2016 NATIONWIDE RETIREE BENEFITS BULLETIN

Transcription

1 2016 NATIONWIDE RETIREE BENEFITS BULLETIN This bulletin describes benefit changes and coverage provisions effective Jan. 1, After you ve reviewed the information, decide if you need to make a change in your health care coverage. Submit the enrollment form only if you are making a change in the coverage shown on your personalized annual enrollment forms. For questions about coverage, see the 2016 Retiree Annual Enrollment Guide for contact information.

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3 IN THIS GUIDE Medicare-Eligible Retiree Coverage 2 Medical Coverage Options 2 Prescription Drug Coverage Options 2 Changes in Contributions 2 Non-Medicare-Eligible Retiree Coverage 4 Health Care Options and Coverage 4 Changes in Contributions 5 Health Savings Account (HSA) Contribution Limit Changes 6 All Retirees 6 Life Insurance Contribution Increase Household Members Benefits Changes Health Care Reform Enclosed with this bulletin is an updated Summary Plan Description and Schedule of Benefits that describe in more detail the coverage options available to you. Retiree benefits information is also available at nationwide.com/imretired.

4 MEDICARE-ELIGIBLE RETIREE COVERAGE You must be enrolled in both Medicare Parts A and B and pay any required Part B premium to enroll in a Nationwide-offered health care option. Medical Coverage Options For 2016 the coverage options offered through UnitedHealthcare (UHC) continue: UnitedHealthcare Group Medicare Advantage (PPO) Plan (MAPPO) UnitedHealthcare Senior Supplement Insurance Plan F (Plan F) UnitedHealthcare Senior Supplement Insurance Plan K (Plan K) There are no coverage changes for A complete summary of the plan provisions for each of the available options is described in the Summary Plan Description Schedule of Benefits (Appendix C). We will continue to offer retirees the opportunity to waive Nationwide-offered coverage to enroll in an Individual Medicare Advantage (Part C) Plan and, if eligible for cost-sharing, to receive a $70 credit per person per month into a Health Reimbursement Account (HRA). Refer to your personalized enrollment form for the coverage options that apply to you. You will automatically remain in your current coverage option if no action is taken. You do not need to take any action if you are satisfied with the coverage option you are currently enrolled in. You will need to complete an enrollment form during annual enrollment only if you wish to change your election(s). Prescription Drug Coverage Options Nationwide continues to offer two prescription drug plans (PDPs) for Medicare-eligible individuals: UnitedHealthcare MedicareRx for Groups Option 1 UnitedHealthcare MedicareRx for Groups Option 2 For 2016, the only change in prescription drug coverage is that coverage is updated to reflect the 2016 Medicare Part D coverage limits. For a complete summary of the plan provisions for each of the available options, please refer to the Schedule of Benefits (Appendix C) as part of the Summary Plan Description. Refer to your personalized enrollment form for the enrollment options that apply to you. You will automatically remain in your current coverage option if no action is taken. You will need to complete an enrollment form during annual enrollment only if you wish to change your election(s). Change in Contributions The medical and prescription drug option costs will increase starting in January The changes reflect the claims experience of the Nationwide group options and the expected increase in the price of prescription drugs and medical services. 2

5 MEDICAL OPTION COSTS Refer to your personalized annual enrollment form for the contribution that applies to you, based on your cost-sharing level. The chart below shows the total monthly cost - before any company cost-sharing - for a member in 2016, compared to The amount that you contribute depends on your individual cost-sharing and who you elect to cover. TOTAL MONTHLY COST 2015 PER MEMBER PER MONTH 2016 PER MEMBER PER MONTH UNITEDHEALTHCARE GROUP MEDICARE ADVANTAGE (PPO) PLAN UNITEDHEALTHCARE SENIOR SUPPLEMENT PLAN K UNITEDHEALTHCARE SENIOR SUPPLEMENT PLAN F $87.09 $91.01 $ $ $ $ PRESCRIPTION DRUG PLAN (PDP) COSTS If you elect one of the UHC PDPs, each Medicare-eligible individual enrolled in coverage will receive a monthly invoice directly from UHC. The cost for prescription drug coverage will increase in TOTAL MONTHLY COST * UNITEDHEALTHCARE MEDICARE Rx FOR GROUPS OPTION 1 UNITEDHEALTHCARE MEDICARE Rx FOR GROUPS OPTION PER MEMBER PER MONTH $89.49 ($54.49 if eligible for credit) $62.51 ($27.51 if eligible for credit) 2016 PER MEMBER PER MONTH $98.41 ($63.41 if eligible for credit) $68.76 ($33.76 if eligible for credit) *If you are eligible for cost-sharing and enroll in a Nationwide-offered health care option, you continue to be eligible for the $35 monthly credit for prescription drug coverage. 3

6 NON-MEDICARE-ELIGIBLE RETIREE COVERAGE HEALTH CARE OPTIONS AND COVERAGE In all locations, for 2016, you continue to have the choice of the PPO Premium option and two Health Savings Choice (HSC) options - HSC1 and HSC2. All available options are administered by UnitedHealthcare (UHC). The options you are eligible for will be displayed on your personalized enrollment forms. Consistent with changes in coverage options offered to associates, we expect to no longer offer the PPO Premium option in the future. You may wish to take this into consideration when making your 2016 election. Coverage Changes Advanced Control Specialty Formulary - Effective Oct. 1, 2015 A new Advanced Control Specialty Formulary will apply to certain drug classes of specialty medications. This means that certain specialty drugs will no longer be covered, where an alternative drug is available to treat the same condition. This new program generally applies to new prescriptions filled on or after Oct. 1, 2015, and replaces the current Specialty Step Therapy Program. (If you are immediately impacted, you and your physician will be contacted directly by CVS/caremark.) The Advanced Control Specialty formulary includes specialty generics and clinically effective brand therapies, and combines other specialty programs such as Specialty Guideline Management (SGM) to help ensure appropriate utilization. Members are required to try the preferred medication(s) within the drug class prior to receiving coverage for the non-preferred drug. The use of the preferred product will be evaluated with your doctor during the review process and medical necessity will be considered/granted if clinically appropriate. Changes to the drugs covered under any of the formulary lists can change periodically. A complete list of the formulary drug exclusions and the alternative preferred options are available by going to caremark.com/nationwide and click on Check Availability & Cost. Effective Jan. 1, 2016: The maximum co-payment for a 30-day supply of a specialty drug increases from $120 to $160. This reflects the sharply rising costs of specialty medications. If you have family coverage, the in-network out-of-pocket maximum for any individual in the family will be limited to $6,850. This means that once out-of-pocket expenses for any individual in the family reach $6,850, the plan will begin to pay 100% of all additional covered expenses for that person. If the total family out-of-pocket limit is reached for remaining family members, the plan will begin to pay 100% for all family members additional eligible expenses. This change does not apply to out-of-network benefits. Coverage Comparisons The chart below shows a comparison of 2016 in-network coverage between the options. Please review the 2016 Schedule of Benefits (Appendix B) for a more complete description of coverage. Coverage provisions vary for the PPO Premium option, compared to the HSC options. 4

7 PPO Premium HSC1 HSC2 Annual Deductible $ 700 for single coverage $1,400 for family coverage $1,500 for single coverage $3,000 for family coverage $3,000 for single coverage $6,000 for family coverage Annual Outof-Pocket Maximum $4,800 for single coverage $6,850 for an individual in family coverage $5,000 for single coverage $6,850 for an individual in family coverage $6,200 for single coverage $6,850 for an individual in family coverage $9,600 for family coverage $10,000 for family coverage $12,400 for family coverage When comparing HSC options, HSC2 may be best if you, for example, expect little or no health care expenses or, if you have an accumulated balance in your HSA to cover your health care expenses. If you are a UHC member, you can find a summary of your historical plan charges (the amount billed) by visiting MyUHC.com. In general, when comparing HSC1 and HSC2 coverage, HSC2 may provide a favorable financial benefit if you expect total in-network medical covered charges for the year to be less than $2,100 for single coverage and less than $4,200 for retiree and spouse coverage. For a complete summary of the plan provisions for each of the available options, please refer to the Schedule of Benefits (Appendix B) in the Summary Plan Description. CHANGES IN CONTRIBUTIONS Health care costs continue to increase. Consistent with national trends, based on an actuarial analysis of our health care plan(s) experience, an increase in funding is again required in 2016 due to increased claims and expected medical inflation. The chart below shows the total monthly cost prior to any company cost-sharing: PPO PREMIUM RETIREE ONLY $750 $815 RETIREE & SPOUSE $1,500 $1,630 RETIREE & CHILD(REN) $1,500 $1,630 FULL FAMILY $2,250 $2,445 HSC1 RETIREE ONLY $560 $605 RETIREE & SPOUSE $1,120 $1,210 RETIREE & CHILD(REN) $1,120 $1,210 FULL FAMILY $1,680 $1,815 HSC2 RETIREE ONLY $525 $565 RETIREE & SPOUSE $1,050 $1,130 RETIREE & CHILD(REN) $1,050 $1,130 FULL FAMILY $1,575 $1,695 5

8 Your cost as a retiree varies depending on your eligibility for and amount of company cost-sharing. Refer to your annual enrollment form for the contribution that applies to you. Be sure to evaluate all of your options to ensure you are making the best financial decisions for you and your family. Health Savings Account (HSA) Contribution Limit Changes If you enroll in a HSC option, you may have the opportunity to set aside pre-tax money in the Nationwide-offered HSA. The money set aside can be used tax-free to meet your deductibles, co-pays and other out-of-pocket qualified medical, dental and vision expenses. Any balance you have at the end of the year rolls over, so you can use it to pay qualified health care expenses in future years. It s yours to keep, plus, the balance can grow over time and you can choose the investment options that best fit your financial needs. The tax-code maximum contribution for 2016 has increased for family coverage. In 2016, the maximum amount you can contribute is $3,350 for an individual and $6,750 for a family. Individuals age 55 or older can also make an additional catch-up contribution of $1,000. ALL RETIREES Life Insurance Contribution Increase If you have retiree life insurance coverage and you contribute towards coverage, your contribution will increase beginning in January, Based on claims experience in the retiree life insurance contract, a rate increase of 15% will apply for 2016 and we expect that retiree life contribution rates will increase again in 2018 and The chart below shows the new contribution rates for 2016 compared to Coverage Amounts: Age*: (Monthly Rate Per $1,000 of coverage) $10,000 and under Over $10,000 $10,000 and under Over $10, $.50 $.50 $.58 $ $.58 $.58 $.67 $ $.58 $.58 $.67 $ $.58 $2.37 $.67 $2.73 *Based on age as of the end of the calendar year For example, if you are age 72 in 2016 and have $10,000 of retiree life insurance coverage, your monthly contribution will increase from $5.80 to $6.70; if $20,000 of coverage, your contribution will increase from $29.50 to $

9 You should have received an election form with your 2016 life insurance elections mailed to your home address. You may elect to decrease the amount of your life insurance coverage at any time by contacting the Associate Service Center. Household Member Benefits Changes Only currently enrolled Household members may continue coverage, if they continue to meet the eligibility requirements. As previously communicated, Nationwide is transitioning away from providing Household Member coverage is the final year for Household Member coverage. Here s what s changing in the coverage and contributions for 2016: - For non-medicare-eligible Household Members, the Advance Control Specialty Formulary and the change in the specialty drug co-payment described above also apply to medical coverage for Household Members. - For Medicare-eligible Household Members, all changes to the retiree health care coverage options described under Medicare-eligible retiree coverage of this bulletin will apply. - Household Member contributions will increase for health care coverage. If you currently have a Household Member enrolled, a Household Member Enrollment Packet is included in your annual enrollment materials. A summary of the coverage and required contributions are shown in the Household Member enrollment information. Please note: Elections for Household Members do not default into the prior year s coverage. You must actively re-enroll Household Members during annual enrollment. If you currently have a Household Member enrolled and did not receive the 2016 Household Member Enrollment Packet in your enrollment packet, you can call the Associate Service Center at Health Care Reform In 2010, the Patient Protection and Affordable Care Act, commonly referred to as health care reform, was first enacted with a number of key mandates. All individuals must have minimum essential health care coverage or pay a penalty. Coverage through Medicare or employer-offered coverage that meets the minimum essential requirements will satisfy the individual coverage requirement. Enrollment in a Nationwide-offered health care option meets the requirement to have minimum essential health care coverage. Alternatively, individuals who are not eligible for Medicare may purchase coverage through federal or state health insurance exchanges, called the Health Insurance Marketplace (Marketplace). You can visit healthcare.gov, the official government website for information and updates on health care reform and the Marketplace or call Health Advocate is also available to answer questions at In you are currently enrolled in Nationwide-offered health care coverage, for tax purposes, you will receive a new tax form In January 2016 with your 2015 coverage information. 7

10 QUESTIONS ABOUT ENROLLMENT OR THESE CHANGES? If you have questions about the changes explained in this bulletin or need help deciding which options are right for you, call Health Advocate at Select option 3 and tell the customer service representative you re a Nationwide retiree (or related to a Nationwide retiree) with questions about annual enrollment. Enrollment advocates are available weekdays 8 a.m. to 9 p.m. ET. If you have general questions about annual enrollment, eligibility, cost sharing or need help filling out your annual enrollment forms you can also call the Associate Service Center at or Source1@nationwide.com. This bulletin describes benefit changes that take effect January 1, 2016 (except where otherwise indicated). For a more complete description of coverage, refer to the updated Summary Plan Description and the 2016 Schedule of Benefits (Appendix B and C) enclosed in your packet of benefit materials. This information can also be found at nationwide.com/imretired. For options and contribution amounts specific to you, refer to your personalized annual enrollment information. 8

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12 Analysts from the Associate Service Center can answer your questions about enrollment. Call the Associate Service Center at or CPR-0225AO.2