Health Plan Changes for Medicare-Eligible Retirees

Health Plan Changes for Medicare-Eligible Retirees

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Effective January 1, 2013

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What is Changing• Reynolds American Inc. is changing the

way it provides health care benefits to retirees who are eligible for Medicare– More choices in health coverage through the

individual market– In many cases, coverage available in the individual

market costs less than the current group plan through RAI.

– Access to benefit advisors to help with choosing coverage that fits your health-care and financial needs.

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Assistance Provided to You• Assistance in choosing individual health

coverage– RAI has made an arrangement with Extend Health, Inc. an

insurance broker that specializes in individual Medicare supplemental insurance coverage.

• Financial Assistance with purchasing medical coverage– Retirees and their dependents who are eligible for Medicare

and have been receiving a subsidy from RAI towards the cost of medical coverage will continue to receive financial help when they enroll through Extend Health.

– RAI will make an annual contribution into a tax-free account, called the Health Reimbursement Arrangement.

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Introducing Extend HealthThe Industry’s Largest Medicare Exchange

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• Independent company

• Partner with 75+ health plan carriers

• Objective and Trusted US based benefit advisors

• Focused on helping each participant make an informed

and confident decision

Who is Extend Health?

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Why Extend Health

• We are experienced in helping people just like you

• Our services are at no cost to you

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Market-Leading Private Sector Clients175 Employers – 40 Fortune 500 Companies

95%+ Client Retention Rate

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Plans & Partners

All Medicare Plan Types

• Medicare Advantage

• Medigap (supplement)

• Prescription Drug (Part D)

VisionDental

Select Carriers

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Educate

Evaluate/Enroll

Manage

The Process

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• Gather information – (e.g. prescriptions)– Pre-existing conditions will not limit your plan selection*– Give us a call: 855-835-3811– www.ExtendHealth.com/rai

EducationGetting Started Guide

* except end-stage renal disease

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• Prepare you for enrollment discussion• Review Medicare basics• Appointment confirmation letter

EducationEnrollment Guide

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Decision Support Tools

• Help Me Choose

• Prescription Profiler

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Licensed Benefit Advisor• 100% domestic workforce• Objective advocacy• Neutral compensation• Extend University• Licensed, certified, appointed• Average age 43

Hours of OperationMonday – Friday8 a.m. – 9 p.m. Eastern Time

Evaluate and Enroll

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Enrollment Process• Benefit Advisors can discuss

coverage options with anyone – need to speak to the participant to complete the enrollment.

• Once you have made a coverage selection, enrollment is conducted via telephone.

• 100% of calls are recorded.

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Medicare and You

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Your Future Coverage

Primary Coverage Medicare A & B

Additional Coverage (Your Choice) Medicare Advantage with

Prescription Drug (MAPD)

Medigap + Prescription Drug

Optional Coverage (your choice)

Dental and Vision

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Initial Coverage You pay Deductible and co-pays for your plan Coverage for the first $2970 in actual cost of meds

Coverage Gap – Donut HoleYou pay 47.5% of brand drugs and 79% of generics until out of pocket costs reach $4750

Catastrophic CoverageYou pay $2.65 for generics and $6.60 for brand or 5% whichever is greater

Medicare PrescriptionDrug Coverage

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Location Specific plans

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Plan TypeNumber of Plans

Offered2012

Monthly Premium Company

Medicare Advantage

15 $0 - $100AARP, Humana,

BCBS of NC,

Medigap/ Medicare

Supplement

32 $58 - $191

AARP, Aetna, Humana, BCBS of NC,

American Continental

Part D 19 $15 - $113

AARP, Aetna, BCBS of NC, Cigna, CVS, Humana, Coventry,

WellCare, Community CCRx

Plan Availability in Winston/Salem

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Plan TypeNumber of

Plans Offered2012

Monthly Premium Company

Vision 1

$14 per person per monthAnnual eye exam: $15

Coverage for eye glasses, lenses and frames

Vision Service Plan (VSP)

Dental 2$19 - $48

$0 - $50 deductible$1,000 - $1,600 annual maximum

Humana, Delta Dental (Renaissance Dental)

Plan Availability in Winston/Salem

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– $0 per month

– $47 per month - network: PPO– Deductible: $0– Doctor co-pay: $15 Specialist co-pay: $40– Hospital: $195 co-pay days 1-6– Emergency Room: $65 co-pay if not admitted– Rx: $7/$40/$80/33%– Mail order: (90 day discount)

Plan Example

Medicare Advantage Plan

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– Medical/Rx $215 ($175 - $40)

– $173 – ($137/plan F + $36/pdp)

– Network: any doctor that accepts Medicare– Deductible: $0– Doctor co-pay: $0 Specialist co-pay: $0– Hospital: $0– Emergency Room: $0 co-pay– Rx: $0 deductible $7/$39/$74/33%– Mail order: (90 day discount)

Plan Example

Medigap Plan F and PDP – 70 year old male

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Auto-Reimbursement How the Process Works

Health Reimbursement Arrangement

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What Is An HRA?

• Tax-advantaged account used to reimburse you for eligible health care expenses

• You must meet Reynolds American Inc.’s eligibility requirements to qualify for HRA

• Your HRA funds will be available January 1, 2013

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Reynolds American Inc.

allocates benefit dollars

to HRA account of

eligible participant

Participant HRA

Account

Administered by Extend Health

Participant enrolls in a medical plan through Extend

Health to enroll in individual coverage

Participant is reimbursed for

healthcare expenses using

HRA benefit dollars

Health Reimbursement Arrangement: How It Works

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How to File a Paper ClaimParticipant pays plan premium or

co-pays

Participant fills out claim form, attaches required information

Extend Health verifies receipt of

payment and eligibility

Extend Health reimburses customer

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Extend HealthHRA Claim Form

Remember,You can be

Reimbursed for Part B by sending in your statement

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How Auto-Reimbursement Works

Participant pays plan premium to

insurance company

Insurance company forwards receipt of payment to Extend

Health

Extend Health verifies receipt of

payment and eligibility

Extend Health reimburses participant

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Next Steps

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Next Steps

Review “Getting Started Guide”

Gather Medicare Prescriptions and Doctor information

Call Extend Health (855) 835 -3811

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Post Enrollment Customer Service

Advocacy and support services• Toll Free number to contact Extend Health

representative• Direct support for claims issues, appeals and

network questions• Renewal process – ability to pick new coverage for

future years – not locked into this year’s choice• Ongoing enrollment services

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Questions