Dominion Retiree Medical

Transcription

1 Dominion Retiree Medical A New Approach to Retiree Medical Benefits Providing Options to Medicare Eligible Retirees Information for Retirees August 2013 HR and Executive Briefing 2013 Dominion

2 Agenda A Message from Tom Farrell New Approach Benefits to Change Who s Affected Introducing Extend Health Transitioning from current coverage What you need to do Your questions 2013 Dominion 2

3 Tom Farrell Chairman, President & CEO Dominion 2013 Dominion 3

4 New Approach Dominion provides more choices to our non-union retirees age 65 and older and will continue to subsidize the cost of coverage. This new approach offers the following enhancements: Multiple plans, many at lower cost Annual stipend funded into a Health Reimbursement Account (HRA), indexed over time to reflect medical cost increases Catastrophic Coverage: 100% reimbursement for eligible prescription drug expenses incurred beyond a certain dollar amount Dedicated and licensed benefits advisors to help with plan choices Transition begins January 2, 2014 with a 3-month open enrollment period. Coverage is effective April 1, Dominion 4

5 Why This Approach Benefits to Retirees More plan options, many at lower cost Protection in the event your prescription drug costs are high A financial subsidy that is indexed to reflect increases in medical costs Dedicated and licensed benefits advisors who will help you choose the best plan for you and provide ongoing advocacy for claim issues Benefits to Dominion Ability to ensure affordable high-quality, ongoing coverage to retirees Immediate and long-term reduction in health care costs 2013 Dominion 5

6 Who s Affected: Non Union Retirees Retirees 65 and Older and their covered spouses Retired on or after Jan. 1, 1993 Transition to Extend Health exchanges Some exceptions apply Retirees Pre-65 and their covered spouses Continue coverage under the current Dominion retiree medical plan until age 65 Transition to Extend Health when reach age 65 Some exceptions apply Future Retirees and their covered spouses Offered medical plans from the exchange when they reach age Dominion 6

7 Who s Affected: Those with HMOs Retirees in parts of Pennsylvania, Ohio, and Arizona Currently offered Medicare HMOs (not traditional retiree coverage) Legacy of the CNG merger; Dominion does not subsidize this cost Three future exchange scenarios based on retirement date Retired between & : One time choice Remain in subsidized HMO Enroll through Extend Health and receive an annual stipend Retired after & before : Ineligible for the stipend Offered Extend Health services to help them shop for a plan Retired on or after Eligible to enroll through Extend Health Cost of coverage will be subsidized by Dominion with annual stipend 2013 Dominion 7

8 Over time, Dominion retiree medical plan design has changed, with more cost shifting to the retiree Stipends are reflective of the portion that Dominion pays Those who retired years ago will have a higher stipend than those who retired more recently, or those who will retire in the future With HRA funding from Dominion, most retirees will be able to purchase insurance that provides equivalent or better benefits, with many plans available at a lower cost 2013 Dominion 8

9 2014 Retiree Stipends Retirement Date Other Criteria Retiree Annual Stipend Spouse Annual Stipend Before None Stay on the Dominion plan to Dominion retiree (excludes pre-merger CNG retirees) $2,800 $2, to Pre-merger CNG retiree $2,000 $1, to None $2,000 $1, Dominion 9

10 2014 Retiree Stipends Retirement Date After Other Criteria Retiree Annual Stipend Spouse Annual Stipend Age 55 or older on $2,000 $1,800 After Age 53 or 54 on $1,800* $1,300* After Age on $1,500* $1,150* After Age on $1,300* $1,000* * Reduced if less than 30 years of service 2013 Dominion 10

11 2014 Retiree Stipends Retirement Date Other Criteria Retiree Annual Stipend Spouse Annual Stipend Before None Stay on the current plan to Choice or Medicare HMO or traditional coverage $2,000 $1,800 On or after Age 55 or older on $2,000 $1,800 On or after Age 53 or 54 on $1,800* $1,300* On or after Age on $1,500* $1,150* On or after Age on $1,300* $1,000* * Reduced if less than 30 years of service 2013 Dominion 11

12 How Can Retirees Pay Less: Example: Average Age 75 in 2014 with 30 years of service Example of Richmond, VA retiree aged 75 requiring an ambulance with overnight hospitalization, cardiologist and primary care provider visits, and prescription drugs for their heart and cholesterol Cost Item (Annual) Current Plan Full Coverage Medigap, and Rx Plan Medicare Advantage Plan (HMO) Medicare Advantage Plan (PPO) Medicare Part B Premium $1,259 $1,259 $1,259 $1,259 Medical Plan Premium / Contribution $485 $2,597 $0 $600 Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above Medical Out-of-Pocket Costs $1,042 $0 $955 $1,135 Drug Out-of-Pocket Costs $240 $472 $500 $500 Stipend N/A ($2,000) ($2,000) ($2,000) Total Costs $3,026 $2,816 $714 $1,494 Decrease in Total Costs Decrease of $210 Decrease of $2,312 Decrease of $1,532 Notes: Actual changes in total costs will depend on each individual s circumstance, stipend cannot be used to reimburse drug out of pocket cost, stipend amount varies based on age, years of service, and retirement date 2013 Dominion 12

13 How Can Retirees Pay Less: Example: High Medical Cost Scenario Age 75 in 2014 with 30 years of service Example of Richmond, VA retiree aged 75 requiring major medical services including surgery, a 9 day hospitalization, several follow-up specialist visits and drugs to manage a heart condition Cost Item (Annual) Current Plan Full Coverage Medigap, and Rx Plan Medicare Advantage Plan (HMO) Medicare Advantage Plan (PPO) Medicare Part B Premium $1,259 $1,259 $1,259 $1,259 Medical Plan Premium / Contribution $485 $2,597 $0 $600 Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above Medical Out-of-Pocket Costs $1,816 $0 $3,400 $3,795 Drug Out-of-Pocket Costs $360 $896 $1,000 $1,000 Stipend N/A ($2,000) ($2,000) ($2,000) Total Costs $3,920 $3,240 $3,659 $4,654 Decrease in Total Costs Decrease of $680 Decrease of $261 Increase of $734 Notes: Actual changes in total costs will depend on each individual s circumstance, stipend cannot be used to reimburse drug out of pocket cost, stipend amount varies based on age, years of service, and retirement date Dominion 13

14 What do you need to do? If either you or your spouse are age 65 or will turn age 65 between now and April 1 st, action is required. If either you or your spouse are not age 65 and will not turn age 65 between now and April 1 st, no action is required at this time Dominion 14

15 Introducing Extend Health Dominion will offer private Medicare exchanges to non-union participants age 65 and older through Extend Health, a private health insurance exchange. Again, these are not the same exchanges that are now open to everyone Extend Health, a Towers Watson company, is the largest private Medicare exchange that Provides a wide selection of carriers and coverage options Works with many companies and unions Provides customized support for retiree needs 2013 Dominion 15

16 The Industry s Largest Medicare Exchange

17 Extend Health, a Towers Watson Company Extend Health works with many companies and unions DuPont, Southern States, Media General, Ford, Alliant Energy, IBEW, First Energy, CSX, Advance Auto Parts, City of Chesapeake, IBM and Time Warner Companies utilizing this approach continue to grow Largest private Medicare exchange Serving more than 300 companies, including 50 in the Fortune 500 Wide selection of plans 90+ national and regional carriers, including Anthem Customized support for retiree needs Retirees receive one-on-one help from licensed benefit advisors to choose their plans and ongoing advocacy with claim issues

18 Next year, we are changing our name! Towers Watson acquired Extend Health in May 2012 Next year, we will become fully integrated with our parent company. We will drop Extend Health from our name and become Towers Watson s OneExchange We will send you a notice to let you know when the change is complete Look for the Towers Watson and OneExchange logos: 18 towerswatson.com 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

19 Plans & Partners All Medicare Plan Types Medicare Advantage Medicare Supplement (aka Medigap) Prescription Drug (Part D) Dental / Vision Over 90 National/Regional Carriers 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only. 19

20 The Process. Educate. Evaluate / Enroll. Manage 20

21 Education Getting Started Guide Gather information (e.g. prescriptions) Pre-existing conditions will not limit your plan selection* Give us a call * except end-stage renal disease 21

22 Education Enrollment Guide Prepare you for your enrollment discussion Review Medicare basics Appointment confirmation letter 22

23 Decision Support Tools Help Me Choose Prescription Profiler Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only. 23

24 Evaluate and Enroll Licensed Benefit Advisor 100% domestic workforce Objective advocacy Neutral compensation Extend University Licensed, certified, appointed Average age 43 Hours of Operation Monday Friday 8 a.m. 9 p.m. Eastern Time 24

25 Enrollment Process Benefit Advisors can discuss coverage options with anyone need to speak to the participant to complete the enrollment Once you have made a coverage selection, enrollment is conducted via telephone 100% of calls are recorded 25

26 Medicare and You 26

27 Your Future Coverage Primary Medicare A Medicare B Your Future Coverage Additional Medigap Medicare Advantage Part D Optional Dental Vision 27

28 Medicare Plan Types 28

29 Medicare Plan Types 29

30 Medicare Prescription Drug Coverage Initial Coverage. You Pay Deductible an co-pays for our plan Coverage for the first $2850 in actual cost of medications Coverage Gap. You Pay 47.5% of Brand Name and 72% of Generics Until your out of pocket cost reach $4550.Catastrophic Coverage You Pay $2.55 for Generics and $6.35 for Brand Name Or 5% whichever is greater 30

31 Catastrophic Coverage Additional financial support provided by Dominion for retirees with significant pharmacy claims Benefit reimburses any prescription drug costs incurred after the Medicare Part D TrOOP maximum is reached for a retiree or eligible dependent within the plan year If you qualify, contact Extend Health for assistance What is Medicare Part D TrOOP? TrOOP is the true out-of-pocket maximum that includes the cost of prescription drugs incurred during the year including any deductible, coinsurance co-pays and payments made in the coverage gap, or doughnut hole. Premiums do not count toward TrOOP. The 2014 amount is $4,

32 Location Specific Plans 32

33 Plans Available in Richmond, Hampton Henrico, and Virginia Beach City or County Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 8 $0 - $81 Medigap/ Medicare Supplement 14 $58 - $202 Part D 17 $13 - $115 33

34 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $41 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 34

35 Medicare Advantage Plan Benefit Cost Monthly Premium $40 Network PPO Deductible $1000 Doctor Copay $15 Specialist Copay $40 Hospital $260 co-pay per day - days 1-7 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply Mail Order $0/ $0/ $125/ $ day supply 35

36 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $218 ($202 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 36

37 Plans Available in Chesterfield County (VA) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 8 $0 - $81 Medigap/ Medicare Supplement 14 $60 - $218 Part D 17 $13 - $125 37

38 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $41 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 38

39 Medicare Advantage Plan Benefit Cost Monthly Premium $50 Network PPO Deductible $1000 Doctor Copay $15 Specialist Copay $40 Hospital $260 co-pay per day - days 1-7 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply Mail Order $0/ $0/ $125/ $ day supply 39

40 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $218 ($202 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 40

41 Plans Available in Charlottesville City (VA) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 4 $0 - $81 Medigap/ Medicare Supplement 14 $60 - $216 Part D 17 $13 - $115 41

42 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $41 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 42

43 Medicare Advantage Plan Benefit Cost Monthly Premium $62 Network PPO Deductible $500 Doctor Copay $15 Specialist Copay $40 Hospital $275 co-pay per day - days 1-6 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $6/ $16/ $45/ $95/ 33% 30 day supply Mail Order $0/ $0/ $125/ $ day supply 43

44 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $218 ($202 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 44

45 Plans Available in Cuyahoga County (OH) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 20 $0 - $165 Medigap/ Medicare Supplement 24 $79 - $259 Part D 18 $13 - $119 45

46 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $36 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 46

47 Medicare Advantage Plan Benefit Cost Monthly Premium $39 Network PPO Deductible $500 Doctor Copay $5 Specialist Copay $30 Hospital $150 co-pay per day - days 1-5 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $4/ $20/ $42/ $85/ 33% 30 day supply Mail Order $10/ $50/ $105/ $ day supply 47

48 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $234 ($218 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 48

49 Plans Available in Allegheny County (PA) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 13 $40 - $224 Medigap/ Medicare Supplement 11 $92 - $348 Part D 16 $13 - $169 49

50 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $39 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 50

51 Medicare Advantage Plan Benefit Cost Monthly Premium $40 Network PPO Deductible $1250 Doctor Copay $10 Specialist Copay $50 Hospital $200 co-pay for each stay Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $10/ $45/ $95/ 33% 30 day supply Mail Order $20/ $112/ $ day supply 51

52 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $281 ($258 Medigap + $23 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $12/ $40/ $90/ 33% 30 day supply Mail Order $0/ $24/ $80/ $ day supply 52

53 Plans Available in Kewaunee County (WI) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 4 $0 - $112 Medigap/ Medicare Supplement 12 $120 - $231 Part D 15 $13 - $137 53

54 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $27 - $39 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 54

55 Medicare Advantage Plan Benefit Cost Monthly Premium $42 Network PPO Deductible $1000 Doctor Copay $10 Specialist Copay $40 Hospital $264 co-pay per day - days 1-7 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $6/ $15/ $45/ $95/ 33% 30 day supply Mail Order $0/ $0/ $125/ $ day supply 55

56 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $232 ($188 Medigap + $44 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $4/ $7/ $40/ $85/ 33% 30 day supply Mail Order $0/ $7/ $115/ $ day supply 56

57 Plans Available in Fairfax County (VA) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 6 $0 - $81 Medigap/ Medicare Supplement 14 $58 - $202 Part D 17 $13 - $115 57

58 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $22 - $41 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 58

59 Medicare Advantage Plan Benefit Cost Monthly Premium $77 Network PPO Deductible $750 Doctor Copay $15 Specialist Copay $40 Hospital $250 co-pay per day - days 1-7 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $7/ $45/ $95/ 33% 30 day supply Mail Order $14/ $90/ $ day supply 59

60 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $218 ($202 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 60

61 Plans Available in Harrison County (WV) Plan Type Number of Plans Offered 2014 Monthly Premium Medicare Advantage 15 $0 - $170 Medigap/ Medicare Supplement 15 $73 - $229 Part D 17 $13 - $169 61

62 Ancillary Coverage Plan Type Number of Plans Offered 2014 Monthly Premium Company $14 per person per month Vision 1 Dental 1 Annual eye exam: $5 Coverage for eye glasses, lenses and frames $19 - $36 $50 deductible $1,000 annual maximum Vision Service Plan (VSP) Delta Dental, Humana 62

63 Medicare Advantage Plan Benefit Cost Monthly Premium $40 Network PPO Deductible $1000 Doctor Copay $15 Specialist Copay $40 Hospital $260 co-pay per day - days 1-7 Emergency Room $65 co-pay if not admitted Rx Deductible $0 Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply Mail Order $0/ $0/ $125/ $ day supply 63

64 Medigap Plan F and PDP (75 yr old male) Benefit Cost Monthly Premium $218 ($202 Medigap + $16 PDP) Network Any doctor that accepts Medicare Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx Deductible $0 Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply Mail Order $0/ $32/ $80/ $ day supply 64

65 Health Reimbursement Arrangement Account Auto-Reimbursement Auto-Reimbursement How the Process Worksent 65

66 What Is An HRA Tax-advantaged account used to reimburse you for eligible health care expenses You must meet Dominion s eligibility requirements to qualify for HRA Your HRA funds will be available April 1, 2014

67 Health Reimbursement Arrangement (HRA) HRA Account Dominion allocates benefit dollars to each retiree s HRA account Participant works through Extend Health to enroll in individual coverage Retirees are reimbursed for eligible health care expenses using HRA benefit dollars extendhealth.com 67

68 Reimbursement options 1. Paper Claims One time or recurring claims forms Fill out form Attach required documentation Submit via Mail, Fax or Web Available for all expense types 2. Automatic Reimbursement Enroll in a participating plan Ask to select option Pay premiums as required Available for plan premiums only 68

69 How to File a Paper Claim Participant pays plan premium or co-pays Extend Health reimburses participant Participant fills out claim form, attaches required information Extend Health verifies receipt of payment and eligibility 69

70 Extend Health HRA Claim Form Remember, You can be Reimbursed for Part B by sending in your statement 70

71 How Auto-Reimbursement Works Participant pays plan premium to insurance company Extend Health reimburses participant Insurance company forwards receipt of payment to Extend Health Extend Health verifies receipt of payment and eligibility 71

72 Auto-Reimbursement (AR) Service offered by Extend Health Available on most plans Works for premium reimbursement only No claim form is required Can take 2-3 billing cycles to initiate If you need your reimbursement sooner, simply file a paper claim. The form and instructions will be provided in your HRA Welcome Kit 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

73 Next Steps 73

74 How This Affects You What you pay May change depending on what coverage you choose Company contribution to your HRA = Up to $200 per month ($100 for retiree and $100 for one dependent) How you enroll You will work with Extend Health to enroll in a plan that meets your medical and prescription needs. We will also help you establish your Health Reimbursement Account Your support Extend Health Advisors will help you understand the costs associated with your coverage premiums, co-payments, deductibles and all other costs

75 Between January and April, 2014 During the transition: You will keep your existing medical plan Your deductible will be waived (except for those currently enrolled in Medicare HMO) Your HRAs will be prorated in 2014 to reflect 9 months coverage Beginning December 10, 2013 you can call Extend Health with questions 75

76 Next Steps 76

77 Next Steps Review The Getting Started Guide Gather Prescription and Doctor Information Call Extend Health One Exchange

78 Post Enrollment Customer Service Advocacy and support services Toll Free number to contact Extend Health representative Direct support for claims issues, appeals and network questions Renewal process ability to pick new coverage for future years not locked into this year s choice Ongoing enrollment services 78

79 Questions 79