2018 Connector Access Guide

Transcription

1 2018 Connector Access Guide

2 OneExchange is now Via Benefits! Please make a note of our new name and logo as you will be receiving information from Via Benefits for your Medicare coverage choices. 2 Contact us by phone:

3 IMPORTANT! The deadline to enroll in new Medicare plans is CoverageEndDate. How to Contact Us Please take a moment to review this guide and learn how Via Benefits Insurance Services can help you evaluate your options on the phone or online without any commitment. Most retirees are able to find coverage equal to or better than their current plan often with savings when they choose a plan from our marketplace. Best of all, our services are provided at no cost to you or your spouse. If you are interested in learning what Via Benefits has to offer, contact us by CoverageEndDate. Allow one hour to review your options and complete an enrollment. Contact us by phone (TTY: 711) Monday through Friday, 8:00 a.m. until 9:00 p.m. Eastern Time Review your options online My.ViaBenefits.com/OPERS OPERS U1C-CAG-CL-OPERS-2018-REV-1 Go online: My.ViaBenefits.com/OPERS 3

4 Connector Access Take advantage of the country s largest private Medicare marketplace Dear FirstName LastName, OPERS has selected Via Benefits to help you decide whether coverage offered in our Medicare marketplace might suit your needs better than your current coverage. By enrolling in a medical plan through Via Benefits, you may be eligible to receive a Health Reimbursement Arrangement (HRA) allowance to help you pay for your health care coverage. To find out if you are eligible to receive an HRA allowance, please contact Via Benefits. Take a moment to review the enclosed guide, which describes the different options available to you. Most retirees find the plans in the Via Benefits Medicare marketplace offer coverage equal to or better than their current plan, sometimes with significant savings. Please note that all plans are not guaranteed issue, and you may be required to undergo medical underwriting before your application is accepted. A Via Benefits licensed benefit advisor will be happy to speak with you about all your options. We offer objective advice from licensed benefit advisors whose compensation is never tied to the plan or carrier you choose. Their priority is to match you with a plan that fits your needs and budget. We are pleased to have the opportunity to help you make an informed and confident decision as you evaluate your Medicare coverage options. We look forward to working with you! 4 Contact us by phone:

5 Contact Via Benefits To take advantage of the services of Via Benefits, contact us by CoverageEndDate. Please allow at least one hour for your call to evaluate your options and complete your enrollment (TTY: 711) Monday through Friday, 8:00 a.m. until 9:00 p.m. Eastern Time Not ready to call? Take a moment to visit us online at the website address printed at the bottom of this page. Our powerful, easy-to-use online tools will help you evaluate your options, with no commitment. Sincerely, The Via Benefits team Go online: My.ViaBenefits.com/OPERS 5

6 6 Contact us by phone:

7 Funding and Reimbursement Your retirement system sponsors funding to help reimburse you for eligible expenses OPERS provides tax-free funding through a program known as a SubsidyAccountFullName. Once you have paid for eligible health care expenses, you may be reimbursed directly from the Subsidy- AccountFullName fund, to the extent they are available. Qualifying for your funding To access these funds you must meet certain qualification requirements, which may include completing your Medicare enrollment and maintaining your coverage through our Medicare marketplace. Your benefit advisor can discuss your specific qualification rules during your enrollment call. Once you have qualified, your SubsidyAccountFullName (SubsidyAccountAbbreviatedName) will be established on HRAStart- Date, with a HRAFrequency credit of HRA Amt. Request reimbursement Via Benefits is the administration service provider of your funding program. Once you qualify, you will submit your reimbursement requests to us. Eligible expenses The retirement system determines reimbursable expenses, which vary by program; that is why we can t give you a list in this guide. However, you will receive a mailing with a list of reimbursable expenses, along with instructions explaining how to access your funding account, and how to submit reimbursement requests. This mailing will arrive about two weeks before your new coverage starts. In the meantime, if you have questions about your funding, a Via Benefits customer service representative will be happy to answer them. U1C-CAG-FUND-COND-OPERS-2018-REV-1 Go online: My.ViaBenefits.com/OPERS 7

8 Automatic Premium Reimbursement Automatic Premium Reimbursement allows you to be reimbursed without submitting a monthly form for premiums only, not for other eligible medical expenses. This feature is available for many of the plan options on the Via Benefits marketplace. If you d like to take advantage of this feature, ask your licensed benefit advisor during your call. You can also turn auto reimbursement on and off from your online account. Note that Automatic Premium Reimbursement reduces the inconvenience of submitting requests for premium reimbursement each month. It is not intended to be the fastest method to receive reimbursement. Most of the time, Automatic Premium Reimbursement payments start to arrive two to three months after the start of your plan. The first payment typically includes a reimbursement for the first two months. Some of this timing depends on your insurance carrier and when your policy was issued. Ongoing Automatic Premium Reimbursements will usually arrive about the same time each month. If you don t activate or your plans does not offer Automatic Premium Reimbursement, you will submit a monthly or recurring reimbursement request to Via Benefits. Direct deposit Direct deposit is mandatory to receive your reimbursements. You can set up direct deposit by calling Via Benefits, or you can turn direct deposit on from your online account. 8 Contact us by phone:

9 How Funding and Reimbursement Works Select your plan(s) and qualify for funding Select your plan(s) in our Medicare marketplace. Your benefit advisor can discuss your specific qualification requirements during your enrollment call. Once you have qualified, we will open your account and become the administrative service provider for your funding program. 1. Pay for your expenses Make your payments for eligible health care expenses directly to your health care provider. 2. Submit reimbursement requests Submit a reimbursement request for eligible health care expenses to Via Benefits. Ask your licensed benefit advisor how to activate automatic reimbursement for your eligible premiums. 3. We reimburse you from your funding program Via Benefits will reimburse you for eligible expenses from the available funds. Your reimbursement will be directly deposited into the bank account you use through your retirement system. You may change the account, but direct deposit is required. You will receive a mailing about two weeks before your new plan starts. This mailing will explain in detail all aspects of your funding arrangement. Go online: My.ViaBenefits.com/OPERS 9

10 10 Contact us by phone:

11 Introducing Via Benefits Trusted advisor to more than a million Medicare-eligible participants Health care coverage decisions are important. If you are thinking of changing from your current plan, deciding which plan or plans to choose can be challenging, because there are so many different types of plans, carriers, and costs. Via Benefits is here to help you sort it all out. Over one million people have turned to us for help deciding on a plan that best matches their needs and budget. The nation s first and largest private Medicare marketplace Via Benefits is not an insurance company. We are the country s largest and oldest private Medicare marketplace. We offer individual Medicare plans Medicare Advantage, Medicare Supplement Insurance (Medigap), and Part D Prescription Drug plans from more than 90 national and regional insurance companies. Since 2004, we have offered personalized service and assistance to satisfied customers throughout the country. Personalized service Although we serve over one million people like you, you re never a number to us. We treat you as an individual. We take the time you need to evaluate your options and make a choice that fits your needs and budget. And, we ll do the same thing separately for your spouse or your other Medicare-eligible dependents, too. U1C-CAG-OPERS-2018-REV-1 Go online: My.ViaBenefits.com/OPERS 11

12 Why Via Benefits? Choice, service and support A better way to find coverage You can choose to shop for plans using our online marketplace or on the phone by speaking with a Via Benefits licensed benefit advisor. By phone, our website or both, you ll find expert help with narrowing your choices down to the plan or plans that fit your needs and budget. Quality plans We work with top national and regional companies to ensure you are able to choose among quality individual plan options. All plans are evaluated for value and customer service by Via Benefits. Comparable or better prices What you pay will ultimately depend on the type of coverage you select. Our research shows that many people pay less, and some pay more depending on the level of coverage they choose and what type of plan they currently have. You may find plans with richer coverage, better value, or a different network a plan that better suits your individual needs. We take the time to understand your needs Our licensed benefit advisors are dedicated men and women who take the time to understand your needs. Then they help you find and enroll in a plan that matches your unique circumstances. We base our hiring on strict criteria. Our service centers are U.S.-based. The average age of our staff is 41. Before ever taking a call, Via Benefits licensed benefit advisors undergo extensive training. They must pass certification tests by the insurance companies we represent and they must be state licensed. Each year they need to be recertified and licensed. 12 Contact us by phone:

13 In addition, we value and reward skills like compassion, dedication, and warmth. Your enrollment call will be handled with the patience and understanding you deserve, and we will never rush you off the phone. It s your choice Licensed benefit advisors are objective advocates, with no financial incentive or reward to sell one insurance company or type of plan over another. So you can be sure that they base their recommendations on YOUR needs. Ease of enrollment Via Benefits will complete your application over the phone and submit it electronically. You won t have to fill out any paperwork, or worry about whether your application is accurate. Support after you enroll When you enroll in a Medicare plan through our marketplace, we continue to be your advocate for as long as you stay enrolled in your plan. And we ll help you year after year! If your needs change or you move, contact us to determine if your plan is still the right one for you. We welcome the opportunity to help you make changes so that you never run the risk of losing your coverage. Go online: My.ViaBenefits.com/OPERS 13

14 Evaluate Your Options Online or on the phone, take a few moments to see how easy we make it to shop and compare Help to research your options If you use a computer, visit our website (address located at the bottom of every other page in this document). Give yourself some time to explore your options, keeping your health care priorities in mind. Our website makes it easy to compare plans. If you don t use a computer, or don t have access to one through a friend, family member, or your local library, just call us. We ll help you shop by phone. Shop & Compare The Shop & Compare section of our website allows you to search for plans available in your area and sort them by price, plan type, insurance company, and other factors. With just a few clicks, you can compare plans side by side and review the details of the plans that interest you. Use your shopping cart If you shop online before your enrollment call, place the plans you like in your shopping cart. Your licensed benefit advisor will be able to see the plans in your cart and talk to you about them, answering any questions you have, and then help you complete the enrollment process. 14 Contact us by phone:

15 Finding plans and plan details All plans available in our Medicare marketplace offer their summary of benefits for review online, with the exception of AARP plans. If you d like to review the summary of benefits of a plan that interests you, click on the plan s name in the search results, and then click on the View link in the Outline of Coverage/Summary of Benefits row of the plan details. You can enroll in a UHC AARP Medigap plan through Via Benefits. It is the policy of UHC AARP to not post premiums on the Via Benefits marketplace. Speak with a licensed benefit advisor to get information, including premiums, on UHC AARP plans. Help Me Choose Help Me Choose simplifies the search process by matching your needs to the plans that offer a good fit. All you need to do is answer some easy questions. To use Help Me Choose, click any Help Me Choose link on the site. Prescription Profiler Prescription Profiler is a powerful tool that lets you find plans with prescription drug coverage based on your lowest estimated annual out-of-pocket cost. Enter your current medications when creating your personal profile, and then click any Prescription Profiler link. Answers to your questions Clicking the Help tab brings you to our searchable knowledge base of frequently asked questions. Topics covered include hopping for plans, billing and premiums, benefits and coverage, and more. My Account and Personal Profile Creating an account on our website allows you to save your prescription drug information, add family members, search for and save plans, and track the status of applications. To create an account, just click the My Account link. Go online: My.ViaBenefits.com/OPERS 15

16 Once you create your account, consider taking the next step by completing your personal profile. The Personal Profile section of our website allows you to save information on your medical preferences and history. Saving this information helps to ensure an accurate and efficient enrollment. Even if you choose not to create an account or complete your personal profile, you re still able to search for plans online and compare your options. Security and privacy Our website is secure, and we guard your privacy. In fact, we consider protecting your security and privacy to be such a top priority that we continuously monitor our systems to ensure it. Frequently Asked Questions Via Benefits has helped over one million individuals enroll in Medicare plans. This list of frequently asked questions is based on our experience working with retirees every day. Will my new plan be as good as my current plan? We work with the top national and regional insurance companies to ensure that you will have quality individual plan options. Individual plans might be similar to your current plan, but you may be surprised to learn that a different plan could be better suited to your needs. Since we offer multiple options, you ll be able to find a plan that closely matches your specific needs. What can I expect to pay for my new plan? What you will pay depends on the type of plan that you select. Generally, Medicare Advantage plans have lower premiums than Medigap plans, but require copayments for services. Medigap plans tend to have higher premiums with low or no copayments for services. During your call, your licensed benefit advisor will work with you to understand the costs and the benefits of the different coverage options available to you. 16 Contact us by phone:

17 Can I continue to use the same insurance company? In many cases, yes, you can. If you have an employer-sponsored plan, it usually works differently than individual health plans, even if it is from the same insurance company. If you have an individual health plan, we may be able to find a plan that is more tailored to your specific needs. We ll help you compare your options to see specifically how each plan fits your needs. Your current insurance company may provide the right plan, or you may discover that another insurer offers a plan that is a better fit. Will Via Benefits be available to help me next year? Yes. When you purchase a Medicare supplemental plan through Via Benefits, we continue to be your advocate as long as you stay enrolled through us. If your medications or needs change, or you move, you may contact us any time to help you figure out if your plan is still the right one for you. We are happy to help you make changes if necessary. Will I pay more for a plan I purchase through you than one I purchase directly from the insurance company? No. You will pay the same amount for your monthly premium whether you go through us or not. The insurance companies pay our business a commission when we enroll you in a plan, but we do not tie our licensed benefit advisors compensation to any particular plan or company. They receive a salary, and we rate them on how satisfied you our customers are with their service. Go online: My.ViaBenefits.com/OPERS 17

18 Call Us Check out our website or give us a call and find out how easy enrollment can be. You have nothing to lose there are no pushy sales people and your information is private. You ll find our phone number printed on every other page of this document. To connect you accurately, our automated system will ask a few questions. Since we want to connect you to a licensed benefit advisor for your state, you ll need to provide your ZIP code and the last four digits of your Social Security number. If you go forward with enrollment, you will talk with other representatives both before and after you speak with your licensed benefit advisor. These customer service agents may collect your personal information, help you complete applications or answer other questions. Most people complete the entire process in one call, which can take up to one hour. You are also welcome to have a family member or trusted friend assist you on the call. Note: Due to legal requirements, you may have to confirm some information multiple times and listen to recorded messages specific to the coverage you select. 18 Contact us by phone:

19 Consider your priorities We will ask you a few questions to evaluate your needs accurately. You may want to prepare in advance, and write your answers on a separate piece of paper. You can then refer to them during your call. Have you found a plan that interests you? Write down the name, along with the reasons you like it. Is it important for you to keep your current doctors? How many doctors or specialists do you see, and how frequently? Do you have any medical conditions or upcoming treatments? Do you have a home in another part of the country, or do you travel often? Do you need routine care while away from home? Are you opposed to paying copayments or deductibles? Go online: My.ViaBenefits.com/OPERS 19

20 Notes 20 Contact us by phone:

21 Go online: My.ViaBenefits.com/OPERS 21

22 22 Contact us by phone:

23 Contents Towers Watson. All Rights Reserved. The information offered on our website and provided in this mailing is believed to be true and correct. Extend Insurance Services, LLC* is Towers Watson s licensed insurance agency. Extend Insurance Services, LLC is a Utah resident insurance agency (Utah License No ) and licensed as a nonresident insurance agency or otherwise authorized to transact business as an insurance agency in all states and the District of Columbia. Extend Insurance Services, LLC represents and receives payment of commissions from the insurance companies for which Extend Insurance Services, LLC is an agent and sells insurance products and services, and may receive other performance-based compensation for its sale of the insurance products and services provided to you. Insurance rates for the insurance products and services offered by Extend Insurance Services, LLC are subject to change. All insurance products and services offered by Extend Insurance Services, LLC may not be available in all states. It is your responsibility to enroll for coverage during the annual Medicare Open Enrollment period. *Extend Insurance Services, LLC is changing its d/b/a from Towers Watson s OneExchange to Via Benefits Insurance Services. Go online: My.ViaBenefits.com/OPERS 23

24 1 1 SP **********************SNGLP T1 P1 <First Name> <Last Name> <Address Line 1> <Address Line 2> <City>, <State> <ZIP CODE> IMPORTANT! TIME-SENSITIVE INFORMATION REGARDING YOUR 2018 HEALTH CARE INFORMATION ENCLOSED.