City of Phoenix Retiree Benefits Overview 2015
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City of Phoenix Retiree Benefits Overview 2015
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City of Phoenix Retiree Benefits Overview 2015. Today’s Topics. 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. - PowerPoint PPT Presentation
Transcript of City of Phoenix Retiree Benefits Overview 2015
City of Phoenix Retiree Benefits Overview2015
Today’s Topics
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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.4
Setting Medical Rates
Stats
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2015 Medical Rates
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2015 Retiree Medical RatesSavers
Choice PlanCigna HMO
BCBS PPO
Single – Not on Medicare $605.57 $754.92 $708.90Family – 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 $599.42Family – 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 $1,143.777
2014 to 2015 Monthly Medical Rate Change
Savers Choice Plan
Cigna HMO
BCBS PPO
Single – Not on Medicare $40.85 $49.44 $46.80Family – 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 $39.64Family – Retiree on Medicare any dependent not on Medicare
$71.41 $86.43 $81.80
Family – Retiree and all dependents on Medicare $69.20 $83.75 $79.278
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
Dental HMO Dental PPOSingle $27.44 $39.95
Plus One $49.58 $88.78Family $87.38 $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 16922phx11
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
oMedicare 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.14
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 Generico$25 Preferred Brand Nameo$40 Non-Preferred Brand Nameo$40 Specialty Drugs
o Your prescription drug list will be bigger than the standard Medicare Part D list.
oThere will be no “Donut Hole.”16
Key Points
CMS requirements may cause disruption with1-2% 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 Pointso You will get a new ID card from Cigna-
HealthSpring 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.
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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 Pointso 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 non-Medicare 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 Cigna-HealthSprings Rx which includes a letter, a Summary of Benefits, and a List of Covered Drugs (Formulary).
You don’t have to do anything!24
Coming in the Mail
The packet you receive from Cigna-HealthSpring Rx will tell you that you have the choice to opt-out 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 opt-out of the Cigna-HealthSprings Rx plan you will lose your medical coverage AND drug coverage.25
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 directoryEvidence 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.28
Customer Service
Cigna-HealthSprings Rx Customer Service 1-800-558-9562
8:00 a.m. to 8:00 p.m. AZ TimeSeven Days a Week
October 1, 2014 – February 14, 2015
After February 14, 2015 availability is Monday through Friday
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Questions?
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