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City of PhoenixRetiree Medical

Coverage Information

2011- 12 Plan Year

Mary Kyle, Deputy Human Resources Director

October 13, 2011

2employee.phoenix.gov/hr

Helpful Reminders

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The 31 Day Rule

31 Days

• Benefit changes for qualified life events must be made within 31 days.

• Marriage, divorce, birth, loss of other group coverage, etc.

• If you forget, you are responsible for the medical, pharmacy and dental claims the ineligible dependent incurs.

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Can I Re-enroll?

Yes, you may re-enroll in City retiree medical coverage during Open Enrollment if you’ve had

CONTINUOUS, COMPARABLE COVERAGE

since the date you dropped the City’s coverage.

Evidence of continuous, comparable coverage is required. Speak with a Benefits Analyst for details.

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Medicare Eligibility

• You are eligible for Medicare on the 1st day of the month you turn 65.

• You are eligible for Medicare if you are

qualified for Social Security Disability Income

(SSDI) for the previous two years. Medicare

enrollment is automatic when disabled.

You must provide a copy of your

Medicare Card to the

Benefits Office.

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Benefits Info Online

employee.phoenix.gov/hrBenefits – Employment Services

Training & Development – Support Services

eCHRIS Self-Service - Retirees

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FORMS DOCUMENTS WEBSITE LINKS UPDATES

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eCHRIS Help• HR Center

– (602) 262-6608– Located on the 1st floor of the Personnel Building.

• Benefits Office– (602) 262-4777– Located on the 4th floor of the Personnel Building.

• Password Help– Call (602) 534-4357

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In the Mail

Keep your address updated

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Self Funding

• Provider networks are leased.– Provider reimbursement levels are set

• City pays a monthly fee to process claims and provide other services.

• City is billed for the amount paid to each doctor, hospital, lab, etc.– This is paid from the Health Care Benefits Trust

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$215 Million =

The total projected cost for medical and pharmacy coverage in the 2011 – 12 Plan Year for

– Employees– Retirees– Covered family members

99.06% is spent directly on claims

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HELP US PROVIDE QUALITY COVERAGE

• Pharmacy – Use Generics where possible to save money for you and for the plan

• Use mail order for maintenance medications• Check retail locations for $4 generic medications

• Visit Urgent Care and Convenience Care Clinics instead of the Emergency Room when appropriate

• Keep yourself healthy • Get annual physicals/check-ups• Get an annual flu shot

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Medical Co-Pays

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Co-Pay Changes as of Aug. 1

Service Current Co-Pay Co-Pay as of 8/1/11

PCP Office Visit $15 $20

Eye Exam $5 $10

Urgent Care $40 $45

Emergency Room $125 $140

Outpatient Surgery $75 $80

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Prescription Co-Pays Do Not Change

Prescription Co-Pays 

TierRetail Co-Pay

30 Day Supply

Mail Order Co-Pay

90 Day Supply

90 Day Fill at Retail

Generic $10 / 30 day supply $20 / 90 day supply $30

Preferred Name Brand $25 / 30 day supply $50 / 90 day supply $75

Non-Preferred Name Brand $40 / 30 day supply $80 / 90 day supply $120

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• To save yourself money as well as the plan, use generics where appropriate

• Mail order saves you money as well as the plan – 2 copays for 3 months of medication

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CIGNA Pharmacy Management Replaced CVS/Caremark

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CIGNA Pharmacy Replaces CVS/Caremark

• Effective on August 1, 2011

• For CIGNA and BlueCross/BlueShield plans.

• You should be using your CIGNA Pharmacy card at this point.

• Contact the onsite Pharmacy Representative in the Benefits Office for help

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Retiree Medicare Meetings

You are invited to a Medicare Information Meeting hosted by the City of Phoenix Benefits Office and the Area Agency on Aging.

 

Learn about the basics of Medicare from an impartial subject matter expert. Find out how the City’s coverage integrates with Medicare.

 No R.S.V.P. necessary. Bring your spouse, family member or friend. We look forward to seeing you there.

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Retiree Medicare Meetings

Tues., October 189:30 – 11:30 a.m.

Weds., November 99:30 – 11:30 a.m.

Thurs., November 179:30 – 11:30 a.m.

Goelet Beuf Senior Center3435 W. Pinnacle Peak Rd.

Phoenix, AZ 85027602-534-9743

Washington Activity Center2240 W. Citrus WayPhoenix, AZ 85015

602-262-6971

So. Mountain Senior Center212 E. Alta Vista Rd.Phoenix, AZ 85040

602-262-4093

We’re sorry if you can’t make it to one of these meetings. Information will be available online at

http://employee.phoenix.gov/hr/retirees/index.html

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Wellness

• Wellness programs help to control medical premium costs.

• The City is introducing a Health Risk Assessment incentive for employees.

• Wellness program options and incentives for retirees will be reviewed and implemented in 2012.

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QUESTIONS AND COMMENTS?