Retiree Health Insurance Benefits

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Sydney Floyd
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1 Retiree Health Insurance Benefits Kim Cinelli Micah Thompson Assistant Director Benefit Specialist x 6121 X Office of Human Resources

2 Agenda Retiree Health Insurance Options WSU/State of Kansas Plans Non-Medicare Plans Medicare Plans 2

3 Retiree Health Insurance Options What options do you have for retiree health insurance? Non Medicare Any WSU health insurance plan (A or C), at the retiree rate. COBRA Other private insurance Medicare eligible Medicare supplemental plan COBRA Other private insurance IMPORTANT!! If a retiree or spouse is Medicare eligible they must select a Medicare Plan. Who can help me decide the best coverage for me and my family? Senior Health Insurance Counseling Center for Kansas (SHICK) at (Medicare only). 3

4 State of Kansas Retiree Health Insurance Who do I talk to about my WSU/State retiree health insurance election? New retirees: WSU Benefits Team member Open Enrollment or other mid-year changes: Direct Bill Membership (State of Kansas) Where do I enroll for WSU/State retiree coverage? Enrollment Website: As a WSU/State retiree you now have a new health insurance Open Enrollment period: October 16 November 15. 4

5 State of Kansas Retiree Health Insurance IMPORTANT Non-Medicare retirees can keep what they have or change health insurance plan providers when they retire. WSU no longer pays a portion of your insurance. Dental Once you waive Dental coverage you can never re-enroll. You cannot have Dental coverage without a medical plan. You must stay on the WSU/State plan continuously in order to remain covered under the State Health Plan (Direct Bill) either as a primary member or a spouse. Once you waive medical coverage, you cannot return to the State Health Plan. Vision Only coverage does not qualify as enrollment in the State Plan. 5

6 State of Kansas Retiree Health Insurance IMPORTANT (continued) Flexible Spending Account (FSA) only available to pay for claims through the end of the month in which you retire Health Savings Account (HSA) continue to use your account balance, but you cannot make any more contributions Retiring at the end of the month will help you avoid any lapse in coverage or period of double coverage. COBRA insurance COBRA insurance can only be purchased in 1 month increments, and must start the day your previous insurance ended. Examples: If a Medicare retiree retires on 3/15/16, they would have a lapse in coverage from 3/16/16 to 3/31/2016 since Medicare always starts the 1 st of the following month. If a Non-Medicare retiree retires on 3/15/16 and gains other employment with insurance starting on April 1 st, they would have a lapse in coverage from 3/16/16 to 3/31/

7 State of Kansas Retiree Health Insurance Who do I call when I have a qualifying event, open enrollment questions, or an address change? Direct Bill Membership (State of Kansas) Your NEW Benefits Administrator Phone: benefits@kdheks.gov Website: What if I have questions about my monthly premiums? Hewlett Packard Member Services Your new billing administrator Phone:

8 Non-Medicare Eligible Options 8

9 Non-Medicare Eligible Option Plan A IMPORTANT Be sure to add all three monthly premiums: medical, vision & dental. 9

10 Non-Medicare Eligible Option Plan C (High Deductible Plan) IMPORTANT Be sure to add all three monthly premiums: medical, vision & dental. 10

11 Description Plan A Plan C Providers Deductible Coinsurance Medical/Pharmacy Out of Pocket Maximum Preferred Lab Adults and Children Annual Exams Prenatal Screenings/Counseling Age appropriate tests/ immunizations/hearing and eye exams 11 Non-Medicare Eligible Options Blue Cross Blue Shield or Aetna $400 Single $800 Family $2,750 Single $5,500 Family 20% No Member Coinsurance $4,750 Single $2,750 Single $9,500 Family $5,500 Family Yes 100% eligible Yes Discount on tests eligible tests Office Visits PCP $30 Copay Specialist $50 Copay Deductible Urgent Care $50 Copay Covered in Full Covered in Full Covered in Full Typically, 1 preventative visit is allowed per year IMPORTANT This comparison is based on Network Providers only Did you know that you can transfer your past State Health Plan DEDUCTIBLE payments? Call Direct Bill for details.

12 Non-Medicare Eligible Options Prescription Drug Benefits For full details go to ov/hcf/sehp/db 2016Book.htm 12

13 Non-Medicare Eligible Options Dental Benefits NEW RETIREE For full details go to ov/hcf/sehp/db 2016Book.htm 13

14 Non-Medicare Eligible Options Vision Benefits (Glasses) 14

15 Non-Medicare Eligible Options Vision Benefits (Contact Lenses) 15

Non-Medicare Eligible Options Medical & Pharmacy Comparison Tools IMPORTANT Castlight allows you to search network providers, check your current deductible

16 Non-Medicare Eligible Options Medical & Pharmacy Comparison Tools IMPORTANT Castlight allows you to search network providers, check your current deductible payments, and helps you compare prices and service ratings. Website: SEHP For full details go to ov/hcf/sehp/db 2016Book.htm 16

money on your prescription drugs Website: https://www.

17 Non-Medicare Eligible Options Medical & Pharmacy Comparison Tools IMPORTANT Rx Savings Solutions, is a pharmacy tool to help save you money on your prescription drugs Website: solutions.com For full details go to v/hcf/sehp/db 2016Book.htm 17

18 Medicare Eligible Options 18

19 Medicare Eligible Options IMPORTANT tips about Medicare Once you retiree, Medicare is your primary insurance (i.e., Medicare pays first) In order to enroll in any State of Kansas Medicare plan you must provide your Medicare Part A & B cards. All Medicare plans are individual plans. You must enroll your spouse and/or dependents separately under a non-medicare (under 65) or Medicare (over 65) plan. 19

20 Medicare Eligible Options IMPORTANT tips about Medicare (continued) Donut hole Generics - covered through the hole for all Part D plans Brand Names only covered through the Aetna plan. Creditable drug coverage Premium Rates Private market Your age matters on many private market plans. As you age your premiums will increase State Health Plan no change in cost based on age 20

21 Medicare Eligible Options Coventry options Blue Cross & Blue Shield options IMPORTANT If you choose Kansas Senior Plan C WITHOUT prescription drug coverage, you must enroll in another creditable drug plan OR you may be subject to fines when you attempt to re-enroll. 21

22 Medicare Eligible Options $$$$ Additional Costs include the cost of Medicare B (and, perhaps, prescription drug) coverage. See SHICK for details. $$$$ IMPORTANT Be sure to add all three monthly premiums for EACH enrolled participant: medical, vision & dental. 22

23 23 Medicare Eligible Options Coventry Advantra PPO Plans IMPORTANT You must enroll in a State Health Plan Part D (Drug) plan Coventry Part D Aetna Part D Advantra Plans are ONLY approved in the following states: Kansas Oklahoma Missouri Arkansas

Medicare Eligible Options Coventry Advantra PPO Plans Description* Freedom Liberty Premiums Per Month (Per person) Provider Coinsurance (for all eligible expenses, unless otherwise noted) With

24 Medicare Eligible Options Coventry Advantra PPO Plans Description* Freedom Liberty Premiums Per Month (Per person) Provider Coinsurance (for all eligible expenses, unless otherwise noted) With Coventry Part D $ With Aetna Part D $ With Coventry Part D $ With Aetna Part D $ Use provider of choice, based on network status and benefit plan description below. $0 $0 Deductible $0 $0 Network Annual Out of Pocket Maximum $1,000 $3,500 Non Network Annual Outof Pocket Maximum 20% Coinsurance to $4,100 35% Coinsurance to $7,500 Office Visits PCP $10 Specialist $25 Urgent Care $30 worldwide PCP $5 Specialist $30 Urgent Care $30 worldwide Physical Exam & Routine Tests $0 Immunizations Covered in Full 20% Coinsurance Hearing exam (1 per year) $0 $30 Vision exam (1 per year) $0 *Benefits on this slide apply to Network Providers only. 24

25 Medicare Eligible Options Kansas Senior Plan C Plan IMPORTANT You have the option to enroll in the following Part D drug plans Aetna (State Health Plan) Purchase prescription drug coverage on the Private Market The medical portion covers what Medicare does not pay (deductible and coinsurance). If Medicare does not cover a service, there is no medical benefit. Coverage is accepted by doctors and hospitals throughout the United States. Foreign travel emergencies are covered, with limitations. 25

26 Medicare Eligible Options Kansas Senior Plan C REMINDER Kansas Senior Plan C is offered through Blue Cross & Blue Shield For full details go to ov/hcf/sehp/db 2016Book.htm 26

Medicare Eligible Options Coventry Part D (Prescription Drug) IMPORTANT Coventry Part D covers through the donut hole, with unlimited coverage on

27 Medicare Eligible Options Coventry Part D (Prescription Drug) IMPORTANT Coventry Part D covers through the donut hole, with unlimited coverage on generic (Tier 1) drugs only. Tier 1-2 add $5 to copay Tier 1 add $5 to copay For full details go to Book.htm 27

28 Medicare Eligible Options Aetna Part D (Prescription Drug) IMPORTANT Aetna Part D covers through the donut hole, with unlimited coverage on generic and brand name drugs. 28

29 Retiree Health Insurance Checklist Pick a Health Insurance Option State of Kansas (Medicare vs. Non-Medicare) COBRA Private Insurance If Medicare eligible Send Medicare A&B Cards to HR Enroll in plan(s) HR will or call with details 29

Retirement and Health Insurance

Retirement and Health Insurance What do I need to know? What do I need to do? Things to Consider Age at Retirement Date of Retirement Supplemental Health Insurance State of Kansas Direct Bill Private Insurance