2017 Healthcare Enrollment Guide for City of Memphis Medicare Eligible Retirees. Sponsored By

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1 2017 Healthcare Enrollment Guide for City of Memphis Medicare Eligible Retirees Sponsored By

2 2017 Post-65 & Medicare Eligible Retiree Healthcare Notification Dear City of Memphis Retirees & Surviving Spouses: We recognize that the City of Memphis has put you in a difficult and uneasy situation, but the Memphis Fire Fighters Association (MFFA) is not only committed to finding the best healthcare options available for post-65 retirees and their spouses, but also to provide additional support. The MFFA has partnered with LABOR FIRST, a Retiree Benefit Administrator and Retiree Advocacy company that specialized in servicing the healthcare needs of retirees of organized labor. We have teamed up with LABOR FIRST to offer three group Medicare Supplement plans and a group Medicare Part D Prescription plan which offers full donut hole coverage. A common complaint we ve heard from post-65 retirees is that they could not find Medicare Part D Prescription plans that covered through the donut hole. We found a plan that does just that. We endorse and support these plans as an option for Post-65, Medicare retirees of the City of Memphis and are available for all post-65 retirees of the City. These are not exclusive to Fire Retirees only. For those who are enrolling into Medicare Part B after age 65, the city has advised they will be paying the late enrollment penalty to Medicare on your behalf. These plan offerings will supplement your Medicare Parts A & B once you are enrolled in Medicare Part A and B. With these plan offerings, the city has agreed to payroll deducting these premiums and remitting them to us for transmittal to the insurance company. By doing so, Public Safety retirees can still claim the $3,000 tax credit under the HELPS ACT, a federal law that reduces your taxable income by up to $3,000 for healthcare premium deductions coming from your pension check. This will allow you to have some savings on your taxes and will possibly increase any refund you may receive. Enclosed in this packet is information on the plan offerings and information concerning enrolling into these plans if you so choose. Questions can be directed to LABOR FIRST at the number and website provided. Sincerely, Thomas Malone Thomas Malone, President IAFF Local 1784 Memphis Fire Fighters Association (901) Office Page 2 of 8

3 CITY OF MEMPHIS MEDICAL: MEDICAL SUPPLEMENT BENEFIT SUMMARY Medical Supplement Pricing (Premiums per person per month) OPTION 1: Plan F Premium OPTION 2: Plan F High Deductible Premium OPTION 3: Plan N Premium Ages $ $76.00 $ Ages $ $84.00 $ Ages $ $93.00 $ Ages 80 + $ $ $ Ages 64 & Under $ $ $ PART A Benefits & Levels: Hospital Plan F Part A Deductible of $1,316 in 2017 Part A Coinsurance: Days all but $322 per day, Days all but per $644 a day Additional 365 days of coverage after Medicare benefits are used Skilled nursing facility care: Days 1-20 Skilled nursing facility care: Days all but $161 per day Blood (first 3 pints) PART B Benefits & Levels: Plan F High Deductible Plan N Physician Plan F Part B Deductible $183 in 2017 Part B Coinsurance: Medicare pays 80% of charges Part B Excess Charges (Charges above Medicare approved amount) Foreign travel Emergency Plan F High Deductible Plan N Member pays 100% $20 office copay and up to $50 E.R. copay COVERED COVERED NOT COVERED Emergency care outside U.S: covered at 80% coinsurance of the billed charges after a $250 deductible annually. Max $50K Lifetime Emergency care outside U.S: covered at 80% coinsurance of the billed charges after a $250 deductible annually. Max $50K Lifetime Emergency care outside U.S: covered at 80% coinsurance of the billed charges after a $250 deductible annually. Max $50K Lifetime MEDICAL SUPPLEMENT PROVIDER: UNITED AMERICAN MEDICAL NETWORK: PLAN ACCEPTED AT ANY PROVIDER / FACILITY THAT ACCEPTS MEDICARE NATIONWIDE Page 3 of 8

4 CITY OF MEMPHIS PHARMACY: PRESCRIPTION DRUG BENEFIT SUMMARY Prescription Drug Pricing (Premiums per person per month) RX Plan All Ages $ RX Benefits & Levels: RX Plan Prescription Deductible $0 Retail 30 Day Supply Tier 1 (Generics) $15 Tier 2 (Non-Preferred Generics) $15 Tier 3 (Preferred Brands) $60 Tier 4 (Non-Preferred Brands) $100 Tier 5 (Specialty) 33% Retail 90 Day Supply* Tier 1 (Generics) $45 Tier 2 (Non-Preferred Generics) $45 Tier 3 (Preferred Brands) $180 Tier 4 (Non-Preferred Brands) $300 Tier 5 (Specialty) N/A Mail-Order 90 Day Supply* Tier 1 (Generics) $30 Tier 2 (Non-Preferred Generics) $30 Tier 3 (Preferred Brands) $120 Tier 4 (Non-Preferred Brands) $200 Tier 5 (Specialty) N/A Part D Specifications Part D Gap Full Catastrophic Covered 100%** All Other Non-Part D Drugs Covered PRESCRIPTION DRUG PROVIDER: EXPRESS SCRIPTS (ESI) PHARMACY NETWORK: OVER 66,000 PHARMACIES NATIONWIDE. INCLUDES ALL MAJOR PHARMACIES (i.e. FRED S, WALGREENS, CVS, KROGER AND RITE AID) * 90 Day Supplies: Some drugs not available at 90 day supplies **Catastrophic Phase : $0.00 Member copay for all drug Tiers Page 4 of 8

5 3 DIFFERENT WAYS TO ENROLL 1. Complete the included Selection Form & Application and return in the envelope provided. (Postage Stamp Required) 2. Call Labor First at (855) to speak with a dedicated Member Advocate. (You will still need to send the completed Application(s) and Pension Form.) 3. If the above options do not fit your needs, please attend one of the group informational sessions. See back cover for information on meeting days, times and location. Who is Labor First? FREQUENTLY ASKED QUESTIONS Labor First is a Retiree Benefits Administrator & Advocacy Company that specializes in retiree healthcare, specifically for the union marketplace. Our dedicated Member Advocates are here to not only assist member with enrollment, but to provide ongoing retiree support to the MFFA sponsored Medical and Prescription Drug plan members for the life of the plan. 1. Does this plan have a Medical Network? No, the Facility or Provider just needs to accept Medicare in order to accept this plan. Additionally, referrals are not required under this United American (UA) Plan. 2. Do I still need my Medicare Card? Yes, you should show your provider your Medicare card and your United American card. The claim will automatically be processed by Medicare and UA. You will receive an EOB from both. 3. When does my Medical premium change if I have a Birthday? If you have a birthday that places you into a higher age bracket during the plan year, your premium increase will not go into effect until the start of the new year. i.e.: Birthdate is July 3, 2017, premium increase would begin January 1, (The shown rates are for 2017 only.) 4. How do I know which Medical plan to choose? Based on your age bracket and Doctor utilization one of the three plan options may be more suited to your needs. If you frequent the Doctors often or prefer no extra out-of-pocket expense after your premium each month, we recommend choosing the Plan F without the deductible. Page 5 of 8

6 5. Are my drugs covered? Most likely yes. This is a much more comprehensive drug plan than individual part D plans. You will receive an abridged Formulary with your Welcome Kit and cards. Note: There are several classes of drugs that are not covered such as lifestyle drugs. 6. Can I go to the same Pharmacy? Most likely yes. There should be little to no pharmacy disruption. You do NOT need new prescriptions for retail pharmacy fills. However, you will see the most cost savings using Express Scripts Mail Order Facility. 7. Is there a Mail Order Pharmacy? Yes, but you will need new prescriptions if you prefer to use the Mail Order Service. The Express Scripts Mail Order Facility number for members is (888) You can have your Doctor Fax Prescriptions to (800) Can I still go to the VA for my drugs? Yes. 9. Will my mail order prescriptions transfer from the old plan? No, you will need to obtain all new scripts from your Provider if you are using Mail Order. If you use a retail Pharmacy you do not need new prescriptions. 10. Do I need Prior Authorizations again for certain prescription medicines? Yes. Particular drugs require Prior Authorizations or may have quantity limits. This is standard in all Medicare type part D plans. Please contact Labor First if you have questions at (855) Can I obtain more detailed information on the Rx plan? Yes. Upon request an ESI pre-enrollment guide can be provided. 12. When will I receive my card/ Welcome Kit? Cards and Welcome Kits should be received around End of February or early March based on your enrollment date. Members and covered Spouses/Medicare Eligible Dependents will each receive their own cards and kits. UA Medicare supplement packets and ESI Rx packets are mailed separately and at different times. 13. Do I get to use my Tax Credit if I am a retired Public Safety Officer? Yes, the City will be participating in HELPS so you can continue to receive the Federal tax-credit. 14. Will my premium change? Yes. Premiums change on a yearly basis every January. Since these are group rated plans the increases tend to be smaller than seen in individual plans. Labor First will negotiate with the carriers each year to keep the costs as low as possible. 15. Is there a website? Yes. For additional information, you can go to Page 6 of 8

7 You are still eligible to enroll in these plans, even if you previously enrolled in a sponsored plan or an Individual plan!! If you have enrolled in a Medicare Supplement plan you will need to call the carrier and cancel the policy. In MOST cases, we are able to automatically dis-enroll you from an MAPD or Part D prescription drug plan, however, we do recommend you contact the carrier as well to ensure dis-enrollment is processed with Medicare. PAPER ENROLLMENT GUIDE Please make sure all three (3) are completed: (1) SELECTION FORM A form is required for each person. Please check the column and your age bracket for the option you would like to enroll in. (2) APPLICATION A form is required for each person Fill in all required information such as: name, date of birth (DOB), social security number, address and Medicare information Sign and date the bottom of the second page (3) PENSION DEDUCTION FORM One form is required for each household The person whose name is on the pension check should complete and sign this form. To complete enrollment, please follow one of the option below to submit your forms. Forms can be faxed to: (856) or ed to: RetireeFirst@laborfirst.com or Mailed to: 3000 Midlantic Drive, Suite 101, Mount Laurel, NJ For further information, please visit or call (855) Page 7 of 8

8 GROUP INFORMATION SESSIONS WEDNESDAY, FEBRUARY 8 TH AND THURDAY FEBRUARY 9 TH FROM 8:30 AM 3:30 PM Located: THE MEMPHIS PUBLIC LIBRARY 3030 POPLAR AVENUE MEMPHIS, TN FOR MORE INFORMATION ABOUT MEETINGS OR TO ENROLL OVER THE PHONE PLEASE CALL LABOR FIRST AT (855) Page 8 of 8