2018 AdventistRetirement

Transcription

1 2018 AdventistRetirement SHARP -Ex Supplemental Healthcare, Adventist Retirement Plan Lisa Turpen, Associate Administrator Lisa Sharpe, SHARP Manager

2 Historical Rewind Adventist Retirement In 1910, the church voted to establish a workers fund known as the Defined Benefit (Legacy/Pension) Plan. Designed on a pay-as-you-go basis for both pension and healthcare benefits. The Hospital portion of the plan was separated from the Church plan in In 1998 the action was taken to freeze the unfunded Defined Benefit (pension) Plan effective and replace it with the Defined Contribution Plan (Adventist Retirement Plan 403-b), effective The Defined Benefit Plan currently provides approximately 17,000 + Retirees with pension benefits. The number of participants in this plan will peak in The final pension payment will be paid the decade of The Defined Contribution Plan has 17,500 active/employee participants and 28,000+ total participants. (retirees do not have to take their money out of the Adventist Retirement Plan at Empower)

3 Retirement Plan Statistics Adventist Retirement Defined Benefit Plan Pension benefits paid over the last 10 years $985,879,075 Projected Defined Benefit Plan Pension benefits to be paid over the next 10 years $1,151,005,233 Healthcare benefits paid over the past 10 years: $357,881,737

4 Service Records Adventist Retirement The manual service record for each denominational employee is maintained by the participating employers. This is the official record through The employer is the custodian of the original record until retirement. By NAD policy, every two years the employer is to provide a copy of the eadventist Personnel service record to each employee. The employee is responsible to verify their record is correct. Any discrepancies must be corrected by the employee working with the employer. The eadventist Personnel service record centralizes data for actuarial studies and reports. Simplifies and accelerates record keeping. Is updated annually by the employer. Issues regarding service credit must be resolved prior to retirement benefits commencing. 4

5 SHARP Supplemental Healthcare Adventist Retirement Plan Adventist Retirement In 1963 Medicare Part A and Part B came in to existence. Medicare has been the primary health coverage for NAD retirees since that time. The SHARP (Supplemental Healthcare Adventist Retirement Plan) began to function in Self-funded plan that coordinated after Medicare made the primary payment. Is not an insurance plan. In 2017 changes were made to the benefit structure of SHARP. The benefit became a Health Reimbursement Account (HRA) benefit. SHARP DVH (dental, vision, hearing) benefit continues. A retiree must have 15 years of qualifying NAD service credit (includes pre-2000 and post-1999 service credit) to be eligible for SHARP benefits. (Other requirements such as non-nad service, are described in the Retirement and SHARP policy books)

6 What is Medicare? Adventist Retirement Medicare Part A Hospital Activates at age 65 even if you are covered by employer healthcare benefits Your employer remains your primary coverage until you terminate employment No monthly premium Medicare Part B Medical/outpatient services You enroll for Part B when you lose your employer healthcare benefit or at age 65, whichever is later. Monthly Part B premium is taken from your Social Security payment Medicare C Medicare Advantage plans Medicare D Medicare prescription drug plans

7 Isn t Medicare Enough? Adventist Retirement Incurred Expenses Not Covered by Medicare may include: Dental, Vision or Hearing (not covered by Medicare) Medicare Part A and Part B co-insurance and deductibles Inpatient, Part A, admission deductible (2018 = $1340/admission) Inpatient, Part A, daily co-insurance for lengthy admissions Outpatient, Part B, annual deductible (2018 = $183) Outpatient, Part B, co-insurance per service Medicare D prescription drug deductible and copayments

8 Medicare Plan Options Adventist Retirement

9 Choosing a Medicare Medical Plan Adventist Retirement Supplement Plan (Medigap) May be higher premium/low to no cost on the back end May go to any doctor or medical facility in the country that accepts Medicare patients Does not include prescription drugs Most plans include foreign travel emergency coverage Guaranteed Issue Medicare Advantage (Part C) Low to no monthly premium/pay as you go Copays, coinsurance, and deductibles apply Network-based plans: HMOs, PPOs Typically includes prescription drugs Out-of-pocket maximum Coordinated care Guaranteed acceptance Except end-stage renal disease (ESRD)

10 Medicare and SHARP Ex Medicare remains the primary medical benefit for the age 65 retiree/eligible spouse. Enroll for Medicare through the Social Security office. Set up an online account to view claims, providers and report fraud. The Retirement office is not involved in your Medicare enrollment. Medicare is available at age 65 even if the retirement age is 66 and 8 months. < age 65 Medicare for disability Medicare Part A (hospital benefit) is automatic for a retiree at age 65. Medicare Part B: the retiree enrolls in this approximately 2 months prior to their retirement date. Do Not enroll in a Medicare D drug plan at this time.

11 Medicare Enrollment Periods Adventist Retirement 2018 Age in Initial Enrollment Period (IEP): Eligible 3 months before the month of, and 3 months after 65th birthday New Retirements (SEP): 60 days before the month group coverage ends and 63 days after the month Medicare Open Enrollment Period (OEP): October 15 December 7 each year

12 SHARP Ex (Exchange) in 2018 Adventist Retirement SHARP remains a self-funded benefit for healthcare assistance. Each NAD participating employer contributes to the retirement plans as outlined in policy. This provides benefits for those currently retired and those who will be eligible for benefits in the upcoming years. Eligibility for SHARP remains the same. 15 years of qualifying, NAD service credit. All retirees/spouses age 65 and over must be enrolled in Medicare Part A and Part B as their primary healthcare coverage. Spouse eligibility is designated by the Retiree taking the Joint & Survivor Benefit at retirement. The two must have been married for at least one year prior to retirement No spousal assistance (earned credit/hra) for a marriage post-retirement.

13 SHARP EX and the HRA Retirees will purchase medical and prescription drug insurance through the Aon Retiree Health Exchange Financial help is given to the retiree by Adventist Retirement through an HRA (health reimbursement account). Similar to the Earned Credit given in the past The HRA amount is based on the retiree s qualifying years of service 5 year bands (the same as the Earned Credit) The advantages for the retiree: choice of healthcare insurance companies allows more retiree specific coverage ability to pay less for equal or better coverage Adventist Retirement continues to subsidize the retiree through the HRA 8/27/

14 2018 HRA Annual Contribution Table Years of Qualifying Church Service * Divorce/shared service DVH Annual Contribution per member HRA Annual Contribution per member Total Annual Contribution per member 35+ $780 $1,620 $2, $696 $1,464 $2, $612 $1,308 $1, $528 $1,152 $1, $444 $996 $1, * $360 $840 $1, * $276 $624 $900

15 Eligible HRA Claims Insurance Premiums Co-pays and co-insurance Medicare D penalty for late enrollment YSA (Your Spending Account) sends a complete list of covered expenses to each eligible retiree Medicare Part B premium (look carefully at your allotted HRA amount) Each retiree must use their individual claim form. The claim form is bar coded to the retiree s account. Do not share claim forms with your spouse or another retiree. You will manage your HRA dollars on an annual basis. 8/27/

16 Catastrophic Drug HRA The SHARP plan created the Catastrophic Drug HRA in A retiree or spouse must be enrolled in a plan through the Aon Retiree Health Exchange. If a retiree or spouse reaches the catastrophic stage of their prescription drug plan, he or she may receive reimbursement for the individual 5% out-of-pocket cost. The retiree or spouse submits a copy of the catastrophic stage explanation of benefits from their drug plan to Your Spending Account (YSA). **Each retiree must call to activate the catastrophic HRA. - A separate, bar-coded claim form is used for this benefit. The Catastrophic Drug HRA is independent of the standard HRA. There is no dollar limit on the amount a retiree or spouse may claim under this benefit. 8/27/

17 SHARP DVH Dental, Vision and Hearing Adventist Retirement Self-funded plan - SHARP pays 80% and the retiree pays 20% Adventist Risk Management, Inc. is under contract with SHARP to provide the claim processing service A Retiree must decide at retirement whether or not to take this benefit. ** Lifetime Yes or No Annual Benefit Limits are: Dental $2200 (no look back provision) Vision $400 (no look back provision) Hearing $2200 (with a one-year look back provision)

18 SHARP DVH Option Earned Credit 2018 DVH TABLE Years of qualifying church service Category DVH Cost/Month (less EC) Total Cost *Divorced/shared service * 1 7* A B C D E F G $95 $95 $95 $95 $95 $95 $95 ($65) ($58) ($51) ($44) ($37) ($30) ($23) $30 $37 $44 $51 $58 $65 $72

19 Medicare Part B Reimbursement The Medicare Part B reimbursement benefit is provided to retirees with DB service and those with mixed DB and DC service. Retirees with DC only service are not eligible for this benefit. Eligibility is based upon being age 65 had 15 YSC and is eligible for the earned credit subsidy. Medicare Part B Premium Reimbursement Table (based on Medicare Base of $ rate frozen in 2015) SHARP Category A B C D E F G Years of Retirement Plan Service ** 1 7** Reimbursement 90% 80% 70% 60% 50% 40% 30% Monthly Reimbursement $94.41 $83.92 $73.43 $62.94 $52.45 $41.96 $ /27/

20 2018 Pre Medicare SHARP < age 65 Pre-Medicare Option is Medical Only coverage $600 individual deductible Does not include dental, vision, hearing or prescriptions. The member must enroll in SHARP Pre-Medicare DVH and/or SHARP Pre-Medicare Rx options individually Access Plan of the Ascend to Wholeness plan. Retiree creates an online account at HealthSCOPE is the TPA paying claims for medical services Aetna Signature Administrators PPO Express Scripts for all Rx (prescription drug) claims $200 individual deductible ARM/WebTPA for all DVH (dental, vision, hearing) claims All deductibles begin again in the Retirement Plan Earned Credit is only applicable if the Retiree qualifies for the earned credit subsidy.

21 Non Medicare (children) SHARP Benefit is available up to the 26 th birthday Benefit includes medical, dental, vision, hearing, prescription and orthodontia. Access Plan of the ARM Ascend To Wholeness plan Aetna Signature Administrators PPO. Medical claims are paid through HealthSCOPE. $600 individual deductible Rx (prescription drug) claims are paid through Express Scripts, DVH claims are paid through ARM/WebTPA. $200 individual deductible Earned Credit is only applicable if the Retiree qualifies for an EC.

22 New Retiree Responsibilities Enroll in Medicare Part A and Part B prior to last day of employer coverage. (2-3 months) Wait for the Welcome Kit and enrollment letter from Aon Retiree Health Exchange. Appointment letter with dedicated account number; the new retiree must call and confirm their appointment with Aon. If you use the Aon website prior to obtaining their dedicated account number, it will delay in their enrollment. Use the Aon account number to create an online account on this dedicated website. Aon Retiree Health Exchange dedicated phone number: Do Not access the Aon open market website/accounts.

23 SHARP Ex Adventist Retirement Plan website Supplemental Healthcare, Adventist Retirement Plan Pre-Retirement Information Aon Retiree Health Exchange Plan documents SHARP-Ex & SHARP Pre-Medicare/Non-Medicare» Pre-Medicare/Non-Medicare Summary of Benefits and Coverage SHARP enrollment forms Phone:

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