Retiree Benefit Source

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1 Retiree Benefit Source J U N E I N S I D E THIS I S S U E : CIGNA MEDICARE SURROUND FOR MEDICARE-ELIGIBLE RETIREES New Medicare Supplement Plan Launched Notice to New Retirees Know Your Insurance Cards Preventive Care Medicare Surround FAQs New LCPS Discounts Events and Contacts The transition of the health insurance plan for our Medicare-eligible retirees from Humana to Cigna has been completed. Effective May 1, 2014, Medicareeligible retirees enrolled in retiree health insurance now have the Cigna Medicare Surround plan as a Medicare supplement/indemnity plan and Cigna Medicare Rx as their prescription drug plan. With this Medicare supplement/indemnity plan Medicare is primary for hospital and medical expenses and Cigna Medicare Surround is secondary. All participants should have received two new cards. The Cigna Indemnity card, to be used along with your Medicare card for medical services, and a Cigna Medicare Rx card to be used for prescription drugs. If you no longer have your Medicare card, call Social Security at to request a replacement. Vision coverage is now through Cigna Vision and Delta Dental continues to be the provider of your dental benefits. We have compiled a list of frequently asked questions about the transition and the new plans. Please see Just the FAQs on pages 4 & 5 for more information. Visit the Retiree pages on the Employee Health, Wellness and Benefits website at for even more information specific to our retirees. CIGNA Office Hours Do you have questions about a doctor's bill or how to make sure an upcoming procedure is approved? A representative from Cigna is available for appointments at the Administration Building in Ashburn. Appointments are required - and available from 9:00 am - 3:00 pm on: July 7 July 21 August 4 If interested, call to schedule your appointment.

2 P A G E 2 NOTICES TO NEW RETIREES WHO ARE MEDICARE-ELIGIBLE If you retired on or after May 1, 2014 and were Medicare-eligible at the time of retirement, Cigna may need to verify that you had prescription drug coverage leading up to your date of enrollment in the Cigna Medicare Rx plan. A letter from the Department of Health and Human Services and Cigna may be mailed to your home requesting confirmation of your prior prescription drug coverage. This letter will reference late enrollment penalties but don t let this worry you! If you had LCPS or other creditable prescription drug coverage during the period referenced in the letter, you will have the coverage necessary to avoid the penalty, however, you must respond to the letter, by the deadline provided, in order to avoid a penalty. You have two easy options for confirming your coverage, which are outlined in the letter and listed below. PHONE: Call Cigna at and provide them with your coverage information. You will be prompted to answer two questions by the automated system then you will be transferred to a customer service representative. Let the customer service representative know that you are responding to a request for information regarding your prior prescription coverage and provide your dates of coverage and the employer name. MAIL: Complete the Declaration of Prior Prescription Drug Coverage form included in the mailing and return it to the address provided in the letter. Complete the top section with your information. The Name of the Medicare Prescription Drug Plan is Cigna Medicare Rx. If you were covered by the LCPS plan you will check the first box I had creditable prescription drug coverage from an Employer/Union List Express Scripts through Loudoun County Public Schools as the name of the employer plan and provide your dates of coverage from initial effective date up to the date of the termination of your active coverage. If you had any other coverage during the period referenced in the letter, include this information. Sign and date the second page and mail the completed form to Cigna by the deadline provided. Keep a copy of your completed letter for your records. If you have any questions about this letter, please contact Cigna at or the Employee Health, Wellness and Benefits at Medicare-eligible retirees must send a copy of their Medicare Card, showing enrollment in Medicare Part A and Medicare Part B, to Employee Health, Wellness and Benefits, to be enrolled in the Medicare supplement plan. Copies can be faxed to , delivered or mailed to Loudoun County Public Schools, Employee Health, Wellness and Benefits, Education Court, Suite 319, Ashburn, VA If you are have not contacted Social Security to apply for Medicare Part B and you are eligible, don t delay! Call or visit your local Social Security Office to start the process.

3 P A G E 3 It can certainly be frustrating to be told that you do not have coverage when seeking vision or dental care or when trying to have a prescription filled, especially when you know you should! The issue could be with the benefit card that you are presenting to the provider or that the provider has on file. There are several providers involved with your full health care package through LCPS. It is important to know your insurance cards and present the correct card to the appropriate healthcare provider.. Know your Insurance Cards Medicare Eligible Participants Cigna Medicare Surround Medical - Medicare Card and Cigna Indemnity Card Prescription - Cigna Medicare Rx Card Vision - Cigna Indemnity Card Dental - Delta Dental Card Non-Medicare Eligible Participants Cigna POS or OAP Medical - Cigna Card Prescription - Express Scripts Card Vision - Davis Vision Card Dental - Delta Dental Card 2014 Cigna POS and OAP Summary Plan Descriptions (SPDs) 2014 Summary Plan Descriptions (SPDs) for the Cigna POS and OAP medical plans are accessible through the Employee Health, Wellness and Benefits website. If you are unable to access these documents online and would like to request a hard copy of the plan SPD, please lcpshealthwellness@lcps.org or call The Cigna Medicare Surround SPD is coming soon!

4 P A G E 4 HEALTH INSURANCE PREVENTIVE CARE In addition to eating healthy, exercising regularly and avoiding tobacco, receiving preventive health care services such as cancer screenings, preventive visits and vaccinations is an important way to keep you and your family healthy. The LCPS Cigna plans cover recommended* preventive care without you having to pay a copay, coinsurance, or deductible when you see a doctor that is in-network or, in the case of the Cigna Medicare Surround Plan, accepts Medicare. Keeping up with your preventive care is a great way to stay ahead of any issues. According to the Center for Disease Control, chronic diseases such as heart disease, cancer and diabetes are responsible for 7 of every 10 deaths among Americans each year - and account for 75% of the nation s health spending. These chronic diseases can be largely preventable through close partnership with your healthcare team, or can be detected early through appropriate preventive screenings. Preventative care includes: Preventive medical exams/annual physical Well-woman exams Routine pre-natal tests Preventive mammograms Preventive cancer screenings Well baby exams Children s immunization vaccines According to the Centers for Disease Control (CDC) Americans use preventive care at about half the recommended rate. Be sure you understand what is covered by your plan before you make an appointment with your doctor. Call the number on the back of your member ID card for information about how our health plan pays for preventive care. *If your doctor orders tests during your preventive care visit that are not preventive, these tests may be subject to deductibles, copays and/or coinsurance. In addition, if you have symptoms of an illness at the time of your preventative visit and your doctor treats an existing condition, treatment or tests for that existing condition are not preventive care and are subject to deductibles, copays and/or coinsurance. Free Biometrics Screenings Biometrics include blood pressure, cholesterol, glucose, waist circumference, height and weight. To assist you with obtaining your biometric numbers, the Inova Mobile Health Services van will be available every month this year. These are FREE screenings for LCPS retirees! Bring your LCPS retiree ID or Cigna card showing coverage through LCPS. Wednesday, July 16, 2014 Administration Building, Ashburn Wednesday, August 13, 2014 Administration Building, Ashburn Wednesday, September 17, 2014 Location TBD

5 P A G E 5 JUST THE FAQS CIGNA MEDICARE SURROUND IS MY DOCTOR IN THE NETWORK? There is no network for the Cigna Medicare Surround plan your health care provider simply must accept Medicare assignment of payment. Medicare is primary and Cigna Medicare Surround is secondary. Your vision plan is with Cigna. You will save money on routine vision if you use a participating Cigna Vision doctor for your annual eye exam. WHAT IF MY DOCTOR DOES NOT ACCEPT MEDICARE? Cigna will reimburse you under the assumption that Medicare has already paid for its share of the services. For example, if Medicare would have paid 80% of the charges, Cigna will reimburse you based on the remaining 20% of the charges. In this case, the doctor may bill you for any, or all, of the portion not billed to Medicare. You may not submit claims to Medicare for direct reimbursement if your doctor does not accept Medicare. MY DOCTOR DOES NOT ACCEPT CIGNA. CAN I STILL SEE HIM/HER? Yes. The Cigna Medicare Surround plan is a plan that does not have a network affiliation. It is administered by Cigna, but your health care professional does not need to be contracted with Cigna your health care provider simply must accept Medicare assignment of payment. This is also the case for your routine vision benefits, however, your out of pocket savings will be greater if you see a provider who participates in Cigna's Vision network. IS THIS A MEDICARE ADVANTAGE PLAN? No. This is a supplemental plan to Medicare Parts A & B. If your health care professional currently does not accept Medicare Advantage Plans, but does accept Medicare assignment of payment, then you can use the Cigna Medicare Surround plan. WHAT LETTER IS ASSIGNED TO THIS PLAN BY MEDICARE? There is no letter assigned to this plan. Medicare assigns letters to the standard MediGap plans that they sell on an individual basis. The benefits in those plans are set, and cannot be changed or supplemented in any way. When employer groups like LCPS purchase supplemental plans for their retirees, changes are usually made to the standard letter plans in order to make them as comprehensive as possible in coverage. A letter cannot be assigned in those instances, per Medicare s rules it s simply a supplemental plan to Medicare Parts A & B. WHAT IF I AM ALSO COVERED BY ANOTHER PLAN (TRICARE, BLUE CROSS, ETC.)? When you receive medical care, present your Medicare card and your Cigna ID card to your health care professional. Medicare will process your claim, and forward it directly to Cigna for any further processing. If you have another plan to which you would like to submit your claim, you are responsible for that submission if your doctor does not submit it on your behalf. WHAT IF I AM TRAVELING ABROAD? AM I STILL COVERED? You are covered should you need emergency services while you are outside of the United States. Generally, emergency department services are provided when you have an injury, a sudden illness, or an illness that quickly gets much worse. Foreign health care providers and hospitals are not required to file with Medicare, so you will pay for your services where you are, and submit the claim to Cigna, who will reimburse your expenses less the $50 emergency services deductible that you will owe under the plan. DO NOT send these charges to Medicare for reimbursement, as Medicare does not cover services incurred outside the United States and you will not be reimbursed. FOR MORE QUESTIONS ABOUT YOUR MEDICAL PLAN, CALL

6 P A G E 6 JUST THE FAQS CIGNA MEDICARE RX WILL I NEED NEW PRESCRIPTIONS? You may continue to fill your prescriptions as you normally would at the retail pharmacy. If you have mail order prescriptions, you will need to work with Cigna Home Delivery Pharmacy to switch. You or your doctor can contact Home Delivery pharmacy at HUMANA SENT ME AN ANNUAL STATEMENT OF ALL OF MY PRESCRIPTIONS. WILL CIGNA DO THAT? You will receive reports from Cigna Medicare Rx that will show how your plan pays your prescription bills. They will also show what you paid or what you need to pay. These reports include an explanation of benefits (EOB) about your pharmacy coverage if you have used your coverage that month. This statement will show the billed charges, what the plan paid and the amount that you paid. I HAD AN AUTHORIZATION OR EXCEPTION ON FILE WITH HUMANA. WILL THAT CHANGE? If you had an exception or authorization for medication(s) with Humana, your doctor will need to contact Cigna to make the same arrangements. CAN I ENROLL IN ANOTHER MEDICARE PART D PLAN FOR MY PRESCRIPTIONS? No. Medicare allows enrollment in only one Part D Prescription drug plan at a time. If you enroll in another Part D plan, your coverage through Cigna Medicare Rx will be cancelled by Medicare. WHAT IS THE TRANSITION OF COVERAGE POLICY? Cigna Medicare Rx wants to make sure that you transition safely into the plan after you enroll. Since some period of time may exist in which you may have a temporary gap in coverage while going through the exception process, it is policy to allow for coverage of a 31-day supply of medication (unless you have a prescription written for fewer days). An extended transition process is provided for circumstances in which an individual is changing from one treatment setting to another. HOW ARE MY DIABETIC SUPPLIES COVERED? Some diabetic supplies are covered under the medical (Part B) portion of your plan. Those include glucose monitors, test strips, lancets, insulin pumps and insulin that is used in pumps. For information on where you can receive those supplies, contact Medicare, Cigna, or refer to the listing on the Employee Health, Wellness and Benefits web site. The diabetic supplies that are covered under your Cigna Medicare Rx plan include injectable insulin, syringes, needles, pens, as well as inhaled insulin devices, and those can be obtained at your pharmacy or through Cigna Home Delivery Pharmacy. HOW ARE VACCINES COVERED? Vaccine coverage varies between Part B and Cigna Medicare Rx, depending on the vaccine, the reason and sometimes the place in which the vaccine is administered. For more information on how your vaccine will be covered, please contact customer service. FOR MORE QUESTIONS ABOUT YOUR PHARMACY PLAN, CALL

7 P A G E 7 CIGNA HEALTHY REWARDS Get discounts on the health products and program you use every day for: Weight management and nutrition Fitness/fitness centers Quitting tobacco Mind/body Vision and hearing care Alternative medicine For more information or to access these services go to or call (800) New Discounts through LCPS UFC Gym Sterling Davenport Drive, Unit 120, Sterling, VA. Contact Adam at The discounts will be no monthly enrollment fee and $59.00 monthly cost for employees, retirees and their dependents. This offers includes kick boxing, boxing and children s classes. This offer is only valid at the Sterling Gym. Koons Sterling Ford Harry Byrd Hwy., Sterling, VA. Contact Steve Arnold at or Steve.Arnold@koonsauto.com for the Friends & Family Discount. You also receive help with pre-owned vehicles. MS Mary Kay Beauty Contact Debbie Major at or at LCPS discount is 30% off of entire order. Dell Computers Call or visit edubuy for a 10-15% discount. Reference Member Number KS Tysons Heating and Air Conditioning, LLC Call for a $60 service fee (regularly $70) and 10% off on parts. Licensed and insured. Home Paramount Pest Control Contact George Dawson at LCPS discount is 15% off on all pest control services. Golds Gym 532 E. Market Street, Leesburg, VA Group rate discount; 10% off retail rates; $15.95 bi-weekly with discount enrollment fee based on chosen terms. Fred s Mobile Auto Spa Contact Fred Shaw at LCPS retirees will receive a one time 20% discount on detailing services at the customers home. To see the entire Employee Discounts list go to / Administration / Business & Financial Services / Employee Health, Wellness and Benefits / Employee Discounts

8 P A G E 8 July 9, 16, July 16 Aug 13 Aug 20 Sept 15 - Sept 25 Sept 17 Sept 24 Calendar of Events Life Management Tobacco Cessation 23, 30, Admin Building *Register June 4th Aug 6 5:30-6:30 pm- Registration Required Biometrics Screening Administration Building Biometrics Screening Administration Building Blood Drive Administration Building, Parking Lot 1:30-6:00 pm Flu Shots Locations to be announced on our website. Biometrics Screening Location TBD Cooking Demonstration Harper Park Middle School 5:30-7:00 pm Open Enrollment is October 15th November 15th with changes effective January 1st. During Open Enrollment, non-medicare eligible retirees, enrolled in the Cigna POS or OAP plan, can elect to change plans or drop dependents from coverage effective January 1, We anticipate premium increases to be consistent with increases from previous years and will publish 2015 premiums as soon as they are finalized. Contacts Cigna or Express Scripts Pharmacy Delta Dental Davis Vision Cigna Vision (Medicare-eligible) or Virginia Retirement System (VRS) VRS 457 Deferred Compensation Plan Defined Contribution Plans Employee Health, Wellness & Benefits lcpshealthwellness@lcps.org Fax: Retirement & Disability Programs lcpsretiredisability@lcps.org Fax: