dominion retiree medical - oneexchange · introducing extend health extend health, a towers watson...

Dominion Retiree Medical

HR and Executive Briefing

August 2013

A New Approach to Retiree Medical Benefits

Providing Options to Medicare Eligible Retirees

Information for Retirees

© 2013 Dominion

© 2013 Dominion 2

Agenda

© 2013 Dominion 2

• A Message from Tom Farrell

• New Approach

• Benefits to Change

• Who‘s Affected

• Introducing Extend Health

• Transitioning from current coverage

• What you need to do

• Your questions

© 2013 Dominion 3

Tom Farrell

Chairman, President & CEO

Dominion

© 2013 Dominion 4

New Approach

© 2013 Dominion

Dominion provides more choices to our non-union retirees

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

• Multiple plans, many at lower cost

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

Transition begins January 2, 2014 with a 3-month open

enrollment period. Coverage is effective April 1, 2014.

© 2013 Dominion 5

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 medical costs

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

© 2013 Dominion 5

© 2013 Dominion 6

Who’s Affected: Non Union Retirees

© 2013 Dominion 6

Retirees 65 and Older and their covered spouses

• Retired on or after Jan. 1, 1993

• Transition to Extend Health exchanges

• Some exceptions apply

Retirees Pre-65 and their covered spouses

• Continue coverage under the current Dominion retiree medical plan until age 65

• Transition to Extend Health when reach age 65

• Some exceptions apply

Future Retirees and their covered spouses

• Offered medical plans from the exchange when they reach age 65.

© 2013 Dominion 7

Who’s Affected: Those with HMOs

Retired on or after 2-1-10

Eligible to enroll

through Extend Health

Cost of coverage will be

subsidized by Dominion

with annual stipend

Retired after 12-31-95 & before 2-1-2010:

• Ineligible for the stipend

• Offered Extend Health services to help them shop for a plan

• Retirees in parts of Pennsylvania, Ohio, and Arizona

– Currently offered Medicare HMOs (not traditional retiree coverage)

– Legacy of the CNG merger; Dominion does not subsidize this cost

• Three future exchange scenarios based on retirement date

Retired between 1-1-93 & 12-31-95: One time choice

• Remain in subsidized HMO

• Enroll through Extend Health and receive an annual stipend

Present this slide

only for meetings

taking place in

HMO territory

© 2013 Dominion 8

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

© 2013 Dominion 9

2014 Retiree Stipends

Retirement Date Other Criteria

Retiree

Annual

Stipend

Spouse

Annual

Stipend

Before 1-1-1993 None Stay on the Dominion plan

1-1-1993 to 12-31-2000

Dominion retiree (excludes

pre-merger CNG retirees) $2,800 $2,400

1-1-1993 to 12-31-2000 Pre-merger CNG retiree $2,000 $1,800

1-1-2001 to 12-31-2004 None $2,000 $1,800

This version

applicable in non-

HMO territory

© 2013 Dominion 10


Retirement Date Other Criteria

Retiree

Annual

Stipend

Spouse

Annual

Stipend

After 12-31-2004

Age 55 or older on 12-31-2004 $2,000 $1,800

After 12-31-2004 Age 53 or 54 on 12-31-2004 $1,800* $1,300*

After 12-31-2004

Age 50 - 52 on 12-31-2004 $1,500* $1,150*

After 12-31-2004 Age 45 - 49 on 12-31-2004 $1,300* $1,000*

This version

applicable in non-

HMO territory

* Reduced if less than 30 years of service

© 2013 Dominion 11


Retirement Date Other Criteria Retiree

Annual

Stipend

Spouse

Annual

Stipend

Before 1-1-1993

None Stay on the current plan

1-1-1993 to 12-31-1995 Choice or Medicare HMO or traditional

coverage

$2,000 $1,800

On or after 2-1-2010

Age 55 or older on 12-31-2004 $2,000 $1,800


Age 53 or 54 on 12-31-2004 $1,800* $1,300*


Age 50 - 52 on 12-31-2004 $1,500* $1,150*

On or after 2-1-2010 Age 45 - 49 on 12-31-2004 $1,300* $1,000*

* Reduced if less than 30 years of service

© 2013 Dominion 12

How Can Retirees Pay Less: Example: “Average” Age 75 in 2014 with 30 years of service

Example of Richmond, VA 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)


(PPO)

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

Medical Plan Premium / Contribution

$485 $2,597 $0 $600

Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above

Medical Out-of-Pocket Costs $1,042 $0 $955 $1,135

Drug Out-of-Pocket Costs $240 $472 $500 $500

Stipend N/A ($2,000) ($2,000) ($2,000)

Total Costs $3,026 $2,816 $714 $1,494

Decrease in Total Costs Decrease of $210 Decrease of $2,312 Decrease of $1,532

© 2013 Dominion 13

How Can Retirees Pay Less: Example: “High Medical Cost” Scenario Age 75 in 2014 with 30 years of service

Example of Richmond, VA 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

13

Cost Item (Annual) Current Plan

Full Coverage Medigap, and Rx

Plan


(HMO)


(PPO)

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

Medical Plan Premium / Contribution

$485 $2,597 $0 $600

Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above

Medical Out-of-Pocket Costs $1,816 $0 $3,400 $3,795

Drug Out-of-Pocket Costs $360 $896 $1,000 $1,000

Stipend N/A ($2,000) ($2,000) ($2,000)

Total Costs $3,920 $3,240 $3,659 $4,654

Decrease in Total Costs Decrease of $680 Decrease of $261 Increase of $734

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

© 2013 Dominion 14

What do you need to do?

If either you or your spouse are age 65 or will turn age 65

between now and April 1st, action is required.

If either you or your spouse are not age 65 and will not turn

age 65 between now and April 1st, no action is required at

this time.

© 2013 Dominion 15

Introducing Extend Health

Extend Health, a Towers Watson company, is the largest private

Medicare exchange that

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

Dominion will offer private Medicare exchanges to non-union participants

age 65 and older through Extend Health, a private health insurance

exchange.

Again, these are not the same exchanges

that are now open to everyone

© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.

The Industry’s Largest Medicare Exchange

• Extend Health works with many companies and unions

– DuPont, Southern States, Media General, Ford, Alliant Energy, IBEW, First Energy, CSX, Advance Auto Parts, City of Chesapeake, IBM and Time Warner

– Companies utilizing this approach continue to grow

• Largest private Medicare exchange

– Serving more than 300 companies, including 50 in the Fortune 500

• Wide selection of plans

– 90+ national and regional carriers, including Anthem

• Customized support for retiree needs

– Retirees receive one-on-one help from licensed benefit advisors to choose their plans and ongoing advocacy with claim issues

Extend Health, a Towers Watson Company

• Towers Watson acquired Extend Health in May 2012

• Next year, we will become fully integrated with our parent

company. We will drop Extend Health from our name and

become Towers Watson’s OneExchange

• We will send you a notice to let you know when the

change is complete

Look for the Towers Watson and OneExchange logos:

18

towerswatson.com © 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Next year, we are changing our name!

© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Plans & Partners

All Medicare Plan Types

• Medicare Advantage

• Medicare Supplement

(aka Medigap)

• Prescription Drug (Part D)

Dental / Vision Over 90

National/Regional

Carriers

19


The Process

20

.

.

.

Educate

Evaluate / Enroll

Manage


Gather information

• (e.g. prescriptions)

• Pre-existing conditions will

not limit your plan selection*

• Give us a call

855-238-0483

www.ExtendHealth.com/Dominion

Education Getting Started Guide

* except end-stage renal disease

21


Education Enrollment Guide

Prepare you for your

enrollment discussion

• Review Medicare

basics

• Appointment

confirmation letter

22


Decision Support Tools

Help Me

Choose

Prescription

Profiler

www.ExtendHealth.com/Dominion

23


Licensed Benefit Advisor

• 100% domestic workforce

• Objective advocacy

• Neutral compensation

• Extend University

• Licensed, certified, appointed

• Average age 43

Hours of Operation

Monday – Friday 8 a.m. – 9 p.m. Eastern Time

Evaluate and Enroll

24


Enrollment Process

• Benefit Advisors can discuss coverage options with anyone – need to speak to the participant to complete the enrollment

• Once you have made a coverage selection, enrollment is conducted via telephone

• 100% of calls are recorded

25


Medicare and You

26


Your Future Coverage

27

Primary • Medicare A

• Medicare B

Additional

• Medigap

• Medicare Advantage

• Part D

Optional • Dental

• Vision

Your

Future

Coverage


Medicare Plan Types

28


Medicare Plan Types

29


Medicare Prescription Drug Coverage

30

Initial Coverage.

Coverage Gap.

.Catastrophic Coverage

You Pay

• Deductible an co-pays for our plan

• Coverage for the first $2850 in actual cost of medications

You Pay

• 47.5% of Brand Name and 72% of Generics

• Until your out of pocket cost reach $4550

You Pay

• $2.55 for Generics and $6.35 for Brand Name

• Or 5% whichever is greater

Additional financial support provided by Dominion for retirees with

significant pharmacy claims

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

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 2014 amount is $4,550.

31

Catastrophic Coverage

© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only. 32

Location Specific Plans

http://www.glitter-graphics.com/graphics/213804


Plans Available in Richmond, Hampton

Henrico, and Virginia Beach City or County

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

8 $0 - $81

Medigap/

Medicare

Supplement

14 $58 - $202

Part D 17 $13 - $115

33


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014

Monthly Premium Company

Vision 1

$14 per person per month

Annual eye exam: $5

Coverage for eye glasses,

lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $41

$50 deductible

$1,000 annual maximum

Delta Dental,

Humana

34



Benefit Cost

Monthly Premium $40

Network PPO

Deductible $1000

Doctor Copay $15

Specialist Copay $40

Hospital $260 co-pay per day - days 1-7

Emergency Room $65 co-pay if not admitted

Rx Deductible $0

Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply

Mail Order $0/ $0/ $125/ $275 90 day supply

35


Medigap Plan F and PDP (75 yr old male)

Benefit Cost

Monthly Premium $218 ($202 Medigap + $16 PDP)

Network Any doctor that accepts Medicare

Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



36


Plans Available in Chesterfield County

(VA)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

8 $0 - $81

Medigap/

Medicare

Supplement

14 $60 - $218

Part D 17 $13 - $125

37


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $41

$50 deductible


Delta Dental,

Humana

38



Benefit Cost

Monthly Premium $50

Network PPO

Deductible $1000

Doctor Copay $15




Rx Deductible $0



39



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



40


Plans Available in Charlottesville City (VA)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

4 $0 - $81

Medigap/

Medicare

Supplement

14 $60 - $216

Part D 17 $13 - $115

41


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $41

$50 deductible


Delta Dental,

Humana

42



Benefit Cost

Monthly Premium $62

Network PPO

Deductible $500

Doctor Copay $15




Rx Deductible $0



43



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



44


Plans Available in Cuyahoga County (OH)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

20 $0 - $165

Medigap/

Medicare

Supplement

24 $79 - $259

Part D 18 $13 - $119

45


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $36

$50 deductible


Delta Dental,

Humana

46



Benefit Cost

Monthly Premium $39

Network PPO

Deductible $500

Doctor Copay $5




Rx Deductible $0



47



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



48


Plans Available in Allegheny County (PA)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

13 $40 - $224

Medigap/

Medicare

Supplement

11 $92 - $348

Part D 16 $13 - $169

49


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $39

$50 deductible


Delta Dental,

Humana

50



Benefit Cost

Monthly Premium $40

Network PPO

Deductible $1250

Doctor Copay $10


Hospital $200 co-pay for each stay


Rx Deductible $0

Rx Tiers $10/ $45/ $95/ 33% 30 day supply

Mail Order $20/ $112/ $285 90 day supply

51



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



52


Plans Available in Kewaunee County (WI)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

4 $0 - $112

Medigap/

Medicare

Supplement

12 $120 - $231

Part D 15 $13 - $137

53


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$27 - $39

$50 deductible


Delta Dental,

Humana

54



Benefit Cost

Monthly Premium $42

Network PPO

Deductible $1000

Doctor Copay $10




Rx Deductible $0



55



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



56


Plans Available in Fairfax County (VA)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

6 $0 - $81

Medigap/

Medicare

Supplement

14 $58 - $202

Part D 17 $13 - $115

57


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$22 - $41

$50 deductible


Delta Dental,

Humana

58



Benefit Cost

Monthly Premium $77

Network PPO

Deductible $750

Doctor Copay $15




Rx Deductible $0

Rx Tiers $7/ $45/ $95/ 33% 30 day supply

Mail Order $14/ $90/ $190 90 day supply

59



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



60


Plans Available in Harrison County (WV)

Plan Type Number of

Plans Offered

2014

Monthly Premium

Medicare

Advantage

15 $0 - $170

Medigap/

Medicare

Supplement

15 $73 - $229

Part D 17 $13 - $169

61


Ancillary Coverage

Plan Type

Number of

Plans

Offered

2014


Vision 1


Annual eye exam: $5


lenses and frames

Vision Service Plan

(VSP)

Dental 1

$19 - $36

$50 deductible


Delta Dental,

Humana

62



Benefit Cost

Monthly Premium $40

Network PPO

Deductible $1000

Doctor Copay $15




Rx Deductible $0



63



Benefit Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx Deductible $0



64


Health Reimbursement

Arrangement Account

Auto-Reimbursement Auto-Reimbursement

How the Process Worksent



What Is An HRA

• Tax-advantaged account used to reimburse you for eligible health care expenses

• You must meet Dominion’s eligibility requirements to qualify for HRA

• Your HRA funds will be available April 1, 2014


Health Reimbursement Arrangement (HRA)

extendhealth.com 67

Dominion

allocates

benefit dollars

to each retiree’s

HRA account

HRA

Account

Retirees are

reimbursed for

eligible health

care expenses

using HRA

benefit dollars

Participant works

through Extend

Health to enroll

in individual

coverage


Reimbursement options

68

• One time or recurring claims forms

• Fill out form

• Attach required documentation

• Submit via Mail, Fax or Web

• Available for all expense types

1.

Paper Claims

• Enroll in a participating plan

• Ask to select option

• Pay premiums as required

• Available for plan premiums only

2.

Automatic

Reimbursement


How to File a Paper Claim

Participant pays plan premium or

co-pays

Participant fills out claim form, attaches required information

Extend Health verifies receipt of

payment and eligibility

Extend Health reimburses participant

69


Extend Health HRA Claim Form

Remember,

You can be

Reimbursed for

Part B by sending

in your statement

70


How Auto-Reimbursement Works

Participant pays plan premium to

insurance company

Insurance company forwards receipt of payment to Extend

Health

Extend Health verifies receipt of

payment and eligibility

Extend Health reimburses participant

71


• Service offered by Extend Health

• Available on most plans

• Works for premium reimbursement only

• No claim form is required

• Can take 2-3 billing cycles to initiate

• If you need your reimbursement sooner, simply

file a paper claim. The form and instructions

will be provided in your HRA Welcome Kit

Auto-Reimbursement (AR)


Next Steps


How This Affects You

• May change – depending on what coverage you choose

• Company contribution to your HRA = Up to $200 per

month ($100 for retiree and $100 for one dependent)

• You will work with Extend Health to enroll in a plan that

meets your medical and prescription needs. We will also

help you establish your Health Reimbursement Account

• Extend Health Advisors will help you understand the costs

associated with your coverage – premiums, co-payments,

deductibles and all other costs

What you

pay

How you

enroll

Your

support


Between January and April, 2014

• During the transition:

• You will keep your existing medical plan

• Your deductible will be waived (except for those currently

enrolled in Medicare HMO)

• Your HRAs will be prorated in 2014 to reflect 9 months

coverage

• Beginning December 10, 2013 you can call Extend Health

with questions

75


Next Steps



Next Steps

77

Review

Gather

Call

The Getting Started Guide

Prescription and

Doctor Information

Extend Health – One Exchange

855-238-0483


Post Enrollment Customer Service

Advocacy and support services

Toll Free number to contact Extend Health

representative 855-238-0483

• Direct support for claims issues, appeals

and network questions

• Renewal process – ability to pick new

coverage for future years – not locked into

this year’s choice

• Ongoing enrollment services

78


Questions


dominion retiree medical - oneexchange · introducing extend health extend health, a towers watson...

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