Hello, and welcome to GEHA s 2017 ABO Benefits Seminar. This webinar provides details on GEHA s 2017 health and dental plans along with our new Life, Accident, and Short term income protection products through GEHAtotal. 1
It s been an exciting year for us here at GEHA. You ll notice a new look, with the introduction of our updated logo. This change establishes a unified look for our growing family of products. Although the logo has changed, our commitment to serve you and our members remains strong. 2
Along with our new look comes a new campaign this open season with The Switch is on. GEHA s welcome mat is out, switch to a health and dental plan from a company that gets you. Where everything we do, we do for, our members. These URLs will take you directly to new online tools to help you and your employees make informed choices about plans and health care costs. Join the movement you and your family deserve. 3
GEHA is a not-for-profit association that has been offering quality, affordable health care to federal employees and their families since 1937. This year we extended our commitment of caring beyond our health and dental plans, with the introduction of GEHAtotal. After our 2017 benefits update we ll briefly go over how GEHAtotal can guard you against unexpected surprises that can impact your financial well-being. Before we dive in, let s quickly go over our agenda. 4
Today we ll discuss some of the changes to our health plans for 2017. We ll talk about the convenient ways you can access quality health care and highlight some of our wellness programs. Then, we ll go through a brief description of GEHA s health plans. We ll provide you with benefit updates and highlights on our FEDVIP dental plan, Connection Dental Federal. We ll go over our premium-free member programs, including vision benefits, that are included with all GEHA plans. Then, we ll conclude with our new financial protection solutions from GEHAtotal. 5
Not only did we change out brand identity, we also expanded our benefits guide to include more comprehensive information on how our members can get the most from their health and dental plans. All our plan materials are available at geha.com and gehadental.com. In the inside cover of the health plan benefit s guide pictured here, you ll see a table of contents with 4 sections. Section 1 details the changes to our health plans for 2017 and includes general differences between Standard Option, High Option and the high-deductible health plan. It also provides information on our interactive tools for comparing the plans on your own, along with a two page side-by-side comparison chart of all the plans. Section 2 is a great resource guide for better understanding the factors that influence health care costs. You ll find explanations of common insurance industry lingo, helpful ways to be a better health advocate for yourself, and a snapshot of how your coverage works in real-life situations. If you need brushing up on how HDHPs and HSAs work, Section 2 is where you ll want to look. Section 3 goes over the additional programs our members enjoy as an association member of GEHA, such as vision benefits. 6
And section 4 outlines our new GEHAtotal income protection solutions available to all eligible federal and civilian Department of Defense employees. 6
Let s go over some of the changes to our health plans in 2017. Our national provider network continues to grow. In 2017 our members will have even greater access to quality care with the Aetna Signature Administrators PPO network in Georgia and Pennsylvania. While North Carolina and South Carolina members will have access to UnitedHealthcare Options PPO. 7
We have also updated the preventive services benefits for diabetic screening to include adults ages 40-70, who are overweight, obese or have high blood pressure. We will offer a number of programs and service to members to assist with special conditions and needs. Members can work with a nurse or health coach to manage obesity, and other chronic conditions, including cancer, while in active treatment. We have also increased and expanded coverage for external hearing aids. Children up to age 22 will be covered annually and adults will be covered every 3 years. In 2017, we will pay $2,500 on the High Option and $2,000 on the Standard Option for hearing aids. 8
GEHA will cover preauthorized Applied Behavioral Therapy, up to 680 hours per year, with a diagnosis of Autism Spectrum Disorder for children ages 1 up to age 18. Brand new for 2017, we have partnered with Smile Brilliant to provide all GEHA members with exclusive discounts for Smile Brilliant s at-home tooth whitening program. We ll also be enhancing our popular Health Rewards Program to make it easier for our members to track healthy behaviors and earn wellness points that can be redeemed for great wellness related merchandise. Our free second-opinion service through Best Doctors, lets you get expert advice to make confident medical decisions no matter where you live. 9
GEHA members appreciate our extensive provider network, affordable premiums, low copays, free in-network preventive care, wellness programs, and excellent customer service. Best of all, you don t need a referral to see a specialist. And GEHA plans cover you when you travel around the world. 10
Get the care you need, when you need it. Sometimes you just can t wait for an appointment during regular business hours, that s why GEHA lets you access quality health care when it s convenient for you. With our Health Advice Line you get expert advice for non-emergency symptoms from a registered nurse, at no extra cost, 24 hours a day, 7 days a week. Depending on your circumstances, a nurse on GEHA s Health Advice Line may arrange a consultation for you with a physician. Your consultation may be by computer or mobile device from home, work, or wherever you are when you call, as allowed by state law. 11
GEHA members have access to more than 1,100 walk-in MInuteClinics within select CVS/Pharmacy and Target Store locations across the country. GEHA Standard and High Option Health Plan members pay a low copay of just $10 per visit and no appointment is needed. Get your pressing health needs addressed at in-network urgent care facilities, with an affordable facility copay of $35 and no deductible or coinsurance for our Standard and High Option Health Plan members. 12
GEHA works with CVS/caremark as our prescription benefits manager. The nationwide network of more than 70,000 retail stores includes 9,600 CVS/pharmacy locations. Also included in-network are Rite Aid, Walmart, Walgreens, and CVS/pharmacy within Target Stores, as well as thousands of independent pharmacies. With CVS/caremark s Mail Service Pharmacy, you can save money while having your maintenance medications delivered to your door. Some drugs qualify for 90-day refills. 13
The CVS/caremark App makes it easy to estimate costs and find the lowest-priced options, locate an in-network pharmacy near you, refill prescriptions and more. 14
GEHA helps our members feel better every day with wellness programs that promote a healthy lifestyle and focus on prevention. GEHA s Health Rewards Program is available to two adult members per household. When members complete their annual Health Risk Assessment they earn a $75 Mastercard debit card. When they complete the free yearly biometric screenings they earn $75 in health reward points. Members can earn an additional $100 of health reward points by completing wellness portal classes such as weight management, stress management or smoking cessation. This program will be enhanced in 2017 which means that points earned in 2016 will need to be redeemed by December 31, 2016. Health Reward points can be used for qualified medical services and health-related care items. 15
Keeping track of your vital health indicators even when you are healthy can help you spot the early warning signs of serious conditions like heart disease and diabetes. That s why we offer our health plan members Free annual Biometric Screenings. A health examiner conducts diabetes, cholesterol, and kidney disease screenings in the comfort of your home or workplace, or at a Quest Diagnostic Patient Service Center near you. You pick the time and location most convenient for you. With GlobalFit, GEHA health plan members get preferred pricing on memberships at more than 9,000 eligible fitness and studio locations. Members have access to topranked healthy eating and weight-loss programs, personalized health coaching, as well as discounts on home health equipment and other fitness products, including wearable fitness trackers. GEHA s partnership with Virtual Lifestyle Management provides free round-the-clock strategies for weight loss to qualified members. VLM s voluntary program focuses on helping you overcome personal obstacles to losing weight. 16
Before we get into the differences between GEHA s Standard and High Option health plans, let s go over some of the great benefits that are covered at 100% on both plans. In-network Maternity Care is covered at 100% on the Standard and High Option health plans. You ll also get 100% coverage for treatment of accidental injuries in a doctor s office or outpatient setting, as long as you seek treatment within 72- hours. When using the LabCard program through Quest Diagnostics you ll pay nothing for most covered lab services and in-network routine adult and well-child preventive care are covered at 100%. 17
This simplified benefit chart helps break down the basic differences between GEHA s three PPO health plans. The Standard Option offers one of the lowest premiums in the FEHB program. With a low $15 in-network primary care copay and a $10 generic prescription copay it s no wonder GEHA s Standard Option Plan is our most popular option for new members. This plan is the best value for healthy people who want comprehensive coverage if and when they need it. With GEHA s High Option Plan you ll get more comprehensive coverage in exchange for higher premiums. This plan is a good option if you take brand-name prescription drugs. Also, once your annual deductible is met you pay a smaller percentage for things like hospital care and outpatient care than you would on the Standard Option. Our third plan, Health Savings Advantage, features a high-deductible-health plan with a health savings account. Although the deductible is higher than our traditional plans, GEHA contributes monthly to your HSA totaling $750 a year for Self Only and $1,500 for Self Plus One or Self and Family. This plan is a great choice for healthy people who typically don t have ongoing medical expenses. The HDHP covers 100% of in-network preventive care, and you pay for the rest of 18
your health care expenses, until your deductible is met. After that, GEHA pays 95 percent of most in-network care. 18
A detailed side-by-side comparison of our plans and benefits is in the health plan benefits guide. It s also available to view and download at geha.com. On the right side of the benefits chart you ll notice two columns for retirees who have Medicare A&B as their primary insurance. Many retirees pay nothing for medical services on both our High and Standard Option health plans when Medicare is primary. 19
The biggest difference in our High and Standard Option plans for both active employees and retirees, besides the premium difference, is how much you pay for brand-name medications. If you take brand-name prescriptions, then you should consider our high option as it offers more comprehensive coverage. If you primarily take generic medications, our Standard Option health plan can save you well over $1,000 annually in premiums for a self only enrollment. 20
If you are still not certain which plan is best for you visit GEHA Keypath Our new, user-friendly tool lets you choose the best coverage for your family based on a few simple lifestyle questions. You can also search for in-network doctors and estimate your health care costs for the year under each of GEHA s plans all in one convenient place. Visit geha.com/switch to use this tool. 21
Here is an example of the Keypath s cost estimator. You can see that this tool lets you adjust the many variables that impact how much you pay for healthcare. The estimated cost breakdown shows you how much you will pay out-of-pocket, based on the circumstances you define. 22
You ll find a complete list of 2017 health plan premiums, on the back of our health plan guide and plan brochure. Here is a snapshot of Non-Postal biweekly premiums for our Standard Option, High Option and High-deductible health plans, along with the cost increases on each plan. Let s move on to our FEDVIP Dental Plan, Connection Dental Federal. 23
GEHA offers two FEDVIP stand-alone dental plans that fit you and your families needs, our Connection Dental Federal High Option and Standard Option dental plans. Enrollment in one of GEHA s health plans is not necessary to enroll in GEHA s FEDVIP dental plans. Both Standard & High Option continue to offer the same great features such as: -Pre-tax payroll deducted premiums. Federal retirees are also eligible, although their premiums are through post-tax annuity deductions. -On both options there are no deductibles in or out of network. -Preventive care is covered at 100% when you see an in-network provider, and -Major services, such as crowns and root canals, have no waiting periods. 24
Orthodontia is paid at 70% and members on the High Option have no waiting period for orthodontia. In 2017, we ve increased our High Option maximum benefit to $35,000. -And you have the freedom to see any dentist. We pay the same amount in- or outof-network. With any dental or health plan it is to your advantage to use in-network providers whenever possible to help save you money. GEHA has a large network of dentists with over 340,000 provider locations nationwide. 25
You ll find a more detailed benefit chart within our dental plan brochure available for download at gehadental.com and in our dental benefits guide. The calendar year maximum benefit the plan pays for Class A, B, and C services is $35,000 per person with the High Option, and $2,500 per person with the Standard Option. -With both plan options Class A preventive services are covered at 100% in network. -Class B includes services such as fillings and extractions The High option covers these services at 80 percent and the Standard Option at 55 percent. -Class C includes services such as root canals, crowns, implants and dentures. The High option covers these at 50 percent and the Standard Option at 35 percent. -Class D or Orthodontic services, for both children and adults, is covered at 70% on both options with a lifetime maximum of 2,500 dollars per covered person. Again, there is no waiting period for orthodontia benefits on the High Option. 26
You ll find our 2017 premiums within our dental plan benefit s guide and dental brochure. For our High Option dental plan you ll see a minimal biweekly increase anywhere from 39 cents to $1.59 cents. For our Standard Option dental plan, depending on where you live and your enrollment option, you ll see a biweekly increase anywhere from 26 cents to 99 cents. 27
Under the Services and Costs tab at gehadental.com, you can navigate to a complete list of covered services, or find out what your premium will be with our easy to use dental premium lookup tool. You can also use our dental procedure pricing tool to help you understand and compare treatment costs. See for yourself at gehadental.com 28
Enrolling in GEHA Connection Dental Federal is easy, just visit BENEFEDS.com or call the Benefeds toll-free number. If you re currently a member you don t need to do anything to continue your coverage for 2017. 29
When you are a GEHA high or standard option health or dental plan member you have access to additional year-round member programs with no additional premium, including our popular vision benefits. You heard right, dental plan members also have access to vision benefits for no additional premium! With Connection Vision powered by EyeMed, GEHA members pay only a $5 copay for in-network eye exams through the extensive EyeMed vision network. Members also receive savings of up-to 40 percent off frames, as well as discounts on eyeglass lenses, conventional contact lenses, and laser vision correction. 30
GEHA health and dental plan members receive between 30 to 60 percent off hearing aids, with an average savings of $1,780 per pair. As I mentioned earlier, for 2017 we have increased and expanded coverage for external hearing aids. Children up to age 22 will be covered annually and adults will be covered every 3 years. The benefit amounts for 2017 are $2,500 on the High Option and $2,000 on the Standard Option for hearing aids. TruHearing offers more than 100 of the newest hearing-aid models from top manufacturers. 31
We re excited to introduce our new GEHA partner, Smile Brilliant. Smile Brilliant is an affordable and easy to use at-home teeth whitening system exclusively available to GEHA health and dental plan members. Our members are guaranteed a 20% discount off the lowest published price on custom fitted trays, teeth whitening gel and desensitizing gel. Best of all, Smile Brilliant is available right now for our current health and dental plan members, so you won t have to wait until 2017. This benefit comes with a 100% satisfaction guarantee. If you re not yet a GEHA member make the switch this Open Season and start enjoying our additional member programs. 32
GEHA members get free activation and a 10% monthly discount when they enroll in Life Alert s monitoring program. Life Alert offers a variety of monitoring options that provides 24/7/365 protection that helps families feel safer and more secure. In addition to being available for our members, this benefit can be shared with extended family members such as parents, grandparents and children. 33
Learn more about all our member benefits on the Plans & Benefits tab at geha.com and gehadental.com. 34
Now let s turn it over to Scott, who will discuss GEHAtotal. 35
GEHA has been protecting the physical health of federal employees and their families for decades. Now we are here to protect your financial health as well with three new insurance solutions Life Insurance, Short-Term Income Protection and Accident Expense Protection. We d like to share a short video with you that captures the essence of GEHAtotal. You ll see this video at GEHAtotal.com along with detailed information and videos for each product. 36
Thinking about what ifs isn t easy especially when it means that your dependents may have to change the way they live after you re gone. Wouldn t it feel good, while you re still here to know that the people you care about wouldn t have additional financial worries if something were to happen to you? Unfortunately, most people don t have enough life insurance even with life insurance offered through work. There can still be significant gaps in meeting financial obligations. And, your needs change as life and circumstances change. Figuring out how much you need doesn t have to be intimidating, and coverage may be more affordable than you think. 37
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Imagine what would happened if your income stopped for months. You would still need to pay for everything from your mortgage and car payment to your cell phone service and groceries. GEHAtotal Short-Term Income Protection provides you a source of income for up to one year if you suffer an illness or injury that keeps you from working. 39
This product has been designed with multiple coverage choices to allow tailoring to personal need. 40
Many people don t think about the unexpected costs that can accompany an accident. That s why there s Accident Expense Protection. It gives you a fixed cash payment based upon the nature of the accident. The money you receive from the Accident Expense Protection benefit is your to use as you decide. Use it to pay everything from your bills to childcare to your medical deductible and more. 41
While anyone can benefit from this coverage, those leading an active lifestyle or who have kids involved in sports activities may especially want to consider this product. 42
For each insurance solution you ll find easy to understand resources like this Life Insurance ebook on the right and light-hearted video clips that are sure to get a chuckle out of you. You do not have to be a GEHA health or dental member to enroll in any GEHAtotal product. 43
These products are available anytime, not just during Open Season. 44
Before we end today s seminar, I d like to go over a few of the services GEHA provides to you and your employees throughout the year. Account Executives are available for: Service visits where we come to your agency and help answer your employee s claim and benefit questions. Wellness events with onsite screenings and wellness-related giveaways Lunch and learns with an industry expert who speaks on your topic of choice such as diabetes management, heart health or proper diet. Retirement seminars where we explain how to coordinate benefits with Medicare Parts A and B New hire orientations where we help your new employees understand their health and dental insurance options And, of course, during Public Service Recognition Week and Open Season, we re here to help with your event planning. 45
GEHA is here to help. We offer several resources to guide you through any questions you may have. 46
Thank you! 47