Transcript 2014-15 Retiree Benefits Update PowerPoint

City of Phoenix
Retiree Benefits Overview
2015
Today’s Topics
Rates
Employer
Sponsored
Medicare Part D
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2007 Changes
 Before 2007, medical rates were the same
for retirees and employees.
 They were rated as one group.
 To comply with GASB 45, retirees and
employees were separated for medical
rates beginning August 1, 2007.

30% increase to rates.
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2007 Changes
 The Qualified City Contribution was
created to reduce this rate increase.
 Reduces the premium by $90 to $375 per
month.
 Includes a $50 per month reduction for family
coverage.
 A $15 million Retiree Rate Stabilization
Fund was created for future retiree needs.
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Setting Medical Rates
Trends
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Claims
Costs
ACA
Stats
2015 Medical Rates
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9.4%
• Full Rate Increase
recommended by
Actuaries.
9.1%
• Rate Increase after
Health Care Reform
costs are removed.
6.1%
• After the Retiree Rate
Stabilization Fund
contributes 3%.
2015 Retiree Medical Rates
Savers
Choice Plan
Cigna
HMO
BCBS
PPO
Single – Not on Medicare
$605.57
$754.92
$708.90
Family – Retiree and 1 or more
dependents not on Medicare
$1,672.81
$2,103.29
$1,970.61
Family – Retiree not on
Medicare, all dependents on
Medicare
$1,118.50
$1,408.33
$1,318.97
Single – On Medicare
$511.89
$638.38
$599.42
Family – Retiree on Medicare
any dependent not on
Medicare
$997.12
$1,258.46
$1,177.76
Family – Retiree and all
dependents on Medicare
$968.72
$1,221.78
$1,143.77
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2014 to 2015
Monthly Medical Rate Change
Savers
Choice Plan
Cigna
HMO
BCBS
PPO
Single – Not on Medicare
$40.85
$49.44
$46.80
Family – Retiree and 1 or more
dependents not on Medicare
$117.73
$142.48
$134.85
Family – Retiree not on
Medicare, all dependents on
Medicare
$79.25
$95.92
$90.78
Single – On Medicare
$34.60
$41.88
$39.64
Family – Retiree on Medicare
any dependent not on
Medicare
$71.41
$86.43
$81.80
$69.20
$83.75
$79.27
Family – Retiree and all
8 dependents on Medicare
Save $25 per month
Reduce your monthly premium
by $25 each month when the
retiree completes an online
Health Risk Assessment.
Find information in your City
of Phoenix Benefits Guide – in
your mailbox around October
18th.
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2015 Retiree Dental Rates
Single
Plus One
Family
Dental HMO
$27.44
$49.58
$87.38
Dental PPO
$39.95
$88.78
$129.84
 Retiree Dental Rates increase 5%
 No plan changes
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Legal Insurance
• Enroll in the Legal Insurance Plan for
$21.90 per month.
• New in 2015! Identity Theft Services.
• Enroll directly with ARAG at
• 1-800-247-4184
• Find information at AragLegalCenter.com
Access Code 16922phx
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New on January 1, 2015
Employer
Sponsored
Medicare Part D
Pharmacy Plan
Also called EGWP
(egg-whip)
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New on January 1, 2015
The City will provide a self-insured group
sponsored Medicare Part D plan to its
Medicare eligible retirees.
The City will receive a direct subsidy from
the Centers for Medicare and Medicaid
Services (CMS) that will be larger than
the retiree drug subsidy currently
received.
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Key Points
o Medicare eligible retirees and their Medicare
eligible dependents will automatically be
enrolled in this employer provided Medicare
Part D Prescription Drug Plan.
IMPORTANT REMINDER!
Retirees and their enrolled dependents are
required to enroll in Medicare Part B as soon as
they are eligible and provide a copy of the
Medicare card to the Benefits Office.
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Key Points
DO NOT ENROLL in MEDICARE PART D!
Your enrollment in the City of Phoenix medical
and pharmacy drug coverage will automatically be
considered to be Medicare Part D enrollment.
If you are enrolled in another Medicare Part D
Plan or a Medicare Advantage Plan with or
without prescription drug coverage, Medicare will
disenroll you from the City’s plan.
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Key Points
o You have the same co-pay structure:
o $10 Generic
o $25 Preferred Brand Name
o $40 Non-Preferred Brand Name
o $40 Specialty Drugs
o Your prescription drug list will be bigger than
the standard Medicare Part D list.
o There will be no “Donut Hole.”
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Key Points
CMS requirements may cause disruption with
1-2% of the current prescriptions. You will be
notified by mail in late October if you are affected
and alternatives will be identified.
If your spouse, qualified domestic partner or child
is not eligible for Medicare, he or she will
continue to be covered by the current Cigna
prescription drug plan. They will receive a new ID
card.
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Key Points
o You will get a new ID card from CignaHealthSpring in the mail in mid-December.
Don’t use your
new card until
January 1st
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Key Points
o You will have most of the same pharmacies in
your current Cigna pharmacy network.
o The VA Pharmacy is not permitted in the
Medicare Part D network because you can
receive benefits from only one government
program at a time.
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Key Points
There will be no interruption in your coverage.
Through December 31st:
January 1, 2015:
Current Cigna Pharmacy
Cigna-HealthSpring Rx
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Key Points
o You continue to get your prescriptions filled at
your local retail pharmacy or through the mail
order pharmacy.
o You can continue to get up a 90-day fill at a
retail pharmacy.
o Open and Read the information you receive
from Cigna-HealthSprings Rx.
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Key Points
o Get your prescriptions refilled in December
through your current Cigna drug plan if
possible.
o Get a new prior authorization after January 1st
if needed. You will receive a letter in late
October if this affects you. Please act quickly
to make a doctor’s appointment if needed.
Note! CMS does not allow more than a 30-day transition fill.
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Prior Authorizations
o Cigna will transfer existing Prior
Authorizations from the current plan to the
new plan for Medicare Part D medications.
o Prior Authorizations will not transfer for nonMedicare Part D drugs such as ED drugs, Rx
vitamins, weight loss or weight gain drugs.
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Coming in the Mail
Mid-October: A newsletter from the City of
Phoenix Benefits Office introducing the
Employer Sponsored Medicare Part D Plan.
Around October 20th: A packet from CignaHealthSprings Rx which includes a letter, a
Summary of Benefits, and a List of Covered
Drugs (Formulary).
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You don’t have to do anything!
Coming in the Mail
The packet you receive from Cigna-HealthSpring
Rx will tell you that you have the choice to optout of this plan per CMS requirements. We DO
NOT RECOMMEND that you do this.
Your prescription drug coverage is part of your
City of Phoenix Retiree Medical Plan. If you optout of the Cigna-HealthSprings Rx plan you will
lose your medical coverage AND drug coverage.
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Coming in the Mail
Mid-December: You will receive your new
pharmacy ID card. Do not use this card
until January 1, 2015.
Your covered dependents may also receive
new ID cards.
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Coming in the Mail
January 2015: You will receive a Welcome Kit
from Cigna-HealthSprings Rx. This will include:
 A pharmacy directory
 Evidence of Coverage – details about the
plan and your rights and responsibilities
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Important Reminder
If you enroll in another Medicare Part D plan or
a Medicare Advantage Plan with or without
prescription drug coverage, Medicare will
disenroll you from the City’s plan. This means
you and your covered dependents will lose
retiree medical and prescription drug coverage
immediately.
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Customer Service
Cigna-HealthSprings Rx Customer Service
1-800-558-9562
8:00 a.m. to 8:00 p.m. AZ Time
Seven Days a Week
October 1, 2014 – February 14, 2015
After February 14, 2015 availability is Monday through Friday
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Cigna Pharmacy On-site
Representative
Kim Baker
[email protected]
(602) 534-5370
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Questions?
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