Helping You Prepare For Your Upcoming Medicare Enrollment
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1 Helping You Prepare For Your Upcoming Medicare Enrollment August 16, Willis Towers Watson. All rights reserved.
2 OneExchange Who We Are Your Future Coverage OneExchange For Your Benefit A Deeper Dive Benefit Advisors, Private Exchange, Optimize Savings Health Reimbursement for You Next Steps Questions and Answer 2
3 OneExchange Health Insurance Marketplace Towers Watson over 100 years experience Over 1.5-million retirees served across 540+ employers Licensed benefit advisor provides guidance & ongoing advocacy Personalized options with plans from a nationwide network of carriers More Choice, More Flexibility Better Value Founded in 2004 No fees for our service Our 12th annual enrollment season First & Largest private Medicare Exchange 3
4 OneExchange Service Centers Operating hours: Monday Friday, 8:00 a.m. until 9:00 p.m. Eastern Time Salt Lake City, UT Phoenix, AZ Dallas, TX 100% Domestic Workforce No Outsourcing! 4
5 Medicare Advantage, Medicare Supplemental and Part D Prescription Drug, Dental and Vision Plans OneExchange offers plans from national and regional carriers 5
6 Your Future Coverage 2016 Willis Towers Watson. All rights reserved.
7 Your Future Coverage How Medicare coverage works Primary Coverage Medicare A and B Additional Coverage (your choice) Medicare Advantage with Prescription Drug (MAPD) or Medigap + Prescription Drug Optional Coverage (your choice) Vision Plans 7
8 Your Medicare Options Option 1: MAPD: Medicare Advantage + Part D Prescription Drug plan HMO MAPD PPO * Note that Medicare Advantage plans are generally network based plans. 8
9 Your Medicare Options Option 2: Medicare Supplement Insurance (Medigap) and Part D Prescription Drug plan Medicare Supplement Insurance Part D Prescription Drug Plan Note: You may need to pay your first premium when you enroll in coverage. 9
10 Medicare Supplement Insurance (MediGap) Lettered Policies Medicare Supplement Insurance (Medigap) Policies Benefits A B C D F G K L M N Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used) Medicare Part B coinsurance or copayment 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% Part A hospice care coinsurance or copayment Skilled nursing facility care coinsurance 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% 100% 100% 100% 100% 50% 75% 100% 100% Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100% Part B deductible 100% 100% Part B excess charges 100% 100% Foreign travel emergency (up to plan limits) Source: CMS 80% 80% 80% 80% 80% 80% Out-of-Pocket limit in 2017 $4,960 $2,480 10
11 Part D Plans 5 Tiers of Co-Pays A prescription drug plan will typically break the formulary into tiers. The tiers correspond to the copayment or coinsurance the beneficiary will pay. Cost-sharing increases with the tier number. Tier 1 is the least expensive, tier 4 or 5 is the most expensive. Tier descriptions: Tier 1 preferred generic Tier 2 non-preferred generic Tier 3 preferred brand Tier 4 non-preferred brand Tier 5 specialty drugs or injectable medicine 11
12 Medicare Prescription Drug Coverage 2017 You Pay Full Retail Until Deductible is Met $0 to $400 You pay 40% of Brand Name and 51% of Generics until your out of pocket costs reach $4950; Pharmaceutical contributions will count towards the $4950 TrOOP Deductible Initial Coverage Coverage Gap Catastrophic Coverage You pay copays for your plan coverage for the first $3700 in actual costs of Medications Only 25% reach Donut Hole Only 4% reach Catastrophic You Pay $3.30 for Generics and $8.25 for Brand Name or 5% - whichever is greater 12
13 A Deeper Dive Into Our Process 2016 Willis Towers Watson. All rights reserved.
14 The OneExchange Process Consultative Process Simplified Selection Effortless Enrollment Ongoing Advocacy 14
15 Education Getting Started Guide: Prepare for your enrollment Pre-existing conditions will not limit your plan selection * Make an appointment to enroll Call Toll Free Medicare.OneExchange.com/Avaya 15
16 Education Enrollment Guide: Understand your options Review Medicare basics What to expect during your enrollment call FAQs Appointment confirmation 16
17 Benefit Advisors Licensed / Certified / Appointed OneExchange University Average age 43 Objective & unbiased 100% domestic workforce Benefit advisors are available: Monday Friday; 8:00 AM. until 9:00 PM Eastern Time 17
18 Decision Support Tools Prescription Profiler Medicare.OneExchange.com/Avaya 24/7 access to your information Load in your prescriptions - Shorten your time on the phone with us! 18
19 Decision Support Tools Help Me Choose comparison tool 19
20 Enrollment Process We ve got your BAC: Benefit Advisors Benefit Advisors can discuss coverage options with anyone Application Data Processors Telephonic enrollment 2 part process Customer Service Reps100% of calls are recorded 20
21 Enrollment Process Selection Confirmation Letter Review the plan(s) that you selected the selection confirmation letter will be sent shortly after you enroll. This letter only confirms that your applications have been submitted. 21
22 Personal Guidance An Ongoing Advocate Navigation Enrollment Prescription changes Affordability concerns Reimbursement issues Late enrollment HRA Annual plan review The plans you select continue on year to year. No need to re-enroll in the fall unless you want to make a plan change. 22
23 Health Reimbursement Arrangement (HRA) 23
24 Health Reimbursement Arrangement Tax-free account used to reimburse you for eligible health care expenses you pay first and then get reimbursed If you are eligible, Avaya will make an Annual contribution to a Health Reimbursement Account (HRA) You may use HRA funding to reimburse yourself for eligible medical and prescription drug premiums, as well as eligible out-of-pocket healthcare expenses Your HRA funding will be available January 1 st, 2017 *When funds available but delays for automatic reimbursement may apply Unused funds DO roll over 24
25 Qualify for your Health Reimbursement Arrangement Enroll in a medical plan through OneExchange before your enrollment period ends on December 31 st, 2016 to have access to your HRA effective January 1 st, You must enroll and remain enrolled through OneExchange each year to continue to have access to your HRA or forever forfeit rights to your HRA. We recommend you schedule a call to enroll, you can also go online to investigate your options and in some cases enroll in a plan. 25
26 Health Reimbursement Arrangement You may be reimbursed up to the amount available in the HRA! 26
27 Health Reimbursement Arrangement Options for Reimbursement Option 1 Automatic Reimbursement (including recurring premiums) Option 2 Manual Reimbursement Participant $ $ Participant OneExchange Insurance Carrier OneExchange Insurance Carrier 27
28 Next Steps 28
29 What You Need To Do: Action Required! Make an appointment to enroll Make sure you have your Medicare card when you call Contact OneExchange Call now to complete your profile and schedule an enrollment appointment You will need your Medicare card, prescription list, and doctor and hospital information 29
30 Questions and Answers?! 30
31 Thank you! Call Now, We Are Ready! Medicare.oneexchange.com/Avaya 31
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