The Wrld Bank Grup Human Resurces, MSN G2-202 (202) 473-2222 INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Washingtn, D.C. 20433 (202) 522-7026 fax INTERNATIONAL DEVELOPMENT ASSOCIATION U.S.A. www.wrldbank.rg/humanresurces June 25, 2012 T all Members f the Medical Insurance Plan fr Retirees: I am pleased t infrm yu that effective July 1, 2012, changes t the premium and benefit structure f the Retiree Medical Insurance Plan (RMIP) will be implemented fr plan participants wh are eligible fr U.S. Medicare. These changes invlve increased RMIP integratin with U.S. Medicare and will result in a mre effective plan design fr bth retirees and the Wrld Bank Grup. These changes were made after an extensive review which included a wrking grup cmprised f WBG staff and representatives frm the 1818 Sciety, the Staff Assciatin, and an utside cnsulting firm. A summary f the changes, alng with frequently asked questins, is enclsed. The review is nt cmplete, and a secnd phase f RMIP review by a wrking grup will begin in Fiscal Year 2013. This review will include the discunts levels fr Medicare and nn- U.S. natinal health plan participatin, a mre detailed review f the RMIP 2 structure, and cntributin brackets fr RMIP premiums. We lk frward t cntinuing t wrk with the 1818 Sciety n issues imprtant t retirees. Sincerely, Alec Albertsn Manager Emplyee Benefits
June 25, 2012 What is changing? WBG will be making a number f changes t the RMIP prgram, with implementatin cnducted in phases, beginning July 1, 2012. These changes will apply t bth Plan 1 and Plan 2 1. Changes Effective July 1, 2012 Full reimbursement t RMIP members enrlled in Medicare Part B fr the standard Medicare Part B premium ($99.90 in 2012). Yu will see this change starting frm yur July pensin depsit r July direct bill frm Aetna. Full reimbursement f the Medicare Part B incme-related premium t RMIP members wh pay this additinal amunt (Incme Related Mnthly Adjustment Amunt/ IRMAA). IRMAA reimbursement will cmmence in January 2013, with the initial payment cvering the perid between July 1, 2012 and December 31, 2012. Instructins n hw t submit yur IRMAA bill fr this reimbursement will fllw in a separate ntice. N RMIP discunts t premiums fr Medicare Part B and Medicare Part A. Changes Effective January 1, 2013 Express Scripts, frmerly Medc 2, will administer prescriptin drug cverage under the Medicare Part D prgram. Express Scripts Medicare (PDP) fr Wrld Bank Grup will be applicable t all Medicare-eligible RMIP members. Watch yur mail fr imprtant benefit infrmatin frm Express Scripts in the cming mnths. Please ensure yu pen any mail with the Express Scripts lg. This Medicare Part D plan features: Better cverage than a standard Medicare Part D plan as it includes a supplementary wrap 3. All drugs available under yur current RMIP plan will cntinue t be available. Cverage similar t yur current prescriptin drug cverage; hwever, members may experience sme lwer r higher cpayments n nn-generic drugs. New prescriptin ID cards fr each eligible member being issued by Express Scripts. Greater subsidies t the RMIP frm Medicare t help manage premium increases. There will be n additinal premium fr retirees fr the Express Scripts Medicare (PDP) fr Wrld Bank Grup. Sme retirees may have t pay an additinal Medicare Part D IRMAA fr this cverage t Medicare but these amunts will be fully reimbursed as is being implemented fr Medicare Part B IRMAA (see abve). Instructins n hw t submit yur IRMAA bill fr this reimbursement will fllw in a separate ntice. Plans will cntinue t crdinate benefits, but the Medicare Savings feature that pertained nly t Plan 1 will be eliminated. In certain cases, this feature prvided additinal reimbursement t RMIP Plan 1 (and nt Plan 2) participants in Medicare fr such csts as deductibles and certain unpaid, but allwable expenses. The Wrld Bank RMIP was the 1 Generally, RMIP 1 is the retiree medical plan fr staff wh met eligibility requirements and were participants in the Staff Retirement Plan n r befre April 14, 1998 and RMIP 2 is the retiree medical plan fr staff wh met eligibility requirements and became participants in the Staff Retirement Plan n r after April 15, 1998. 2 Express Scripts and Medc merged n April 2, 2012. 3 A supplementary wrap is a secnd plan integrated r wrapped arund the Medicare Part D benefits s that the cmbined benefits are similar t thse f the RMIP plan. 2
nly plan identified that cntinued t prvide this feature. Additinal details n this feature are in the FAQs. What RMIP features will stay the same? The 40% discunt n the RMIP premium will be retained fr retirees enrlled in nn-u.s. natinal health plans. The current methds fr crdinating cverage between Medicare and RMIP 1/RMIP 2 remain the same except fr the remval f the Medicare Savings feature under RMIP 1 effective January 1, 2013 (nted abve). RMIP participants will cntinue t be bligated t jin any natinal health plan fr which they are eligible and fr which they can participate n the basis as generally applicable t ther natinals f their cuntry f residence. Actins Needed by RMIP Members Enrlled in Medicare In preparatin fr these RMIP changes, thse enrlled in Medicare will need t take the fllwing steps: Watch yur mail fr mre infrmatin frm Express Scripts regarding the Express Scripts Medicare (PDP) fr Wrld Bank Grup prescriptin drug plan. Lk fr changes in yur mnthly pensin beginning with the July 31, 2012 payment. The pensin payment will reflect reimbursement f the full Medicare Part B standard premium f $99.90, and n discunts t premiums fr Medicare Part B and Medicare Part A. Lk fr mre infrmatin later this year n hw t claim reimbursement fr the additinal Medicare Part B incme-related premium (if applicable). The initial reimbursement, effected after January 1, 2013, will be fr the perid frm July 1, 2012 t December 31, 2012. Infrmatin will als be prvided n hw the incme-related premium fr Express Scripts Medicare (PDP) fr Wrld Bank Grup prescriptin drug plan which becmes effective January 1, 2013 will be reimbursed. If yu pay yur RMIP premiums directly t Aetna, make sure WBG has yur current address n file. Yu can update yur address by cntacting the Pensin ffice, 1pensin@wrldbank.rg r fax a signed change f address t: 202-522-1723. N actin is required by RMIP members wh are nt enrlled in Medicare. Fr Mre Infrmatin If yu need additinal infrmatin n the upcming changes, please visit the HR website, www.wrldbank.rg/humanresurces, r cntact the HR Service Center, hrservicecenter@wrldbank.rg, r call, 202-473-2222. 3
Frequently Asked Questins (FAQs) 1. Hw were the changes t RMIP cnsidered? A wrking grup created by a Bank-wide Staff Benefits Review Steering Cmmittee and cmprising internal WBG staff and representatives frm the 1818 Sciety, the Staff Assciatin, and an independent cnsulting firm recently cmpleted a review f the current RMIP structure. The wrking grup specifically examined: Retiree premiums and WBG cntributins fr RMIP1 and RMIP2 4 Retiree premium discunts fr natinal health plan cverage Crdinatin f benefits between the RMIP and Medicare Mandatry natinal health plan participatin requirements Hw the RMIP cmpares t the plans f ther U.S.-based internatinal rganizatins. This cmprehensive review was cnducted, in part, t address cncerns raised by Medicare-enrlled retirees regarding the amunt f RMIP discunt prvided cmpared t the retiree cst fr mandatry participatin in Medicare. 2. Why are these changes being made t the RMIP? The imprved integratin with Medicare prvides savings fr bth the plan and participants. 3. Is enrllment/participatin in Medicare still mandatry? Yes. RMIP members are still required t enrll in Medicare Part A if yu are eligible and can d s withut paying a mnthly premium, and in Medicare Part B, if eligible and can d s n the same basis as generally applicable t ther US natinals. 4. Was remving the mandatry Medicare participatin requirement cnsidered? WBG reviewed this ptin; hwever, it was cst prhibitive and wuld result in the lss f savings t the RMIP derived by retirees participatin in Medicare. 5. When I enrlled in Medicare Part B, I had t pay a late enrllment penalty. Will I als be reimbursed fr this penalty amunt? N. Reimbursement will nly be made fr the standard Medicare Part B premium ($99.90 in 2012) and fr the incme-related additinal premium, if applicable. There will be n reimbursement fr a late enrllment penalty. 6. Will the Full Crdinatin f benefits methd fr RMIP1 and the Exclusin Methd f benefits fr RMIP2 Medicare members cntinue? Yes. 7. Will my RMIP premium increase if I am enrlled in Medicare A and nt Medicare B? If yu are enrlled in Medicare A nly, yu will n lnger receive any discunt and yur RMIP premium effective July 1, 2012 will be higher. If yur premium is deducted frm yur mnthly pensin, yur pensin depsit n July 31 will be smaller. 8. Will the Bank ntify me if my RMIP premium will change effective with the July 31 pensin depsit? Yes, the Bank will mail a ntice in July with the amunt f the new premium t thse retirees with premium changes. 4 Generally, RMIP 1 is the retiree medical plan fr staff wh met eligibility requirements and were participants in the Staff Retirement Plan n r befre April 14, 1998 and RMIP 2 is the retiree medical plan fr staff wh met eligibility requirements and became participants in the Staff Retirement Plan n r after April 15, 1998. 4
9. If I am nt enrlled in Medicare, will my RMIP premium change? Yur premium fr the remainder f 2012 will be unaffected if yu are nt enrlled in Medicare. Future RMIP premiums shuld increase mre slwly than therwise due t the fllwing: (i) an additinal subsidy that will be received frm Medicare fr the Express Scripts Medicare (PDP) fr Wrld Bank Grup, (ii) the discunt fr Medicare A and Medicare B has been reduced t zer percent, (iii) the Medicare Savings feature has been eliminated, and (iv) the Medicare B premium reimbursement will be financed in the rati f 75% Bank and 25% RMIP members. 10. If I am enrlled in anther Natinal Health Care Plan, will I cntinue t receive the 40% premium discunt? Participants enrlled in anther Natinal Health Care plan will cntinue t receive the 40% discunt n their premiums. 11. Will the WBG cntinue t review the RMIP plans? Yes, the plans will cntinue t be reviewed peridically. As nted abve, phase 2 f the RMIP review will include a study f the current levels f the Medicare Part A and nn-u.s. health plan discunts, the RMIP 2 structure, the RMIP premium incme brackets, and the adequacy f the access f Medicare participants t dctrs. 12. Where can I learn mre abut the Express Scripts Medicare (PDP) fr Wrld Bank Grup? Express Scripts\Medc and WBG will send detailed cmmunicatins later this year. Additinal infrmatin n Medicare Part D plans is als available n www.scialsecurity.gv/mediinf.htm r by calling Scial Security at 1-800-772-1213 (TTY: 1-800-325-0778). 13. Will I have access t the same pharmacies? Yes, with the exceptin f Veterans Administratin (VA) pharmacies. VA pharmacies are nt permitted t participate in Medicare Part D pharmacy netwrks. If yu are eligible fr VA benefits, yu can still use VA pharmacies under thse benefits. Hwever, the cst f thse medicatins and what yu pay ut-f-pcket will nt cunt tward yur Medicare Part D drug spend r ut-f-pcket cst accumulatrs. 14. Hw will the Express Scripts Medicare prescriptin drug plan differ frm what I currently use? The preferred drug list ( frmulary ) may differ slightly, but all drugs cvered by the RMIP will cntinue t be available. Overall, the change will prvide lwer csts fr prescriptin drug benefits. Hwever, members may experience sme lwer r higher cpayments n nngeneric drugs. 15. What can I d if I d nt want t enrll in the Express Scripts Medicare (PDP) fr Wrld Bank Grup? Yu may pt ut f the Medicare Part D (PDP), but please be aware that if yu d s yu wuld nt have any prescriptin drug cverage available t yu frm the RMIP. 16. Hw will WBG reimburse me fr my Medicare Part B standard premiums and incmerelated premium payments? Beginning in July 2012, yur pensin payment (issued n r abut July 31, 2012) will include the Medicare Part B standard premium. Fr thse retirees wh pay the additinal incme-related premium fr Medicare Part B, additinal infrmatin will be prvided with yur annual change ntice in Octber n hw t receive reimbursement fr the incme related prtin (IRMAA) f the Medicare B premium later this year. Infrmatin will als be prvided n hw the IRMAA fr the Medicare Part D drug plan (Medicare D) will be reimbursed. 5
17. My spuse/dmestic partner and I are bth enrlled in Medicare. D we receive reimbursement fr bth f ur Medicare Part B standard premiums and IRMAA? Yes. As lng as WBG has a recrd f yu and yur spuse s/dmestic partner s enrllment in Medicare Part B and the RMIP, yu bth will receive reimbursement fr the Part B standard premium and fr IRMAA if yu are required t pay IRMAA. 18. When will Medicare reimbursement cmmence? As f July 1, 2012, Medicare discunts will n lnger be prvided. This means that the discunts will be included in yur June 2012 pensin payment (issued n r abut June 30, 2012) but nt in yur July 2012 pensin payment (issued n r abut July 31, 2012). 19. I tk my pensin in a lump sum payment. Hw will I receive the Medicare Part B standard premium reimbursement? Aetna will be instructed t adjust premiums fr retirees enrlled in Medicare B effective with their July premium payments. It is imprtant that yu make sure that Aetna Direct Billing has yur crrect mailing address. Yu can cmplete the change n the back f yur mnthly billing statement r fax yur new address t them n 859-280-1267. Make sure t include yur ID number and a daytime cntact number. 20. My spuse/dmestic partner is nt yet eligible fr Medicare. Will we bth be enrlled in the Express Scripts Medicare (PDP) as f January 1, 2013? N. Only thse RMIP members wh are eligible fr and enrlled in Medicare will be enrlled in the mdified RMIP prescriptin drug plan. Thse RMIP members wh are nt yet Medicare-eligible will cntinue in the current RMIP prescriptin drug plan. 21. Hw will the Express Scripts and Medc merger impact my prescriptin drug cverage? Yur prescriptin benefit remains unchanged. Yu will cntinue t have access t the same medicatins, and supprt f pharmacists and clinical experts as befre. Yu can cntinue t call the number lcated n the back f yur Medc ID card. Members shuld cntinue t access the website at www.medc.cm. 22. I am in RMIP Plan 1. Hw will the eliminatin f Medicare Savings feature as f January 1, 2013 affect me? Medicare Savings is a RMIP Plan 1 feature that calculates the amunt the RMIP saves n a claim payment due t a retiree receiving a benefit frm Medicare. The amunt saved is then applied t ffset the retiree s ut-f-pcket csts fr claims during the calendar year, such as cpays and cinsurance amunts. As f January 1, 2013, the RMIP will cntinue t crdinate Plan 1 claim payments with Medicare, using the full crdinatin methd currently emplyed. Hwever, Plan 1 retirees will see an increase in ut-f-pcket csts since the amunt the RMIP saves n claims will nt be applied t ffset ut-f-pcket csts during the calendar year. Since the Medicare Savings feature applies nly t Plan 1 participants, this change des nt affect Plan 2 participants. 6