Helping You Prepare For Your Upcoming Health Insurance .

Transcription

Helping You Prepare For Your UpcomingHealth Insurance Enrollment

Who We Are Transitions Can Be A Good Thing! OneExchange – For Your Benefit A Deeper Dive – Benefit Advisors,Private Exchange, Optimize Savings,Health Reimbursement for You Next Stepstowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.2

About OneExchange RetireeTowers Watsonover100Over 1-millionLicensed advisorprovidesguidance and ongoing540 employersadvocacyretirees served acrossyears experienceanationwide network of carriersPersonalized options with plansfromFounded in 2004More Choice, More Flexibility– Better ValueFirst and LargestNo fees forour serviceOur10th annualprivate Medicare Exchangeenrollment seasontowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.3

Our Service CentersOperating hours:Monday – Friday,5:00 a.m. until 6:00 p.m.Pacific TimeSalt Lake City, UTIrving, TXDallas, TXtowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.100% Domestic WorkforceNo Outsourcing!4

Plans and PartnersAll Plan rescription Drug(Part D)Wide selection of plans from leading national / regional carrierstowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.5

Your Future Coveragetowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Your Future CoveragePrimary CoverageMedicare A and BAdditional Coverage (your choice)Medicare Advantage withPrescription Drug (MAPD) orMedigap Prescription DrugOptional Coverage (your choice) Dental Plans Vision Planstowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.7

OPTION 1Medicare Advantage Plan with Prescription Drug Coverage (MAPD)*HMOMEDICAREADVANTAGEPPO* Note that Medicare Advantage plans are generally network based plans.towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.8

OPTION 2Medigap Plan Part D PlanMEDIGAPPLANPART DPLANNote: You may need to pay your first month’s premium when you enroll in coverage.towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.9

MediGap – Lettered PlansMedicare Supplement Insurance (Medigap) PlansBenefitsABCDFGKLMNMedicare Part A coinsuranceand hospital costs (up to anadditional 365 days afterMedicare benefits are are Part B coinsuranceor od (first 3 pints)100%100%100%100%100%100%50%75%100%100%Part A hospice carecoinsurance or 0%100%80%80%Skilled nursing facility carecoinsurancePart A deductiblePart B deductible100%100%100%Part B excess chargesForeign travel emergency(up to plan limits)80%80%Source: CMS100%100%80%80%Out-of-Pocketlimit in 2015 4,940 2,470towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.10

Part D Plans – 5 Tiers of Co-PaysA prescription drug plan will typicallybreak the formulary into “tiers.” Thetiers correspond to the copayment orcoinsurance the beneficiary will pay.Cost-sharing increases with the tier number.Tier 1 is the least expensive, tier 4 or 5 is themost expensive.Tier descriptions: Tier 1 preferred genericTier 2 non-preferred genericTier 3 preferred brandTier 4 non-preferred brandTier 5 specialty drugs or injectable medicinetowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.11

Medicare Prescription Drug Coverage 2016You pay 45% of Brand Nameand 58% of Generics untilyour out of pocket costsreach 4850; Pharmaceuticalcontributions will counttowards the 4850 TrOOPYou Pay Full RetailUntil Deductible is Met2016 - 0 to 360DeductibleInitialCoverageYou pay copays foryour plan coveragefor the first 3310 inactual costs ofMedicationsCoverageGapOnly 25% reachDonut HoleCatastrophicCoverageOnly 4% reachCatastrophicYou Pay 2.95 forGenerics and 7.40 forBrand Name or 5% whichever is greater **towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.12

A Deeper Dive Into Our Processtowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

The Transition tlessEnrollmentOngoingAdvocacytowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.14

EducationEnrollment Guide: Prepare forYour Enrollment Consultation Review Medicare basics What to expect on yourenrollment call FAQs Appointment /LLNStowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.15

Benefit Advisors Licensed / Certified / AppointedOneExchange University Objective and unbiased100% domestic workforceBenefit advisors are available:Monday – Friday, 5:00 a.m. until 6:00 p.m. Pacific Timetowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Decision Support LLNS24/7 access to your informationLoad in your prescriptions - Shorten your time on the phone with us!towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.17

Decision Support ToolsHelp Me ChooseComparison Tooltowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.18

Enrollment Process Benefit Advisors can discuss coverageoptions with anyone Telephonic enrollment – 2 part process 100% of calls are recordedWe’ve got your BAC: Benefit Advisors Application Data Processors Customer Service Repstowerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.19

Selection Confirmation NoticeYou may review theplan(s) that youselected – will besent shortly afteryou enroll.towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.20

Personal GuidanceAn Ongoing Advocate Navigation Enrollment Prescriptionchanges Affordabilityconcerns Reimbursementissues Late enrollment HRA Annual planreviewThe plans you select continue on year to year.No need to re-enroll in the fall unless you wantto make a plan change.towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.21

Health Reimbursement Arrangement (HRA)towerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Health Reimbursement ArrangementYou may be reimbursed up to the amount available in the HRA!towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Health Reimbursement Arrangement12Reimbursement ncluding recurring premiums) OneExchangeReimbursements areup to the amountavailable in the HRAParticipantInsuranceCarrier .com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.24

Localized SlidesLivermore, CA94550towerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.25

Plans Available in Alameda CountyPlan TypeMedicare AdvantageNumber ofPlans Offered52016MonthlyPremiumCarriers 21 - 221BS of CA, AARP,Humana, Scan,Health NetHealth Net, AARP,Humana, BS of CA,Medigap /Medicare SupplementPrescription Drug(Part D)20 66 - 259Anthem BC of CA,Cigna20 18 - 132AARP, Aetna,CIGNA, ExpressScripts, Humana,SilverScript,WellCare, BS of CA,Anthem BC of CAtowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.26

Plans Available in Alameda CountyPlan TypeVisionNumber ofPlansOffered2016 PremiumCarriers1 168 annual / 14 moVision ServicePlan (VSP)Annual eye exam: 5Coverage for eye glasses,lenses and framesDental4 32 - 63 monthly 0 - 75 deductible 0 - 1500 annual maximumSecurity Life,MetLife DentalRenaissance,Vision plans and Dental plans are not Medicare planstowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.27

Medicare Advantage PlanBenefitCost2016Premium 21NetworkHMODeductible 0Doctor Copay 0Specialist Copay 10HospitalDays 1 – 5: 175 per dayEmergency Room 75Rx – DeductibleCopay Tiers 0 0 / 5 / 40 / 90 / 33%30 daysMail Order 5 / 10 / 80 / 18090 daystowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.28

Medigap Plan F PDP (75-year old male)BenefitCostPremium 208 ( 185 Medical 23 pdp)NetworkNot ApplicableDeductible 0Doctor Copay 0Specialist Copay 0Hospital 0Emergency Room 0Rx – DeductibleCopay Tiers 0 3 / 17 / 46 / 47% / 33%Mail Order 7 / 42 / 115 / 47%towerswatson.com201630 days90 days 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.29

Localized SlidesTracy, CA95376towerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.30

Plans Available in San Joaquin CountyPlan TypeMedicare AdvantageNumber ofPlans Offered2015MonthlyPremiumCarriers2 50 - 61Humana, ScanHealth Net, AARP,Humana, Cigna,Medigap /Medicare SupplementPrescription Drug(Part D)26 80 - 259Anthem BC of CA,BS of CA20 18 - 132AARP, Aetna, CIGNA,Express Scripts,Humana, SilverScript,WellCare, BS of CA,Anthem BC of CAtowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.31

Plans Available in San Joaquin CountyPlan TypeVisionNumber ofPlansOffered2015 PremiumCarriers1 168 annual / 14 moVision ServicePlan (VSP)Annual eye exam: 5Coverage for eye glasses,lenses and framesDental4 32 - 63 monthly 0 - 75 deductible 0 - 1500 annual maximumRenaissance,MetLife Dental,Security LifeVision plans and Dental plans are not Medicare planstowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.32

Medicare Advantage PlanBenefitCost2015Premium 50NetworkHMODeductible 10Doctor Copay 15Specialist Copay 25HospitalDays 1 – 8: 175 per dayEmergency Room 75Rx – DeductibleCopay Tiers 0 7 / 10 / 47 / 100 / 33%30 daysMail Order 14 / 20 / 131 / 29090 daystowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.33

Medigap Plan F PDP (75-year old male)BenefitCostPremium 206 ( 183 Medical 23 pdp)NetworkNot ApplicableDeductible 0Doctor Copay 0Specialist Copay 0Hospital 0Emergency Room 0Rx – DeductibleCopay Tiers 0 3 / 17 / 46 / 47% / 33%30 daysMail Order 7 / 42 / 115 / 47%90 daystowerswatson.com2015 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.34

Next Stepstowerswatson.com 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

What You Need To Do: Action Required!Contact OneExchange1-866-682-4841 Call now to complete your profile andschedule an enrollment appointment You will need your Medicare card,prescription list, and doctor and hospitalinformationWe are Ready!towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Call Now, We Are Ready!1-866-682-4841towerswatson.com 2015 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.37

Medicare Advantage 2 50 - 61 Humana, Scan Medigap / Medicare Supplement 26 80 - 259 Health Net, AARP, Humana, Cigna, Anthem BC of CA, BS of CA Prescription Drug (Part D) 20 18 - 132 AARP, Aetna, CIGNA, Express Scripts,