Pennsylvania Public School Employees Retirement System (PSERS) NEWS For Retirees Eligible for Premium Assistance Summer 2016 The Advantages of Being a Member of the Health Options Program The Health Options Program, sponsored by PSERS, provides comprehensive medical and prescription drug coverage exclusively to our retirees and their families. Here are some of its many advantages. Age 65 Discount If you enroll in the HOP Medical Plan within 180 days of your 65th birthday, you will pay a discounted premium. Substantial Premium Subsidy If you are eligible for Premium Assistance and enroll in the Health Options Program, you can receive up to $100 per month in Premium Assistance from PSERS to help pay for health care coverage. Choice The Health Options Program offers a choice of medical options for both Medicare-eligible and non-medicare-eligible participants. Depending on which you choose, prescription drug coverage is either included or an additional option. Convenience We make paying monthly premiums easy by deducting them automatically from your retirement benefit (as long as your benefit exceeds the premium cost). Flexibility You may change your option each year during the Option Selection Period in the fall for coverage the upcoming calendar year. You may also enroll, add dependents or change your option within 180 days of you or one of your dependents experiencing a Qualifying Event. (See page 2.) SilverSneakers If you enroll in the HOP Medical Plan or the HOP Pre-65 Medical Plan, you can join the SilverSneakers Fitness Program at no additional cost. (See page 3.) To find a location near you, go online to www.silversneakers.com. Access to Resources Newsletters, booklets and a website (www.hopbenefits.com) provide important information to help you make informed health care decisions and lead a healthier lifestyle. In addition, the HOP Administration Unit is staffed with customer service representatives who are specially trained and dedicated to helping participants. You can reach one by calling 1-800-773-7725 weekdays from 8 a.m. to 7 p.m. Eastern time.
EXAMPLES OF QUALIFYING EVENTS If Your School District Terminates Your Medical Coverage You retire or involuntarily lose health care coverage under your school employer s health plan. Coverage under your school employer s health plan includes any COBRA continuation coverage you may elect under that school employer s plan. You involuntarily lose health care coverage under a non-school employer s health plan (which includes any COBRA continuation coverage you may elect under that non-school employer s health plan). There is a change in your family status (including divorce, the death of a spouse, addition of a dependent through birth, adoption or marriage, or a dependent loses eligibility). You or your spouse reach age 65 or become eligible for Medicare. You become eligible for Premium Assistance due to a change in legislation. A plan approved for Premium Assistance terminates or you move out of a plan s service area. Depending on individual circumstances, Qualifying Events may apply independently to you, your spouse and/or your dependents. For example, if your spouse turns age 65 and becomes eligible for Medicare, he or she can choose to enroll in the Health Options Program, whether or not you also enroll. Pennsylvania public school employers are required by law to provide retirees who have 30 years of service or meet certain other conditions the option to continue their school plan s coverage at their own expense until they become eligible for Medicare. Some school districts and other school employers also offer Medicare Supplement plans for retirees after they become eligible for Medicare. If you re eligible for Premium Assistance and remain in a school-sponsored plan, you ll save up to $100 a month in any premiums you pay for your coverage. Unfortunately, given today s economic challenges, many school districts are terminating their Medicare Supplement programs. If this happens to you, you must enroll in another plan approved for Premium Assistance; otherwise, you will lose the advantage of this special discount. The medical plans in the Health Options Program may be the only plans available to you that are approved for Premium Assistance. If your school district terminates its Medicare Supplement plan, and you and your eligible dependents enroll in the Health Options Program within 180 days, you will continue to have uninterrupted medical coverage and your Premium Assistance will continue. Generally, when a school district is considering terminating coverage, the Health Options Program is notified in advance. The Health Options Program then automatically provides information to all affected retirees about how to make the transition from the school district plan to any of the options available under the Health Options Program. However, if your school district ends its Medicare Supplement plan and you do not receive this information, call the HOP Administration Unit (1-800-773-7725) and they will explain the process and make sure you receive all the information you need. 2
SEPTEMBER IS HEALTHY AGING MONTH No matter what your age, regular exercise and good nutrition are important to your physical and mental health. When you re young, healthy habits help you develop strength and stamina. As you mature, they help you reduce the risk of heart disease, osteoporosis and other agerelated conditions. September is Healthy Aging Month, an initiative created about 20 years ago when baby boomers (the nearly 80 million Americans born between 1946 and 1964) started turning 50. Now, the last of the baby boomers those born in 1964 are in their 50s. The goal of Healthy Aging is to promote the positive aspects of aging and encourage adults to improve their physical, mental, social and financial health. One advantage of the Health Options Program is that we provide our members with customized health care materials to help them make informed decisions and lead a healthier lifestyle. As a member, you will receive newsletters and booklets to help you make the most of your participation in the plan. Similarly, customer service representatives at the HOP Administration Unit are specially trained and dedicated to helping participants understand and optimize their medical and dental coverage. You can reach a representative by calling 1-800-773-7725 weekdays from 8 a.m. to 7 p.m. Eastern time. Our website (www.hopbenefits.com) is accessible 24 hours a day, 7 days a week and provides a variety of resources that promote healthy aging. With boomers now moving into their 70s, healthy aging is an even hotter topic especially since it s never too late to start making healthier lifestyle choices. Eating the right foods, practicing portion control and incorporating physical activity into your daily routine can go a long way toward healthy aging. Celebrate Healthy Aging with SilverSneakers SilverSneakers Fitness is free to members enrolled in the HOP Medical Plan and the HOP Pre-65 Medical Plan. The program may also be available to Health Options Program members in Medicare Advantage plans. SilverSneakers is designed to help you maintain good health and independence. Offering membership privileges in thousands of participating fitness locations, your SilverSneakers benefit includes basic amenities and signature classes designed specifically for older adults and taught by certified instructors. Or, with SilverSneakers FLEX, you can participate in fitness classes right in your neighborhood through a walking club, an aerobic dance class at your local recreation center, tai chi at the park and much more. To learn more, call the HOP Administration Unit toll-free at 1-800-773-7725. 3
Are You Almost 65? If you re a PSERS retiree about to turn age 65, we take a number of steps to make sure you understand how the Program works. First, we send you a package of information from four to nine months before your 65th birthday. We mail these twice a year in the fall for people turning age 65 during the first six months of the following year and in the spring for people turning age 65 in the second half of the year. The package contains a description of the medical and prescription drug benefits available under the Health Options Program plus a personalized statement that has information specific to you, including your monthly premiums for all your coverage options. Our latest method for reaching our soonto-be-65 audience is via our website (www.hopbenefits.com). Besides all the regular features available on the website, if you register, you ll find a personalized statement with all the same information as the printed statement you receive in the mail. Plus, if you misplace or want another copy of your statement, a printer-friendly version is available. In addition, we conduct meetings twice a year at locations throughout the Commonwealth for retirees approaching age 65. Look for the meeting schedule in the package you receive in the mail. REMEMBER TO CALL PSERS If you are receiving Premium Assistance and your out-of-pocket premium expense changes or stops, it is your responsibility to notify PSERS. You must also notify PSERS if you have terminated your health coverage with your former school employer and have not enrolled in the Health Options Program. If you are unsure about your eligibility for Premium Assistance, call the Premium Assistance Unit at 1-866-483-5509 and ask a customer service representative to check your retirement benefit record. 4
Recipe Get Out the Grill for Mediterranean-style Grilled Salmon Fish is an important part of a hearthealthy diet. Oily fish, like salmon, contain omega-3 fatty acids, which can help lower elevated triglyceride levels, relieve stiffness and joint pain and even help with depression. In honor of Healthy Aging Month, try this recipe from the Mayo Clinic the next time you fire up the grill. Ingredients (Serves 4) 4 tablespoons chopped fresh basil 1 tablespoon minced garlic 2 tablespoons lemon juice 1 tablespoon chopped fresh parsley 4 salmon fillets, each 5 ounces Cracked black pepper, to taste 4 green olives, chopped 4 thin slices lemon Directions Prepare a hot fire in a charcoal grill or heat a gas grill or broiler. Away from the heat source, lightly coat the grill rack or broiler pan with cooking spray. Position the cooking rack 4 to 6 inches from the heat source. In a small bowl, combine the basil, parsley, minced garlic and lemon juice. Spray the fish with cooking spray. Sprinkle with black pepper. Top each fillet with equal amounts of the basilgarlic mixture. Place the fish herb-side down on the grill. Grill over high heat. When the edges turn white, after about 3 to 4 minutes, turn the fish over and place on aluminum foil. Move the fish to a cooler part of the grill or reduce the heat. Grill until the fish is opaque throughout when tested with the tip of a knife and an instant-read thermometer inserted into the thickest part of the fish reads 145 F (about 4 minutes longer). Remove the salmon and place on warmed plates. Garnish with green olives and lemon slices. Nutritional analysis per serving (Serving size: 1 fillet): Total carbohydrate: 2 g Cholesterol: 78 mg Sodium: 105 mg Protein: 28 g Saturated fat: 1.5 g Monounsaturated fat 3 g Total fat: 9 g Calories 183 5
HOP Administration Unit P.O. Box 1764 Lancaster, PA 17608-1764 The Advantages of Being a Health Options Program Member Have a Question? If You Have a Question About Please Call Or Go Online Enrollment in the Health Options Program Health Options Program in general HOP Administration Unit 1-800-PSERS25 (1-800-773-7725) From outside the U.S.: +1-717-305-7388 8 a.m. to 7 p.m. Eastern time, weekdays Health Options Program Website www.hopbenefits.com Premium Assistance Premium Assistance Office 1-866-483-5509 8 a.m. to 4:30 p.m. Eastern time, weekdays Retirement PSERS 1-888-PSERS4U (1-888-773-7748) 7:30 a.m. to 5 p.m. Eastern time, weekdays PSERS Website www.psers.state.pa.us Medicare Medicare 1-800-MEDICARE (1-800-633-4227) Medicare Website www.medicare.gov