2018 Annual Enrollment Non-Medicare Eligible Retirees Jennifer Gondorchin November 2017
Agenda • Annual Enrollment for Non-Medicare Eligible Retirees • Medical Plans for Non-Medicare Eligible Retirees • The Affordable Care Act • Important Points To Remember • Benefits Department Contacts • Questions & Answers Jennifer Gondorchin | 2018 Annual Enrollment – Non-Medicare Eligible Retirees 2 11/6/2017
2018 Annual Enrollment • Fermilab’s Annual Enrollment applies only to retirees and dependents who are not eligible for Medicare . • Dependents of retirees enrolled in the OneExchange program may be covered in Fermilab’s retiree medical plan if the dependent is not Medicare eligible. • The Annual Enrollment period is November 2 to 15 . • Changes take effect January 1, 2018 . • If you do nothing your medical plan and coverage tier will remain the same in 2018. • All Medicare eligible retirees will continue to partner with OneExchange for medical and prescription drug coverage to supplement Medicare. • This Annual Enrollment is not applicable to retirees with Medicare . • OneExchange communicates directly with Medicare eligible retirees about their coverage options for 2018. • This presentation will not address Medicare’s annual open enrollment or related topics. These questions should be directed to OneExchange. 3 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
2018 Retiree Medical Change Form • If you want to make a change to your medical plan or coverage level for 2018 during this Annual Enrollment, use this form. • Select the plan and select the coverage tier. • Enroll the participants in the plan. • No new dependents may be added. • Newly acquired dependents must be added within 31 days of the event (i.e., marriage, birth or adoption). • Also use this form to cancel coverage effective January 1, 2018. • If you cancel coverage or drop a dependent you may not re-enroll. • Return the form to the Benefits Office by Wednesday, November 15, 2017 . 4 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
2017 Retiree Medical Plan Enrollment - FAQ What is Annual Enrollment for retirees? Annual enrollment gives our retirees an opportunity to change medical plans or coverage tiers (i.e., who is covered). What happens if the retiree or spouse is moving to OneExchange? The member who is not on Medicare will stay on the current plan while the retiree or spouse moves to OneExchange. If the remaining participant is not the retiree, the subscriber will now be the trailing dependent. A new ID card will be issued. Do I have to do anything during Annual Enrollment? If you do nothing your medical plan and coverage tier will remain the same in 2018. 5 11/6/2017 Jennifer Gondorchin | 2017 Annual Enrollment - Non-Medicare Eligible Retirees
2018 Retiree Premiums • Fermilab continues to subsidize premiums for our retirees who are not yet eligible for Medicare. • No Increases! Coverage Tier BCBS PPO BCBS Blue Advantage HMO Single $235.48 $221.31 Retiree & Spouse $475.66 $425.84 Retiree & Child(ren) $430.22 $408.19 Family $679.36 $633.25 6 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
Medical Plans – BCBS – PPO • Co-pays, deductibles and out of pocket maximum will remain the same. • No PCP selection or referrals required. • Physician office visits covered at 100% after copayment. • Includes x- ray and labs provided in doctor’s office during visit. In Network Out of Network Copayments $30 PCP, $40 Specialist Deductible Individual $500 Individual $750 Family Max $1,500 Family Max $2,250 Coinsurance You pay 10% after You pay 20% after deductible deductible Out-of-Pocket Max Individual $2,200 Individual $4,150 Family Max $6,600 Family Max $12,450 7 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
Medical Plans – BCBS – Blue Advantage HMO • You must select a Medical Group and Primary Care Physician (PCP). • All care must be received within your chosen Medical Group. • All non-PCP provided services require a PCP referral. • There is no out-of-network coverage. • Physician and ER copayments will remain the same. In Network Out of Network Physician $20 PCP, $30 Specialist N/A Copayments ER Copayment $150 Deductible N/A N/A Coinsurance N/A N/A Out-of-Pocket Max Individual $1,500 N/A Family Max $3,000 8 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
Pharmacy Benefit Manager (PBM) Change in PPO Plan • An extensive evaluation of the pharmacy benefit The PBM change contract with Blue Cross identified opportunities to does not apply to improve services and cost. the HMO plan. • Currently both plans contract with Prime Therapeutics to provide pharmacy benefits services. • Prime Therapeutics is owned by Blue Cross Blue Prime Therapeutics Shield. remains the PBM • Following a competitive bidding and evaluation for the HMO in process, Express Scripts was chosen as a new 2018. pharmacy benefit manager for retirees who are enrolled in the PPO Plan. • Express Scripts offers Fermilab enhanced There will be no services, broad networks and better prescription changes to prices. prescription drug • Because prescription drug costs are expected copayments in to be lower, the laboratory will not increase retiree costs for PPO coverage in 2018, 2018. although other health care costs will rise. 9 11/6/2017 WDRS Benefits Office | 2018 Open Enrollment
Express Scripts • No plan design changes • 70,000 pharmacies nationwide • A pharmacy and formulary list is available at www.express- scripts.com/NATPLSBASIC • Express Scripts will not have employee specific information until after open enrollment. • As a part of the transition Express Scripts will receive all current approved prior authorizations, retail and mail order drug refill information. • Express Scripts will issue pharmacy ID cards mid- December. • PPO participants will receive 2 ID cards 10 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
Using Your Preventive Care Benefits • Receiving preventive care services and establishing a relationship with a primary care physician is important at all ages. • Both medical plans cover preventive care services when utilizing an in-network provider. • Patients who maintain a relationship with a primary care physician and receive regular preventive care treatment have fewer emergency rooms visits, fewer hospital stays, and are more likely to lead an active lifestyle as they age. • Consider using the following resources to locate a primary care physician: – Search www.bcbsil.com. – Ask fellow retirees, family and friends for a referral and read the physician’s online reviews. • Review the adult wellness guidelines from the American Academy of Family Physicians provided by BCBS of IL. 11 11/6/2017 WDRS Benefits Office | 2018 Open Enrollment
Go Mobile! Access benefits information via mobile device • Are you always on the go? • Mobile apps allow you to access the information you need when you need it. • Blue Access mobile allows secure access to healthcare coverage information, claims status, provider search and ID cards from your mobile device. 12 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees 11/6/2017
ACA Mandated 1095 Reporting • The Affordable Care Act (ACA) requires employers to provide a statement to employees and retirees that includes information about the type of healthcare coverage offered to the employees, if any, during the prior year. • This statement is to be filed with the employee’s Federal tax return. Think of the Form 1095 as a type of W - 2 for the health insurance offered to you during the year. The 1095 forms must be provided to retirees by January 31, 2018. • The 1095 form is your proof that you had the required coverage. Retirees that were covered either in the active employee plan or retiree non-Medicare eligible plan for any portion of 2017 will receive a form. 13 11/6/2017 Jennifer Gondorchin | 2018 Annual Enrollment - Non-Medicare Eligible Retirees
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