Transcript Presentation Title - Indiana University
IU Retiree Status
Health Care Options
Susan Brewer
University Director of Health Care and Welfare Program Services
IUPUI Pre-Retirement Symposium March 25, 2010
IUPUI Pre-Retirement Symposium This presentation does not reflect any potential changes related to recent Health Care Reform legislation March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
IU Retiree Status Health Care Options
• Who’s eligible?
• What plans are available?
• Under age 65 • Age 65+ • Some Rules and Considerations • Medicare Part D prescription coverage
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IUPUI Pre-Retirement Symposium
Resources
• University Benefits web page http://hr.iu.edu
• Participant Rights & Responsibilities • New online benefits video March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
IU Retiree Status Health Care Options
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IUPUI Pre-Retirement Symposium
New Benefits Video
March 25, 2010
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IUPUI Pre-Retirement Symposium
Who is Eligible?
•
Employees with “IU Retiree Status”
(meet age and length-of-service criteria) •
Their dependents covered at the time of termination
(or at the time COBRA ends) March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
IU Retiree Status
Age at Termination
55 56 57 58 59 60*
Minimum Years of Active Full-Time IU Service
30 28 26 24 22 20
Age at Termination
61* 62* 63 64 65
Minimum Years of Active Full-Time IU Service
18 16 14 12 10 • At ages 60, 61, 62 employees covered by PERF on the date of termination will qualify with at least 15 years of IU service.
• Years of IU service are pro-rated for ages that fall between the ages listed above.
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March 25, 2010 IUPUI Pre-Retirement Symposium
IU Retiree Status
• Years of IU service – full-time, appointed service excluding periods of leave without pay. Sabbatical leaves and leaves for purposes of research of distinction are included.
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IUPUI Pre-Retirement Symposium
IU Retiree Status Benefits
• Health Care • Life Insurance • Fee Courtesy • Retain IU Email Address • Other Campus-Specific Benefits March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
Health Plan Options (As of January 2010)
1.
Retirees may move to their spouse’s IU coverage and retain eligibility.
2. Temporary Continuation of Active Employee Coverage – “COBRA” 3. Under age 65 (i.e., not Medicare eligible) • IU PPO $900 Deductible 4. Age 65+ (i.e., Medicare eligible) • Blue Retiree Plan supplement (Insured by Anthem)
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March 25, 2010 IUPUI Pre-Retirement Symposium
“Rules” for Retiree Health Coverage
• Those retirees eligible for Medicare MUST carry Medicare Parts A & B; and must carry a Medicare D plan in order to have prescription coverage.
• Retiree/Spouse may split coverage between plans when one is over and one is under age 65 • Cannot reinstate after dropping IU-sponsored coverage • Generally cannot add new dependents
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March 25, 2010 IUPUI Pre-Retirement Symposium
COBRA Option – Federal program for all employees losing coverage
• Temporary Continuation of Active Coverage (PPOs or HDHP/Medical Savings and/or Dental) • 18 months (however, COBRA medical ends if you become Medicare eligible after enrolling in COBRA) • Advantages: • Keep Dental Coverage (dental is not a retiree benefit) • Maintain Open Enrollment Options (e.g., add dependents) • Keep PPO Blue Access (not a retiree option)
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March 25, 2010 IUPUI Pre-Retirement Symposium
Options Under Age 65
• Same PPO $900 Deductible plan as active employees, except: • Premium is the same as COBRA rate • You can think of this plan as a continuation of COBRA medical coverage until you reach Medicare eligibility.
• Dental coverage is not a Retiree option, but you may continue it for 18 months under COBRA
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March 25, 2010 IUPUI Pre-Retirement Symposium
2010 Premium Rates
IU PPO $900 Deductible Plan – Under Age 65 (same as COBRA Rates)
• One Participant • Participant and Child(ren) • Retiree and Spouse • Retiree and Family $ 404.20
$ 806.25
$ 985.63
$ 1,119.33
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March 25, 2010 IUPUI Pre-Retirement Symposium
What is the Advantage of IU-sponsored Coverage?
• You don’t have to show “proof of insurability” or fill out a health questionnaire.
• There is no pre-existing condition exclusion.
• The premium is not based on your ‘enrolled’ or ‘attained’ age • The premium is not based on lifestyle factors such as smoking, weight, or on prescription drug use, etc.
• Prescription benefit: no maximum and copays are low
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March 25, 2010 IUPUI Pre-Retirement Symposium
Commercial Plan Cost Comparison
• Female, age 63 • No pre-existing conditions; non-smoker; not overweight • $2,000 deductible • $30 visit copay (only 2 visits covered, i.e., major medical coverage only) • 30% copay In-Network, 40% copay Out-of-Network • $5,000 copay maximum • • $500 prescription coverage limit; $200 Rx deductible
Estimated Premium: $352.16/month
denied based on risk factors) (coverage may be
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March 25, 2010 IUPUI Pre-Retirement Symposium
Commercial Plan Cost Comparison
• • Female, age 63 • No pre-existing conditions; non-smoker • $500 deductible • $30 primary care/ $40 specialist visit copay • 20% copay In-Network, 40% Out-of-Network • $3,000 copay maximum • Prescription Coverage: $15/ $30 w/ $250 deductible and 40% up to $4,000 maximum benefit
“Base Premium”: $658.88/month
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March 25, 2010 IUPUI Pre-Retirement Symposium
Options Age 65 and Over
Anthem Blue Retiree Plan
• Medicare Supplement or “Medigap” coordinates with “Original Medicare” • Pays Medicare deductibles and copays • Includes a wellness benefit (in addition to Medicare preventive coverage) • No prescription coverage (you must elect a Medicare Part D plan to have prescription coverage)
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March 25, 2010 IUPUI Pre-Retirement Symposium
Age 65 and Over
Anthem Blue Retiree
Requirements: • You must be Medicare Eligible (Age 65+) • You must enroll in Medicare Parts A & B • If you want prescription coverage, you must enroll in Medicare Part D
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March 25, 2010 IUPUI Pre-Retirement Symposium
Some Things to Consider
There is no need for 2 Medicare Supplements A Retiree may switch to spouse’s IU coverage and retain eligibility for IU Retiree coverage options whether spouse has IU Retiree Status or not Compare non-IU Plans (Examples: AARP, BC/BS, RIPEA, etc.) In some areas, Medicare Advantage plans (HMO and PPO) may be available —they combine medical and prescription coverage in one plan and one premium. Clarian has one such plan.
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March 25, 2010 IUPUI Pre-Retirement Symposium
Clarian Health Plan Medicare Advantage
You pay Medicare Part B premium plus one HMO premium with includes both medical and Rx Uses a Clarian HMO network 4 plan options: Value, Select, Select+, Choice Premiums: $0, $37, $67, $93 Plans have fixed-dollar copays on most services, e.g. office visits, inpatient per day, Rx www.clarinhealthplans.org
800-455-9776
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IUPUI Pre-Retirement Symposium
www.medicare.gov
March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
What Does Blue Retiree Coverage Cost?
The Retiree pays the full cost of coverage.
Premiums Change Annually with inflation, but otherwise are not based on age For PPO retiree and dependent coverage, when one is ‘under 65’ and one is ‘over 65,’ separate premiums must be added together.
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March 25, 2010 IUPUI Pre-Retirement Symposium
2010 Premium Rates
Blue Retiree Plan – Age 65+
• One Participant • Retiree and Spouse $175.29
$350.58
• Note: to obtain the total cost, you must add the cost of Medicare B (about $100) and a Medicare D prescription plan (about $28 to $100).
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March 25, 2010 IUPUI Pre-Retirement Symposium
Premiums – Other Commercial Plans
Most commercial plans are based on age ratings: • Issue-age-rated • Attained-age-rated May also begin at an “introductory” discount price that ends after the introductory period.
After your Special Enrollment Period, you can be denied coverage; have coverage delayed; or have the premium based on health factors.
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March 25, 2010 IUPUI Pre-Retirement Symposium
Premiums – Other Commercial Plans
Issue-age-rated
: Rate is based on your age at the time you buy the policy • Younger pays less; older pays more • Rates can go up based on inflation and other factors, but not due to age • Example: • Retiree A, age 65, buys a plan pays $160/month; • Retiree B, age 72, buys the same plan and pays $190/month.
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March 25, 2010 IUPUI Pre-Retirement Symposium
Premiums – Other Commercial Plans
Attained-age-rated
: Rate is based on current age • As you get older, the rate goes up based on your age. Rates can also go up based on inflation and other factors.
• These plans are the least expensive to start and may become the most expensive over time • Example: • Retiree C, age 65, buys a plan and pays $140/month; at age 66 pays $150…. and by age 75 has gone to $200/month.
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March 25, 2010 IUPUI Pre-Retirement Symposium
Medicare Enrollment
• Medicare open enrollment is a 6-month period: starts first month in which you are both age 65 and enrolled in Medicare Part B. • During this open enrollment you cannot be denied a supplement plan, charged higher premiums for health factors, or be made to wait for pre-existing condition coverage.
• Those with Medicare can switch plans between January 1 and March 31 each year.
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March 25, 2010 IUPUI Pre-Retirement Symposium
Medicare Part D Notice
• Federal law requires employers to notify employees of certain Medicare prescription drug information, deadlines, and penalties.
• IU’s notice is printed annually in the Informed Employee bulletin and at http://hr.iu.edu
• IU covered employees do not pay a penalty to enroll in Medicare Rx plan within 63 days of retiring.
• Premium penalties after 63 days are significant • Note: there is no 63-day grace period when COBRA ends
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IUPUI Pre-Retirement Symposium
Finding a Medicare D Plan
March 25, 2010
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IUPUI Pre-Retirement Symposium
Other Retiree Status Benefits
• Retiree Life Insurance $6,000 in IU-paid life insurance Keep beneficiary current!
• IU Tuition Benefit Same benefit as active employee • Keep IU Email Address March 25, 2010
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March 25, 2010 IUPUI Pre-Retirement Symposium
Other IUPUI Campus Benefits
• Discount on non-credit classes through Continuing Studies • Employee prices on hardware, software, and technology workshops through UITS • Employee prices at IUPUI sports facilities
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March 25, 2010 IUPUI Pre-Retirement Symposium
Separation Pay
• Staff employees receive pay for certain accrued paid-time-off benefits • 2010 tax rates for separation pay: Federal State County FICA • Consider deferring separation pay to supplemental retirement plans
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March 25, 2010 IUPUI Pre-Retirement Symposium
Separation Pay
• Support and service staff: Accrued holidays Accrued compensatory time Vacation hours up to the maximum allowed per university policy Pro-rated sick time for accrued sick hours in excess of 152 hours if enrolled in PERF or IU Retirement Plan 11.25%
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March 25, 2010 IUPUI Pre-Retirement Symposium
Separation Pay
• Professional staff: Accrued holidays Accrued compensatory time, if applicable Accrued PTO hours Accrued honorary vacation (if applicable) up to the maximum allowed per university policy Pro-rated sick time for accrued sick hours in excess of 152 if enrolled in PERF or IU Retirement Plan 11.25%
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March 25, 2010 IUPUI Pre-Retirement Symposium
University Human Resource Services
http://hr.iu.edu
Click “Benefits”
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