This booklet contains important information on how health care plan changes will affect you. *Services provided by Mercer Health & enefits Administration LLC. Mercer Marketplace 365SM* P.O. ox 14401, Des Moines, IA 50306-3401 844.618.6285 (toll-free) 800.695.1317 (TTY) 857.362.2999 (fax) Ahlstrom.Retiree.Exchange@mercer.com http://retiree.mercermarketplace.com/ahlstrom
INCLUDED IN THIS KIT WHO S WHO...3 There are many people supporting you through this change. This list will help you understand the roles and responsibilities of each group. WHAT YOU NEED TO KNOW...4 Knowing what to do and what to expect will help you prepare for a smooth transition. APPOINTMENT PREPARATION...5 Following these steps will help you get the most out of your appointment with your enefits Counselor. QUESTIONS TO THINK AOUT...6 Considering these issues will help you make an informed decision. HEALTH CARE PROVIDER TRACKER...7 List your important health care providers to help determine what kind of plan will best meet your needs. PRESCRIPTION DRU TRACKER...8 ather your prescriptions in one place to give you a head start toward making a sound selection. MEDICARE OPTIONS...9 This tutorial will help you decide which plan options best fit your needs and budget. HEALTH REIMURSEMENT ACCOUNT (HRA)...10 Important facts about the HRA. NOTES...11 Use this page to keep track of any items you wish to discuss when you talk to your enefits Counselor. PAE 2 Welcome to Mercer Marketplace 365. Having the right health care coverage to meet your needs and budget during retirement is important. That s why Ahlstrom is partnering with Mercer Marketplace 365 to provide resources that will help you choose a plan from a variety of health care coverage options. You will shop for and enroll in your new coverage through Mercer Marketplace 365. You now have several options to choose from to meet your medical and prescription drug needs. Mercer Marketplace 365 and its enefits Counselors are ready to support you before, during, and long after your medical plan changes. They will help you understand the different individual plans offered to you, determine the best plan for you, and help you enroll. When you sign up for your new coverage through Mercer Marketplace 365, Ahlstrom will provide you with a subsidy to offset the cost of your health insurance. The subsidy will be placed in a Health Reimbursement Account ( HRA ) set up in your name. This is a special, tax-free account that you may use to reimburse yourself for insurance premiums. Page 10 provides more information about your Health Reimbursement Account. To be eligible for the subsidy, you must enroll for medical coverage through Mercer Marketplace 365. You will have a dedicated enefits Counselor from Mercer Marketplace 365. Your enefits Counselor will help you compare your medical, and prescription drug coverage options. You can also visit our website to compare your options and learn more about Medicare. Refer to page 5 for more information about connecting with your enefits Counselor. In the meantime, review this Welcome Kit. It contains tools and exercises to help you start learning about your new health plan options. Completing the information in this kit will make it easy for you and your enefits Counselor to evaluate your options and get you enrolled. Our team is excited to serve you in this new program. enefits Counselors are available to support you during your enrollment period. You may reach Mercer Marketplace 365 Monday through Friday from 8:00 a.m. to 5:30 p.m. EST at 1-844-618-6285 toll-free (TTY 1-800-695-1317) to set up a consultation. Or, visit us online at http://retiree.mercermarketplace.com/ahlstrom at your convenience, 24 hours a day, seven days a week. For additional information about Mercer Marketplace 365, including our compensation and privacy practices, please see the enclosed documents. We look forward to working with you. Mercer Marketplace 365
Our enefits Counselors will help you through the change in health insurance and get the most out of your Health Reimbursement Account (HRA). Who s Who? You are not alone in this change. Ahlstrom carefully evaluated the retiree health insurance market and selected a team of companies and individuals to support you throughout the enrollment period and in the future. Ahlstrom values their retiree relationships and continues to work to provide access to comprehensive programs that support the needs of retirees and their families. Ahlstrom research determined that the robust individual health insurance market offers retirees more choice and greater flexibility in coverage options to maximize the value of your HRA dollars. To best support retirees with the service and support necessary for this transition, Ahlstrom evaluated several potential partners and has assembled the following team: MERCER MARKETPLACE 365 Our enefits Counselors are licensed insurance professionals who are available to assist you with this transition. They will help you learn how to evaluate and compare plans to select a strategy that best fits your needs. When you have selected your plan(s), your enefits Counselor will help you through the enrollment process to ensure that all information is submitted accurately and timely to the insurance carrier(s). Once you have enrolled, your enefits Counselor continues to support you throughout the year with your reimbursement requests, HRA inquiries, and insurance advocacy. INSURANCE COMPANIES You will be able to enroll in individual health plan policies offered by leading health insurance companies. You may choose from any of several Medicare Supplement, Medicare Advantage, and Part D plans. Once you enroll in your selected plan, a new health insurance card will be issued to you by your new insurance carrier. You may also enroll in other insurance--- dental and vision, for example--- through Mercer Marketplace 365, however these premiums are not eligible for the company subsidy. PAE 3
WHAT YOU NEED TO KNOW efore your call with Mercer Marketplace 365 KEEP TRACK OF YOUR HEALTH AND PRESCRIPTION DRU COSTS AND LIST YOUR PROVIDERS Start by keeping track of your individual health care needs. This step will prepare you for your call with your enefits Counselor. Use the Health Care Provider Tracker to list your important providers. Use the Prescription Drug Tracker to record your monthly prescriptions. Providing correct information in the trackers will help your enefits Counselor at Mercer Marketplace 365 analyze your health care insurance needs. As soon as possible SCHEDULE A TELEPHONE APPOINTMENT WITH YOUR ENEFITS COUNSELOR Call Mercer Marketplace 365 to schedule a one-on-one consultation with your enefits Counselor during the dedicated enrollment period. During this call, you should notify your enefits Counselor if you will be opting-out of coverage. If you are uncertain about what to do, take this opportunity to discuss your options with your enefits Counselor. ENROLL IN YOUR HEALTH PLAN When you are ready to enroll in your new plan(s), call your enefits Counselor at 1-844-618-6285 or TTY 1-800-695-1317. PAE 4
NEXT STEPS Appointment Preparation ACT QUICKLY for your new health care plan to be effective on as soon as possible QUESTIONS FOR MY ENEFITS COUNSELOR Follow these steps to ensure that you are prepared for your phone consultation with a Mercer Marketplace 365 enefits Counselor. 1 Call Mercer Marketplace 365 any business day between 8:00 a.m. and 5:30 p.m. EST at 1-844-618-6285 to schedule your one-on-one consultation with a enefits Counselor. Appointment Date Time enefits Counselor Phone 2 Prepare for your appointment. To help guide your decision, please see the Questions To Think About on page 6. 3 Complete the Health Care Provider Tracker and Prescription Drug Tracker forms included in this kit. Please mail, fax, or email this information at least 10 days before your appointment. Email: Ahlstrom.Retiree.Exchange@mercer.com Secure fax: 857-362-2999 Address: Mercer Marketplace 365 P.O. ox 14401 Des Moines, IA 50306-3401 Please see page 9 for information on the differences among Medicare, Medicare Supplement, and Medicare Advantage Plans. 4 5 Write down your questions or concerns in the space on the left side of this page. Your enefits Counselor will take the time to explain your health care insurance options and answer any questions you have. Our goal is to help you select the health plan that best fits your needs. Have your Medicare (red, white, and blue) ID card available. You will need to provide both your Part A and Part effective dates. Please do not email or fax this card or Medicare number. PAE 5
PREPARIN FOR YOUR CONSULTATION Questions to Think About 1.Do you have end stage renal disease (ESRD)? With so many health care plans to consider, it helps to narrow down options based on certain criteria that are important to you. Your answers to these questions will help the enefits Counselor discuss health care insurance plans that best fit your needs. 2.Do you currently reside in a Nursing Home or Assisted Living Facility? 3.Do you anticipate spending considerable time away from your primary residence during which you would seek nonemergency medical care? 4.Do you use the same group of health care providers? Are they relatively consistent and close to home? 5.Are you comfortable with an HMO/PPO network which may include some, but not all, of your providers and may not provide care outside your area without additional higher fees? 6.Would you be willing to switch providers if the most economical health plan did not include your current providers? 7.Do you use health care providers that do not accept Medicare? (You can call your providers and ask the billing department.) 8.Are you entitled to TRICARE For Life, other prescription drug/ health benefits through the VA, or any other health or prescription drug benefits not listed here? 9.Has Medicare or the Social Security Administration notified you that you are eligible for assistance with paying for Medicare prescription drug plan costs? 10.Are you currently receiving Medicaid benefits? PAE 6
NAME PHONE (PLEASE PRINT) Health Care Provider Tracker List your current health care providers on this sheet. Most health care plans like HMOs and PPOs use networks. athering your health care providers information here will help you and a enefits Counselor compare access to your current providers. You also can contact your providers and ask them which Medicare plans they accept. 1. PRIMARY CARE PHYSICIAN NAME PHONE ADDRESS athering your health care providers information will help determine if your providers accept the new health insurance you are considering. TIP Some providers do not participate in certain HMO and PPO plans. 2. SPECIALIST NAME PHONE ADDRESS 3. SPECIALIST NAME PHONE ADDRESS 4. OTHER NAME PHONE ADDRESS 5. OTHER NAME PHONE ADDRESS Please submit this worksheet prior to your scheduled appointment. Mail, fax, or email to: Mercer Marketplace 365 P.O. ox 14401, Des Moines, IA 50306-3401 Fax: 857-362-2999 Email: Ahlstrom.Retiree.Exchange@mercer.com PAE 7
All Medicare Part D prescription drug plans cover generic drugs at considerable savings over brandname prescriptions. You may want to have a discussion with your provider regarding the possibility of switching current brand prescriptions to generics before you enroll in a new Prescription Drug plan. NAME PHONE (PLEASE PRINT) Prescription Drug Tracker (Please Print Clearly) In order to construct an accurate cost analysis, we will need your complete and accurate prescription drug information. For example, it is important to indicate the name of the prescription drug that you are taking, and whether you are taking a RAND or ENERIC version. Please note, over-the-counter medications, vitamins, and supplements are not covered by prescription drug plans (e.g., Medicare Part D) and therefore are not required on this form. IF THE IF THE SUPPLY SUPPLY OF A OF PRESCRIPTION A MEDICATION DRU LASTS LASTS LONER LONER THAN THAN ONE ONE MONTH MONTH OR IS OR IS ONLY USED AS NEEDED (PRN), PLEASE TELL US HOW OFTEN IT IS ORDERED. NAME OF MEDICINE (Excluding vitamins and over the counter) RAND OR ENERIC FORM AND DOSAE PACKAE SIZE / QUANTITY MONTHLY (Quantities, number of packages) COST EXAMPLES: Simvastatin 20 mg tablet 30 30 Timolol Maleate Opthalmic Sol 0.5% OP Sol 10 ml bottle 1 bottle per month Nasocort AQ AER 55 mcg/ac 16.5 gm inhaler 1 inhaler per month Ciclopirox el 0.77% gel 30 gm tube 1 tube per month Lantus Solostar INJ PAE 8 + + + + + 1 ml 3 ml pen (pack of 5) 10 pens (2 packs of 5 pens per month) Please complete one Prescription Drug Tracker per person. Please mail, fax, or email this worksheet 10-14 days before your scheduled appointment to: Mercer Marketplace 365 P.O. ox 14401, Des Moines, IA 50306-3401 Fax: 857-362-2999 Email: Ahlstrom.Retiree.Exchange@mercer.com
Original Medicare with Medicare Supplement (Medigap) vs. Medicare Advantage Use this chart to help you decide which plan is right for you. TIP oth Part D and Medicare Advantage plans are subject to the coverage gap (i.e., donut hole ) ORIINAL MEDICARE WITH MEDICARE SUPPLEMENT PART A (HOSPITAL INSURANCE) PART (MEDICAL INSURANCE) Medicare provides this coverage. You have your choice of doctors, hospitals, and other providers that accept Medicare. Most people pay a monthly premium for Part. In addition, you will pay deductibles for services covered under Parts A and and pay co-insurance for all Medicare-covered services. IN ADDITION, YOU MAY ADD A MEDICARE SUPPLEMENT POLICY TO YOUR PART A AND MEDICARE COVERAE. These plans are offered by private insurance companies that pay all or part of the deductibles and co-insurance with predictable out-of-pocket expenses. If you have a Medicare Supplement policy you cannot join a Medicare Advantage Plan. No network restrictions, as long as the provider accepts Medicare. STEP 1: DECIDE IF YOU WANT MEDICARE ADVANTAE PLAN LIKE AN HMO OR PPO NETWORK PART C: INCLUDES OTH PART A (HOSPITAL INSURANCE) & PART (MEDICAL INSURANCE) Private insurance companies approved by Medicare provide this coverage. In most plans, you need to use approved network doctors, hospitals, and other providers or you will pay more. You pay a monthly premium (depending upon the plan), your Part premium, and co-payments for covered services. Costs, rules, and coverage beyond what s covered in Medicare Parts A and will vary by plan. Note: If you join a Medicare Advantage Plan, you do not need to have a Medicare Supplement policy. Normally you will see lower monthly premium costs, but higher out-ofpocket expenses when services are rendered. STEP 2: DECIDE IF YOU WANT PRESCRIPTION DRU COVERAE (PART D) If you want this coverage, you must choose a Medicare Prescription Drug Plan. These plans are run by private insurance companies approved by Medicare. You must pay the monthly plan premium and drug co-payments. Most Medicare Advantage Plans include prescription drug coverage (Part D). enerally, the drug premium is included in your monthly Medicare Advantage premium. You will be responsible for co-payments and any other plan costs. PAE 9
HRA Ahlstrom is providing an HRA for their retirees. This HRA may be used for Individual Health and Prescription Drug plan(s). This means that once you select your new plan(s), you will first pay your premiums directly to your insurance carrier, then be reimbursed by Mercer Marketplace 365 from your HRA account. ecause Mercer Marketplace 365 is administering these HRA reimbursements, you will have one place to call for all your insurance and reimbursement needs. Any change will be provided via direct communication from Ahlstrom. > Who s covered? Medicare-eligible retirees, if they elect individual health care insurance coverage through Mercer Marketplace 365. > How can I use the HRA? You can be reimbursed for monthly health care premiums, as well as Medicare Part and D premiums. ONLINE ACCESS OF YOUR HRA You will be able to access your HRA information 24/7 by taking the following steps: 1) Visit http://retiree.mercermarketplace.com/ Ahlstrom In the far right box, outlined in red below, click LOIN. 2) Next, in the red box outlined below, enter your Social Security Number (omit any dashes) as your User Name, and your Date of irth (MMDDYYYY) as your password. You will be prompted to change your password after you complete this initial log in. (This is a secure site.) REIMURSEMENTS FROM YOUR HRA Your enefits Counselor will let you know if the plan you select is eligible for the Automatic Reimbursement feature. If you are eligible and you select Automatic Reimbursement when submitting a claim, payments will be processed each month based on the scheduled dates for your employer s plan; please refer to the Plan Information section, accessible from your dashboard. Approved claims received Monday through noon on Friday will be reimbursed Friday of the following week, excluding bank holidays. Direct deposits are made that Friday. Hard checks will be issued Friday and take approximately 3-5 business days to be delivered. PAE 10 To be eligible for subsidy from Ahlstrom, you must enroll through Mercer Marketplace 365 for your medical coverage. 3) From your dashboard, shown below, you can: View your account balance Submit claims and check their status Set up or edit direct deposit Access many other convenient features
NOTES AND QUESTIONS FOR A ENEFITS COUNSELOR PAE 11
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