What is changing · 2018-08-24 · What is changing What is not ... Background Advantages for...

What is changing

What is not changing

What is a Medicare Exchange and how does it work?

How does it differ from what we have today?

Background

Advantages for retirees

New process

Via Benefits presentation

Q&A

2

Announcement sent to all retirees in May 2018 RIT is changing the way Medicare-eligible retirees, LTD

recipients and their Medicare-eligible family members access and enroll in medical, prescription drug, and dental coverage

Beginning in 2019, RIT will no longer offer group health coverage to supplement Medicare

Instead, RIT will offer supplemental coverage through a private Medicare Exchange, Via Benefits.

Great News! Benefit Advisors will help you pick the plan that is right for you.

RIT will provide its financial support through a Health Reimbursement Arrangement (HRA).

3

RIT will continue to provide access to quality healthcare coverage for our retirees.

RIT will continue to provide financial support for healthcare coverage for our retirees.

RIT will continue to offer a number of other benefits our retirees currently enjoy. You will find details on the RIT benefits website (www.rit.edu/benefits). ◦ Vision coverage, legal services coverage, and identity theft protection, with an annual open

enrollment (Lifetime Benefit Solutions will continue to bill you for these benefits)

◦ Pet insurance and auto/homeowners insurance (you would continue to pay your premiums directly to the insurance company)

◦ Tuition waiver for the retiree and eligible family members for RIT courses, 10% discount at Barnes & Noble @ RIT on most items if you show your RIT ID card (obtain an ID card at the Registrar’s Office, 1st floor of Eastman Hall), access to RIT facilities, including the Student Life Center if you want to work out and the Wallace Library, and the RARES discount card.

4

http://www.rit.edu/benefits

Organized approach to the individual Medicare marketplace Retiree has large selection of individual medical and prescription

drug plans from multiple carriers available in their geographic area, and including RIT’s current insurers, Excellus BlueCross BlueShield and MVP Healthcare. ◦ The retiree and spouse/partner can each choose a different plan; this is great

news for those couples who have very different healthcare needs.

Trained advisors and modeling tools help retirees navigate and select a plan to best meet their expected needs ◦ Advisors are all located in the U.S. and are objective, knowledgeable, and do

not receive a commission for enrolling retirees.

Employer (RIT) funds health reimbursement arrangements (HRA) to help retirees pay for their coverage. The HRA can be used for premiums and qualifying out-of-pocket expenses. ◦ Your personalized annual amount is found in the mailing RIT sent to you in

mid-August

5

Employer Group Model Medicare Exchange Model

Employer selects a few plans to offer

Retiree chooses from all plans available in the Exchange

Employer performs administrative responsibilities, including enrollment, communications, retiree billing, payment to carriers

Exchange performs all administrative work Retiree/spouse/partner make payments directly to Medicare carrier(s)

Employer subsidizes coverage with cost often tied to annual premium increases in a particular plan

Employer sets HRA amount and changes as desired; not linked to healthcare inflation

6

Rapidly growing liability for retiree healthcare is unsustainable Lack of control over cost escalation for RIT Limited offerings with very rich benefits – expensive for RIT,

retirees, and limited choice for retirees Medicare Exchange is relatively recent marketplace innovation We explored for several years to ensure it was right for our

retirees Added two retirees to our Benefits Advisory Group, which helped

us through the process to ensure we had input from faculty, staff and retirees

Conducted rigorous competitive bidding process, selected Via Benefits ◦ Very first Medicare Exchange (different name), most experienced ◦ Works with largest number of employers ◦ Includes plans from Excellus BlueCross BlueShield and MVP Healthcare

7

Expert advice: Access to individual marketplace in an organized manner with expert help - decision support from U.S.-based licensed, non-commissioned Medicare experts and modeling tools ensures each retiree makes an informed choice

More choice and flexibility: Wider range of coverage available for retirees to better meet their medical and financial needs. Potential for having some out-of-pocket costs reimbursed from the HRA. Unused HRA funds carry over for future use.

Individual coverage: Retiree and spouse/partner can choose different plans from each other if they have different medical needs (which they cannot do under the employer group model)

Joint HRA: Retiree and eligible spouse/partner will have a joint HRA, which either or both can access (reimbursements for the domestic partner will be taxable to the retiree)

Year-round support: Customer service and support advocates provide help for post-enrollment issues or concerns

Sustainability: RIT has more control over its cost, making it a more sustainable model for the future

8

Enrollment through Via Benefits, not RIT, for medical, Rx and dental ◦ Will continue to enroll for vision, legal services, and identity theft protection

coverage directly through RIT

YOU MUST TAKE ACTION and ENROLL BY DECEMBER 31, 2018 IN ORDER TO HAVE MEDICAL AND RX COVERAGE IN 2019 (beyond Medicare Parts A and B) ◦ Group coverage will not carry over into 2019 ◦ Must enroll in a Medicare medical plan through Via Benefits to qualify for your

HRA

Billing and payment for medical and Rx will be through your selected Medicare plan(s), not RIT ◦ Reimbursement for eligible premiums and out of pocket expenses will be

administered by Via Benefits ◦ Lifetime Benefit Solutions will continue to bill retirees for RIT vision, legal

services, and identity theft protection coverage

All questions about medical, Rx and dental must go to Via Benefits, not to RIT ◦ Before and during enrollment period ◦ During plan year

9

You will be able to purchase dental coverage through Via Benefits effective January 1, 2019

There are a number of dental plans available based on your geographic area

More flexible: you can enroll in future years

Note that some carriers have waiting periods - ask your Benefit Advisor about the plan details during your enrollment call

If you are currently enrolled in RIT’s dental coverage with MetLife, you can continue that coverage directly with MetLife

10

Same reminder as in past years Do NOT enroll in a separate Medicare

medical/Rx coverage outside of Via Benefits If you enroll in coverage outside of Via

Benefits ◦ Your coverage through Via Benefits will be

cancelled by the Centers for Medicare and Medicaid Services (CMS) (you cannot be enrolled in more than one plan)

◦ You will not be eligible for reimbursement from the HRA or any other RIT financial support

11

Legal requirement for HRAs that access must only be for retirees ◦ Law does not allow anyone who is an employee of RIT to access the HRA funds ◦ This rule applies whether it is you or your spouse/partner who is employed by

RIT; if you decide to work at RIT after you have retired, neither of you would be able to use HRA funds for expenses incurred during your employment period

◦ Once you re-retire employment, you will regain access to all of your unused HRA dollars.

The coverage and HRA deposits depend on the employee type and expected duration ◦ Adjunct – you can keep your coverage through Via Benefits, but you cannot use

the HRA for premiums or out of pockets expenses incurred while you are employed. There would be HRA deposits while employed.

◦ Regular full or part-time employee: If hired for less than 6 month assignment, same as adjunct

If hired for 6 months or more, or if unknown at time of re-employment, you will have RIT employee benefits Your coverage through Via Benefits needs to be cancelled

You may want cancel Medicare Part B so you don’t continue to pay the premium

No annual HRA deposits will be made while you are employed, but will resume when you re-retire. You will not have access to the HRA while you are employed; any funds in HRA will remain for you to access for future expenses when you re-retire.

12

willistowerswatson.com

Helping You Prepare

For Your Upcoming

Medicare Enrollment

© 2017 Willis Towers Watson. All rights reserved.


Discussion Topics

14 © 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

Medicare — Plan Types

Who We Are

2

1

Via Benefits Enrollment Process

Health Reimbursement Arrangement (HRA)

Action Items and Timeline

3

4

5

willistowerswatson.com 15

Who We Are

© 2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.


Experience That Counts for the People Who Need It Most


#1 The first and

largest private

Medicare

company

100+

Insurance

providers

1.7 million

Retirees from

more than

560 employers

9 10 out

of

Retirees

reported they

would work

with Via

Benefits

again

14 Year of service

TH


Our Service Centers

Operating Hours: Monday – Friday, 8:00am – 9:00pm ET


Salt Lake City

Phoenix

Dallas


Medicare — Plan Types



Plans & Insurers

PLANS

Medicare Advantage Medicare Supplement

(Medigap) Prescription Drug

(Part D)


INSURERS

Dental Plans Available


+

+

Your Future Coverage


Original Medicare

Parts A & B

MAPD

Medicare Advantage

with Prescription Drug

coverage

Medigap

+ Prescription Drug Plans

(Part D)

Optional Coverage

Dental

Plans

OR

Additional Coverage

How Medicare Coverage Works


Your Future Supplemental Coverage Options

MAPD Plans


MAPD Medicare Advantage

with Prescription Drug

coverage

HMO

Health

Maintenance

Organization

PPO

Preferred

Provider

Organization


Your Future Supplemental Coverage Options

Medigap Plans


Medigap

Prescription

Drug Plans

(Part D)

+


Medicare Supplement Insurance (Medigap): Lettered Policies


Medicare Supplement Insurance (Medigap) Policies

Benefits A B C D F G K L M N

Medicare Part A coinsurance and

hospital costs (up to an additional

365 days after Medicare benefits are

used)

100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Medicare Part B coinsurance or

copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Part A hospice care coinsurance

or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Skilled nursing facility care

coinsurance 100% 100% 100% 100% 50% 75% 100% 100%

Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100%

Part B deductible 100% 100%

Part B excess charges 100% 100%

Foreign travel emergency (up to plan limits)

80% 80% 80% 80% 80% 80%

Source: CMS

Out-of-Pocket

limit in 2018

$5,240 $2,620


Part D Plans — 5 Tiers of Co-Pays


Tier 2- Non-preferred generic

Tier 1- Preferred generic

Tier 3- Preferred brand

Tier 4- Non-preferred brand

Tier 5- Specialty drugs or injectables


Medicare Prescription Drug Coverage 2019


$3.40 for Generics

$8.50 for Brand Name

5% whichever is greater

Catastrophic Coverage

(only 4% will reach)

Coverage Gap

(only 25% will reach)

Initial Coverage

Deductible

25% for Brand Name

[accelerated due to

BBA-2018];

37% for Generics

Beneficiary Pays

$0 - $415

$3820

$5100

Total Cost

Full retail until deductible

is met

Copays for your plan

coverage- 25%

70%

manufacturer

discounts

count towards

TrOOP


Catastrophic Coverage Special Payments

Additional level of benefit for

participants with high drug costs

RIT has defined a specific overall

annual limit per person per year

to help cover the copayment

costs for RIT retirees while in the

Catastrophic phase.

It is expected that it will be

sufficient to cover the needs of

those retirees who reach this

level of need.

The Funding Guide to

Reimbursement mailing in

January 2019 will include

detailed information about this

benefit.

26 © [yyyy] Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.


Via Benefits Process



How We Can Help


Consultative Process

Simplified Selection

Effortless Enrollment

Ongoing Advocacy


Education


Getting Started Guide

Prepare for your enrollment

Call Toll Free to make an appointment

to enroll

1-888-586-0693

My.ViaBenefits.com/RIT


Education


Enrollment Guide

Understand your options

Call Toll Free to enroll

1-888-586-0693



Licensed/Certified/Appointed

Average age 43

Objective and unbiased (noncommissioned)

100% domestic workforce

Benefit Advisors


Benefit advisors are available:

Monday through Friday, 8:00 AM until 9:00 PM Eastern Time


Online Support Tools


Prescription Profiler

Load in your prescriptions — Shorten your time on the phone with us!


Online Support Tools


Help Me Choose Comparison Tool


24/7 access to your information


Enrollment Process


1 Benefit Advisors

Benefit Advisors can discuss

coverage options with anyone

Application Data Processor

Telephonic enrollment

2

100% of calls are recorded


Personal Guidance

An Ongoing Advocate


Navigation

Enrollment

Prescription changes

Affordability concerns

Reimbursement issues

Late enrollment

Annual plan review

HRA

The plans you select continue on year-to-year.

No need to re-enroll in the fall unless you want to make a plan change the following

year.


Health Reimbursement

Arrangement (HRA)



Health Reimbursement Arrangement


used to reimburse you for eligible health care expenses — you pay first and then get reimbursed

Tax-free account

If you are eligible

RIT will make an annual contribution to a Health Reimbursement Account (HRA)

You may use

HRA funding to reimburse yourself for eligible medical, prescription drug, dental and vision premiums, as well as eligible out-of-pocket healthcare expenses

Your HRA funding will be available:

January 1, 2019

Unused funds DO roll over.




You may be reimbursed up to the amount available in your HRA!

How the HRA works

YOU Insurance

Provider

Premium

Reimburse (Check or Direct Deposit)

Receipt of Payment




Automatic Monthly Premium Reimbursement

Up to the amount available in your HRA

YOU Your Bank

Reimburse

Insurance Provider

Set Up Automatic Withdrawal

Receipt of Payment

Premium




Manual Reimbursement

Up to the amount available in your HRA

YOU

Insurance or Other

Provider


Qualify for Your Health Reimbursement Arrangement


Funding Guide

Enroll in a medical plan through

Via Benefits before your enrollment

period ends on December 31, 2018

to have access to your HRA

You must remain enrolled in a

medical plan through Via Benefits

each year to continue to have access

to your HRA.


Next Steps



What You Need to Do

Schedule your enrollment call


Contact Via Benefits @ 1 888-586-0693

Call now to complete your

profile and schedule an

enrollment appointment

You will need your:

Medicare card or Medicare

Beneficiary Number (MBI) and

your Part A and Part B effective

dates

Prescription list

Doctors’ information

Hospital information


Call Now … We’re Ready


1-888-586-0693


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What is changing · 2018-08-24 · What is changing What is not ... Background Advantages for...

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