NEWS For Retirees Eligible for Premium Assistance Spring 2016

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1 Pennsylvania Public School Employees Retirement System (PSERS) NEWS For Retirees Eligible for Premium Assistance Spring 2016 Get a Good Night s Sleep: Your Health Depends on It Getting a good night s sleep is just as important to your overall health as following a nutritious diet and getting regular exercise. However, one-third of American adults get fewer than the seven to nine hours recommended by many doctors. While some believe that you need fewer hours as you age, others argue that there s no lessening of your need for sleep as you move into your 60s, 70s and beyond. Regardless of your age, sleep boosts both your mental and physical health. While you re sleeping, your brain forms new pathways to enhance your memory and ability to solve problems and make decisions. Sleep also helps with the healing and repair of your heart and blood vessels. Ongoing sleep deficiency is linked to an increased risk of heart and kidney disease, high blood pressure, diabetes and stroke. Poor sleeping habits can also weaken your immune system s response to common infections. If you often wake up feeling tired, take frequent naps during the day or easily fall asleep when watching television, you may not be getting enough sleep. Try incorporating some of the tips below into your daily routine to help improve the quality of your sleep. When possible, follow the same schedule each day for when you wake up, go to bed, eat and exercise. Limit the number of times you nap during the day, especially in the late afternoon. Reduce your use of caffeine, alcohol and cigarettes these are stimulants that can keep you awake. Establish a regular bedtime routine to wind down at the end of the day (e.g., read a book or magazine, write in a journal, take a warm bath). IT S NOTHING TO LOSE SLEEP OVER Humans spend about one-third of their lives sleeping. Only one-half of a dolphin s brain sleeps at a time. Lack of sleep can cause weight gain of two pounds in less than a week. Before alarm clocks were invented, some people in England had the job of waking up their clients in the morning by tapping on their windows with sticks. It s impossible to sneeze when sleeping. Cats sleep for 70% of their lives. You burn more calories sleeping than watching TV.

2 Why Join the Health Options Program There are many reasons to join. Consider these: If you are eligible for Premium Assistance, you ll save up to $100 a month in premiums. Unlike other retiree medical programs, the Health Options Program is designed exclusively for both Medicare-eligible and non-medicare-eligible PSERS retirees and their dependents. The Program offers a choice of medical, prescription drug and dental options. The Health Options Program is committed to keeping premium rates as low as possible. In most cases, your monthly premium can be deducted automatically from your retirement benefit. If you enroll in the HOP Medical Plan or the HOP Pre-65 Medical Plan, you can join Healthways SilverSneakers Fitness at no additional cost. You can change from one option to another each fall during the Option Selection Period. The change becomes effective the following January 1. If you or a dependent experiences a Qualifying Event, you can enroll, add dependents, or change your option at any time during the year, within 180 days of the Qualifying Event. The Health Options Program wants you to have the health care resources you need. Customer service representatives are available to answer your questions. We also send newsletters, personalized statements, and booklets and maintain a website for online access to Program information. Are You Almost 65? If you re a PSERS retiree about to turn age 65, we have a number of ways to ensure that you understand how the Health Options Program works. First, we send you a package of information from four to nine months before your 65th birthday. We mail these twice a year in the fall for people turning age 65 during the first six months of the following year and in the spring for people turning age 65 in the second half of the year. The package contains a description of the medical, prescription drug and dental benefits available under the Health Options Program plus a personalized statement that has information specific to you, including your monthly premiums for all your coverage options. In addition, we conduct meetings twice a year at locations throughout the Commonwealth for retirees approaching age 65. Look for the meeting schedule in the package you receive in the mail. Our latest method for reaching our soon-to-be-65 audience is via our website ( Besides all the regular features available on the website, if you register, you ll find a personalized statement with all the same information as the printed statement you receive in the mail. Plus, if you misplace or want another copy of your statement, a printer-friendly version is available. Revisiting the Health Options Program Video We ve updated our highlights video about the Health Options Program in We hope you find it informative and entertaining as it explains the differences between Medicare Supplement plans (the HOP Medical Plan and the Value Medical Plan) and Medicare Advantage plans (Highmark, Aetna, Independence BlueCross, Capital BlueCross and UPMC). Just click on the video link that appears on the home page of 2

3 What Members Told Us In Their Own Words Last fall, we included a survey in the materials members received at the start of the Open Enrollment Period. The survey asked them to rate the materials and included questions about telephone meetings, which were conducted for the first time last year. Of the members who had an opinion regarding the telephone meetings: Almost three-quarters thought the telephone meetings were a good idea. Six out of ten thought they were helpful. The answers to the questions about the written materials we mailed for the Open Enrollment Period were similar to past years : 87% rated the materials as 8 or higher on a scale of 1 (not satisfied) to 10 (very satisfied), and 84% felt they received the right amount of information not too much or too little. The personalized statement continues to meet members needs as well. On a scale of 1 (not understandable) to 10 (very understandable), 88% rated the statement s understandability as 8, 9 or 10. We appreciate this feedback from the 3,000 members who took the time to respond to our survey. We work hard to provide our members with access to the information they need to make informed health care decisions and lead a healthier lifestyle Please Tell Us What You Think Pennsylvania Public School Employees Retirement System (PSERS) Just over one-third of the members who responded to the survey also shared their thoughts about their experience with the Health Options Program. I like the telephone meetings and would participate in others. Sometimes I don t know what questions to ask, so this is helpful to me. [The] packet of information was well organized and easy to understand. Thank you for providing to our seniors. Not everyone cares. At first, I was overwhelmed with the changes/options. The Dental Plan & Value Plan info required lots of study. No complaints! Just a few hours of indecision. I changed my plan, but everything was very understandable. I had two questions and called and the staff members answered quickly and even the wait was less than two or three minutes. Besides the good medical coverage, I take full advantage of SilverSneakers. Keep up the good work. Liked the current year compared to the future year. Knew how your monthly pension would be affected. Overall an excellent job on the materials. Keep up the personal coverage. Continue to keep rates down. Retired over 22 years ago could use more premium assistance. 3

4 PREMIUM ASSISTANCE Annual Verification of Payments Premium Assistance is a reimbursement of a premium paid by an eligible retiree to an approved health plan. It is added to a retiree s retirement benefit and is not subject to federal or state income tax. In order to preserve this tax-favored treatment, PSERS is required to obtain verification that retirees who receive Premium Assistance actually have out-of-pocket premium expenses from approved plans. Each year, PSERS asks school employers to verify that Premium Assistance recipients have paid premiums each month that equal or exceed the amount of the Premium Assistance benefit. If the school employer is unable to do so, PSERS must collect unverified benefits from the retiree. Remember to Call PSERS Don t know if you re eligible for Premium Assistance? Call for help. PSERS sends a letter to all retirees who have received overpayments. The letter advises them of the amount of Premium Assistance they will receive in the future, if any, and requests that overpayments be returned. The amount due can be paid in a lump sum or deducted in $100 increments each month from the retiree s retirement benefit until the overpayment is recouped. If a retiree has been receiving $100 in Premium Assistance with no out-of-pocket expense from an approved plan, this will result in a $200 reduction in the retiree s monthly benefit ($100 for the loss of the Premium Assistance and $100 to repay the debt). No interest is charged on the balance of the debt while the monthly deductions are being made. If you are receiving Premium Assistance and your out-of-pocket premium expense changes or stops, it is your responsibility to notify PSERS. You must also notify PSERS if you have terminated your health coverage with your former school employer and have not enrolled in the Health Options Program. About 20,000 PSERS retirees receive Premium Assistance for the premiums paid to former school employers. In most cases, overpayments result when a retiree terminates coverage and fails to notify PSERS. Each year, the verification process identifies about 500 retirees who have received Premium Assistance to which they were not entitled. If you are unsure about your eligibility for Premium Assistance, call the Premium Assistance Unit at and ask a customer service representative to check your retirement benefit records. 4

5 SUMMER NOTES June Is Cataract Awareness Month The National Eye Institute reports that by age 80, more than half of all Americans either have a cataract or have had cataract surgery. June is designated as Cataract Awareness Month in an effort help increase awareness about this all-too-common condition. What it is. A cataract is a clouding of the eye s naturally clear lens. Symptoms. Cataracts can make your vision blurry, cloudy or dim. Things also may not seem as bright or colorful as they used to be. Some people with cataracts say it is like looking through a dirty window. Normal Vision Cataract Vision Causes. Most cataracts progress gradually over a period of years. The lens of our eyes that enables us to focus and see is made of mostly water and protein. A precise balance of these elements keeps the lens clear and lets light pass through it. As we age, some of the protein may clump together and start to cloud a small area of the lens. This is the start of a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see. Treatment. At first, symptoms may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses or magnifying lenses. However, if your vision loss interferes with everyday activities, such as driving, reading or watching TV, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. If you think you may have a cataract, talk to your doctor about a treatment plan. Members Are Shaping Up With SilverSneakers The Healthways SilverSneakers Fitness program is free for Health Options Program members enrolled in the HOP Medical Plan or the HOP Pre-65 Medical Plan (but not the Value Medical Plan). With over 850 SilverSneakers fitness facilities in Pennsylvania alone, our members are taking advantage of the opportunity to get out and be active. Here are some basic statistics on SilverSneakers usage by eligible PSERS retirees. Over 12,000 PSERS retirees are active participants in the program. On average, participants visit a SilverSneakers facility eight times per month. A little more than 20% of participants are over the age of 75. 5

6 HOP Administration Unit P.O. Box 1764 Lancaster, PA How to Get a Good Night s Sleep Have a Question? If You Have a Question About Please Call Or Go Online Enrollment in the Health Options Program Health Options Program in general HOP Administration Unit PSERS25 ( ) From outside the U.S.: a.m. to 7 p.m. eastern time, weekdays Health Options Program Website Premium Assistance Premium Assistance Office a.m. to 4:30 p.m. eastern time, weekdays Retirement PSERS PSERS4U ( ) 7:30 a.m. to 5 p.m. eastern time, weekdays PSERS Website Medicare Medicare MEDICARE ( ) Medicare Website