2019 Annual Enrollment Non-Medicare Eligible Retirees Jennifer - PowerPoint PPT Presentation

2019 Annual Enrollment Non-Medicare Eligible Retirees Jennifer Gondorchin November 2018

Agenda • Annual Enrollment for Non-Medicare Eligible Retirees • Medical Plans for Non-Medicare Eligible Retirees • PPO plan Prescription Drug Changes • Telehealth – PPO Plan • The Affordable Care Act • Medicare – Via Benefits Age-in Process • Important Points To Remember • Benefits Department Contacts • Questions & Answers Jennifer Gondorchin | 2019 Annual Enrollment – Non-Medicare Eligible Retirees 2 11/2/2018

2019 Annual Enrollment • Fermilab’s Annual Enrollment applies only to retirees and dependents who are not eligible for Medicare . • Dependents of retirees enrolled in the Via Benefits program may be covered in Fermilab’s retiree medical plan if the dependent is not Medicare eligible. • The Annual Enrollment period is November 1 to 16 . • Changes take effect January 1, 2019 . • If you do nothing your medical plan and coverage tier will remain the same in 2019. • All Medicare eligible retirees will continue to partner with Via Benefits for medical and prescription drug coverage to supplement Medicare. • This Annual Enrollment is not applicable to retirees with Medicare . • Via Benefits communicates directly with Medicare eligible retirees about their coverage options for 2019. • This presentation will not address Medicare’s annual open enrollment or related topics. These questions should be directed to Via Benefits. 3 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

2019 Retiree Medical Change Form • If you want to make a change to your medical plan or coverage level for 2019 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, 2019. • If you cancel coverage or drop a dependent you may not re-enroll. • Return the form to the Benefits Office by Friday, November 16, 2018 . 4 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

2019 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 Via Benefits? The member who is not on Medicare will stay on the current plan while the retiree or spouse moves to Via Benefits. 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 2019. 5 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

2019 Retiree Premiums • Fermilab continues to subsidize premiums for our retirees who are not yet eligible for Medicare. • Effective January 1, 2019 retiree contributions will go up overall 14% . Some coverage tiers and plans are less than 14% and some are more than 14%. Coverage Tier BCBS PPO BCBS Blue Advantage HMO Single $263.07 $238.13 Retiree & Spouse $575.68 $498.19 Retiree & Child(ren) $480.62 $439.21 Family $822.20 $740.84 6 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

Medical Plans – BCBS – PPO • Co-pays, deductibles and out of pocket maximums 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 11/2/2018 Jennifer Gondorchin | 2019 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 except in emergencies. • 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 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

PPO Plans Prescription Drug Formulary Changes • Effective January 1, 2019 the Express Scripts formulary will have some minor changes. If you or a covered dependent are impacted by the change you will receive a letter from Express Scripts notifying you of the change and outlining the steps you need to take. • The chart shows a snapshot of the drug classifications impacted by the changes. Some of the drugs may require prior authorization before the plan will pay for the drug. • Some drugs may require you to try utilizing a different drug before the plan will pay for the higher cost drug. This approach, which is intended to control the costs posed by prescription drugs, is also known as step therapy. • Drug quantity limits are in place for some drug categories. 9 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

PPO Plans Prescription Drug Formulary Changes Prior Authorization Step Therapy Drug Quantity Limits Allergies Blood Cell Deficiency Anti-infective Specialty Asthma Specialty Bone Conditions Asthma – Specialty Bone Conditions BPH Blood Cell Deficiency Diabetes Fertility Bone Conditions High Blood Cholesterol Growth Hormone Diabetes Inflammatory Conditions Hepatitis C Endocrine Disorder Narcolepsy High Blood Cholesterol Fertility Pain High Blood Pressure Hepatitis C Sexual Disorders Inflammatory Conditions High Blood Cholesterol Skin Conditions Mental Health/Behavioral Health High Blood Pressure Metabolic, Immune disorders or Inflammatory Conditions – Sleep Disorder Inherited Rare Disease Specialty Multiple Sclerosis Multiple Sclerosis Multiple Sclerosis Osteoarthritis Oncology Pain Neurological Disorders Pulmonary Arterial Hypertension Pulmonary Hypertension Hormone Supplementation Migraine Headaches Impotence 10 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

Telehealth – MDLIVE – PPO plans only • MDLIVE is an integrated BCBSIL partner • $15 co-pay for a virtual visit; 50% reduction from traditional office visit • MDLIVE treats over 50 non-emergency medical conditions: – Common cold, Allergies, Constipation, Cough, Diarrhea, Ear Problems, Pink eye, Rash, Respiratory Problems, Sore throat, UTI (Females, 18+), Fever, Flu, Headache, Insect Bites, Nausea, Vomiting • Behavioral health – Counselor and Psychiatrist • Dermatologist 11 11/2/2018 Jennifer Gondorchin | 2019 Annual Enrollment - Non-Medicare Eligible Retirees

When to Use Virtual Visits Non-Emergency Medical Conditions • Allergies • Cold and flu • Diarrhea • Earache • Fever • Headache • Insect bites • Nausea • Pinkeye • Sore throat 12

Schedule a Visit BY TELEPHONE Speak with a care coordinator to Automatically connect 888-676-4204 confirm a virtual visit is appropriate with an available doctor Call toll-free hotline and be directed to a list of eligible or schedule a future 24/7/365 doctors to select from appointment BY ONLINE VIDEO Automatically connect with Receive system assistance to confirm MDLIVE.com/BCBSIL an available doctor via a virtual visit is appropriate, and view Visit MDLIVE’s website online portal or schedule a a list of doctors using specialty, and log in with future appointment language, gender, location or next username and available doctor criteria password BY MOBILE APP Log in to mobile Receive system assistance to confirm Automatically connect with app with a virtual visit is appropriate, and view an available doctor via username and a list of doctors using specialty, smartphone or schedule a password language, gender, location or next future appointment available doctor criteria Note: Service availability and communication mode dependent upon member’s location at time of service. MDLIVE, an independent company, that provides virtual visit services for Blue Cross and Blue Shield of Illinois. 13 MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers.

Requesting a Virtual Visit Jane Doe Log in via Blue Access Choose first available Provide a brief medical Receive confirmation SM or for Members provider or schedule an history, pharmacy and visit the doctor mdlive.com/bcbsil, appointment information and method or therapist! choose location* and of payment doctor for visit Jane Doe *Each state has different regulations for virtual visits. The state the member is in when requesting a virtual visit will determine whether the consultation is by phone or by video. 14