Get Ready to Retire 2017 Transition to Retirement Guide Keep this guide for your records
INSIDE THIS GUIDE PREPARING TO RETIRE 3 IMPORTANT GUIDELINES 5 EVIDENCE OF CONTINUOUS HEALTH CARE COVERAGE 6 HEALTH INSURANCE MARKETPLACE COVERAGE 6 ELIGIBILITY FOR RETIREE HEALTH CARE COVERAGE 8 ELECTING RETIREE HEALTH CARE FOR YOU AND YOUR DEPENDENTS 9 CONTINUING COVERAGE THROUGH COBRA 10 NON-MEDICARE-ELIGIBLE COVERAGE 11 MEDICARE-ELIGIBLE COVERAGE NATIONWIDE RETIREES 12 HEALTH REIMBURSEMENT ACCOUNTS NATIONWIDE RETIREES 14 MEDICARE-ELIGIBLE COVERAGE & HEALTH REIMBURSEMENT ACCOUNTS HARLEYSVILLE 15 RETIREE GROUP LIFE INSURANCE 16 WHAT HAPPENS AFTER RETIREMENT? 17 WHAT ABOUT ID CARDS? 19 VOLUNTARY BENEFITS 19 A FINAL NOTE 20 Questions? If you have questions about retiring from Nationwide after reading this guide, please call the Associate Service Center at 855-550-0411 or submit a question at myplace in the side navigation bar. Health Advocate is another resource available to you. They can help answer your health care benefit questions. Health Advocate is a service provided and paid for by Nationwide to help you and your entire family navigate the health care system and maximize your health care benefits. Health Advocate s confidential service is offered at no additional cost to you and can help you with clinical and administrative issues involving your medical, hospital, vision, dental, pharmacy and other healthcare needs. If you have a health care or insurance issue you need help with, call Health Advocate toll-free at 866-695-8622. 2
In addition, you may call 800-428-2363 for a complimentary consultation with a Fidelity retirement representative to answer questions about how to: Not outlive your savings in retirement Generate a predictable stream of retirement income Invest to maintain your current lifestyle in retirement Plan for tax-smart withdrawals Investing involves risk, including risk of loss. Guidance provided is educational. Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI 02917. 775961.1.0 PREPARING TO RETIRE Retiring can be an exciting time, but it can also be stressful as you work to ensure that your benefits are ready for you when you need them. This guide is designed to help you think through some of the details related to Nationwide-offered benefits so you can relax and enjoy your retirement. Here is a checklist to help you through the process: ITEMS TO COMPLETE Read this guide to understand what benefits you may be eligible for as a retiree, your health care coverage options (including who you can cover) and to understand the importance of maintaining continuous health care coverage from the time you retire. Harleysville associates should pay special attention to sections that apply only to them. Review your personalized Retiree Benefits Election Form. It lists all available coverage options and monthly contribution rates. Compare your health care coverage options. There are separate coverage options for Medicare-eligible individuals and non-medicare-eligible individuals. Details of coverage options available to Nationwide retirees and dependents are included in Appendix B and Appendix C 2017 Schedule of Benefits, which are part of the Summary Plan Description. You are only eligible to enroll in the plans that are shown on your personalized enrollment forms. If you believe your personalized enrollment forms do not show the correct options due to a change in your status, such as becoming Medicare-eligible, please contact the Associate Service Center (ASC) to update your options. For Harleysville Medicare-eligible associates or dependents only: You have the opportunity to enroll in an individual Medicare plan of your choice and will be assisted 3
in the enrollment process by OneExchange. See page 17 of this Guide for more information. Consider your prescription drug coverage options. Prescription drug coverage is included with all of the non-medicare-eligible plans. Prescription drug coverage is not included with the three Medicare-eligible plans and must be elected separately. Details of the Medicare-eligible prescription drug options available to Nationwide retirees and dependents are included in Appendix C 2017 Schedule of Benefits for Medicare Eligible Participants. For Harleysville Medicare-eligible associates or dependents only: You have the opportunity to enroll in an individual Medicare Prescription Drug Plan of your choice and will be assisted in the enrollment process by OneExchange. Complete and Return the following forms to the ASC as soon as possible, but preferably 30 days before your retirement effective date: Retiree Benefits Election Form Retiree Group Life Insurance Beneficiary Form (included if you re eligible to enroll) Retirement Announcement Form (if you want your retirement announced in the InSide Extra) Watch your mail for an Invoice from Conexis if you elected retiree medical or retiree life insurance benefits. Your first invoice should arrive no later than the 10 th day of the month in which your retiree medical or life insurance benefits are effective. Call The Nationwide Retirement Center (NRC) at 800-238-4015 or visit www.netbenefits.com/nationwide to elect your pension benefit. You should make your pension benefit election no later than 30 days before your retirement date. Once your pension benefit election is recorded with the NRC, you ll receive a confirmation of your election. Review the confirmation, sign and date the Pension Benefit Election Authorization Form and return it to the NRC. If you elect retiree medical benefits, you must also elect and begin receiving your pension payments. Watch for your COBRA notice in the mail. COBRA stands for Consolidated Omnibus Budget Reconciliation Act, which became law in 1986. COBRA gives you the right to temporarily continue certain benefits that would otherwise end when you leave the company. Your COBRA notice will be mailed to you by our COBRA administrator, CONEXIS after your last day of employment is recorded in HRIS by your manager. Be sure to look in this guide for more information. Find answers to other questions about leaving the company by reading the 2017 Leaving Nationwide Guide. 4
IMPORTANT GUIDELINES As you review your benefit options, keep these guidelines in mind. If you meet the eligibility requirements, you can elect health care coverage for yourself and your eligible dependent(s) when you retire. Depending upon your age and the age of your dependent(s), you will be offered options for Medicare-eligible and/or non-medicare-eligible coverage. All family members who qualify for and are enrolled in Nationwide-offered health care coverage must be enrolled in the same coverage option. If you or an eligible dependent become Medicare-eligible due to age or disability, that individual is no longer eligible for coverage under the non-medicare plan options offered by Nationwide. Enrollment in Medicare Part A and Part B is required at that time. Contact the ASC as soon as you know you ll become Medicare-eligible for information about the Medicare plan options offered by Nationwide and to ensure you have no break in coverage. If you are a Harleysville retiree, contact the ASC for information about OneExchange s services to assist you. While Nationwide offers a variety of health care coverage options for retirees, you should also consider and compare any other coverage options that may be available to you and your family, such as coverage through a spouse s/domestic partner s employer s plan. Your goal is to obtain the best coverage with the highest value to you, so it pays to take the time to research all of your options. Remember, eligible individuals can return to Nationwide-offered health care coverage during a future annual enrollment as long as evidence of continuous coverage is provided. If you and any eligible dependent(s) are enrolled in Nationwide-offered health care coverage as of your last day of employment, your coverage will continue through the last day of the month in which your termination of employment occurs, provided that: You elect to begin monthly Nationwide Retirement Plan benefits (or elect a total lump sum distribution, if eligible) effective the first of the month immediately following your last day of employment, and You elect Nationwide-offered retiree health care coverage to begin the first of the month immediately following your last day of employment. If you don t start both your monthly pension benefits and your retiree health care coverage the first day of the month following your last day of employment, any Nationwide-offered health care coverage in effect for you and any eligible dependent(s) as an active associate will end on your last day of employment. If you were subject to the biweekly medical coverage surcharge as an active associate in 2017 because your enrolled spouse or domestic partner had access to other employeroffered medical coverage, you no longer will be subject to this surcharge as a retiree. 5
EVIDENCE OF CONTINUOUS HEALTH CARE COVERAGE Following your termination, if you and any eligible dependents who are not currently enrolled in Nationwide-offered health care coverage wish to re-enroll, you ll need to provide evidence of continuous coverage since the later of: The date of your termination of employment. The date any Nationwide-offered health care coverage ended for the individual being enrolled. Evidence of continuous coverage means evidence that you or your eligible dependent, for whom coverage is sought, has had medical benefits coverage continuously in effect under a: Current employer s health care plan. Former employer s (including military) retiree health care plan. Spouse s/domestic partner s employer s (including military) health care plan. Spouse s/domestic partner s employer s (including military) retiree health care plan. Spouse s/domestic partner s former employer s (including military) retiree health care plan. COBRA continuation health care plan. Group Medicare Advantage (Part C) health care plan, if Medicare-eligible. Individual Medicare Advantage (Part C) health care plan, if Medicare-eligible. Federal or state Health Insurance Marketplace Silver, Gold, or Platinum qualified health care plan (excluding the lowest level Bronze coverage) as defined by Healthcare.gov, if non- Medicare-eligible. Note: Enrollment in Original Medicare Parts A and B with or without an Individual Medicare supplement plan does not qualify as evidence of continuous health care coverage. Note: For this purpose, employer contributions to an employer-sponsored retiree Health Reimbursement Account is considered a retiree health care plan that would satisfy the Evidence of Continuous Coverage requirement. HEALTH INSURANCE MARKETPLACE COVERAGE The Patient Protection and Affordable Care Act enacted in 2010, commonly referred to as health care reform or the Affordable Care Act, requires all individuals, including retirees, to have health care coverage or pay a fee. 6
To avoid the fee, you need health care coverage that qualifies as minimum essential coverage. If you re covered by any of the following, you re considered to have minimum essential coverage and don t have to pay a fee: Any employer offered plan (including COBRA) this includes the Nationwide retiree plans Medicare Medicaid The Children s Health Insurance Program (CHIP) TRICARE (for veterans and veteran families) Veterans health care programs Peace Corps Volunteer plans Any Marketplace plan or any individual insurance plan you are already enrolled in that provides minimum essential coverage Please note: Some of the plans listed above do NOT satisfy Nationwide s Evidence of Continuous Coverage requirements as outlined in the Nationwide Retiree Health Care Plan SPD and shown elsewhere in this guide. Enrollment in a Nationwide-offered health care option meets the requirement of being covered by an employer-offered plan. Important information for non-medicare-eligible retirees only: As noted above, an option available to you if you are not Medicare-eligible, is coverage through federal or state health insurance exchanges called the Marketplace. Depending on your household income, if you purchase coverage in the Marketplace you may be able to get lower costs on monthly premiums (a federal premium tax credit) or on out-of-pocket costs, or get free or low-cost coverage. These lower costs on Marketplace coverage are not available if you are enrolled in a Nationwide-offered health care option. Remember, if you waive coverage in Nationwide-offered healthcare coverage at the time you retire, evidence of continuous health care coverage is required to re-enroll at a later date (refer to page 7). Coverage through the Marketplace for a Silver, Gold or Platinum category health care plan will qualify as evidence of continuous coverage. It is important to be a good health care consumer and understand the changing landscape of health care. Marketplace coverage may provide you with attractive options and plan choices. You should review your choices and choose an option that makes the most sense to you. We understand that many of the terms associated with health care reform may be unfamiliar to you. You can visit healthcare.gov, the official government website for information on health care reform and the Marketplace. You can also get Marketplace help online, by phone, chat or in person. Call 1-800-318-2596, 24 hours a day, seven days a week. (TTY: 1-855-889-4325). 7
ELIGIBILITY FOR RETIREE HEALTH CARE COVERAGE There are several categories of eligibility for retiree health care coverage that are described below. You should review the retiree health care SPD for a complete description of the eligibility requirements and contact the Associate Service Center at 855-550-0411 to confirm your eligibility to continue health care coverage. Nationwide associates and Allied acquisition associates Associates age 55 or older at the point of termination (age 52 or older if termination is the result of a job elimination), who have a minimum of 120 months of retiree health care eligibility service, qualify for access to retiree health care coverage, but not company costsharing. Associates age 55 or older at the point of termination (age 52 or older if termination is the result of a job elimination) qualify for retiree health care coverage with company cost-sharing, based on the Nationwide cost-sharing schedule and their cost-sharing service as of Dec. 31, 2009, if they: o Have been continuously employed since any date prior to June 1, 2000. o Have a minimum of 180 months of retiree health care eligibility service. Calfarm acquisition associates CalFarm acquisition associates age 55 or older at the point of termination (age 52 or older if termination is the result of a job elimination) qualify for retiree health care coverage with company cost-sharing, based on the Nationwide cost-sharing schedule and their costsharing service as of Dec. 31, 2009, if they: o Have remained continuously employed since the acquisition. o Have a minimum of 180 months of Nationwide retiree medical eligibility service. CalFarm acquisition associates who meet the criteria outlined above will receive credit for their combined pre- acquisition CalFarm service and Nationwide service as of Dec. 31, 2009, when calculating cost-sharing. Provident acquisition associates Provident acquisition associates age 55 or older at the point of termination (age 52 or older if termination is the result of a job elimination) qualify for retiree health care coverage with company cost-sharing, based on the Provident cost-sharing schedule and their cost-sharing service as of Dec. 31, 2009 if they: o o Have remained continuously employed since the acquisition. Have a minimum of 120 months of combined Provident and Nationwide retiree health care eligibility service. 8
Harleysville acquisition associates Harleysville acquisition associates and their eligible dependents not yet eligible for Medicare qualify for access to group retiree health care coverage if age 55 or older at the point of termination (age 52 or older if termination is the result of a job elimination) and if they have a minimum of 120 months of retiree health care eligibility service. Harleysville acquisition associates and their eligible dependents who are eligible for Medicare have the opportunity to enroll in an individual Medicare plan as long as they have at least 120 months of retiree health care eligibility service when employment ends or are over age 65 and have at least 60 months of retiree health care eligibility service when their employment ends prior to Jan, 1, 2018. Harleysville acquisition associates will be assisted in the enrollment process by OneExchange. Company financial support may be available at age 65 if you were hired at Harleysville prior to Jan. 1, 1993, and have at least 20 years of service as of Dec. 31, 2012. The company financial support will be credited to a Health Reimbursement Account beginning the later of the month in which your employment ends or the month you are eligible for Medicare. Residing Outside the United States Retirees of Nationwide, Long-Term Disability recipients and their eligible dependents who permanently reside outside the United States are not eligible to enroll in Nationwide-offered plans. ELECTING RETIREE HEALTH CARE FOR YOU AND YOUR DEPENDENTS Associates who qualify for retiree health care coverage may cover a spouse/domestic partner and any dependent children/children of their domestic partner they had as of their date of termination. A baby born to the retiree within 10 months of termination also qualifies for coverage. If you qualify for retiree health care coverage, you may elect to commence coverage the month immediately following termination of employment, provided you commence monthly pension plan benefits (or elect a total lump sum distribution, if eligible) at the same time. If you delay commencement of pension plan benefits, you also have to delay commencement of retiree health care coverage. If you commence retirement plan benefits as well as retiree health care coverage effective the month immediately following termination of employment, any Nationwide-offered health care coverage in effect for you and any eligible dependents at the point of termination will continue through the end of the month. If you qualify for but don t commence retiree health care coverage effective the month immediately following termination of employment, any Nationwide-offered health care coverage in effect for you and any dependents will end on your last day of employment. In order to elect retiree health care 9
coverage at a later date, evidence of continuous health care coverage since your date of termination will be required. This same requirement applies to eligible dependents. See the Evidence of Continuous Health Care Coverage section of this guide. Nationwide requires you to verify your dependent s eligibility. You ll be notified when proof of eligibility is required. Respond promptly when providing your eligibility documentation to prevent termination of those individual s coverage or a delay in starting their coverage. Nationwide allows coverage to continue in Nationwide-offered coverage through the end of the calendar year in which dependent children turn 26, subject to the eligibility requirements stated in the plan. Eligibility for an enrolled spouse ends immediately in the event of a divorce and is effective as of the divorce date. If your enrolled domestic partner no longer meets the definition of a domestic partner, his/her eligibility ends as of the date he/she no longer meets the eligibility requirements. If a retiree loses his/her eligibility for coverage, then his/her spouse/domestic partner and/or children become ineligible for coverage. You must notify Nationwide immediately of any change in eligibility. Questions? For questions regarding eligibility for retiree health care coverage, available coverage options, the cost of coverage and/or retirement procedures, contact the Associate Service Center at 855-550- 0411. CONTINUING COVERAGE THROUGH COBRA When you terminate your active employment, you and your dependents who are enrolled in health care, dental, vision and/or supplemental accident coverage have the right to temporarily continue that coverage under provisions of COBRA. You also have the right to continue your Family Medical Flexible Spending Account (FSA) under COBRA for the calendar year in which termination of employment occurs. If you do not choose to continue your FSA under COBRA, you will only be able to file claims for expenses incurred prior to your termination of employment. Each individual losing health care, dental, vision and/or supplemental accident coverage as a result of your termination of employment will be sent a COBRA Election Form by CONEXIS (Nationwide s COBRA Plan administrator) following your termination of employment. Each individual who is losing coverage may elect single continuation coverage and not include other family members. As an alternative, family members may elect coverage as a group. It is not necessary to elect all available categories of COBRA coverage in order to continue a specific coverage under COBRA. For example, if an individual is eligible to continue health care, dental and vision coverage under COBRA, but they wish to continue only one or two of those categories of coverage, that is permitted. 10
In order to continue existing health care, dental, vision and/or supplemental accident coverage, CONEXIS must receive a completed COBRA Election Form within 60 days of either the date coverage ended as a result of your termination of employment or the date the COBRA Election form is mailed by CONEXIS, whichever is later. If COBRA continuation coverage is elected, the first payment must be received by CONEXIS within 45 days of the election of COBRA coverage. Subsequent payments are due the first day of each month. These same deadlines apply to continuing an FSA under COBRA. In general, COBRA coverage for you and any covered dependents may be continued for up to 18 months even if you are entitled to Medicare when you elect COBRA. If you become entitled to Medicare after electing COBRA, your COBRA coverage will terminate. However, COBRA for your spouse and dependents may continue for up to 18 additional months (for a total of up to 36 months of COBRA coverage). Under certain circumstances, an individual enrolled for COBRA coverage may qualify for an extension to their initial COBRA coverage period. NON-MEDICARE-ELIGIBLE COVERAGE The following health care options are available to non-medicare-eligible individuals in all locations, and are administered by UnitedHealthcare: Health Savings Choice 1 (HSC1) Health Savings Choice 2 (HSC2) PPO Premium Prescription drug coverage is included with all options. OptumRx administers the prescription drug coverage for the HSC1, HSC2 and PPO Premium options. The phone number for OptumRx is 800-201-1336. Refer to Appendix B - 2017 Schedule of Benefits for Non-Medicare Eligible Participants for an overview of each of the Nationwide-offered health care options. If you have questions about any of the UnitedHealthcare coverage options, call UnitedHealthcare at 800-201-1336. If you elect coverage under a different health care option when you retire, your deductible will restart. If you or an eligible dependent becomes Medicare-eligible, either at age 65 or at an earlier age due to disability, contact the ASC for enrollment in Medicare options. Health Savings Account As a non-medicare-eligible individual, if you elect HSC1 or HSC2 you may be eligible to contribute tax-deductible money to a Health Savings Account (HSA). The HSA is a tax advantaged medical savings account you can use to cover deductibles, co-payments, coinsurance and other qualified medical expenses. Federal law limits the maximum amount you can contribute. In 2017, you may contribute up to $3,400 if you elect individual coverage and up to $6,750 if you elect family 11
coverage. If you are age 55 or older, or will reach age 55 during 2017, you can make an additional catch-up contribution up to $1,000. WageWorks administers the Nationwide HSA in partnership with Bank of New York Mellon. You ll need to send your contributions directly to Bank of New York Mellon. As a retiree you will pay for any fees associated with your participation in a Nationwide HSA. An Application and Adoption Agreement for the Nationwide-offered HSA is enclosed with this Guide if you are eligible for HSC1 or HSC2. You may establish an HSA with another provider. If you choose to do so, please contact that provider for contribution instructions. In general, if you elect either the HSC1 or HSC2 health care option which qualify as high deductible health plans and want to contribute to a HSA, you cannot have health care coverage under another plan unless that plan is a high deductible health plan. See IRS Publication 969 for specific rules on eligibility, contribution limits and distributions. Consider all your coverage options While Nationwide offers a variety of health care coverage options for non-medicare-eligible individuals, you should also consider and compare any other coverage options that may be available, such as coverage through a spouse s/domestic partner s employer s plan. Remember, eligible individuals can return to Nationwide-offered health care coverage during a future annual enrollment or qualified loss of coverage event, as long as they can show that they have maintained continuous health care coverage. Look in this guide for a full description of the Evidence of Continuous Coverage requirements on page 7. Coverage changes are effective the first day of the month following the event. MEDICARE-ELIGIBLE COVERAGE Nationwide retirees Medicare-eligible individuals are eligible to select from three medical and two prescription drug plans. In order to enroll in one of the medical plan options, a Medicare-eligible individual must be enrolled in Medicare Parts A and B and pay the Part B premium. Medical coverage options: UnitedHealthcare Group Medicare Advantage (PPO) Plan UnitedHealthcare Senior Supplement Insurance Plan F UnitedHealthcare Senior Supplement Insurance Plan K 12
Prescription drug coverage options: UnitedHealthcare MedicareRx for Groups Option 1 UnitedHealthcare MedicareRx for Groups Option 2 Please refer to Appendix C 2016 Schedule of Benefits for Medicare-eligible participants for details on the medical coverage options as well as prescription drug information. If you have questions about any of the UnitedHealthcare coverage options (medical or Rx), call UnitedHealthcare at 877-711-5893. When deciding which coverage option provides your best value, be sure to consider: Whether your provider accepts the plan, The monthly premium cost under each of the Nationwide-offered options, and The out-of-pocket expenses incurred under each medical and prescription drug option; for example, co-pays and coinsurance. If you re eligible for Medicare All family members who are Medicare-eligible and who qualify for and are enrolled in Nationwideoffered coverage must be enrolled in the same plan. For example, if you are a Medicare-eligible retiree, you cannot enroll yourself in the UnitedHealthcare Group Medicare Advantage (PPO) Plan and your spouse or child in one of the UnitedHealthcare Senior Supplement plans. Enrollment in Medicare Part A and Part B and payment of the required Part B premium is required in order to enroll in a Nationwide-offered health care option. If either you or your spouse will become Medicare-eligible in the calendar year, you should take that into account when making your annual enrollment elections. Consider all your coverage options While Nationwide offers three medical coverage options for Medicare-eligible individuals, you should not limit your coverage decision to only these three options. If you or an eligible dependent have access to coverage through another source, you may decide that an alternative coverage option makes the most sense. Depending on your individual coverage needs, you may want to consider another Medicare Advantage plan (Medicare Part C) or an individual Medicare supplement plan. Eligible individuals can return to Nationwide-offered health care coverage during a future annual enrollment or qualified loss of coverage event, as long as you can show that they have maintained health care coverage that qualifies as continuous coverage. Remember that enrollment in original Medicare A and B, with or without an individual Medicare Supplement plan, does not qualify as evidence of continuous health care coverage. Also, if you enroll in coverage that results in your loss of eligibility all of your dependents will lose their eligibility as well. 13
For more information on Medicare Advantage and Medicare Supplement plans offered in your area, review the 2016 Medicare & You handbook, visit medicare.gov or call Medicare at 800- MEDICARE, 24 hours a day, 7 days a week. TTY users should call 877-486-2048. You can also get assistance through your state Senior s Health Insurance Information Program (SHIIP) office which can be found on the Medicare website. HEALTH REIMBURSEMENT ACCOUNTS Nationwide retirees If you are eligible for cost-sharing*, are Medicare-eligible and you or a dependent enroll in one of the Nationwide-offered medical plans, you are eligible to receive a credit of $35 per month, per enrolled individual. How the $35 credit is applied depends on the plan you elect and whether you elect Nationwide-offered prescription drug coverage. If you enroll in any of the Nationwide Medicare-eligible health care options and you also elect one of the Nationwide-offered UnitedHealthcare Prescription Drug Plans (PDP): Your $35 credit will be applied directly to the cost of your PDP to reduce your monthly invoice from UnitedHealthcare. If you elect either of the Senior Supplement Plans and do not enroll in a UnitedHealthcare PDP through Nationwide: The $35 credit will be credited to a Health Reimbursement Account (HRA) administered by WageWorks. You can then use the credit toward the cost of the Senior Supplement Plan or any other eligible health care expenses. If you waive Nationwide-offered coverage and enroll in an Individual Medicare Advantage Plan (Medicare Part C) and are eligible for cost-sharing: Instead of the $35 referred to above, Nationwide will contribute $70 per month to your HRA for each Medicareeligible individual who waives coverage. A copy of the membership ID card for the Individual Medicare Advantage plan each individual is enrolled in is required before the credit can begin. Failure to provide a copy of the ID card will result in a delay or forfeiture of the HRA credit. What does cost-sharing mean? Cost-sharing means the company contributes toward the cost of a retiree s medical coverage. Not all retirees who qualify for retiree medical coverage qualify for cost-sharing. Some qualify for retiree medical coverage on an access-only basis, which means you pay the total cost of coverage. How can I use my HRA funds? Distributions from the HRA can be used only to reimburse Qualified Medical Expenses for the individuals who receive credits to the HRA. The funds in your HRA can be used for eligible health 14
care expenses, such as: All Medicare premiums. Medicare Advantage Plan deductibles, co-payments, coinsurance or other cost-sharing under a Medicare Advantage plan. Contributions toward the cost of Nationwide-offered health care and/or prescription drug coverage (but not out-of-pocket prescription drug costs). Contributions you and your spouse make toward the cost of other health care coverage, including the cost of qualifying long-term care coverage. Out-of-pocket costs paid to doctors, hospitals, technicians and other health care providers as long as the costs aren t for prescription drugs that qualify under Medicare Part D. HRA administration The HRA is administered by WageWorks. If you or a covered dependent first qualify for HRA credits in 2017 WageWorks will send you a welcome packet that explains how to submit claims for eligible expenses. If you already have a Nationwide-offered HRA, you will not receive a welcome packet. Contact WageWorks at 877-924-3967 with questions about your HRA. WageWorks website is wageworks.com. MEDICARE-ELIGIBLE COVERAGE Harleysville retirees Harleysville retirees who are Medicare-eligible have the opportunity to enroll in an individual Medicare plan of your choice and will be assisted in the enrollment process by OneExchange. OneExchange is a resource that will help you evaluate your plan options, provide advice and decision making support, and assist you in completing your enrollment. You can contact OneExchange by calling 855-872-6809. You are eligible for this resource if: You leave the company after you reach age 55 and you have at least 10 years of service, OR; You leave the company after reaching age 65 prior to Jan. 1, 2018, and you have at least five years of service. HEALTH REIMBURSEMENT ACCOUNTS Harleysville retirees For the majority of Harleysville associates, company financial support is only available through 15
the Retiree Health Care Credit program. However, you may be eligible for retiree health care company financial support under the Harleysville Retiree Health Benefit Program if you were hired at Harleysville prior to Jan. 1, 1993, have been continuously employed by Harleysville and terminate after reaching age 55. If you meet those requirements, the company will contribute toward your cost of health care based on your years of Harleysville service as of Dec. 31, 2012. ANNUAL COMPANY CONTRIBUTIONS (AGE 65 & OVER) BY YEARS OF SERVICE 35+ $704 30-34 $645 25-29 $587 UNDER 25 $528 The company financial support will be credited to a HRA, administered by OneExchange, quarterly beginning the later of the month in which your employment ends or the month you are eligible for Medicare. How can I use my HRA funds? Distributions from the HRA can be used only to reimburse Qualified Medical Expenses for the individuals who receive credits to the HRA. The funds in your HRA can be used for eligible health care expenses, such as: All Medicare premiums. Medicare Advantage Plan deductibles, co-payments, coinsurance or other cost-sharing under a Medicare Advantage plan. Contributions toward the cost of Nationwide-offered health care and/or prescription drug coverage (but not out-of-pocket prescription drug costs). Contributions you and your spouse make toward the cost of other health care coverage, including the cost of qualifying long-term care coverage. Out-of-pocket costs paid to doctors, hospitals, technicians and other health care providers as long as the costs aren t for prescription drugs that qualify under Medicare Part D. HRA administration The HRA is administered by OneExchange. OneExchange will send you a welcome packet that explains the process for submitting claims for eligible expenses. RETIREE GROUP LIFE INSURANCE If you are eligible to elect Retiree Group Life Insurance when you retire, you may convert all or part of the difference between any Associate Group Life Insurance in effect at the time of your 16
termination minus any Retiree Group Life Insurance elected (see below). This same conversion privilege applies to Spouse Group Life Insurance. You must apply within 31 days from your termination date or you will lose your conversion rights. No underwriting approval is required. To arrange for conversion of existing Associate and/or Spouse Group Life Insurance, call Nationwide Direct at 855-529-2729. The active policy number you will converting from is 0,4777,1, [your associate ID number]. For Harleysville associates only: Harleysville acquisition associates who were employed by Worcester Insurance Company prior to May 1, 1988, who retire at age 55 or later with at least 10 years of service may continue $25,000 of Retiree Group Life Insurance. There currently is no retiree contribution for this coverage. Retiree Group Life Insurance is not available to any other Harleysville acquisition associate. For all other associates: You may also qualify for Retiree Group Life Insurance if you have continuously maintained Associate Group Life Insurance coverage since Dec. 31, 1994. You may elect to continue a portion of that coverage as Retiree Group Life Insurance. The formula used to determine how much Associate Group Life Insurance may be continued as Retiree Group Life Insurance is based on the lowest amount of associate coverage continuously in effect since Jan. 1, 1996. Based on that amount, an associate may continue 25 percent of the first $40,000 of coverage ($10,000) and 15 percent of any coverage over $40,000 (subject to a combined minimum of $5,000 and combined maximum of $64,000). Provident acquisition associates may continue Retiree Group Life Insurance with the lesser of either $25,000 or the lowest amount of Associate Group Life Insurance continuously in effect since Jan. 1, 2003. Contribution rates for Retiree Group Life Insurance are based on age and coverage amount. Based on claims experience in the retiree life insurance contract, a rate increase of approximately 15% is expected in 2018 and a 10% increase in 2020. 2017 RETIREE LIFE INSURANCE CONTRIBUTION Your Age At The End Of The Year Your Cost Per $1,000 Up To $10,000 Your Cost Per $1,000 Over $10,000 55-59 $.58 $0.58 60-64 $.67 $0.87 65-69 $.67 $1.69 70+ $.67 $2.73 Retirees with a coverage amount of more than $10,000 have one contribution rate for the first $10,000 of coverage and another for coverage over $10,000. The cost for each level of coverage appears on a separate line on pension checks or on invoices from CONEXIS. WHAT HAPPENS AFTER RETIREMENT? Deductions for any contribution you were making to United Way will end. You will still have the 17
opportunity to contribute to United Way, and the company will still match your contribution. If you participated in one of Nationwide s deferred compensation programs, be sure your direct deposit information remains updated at Nationwide by calling the Associate Service Center. If you move after you retire, you should update your address with any of the service providers that administer your Nationwide-offered benefits as well as the Associate Service Center. Each year during the fourth quarter, Nationwide has an annual enrollment period. At that time, you can elect to start, stop or change your health care coverage election(s) for the next calendar year. The same is true for Medicare prescription drug coverage elections. If you re enrolled for Retiree Group Life Insurance, you may reduce your coverage amount at any time, but you can never re-elect the amount by which you reduced your coverage. If you re enrolled for medical coverage, you may drop your coverage at any time. The coverage change will be effective on the last day of the month following receipt of your written request. Once annual enrollment ends, you can t make any benefit election changes until next year s annual enrollment period unless you experience a Qualified Change in Status event. For retirees, Qualified Change in Status events include: Divorce, dissolution or court-ordered legal separation. Gain or loss of coverage under another plan for you or an eligible dependent. A covered dependent child no longer meeting all eligibility criteria for coverage under the Nationwide health care plan(s) or the Nationwide retiree health care plan(s). If you are non-medicare-eligible and are enrolled in a Marketplace qualified health plan, a gain or loss of Marketplace coverage due to an event which is considered a qualifying event for purposes of Marketplace coverage (examples include gaining or losing eligibility for premium tax credits or cost-sharing reductions, relocation resulting in new or different Qualified Health Plan selection). It does not include loss of Marketplace coverage due to a voluntary termination of coverage including termination or loss due to failure to pay premiums on a timely basis. You or an eligible dependent becomes Medicare-eligible, either at age 65 or at an earlier age due to disability. New elections are required when you become Medicare-eligible. Any change in coverage must be consistent with a Qualified Change in Status. To be consistent, the Qualified Change in Status must result in you, your spouse/domestic partner or eligible dependent child gaining or losing benefit coverage and the coverage election must be directly related to that gain or loss of coverage. If you experience a Qualified Change in Status event, call the ASC at 855-550-0411 within 60 days of the event. You have 60 days from the date of the Qualified Change in Status event to make changes to your benefit elections. The effective date of the change will be the first day of the month after the ASC receives your written change request. Please notify the ASC as soon as possible 18
should an individual no longer be eligible for coverage (such as divorce, termination of domestic partnership, or a dependent loses eligibility). WHAT ABOUT ID CARDS? If you re currently enrolled in the HSC1 or HSC2 option, and elect retiree health care coverage in that same coverage option, you should continue to use your existing health care ID card. If you re not currently enrolled for Nationwide-offered health care coverage, but elect health care coverage when you retire, you will receive new health care ID cards. If retiree health care coverage is elected in a Medicare-eligible coverage option, and Nationwide-offered prescription drug coverage is also elected, you will receive new, separate, prescription drug ID cards. VOLUNTARY BENEFITS As part of Nationwide s ongoing effort to meet the needs of our retirees, we ve arranged for you to have access to the following products and services at special discounts and group rates. Dental benefits program Choose from two plans and access a network of participating dentists who will accept MetLife s negotiated fees as payment-in-full for dental services. You ll be able to sign up for this program approximately 45 days following your retirement effective date. Information about this program as well as enrollment forms will be mailed to you directly from MetLife. Please note that this generally is a one-time opportunity to enroll at retirement unless you elect continuation of your active dental benefit plan through COBRA. In that case, a second enrollment opportunity will be available when your COBRA dental benefits end. Vision benefits discount program The MetLife VisionAccess Program saves you and your qualified dependents money on regular eye exams and provides discounts on eye wear at participating private practice providers nationwide. You can use this program as often as you need to. Simply find a MetLife private practice provider by calling MetLife at 800-438-6388 or visit mybenefits.metlife.com/mybenefits and give the office the program code MET2020. Long-term care insurance If you are enrolled in this coverage for in-home nursing, assisted living and other long-term care (LTC) services as an active associate, it can be continued as a retiree. Contact your current LTC provider, either MetLife or Genworth. 19
A FINAL NOTE This guide is designed to help you understand the basics of enrolling well. For more specific plan information and details to educate yourself, to help you understand the benefits available to you, please see the Summary Plan Description and Appendix B 2017 Schedule of Benefits for Non- Medicare-Eligible Participants (if you are non-medicare-eligible) or Appendix C 2017 Schedule of Benefits for Medicare-Eligible Participants (if you are Medicare-eligible). This will allow you to make informed benefit decisions. Please note: Nationwide believes in the philosophies, policies, procedures and coverages described in this guide. However, Nationwide reserves the right to alter, amend, modify or terminate them at any time. The philosophies, policies, procedures and coverages described in this guide are not promises of benefits or conditions of employment, nor do they imply or constitute any employment contract. The legal plan documents govern administration and all benefit payments. If there is a conflict between the information in the guide and the legal plan documents, the plan documents will be the final authority in all cases. Because of the diversity among associates, LTD recipients and retirees in terms of their needs, it is recommended that you review your options with whoever helps you with insurance and financial matters before making any benefit decisions. Analysts from the Associate Service Center can answer your questions about enrollment. Call the Associate Service Center at 855-550-0411 or email assocntr@nationwide.com. G-9847 (10/16) 20