dominion retiree medical · 2015. 2. 5. · dominion retiree medical hr and executive briefing...

Dominion Retiree Medical

HR and Executive Briefing August 2013

Our Approach to Retiree Medical Benefits Providing Options to Medicare Eligible Retirees Information for Retirees

© 2013 Dominion



Today’s Discussion Topics

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• A Message from Tom Farrell • The Approach • Effects of Change • Introduce Towers Watson OneExchange • Benefits of the New Approach • Paying for Coverage • What you need to do • Your questions



Tom Farrell Chairman, President & CEO Dominion



The Approach

© 2013 Dominion

Dominion provides more choices to our eligible retirees and eligible covered spouses age 65 and older and will continue to subsidize the cost of coverage. This new approach offers the following enhancements:

• Catastrophic Coverage: 100% reimbursement for eligible prescription drug expenses incurred beyond a certain dollar amount

• Dedicated and licensed benefits advisors to help with plan choices and provide ongoing advocacy

• More plan options, many at lower

cost

• Annual stipend funded into a Health Reimbursement Account (HRA), indexed over time to reflect increases in medical CPI

Transition begins now with a 1-month open enrollment period. Coverage is effective March 1, 2015.



Effects of Change

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Millstone Retirees and their covered spouses age 65 and older • Retired after May 31, 2014 • Transition to private Medicare exchanges available through

OneExchange effective March 1, 2015

Millstone Retirees and their covered spouses that are not yet 65 • Retired after May 31, 2014 • Continue coverage under current Dominion retiree medical plan

until age 65



Introducing OneExchange

•OneExchange, a Towers Watson company, is the largest private Medicare exchange that

• Provides a wide selection of carriers and coverage options • Works with over 300 companies • Provides customized support for retiree needs

Dominion offers private Medicare exchanges to eligible participants age 65 and older through OneExchange, a private health insurance exchange. Again, these are not the same exchanges

that are available as a result of the Affordable Care Act



Why This Approach • Benefits to Retirees

– More plan options, many at lower cost – Protection in the event your prescription drug costs are high – A financial subsidy that is indexed to reflect increases in the medical

CPI – Dedicated and licensed benefits advisors who will help you choose

the best plan for you and provide ongoing advocacy for claim issues

• Benefits to Dominion – Ability to ensure affordable high-quality, ongoing coverage to

retirees – Immediate and long-term reduction in health care costs

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Single choice for supplemental coverage: The Dominion Retiree Medical Plan

Medicare Part B Dominion Retiree Medical Plan

Retiree pays contribution based on age and service

ONE CHOICE

Retiree purchases



More plan options, customized to fit your needs

Medicare Part B

Dominion provides funding through HRA (i.e. stipend)

MULTIPLE CHOICES

Retiree Purchases

Plans

Medigap & Part D RX

Medicare Advantage



Over time, Dominion retiree medical plan design has changed, with more cost shifting to the retiree

• Stipends are reflective of the portion that Dominion pays • Those who retired years ago will have a higher stipend than

those who retired more recently, or those who will retire in the future

• With HRA funding from Dominion, most retirees will be able to

purchase insurance that provides equivalent or better benefits, with many plans available at a lower cost



Paying for Coverage

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• Dominion will fund a Health Reimbursement Account (HRA) with an annual stipend for each eligible retiree and eligible spouse who enrolls through OneExchange

– Stipends depend on retirement date and length of service – Stipends adjusted annually to reflect medical CPI – HRA will be combined for retiree and eligible spouse – Funds can be carried over from year to year if unused – Annual stipend will be prorated for the months you participate

• HRA used to pay premiums and other eligible expenses

– Medicare Part B and Part D premiums – Medicare supplement and Medicare Advantage premiums – Most medical out-of-pocket expenses – Out-of-pocket prescription drug costs are not eligible – OneExchange administers the HRA

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How Can Retirees Pay Less: Example: “Average” Age 75 in 2015 with 30 years of service

Example of Groton, CT retiree aged 75 requiring an ambulance with overnight hospitalization, cardiologist and primary care provider visits, and prescription drugs for their heart and cholesterol

Notes: Actual changes in total costs will depend on each individual’s circumstance, stipend cannot be used to reimburse drug out of pocket cost, stipend amount varies based on age, years of service, and retirement date

Cost Item (Annual) Current Plan Full Coverage

Medigap, and Rx Plan Medicare Advantage

Plan (HMO)

Medicare Part B Premium $1,259 $1,259 $1,259

Medical Plan Premium / Contribution

$516 $2,646 $0

Drug Plan Premium N/A, incl. above $578 N/A, incl. above

Medical Out-of-Pocket Costs $1,042 $0 $1,290

Drug Out-of-Pocket Costs $240 $480 $628

Stipend N/A ($2,060) ($2,060)

Total Costs $3,057 $2,903 $1,117

Decrease in Total Costs Decrease of $154 Decrease of $1,940

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How Can Retirees Pay Less: Example: “High Medical Cost” Scenario Age 75 in 2015 with 30 years of service

Example of Groton, CT retiree aged 75 requiring major medical services including surgery, a 9 day hospitalization, several follow-up specialist visits and drugs to manage a heart condition

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Plan (HMO)



$516 $2,646 $0



Drug Out-of-Pocket Costs $360 $920 $1,145

Stipend N/A ($2,060) ($2,060)

Total Costs $3,951 $3,343 $4,189

Decrease in Total Costs Decrease of $608 Increase of $238


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What do you need to do?

If either you or your eligible covered spouse are age 65 or will turn age 65 between now and April 1, 2015 - action is

required.

If either you or your eligible covered spouse are not age 65 and will not turn age 65 between now and April 1, 2015, no

action is required at this time.

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OneExchange

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Your Experience

Announcement & Education

Evaluation & Enrollment

Ongoing Communications

& Advocacy

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Education

Prepare for Your Enrollment Consultation � Review Medicare basics � What to expect on your

enrollment call � FAQs � Appointment confirmation

will be sent in February

Enrollment Guide

medicare.oneExchange.com/dominion

1-855-238-0483

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Benefit Advisors

� Licensed / Certified / Appointed � OneExchange University™ � Average age 43 � Objective & unbiased � 100% domestic workforce

Hours of Operation

Monday – Friday 8 am – 9 pm ET

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Decision Support Tools

� Help Me Choose

� Prescription Profiler

medicare.oneExchange.com/dominion

24/7 access to your information

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Enrollment Process

� Benefit Advisors can discuss coverage options with anyone

� Telephonic enrollment – 2 part process � 100% of calls are recorded

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Selection Confirmation Notice

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Health Reimbursement Arrangement

HRA

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What Is An HRA?

� Tax-free account used to reimburse you for eligible health care expenses — you pay first and then get reimbursed

� If you are eligible, Dominion will make an annual contribution to a Health Reimbursement Arrangement (HRA)

� You may use HRA funding to reimburse yourself for eligible medical, prescription drug, dental, vision premiums (even Medicare Part B premiums), and eligible out-of-pocket medical expenses

� Your HRA funding will be available March 1, 2015

Unused Funds do rollover

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Health Reimbursement Arrangement

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Health Reimbursement Arrangement Reimbursement Options

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Personal Guidance For a Lifetime

A Lifetime Advocate � Navigation � Enrollment � Claim issues � Affordability concerns � Prescription � Late enrollment � HRA � Annual plan review

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Localized Slides

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Plans Available in New London County

Plan Type Number of

Plans Offered

2015 Monthly Premium

Carriers

Medicare Advantage 4 $0 - $99 United Health Care

Medigap / Medicare Supplement 12 $73 - $277 AARP, Humana

Prescription Drug (Part D)

17 $13 - $121

AARP, Aetna, Cigna, Humana, Express Scripts,

SilverScript, Wellcare

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Plans Available in New London County

Plan Type Number of

Plans Offered

2015 Premium Carriers

Vision 1 $168 annual Annual eye exam: $5

Coverage for eye glasses, lenses and frames

Vision Service Plan (VSP)

Dental 4 $28- $60 monthly $0 - $75 deductible

$0 - $1500 annual maximum

Delta Dental, Humana,

MetLife Dental

Vision plans and Dental plans are not Medicare plans

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Medicare Advantage Plan

Benefit Cost 2015 Premium $0 Network HMO Deductible $0 Doctor Copay $10 Specialist Copay $50 Hospital Days 1 – 5: $335 per day Emergency Room $65 Rx – Deductible Copay Tiers

$0 $5 / $8 / $45 / $95 / 33% 30 days

Mail Order (90 day) $10 / $16 / $125 / $275 90 days

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Medigap Plan F + PDP (Community Rated)

Benefit Cost 2015 Premium $243 ($221 Medical + $22 PDP) Network Not Applicable Deductible $0 Doctor Copay $0 Specialist Copay $0 Hospital $0 Emergency Room $0 Rx – Deductible Copay Tiers

$0 $0 / $15 / $40 / $90 / 33% 30 days

Mail Order (90 day) $0 / $40 / $78 / $180 90 days

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Example of Groton, CT retiree aged 75 requiring an ambulance with overnight hospitalization, cardiologist and primary care provider visits, and prescription drugs for their heart and cholesterol




Plan (HMO)



$516 $2,646 $0




Stipend N/A ($2,060) ($2,060)

Total Costs $3,057 $2,903 $1,117


© 2013 Dominion 34


Example of Groton, CT retiree aged 75 requiring major medical services including surgery, a 9 day hospitalization, several follow-up specialist visits and drugs to manage a heart condition

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Plan (HMO)



$516 $2,646 $0




Stipend N/A ($2,060) ($2,060)

Total Costs $3,951 $3,343 $4,189



© 2013 Dominion 35 35

Cost Item (Annual) Current Plan Full Coverage Medigap,

and Rx Plan Medicare Advantage

Plan (HMO)



$588 $2,646 $0




Stipend N/A ($1,850) ($1,850)

Total Costs $3,129 $3,113 $1,327


Note: Actual changes in total costs will depend on each individual’s circumstance, premiums and stipend are based on a retiree aged 65 in 2015, Stipend cannot be used to reimburse drug out of pocket cost, Stipend amount varies based on age, years of service, and retirement date

Example of Groton, CT retiree with 30 years of service who will be aged 65 in 2016 requiring an ambulance with overnight hospitalization, cardiologist and primary care provider visits, and prescription drugs for their heart and cholesterol


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Example of Groton, CT retiree with 30 years of service who will be aged 65 in 2016 requiring major medical services including surgery, a 9 day hospitalization, several follow-up specialist visits and drugs to manage a heart condition

36



Plan (HMO)



$588 $2,646 $0




Stipend N/A ($1,850) ($1,850)

Total Costs $4,023 $3,553 $4,399


Note: Actual changes in total costs will depend on each individual’s circumstance, premiums and stipend are based on a retiree aged 65 in 2015, Stipend cannot be used to reimburse drug out of pocket cost, Stipend amount varies based on age, years of service, and retirement date

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Medicare Prescription Drug Coverage 2015

Catastrophic Coverage

Coverage Gap

Initial Coverage Deductible

You Pay Full Retail Until Deductible is Met 2015 - $320

You pay copays for your plan coverage for the first $2960 in actual costs of Medications

You pay 45% of Brand Name and 65% of Generics until your out of pocket costs reach $4700; Pharmaceutical contributions will count towards the $4700 TrOOP

You Pay $2.65 for Generics and $6.60 for Brand Name or 5% - whichever is greater

Only 25% reach Donut Hole

Only 4% reach Catastrophic

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z Additional financial support provided by Dominion for retirees with significant pharmacy claims

z Benefit reimburses any prescription drug costs incurred after the Medicare Part D TrOOP maximum is reached for a retiree or eligible dependent within the plan year

z If you qualify, contact Extend Health for assistance

What is Medicare Part D TrOOP?

TrOOP is the true out-of-pocket maximum that includes the cost of prescription drugs incurred during the year — including any

deductible, coinsurance co-pays and payments made in the coverage gap, or “doughnut hole.” Premiums do not count

toward TrOOP. The 2015 amount is $4,700.

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Catastrophic Coverage

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What You Need To Do: Action Required!

Contact OneExchange

1-855-238-0483 medicare.oneexchange.com/dominion

� Call now to complete your profile and schedule an enrollment appointment

� You will need your Medicare card, prescriptions list, and doctors & hospitals information

We Are Ready!

dominion retiree medical · 2015. 2. 5. · dominion retiree medical hr and executive briefing...

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