SEMINAR WILL BEGIN SHORTLY

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1 SEMINAR WILL BEGIN SHORTLY TRICARE Supplement Plan American Military Retirees Association (AMRA) CrawfordAdvisors, LLC Consulting, Brokerage & Administration

2 2 Dial: Access Code: Pin: Area for typing any questions/comments.

3 TRICARE Supplement Plan American Military Retirees Association (AMRA) CrawfordAdvisors, LLC Consulting, Brokerage & Administration

4 Patrick C. Haynes, Jr. As counsel for Crawford Advisors Employee Benefits and Executive Compensation Group, Mr. Haynes advises employers and plan sponsors in a variety of health and welfare benefit plan compliance matters, including, but not limited to, tax qualification and other Internal Revenue Code issues, ERISA, COBRA and HIPAA portability and privacy issues. Mr. Haynes lectures frequently and has published many articles on health and welfare benefit plan compliance topics. Practice Areas Employee Benefits & Exec Comp, ERISA, COBRA, HIPAA, 125, and 105, 106, 129, 132 Education Temple University School of Law, LL.M. Rutgers University School of Law, J.D. Rutgers University School of Business, M.B.A. Rutgers University College of Arts & Sciences, B.A. Admitted to Practice U.S. Supreme Court Federal and State Courts of New Jersey Pennsylvania Connecticut District of Columbia 200 International Circle, Suite 4500 Hunt Valley, MD East Lancaster Ave, Suite 640 Radnor, PA

5 Fayton Washington As the Business and Development and Marketing Manager for ASI, Association and Society Insurance Corporation, Mr. Washington travels the country meeting with employers and benefit specialists from various industries and backgrounds training them on rules, regulations, and implementation of the Corporate TRICARE Supplement Plan. He works with over 400 corporate accounts, helping employer groups meet the needs of their employees and improving their overall bottom-line. Education University of South Carolina, B.A. University of South Carolina, M.B.A Research Blvd Ste 300. Rockville, MD

6 6 Agenda Brief Overview of the Supplement Plan Who is Eligible for the Supplement Plan? About TRICARE A Description TRICARE Supplement The Options Premium Cost Monthly Pre-Tax Administration of the Supplement Plan

7 Brief Overview 1 The Corporate TRICARE Supplement is a voluntary plan designated for companies that employ the military retiree community This voluntary supplemental health benefit is an option available to employees and their dependents who are eligible for TRICARE. Eligible employees who enroll in the plan are responsible for 100% of the monthly premium amounts. Monthly premium payments are made with pre-tax dollars through payroll deduction. Client groups include many of the top ten defense contractors, as well as professional, social, fraternal, military and trade associations. We also work with municipalities, federal credit unions and financial institutions from all over the United States.

8 Eligible Employees Are under age 65 and retired from any branch of the armed services (Army, Navy, Marines Corp, Air Force, Coast Guard, Public Health Service or National Oceanic and Atmospheric Administration (NOAA)) 1 Military retirees entitled to retired, retainer or equivalent pay 2 TRICARE Retired Reserve under age 60 ( Gray Area retirees) 3 4 Spouses and surviving spouses of retired Military personnel Retired reservists over age 60 with at least 20 years of military service These eligible individuals must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) (DEERS is a worldwide, computerized database of uniformed services members, their family members and others who are eligible for military benefits)

9 Eligible dependents are covered up to age 21 or 23 if a full-time student Incapacitated dependents are covered past age 21 or 23 if primarily dependent on the member for support and continue TRICARE eligibility. 1 Dependent Eligibility Age 2 Not subject to Health Care Reform. The Patient Protection and Affordable Care Act (Public Law ) did not give the DOD the authority to offer this benefit through TRICARE. However, H.R.4923: TRICARE Dependent Coverage Extension Act was introduced on March 24, This act is to extend TRICARE coverage to certain dependents under the age of 26. According to the DOD, if enacted into law, they will make every effort to implement its provisions as soon as possible. This bill never became law. This bill was proposed in a previous session of Congress. Sessions of Congress last two years, and at the end of each session all proposed bills and resolutions that haven't passed are cleared from the books. Members often reintroduce bills that did not come up for debate under a new number in the next session.

10 Exceptions to the Age 65 Eligibility Rule Employees and spouses who are over age 65 are eligible to enroll in the TRICARE Supplement Plan, if they: 1 2 Reside inside or outside the U.S. or its territories (these individuals must be enrolled in Medicare Part B and eligible for Medicare Part A) Are not eligible for Medicare (these individuals must have received a Statement of Disallowance from Social Security Administration and their DEERS files must be updated)

11 ABOUT TRICARE: Healthcare Program for the Armed Services Community

12 Features of TRICARE Standard INDEMNITY- FEE-FOR-SERVICE PLAN No enrollment required or enrollment fee to pay Flexibility and freedom of choice when selecting a civilian provider (inpatient or outpatient) Access to Military Treatment Facility (MTF) on a space available basis No referral required Provides worldwide access to healthcare Works with TRICARE Extra Pays all but the 25% cost share and excess charges after the Outpatient Deductible ($150 per person/$300 per family) is met

Features of TRICARE Extra PREFERRED PROVIDER ORGANIZATION 1 2 3 4 5 6 7 No enrollment required or enrollment fee to pay Flexibility and freedom of choice when selecting a civilian network provider

13 Features of TRICARE Extra PREFERRED PROVIDER ORGANIZATION No enrollment required or enrollment fee to pay Flexibility and freedom of choice when selecting a civilian network provider (inpatient or outpatient) Access to Military Treatment Facility on a space available basis No referral required Only available in the United States Works with TRICARE Extra Pays all but the 20% cost share after the Outpatient Deductible ($150 per person/$300 per family) is met

14 TRICARE Supplement Plan

15 1 Features of the TRICARE Supplement Plan Eligible employees may opt out of employer s provided Group Health Plan which reduces the employer s healthcare cost No pre-existing condition limitation Guaranteed issue Helps to provide greater access to civilian providers worldwide Helps to pay the portion of the covered expenses that retirees and eligible family members are responsible for paying Covers the balance of eligible billed charges that are covered by TRICARE after the Plan Deductible has been met Portability, if coverage ends for any reason, employees can keep the plan

16 How the Supplement Plan works with Standard/Extra Enrollment Fee Outpatient Deductible Copayment TRICARE Standard $150 per person/$300 per family Cost Share Pays 75% Allowed charge Excess Charges Prescription Civilian Network or TRICARE Mail Order Prescription Civilian Non- Network Does not pay excess charge Pays all but $3/$9/$22 copayment Pays all but deductible & $9/20% or $22/20% TRICARE Supplement Pays 100% deductible Pays 25% cost share Pays 100% excess charges up to Legal Limit Pays copayments ($3/$9/$22) Pays deductible plus $9/20% or $22/20% N/A TRICARE Extra $150 per person/$300 per family None Pays 80% negotiated cost N/A Pays all but $3/$9/$22 copayment N/A TRICARE Supplement Pays 100% deductible Pays your 20% cost share Pays copayments ($3/$9/$22) Covered Expenses are subject to fiscal year Plan Deductible of $100 per person or $200 per family

17 Monthly Premium Amounts Employee Only $60.00 Employee plus Spouse $ Employee plus Child (ren) $ Employee plus Family $ TRICARE Supplement Annual Deductible $100/individual and $200/family Employees may use pre-tax dollars to pay premiums

18 Administration of the Supplement Plan

19 Plan Sponsor American Military Retirees Association (AMRA): a nonprofit corporation with National Headquarters located in Plattsburgh, New York. AMRA was incorporated in 1973 in New York State by and for all military retirees of the United States Armed Forces. Included in the monthly premium rates is $1.00 for the AMRA association dues. This amount is deducted and paid to AMRA on a monthly basis.

20 Plan Underwriter Monumental Life Insurance Company Cedar Rapids, IA Transamerica Financial Life Insurance Company Harrison, NY AEGON companies AEGON is one of the world s leading life insurance and pension organizations and a provider of investment products, with businesses in over 20 markets in the Americas, Europe and Asia.

21 Questions Crawford Advisors, LLC 200 International Circle, Suite 4500, Hunt Valley, MD East Lancaster Ave, Suite 640, Radnor, PA Via to: To Download These Slides:

Qualified Medical Child Support Orders (QMCSO) Employer and Plan Administrator Responsibilities Before and After Health Care Reform

Qualified Medical Child Support Orders (QMCSO) Employer and Plan Administrator Responsibilities Before and After Health Care Reform 2 3 Patrick C. Haynes, Jr. Today s presenter As counsel for Crawford