Upload
acacia
View
41
Download
0
Tags:
Embed Size (px)
DESCRIPTION
Welcome to RCRV’s presentation of Rockwell Collins Insurance Programs available to RC retirees for 2014 10/8/2013. RCRV Presenters. Don Grimm Harlan Hanson James Wolfe - PowerPoint PPT Presentation
Citation preview
1
Welcome to RCRV’s presentation of Rockwell Collins Insurance Programs available to RC
retirees for 2014
10/8/2013
2
RCRV Presenters
Don Grimm Harlan Hanson James Wolfe
RCRV SHIIP Counselors for the Senior Health Insurance Information Program of the State of Iowa Insurance Division
3
Thank You RCRV St Luke’s Hospital & Angela Berns for all
the handouts plus the reservations for today’s meeting.
Rockwell Collins for providing our meeting room as well as support from Cypress, CA.
Extend Health for joining us at several of our meetings
4
Disclaimer We do not make decisions for Rockwell
Collins (RC), we are here to present information only
We will not discuss Rockwell Collins Policies or Government Health Care Policy issues
Please hold all questions until the end Save personal questions for one-on-one
discussions with a counselor at the end of the presentations
5
What is SHIIP?
Objective Information Source Part of the State of Iowa Insurance
Division
Answers questions and provides assistance
Doesn’t recommend or endorse specific companies, products or agents
6
Rockwell Collins Medicare Insurance Program Rockwell Collins (RC) has partnered with Extend
Health to provide coverage for Medicare-eligible retirees and spouses
RC will continue to provide up to $669 for each eligible retiree and their eligible spouse (based on 25 years of service with RC)
You will receive these funds in a Health Reimbursement Arrangement (HRA) administered by Extend Health
You can be reimbursed for your premiums only by submitting claims to Extend Health
7
Who is Extend Health? Extend Health is the largest private
Medicare exchange in the industry They have over 2500 agents, located in
Texas and Utah who will work with you to enroll you in a plan of your choice
This is Rockwell Collins third year with them
Insurance Questions--contact Extend Health at 1-866-249-9924
8
Extend Health’s 2014 Offerings
13 Part D plans (from 3 carriers) will be offered by Extend Health. Several plans have been discontinued or replaced by other plans. See Extend Health’s website for details.
7 MAPD (Medicare Advantage with Prescription Drugs) plans by 3 carriers will be offered by Extend Health. Several HMO’s from $0 to $85 per month and 3 PPO’s from $0 to $37 per month are being offered. See Extend Health’s website for details.
3 Medigap carriers plans will be offered by Extend Health. You will have a choice of Plans C, D, F, or N plus High Deductible F. See Extend Health’s website for details.
The above is for Linn County. Other counties may have more or less plans available.
If you find a more economical drug plan than offered by Extend Health (and have signed up for a Health plan with Extend Health), you may sign up for a drug plan yourself, or through SHIIP or an agent of your choice and still collect your HRA.
9
Enrollment Period
Medicare Open Enrollment is from 10/15/13 through 12/7/13
2014 information was available on Oct. 1, 2013 at www.medicare.gov or www.extendhealth.com/rockwellcollins.
You must enroll via Extend Health, or the HRA will not be available to you now or in the future
If you are turning 65 and have under-65 dependents, you must enroll prior to the month of your birthday or risk the chance of having your dependent’s insurance canceled by RC. See current contract info in future cell.
10
If You Want To Stay With Your Current Provider
If you are already enrolled in a plan through Extend Health and wish to continue that plan, you don’t need to do anything
We still recommend you review your drug programs. Many retirees can get a more economical drug program if they just look!
11
Health Reimbursement Arrangement (HRA) RC will provide a HRA for each Medicare recipient
(you and your eligible spouse) if enrolled via Extend Health
You will get this money by providing a claim form to Extend Health for each premium paid along with proof of payment. Use the recurring form for monthly reimbursements for your Part B premium.
HRA funds can only be used for reimbursement of premiums, not for copays or other medical costs
Put both retiree and spouse on a separate recurring claim forms. Retiree info must be on the top of each form!
1212
HRA Info (cont) Your Medicare Part B premiums ($104.90 for
2013) can be reimbursed from the HRA. Proof of payment can come from one of the following documents sent to you by social security:
Statement received in Dec of 2013 showing benefits and deductions for the coming year, 2014
SA-1099 received in January 2015 for your 2014 income tax records
If your spouse does not use all the money in his or her HRA, you can claim your spouse’s portion
13
HRA Info (cont) No carry over. You must claim all your HRA for 2014
(claims will be accepted through 3/31/15) or you will lose it. (For 2013 dollars, you must claim by 3/31/14)
You must enroll in either a Medigap, Medicare Advantage or Part D Drug Plan through Extend Health to be eligible for the HRA
If you had 25 years (or more) with RC, you will receive $669 each for you and your spouse (if applicable)
If you had less than 25 years with RC you will receive notification of your HRA amount at the time you retire and a balance indicator as you receive funds from your HRA
14
Bargaining Unit Insurance current contract If you retired under the current contract:
Your coverage remains the same until 12/31/13, Then you will transfer to Family Medical Care Plan (FMCP) offered by the Union. If you turn 65 prior to 12/31/13, you must sign up for Medicare Parts A and B. You must also sign up for a supplement, MA plan and/or drug plan as well via Extend Health to be eligible for your HRA with an effective date of 1/1/14.
If you retired during the current contract and do not reach age 65 until 2019, then you are covered until 12/31/2018 by your contract.
If you or your spouse are under 65 and not Medicare eligible in 2014, then call FMCP directly at 1-877-937-9602.
15
Bargaining Unit Insurance prior contract (ended on 5/1/13)
If you retired under prior contract that expired in May of 2013, and are Medicare-eligible, you are covered until 12/31/13 then you must follow the same Extend Health/HRA program as non-bargaining unit retirees.
If you are under 65, then you will be covered via the Collins-sponsored group medical plan through December 31, 2013 as other bargaining unit retirees. Then you will be offered the same PPO Plus Plan that Rockwell Collins offers all retirees under Medicare age effective 1/1/14.
16
Rockwell Collins Insurance for Under 65 Retirees (Non Bargaining unit only)
RC will continue to provide the PPO Plus plan administered by Wellmark BCBS
This is a high deductible health plan which is eligible for a HSA HSA contributions must be made after tax
and claimed on your next year taxes Letters will be sent out Oct 28, 2013
defining RC’s offering.
17
Split Families(One Spouse under 65, the other on Medicare) People on Medicare will need to select a program via Extend
Health (no action required if you want the same plan from Extend Health in 2014 that you had in 2013)
Folks under 65 will continue to have the PPO Plus plan administered by Wellmark BCBS
4 months prior to your 65th birthday, you will get a package from Extend Health. You must enroll in a plan with the same effective date as your Medicare effective date or risk not having insurance for your dependents and you will not receive a HRA.
You must have a spouse covered under the RC plan if you want coverage for other dependents. If you and your spouse are both Medicare eligible, then RC insurance will not be offered to the remaining dependents
18
Medicare Info
From this point forward, we will be reviewing Medicare requirements. This is to provide info to folks turning 65 next year and it is a good review for the rest of you already on Medicare.
19
People Turning 65 in 2014 In Iowa, over 40,000 people are turning 65 in 2013 and
about the same in 2014 Rockwell Collins retirees turning 65 will receive a
package from Extend Health 4 months prior to their birthday. To preserve your eligibility for the RC HRA you must sign up for a health insurance plan through Extend Health prior to your birthday.
Your plan must take effect on the same date as your Medicare effective date
If not, you may lose your RC insurance for your dependents who are not yet 65. You may also lose the HRA for both yourself and your spouse now and in the future years.
20
MEDICARE Who Is Eligible?
Age 65 and older
MEDICARE
End-Stage Renal
DiseaseDisability
Must be a U.S. citizen or permanent resident for 5 years
21
Medicare Health Insurance
Part A Hospital Insurance
Part B Medical
Insurance
MEDICARE
22
Monthly Medicare Part A Premiums - 2013
Based on Work Credits 40 quarters ----------------- Free
(Eligible for Social Security benefits)
30-39 quarters ------------- $243 Less than 30 quarters -- $441
23
Enrolling in Medicare Part A
For people who have 40 work quarters of credit, i.e., for whom Part A is free
Enrollment is automatic if drawing Social Security benefits
No penalty for delaying Part A if it is free. Can enroll during Initial Enrollment Period or later
24
Enrolling in Medicare Part B
Initial Enrollment Period 7 months, beginning 3 months before age 65 (Enrollment automatic if drawing SSA)
General Enrollment Period January 1 through March 31 each year Coverage effective July 1 Premium increases 10% for each 12-month
period you were eligible but did not enroll Pay this penalty as long as you have Part B
25
Medicare-Eligible Retired & No Working Spouse
Medicare is your primary coverage. Need to enroll in Medicare
Part A and Part B. Enrolling in Part B later can
result in higher premium and a wait before getting coverage.
All Rockwell Collins Retirees at age 65 must enroll in Part A and B unless your spouse is working and you are covered on their insurance
26
Medicare-Eligible and You or Your Spouse Works
Can continue on employer plan Employer’s plan remains primary to
Medicare Employer can’t offer alternatives Don’t need to enroll in Medicare Part B Can enroll in Part B when worker retires
regular premium & no delay in coverage
27
Part B for Worker or Spouse Special Enrollment Period For worker or spouse with
Medicare Up to 8 months after worker
retires. (Rockwell Collins Retirees must have insurance through Extend Health with same effective date as your Medicare effective coverage to get HRA and to keep insurance for your under age 65 dependents)
28
You might want to delay Part A if
You are working or covered by a working spouse and
the employer plan is a qualified high deductible plan and you have a Health Savings Account
29
Your Medicare Coverage Choices
Original Medicare Medicare Advantage
Part A & B Part C = Parts A & B
Part D Drug Benefit Part D Drug Benefit
Medicare Supplement
30
Medicare Part A
Home Health
Care
Hospital Insurance
Skilled Nursing Facility
Inpatient Hospital
Hospice
31
Part A Inpatient What You Pay (2013)
Days 1-60 Days 61-90 60 Lifetime Reserve Days
You pay all
costs
Deductible $1,184
Daily Coinsurance
$296
Daily Coinsurance
$592
Renewable days
Renewable days
Each day available only
once
32
Medicare Part B$104.90 per Month (2013)
OtherServices &
Supplies
DoctorServices
OutpatientHospital & Emergency
Room
Home Health Care
Medical Insurance
DurableMedical
Equipment
33
CoveredPreventive Services
Welcome to Medicare preventive visit
Annual wellness visit Abdominal aortic aneurysm
screening Bone mass measurement Cardiovascular screenings Colorectal cancer screenings Diabetes screening Glaucoma tests
34
CoveredPreventive Services (Cont) Mammograms (screening) Pap test/pelvic exam/clinical breast exam Prostate cancer screening Flu shots, pneumococcal shots & Hepatitis B
shots Smoking cessation Alcohol misuse counseling Depression screening Obesity screening & counseling Behavioral Therapy for Cardiovascular
35
Medicare SupplementInsurance
Health insurance policies sold by private insurance companies
Also called “Medigap” Cover “gaps” in Original Medicare Plan 10 standardized policies Plans A, B, C, D, F, G, K, L, M, N Extend Health has Plans C, D, F, F High
Deductible and N available only Costs may vary
By plan By company Where you live
36
Medicare Part D
Available to all people on Medicare Enrolled in Part A and/or Part B Includes those on Medicare due to
disability Don’t need part D if covered by current
bargaining unit contract plan until 1/1/2014 then must have signed up for a Part D PDP (Prescription Drug Plan)
37
Initial Enrollment Period (IEP)
New Medicare Beneficiary – can join a drug plan any time during the 7-month period surrounding their Medicare eligibility (Bargaining unit folks must have Medicare A and B effective at time of their normal Medicare Effectivity)
38
Annual Coordinated Election Period October 15 – December 7
During the Annual Election Period you can: Change prescription drug plans Enroll in a drug plan for the first time Drop Medicare drug coverage Enroll in a Medicare Advantage plan Change Medicare Advantage plans Disenroll from a Medicare Advantage plan
or Keep your current coverage
O-5
39
Monthly Medicare Part D Premiums
Income above: $85,000 individual and $170,000 joint – you will pay a higher
premium
40
Late Enrollment Penalty Assessed 1% of base premium* for
every month you were eligible to enroll in Medicare’s prescription drug coverage and did not enroll.
Pay penalty for your life timeExample: Did not enroll in 2006-your
penalty would be 91 months X 1% or 91% X $32.42 per month in penalty or $29.50 per month penalty (penalty goes up each year if National averages go up)
* $32.42 in 2014
41
Standard Benefit-What You Pay, 2014 costs
Deductible—cannot exceed $310
Co-payment or coinsurance until you reach the coverage gap (or donut hole)--which is $2,850 in total drug costs (what you pay and the plan pays)
Coverage gap—once you reach the gap, you get a 52.5% discount on brand name drugs and 27% discount on generics; when your true out-of-pocket costs reach $4,550 the gap ends
5% coinsurance after you leave the gap or $2.55/$6.35 whichever is cheaper
42
Creditable Coverage Notice
Individuals receiving their prescription drug coverage from an employer, retiree or pre-standard Medicare supplement plan will receive a notice by September 30 each year telling them if their coverage is “as good as or better than Medicare coverage”
43
Comparing Part D Plans
Premium
Deductible
Formulary
Cost
Coverage in the Gap
Pharmacy
44
How do you compare plans?
Information is Online
www.medicare.gov
SHIIP can help you compare plans! Phone numbers later in presentation
45
46
Medicare Advantage(Part C)
Medicare Advantage Plan
Dr. A
$$
$$
$
$
$
Dr. B Lab
Hospital
Home Health Agency
AmbulanceService Drugs
Medicare $
OtherInsurance
47
Medicare Advantage Eligibility
Have Medicare Parts A & B Covers people on Medicare because of
disability
Do not have end-stage renal disease
Live in service area
48
Medicare Advantage A Private Solution
Medicare contracts with a private company on an annual basis
Contracts require that plans provide Medicare Part A & B services
The plan handles claims You receive services and make payments
based on the private plan’s rules There are no supplements for these plans
and Medicare supplement insurance will not pay
49
Medicare Advantage Out-of-Pocket Costs
Must still pay Part B premium
May pay additional monthly premium
Pay other out-of-pocket costs Different from Original Medicare
Plan Vary from plan to plan
50
Medicare AdvantageAnnual Contracts
Contract year is January 1 through December 31
The plan can be renewed, changedor terminated on an annual basis
51
Medicare Advantage Types of Plans
HMO-Health Maintenance Organization
POS—HMO with Point of Service Option
PPO-Preferred Provider Organization
Cost Plan
52
Medicare HMO/POS
Check that your providers will accept the plan. Generally must get care and services from
plan’s network May have to pay full cost of care outside of
plan’s network POS allows visits to “out-of-network”
providers May need to choose primary care doctor Need referral to see a specialist
53
Medicare PPO
Can see any doctor or provider that accepts Medicare with some
exceptions, ask before you go! Don’t need referral to see specialist Don’t need referral to see out-of-
network provider Copayment amounts set by plan
Will usually pay more for out-of-network care
54
Initial Enrollment Period
New Medicare Beneficiary – Can join a Medicare Advantage plan any time
during the 7-month period surrounding their Medicare eligibility.
If you are a RC retiree you must enroll via Extend Health with a plan effective on the same date as your Medicare effective date or you will not get the HRA and if you have dependents under age 65, they may have their insurance with RC canceled.
55
Protection when Enrolling in a MA Plan
If you enroll in a Medicare Advantage plan when you first enroll in Medicare part B
at age 65 and disenroll within 12
months, you can go to Original Medicare
and get any Medicare supplement offered
in Iowa.
But these changes must be done via Extend Health Counselors to assure HRA.
56
Open Enrollment Period
October 15 – December 7
Can choose new plan Medicare Advantage Plan Medicare Prescription Drug Plan Original Medicare Plan
New plan starts January 1
57
Medicare Advantage Disenrollment Period
January 1 – February 14 each year Can return to original Medicare Can enroll in a stand alone Part D drug plan Change effective first day of following
month
Again, these changes must be done via Extend Health
58
Key Questions when Shopping for MA Plans
Will my doctors, hospital and other medical providers accept payment from the MA plan?
What are the deductibles, co-payments or coinsurance for the benefits I’m most likely to use?
What is the annual out-of-pocket maximum? What is the premium? Do I live in the service area for the plan? Does the plan include prescription drug
coverage?
59
For Assistance Call for appointments
Extend Health 1-866-249-9924 UnityPoint Health St Luke’s Hospital SHIIP 319-369-7475 Heritage AAA SHIIP 319-398-5559 or 1-800-332-5934 Mercy Medical Center SHIIP 319-861-7887 Witwer Center SHIIP 319-398-3636 Meth-Wick SHIIP, 319-297-8646 (Meth-Wick Residents
only) Jones County RSVP/SHIIP 319-560-0811 SHIIP Office, Des Moines 1-800-351-4664 Rockwell Collins Retirement Dept. 1-800-236-3071 Family Medical Care Plan (FMCP) 1-877-937-9602
60
Thank you for Coming Any Questions
After group questions, we have several SHIIP Counselors situated around the room who will answer your questions one on one