive Plan 3 National PPO Residence) $ monthly premium $ (Miami-Dade County Cigna Leon Medical Center Plans Leon Cares (HMO) Zero Premium Plan If you are a retiree that lives outside of the Miami-Dade County area, there are benefit plans available for you. If you move outside of your Medicare Advantage plan area you can change your Medicare plan.

20 UHC Medicare Supplement Plans UnitedHealthcare AARP Medicare Supplement Plans Premiums based on your age, gender, place of residence and tobacco status (You can choose another Supplement plan these plans are recommended) Plan A Plan F Plan N

21 UHC Medicare Part D Pharmacy Plans UnitedHealthcare MedicareRx Plan Comprehensive Premier $ monthly premium $ monthly premium

22 What Should I Expect After I Enroll? AFTER YOU SUBMIT YOUR MEDICARE ENROLLMENT TO CIGNA OR UHC YOU WILL RECEIVE A WELCOME PACKAGE AND ID CARDS HEALTHCARE PROVIDERS WILL SEND ENROLLMENT INFORMATION TO FBMC ON DECEMBER 1 TO SET UP BILLING PROCESSES FOR MEDICARE PLAN SELECTIONS.

23 WHAT S NEW IN PLAN YEAR 2015 FLEXIBLE BENEFITS? Miami-Dade County Public Schools will continue to offer a wide range of high-quality, elective benefits at very competitive prices, including: Dental Options DHMO Plans: DeltaCare USA Dental DHMO Plans Standard and High UnitedHealthcare Solstice Dental DHMO Plans Standard and High Vision Options Indemnity Plans: Delta Indemnity Dental Plans Standard and High UnitedHealthcare PPO Plans Standard and High Davis Vision Plan UnitedHealthcare Vision Plan

24 WHAT S NEW IN PLAN YEAR 2015 FLEXIBLE BENEFITS? Legal Options ARAG Legal Plan and ARAG Senior Advocate MetLaw Legal Plan and MetLaw Senior Advocate Identity Theft Protection Hospital Income Protection ID Watchdog Offered by Cigna Voluntary Life Insurance Offered by MetLife You may NOT select Voluntary Life or Accidental Death and Dismemberment (AD&D) if you do not have current active coverage. If you currently have Voluntary Life and/or AD&D, you can decrease or cancel, you CANNOT increase the coverage level.

25 WHAT S NEW IN PLAN YEAR 2015 FLEXIBLE BENEFITS? Accidental Death and Dismemberment Offered by MetLife You may NOT select Voluntary Life or Accidental Death and Dismemberment (AD&D) if you do not have current active coverage. If you currently have Voluntary Life and/or AD&D, you can decrease or cancel, you CANNOT increase the coverage level.. M-DCPS continues to promote Well Way as your wellness resource for information regarding healthy eating and lifestyle in order for you and your family to live longer, healthier lives. These resources are available to retirees and dependent(s) enrolled in a Cigna Healthcare plan. Through the Well Way program, we want to increase your awareness of your benefits and help you assess your personal health status. We aim to establish and maintain a workplace that encourages environmental and social support for a healthy lifestyle.

26 What s Next? Cigna Leon Medical Center Plan & UnitedHealth Care Presentations

27 Call or toll free ; TTY a.m. to 8 p.m. / 7 days a week

28 WELCOME! We are happy to provide you with details of the Leon Medical Centers Health Plans. Leon Medical Centers Health Plans is an HMO Medicare Advantage Plan with Part D Prescription Drug coverage. We will discuss: Benefits Features Uniqueness of the Leon Medical Centers Health Plans How to enroll

29 Am I eligible to join Leon Medical Centers Health Plans? There are three basic requirements: 1. You must have both Medicare Part A and Part B 2. You must live in our service area six months out of the year 3. You must not have End-Stage Renal Disease (ESRD) MEDICARE A and B Service Area NO ESRD

30 Medicare Part A and Part B PART A Hospital Insurance Benefits Covering Medicare Approved Amounts Days 1-60: Days 61-90: Days 91 +: $1,216 Deductible per benefit period. $304 per day $608 per day These amounts may change for 2015 PART B Medical Insurance Benefits Covering Medicare Approved Amounts Medicare pays: 80% of approved charges Beneficiary pays: 20% of approved charges - Monthly Premium $ Annual Deductible $ These amounts may change for 2015 Medicare Supplements Monthly plan premiums vary from plan to plan and company to company. Help pay some costs (coinsurance and deductibles) that Original Medicare does not cover. Only work with Original Medicare. Medicare Supplements cannot be used with Medicare Advantage plans to cover copayments. Lifetime Reserve Days: Once the 60 reserve days are used, you don t get any more extra days during your lifetime. Most people will pay $104.90, but your Part B premium may be higher based on your income.

31 Medicare Part C and Part D Part C: Medicare Advantage Plans Are operated by private companies contracted with Medicare. Medicare pays a monthly fee to the plan for your care. The plan then directly pays the doctors and hospitals. Part C plans combine hospital costs, doctor and outpatient care into one plan. Part D: Prescription Drug Plans Exact coverage and costs are different for each Medicare drug plan, but all plans must offer at least a standard level of coverage set by Medicare. Plans are available as stand-alone plans. Some Medicare Advantage plans offer built-in prescription drug coverage.

32 Service Area Partial Miami-Dade County

33 $10,000 in Medications Leon Medical Centers Health Plans knows the concern that many have with the high cost of medications, so at Leon we offer: $10,000 in initial coverage for brand name and generic drugs. All generic medications are 100% free and unlimited through the gap. With no co-pay at our pharmacies or home delivery. Hearing Services Routine hearing exam (for up to 1 every year): You pay nothing Hearing aid fitting/evaluation (for up to 2 every three years): You pay nothing Hearing aid: You pay nothing Our plan pays up to $2,100 every three years for hearing aids. Plan will cover 2 hearing aids every three years and will pay for the first $1,050 per ear and per hearing aid. Total benefit value of $2,100. $3,000 in Dental Coverage Extractions, fillings, crowns, and much more. Dentures, partial and complete (one every five years). Must be enrolled for 90 days. No out-of-pocket costs. Vision Services Routine eye exam, Eyeglasses (frames and lenses) (for up to 2 every year): You pay nothing Our plan pays up to $350 every year for eye glasses (frames and lenses). Or $0 copay for up to 4 boxes of contact lenses each year with value not to exceed $35 per box of contact lenses for a total benefit value of $140. Large Network of Hospitals At Leon Medical Centers Health Plans we recognize that sometimes you have to resort to a hospital, which is why at Leon you have access to a large network of hospitals. Major hospitals near you. Without any copay. In case of an emergency you can go to any hospital, worldwide.

34 Your prescription cost as a Member of Leon Cares Your Deductible: $0 Initial Coverage Limit: $10,000 What you Pay until you reach $10,000: Preferred Retail Cost-Sharing Tier One-month supply Tier 1 (Generic) $0 $0 Three-month supply Tier 2 (Brand) $0 $0 Tier 3 33% of the cost Not Offered (Specialty Tier) Standard Retail Cost-Sharing Tier One-month supply Three-month supply Tier 1 (Generic) $5 copay $15 copay Tier 2 (Brand) $10 copay $30 copay Tier 3 (Specialty Tier) 33% of the cost Not Offered What you Pay in the Coverage Gap: Preferred Retail Cost-Sharing Tier Tier 1 (Generic) Drugs One-month Three-month Covered supply supply All $0 $0 Standard Retail Cost-Sharing Tier Tier 1 (Generic) Drugs One-month Three-month Covered supply supply All $5 copay $15 copay Catastrophic Coverage: Once you reach the $4,750 out-of-pocket limit, you will pay the greater of 5% coinsurance or reduced co-pays ($2.65 or $6.60, depending on the drug) for the remainder of the year The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement; for more information contact the plan.

35 Part D Prescription Drug Benefit Extra Help: You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call MEDICARE ( ). TTY users should call , 24 hours a day/7 days a week; The Social Security Office at between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, ; or your State Medicaid Office. Formulary: Lists the individual drugs covered by the plan. Our plan has the following Coverage rules: Tiers: Many plans (including Leon Medical Centers Health Plans) place drugs into different tiers or levels. Drugs in each tier have different costs. Prior Authorization: Some drugs require you and/or your prescriber to contact the drug plan before you can fill certain prescriptions. Your prescriber may need to show that the drug is medically necessary for the plan to cover it. Quantity Limits: Limits on how much medication you can get at a time. Step Therapy: You must try one or more similar, lower-cost drugs before the plan will cover the prescribed drug. If your prescriber believes that one of these coverage rules should be waived, you can ask for an exception.

36 Your cost as a Member of Leon Cares Benefit highlights What your Leon Cares plan pays After Medicare s payment Calendar Year Deductible $0 Inpatient Hospital $0 Skilled Nursing Facility (up to 100) $0 Primary Care Physician $0 Specialist $0 Emergency Room $0, worldwide Outpatient Hospital Surgery $0 Outpatient Hospital Non Surgical $0 Home Health Care $0 Durable Medical Equipment and Supplies The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. $0

37 And Much More! At our seven Medical Centers in Miami-Dade County our patients receive all services under one roof: Primary Care and Specialists Urgent Care Dental Pharmacy Audiology Optical Laboratories and X-rays CT scan Podiatry Physical Therapy Chiropractors Ophthalmology Social Services Center for Diabetes Chronic Disease Department Walk-Ins Welcome Free Transportation Information Booths Leon Healthy Living Centers These services and many more are at your disposition when you join any of our 7 Leon Medical Centers located in Miami-Dade.

38 Leon Healthy Living Centers Leon Healthy Living Centers offer a range of programs and activities to help you live a healthier, fuller life. With modern gyms that have state-of-the-art equipment, you can begin an exercise regimen that s right for you. Leon Healthy Living Centers professional staff and on-site certified trainers will help you customize your training and monitor your progress. Plus, with a variety of health seminars and educational programs such as computer classes, English classes, and assistance with citizenship, you can continue to learn and be mentally stimulated. Leon Healthy Living Centers also offer social activities that include games, such as dominoes, canasta, and other entertainment.

39 Focus on Preventive Care We reward our doctors by the QUALITY of CARE they give our members. Preventive care is one of Leon Medical Centers Health Plans core beliefs. Leon Medical Centers Health Plans members are covered for annual physical exams and other screenings.

40 What is Coordinated Care? We believe its our job to support the relationship with your doctor. Our plans are designed so your Primary Care Physician (PCP) coordinates all your medical care. Your PCP will refer you to and communicate with specialists within our network. This communication helps reduce duplication of medical services and may improve the overall healthcare services you receive. This is called coordinating your care with all of your doctors. You must choose a Primary Care Physician from our network.

41 Emergency Care When you have a medical emergency, you believe that your health is in serious danger. A medical emergency can include severe pain, a bad injury, a sudden illness, or a medical condition that is quickly getting much worse. In the case of an emergency, you do not have to stay within the network. You may dial 911 and use the nearest emergency room.

42 What is Urgent Care? Urgently needed care is a non-emergency situation when: You need medical care right away because of an illness, injury, or condition that you did not expect or anticipate, but your health is not in serious danger. Because of the situation, it isn t reasonable for you to obtain medical care from a network provider. Ordinarily, these services are provided when you are out of the service area. In extraordinary cases, these are services provided when you are in the service area but plan providers are not available. Generally, these services may be received at designated urgent care centers or urgent care facilities.

43 Information There are several documents that will assist in providing information related to the plans offered in your area. The Summary of Benefits illustrates plan benefits. The Prescription Drug Formulary lists Medications covered by the plan. The Provider and Pharmacy Directory lists all contracted providers.

44 Information Each of the documents below can be found on our website: Evidence of Coverage Drug Formulary Provider & Pharmacy Directory Summary of Benefits

45 As a Leon Medical Centers Health Plans Member You should present only your Leon Medical Centers Health Plans ID card when you receive medical services. Front Back Always remember to store your Original Medicare card in a safe place.

46 What s Next? Enrollment in Leon Medical Centers Health Plans is easy! Benefit Fair enrollment One of seven Leon Medical Centers in Miami-Dade County Enrollment packet mailed to your house After you enroll, you will receive the following: Letter of Acknowledgement and Confirmation Welcome Call Member ID Card Evidence of Coverage

47 The Ingredients 7 state-of-the-art Medical Centers 4 cutting-edge Healthy Living Centers 5 Hospital Service Centers 6 Urgent Care Centers employees On-site diagnostics 70 primary care physicians Large network of specialists based at Leon Medical Centers 200 custom transport buses 7 Medical center based pharmacies 25 Pharmacists State-of-the-art refill center 60 pharmacy delivery specialists 136 customer service personnel 44 service assessment personnel

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49 Leon Medical Centers Locations

50 Miami Dade County Public Schools Retiree Open Enrollment Meeting Oct/Nov 2014 Florida School Retiree Benefits Y0066_140723_ Approved Consortium

51 CHOICE starts here. Why We re Here Effective 01/01/2015, Miami Dade County Schools will be offering additional health care plan choices to retirees who are eligible for both Medicare Parts A & B UnitedHealthcare Options AARP Medicare Supplement Plans (A, F, N) New A Plan Unchanged F & N Plans Two New MedicareRX plans (Part D) Comprehensive Premier Medicare Advantage with Pharmacy (Option 3) Medicare Advantage with Pharmacy ($45 Premium) OPEN ENROLLMENT MEETING

52 Medicare Supplement Insurance Plans

53 Who is eligible?

54 Important Things to Know You can enroll in the AARP Medicare Supplement Insurance Plan A, F or N to continue to participate in the Miami Dade Public School Retiree group plan (Florida School Retiree Benefit Consortium) You also need to select the UnitedHealthcare MedicareRx for Groups PDP plan separately as it is not included in the medical plan The AARP membership will be covered at no expense to you as part of the Florida School Retiree Benefit Consortium

55 Medicare Prescription Plans (Part D)

56 STEP 1: LEARN ABOUT YOUR OPTIONS UnitedHealthcare Prescription Drug Plans (Part D) Costs All Medicare Part D plans are set up in drug payment stages. Each stage tells you the amount you pay and the amount your plan pays for covered medications. Initial Coverage Coverage Gap Catastrophic Coverage You pay co-pay or co-insurance for each covered drug, depending on plan. You pay 45% of brand name drug prices and no more than 65% generic drug prices. Your plan will pay most of the cost for your drugs Total Drug Costs: The amount you pay (or others pay on your behalf) and the plan pays for prescription drugs. This does not include premiums. Out-of-Pocket Costs: The amount you pay (or others pay on your behalf) for prescription drugs This does not include premiums OPEN ENROLLMENT MEETING

57 STEP 1: LEARN ABOUT YOUR OPTIONS Two Plans That May Fit Your Needs Comprehensive ($84.18) Premier ($155.31) Tier 1 Copay $2-$10 $2-$7 Tier 2 Copay $45 $30 Tier 3 Copay $75 $60 Tier 4 Copay 33% $75 Gap Coverage Tier 1 $2-$10 Tier % Mail Order 90 day supply 2x copay Full coverage 2x copay OPEN ENROLLMENT MEETING

58 Medicare Advantage Plans (Part C)

59 STEP 1: LEARN ABOUT YOUR OPTIONS Medicare Advantage Plans (Part C) Coverage Medicare Advantage plans combine coverage for hospital stays with coverage for doctor visits, outpatient care, preventive care and often extra benefits like vision, dental, wellness and hearing exams. Many plans include Part D prescription drug coverage, too. Certain Medicare Advantage plans allow you to add a standalone prescription drug plan Medicare Part A Hospital Medicare Part B Doctor and outpatient Medicare Part D Prescription drug coverage is included in some plans Additional Benefits Vision, hearing, dental and wellness programs are often included

60 CHOICE starts here. Group Medicare Advantage Plans MAPD NPPO (UHC Plan 3) MAPD PPO Plus $45Premium Network Non-Network Network Out-of Network Deductible 0 0 $400 $400 Out of Pocket Max $2,500 $2,500 $6,700 (Combined) $6,700 (Combined) Primary Care Physician (PCP) $5 $5 $25 $25 Specialist $15 $15 $50 $50 Urgent Care $35 $35 $35 $35 Emergency Services $65 $65 $65 $65 Outpatient Surgery $15 $15 20% 20% Inpatient Hosptial Stay $175 per admit $175 per admit $230 copay per days 1-7, $0 copay days 8 and beyond $230 copay per days 1-7, $0 copay days 8 and beyond Physical/Speech Therapy $20 $20 20% 20% Chiropractic (Medicare $15 $15 $20 $20 Covered) Annual wellness exam $0 $0 $0 $0 (Medicare Covered) Routine Immunizations $0 $0 $0 $0 Durable Medical Equipment 20% 20% 20% 20% Hearing aid allowance every 36 months $500 $500 $500 $500

61 CHOICE starts here. Group Medicare Advantage Plans MAPD NPPO (UHC Plan 3) MAPD PPO Plus (UHC $45 Premium) Tier 1 $5 25% Tier 2 $30 25% Tier 3 $60 25% Tier 4 $80 25% Mail Order 90 day supply Tier 1 $0 Tier 1 25% Tier 2 $60 Tier 2 25% Tier 3 $120 Tier 3 25% Tier 4 $180 Tier 4 25% Gap Coverage Full Coverage 45% Brand/65% Generic

62 CHOICE starts here. Medicare Advantage added programs Stay physically fit and active at no additional cost. Staying active with SilverSneakers Fitness Program. Choose a fitness center from more than 11,000 participating locations. (Find the nearest location at You re never alone. Whether you have questions about a medication or have a health concern in the middle of the night, with NurseLine a nurse answers your call 24 hours a day Hearing aids starting at $599 each, depending on the model you choose. hi HealthInnovations is UnitedHealthcare s hearing aid program that provides custom programmed hearing aids that may address your personal hearing needs OPEN ENROLLMENT MEETING

63 We re here to help. Questions? Dedicated Customer Service representatives are trained to identify your specific needs and match them to Florida School Retiree Benefit Consortium s UnitedHealthcare s portfolio of health plan options. Before you call: Have your Medicare ID card on hand and list of prescription drugs Think about how much you want to spend on your new plan(s) Would your rather pay a lower premium and copay for services as you use them. Or pay a higher premium and have little to no cost of services Have your doctors names and addresses ready. Would you change doctors of provider if it meant you could save Healthcare costs? Do you travel out of state? Out of county? OPEN ENROLLMENT MEETING

64 Questions? Call us on the dedicated Florida School Retiree Benefit Consortium toll-free number: , TTY a.m. 8 p.m. local time, 7 days a week OPEN ENROLLMENT MEETING

65 WE ARE HEALTH AND SERVICES FOR OUR PATIENTS All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc.