What s New for 2019 THE SOURCE. The New Oxy Medicare Advantage PPO Plan. Your Benefit News for Retirees
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1 Your Benefit News for Retirees What s New for 2019 The New Oxy Medicare Advantage PPO Plan THE SOURCE Previously, Oxy announced a new retiree medical plan effective January 1, 2019, for retirees, spouses and dependents who are eligible for Medicare. The new Oxy Medicare Advantage PPO Plan also known as the Aetna Medicare SM Plan (PPO) with an extended service area (ESA) includes Medicare Part D expanded prescription drug coverage. It will replace the current Oxy Retiree Medical Plan, including prescription drug coverage through Express Scripts, for all Medicare-eligible plan participants. This new plan is only available to covered retirees, spouses and dependents who are eligible for Medicare. If you (or your covered spouse or dependents) are not currently eligible for Medicare, and are enrolled in the Oxy Retiree Medical Plan, you will remain in that plan until you become eligible for Medicare. Why change? Providing comprehensive health care benefits to our retirees has always been important to Oxy. The changes we are making not only offer more value to our retirees, spouses and dependents who are eligible for Medicare, but also help Oxy preserve its ability to offer you a great medical and prescription drug program without compromising your care or your budget. Medicare Advantage plans receive funding that is not available to traditional Medicare plans. As a result, Aetna can provide Oxy retirees with better coverage at a lower cost. No action required. You don t need to do anything to retain your retiree medical and/or dental coverage in If you are currently enrolled in Medicare Part A and Part B, you will be automatically enrolled in the Oxy Medicare Advantage PPO Plan and Medicare Part D. If you or your covered dependents are not Medicareeligible, coverage will continue under the current Oxy Retiree Medical Plan for If you prefer, you can opt out of the new Oxy Medicare Advantage PPO Plan by calling OxyLink at between October 15 and October 26. Remember, if you opt out, you will lose medical and prescription drug coverage through Oxy. If you have questions about your benefits, call OxyLink at or oxylink@oxy.com. IMPORTANT Not all benefits described in this newsletter apply to all participants. Represented retirees should refer to their collective bargaining agreement for benefit eligibility. 1 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
2 THE SOURCE Your Benefit News for Retirees 2019 Medical plan benefits expanded For non-medicare-eligible retirees What s the same? Same comprehensive Retiree Medical Plan with Aetna and prescription drug coverage through Express Scripts. Continued access to current physicians. What s new or changed? Hearing aid benefit: $2,500 allowance every three years. Acupuncture therapy: up to 26 visits per calendar year. Chiropractic visits increased from 25 to 26 visits per calendar year. What is a Medicare Advantage plan? A Medicare Advantage plan is another way to provide Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) benefits. In some cases, such as with the new Oxy Medicare Advantage PPO Plan, a Medicare Advantage plan can also offer another way to provide Medicare Part D (prescription drug benefits). Medicare Advantage plans are offered through private insurance companies that have been approved by Medicare. These plans provide the same coverage as traditional Medicare and often offer additional services not covered by Medicare, like fitness programs and access to wellness care. 2 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
3 Enhancements and conveniences you can appreciate For Medicare-eligible retirees What s the same? The same trusted partner Aetna. Continued access to current physicians. Comparable prescription drug benefits. What s new or changed? No annual deductible. Simple, convenient copays. Lower annual out-of-pocket maximum. Same cost share for in- and out-of-network providers. Prescription drug coverage moving to Aetna. Single ID card for both medical and prescription drug coverage. The option to use retail pharmacies rather than mail order pharmacy to fill your maintenance prescriptions without penalty. Coordinated care and annual healthy home visits. Hearing aid benefit: $2,500 allowance every three years. Acupuncture therapy for pain management. Programs and health advocates to help with chronic conditions. Access to the SilverSneakers fitness plan, meal service following in-patient hospital stays and covered transportation services all at no cost. oxylink.oxy.com Oxy Medicare Advantage PPO Plan 3
4 THE SOURCE Your Benefit News for Retirees Oxy retiree medical plans benefit overview The following chart offers an overview of benefits under the new Oxy Medicare Advantage PPO Plan and the 2019 Oxy Retiree Medical Plan. FEATURES NEW Oxy Medicare Advantage PPO Plan for Medicare-eligible participants 2019 Oxy Retiree Medical Plan for non-medicare participants Plan Administrator Aetna Aetna Annual Deductible NO YES Annual Out-of-Pocket Maximum $2,000 $2,500 Healthy Home Visits YES NO Teladoc YES YES Prescription Drug Administrator Aetna Express Scripts Preventive Services $0 $0 Doctor Office Visit $30 copay 20% after deductible Specialist Office Visit $40 copay 20% after deductible Acupuncture Therapy $40 copay, unlimited visits 20% after deductible, 26 visits per year Hospitalization $120 copay 10% after deductible Outpatient Surgery $100 copay 20% after deductible Lab or X-ray $40 copay 20% after deductible Ambulance $40 copay 20% after deductible Urgent Care $50 copay 20% after deductible Emergency Room $100 copay, waived if admitted 10% after deductible Annual Eye Exam $0 $0 Home Health Care $0, unlimited visits 20% after deductible, 120 visits per year Hospice Care $0, unlimited visits 10% after deductible, unlimited visits Durable Medical Equipment or Prosthetics 20% with no deductible 20% after deductible Hearing Aids $2,500 allowance every three years 20% after deductible, up to a $2,500 allowance every three years Diabetic Monitoring Supplies $0 20% after deductible Transportation Services $0, 24 one-way trips up to 60 miles each per calendar year No coverage Meal Service after In-patient Stay $0, up to 14 meals No coverage 4 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
5 2019 Medical plan contributions In the past, the contribution base rate was the same for both non-medicare-eligible and Medicare-eligible participants. Beginning January 1, 2019, that won t be the case. Here s how it will work. Medicare-eligible participants. The monthly base rate will be much lower, decreasing by over 50% for 2019, from $140 to $65. Your monthly contribution will continue to be based on a multiple of the base rate determined by the retiree s age plus service at retirement. Non-Medicare-eligible participants. The monthly base rate will increase by 7% for 2019, from $140 to $150. When coverage is split. In cases where coverage is split between one Medicare-eligible participant and one non-medicare-eligible participant, their base rates will be different and, in some cases, the multiple may be different Base Rate Medicare-eligible Retiree $65 Non-Medicare-eligible Retiree $150 Two plans? In some cases yes. If you are Medicare-eligible and your covered spouse or dependent children are not (or vice versa), you will be in separate plans. Retirees and covered dependents who are not Medicare-eligible will remain in the current Oxy Retiree Medical Plan. Medicare-eligible retirees, covered spouses and dependents will participate in the new Oxy Medicare Advantage PPO Plan. oxylink.oxy.com Oxy Medicare Advantage PPO Plan 5
6 THE SOURCE Your Benefit News for Retirees Relax. We ve done the math. Here are the contributions for 2019 under the new structure Monthly Retiree Medical Contributions COVERAGE TIER Medicareeligible Retiree Medicareeligible Spouse Medicareeligible Child(ren) 1 Retiree Age + Service at Retirement 80+ (1X) (2X) (3X) (4X) 2 Retiree Only Yes $65 $130 $130 $130 Retiree Only No $150 $300 $450 $600 Surviving Spouse Only Yes $65 $130 $130 $130 Surviving Spouse Only No $150 $300 $450 $600 Retiree + Spouse Yes Yes $130 $260 $260 $260 Retiree + Spouse Yes No $215 $430 $580 $730 Retiree + Spouse No Yes $215 $430 $580 $730 Retiree + Spouse No No $300 $600 $900 $1,200 Retiree + Family Yes Yes Yes $195 $390 $390 $390 Retiree + Family Yes Yes No $280 $560 $710 $860 Retiree + Family Yes No Yes $280 $560 $710 $860 Retiree + Family Yes No No $365 $730 $1,030 $1,330 Retiree + Family No Yes Yes $280 $560 $710 $860 Retiree + Family No Yes No $365 $730 $1,030 $1,330 Retiree + Family No No Yes $365 $730 $1,030 $1,330 Retiree + Family No No No $450 $900 $1,350 $1,800 If your coverage tier is not shown, call OxyLink at for your monthly contribution rate. To review all of the individual age plus service multiples, go to oxylink.oxy.com and select Information for Retirees. 1 If retiree covers more than one child, retiree will pay the Medicare-eligible rate if at least one child is disabled. Otherwise retiree will be charged the non-medicare eligible rate. 2 Medicare-eligible participants pay a maximum of 2X base rate. 6 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
7 Take a look at these examples John Retiree Only coverage Eligible for Medicare John is eligible for Medicare. He is single and covers no dependent children. His age plus service at retirement was 85 (1X base rate). As a result, his Retiree Only contribution for the new Oxy Medicare Advantage PPO Plan for 2019 is $65 a month down from $140 in How it s calculated John: $65 base x 1, for a total of $65 Edward & Rose Retiree + Spouse coverage Eligible for Medicare How it s calculated Ed and Rose are both Medicare-eligible. Ed s age plus service at retirement was 75 (2X base rate). His Retiree + Spouse coverage for 2019 will be $260 per month down from $560 in Ed: $65 base x 2 = $130 + Rose: $65 base x 2 = $130, for a total of $260 Elaine & Vijay Retiree + Spouse coverage Split eligibility for Medicare How it s calculated Elaine is not eligible for Medicare but her husband, Vijay, is eligible. This means they are considered a split family one is Medicare-eligible and the other is not. Their contributions are calculated with separate base rates. Elaine s age plus service at retirement was 82 (1X base rate of $150). Since her husband, Vijay, is Medicare-eligible, his base rate is $65. Elaine s Retiree + Spouse contribution for 2019 will be $215 per month down from $280 in Elaine: $150 base x 1 = $150 + Vijay: $65 base x 1 = $65, for a total of $215 oxylink.oxy.com Oxy Medicare Advantage PPO Plan 7
8 THE SOURCE Your Benefit News for Retirees Take a look at these examples (continued) Carol & Bill Retiree + Spouse coverage Not eligible for Medicare How it s calculated Brian & Grace Retiree + Family coverage Split eligibility for Medicare How it s calculated Carol and Bill are not eligible for Medicare. Carol s age plus service at retirement was 77, making her cost 2X the base rate of $150. The cost for her husband, Bill, is also 2X the base rate of $150. As a result, her Retiree + Spouse coverage will be $600 per month a 7% increase ($40) over the 2018 contribution of $560. Carol: $150 base x 2 = $300 + Bill: $150 base x 2 = $300, for a total of $600 Brian is eligible for Medicare and his age plus service at retirement was 75. He and his wife, Grace, have a child, who is also covered under the plan. Grace is not yet eligible for Medicare. They are considered a split family Brian is Medicare-eligible and Grace and their covered child are not. Their contributions will be calculated using separate base rates with the addition of covering a child. Brian s cost of coverage is 2X the base rate of $65 or $130. Grace and their child are not Medicare-eligible, so the cost for each of them is 2X the base rate of $150. Brian s Retiree + Family coverage for 2019 will be $730 per month down from $840 in Brian: $65 base x 2 = $130 + Grace: $150 base x 2 = $300 + Child: $150 base x 2 = $300, for a total of $730 8 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
9 2019 Dental contributions Dental discount program Oxy will continue to offer retiree dental coverage through Aetna to eligible Oxy retirees. Dental contributions will remain the same for 2019: 2019 Monthly Retiree Dental Contributions Coverage Level Monthly Amount Retiree Only $52 Retiree + One $105 Family $158 If you waived retiree dental coverage when first offered, you may not enroll in the Retiree Dental Plan unless you or your spouse (or a surviving spouse) currently has other dental insurance coverage (including COBRA continuation coverage) and you lose eligibility for that coverage. In that case, you may enroll in the Retiree Dental Plan within 31 days of the loss of coverage with proof of the loss. The Vital Savings By Aetna Dental Discount Program is an optional discount program available through Aetna to Oxy retirees and their dependents who are eligible for retiree medical coverage. This discount program is not insurance and is in lieu of the Retiree Dental Plan. The program provides you access to a nationwide network of dentists who have agreed to provide a discount ranging from 15% to 50% on certain services. There is a small monthly fee of $4 to participate in the program ($7 per family). You must complete and submit an enrollment form to participate. You can find a form at oxylink.oxy. com by selecting Plan Documents & Information, then Discount Programs. Questions? Log into vitalsavingsbyaetna.com (select No when asked if you are an employer, administrator or trustee; select Yes when asked if you were referred to this site by your employer, administrator, school or trustee. Then, select I am sending my enrollment form or have enrolled directly with Aetna). If you prefer to enroll by phone, call VITAL. The Employer Promotional Code is oxylink.oxy.com Oxy Medicare Advantage PPO Plan 9
10 THE SOURCE Your Benefit News for Retirees Vision and hearing discount programs Routine vision exams are covered at 100% under both the current Oxy Retiree Medical Plan and the new Oxy Medicare Advantage PPO Plan. New for 2019, Oxy has added coverage for hearing aids under both plans. If enrolled in an Aetna medical or dental plan, you are automatically eligible for Aetna s vision and hearing discount programs. The programs are offered at no cost and can provide you and your enrolled dependents significant savings when you use participating providers. These programs can provide substantial discounts on hearing exams, hearing aids, eyeglass frames, corrective lenses, contact lenses, non-prescription sunglasses, contact lens solutions and accessories. The vision programs also offer discounts on LASIK surgery, eye examinations and a mail-order contact lens program. Want more information? Log into Aetna Navigator aetna.com and select Get Discounts under Health Programs or call Aetna customer service at The company expects and intends to continue its benefit plans but does not guarantee any specific level of benefits or the continuation of any benefit plan during any periods of active employment, inactive employment, disability or retirement. Benefits are provided solely at the company s discretion and do not create a contract of employment. The company reserves the right to modify, suspend, change or terminate any of its plans at any time. This information is applicable to eligible non-represented employees. Applicability to represented employees is governed by local collective bargaining agreements. Subject to this and future agreements, the company reserves the right to change, amend or terminate any benefit plan at any time. The information provided in this document is not tax advice. While the information is believed to be accurate as of the print date, it is subject to change. Consult a qualified tax advisor for help in determining any tax benefit mentioned herein. 10 Oxy Medicare Advantage PPO Plan oxylink.oxy.com
11 BeneBits Update contact information. Be sure your contact information and your emergency contact information is up to date: Online: Go to oxylink.oxy.com, select Employee Self Service, then Personal Details. By phone: Contact OxyLink weekdays at (800) ( outside the United States), Monday through Friday, 8:00 a.m. to 4:30 p.m., CST. By PayFlex for retiree medical and dental billing. PayFlex will continue to handle the retiree billing services for Oxy s retiree medical and/or retiree dental plans. Visit payflex.com to view your balance, manage your profile and notifications. You may also set up Electronic Funds Transfer (EFT) by linking your bank account through Account Settings to automatically pay your monthly premium and eliminate receiving a coupon book and monthly statements. If you have any questions, please contact PayFlex billing at Check beneficiary designations. It is important to check your beneficiary designations, as applicable, from time to time and update them, as needed. If you do not name a beneficiary, benefits will be payable in accordance to plan rules. Basic Life: Go to oxylink.oxy.com or call OxyLink at to request a form. Group Universal Life (GUL): Go to mybenefits. metlife.com or call MetLife customer service at (k) and Retirement Plans: Go to oxy.voya. com or call the Oxy Retirement Service Center at 844-OXY-401K ( ). Disabled dependents. If you have an eligible disabled dependent currently covered under an Oxy retiree medical plan, and that dependent is Medicare-eligible or becomes Medicare-eligible, contact OxyLink as soon as possible to provide the date your dependent became or will become eligible for Medicare. This will allow us to enroll your dependent in the new Oxy Medicare Advantage PPO Plan at a lower contribution rate. oxylink.oxy.com Oxy Medicare Advantage PPO Plan 11
12 Questions? Oxy Medicare Advantage PPO Plan For Medicare-eligible participants Oxy Retiree Medical Plan For non-medicare participants OxyLink Aetna Medicare Services oxy.aetnamedicare.com Monday through Friday 8:00 a.m. to 6:00 p.m. (all time zones) Aetna aetna.com Monday through Friday 8:00 a.m. to 6:00 p.m. (Central time) oxylink.oxy.com Monday through Friday 8:00 a.m. to 4:30 p.m. (Central time) OxyLink 4500 S 129th East Avenue Tulsa, OK Presorted First Class Mail U.S. Postage PAID Fidelity Investments Important Retiree Medical Plan Enrollment Information GENERAL NOV 2018 ERNA
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