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Important InformationYour Responsibilitiesas a CTPF Health PlanEnrolleeYou are responsible for contacting CTPFimmediately if any of the following 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, becoming Medicare eligiblebefore age 65, or loss of Medicare coveragefor any reasonn  change in Medicare premium (such asdecrease or elimination of Medicare Part Apremium, or qualifying for a state premiumassistance program)n  your health plan or prescription ID carddoes not reflect your current enrollmentn  your pension deduction does not matchyour coverage or required premiumTurning Age 65If you (or your dependent) plan to enroll in aCTPF Medicare plan, apply for Medicare threemonths before the month you turn age 65 toensure timely enrollment. See Medicare 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 datesCurrent CTPF non-MEdicare Health Plan EnrolleesIf you are currently enrolled in a CTPF nonMedicare plan and want to continue coveragewith CTPF when you turn 65, you must enroll inMedicare Part A and Part B, and provide CTPFwith proof of enrollment before the month ofyour 65th birthday. If you fail to provide proof ofMedicare enrollment, your CTPF health insurancewill terminate at the end of the month in whichyou turn 65.More Information about turning AGE 65CTPF offers quarterly “Birthday Parties” designedto help members turning age 65 evaluate theirhealth insurance options and enroll in Medicare.See page 47 for information.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 for information.6C T P F 2 0 1 3 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. c t p f. o r g f o r m o r e i n f o r m at i o nEnrollment FormsSurvivorsAn enrollment form and return envelope for mostCTPF plans are included in this handbook.To enroll in the AARP Medicare SupplementPlan F (UnitedHealthcare) with Express ScriptsMedicare (PDP) for CTPF or the Humana GroupMedicare HMO with Part D Pharmacy, see theinstructions in “How to Enroll” on pages 32-33.Return completed enrollment forms and allrequired documentation to:Chicago Teachers’ Pension Fund203 North LaSalle Street, suite 2600Chicago, IL 60601-1231Make sure you return all enrollment formsto CTPF. If you return your forms to an insurancecompany they will not be processed.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.ID CardsCTPF 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.Health plan enrollees receive health insuranceID cards by mail directly from their healthinsurance plan. ID cards are normally issued atthe time of enrollment or when a health planchange is made.If you need a replacement card, contactyour health insurance plan directly. Find contactinformation on pages 44 and 45.Dental PlansAuthorized RepresentativeIf 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.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.C T P F 2 0 1 3 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 childrenunder the 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 3 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. c t p f. o r g f o r m o r e i n f o 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 unionCivil 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 30n  Proof of Illinois residencyn  Veterans’ Affairs Release Form (DD-214) with releasedate from servicen  Certified copy of birth certificate* CTPF may require periodic updates to disabled child documentation. See page 8 for dependenteligibility requirements.C T P F 2 0 1 3 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 2013, see the Medicareinformation and CTPF plan enrollmentrequirements beginning on page 24, and the CTPFBirthday Party information on page 47.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, 2012, you may enroll in a CTPFplan during the Open Enrollment Period,October 1 – October 31, 2012. Coverage willbecome effective January 1, 2013.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 marriage/civil union or divorce/dissolutionnbirth, adoption, or legal guardianshipn  terminationof a Primary Care Physician forHMO plan enrolleesn  within30 days of first becoming eligible forMedicare102013 Open EnrollmentThe annual Open Enrollment Period is thetime when you or a dependent can enroll in aCTPF plan for the first time or change plans.Open enrollment begins October 1 and endsOctober 31, 2012. Changes made during OpenEnrollment become effective January 1, 2013.You can get started with enrollment byfollowing these steps:1. M ake sure you understand any plan changes(see page 3). Review the non-Medicare orMedicare plan comparison grids (see pages 16and 32).2. I f you want to continue coverage in the sameplan, you do not need to take any action.Coverage will continue.3. I f you or a dependent want to enroll for thefirst time or change plans, you must completean enrollment form. An enrollment form formost plans is included in the center of thishandbook.To enroll in the AARP Medicare SupplementPlan F (UnitedHealthcare) with Express ScriptsMedicare (PDP) for CTPF or the Humana GroupMedicare HMO with Part D Pharmacy, see the“How to Enroll” section on pages 32-33.4. R eturn completed enrollment forms and allrequired documentation to:Chicago Teachers’ Pension Fund203 North LaSalle Street, suite 2600Chicago, IL 60601-1231Make sure you return all enrollment formsto CTPF. If you return your forms to an insurancecompany they will not be processed.C T P F 2 0 1 3 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. c t p f. o r g f o r m o r e i n f o r m at i o nCTPF’s Health InsurancePremium Subsidy 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.The amount CTPF can spend on retireehealth insurance is limited by state law. Eachyear, the CTPF Board of Trustees set a premiumsubsidy amount. The subsidy for plan year 2013will be 60% of the total premium cost (certainlimitations may apply). The subsidy is subjectto change at the discretion of the Board. CTPFwill make every reasonable attempt to notifymembers in advance of any change.Premium cost for dependent coverage is noteligible for the subsidy.Parts A, B, and D, nor does it subsidize theincome-related monthly adjustment amount(IRMAA) assessed by Medicare for individualswith higher incomes. Penalties and adjustmentsare the total responsibility of the member. CTPFmay bill a member to recover these costs ifCTPF pays these costs in error.Subsidy for CTPF PlansMedicare Part B SubsidyIf 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 MedicareCTPF 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 28 for information.Third Party Payer enrollees will have anyavailable premium subsidy applied directly totheir monthly pension benefit.If you make your Part B payment directly toMedicare, CTPF will add your premium subsidyto your pension payment.Subsidy for Non-CTPFHealth InsuranceMembers enrolled in non-CTPF individual orgroup health insurance plans are eligible for asubsidy of their health insurance premium cost,subject to maximum reimbursement amountsthat CTPF publishes each year. In calculating theallowable premium subsidy, CTPF offsets anyamount of a member’s premium cost that hasalready been subsidized by another entity (forexample, a spouse plan). A subsidy application ismailed each year to members enrolled in nonCTPF health insurance. The subsidy is paid outretroactively in an annual payment. Premiumpayment documentation is required and isexplained in the application.C T P F 2 0 1 3 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- R e t i r e m e n t H e a lt h I n s u r a n c e 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.C T P F 2 0 1 3 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. c t p f. o r g f o r m o r e i n f o 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 2013 the IRS allows individuals tocontribute up to 3,250 and families up to 6,450 to a Health Savings Account. Individualsage 55 or older may also make a 1,000 “catchup contribution” for 2013 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 Blue Cross Blue Shield HMOIllinois plan and the UnitedHealthcare ChoiceHMO plan. These plans include both medical andprescription drug coverage.A Health Maintenance Organization (HMO)may provide 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.The HMO may require you to choose aprimary care physician (PCP) to coordinateyour care. Your PCP can be an internist, generalpractitioner, or family practitioner. You have theoption to change your PCP at any time (changesmay not be effective immediately). For a directoryof participating 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 3 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 –2013 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. WhileBlue Crossand BlueShield PPOevery 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.Blue CrossUnitedHealthcareand Blue ShieldChoiceHMO IllinoisPlus PPOUnitedHealthcare UnitedHealthcareHigh DeductibleChoicePlan with HSAHMOCTPF retiree/survivor cost for single coveragemonthly premium cost with CTPF premium subsidy* t 495.06 449.91 390.21 572.46 370.51CTPF retiree/survivor 1 dependentmonthly premium cost with CTPF premium subsidy* t 1,732.71 1,574.68 1,365.73 2,003.60 1,296.78CTPF retiree/survivor 2 or more dependentsmonthly premium cost with CTPF premium subsidy* t 2,970.36 2,699.45 2,341.25 3,434.74 2,223.04CTPF dependent cost for single coverage (dependents do not receive the CTPF premium subsidy) t 1,237.65 1,124.77 975.53 1,431.14 926.27* The retiree/survivor cost is the amount paid for monthly coverage after C

ChiCagO TEaChErs' PEnsiOn Fund 2013 health Insurance handbook and open enrollment GuIde Inside: Important Health Insurance Plan Changes for 2013 PlEasE kEEP This handbOOk FOr FuTurE rEFErEnCE o ctober I s o pen e nrollment m onth Chicago Teachers' Pension Fund Board of Trustees Jay C. Rehak, president Lois W. Ashford, vice president Tina .