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OctoberisOpenEnrollmentChicago Teachers’ Pension FundMont2012 Health Insurance HandbookandOpen Enrollment GuideInside: Important Health InsurancePlan Changes for 2012Please keep this handbook for future referenceChicago Teachers’ Pension Fundh
ntelmol inarrnbn e Wepern O ar oanrfo Semiyda ncetorrautessIngihRetOpen Enrollment Health Insurance Seminars and WebinarsalHeprovide an opportunity to review 2012 health plan choicesOpen Enrollment Seminarsand NEW Webinarand changes. Members may also direct questions to healthinsurance plan administrators and CTPF staff, and receiveassistance filling out forms. See below for registrationinformation.New WEBINARSAvoid the hassles of travel and find all the information you need withoutleaving home. Join a live Webinar with interactive question and answersession.Monday, October 3, 2011n 9:30 a.m. Medicare plansn 1:30 p.m. Non-Medicare plansRegister in advance and receive login instructions at www.ctpf.org.Traditional Open Enrollment SeminarsTuesday, October 11, 2011Wednesday, October 5, 2011Hilton Oak LawnJames R .Thompson Center,9333 South Cicero Ave.Assembly Hall J (lower level)Oak Lawn, Illinois 60453100 W. Randolph Streetn 9:00 a.m. Medicare plansChicago, IL 60601n 1:00 p.m. Non-Medicaren 9:00 a.m. Medicare plansn 1:00 p.m. Non-Medicare plansRegistrationWebinar:Logon to www.ctpf.org for login/registration instructions.Traditional Seminars: Advance registration is required and space is limited,call 312.641.4464 to register.The Open Enrollment Period for CTPF health insuranceprograms runs October 1 – October 31, 2011.Changes made during Open Enrollment take effect January 1, 2012.Bring this handbook with you to the Open Enrollment Seminar.Keep this handbook for future reference. Additional copies are available at www.ctpf.org.
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nImportant 2012 ChangesJanuary 1, 2012, through December 31, 2012Changes in Plans for Medicare Eligible MembersCTPF Health InsurancePremium SubsidyThe CTPF health insurancepremium subsidy for 2012 is 60%.See page 11 for more information.New Pharmacy ProviderEffective January 1, 2012, Medco will providepharmacy benefits for the following plans:n BCBS Supplement to Medicaren BCBS HMO Illinois (Medicare)n AARP Medicare Supplement Plan F (UnitedHealthcare)Humana Group Medicare HMO with Part DPharmacy plan enrollees will not have Medco coveragefor prescriptions. Prescription coverage will continueunder the Humana Plan.CTPF plan administrators will attempt to transferremaining mail order refills to Medco. Contact MedcoCustomer Service after January 1, 2012, to make sureyour prescription refills have been transferred.CoPaysEnrollees taking prescription drugs that requireprior authorization will need to obtain new priorauthorization approval from their physicians.Under the Medco plan, prescription copays up to a31-day retail supply are 5 generic, 30 preferredbrand, and 45 non-preferred brand; 90-day supplycopays at retail or mail order are 10 generic, 60preferred brand, and 90 non-preferred brand.EnrollmentYou do not need to take any action to enroll inMedco pharmacy services. Enrollment is automaticfor current enrollees. All CTPF Medicare enrollees(except for Humana HMO) will receive a newprescription drug card, effective January 1, 2012,directly from Medco. BCBS enrollees will also receivenew ID cards for medical coverage.Notify Your PharmacyMedicare enrollees should provide their new MedcoID cards to their pharmacy to make sure prescriptionbenefits are not interrupted.Prior AuthorizationAdditional InformationWatch your mail for additional plan informationincluding prescription drug card, formulary, and mailservice order form, which will be sent directlyfrom Medco.Questions? (help available Beginning 10/01/2011)If you have coverage questions or need assistance, callMedco at 1-800-864-1416 or 1-800-716-3231 TTY/TDD(24 hours a day, 7 days a week), or visit the dedicatedwebsite www.medco.com/medd/ctpf.other 2012 ChangesDomestic Partners and Civil UnionsRates Reduced for MedicareEligible Members2012 Rates for all plans for Medicare eligible membershave been reduced between 9% and 20% for 2012. Seethe chart on page 31 for actual cost.Blue Cross and Blue Shield Supplementto MedicareMaximum out-of-pocket expense is now 1,500.Humana Group Medicare HMO withPart D PharmacyEffective January 1, 2012, domestic partners willno longer be eligible for CTPF health insurancecoverage. Dependents who lose coverage may applyfor continuation coverage under CTPF COBRA, seepage 39. Contact CTPF Member Services for moreinformation.Health insurance coverage is available for partiesto a civil union. Parties to a civil union may be same- oropposite-sex couples. See page 9 for documentationrequirements.Some copays have changed. Chiropractic visitswere reduced to 20 from 25. Outpatient behavioralhealth visits were reduced to 40 from 50 at anoutpatient facility.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e3
ContentsIntroductionRetiree Health InsuranceCurrent EnrolleesCOBRA Enrollees2012 Open EnrollmentReducing Your CostFraudDisclaimer55555555Important Information6Eligibility Requirements8Your ResponsibilitiesTurning Age 65Enrollment FormsID CardsAuthorized RepresentativePower of AttorneyHealth Insurance SubsidySurvivorsDental PlansRetirees and DependentsSurvivorsDependents DefinedDocumentation RequirementsEnrollmentInitial Enrollment PeriodSpecial Enrollment PeriodTurning Age 652012 Open Enrollment66677777788891010101010CTPF’s Health Insurance Premium Subsidy 11Subsidy for CTPF PlansSubsidy for CPS or Charter School COBRASubsidy for MedicareSubsidy for Non-CTPF Health Insurance11111111Overview of Health Insurance Options forNon-Medicare Eligible Members12CPS/Charter School Continuation CoveragePreferred Provider Organization (PPO)High Deductible Health Plan (HDHP) with HSAHealth Maintenance Organization (HMO)412121313Non-Medicare Eligible Members –Plan Cost Comparison14Non-Medicare Plan Contact Info.15Plan Comparison Charts Non-MedicareEligible Members16Overview of Plans for MedicareEligible Members24Important Medicare Information26Notice of Creditable Coverage30Plan Cost ComparisonMedicare Eligible Members31Plan Cost Comparison Charts –Medicare Eligible Members32Couple Coverage38CTPF COBRA39Ending Insurance Coverage42Important Terms43Contact Information44Health Insurance Privacy Policy46Turning Age 65Health Maintenance Organization (HMO)Plans that Supplement MedicareMedicare Advantage PlanMedco Prescription Drug CoverageMedicare DefinedThe Parts of MedicareMedicare CostApplying for MedicarePaying for Medicare Part ATurning 65CTPF Plan Enrollment RequirementsMaintaining Medicare CoverageBefore You Enroll in a CTPF PlanMedicare Eligibility Due to DisabilityMedicare Eligibility Due to ESRD or ALSMedicare Part D NoticeOverviewCTPF COBRA EligibilityDuration of CTPF COBRA CoverageNotification of CTPF COBRA EligibilityCTPF COBRA EnrollmentContinuation PeriodDisability ExtensionPremium Payment under CTPF COBRAAdding New DependentsTermination of Coverage under CTPF COBRAConversion PrivilegeVoluntarily Ending CoverageSurvivorsInvoluntarily Ending CoverageRefund of PremiumC T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n e n r o l l m e n t g u i d 141414142424242
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nIntroductionRetiree Health Insurance2012 Open EnrollmentChoosing a health insurance plan for you andyour eligible dependents is one of your mostimportant decisions. The Chicago Teachers’Pension Fund (CTPF) sponsors comprehensivehealth insurance plans designed to promotewellness and provide high-quality coverage ata reasonable cost.CTPF offers heath insurance benefits toretirees, dependents, and survivors if the retiree’sfinal teaching service was with the Chicago Publicor Charter Schools. Qualified retirees may enrollin a plan for:The annual Open Enrollment Period for theCTPF health insurance program runs fromOctober 1 – October 31, 2011. During OpenEnrollment, you may enroll in a CTPF healthinsurance plan for the first time, change a healthinsurance plan or carrier, or add a dependent to ahealth plan. Changes made during this period gointo effect on January 1, 2012.n Non-Medicare eligible membersn Medicare-eligible members who maintainenrollment in Medicare Part A and Part B.This handbook provides information aboutCTPF’s current health insurance options, rates,and changes to health insurance plans. Readthis handbook carefully, and familiarize yourselfwith your options. Please keep this documentfor future reference. Additional copies areavailable at www.ctpf.org.Current CTPF EnrolleesIf you are currently enrolled in a CTPF plan andwant to continue coverage in 2012, you do notneed to take any action to stay enrolled.*Your coverage will continue. See page 3 forimportant plan changes.COBRA EnrolleesIf you currently have insurance through yourformer employer’s COBRA program and wishto join a CTPF plan in January, you may enrollduring Open Enrollment. Enrollment from aCOBRA to a CTPF plan is not automatic. ContactCTPF before your coverage ends for enrollmentinformation.Reducing Your CostCTPF Health Insurance Premium SubsidyCTPF members whose final teaching servicewas with CTPF may receive a health insurancepremium subsidy. The subsidy, set annually, paysa percentage of health insurance costs for eligibleCTPF retirees and their survivors. The CTPFBoard of Trustees has approved a 60% subsidy,effective January 1, 2012. The subsidy is subjectto change at the discretion of the Board. Seepage 11 for information.FraudFalsifying information and/or documentation toobtain health insurance coverage through CTPFwill result in a loss of health insurance.DisclaimerIf this summary description differs from the plantext or any plan term or condition, the officialcontract document governs. This handbookcontains information regarding benefitsvoluntarily provided by CTPF. Plan provisionsmay change without prior notice.* If you currently provide health insurance to adependent who is a domestic partner, coverage foryour partner will end in 2012. See page 3 for benefitsavailable for parties to civil unions.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e5
Important InformationYour Responsibilitiesas a CTPF Health PlanEnrolleeYou must contact CTPF immediately if any of thefollowing events occur:n change of address for you or yourdependentsn death of a spouse or dependentn marriage, civil union, divorce, legalseparation, annulmentn dependent loss of eligibilityn change in Medicare status, includingturning age 65 or becoming Medicareeligible for another reason6Turning Age 65If you (or your dependent) plan to enroll ina CTPF Medicare plan, apply for Medicarethree months before the month you turn age65 to ensure timely enrollment. See Medicareinformation on page 26.To enroll in a CTPF Medicare plan, you mustenroll in Medicare Part A and Part B, and provideCTPF with proof of enrollment before the monthof your 65th birthday. Acceptable proof includes:n a copy of the Medicare card, orn n entitlement letter with Medicare numberafrom the Social Security Administrationverifying enrollment, with effective datesn change in Medicare payment status (suchas qualifying for state premium assistanceprogram)If you are currently enrolled in a CTPFnon-Medicare plan and fail to provide proof ofMedicare enrollment, your premium will increasesignificantly when you turn 65.n your pension deduction does not matchyour coverage or required premiumEnrollment Formsn you lose Medicare coverage due tononpayment of premiumAn enrollment form for most CTPF plans isincluded in this handbook.To enroll in the AARP Medicare SupplementPlan F or the Humana Group Medicare HMO withPart D Pharmacy, call CTPF Member Services at312.641.4464, and request enrollment information.Return all enrollment forms and associateddocumentation to:Chicago Teachers’ Pension Fund203 North LaSalle Street, suite 2600Chicago, IL 60601-1231Do not send enrollment forms to the healthinsurance plan administrator or your enrollmentwill not be processed.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n e n r o l l m e n t g u i d e
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nID CardsSurvivorsHealth plan enrollees receive health insuranceID cards by mail directly from their health planadministrator. ID cards are normally issued at thetime of enrollment or when a health plan changeis made.New prescription cards will be issued tomembers enrolled in the Medco MedicarePrescription Plan (PDP) for CTPF. Members enrolledin the BCBS Supplement to Medicare and BCBSHMO Illinois will also receive new ID cards formedical coverage.If you need a replacement card, contact thehealth plan administrator directly. Find contactinformation on pages 44 and 45.A surviving spouse and/or dependent child ofa deceased member whose final system wasCTPF may join a CTPF health insurance plan andreceive a health insurance premium subsidy.A surviving spouse and/or dependent child ofa deceased member whose final system was notCTPF may not join a CTPF health insurance planor receive a health insurance premium subsidy.Survivors who had coverage as a dependentmay be eligible to continue coverage underCTPF COBRA. Survivors who want CTPF healthinsurance coverage should contact CTPF as soonas possible to obtain the necessary forms so thatcoverage is not interrupted.Authorized RepresentativeDental PlansIf you want a family member to assist you withhealth insurance issues, you can submit aHIPAA Authorized Representative Designationform, available at www.ctpf.org or from MemberServices. Your Authorized Representative maydiscuss your health insurance options, butcannot make care or treatment decisions.CTPF health insurance plans do not includedental coverage. CTPF retirees may qualifyfor dental insurance through other agenciesincluding the American Federation of Teachers,the Chicago Teachers Union, or the RetiredTeachers Association of Chicago. See page 45.Power of AttorneyIf you want a family member or representativeto act on your behalf, you must file a power ofattorney with CTPF and the health care provider.Health Insurance SubsidyWhen you are enrolled in a CTPF plan, youreceive any available health insurance subsidydirectly in your monthly pension benefit.Members enrolled in non-CTPF plans arealso eligible for a subsidy of their healthinsurance premium cost. Applications are mailedon a yearly basis, typically in early Spring.See page 11.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e7
Eligibility RequirementsWho Can Enroll in a CTPF Plan?Retirees and DependentsCTPF retirees/survivors and their eligibledependents may qualify to enroll in a CTPFhealth insurance plan. To qualify, CTPF must bethe retiree’s final retirement system. A retiree/survivor and or dependent may initially enroll ina CTPF plan once in a lifetime unless he or sheexperiences a qualifying event noted on page 10.SurvivorsUpon the death of a member, dependentswho were covered under the member’s CTPFsponsored health plan should contact MemberServices as soon as possible to determinecontinued eligibility for insurance coverage orfor CTPF continuation coverage (COBRA).If the member’s final system was CTPF, hisor her surviving dependents may be eligiblefor health insurance benefits, and the healthinsurance premium subsidy. If the member’s finalsystem was not CTPF, his/her dependents are noteligible for coverage.Dependents Defined*Eligible dependents include:n alegal spouse as defined by yourstate of residencen aparty to a civil unionn children underthe age of 26n unmarriedveteran adult children underthe age of 30n childrenwho are mentally or physicallydisabled from a cause originating prior toage 23, and who are financially dependenton you for more than one-half of theirsupport and maintenance.Dependent enrollment is contingent uponmeeting the documentation requirements listedon page 9.It is your responsibility to notify CTPF inwriting when your dependent no longer meetseligibility requirements.* For the purposes of dependent eligibility,the term children includes:n naturaln stepchildrenchildrenn legallyadopted childrenn childrenfor whom you havepermanent legal guardianshipn disabled8C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n e n r o l l m e n t g u i d echildren
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nDocumentation RequirementsThe following documentation must be provided when you add a dependent to a CTPF Health Insurance Plan.Type of DependentSupporting Documentation RequiredLegal spouse as defined by your stateof residenceMarriage certificate or tax returnindicating spouse’s nameParty to a civil union*Civil union certificateDisabled child**Certified copy of birth certificate and an original letter fromphysician certifying disability on physician letterhead withdate disability occurred. Disability must have occurred priorto age 23.Natural child under the age of 26Certified copy of birth certificateAdopted child under age 26Adoption decree/order with judge’s signature and circuitclerk’s stamp or seal, and proof of birth dateStepchild under age 26Certified copy of birth certificate indicating spouse ischild’s natural parentChild under legal guardianship,under age 26Certified guardianship appointment with circuit clerkstamp or seal, and proof of birth dateUnmarried veteran adult child under age 30nP roof of Illinois residencynV eterans’ Affairs Release Form (DD-214) with releasedate from servicen Certified copy of birth certificate* effective January 1, 2012, domestic partners will not be eligible for coverage under CTPF plans.** CTPF may require periodic updates to disabled child documentation. See page 8 for dependenteligibility requirements.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e9
Enrollment: When Can I Join?A retiree/survivor and or dependent may initially enroll in a CTPF plan once in a lifetime, unlesshe or she experiences a qualifying event noted below.Initial Enrollment PeriodTurning Age 65You may initially enroll in CTPF coverage whenone of the following events occurs:If you will turn age 65 in 2012, see the Medicareinformation and CTPF plan enrollmentrequirements beginning on page 26.n within30 days after COBRA continuationcoverage under the Board of Educationor Charter School active employee grouphealth program ends,* unless coverage iscancelled due to non-payment of premiumn within30 days of the effective date ofpension benefitsn duringthe Annual Open Enrollment Period(once in a lifetime)n within30 days of first becoming eligible forMedicaren whencoverage is cancelled by a formergroup plan through no fault of your own* If your COBRA continuation coverage endsDecember 31, 2011, you may enroll in a CTPFplan during the Open Enrollment Period,October 1 – October 31, 2011. Coverage willbecome effective January 1, 2012.Special Enrollment Periodwith a Qualifying EventIn addition to the annual Open EnrollmentPeriod, you have 30 days after a qualifying eventto change plans or add an eligible dependent.Qualifying events may include:n changein permanent address that affectsthe availability of an HMO or MedicareAdvantage plann marriagenor civil unionbirth, adoption, or legal guardianshipn terminationof a Primary Care Physician forHMO plan enrolleesn within30 days of first becoming eligible forMedicare102012 Open EnrollmentThe annual Open Enrollment Period is the timewhen you or a dependent can enroll in a CTPFplan for the first time or change plans. Openenrollment begins October 1 and ends October31, 2011. Changes made during Open Enrollmentbecome effective January 1, 2012.You can get started with enrollment byfollowing the steps below:STEP 1: Make sure you understand any planchanges (see page 3 for a summary).Review the non-Medicare or Medicareplan comparison grids (pages 16 and 32).STEP 2: If you want to continue coverage in thesame plan, you do not need to take anyaction. Coverage will continue.*STEP 3: If you or a dependent want to enrollfor the first time or change plans, youmust complete an enrollment form.An enrollment form for most plans isincluded in the center of this handbook.To enroll in the AARP MedicareSupplement Plan F (UnitedHealthcare)or the Humana HMO, call CTPF MemberServices at 312.641.4464, and requestenrollment information.Send completed forms, along withany required documentation, to CTPF.All materials must be postmarked byOctober 31, 2011.SEND all enrollment FORMS and requiredDOCUMENTATION to CTPF. Do not send formsto plan Administrators.* If you currently provide health insurance to adependent who is a domestic partner, coverage foryour partner will end in 2012. See page 3 for benefitsavailable for parties to civil unions.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n e n r o l l m e n t g u i d e
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nCTPF’s Health Insurance PremiumSubsidy ProgramCTPF retirees’ whose final teaching service waswith the Chicago Public or Charter Schools, mayqualify for a partial subsidy of their insurancepremiums. A surviving spouse and/or dependentchildren who receive a survivor’s pension mayalso qualify for a premium subsidy.Each year, the CTPF Board of Trusteesdetermines a premium subsidy. The CTPF healthinsurance premium subsidy will be 60%, effectiveJanuary 1, 2012. The subsidy is subject to changeat the discretion of the Board. CTPF will makeevery reasonable attempt to notify members inadvance of any change.The subsidy only applies to the retireeor survivor portion of the health insurancepremium. Premium cost for dependent coverageis not eligible for the subsidy.Subsidy for CTPF PlansIf you are enrolled in a CTPF health insuranceplan, the subsidy is automatically applied to yourmonthly pension benefit.For example, if your monthly premium is 1,000 and the approved subsidy percentageis 60%, CTPF deducts 400 from your monthlypension for premium costs, and pays theremaining 600 on your behalf.Subsidy for CPS orCharter School COBRAIf you are enrolled in COBRA continuationcoverage, CTPF automatically applies thesubsidy to your monthly pension benefit. Thenecessary authorization forms must be on file.Subsidy for MedicareCTPF provides health insurance premiumsubsidy for Medicare premiums, with somerestrictions. CTPF does not subsidize anypenalties for late enrollment into Medicare PartsA, B, and D, nor does it subsidize the income-related monthly adjustment amount (IRMAA)assessed by Medicare for individuals with higherincomes. Penalties and adjustments are the totalresponsibility of the member. CTPF may bill amember to recover these costs if CTPF paysthese costs in error.CTPF EnrolleesMedicare Part A SubsidyRetirees enrolled in a CTPF health insurance planwho must also pay for Medicare Part A mustenroll in the CTPF Third Party Payer Program toreceive a subsidy. See page 27 for information.Medicare Part B SubsidyIf you make your Part B payment directly toMedicare, CTPF will add your premium subsidyto your pension payment. If your Part B premiumincreases, provide CTPF with written proof (aCMS premium notification letter or a Medicarepremium bill) so your subsidy can be adjusted.Third Party Payer enrollees will have anyavailable premium subsidy applied directly totheir monthly pension benefit.Subsidy for Non-CTPFHealth InsuranceMembers enrolled in non-CTPF individual orgroup health insurance plans are eligible fora subsidy of their health insurance premiumcost, subject to maximum reimbursementamounts that CTPF publishes each fiscal year.In calculating the allowable premium subsidy,CTPF offsets any amount of a member’s premiumcost that has already been subsidized by anotherentity (for example, a spouse plan). A subsidyapplication is mailed each year to membersenrolled in non-CTPF health insurance. Thesubsidy is paid out retroactively in an annualpayment. Premium payment documentation isrequired and is explained in the application.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e11
Overview of Health Insurance Optionsfor Non-Medicare Eligible MembersThe following pages offer general descriptions of the types of health insuranceoptions for CTPF retirees who are not eligible for Medicare. All CTPF health insuranceplans include comprehensive medical and prescription drug coverage. Specific planinformation can be found in the charts beginning on page 16.P o s t- Re t i r e m e n t He a lt h I n s u r a n ce Op t i o n sCPS/Charter School Continuation CoverageThe Consolidated Omnibus Budget ReconciliationAct of 1985 (COBRA), allows you to pay forthe same health insurance coverage that youreceived during employment, usually for18 months.Health insurance costs are generally lowerunder COBRA continuation coverage than theywould be under a CTPF plan. Many choose thisoption and extend coverage for the maximumtime allowed, normally 18 months.Under COBRA continuation coverage, you paypremiums directly to your former employer. Theemployer administers the program, determineseligibility, and processes applications. In orderto maintain coverage, you must make monthlypremium payments on time or your coverage maybe cancelled.Contact your employer for additionalinformation.Preferred Provider Organization (PPO)CTPF offers two PPO options, the Blue Cross andBlue Shield PPO and UnitedHealthcare ChoicePlus PPO. These plans include both medical andprescription drug coverage.A Preferred Provider Organization (PPO)is a network of physicians, hospitals, andother professionals that have agreed to acceptestablished fees from a health plan.12You decide whether or not to use a PPOnetwork provider, but plans generally pay ahigher percentage of covered charges for serviceswithin the PPO network. These plans include bothmedical and prescription drug coverage.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n e n r o l l m e n t g u i d e
V i s i t o u r w e b s i t e w w w. ctpf. o r g fo r m o r e i n fo r m at i o nHigh Deductible Health Planwith Health Savings AccountCTPF offers the UnitedHealthcare High DeductiblePlan with HSA. This plan includes both medicaland prescription drug coverage.A High Deductible Health Plan (HDHP) is aPPO which provides a lower premium optioncompared to traditional PPO plans. The HDHPincludes a Health Savings Account (HSA), a taxadvantaged method of accumulating savings tooffset the higher deductible.Preventive services are not subject to thedeductible and are reimbursed at 100%.For 2012 the IRS allows individuals tocontribute up to 3,100 and families up to 6,250 to a Health Savings Account. Individualsage 55 or older may also make a 1,000 “catchup contribution” for 2012 and all years goingforward.HSA funds are portable and accumulateinterest. Interest earned and withdrawals forqualified expenses are not subject to federalincome taxes.Health Maintenance Organization (HMO)CTPF offers the BCBS HMO Illinois plan and theUnitedHealthcare Choice HMO plan. These plansinclude both medical and prescription drugcoverage.A Health Maintenance Organization (HMO)generally provides broader coverage than othertypes of plans. HMOs do not have deductibles,coinsurance, or claim forms to file. In traditionalHMOs, all health care must be provided (exceptin emergencies) by doctors, hospitals, andpharmacies that belong to the HMO network.An HMO may require you to choose a primarycare physician (PCP) to coordinate your care.Your PCP can be an internist, general practitioner,or family practitioner. You have the option tochange your PCP at any time (changes may notbe effective immediately). For a directory ofparticipating providers, call the HMO directlyor attend a CTPF Open Enrollment HealthInsurance Seminar.Some HMOs have limited service areas,so consider this option carefully if you travelfrequently, do not live in the same place for 12months of the year, or have dependents livingaway from home.C T P F 2 0 1 2 h e a lt h i n s u r a n c e HAN D B O O K a n d O p e n E n r o l l m e n t g u i d e13
Non-Medicare Eligible Members –Plan Cost ComparisonThe following health insurance plans are availableto non-Medicare eligible participants. If you areage 65 or over, you do not qualify for these plans.This comparison is to be used as a guide. Incase this summary differs from the health plantext or any health plan term or condition, theofficial contract document must govern. Whileevery effort has been made to ensure up-to-dateinformation, CTPF is not responsible for finaladjudication of insurance claims, which are solelythe responsibility of the health plan.Some plans have geographic restrictions andmay not be a good choice if you travel frequentlyor have dependents who live away from home.MemberMember 1Member 2 or more 1,240.13 2,480.26 3.63Member’s monthly cost*428.481,499.692,570.90BCBS HMO IllinoisMonthly premium cost894.981,789.962,684.94Member’s monthly 7Member’s monthly cost*545.201,908.193,271.18UnitedHealthcare High DeductiblePlan with HSAMonthly premium cost882.161,764.322,646.48Member’s monthly cost*352.861,235.022,117.18PlanBlue Cross and Blue Shield PPOMonthly premium costMember’s monthly cost*UnitedHealthcareChoice Plus PPOMonthly premium costUnitedHealthcareChoice HMOMonthly premium cost* Reflects the health insurance premium subsidy for retirees and surviv
important decisions. The Chicago Teachers' Pension Fund (CTPF) sponsors comprehensive health insurance plans designed to promote wellness and provide high-quality coverage at a reasonable cost. CTPF offers heath insurance benefits to retirees, dependents, and survivors if the retiree's final teaching service was with the Chicago Public or .
