PRE-MEDICARE AGE-IN PRESENTATION 775-684-7000 P LAN Y EAR 2020 or 1-800-326-5496 J ULY 1, 2019 – J UNE 30, 2020 www.pebp.state.nv.us
Today’s Topics PEBP and Via Benefits Forms PEBP’s Medicare Requirements PEBP Dental Plan Option Enrollment Options ❔ Who is Via Benefits CDHP HRA vs Via Benefits HRA How the Via Benefits HRA Works Importance of Enrollment through Via Benefits
Approximately 2 months* before your 65 th birthday, PEBP will mail you: • Happy Birthday Letter • PEBP and Medicare Guide (Also available interactively online) • Retiree Benefit Enrollment and Change Form (RBECF) *If not received about 6 weeks prior to your birthday month please call PEBP Member Services to be sure it is on its way
Retiree Benefit Enrollment and Change Form (RBECF) Medicare Effective Date RBECFs must be filled out and mailed or hand delivered to PEBP as they are barcoded. No faxes or emails will be accepted.
It’s as easy as 1 -2-3 (4-5) Contact the Social Security Administration and enroll in Medicare Part A (as eligible) and purchase Medicare Part B Mail or walk in a copy of your Medicare card to the PEBP Office. Mail PEBP the original signed RBECF Call Via Benefits to schedule an appointment and set up your online profile Call Via Benefits and complete your medical plan enrollment Wait for your funding packet to arrive from Via Benefits (this can take between 8-12 weeks from your effective date)
Step 1 Enroll in Medicare PEBP’s Medicare Requirements
Premium-Free Medicare Part A You or your spouse (or former 💹 Social Security spouse of 10 years) have at least 40 credits (10 years) in which you paid Social Security taxes OR You are eligible for Railroad Retirement Benefits 01-01-2020 OR 01-01-2020 You are under age 65 and Please call the Social Security Administration approved for Social Security (SSA) to verify your Medicare Eligibility Disability Benefits 1-800-772-1213 Everyone age 65 or older can purchase Medicare Part B
PEBP’s Medicare Requirements • Medicare A+B card • Military ID (front and back) TRICARE • Not required to enroll in Medicare ACTIVE EMPLOYEE until 60-90 days prior to retirement • PEBP Medicare requirements apply to SPOUSE/DP covered spouses and domestic partners CURRENTLY RETIRED Approaching 65th birthday • Enroll in premium-free Medicare Part A as eligible per Social NEWLY RETIRING AFTER AGE 65 Security (SSA) guidelines (60-90 days prior to retirement) • Must purchase Medicare Part B from SSA CURRENTLY RETIRED Under 65 and approved for Social Security Disability benefits (after 24 month waiting period)
Step 2 PEBP Enrollment Options Sending PEBP Your Paperwork
Not required to enroll in Medicare If Medicare is Active obtained, Active Employee Not yet Retiring submit copy of card to PEBP Newly retiring? Enroll in Medicare A+B 60-90 days prior CDHP HSA will to retirement become HRA (if applicable)
Not required to enroll at Via Benefits Copy of Medicare A+B Medicare A+B Medicare A+B and and card and TRICARE for Life Military ID TRICARE for Life TRICARE for Life (front and back) Mail RBECF to elect or Thank you for your service! decline dental and establish your HRA
Must enroll at Via Benefits No Covered Dependents Copy of or Medicare A+B Medicare A+B Participant and card to PEBP Dependent both have Medicare Newly retiring? Enroll in Medicare A+B 60-90 days prior Mail RBECF to to retirement elect or decline dental
Retiree may stay on PEBP PPO, EPO, or HMO with dependent OR Medicare A+B Participant Medicare Non-Medicare Dependent eligible retiree Or Covering Dependents may enroll at Non-Medicare Participant Via Benefits Medicare A+B Dependent AND Retiree only: Monthly premium reduced by Unsubsidized $135.50 after receipt dependent(s) of Medicare Part B card may stay on PEBP or terminate coverage or vice versa
May remain on PEBP PPO, EPO or HMO MUST purchase Medicare MEDICAL (PART B) 01-01-2020 Part B NOT eligible for premium free No Medicare Part A Medicare Part A Obtain SSA Eligibility Letter (lack Retiree only: Monthly of credits) premium reduced by $135.50 after receipt of Medicare Part B card Complete RBECF submit all documents to PEBP
PEBP Dental Option • Via Benefits medical plan = option to elect PEBP dental • Mail in RBECF to enroll (or decline) in PEBP dental • Dental coverage effective for the entire plan year • Automatic reimbursement, no paper claim required • Monthly dental premium will be deducted from your PERS pension • No PERS pension? Pay online or set up automatic payments through your E-PEBP Portal Monthly PY20 PEBP Dental Rates July 1, 2019 – June 30, 2020 State Retiree Non-State Retiree Retiree only $40.47 $41.18 Retiree + Spouse/DP* $80.93 $82.37 *Spouse/DP must also have a medical plan through Via Benefits in order to elect PEBP dental
Review YOU’VE ALREADY: ✓ Enrolled in Medicare A+B (Original Medicare) through Social Security, as eligible. Medicare will be your primary coverage. └› Medicare A provides about 80% hospital coverage Medicare B provides about 80% medical coverage ✓ Provided proof of your Medicare enrollment by sending a copy of your Medicare A+B card to PEBP. ✓ Mailed your RBECF to elect or decline PEBP dental, establish your Via HRA and change your status to “Medicare Eligible”. Contact SSA to check your Medicare eligibility and complete enrollment.
What to Do Next ❑ Read all material PEBP and Via Benefits mails you and develop an idea of what medical and pharmacy plan you would like to select with Via Benefits Prepare ❑ Call Via Benefits at 1-888-598-7545 to schedule and appointment with a certified licensed benefit advisor Call ❑ Complete enrollment by calling and speaking to a licensed benefit advisor Enroll ❑ Via Benefits will now manage your new plan and funding account. Wait 8-12 weeks for your funding packet to arrive from Via Benefits Wait
Steps 3 and 4 Who is Via Benefits? Your Future Coverage
Who is ? First and largest private Personalized options Medicare Market with plans from a Exchange Company nationwide network 120+ 15 th Year of Service Insurance Companies 9 out of 10 Retirees 1.9 Million Retirees reported they would work from 680+ employers with Via Benefits again Licensed Advisors Never any provide guidance and fees for services ongoing advocacy
Via Benefits Process Consultative Process Simplified Selection A Licensed Benefit Advisors will explain the details of Advisor will assist you coverage and answer to find a plan that your questions meets your needs and fit your budget Effortless Enrollment Ongoing Advocacy Dedicated specialist are a phone call away The insurance enrollment forms will to help you with your be completed over new healthcare coverage the phone
24/7 access to your information Want more information? Contact Via Benefits at 1-888-598-7545 https://My.ViaBenefits.com/PEBP
When to Call Via Benefits Via Benefits is Your Ongoing Advocate Navigation Update personal information Questions and concerns Affordability concerns Billing Issues Carrier and provider issues HRA reimbursement issues Annual plan review The plans run Jan-Dec. No need to re-enroll during Medicare Open Enrollment unless you want to make a plan change. Call Via at 1-888-598-7545!
Medicare Options Medicare Advantage Plan with Prescription Drug vs Medigap + Prescription Drug
Your Future Coverage How Medicare Coverage Works Primary Coverage Medicare A and B
Medicare Advantage with Prescription Drug Coverage (MAPD) HMO PPO Medicare Advantage plans are generally network based plans. 25
Medigap + Part D Medicare Supplement Insurance (Medigap) must purchase separate Part D Prescription Drug Plan (PDP) Note: You may need to pay your first premium when you initially enroll.
Medigap Lettered Policies Benefits A B D G K L M N Part A coinsurance and hospital costs 100% 100% 100% 100% 100% 100% 100% 100% (up to an additional 365 days after Medicare benefits are used) Part B coinsurance or copayment 100% 100% 100% 100% 50% 75% 100% 100% Blood (first 3 pints) 100% 100% 100% 100% 50% 75% 100% 100% Part A hospice coinsurance or copayment 100% 100% 100% 100% 50% 75% 100% 100% Skilled nursing facility care coinsurance 100% 100% 50% 75% 100% 100% Part A deductible 100% 100% 100% 50% 75% 50% 100% Part B excess charges 100% Foreign travel emergency (up to plan limits) 80% 80% 80% 80% Out-of-Pocket limit in 2020 Please discuss all of your options with a $5,880 $2,940 Via Benefits Licensed Benefit Advisor Source: CMS
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