road to retirement - purdue university to... · •purdue and pura have partnered with henriott...
TRANSCRIPT
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A program for Purdue employees approaching retirement.
Road to Retirement
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• Faculty or Staff members
• age 55 or more
• with at least 10 years of service in a benefits-eligible position
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• Free Membership
• Monthly luncheons with interesting speakers
• Trips and tours
• Campus and community activities
• PURA Newsletter
• Volunteer Opportunities
See the Retiree Brochure and the
PURA website for information -
www.purdue.edu/retirees
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Organizing Your Affairs
Members of the PURA Benefits committee have
produced three helpful documents that provide an
excellent way to keep track of your important
personal information.
You can access these online at the PURA website:
www.purdue.edu/retirees
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Benefit Programs for Official Retirees
• Complimentary “A” parking permit
• Fee privileges
• Staff rates on tickets, recreational facilities
• Nursing Center services
• Flu Shots
• University email address and data network remote facilities
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Benefit Programs for Official Retirees
• Optional participation in University-sponsored
group medical & prescription insurance
– Retiree enrolled in a Purdue plan can continue to
cover Spouse/Dependent*
– Surviving Spouse/Dependent* can continue to be
covered
• Optional participation in Group Life Insurance
plan to age 65
* Dependent eligibility rules apply
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Medical Plan Options
Plans are reviewed annually
and are subject to change.
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Medical Plan CoverageRetiree or Spouse Under Age 65
• Continue on plans with same benefits as active employees until age 65 or eligible for Medicare prior to 65.
• You pay the full cost.
• Can change plan during annual open enrollment.
• New options for 2017 – Marketplace plans through the Henriott Group Inc.
• When Medicare eligible (usu. age 65), can join a Purdue retiree group plan.
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If I retire before age 65 what are my insurance options?
• An Official Retiree can continue their Purdue health insurance plan for themselves and their eligible dependents, and will be billed for the full cost of the insurance. The bill comes from Infinisource.
• Purdue and PURA have partnered with Henriott Group, Inc. to offer additional health insurance options. Retirees and eligible dependents who are not yet eligible for Medicare can consult with Henriott Group for help to enroll in a Marketplace plan.
• Open Enrollment for Marketplace plans is a qualifying Life Event to stop your Purdue U-65 Retiree plan.
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2017 Monthly Medical Premiums *Retiree and/or Spouse not Medicare eligible
3% discount for annual payment. Billed from Infinisource.
Purdue Health PlanSingle coverage $611
Retiree + Spouse $1,374
PHP No HSA 1Single coverage $533
Retiree + Spouse $1,200
PHP No HSA 2Single coverage $481
Retiree + Spouse $1,082
*Tobacco-User Additional Premium $500/person/year
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Retiree Group Plans - Retirees with Medicare
• Medicare Part A – Hospital (Inpatient)
- No monthly premium - Paid during working years
• Medicare Part B – Medical (Outpatient)
- Sign up at 65 or at full retirement
- Base Premium for 2017 is $134/month
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• Medicare Part C - Private Insurance– Medicare Advantage - PPO, HMO, Private Fee for Service
– Pay Part B monthly premium + insurance premium
• Medicare Part D - Prescription Drug Coverage– Pay monthly premium to insurance company
• Parts B, C and D have a Premium– Parts B & D have penalty if not joined when eligible
– Special Enrollment Period (SEP) at retirement
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Creditable Coverage, Medicare Parts B and D
– Active employees who have coverage from employer’s
medical/Rx insurance, as good or better than Medicare
– Part B and/or Part D penalty may apply if cannot show
creditable coverage past age 65 (eligibility for Medicare)
• COBRA and employers’ retiree plans
are NOT “Creditable”
– Employer will provide evidence of creditable coverage
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Medical Plans 2017 - Age 65+, Medicare eligible
The PURcare plan – Supplement (incl. Vision) + Prescription plan
– Supplement to Medicare Parts A and B through UnitedHealthcare
– Excellent Nationwide coverage
– See any doctor or any provider that accepts Medicare for medically necessary coverage
– Includes Medicare Part D prescription drug coverage
– International coverage for illness/accident
– Extra coverage above individual plans (e.g. Hospital, Skilled Nursing)
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Medical Plans 2017 - Medicare eligible
UnitedHealthcare Group Medicare Advantage PPO
– Medicare Part C private insurance
– A type of Medicare Advantage Plan approved by Medicare
• Nation-wide PPO network
• Out of Network - any Medicare doctor or facility that will
accept payment from the plan
• Payment to provider is the same reimbursement as Medicare
Includes medical/hospital and Part D prescription coverage
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Group Health Plan Eligibility
– Official Retiree and Qualifying Spouse
– Enrolled in Medicare Part A & B
– Age 65 (PURcare)
If you’re retired, age 65+ with Medicare, and choose
an individual health insurance plan, you will not be
eligible to return to a Purdue retiree group plan.
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PURcare - Senior Supplement + Part D
• PURcare premium for 2017 is $263.85/month/person
– Veterans with Rx coverage from VA, $193.70/month
• $300 annual deductible (Medicare Parts A and B)
– Once satisfied, Senior Supplement pays 100% of Medicare
A & B allowed amounts for rest of year
• $150 annual Vision benefit with no deductible
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PURcare Vision Benefit
A vision rider of $150 per year for expenses not allowed by Medicare
• No Network, use any provider
• No 12 month waiting period requirement
• May use for frames, lenses, second pair of glasses, refraction
• Not for refraction/glasses immediately following cataract surgery
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2017 PURcare Part D Plan
Prescription drug coverage
– Exceeds coverage required under Medicare Part D legislation
• No deductible
• Open formulary (FDA approved, medically necessary)
• No step therapy
• Few prior authorizations or limited quantities
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2017 PURcare Part D PlanInitial Coverage stage
Retail Pharmacy (30 or 90-day supply)
You pay the lesser of:
50% co-insurance
OR the maximum co-pay
o Tier 1 $10 /mo.
o Tier 2 $45 /mo.
o Tier 3-4 $95 /mo.
Mail-Order Pharmacy (90-day supply)
You pay the lesser of:
45% co-insurance
OR the maximum co-pay
o Tier 1 $20
o Tier 2 $90
o Tier 3-4 $190
Until you reach the 2017 Coverage Gap
$3,700 Total Rx cost (the $ you pay + $ insurance pays)
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Medicare standard Gap coverage
You pay
• 40% for brand name Rx
• 51% for generic Rx
✓ The manufacturer’s discount on brand name Rx counts toward your annual total out-of-pocket.
2017 PURcare Part D PlanCoverage Gap stage (Donut Hole)
No cost when you reach Catastrophic coverage
(after $4,950 out-of-pocket in 2017).
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Closing the Gap (Donut Hole)
Your share decreases each year –
• 2017 51% for generics and 40% brand drugs
• 2018 44% for generics and 35% brand drugs
• 2019 37% for generics and 30% brand drugs
• 2020 25% for generics and 25% brand drugs
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2017 Group Medicare Advantage
UnitedHealthcare PPO - National network
• Monthly Premium is $208.49 per person per month for
medical/hospital and Part D prescription coverage
• You pay co-pay/co-insurance for Medicare covered Part A & B
services/supplies until your reach Annual Maximum out-of-pocket
Primary Care Office Visit $20
Specialist Office Visit $35
Annual Maximum Out-of-Pocket $3400
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2017 Group Medicare Advantage PPO
Prescription Drug Coverage
• Defined 4-Tier formulary (not all drugs covered)
• Step therapy, prior approval, limited quantities on some covered drugs
Initial Coverage Stage
• Drug tier determines cost - $4, $28, $58, 33% at local pharmacy
In the Gap –if total Rx cost ($ you pay + $ insurance pays) reaches $3,700
• You pay only your co-pay for Tier 1 generic drugs
• Tier 2, 3, 4 – standard Gap coverage; 40% - brand, 51% - generics
Catastrophic Coverage
• after $4,950 total out-of-pocket, you pay 5% or very small co-pay
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Plan Comparison
PURcare
• Higher monthly premium ($263.85)
• Lower risk; out-of-pocket costs for hosp./medical ($300)
• Broader Rx coverage with few restrictions
• 100% Rx coverage during catastrophic phase
Medicare Advantage PPO
• Lower monthly premium ($208.49)
• Higher risk; out-of-pocket costs for hosp./medical ($3400)
• More limited Rx coverage, but with coverage of Tier 1 generics in the gap
• More Rx restrictions and some cost during catastrophic phase
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Retiree Dental Option in 2017
Anthem Preventive Dental Plan– oral exams and teeth cleaning twice per calendar year
– bitewing X-rays once per calendar year
– a full mouth X-ray once every five years
– once-a-year brush biopsy to detect oral cancer
A third cleaning will be covered for members with certain conditions, such as diabetes and oncology patients.
Covered Claims paid 100% In-Network; Out-of-network may be balance billed.
For Retirees over age 65; Participation is Optional.Monthly premium billed by and paid to AmWins
• Retiree only $14.51/month
• Retiree & Spouse $29.02/month
Administrative fee $2.25/month - EFT or $2.75/month - Check
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Additional Benefits for Both Plans
SilverSneakers www.silversneakers.com
You pay no membership fee for any of these local facilities:
Over 13,000 participating clubs nationwide
24-Hour NurseLine
Optum Discount
27
Cordova Recreational Sports Center A.H. Ismail Center
Club Newtone Faith East and Faith West Centers
Lafayette Family YMCA - two locations Snap Fitness - two locations
Parkwest Fitness Curves (women only) - three locations
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Why a Purdue Retiree Group Plan?
• Purdue HR staff assigned to help you
• Not age rated – premiums do not increase with age
• No yearly re-enrollment for either plan option
• Better benefits than most individual plans offer
• PURA Benefits Committee works on your behalf to
negotiate best possible plans
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Message from PURA Benefits Committee
“PURA believes that prudent retiree health insurance
decisions should be determined by value, service and
dependability. Your health insurance is important to your
well-being and peace of mind. Choosing an insurance plan
on the basis of price alone can be risky and costly.”
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Life Insurance
Official retirees have various options to continue, port or convert Minnesota Life coverage without proof of good health.
All options require action by the retiree within 31 days of the date your employee coverage terminates.
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Retiring Under Age 65
You are eligible to:
– Continue Basic Term Life (1.5x Salary) and Additional
Term Life – all or part – by paying the full cost
– Continue all or part of coverage for dependents
– Port (extend) Accidental Death & Dismemberment
coverage for you and/or your dependents to age 70
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Life Insurance age 65 – 69 *
You are eligible to:
– Convert Basic Term Life (1.5x Salary) to an individual
policy with Minnesota Life by paying the full cost
– Port (extend) Additional Term Life and/or AD&D to
age 70 by paying the full cost
* Cost is dependent upon age and amount of coverage
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Life Insurance age 70+
• If you have ported (extended) your Additional Term Life
coverage up to this point, or if you are retiring at age 70 or
older, you may convert all or part of the coverage to an
individual policy without proof of good health. You can
keep this coverage for life by paying the full cost.
• Cost is based on age and coverage amount.
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Retirement – Your reward
for a job well done!
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Questions?
Thank you for attending.
Kate LaMar
Human Resources
765-494-1694