Annual Enrollment 2015 October 2014 NIN:

Transcription

1 October 2014 NIN:

2 Take control. Let s (en)roll. Understanding your options is the first step toward selecting the right coverage for you and your family. AT&T continues our commitment to providing you with tools and resources to help you make the most of your health and welfare benefits. We want to help you focus on navigating your options not navigating the process. Read through this booklet to see the highlights about your benefits in 2015, get a quick overview of your options and discover tools and resources that can help you make your decisions. When you re ready, visit the AT&T Benefits Center from resources.hewitt.com/att. Clear instructions, helpful decision tools, quick access that s how we (en)roll. Don t forget: your annual enrollment opportunity runs from Oct. 20 at 7 a.m. to Oct. 31 at 7 p.m. Central time.

3 1 Overview Don t miss out: Choose the option that fits you best Keep your account secure... 3 Get ready to roll... 4 Choose your benefits for Meet your new medical benefits administrator for Check your supplemental life insurance rates... 9 Consider your dependents Know how your benefits options work with Medicare. 11 Understand your medical coverage options Take advantage of all your benefits PDF navigation Each page contains arrows or to the right and left of the page number. Click these icons to advance to the next page or return to the previous page. Click Annual Enrollment 2015 in the upper left corner of any page to return to the table of contents. You are receiving this annual enrollment booklet because you are: An AT&T retiree who is not yet 65 (or former AT&T employee not yet 65 but eligible for Medicare through disability) and remains eligible for benefits through AT&T for 2015; or An AT&T retiree age 65 or older who will transition from AT&T group health coverage to an individual health plan through the Aon Retiree Health Exchange beginning Jan. 1, 2015, but has a dependent who remains eligible for AT&T benefits for 2015; or Part of a company couple, meaning that you are eligible for benefits both as an AT&T retiree and a dependent. You must determine which status works best for you. If you are eligible for the Aon Retiree Health Exchange: You must enroll in medical or prescription drug coverage through the exchange for your dependent (younger than 65) to continue coverage through AT&T. You remain eligible for CarePlus and life insurance benefits, if applicable, through AT&T. Be sure to read those sections in this booklet.

4 2 Don t miss out: Choose the option that fits you best Pay less in monthly contributions with the AT&T SelectMed Medical option AT&T provides two options for your medical coverage the AT&T SelectMed Medical option ( SelectMed ) formerly the Alternative Medical option, and your existing Regional Medical option. Both options are significantly subsidized by the company, but your costs are different. Your monthly contributions for SelectMed are lower and are comparable to plans offered to active bargained AT&T employees. In addition, AT&T generally pays a higher percentage towards your overall costs when you enroll in the SelectMed option. That means most individuals will experience lower costs by enrolling in SelectMed versus the Regional Medical option. The choice is yours. Review your expenses and take a look at your health plan comparison charts to compare options before you enroll. Also, log on to the AT&T Benefits Center website at resources.hewitt.com/att and find cost estimators under Health Tools that can help you do the math.

5 3 Keep your account secure The AT&T Benefits Center website recently implemented increased security for your protection. If you haven t visited the website in a while, you will be prompted to enter a series of security questions and answers after logging in and before gaining access.

6 4 Get ready to roll Take the guesswork out of making your enrollment decisions. Find details you need to know and get ready to (en)roll: 1 Take an active role in reviewing your current benefit options. Coverage options and related costs may have changed. Note that your health and welfare program names have changed. 2 3 Review all benefit costs, not just contributions, as they may have changed for Before you receive care, verify that your medical, dental and/or vision providers are in the network, if you are enrolled in network coverage. You can confirm this directly with your provider and the benefits administrator.

7 5 4 Review your health plan comparison charts on the AT&T Benefits Center website for details about your medical, dental and vision benefits. Review your Summary Plan Descriptions (SPDs), Summaries of Material Modifications (SMMs) and Summary of Benefits and Coverage (SBC). Log onto resources.hewitt.com/att and click Review Summary Plan Descriptions (SPDs) on the bottom left side of the page. 6 Get familiar with your benefits tools and resources: The Health Tools section of the AT&T Benefits Center website under My Quick Links offers network provider directories, a medical expense estimator and more. Your benefits administrators websites also offer tools to help you estimate costs. See the Your Benefits section at access.att.com for general benefits information and links to benefit administrators websites. 5 If you have a change-in-status event after Sept. 1, 2014 (such as a marriage), make two separate elections: one for the rest of 2014 and then one for For a full list of change-in-status events, refer to your SPD. Find mobile apps from benefit administrators like CVS for managing prescriptions and United Healthcare to find providers. Get them where you find apps to download on your mobile device.

8 6 Choose your benefits for 2015 Make sure you ve done the leg work it s almost time to enroll. The AT&T Benefits Center website is equipped to help you with that. Enrolling in your benefits for 2015 doesn t have to take forever. Just log on to resources.hewitt.com/att using your AT&T Benefits Center username and password. Then, under My Quick Links, click Visit AT&T Benefits Center. Once you reach the AT&T Benefits Center website, click Enroll in the Your Action Needed box to choose your elections and complete your enrollment. If you don t have Internet access, call the AT&T Benefits Center at during your enrollment period to enroll. (Wait times typically increase during this time.)

9 7 Meet your new medical benefits administrator for 2015 This article applies only to West Region retirees. In 2015, Blue Cross Blue Shield of Illinois (BCBSIL) will be the exclusive medical benefits administrator for your company self-insured options under the AT&T West Medical Program. This change does not impact the current administrators for prescription drug and mental health/substance abuse benefits under the Medical Program. If you are currently enrolled in a self-insured option, please ensure that your current provider is in the Blue Cross PPO network. Details follow. Is your medical provider in the network? For 2015, the Blue Cross PPO network will be the exclusive provider network for your company self-insured options under the AT&T West Medical Program. Before enrolling for 2015, confirm that your doctors are in the Blue Cross PPO Network by going to bcbsil.com/att and clicking on the Doctors and Hospitals tab. This website provides links to learn about available member tools and resources. You also can click Take a Tour of Blue Access for Members on the right side of the home page to learn more. Blue Cross Blue Shield provides an extensive health care network. If you find that your physician is not currently in a Blue Cross Blue Shield network, ask them to join. Your provider can contact Blue Cross Blue Shield s customer service center at You or your provider can also go online to bcbsil.com/att, click Find A Doctor and then Recommend a Provider in the middle of the page.

10 8 Transition of Care may apply to you If you are currently enrolled in a self-insured medical option, the following transition of care guidelines may apply. Please review them carefully. If you or a covered family member are undergoing medical treatment and/or planning for surgical services that will continue beyond Dec. 31, 2014, you will need to verify that your treating provider is a member of the Blue Cross PPO network to receive the highest level of coverage. If your provider is not in the network, contact BCBSIL at , to apply for transition of care benefits after you enroll. You and your provider must complete a transition of care application form and submit to BCBSIL to find out if you meet the criteria for these benefits. BCBSIL must receive the form by Jan. 31, 2015, for consideration. Once approved, you will receive written confirmation from BCBSIL. Health conditions qualifying for transition of care benefits from Jan. 1 through March 31, 2015, include: End-stage renal disease and dialysis (applied to the physician or other provider or dialysis center). Nonsurgical cancer therapies, including chemotherapy and radiation. Pregnancy, regardless of trimester, through postpartum follow-up visit. Symptomatic AIDS. Transplants (solid organ and bone marrow). Conditions in which federal law requires transition of care. Your claims for service provided from Jan. 1 through March 31, 2015, will be reimbursed at the non-network level, resulting in higher out-of-pocket expenses, if:

11 9 Your treating provider is not a member of the Blue Cross PPO network and you do not apply for transition of care benefits, or Your application is not approved for transition of care benefits. Check your supplemental life insurance rates Supplemental Life Insurance rates may change for Be sure to review your rates. You also should choose the correct smoker designation for supplemental coverage. If you are a non-smoker but don t choose the correct designation, you may pay higher rates than necessary. If you don t smoke, simply choose the non-smoker option for this benefit.

12 10 Consider your dependents You can enroll eligible dependents for medical coverage up to age 26. Check the enrollment status of your current dependents. You do not need to re-enroll them. To add new dependents to coverage, visit the AT&T Benefits Center website. If you are adding dependents for vision and dental coverage, different age limits apply. Consult your SPD for those programs for complete details. New dependents must be enrolled within 31 days from their birth or placement for coverage to begin on the date of birth or placement. (You can enroll newborns or newly adopted children without a Social Security number. When you receive your child s Social Security number, share it with the AT&T Benefits Center.) Coverage can t begin unless you show proof that your child is eligible by the

13 11 given deadline. Refer to your program s Summary Plan Description (SPD) or contact the AT&T Benefits Center for more information if you miss enrolling your child by the due date. Note: You must remove dependents from coverage when they are no longer eligible or risk penalties for benefits fraud. AT&T may audit for benefit eligibility at any time. Know how your benefits options work with Medicare Know that it is up to you and your covered dependents to enroll in Medicare parts A and B and stay enrolled while retired when you first become eligible for Medicare, generally at age 65, but also if you become disabled as determined by the Social Security Administration. It is important that you take this step in order to be sure you have coverage of your health care expenses without reduction or gaps. Effective Jan. 1, 2015, once you are at least age 65 and Medicare eligible, your coverage under the AT&Tsponsored group health plan will end.* The company has arranged access to the Aon Retiree Health Exchange where you can receive assistance in enrolling in health insurance coverage available through the Private Exchange. While this is a change from how you traditionally received Health Benefits, in 2015, AT&T expects to spend an amount comparable to 2014 but in a new way. For those who are eligible, AT&T will provide a tax-free Health Reimbursement Account (HRA). * For 2015 this change does not apply if you are not a resident of the United States or if you reside in Puerto Rico, the Virgin Islands or Guam.

14 12 If you or your enrolled dependent(s) is already age 65 or will reach age 65 on or before Feb. 1, 2015, this change will apply effective Jan. 1, 2015, and you will have received extensive communications explaining the change and steps you need to take. If you or your enrolled dependent(s) will reach age 65 in 2015 but after Feb. 1, 2015, you will need to take action to enroll in coverage through the Private Exchange. You will receive information about 90 days before you become eligible to enroll in coverage through the Private Exchange on how to enroll and how coverage purchased through the Private Exchange coordinates with Medicare coverage. You will need to be enrolled in Medicare to be eligible to enroll in coverage through the Private Exchange. If you or other family members will be enrolled in the Company sponsored coverage effective Jan. 1, 2015, and Medicare will be the primary coverage for at least one but not all of your family members, you must make two separate enrollment actions: For family members who are over age 65 or who will become age 65 on or before Feb. 1, 2015, enrollment will be through the Aon Retiree Health Exchange. For family members who are not Medicare-eligible or who are Medicare-eligible but have not reached age 65 by Feb. 1, 2015, enrollment will be through the AT&T Benefits Center. Separate elections will be required for family members who are Medicare-eligible and for those who are not. Before you become eligible, you will receive information on how to enroll, how the exchange coordinates with Medicare coverage and how to get medical care. Check with the AT&T Benefits Center to find out if Medicare should be your primary coverage and how your Medicare status may affect your program options. Also, refer to your SPD for more about how AT&T programs work with Medicare.

15 13 Take note: AT&T MedicareRx reminders Each Medicare-eligible retiree and dependent currently enrolled in AT&T MedicareRx will receive an Annual Notice of Change and Evidence of Coverage from the SilverScript Insurance Company. Medicare requires this notice, so if you do not receive one by Nov. 15, please contact SilverScript at If you drop AT&T MedicareRx coverage If you are an AT&T retiree or Long Term Disability (LTD) participant and opt out or disenroll from AT&T MedicareRx coverage, you and your dependents will not have any Prescription Drug coverage through AT&T. However, if you are an AT&T retiree or LTD participant and your dependent opts out or disenrolls and elects an individual Medicare Part D policy, while you remain enrolled in AT&T MedicareRx, the AT&T Prescription Drug Program will coordinate with your dependent s Medicare Part D Plan and pay Benefits as secondary coverage to the Medicare Part D policy.

16 14 Couples who both retired from AT&T You can only enroll once in AT&T MedicareRx. That means you can t elect primary coverage for yourself and enroll as a dependent under your spouse s coverage. If you and your covered spouse are both AT&T retirees with AT&T-sponsored medical coverage and want to use the same AT&T MedicareRx account for purposes of coordinating your Deductible and/or Out-of-Pocket, if applicable, per your plan provisions, only one of you can be the primary; the other must enroll as a dependent. Income-Related Monthly Adjustment Amount Like Medicare Part B, Medicare Part D requires an additional premium for those with income above a certain level. This is called the Income-Related Monthly Adjustment Amount (IRMAA). For more information on IRMAA, go to socialsecurity.gov/pubs/en pdf. Contact the AT&T Benefits Center after Jan. 1, 2015, for more information.

17 15 Understand your medical coverage options You may be eligible for Fully-Insured Managed Care options or Outside-Network-Area (ONA) medical coverage. Fully-Insured Managed Care options You may be eligible for a Fully-Insured Managed Care option (FIMCO), based on your home ZIP code. FIMCOs are alternatives to the company self-funded option under the plan. Availability can change each year, so if your current option is not offered in 2015 you will be automatically enrolled in the company self-funded option available to you, unless you choose another option. As benefits, contribution amounts and provider networks offered by a FIMCO can change each year, it s important to review your health plan comparison charts and 2015 contribution amounts. If your dependents are eligible for coverage under your company self-funded option, they will likely be eligible for FIMCOs. For some dependents (e.g., Legally Recognized Partners (LRPs) and disabled dependents), certain FIMCOs may need more information or may not provide coverage. Call the insurance provider s service center (not the AT&T Benefits Center) to verify whether the FIMCO will cover these dependents. Before you enroll or re-enroll in a FIMCO for 2015, review the health plan comparison charts on the AT&T Benefits Center website or call the insurance provider s service center (not the AT&T Benefits Center) with questions. Outside-Network-Area options This does not apply to Fully-Insured Managed Care options. Network providers are readily available in most areas. If you live in an area that does not meet the criteria for certain types of network providers, you can choose Outside- Network-Area (ONA) coverage during annual enrollment. Network or ONA coverage is based on your home ZIP code.

18 16 If you enroll in ONA coverage, you can go to any medical provider and receive the network level of benefits. You also can switch to network coverage at any time during the year. Network coverage takes effect the first day of the month after the month in which you asked to change to network coverage. Once you choose Network coverage, you must always use network providers or risk paying higher costs. Review your enrollment information and your health plan comparison charts to confirm your options. Take advantage of all your benefits There s more to your benefits than just medical, dental and vision coverage. Don t miss out on other benefits such as CarePlus. Also get important reminders for prescription drug coverage and how to make sure your beneficiary information is up to date. Consider CarePlus CarePlus is a supplemental benefit program that helps cover the cost of certain medical treatments not usually covered by AT&T medical program options. You don't need to be enrolled in a separate AT&T medical program to sign up.

19 17 CarePlus also provides reimbursement for certain hearing aid devices. Review your CarePlus SPD to learn how this benefit is reimbursed. Also, find the full list of covered services in your CarePlus SPD. Most services must be pre-approved by UnitedHealthcare. To learn more, call UnitedHealthcare at Monday through Friday from 7 a.m. to 7 p.m. Central time. Need a second opinion? Check out MyConsult through Cleveland Clinic Through CarePlus, you also can get online medical second opinions for more than 1,200 diagnoses through Cleveland Clinic's MyConsult Online Medical Second Opinion program*. Visit the MyConsult AT&T website, eclevelandclinic.org/att, to learn more. *MyConsult program not available in North Dakota or Guam. Know your 2014 prescription copayment deadlines This article does not apply to those enrolled in Fully- Insured Managed Care options. Submit your eligible 2014 prescription drug orders or refills by the deadlines below for the 2014 copayment amounts to apply. Your 2015 copayment and deductibles which may have changed will apply to orders eligible for refill on or after Jan. 1, 2015, no matter when you place the order. CVS Caremark Mail Order/FastStart: Prescriptions are due by 11 a.m. Central time on Dec. 30, If FastStart contacts your physician with questions, responses are due by 11 a.m. Central time on Dec. 27, Tip: Allow more time for mail orders during the holiday season.

20 18 By 11 p.m. Central time on Dec. 31, 2014, you must: Place refill orders through a service associate by telephone. By 11:59 p.m. Central time on Dec. 31, 2014, you must: Purchase your prescriptions at a retail pharmacy. Complete your prescription order using the IVR or the Internet. Get the scoop on medical ID cards You will receive a new medical ID card for 2015 only if you: Elected a new plan option. Added dependents. Have certain changes to your medical ID information, such as a name change. Remain enrolled in a plan option that has recently changed names. If any of these apply, your new card should arrive before January Don t worry if you don t yet have your card and need care. Your provider can confirm coverage through your benefits administrator or by using your annual enrollment confirmation statement. You also may be able to print your medical ID card from your benefits administrator s website. Update your beneficiary information Now is a good time to update your beneficiary designations, especially if you ve had a recent life event (e.g., marriage or divorce). Depending on your benefit program, if you divorce, your former spouse may automatically be removed as your beneficiary. If this happens, but you want a former spouse to continue as your beneficiary, you must complete a new designation after the divorce to name your former spouse as the beneficiary.

21 19 Not all benefit programs allow a beneficiary designation and instead, plan rules may specify how benefits are paid after your death. Read your applicable benefit program s Summary Plan Description (SPD) to determine how each of your AT&T benefits will be paid. Fidelity s online beneficiary tool makes it easy to designate beneficiaries for your savings plan, life insurance, qualified pension program and final wages. Find this tool and more on netbenefits.com/att. Click Your Profile on the top of the home page and select Beneficiaries to get started. Massachusetts Creditable Coverage Medical plans provided by AT&T are subject to federal law and, while generous, are not guaranteed to meet all state creditable coverage specifications. For example, certain coverage options available under the AT&T medical plans for 2015 do not meet the technical specifications for creditable coverage in Massachusetts. If you are a Massachusetts resident and are not enrolled in Medicare or coverage that meets the state s specifications, you could be subject to a Massachusetts state tax penalty. In most cases, there are alternative coverage options available that do meet the Massachusetts creditable coverage specifications. Refer to the chart on the next page for the list of the 2015 medical coverage options that do or do not meet these specifications.

22 20 Plan options that do not meet MA Creditable Coverage specifications AT&T Medical and Group Life Insurance Plan CustomCare (Network and ONA Retiree options) The Pacific Telesis Group Health Care Network Plan (PTG HCN) (PTG HCN Network and ONA Retiree options) Ameritech Comprehensive Health Care Plan (PPO, and HCN ONA Retiree option) SNET Bargaining Unit Retiree Health Plan (POS ONA and MPR Retiree plan options) Alternate plan options that do meet MA Creditable Coverage specifications Southwest SelectMed HCN Southwest SelectMed HCN ONA West SelectMed HCN West SelectMed HCN ONA Midwest SelectMed HCN Midwest SelectMed PPO/ Non-PPO Midwest SelectMed HCN ONA East SelectMed HCN East SelectMed HCN ONA East SelectMed Medicare Indemnity Be sure to review the benefit plan options available to you during annual enrollment, and be aware of any state creditable coverage requirements when making your annual enrollment decision. If you have questions, please contact the AT&T Benefits Center at between 7 a.m. and 7 p.m. Central time, Monday Friday. Women s Health and Cancer Rights Act of 1998 Annual Notice As required by the Women s Health and Cancer Rights Act of 1998, your AT&T company medical program provides benefits for mastectomy-related services, such as: Reconstruction and surgery to achieve symmetry between breasts; Prosthesis; Complications resulting from a mastectomy (including lymphedema); in a manner determined by the patient and physician. Coverage may be subject to applicable annual deductibles, copayments and coinsurance.

23 21 DISTRIBUTION: Distributed to retired bargained employees of Legacy SBC Midwest IBEW Core Local 21 Ameritech Advanced Data Services of Illinois and Indiana and nonmanagement nonunion employees of Legacy SBC Midwest ADV Ameritech Advertising Services CWA; nonmanagement nonunion employees of Legacy SBC Midwest Core IBEW and bargained employees of Legacy SBC Midwest Global Services, Inc. (AIS) IBEW Local 21, Legacy SBC Midwest IBEW Local 134, Legacy SBC Midwest Global Services, Inc. IBEW Local 58 who retired before 6/23/13; retired bargained employees of SBC Long Distance, Inc. (SBLD) IBEW Local 21 who retired before 1/1/11; retired bargained employees of Legacy SBC Midwest Global Services, Inc. COS CWA who retired on or after 9/1/92 and before 4/9/12; retired bargained employees of Legacy SBC Midwest Core IBEW and Legacy SBC Midwest Ameritech Engineers who retired on and after 1/1/93 and before 6/23/13; nonmanagement nonunion employees of Legacy SBC Midwest Core CWA and West Core CWA who retired before 4/9/12; bargained employees of Legacy SBC Midwest Core CWA and Ameritech (Midwest) Global Services, Inc. CWA who retired on and after 1/1/93 and before 4/9/12; bargained employees of Legacy SBC Midwest ADV Ameritech Advertising Services CWA who retired on or after 1/1/93 and on or before 5/9/12; bargained employees of West Region IBEW 1269 (formerly ORTT) and Legacy SBC West TIU who retired on or after 1/2/91 and before 7/16/12; bargained employees of Legacy SBC Midwest Global Services, Inc. IBEW Local 494 (LTD Only) with an LTD date before 6/23/13; bargained employees of Legacy SBC East who retired on or after 1/1/90 and on or before 5/9/12; bargained employees of West Core CWA who retired on or after 1/2/91 and before 4/9/12; and any associated LTD recipients, survivors of retirees and COBRA participants. IMPORTANT: This document was written to make it easier to read. So, sometimes it uses informal language, like AT&T employees, instead of precise legal terms. Also, this is only a summary, and your particular situation could be handled differently. Specific details about your benefits, including eligibility rules, are in the summary plan descriptions (SPDs), summaries of material modifications (SMMs) or the plan documents. The plan documents always govern, and they are the final authority on the terms of your benefits. AT&T reserves the right to terminate or amend any and all benefits plans, and your participation in the plan is neither a contract nor a guarantee of future employment.

24 AT&T Inc. and Participating Companies Human Resources-Benefits P.O. Box St. Louis, MO Forwarding Service Requested NIN: