Transcript 2015 Retiree Presentation

2015 OPEN ENROLLMENT
Retiree
Better Choices for a healthier you
What Is
Changing
2015? Healthcare Plan Benefits (co-pays,
deductibles, etc.), Pharmacy
Vendor, Tobacco Surcharge and
Premiums
2015 Open Enrollment information available on-line at
http://www.usg.edu/hr/benefits/retiree_benefits
November
3rd – 14th
Start Thinking
About Your
Benefits Now
Retiree Communications
• Open Enrollment Packets
– Will be mailed from ADP the week of October 27th
– Includes:
 2015 Open Enrollment Worksheet
 2015 Retiree What’s Changing Brochure
 USG Tobacco-Use Certification Form if enrolled in the
Healthcare plan
 How to enroll in Benefits for 2015 Open Enrollment
• What do if I don’t want to change anything?
– Your current elections will continue in 2015
– Tobacco Surcharge increases from $50 to $75
– Use the Tobacco Certification form to certify your tobacco use
status and return to the Shared Services Center
2015 Medical Changes
Overall USG 2015 Plan Objectives
• Wellness incentives to increase health status awareness
(Year one) - Actives and Pre-65
• Adding programs and tools to improve health outcomes
and health decisions - Actives and Pre-65
• Making plan design changes to encourage appropriate
plan utilization i.e. pharmacy usage, emergency room
• Sharing cost increases between employees & employer
• Plan becomes secondary coverage for all Medicare
Eligible retirees
• Striving to ensure a sustainable group healthcare plan
8
Open Access POS is now
Comprehensive Care plan
• Plan Change Highlights:
– Increase in-network deductible: Individual $500 Family $1500
– Increase in-network out of pocket maximum: Single $1250 Family
$2500
– Increase in-network specialist office visit co-pay by $10 from $20 to
$30
• See Comparison for summary of all plan changes
9
HSA Open Access POS is now
Consumer Choice HSA plan
• Plan Change Highlights:
– Increase in-network out-of-pocket maximum Single $3,500 Family
$7,000
– Increase in-network employee co-insurance from 15% to 20%
(employer co-insurance decreases from 85% to 80%)
– Increase out of network deductible: Single $5,000 Family $6,000
• See Comparison for summary of all changes
10
BlueChoice HMO
• Plan Change Highlights:
– Increase in-patient hospital services co-pay from $250 to $500
– Increase primary care office visit co-pay from $20 to $30
– Increase specialist office visit co-pay from $25 to $50
– Increase hospital co-pay from $250 to $500
– Increase brand name prescription drug co-pay from $25 to $35
– Add 20% co-insurance to non-preferred brand name prescription
drug with a $45 minimum and $125 maximum cost share
• See Comparison for summary of plan changes
11
New Pharmacy Vendor for BCBSGa Plans
• Express Scripts will be replaced by CVS Caremark
• Accepted by 68,000 retail pharmacies
– Prescriptions refills will transfer
• Except for controlled substances and compound medications
– A new prescription is needed from your prescriber to continue receiving
prescription refills for these medications
– CVS/Caremark is available to assist you with this process
– Medicare Part D- SilverScript
• Will receive mailing to notify of automatic enrollment and the
option to opt out
• No action necessary
CVS CareMark/Silverscript
• CVS Caremark Customer Service hotline
– Available on October 27th
– Answers to general inquiries; current information not
available
– New formulary list with drug alternatives
CVS Caremark / SilverScript
877.362.3922 or 866.275.5247
Kaiser HMO Plan
• Increase emergency room co-pay from $150 to $250
• Increase preferred brand drug co-pay from $25 to $35
Kaiser Sr. Advantage HMO Plan
• Decreases in co-pays for most services except
pharmacy
• Increase preferred brand name drug co-pay from $25
to $35
• Includes SilverSneakers fitness program
14
2015 USG Pricing Strategy –
Defined Contribution
• Employer share of the premium based on a ‘defined’ or fixed dollar
amount of the total monthly healthcare plan premium instead of a
percentage of the premium
Example:
• Total Monthly Premium for Comprehensive Care plan = $500 - USG
will pay $350 and employee will pay $150 per month (70/30 split)
• If employee enrolls in Consumer Choice HSA plan, total premium is
$400 per month, USG will pay $350 and employee will pay $50
• If employee enrolls in BlueChoice HMO total premium is $550 per
month, USG will be $350 and employee will pay $200 per month
Medicare Eligible Retirees
• USG plan will become secondary coverage for all
Medicare eligible retirees effective 7/1/15
• USG will assist Retirees not currently enrolled in Medicare
(‘grandfathered’) to enroll in Medicare during January –
March 2015
• USG will pay late enrollment penalty for retirees who enroll
during this period
• As of 7/1/15 – rates will be the same for all retirees since
the plan will be secondary coverage only – no longer have
‘enrolled and not enrolled’ rates
Medicare and Kaiser Sr. Advantage
• Medicare-eligible retirees and/or dependents must have
Medicare Parts A and B and must assign coverage to
Kaiser to qualify for the Kaiser Sr. Advantage HMO Plan
Medicare and BlueChoice HMO
• The BlueChoice HMO does not offer a Medicare-eligible
retiree health care plan
• If you are covered by the BlueChoice HMO plan, you must
choose another plan when you become eligible for
Medicare
• You will receive notification prior to your 65th birthday
notifying you that you must make a change
Adding Child Dependents to
Healthcare Coverage
• Affordable Care Act required one time opportunity to enroll
child dependents ages age 19 – 25 in healthcare coverage
• This will be the last year retirees will have this option
during open enrollment
• If you experience a family status change during the year, it
may qualify you to add a dependent to your coverage –
contact the Shared Services Center
2015 Healthcare Premiums –
Medicare Eligible Retirees
Medicare
Retiree
Retiree w/
Spouse (both
Medicare
Eligible)
Medicare
Retiree w/
Child
Non-Medicare
Retiree
w/Medicare
Spouse
Medicare Retiree
w/
Non-Medicare
Spouse
Non-Medicare
Retiree w/
Medicare Spouse &
Family
Medicare Retiree
w/
Non-Medicare
Spouse & Family
Retiree w Spouse
(both Medicare
Eligible)
w/ Family
Consumer Choice HSA
Retiree
$62.00
$128.00
$110.00
$128.00
$128.00
$176.00
$176.00
$176.00
$116.00
$232.00
$251.00
$286.00
$302.00
$430.00
$438.00
$368.00
$216.00
$432.00
$351.00
$386.00
$402.00
$530.00
$538.00
$568.00
Comprehensive Care -Both Enrolled
Retiree
Comprehensive Care -Not Enrolled
Retiree
Comprehensive Care-One Enrolled
Retiree
$332.00
$468.00
Kaiser Senior Advantage
Retiree
$91.00
$182.00
$234.00
$234.00
$234.00
$369.00
$369.00
$325.00
2015 Healthcare Plan Changes
Consumer Choice HSA€
Comprehensive Care
BlueChoice HMO Plan
Kaiser HMO Plan
In-network
Out-of-network
In-network
Out-of-network
In-network
In-network
Deductible—Single
$1,500
$3,000
$500
$1,500
None
None
Deductible—Family
$3,000
$6,000
$1,500
$4,500
None
None
Out-of-Pocket Maximum—Single
$3,500
$7,000
$1,250
$3,750
$5,500
$6,350
Out-of-Pocket Maximum—Family
$7,000
$14,000
$2,500
$7,500
$9,900
$12,700
Coinsurance (% network rate)
80%
60%
90%
60%
100%
100%
Preventive Care Visits
100%
60%
100%
Not covered
100%
100%
Physician’s Office Visit
80%
60%
$20 copay
60%
$30 copay
$20 copay
Specialist Office Visit
80%
60%
$30 copay
60%
$50 copay
$25 copay
Outpatient Hospital Services
80%
60%
90%
60%
$200 copay
$100 copay
Inpatient Hospital Services
80%
60%
90%
60%
$500 copay
$250 copay
Urgent Care
80%
60%
$35 copay
60%
Medical Benefits
$50 copay
$30 copay
80%
$150 copay, then 90% after ded.
$250 copay
$250 copay
Generic
80%
$10 copay
$10 copay
$10 copay
Preferred Brand
80%
$35 copay
$35 copay
$35 copay **
Non-preferred Brand
80%
20% w/ $45 min & $125 max
20% w/ $45 min & $125 max
Not Covered
Emergency Care
Pharmacy Benefits
Retail Rx - 30 day supply
** Kaiser Pharmacy Only
Mail Order - 90 day supply
Generic
80%
$25 copay
$25 copay
$20 copay
Preferred Brand
80%
$87.50 copay
$87.50 copay
$70 copay **
Non-preferred Brand
80%
20% w/ $112.50 min and $250 max
20% w/ $112.50 min and $250 max
Not Covered
Combined w/ medical OOPM
$1,100/Member; capped at $3,300
$1,100/Member; capped at $3,300
N/A
$375 Single/$750 Family
None
None
None
Pharmacy Out-of-Pocket Maximum
Employer HSA Contribution
Dollar for dollar match
ID Cards
2015 BCBSGa Healthcare ID Cards
• Every retiree enrolled in medical coverage will receive a
new card for the 2015 plan year
• USG logo is located on the front and BCBSGa network of
providers
2015 BCBSGa Healthcare ID Cards
• Non-Medicare eligible retirees
– Non-Medicare eligible retirees will receive one card
with healthcare and pharmacy information
• Medicare eligible retirees
– Medicare eligible retirees enrolled in the Consumer
Choice HSA plan will receive one card from BCBSGa
with healthcare and pharmacy information
– Medicare eligible retirees enrolled in the
Comprehensive Care plan will receive a healthcare ID
from BCBSGa and prescription benefits card from
SilverScript
2015 Dental Changes
2015 Dental Plans
• No Changes to Plan benefits – choice of two plans, Base plan
or High plan
• Premiums increase slightly
2015 Vision Plan
• No Changes to plan benefits or premiums
2015 Life Insurance – Minnesota Life
• No Changes to plan benefits or premiums
• Update beneficiaries on-line through ADP portal or request
paper form from Shared Services
Key Dates to Remember
Return enrollment paperwork to Shared Services
by November 14, 2014
Mailing Address:
USG Shared Services Center
1005 George J. Lyons Parkway
Sandersville, GA 31082
If you have questions, call the USG Shared Services
Center at 1-855-214-2644 or e-mail at
[email protected]