Download 2017 Benefits

2017 Benefits
Your Emeriti Retirement Health Plan
What’s New In 2017?
Insurance plan options
stay the same
Premiums for Rx
plans increase
4.3%
Premiums for Medicare
Advantage Plans
increase 6.5%
Dental plan premium
will NOT increase
Premiums for SRM Plans
K & L increase 3.5%
Premiums for Pre-65
plans will increase
10%
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Your Emeriti Retirement Health Benefit
Tax-advantaged
Tax-free
Flexible
Retiree Health
Account
Reimbursement
Benefit
Group Health
Insurance
For Qualified
Out-of-Pocket Medical
Expenses
Underwritten
By Aetna
(HealthPartners in
Minnesota)
For you and your dependents
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2017 Retiree Health Plans
3 Medicare
Advantage Plans
2 Medicare
Supplement Plans
3 Medicare-approved
Part D prescription
drug plans
Underwritten
by Aetna
Annual choice
Guaranteed issue
Optional dental plan
Benefits available to employee (retiree) and, if the plan permits, spouse and eligible dependents
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How Supplement Retiree Medical Plans (SRM) L & K
Work
Medicare is primary
insurance
Use Medicare card &
Aetna card
Aetna plans coordinate with
Original Medicare Parts A & B
You pay Part B premium
No plan deductibles.
No extra benefits.
You pay percentage of
Medicare Parts A & B
deductibles.
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How Medicare Advantage Plans Work
Aetna is primary insurance
Use one Aetna card
Aetna provides Medicare
Parts A & B benefits
You still get your Medicare card
Extra Benefits
Annual eye & hearing exams
Silver & Fit Exercise &
Healthy Aging Program
Aetna Nurse Case Manager
Wellness Coach
You still pay Part B premium
No plan deductibles.
No Medicare Parts A & B
deductibles.
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2017 Aetna POST-65 Medical Plans – CHOOSE ONE PLAN
1
2
3
4
Medicare
Advantage
Medicare
Advantage
Medicare
Advantage
Aetna SRM
Aetna SRM
Premium
Plus
Standard
Plan L
Plan K
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Plan
Deductible
$0*
$0*
$0*
$0
$0
Medicare
Deductible
$0
$0
$0
25% of Part A
100% of Part B
50% of Part A
100% of Part B
Primary
Care
$15 copay *
15% coinsurance
$15 copay
in-network
in-network
25%
coinsurance
50%
coinsurance
Specialist
$15 copay *
15% coinsurance
$40 copay
in-network
in-network
25%
coinsurance
50%
coinsurance
$500 per admission
$200 per day (1-7)
in-network
in-network
25% of the
Medicare Part
A deductible
50% of the
Medicare Part A
deductible
Hospital
Covered 100%
Preventive
Care
Covered 100%
Covered 100%
Covered 100%
Some paid by
Medicare
Some paid by
Medicare
Out-ofPocket
Limit
$2,000 *
$2,750 (in-network)
$5,500
$6,700 (in-network)
$10,000
$2,480
$4,960
(out-of-network)
(out-of-network)
*In- and out-of-network
NOTES: The ESA-PPO Plan has the same benefits as the In-Network PPO Plan.
Aetna’s GMS Plans A and L will be offered in Florida in place of SRM Plans K and L.
For 2016, the SRM Plans are not available in VT, MD, MN, and U.S. Territories.
For 2016, Part A Deductible - $1,288; Part B Deductible - $166
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2017 Aetna Part D Drug Plans – CHOOSE ONE PLAN
1
Rx Premium
2
Rx Plus
3
Rx Standard
Open Formulary
Open Formulary
GRP B2 Formulary
Deductible: $100
Deductible: $100
Deductible: $310
Initial Coverage Limit:
Initial Coverage Limit:
Initial Coverage Limit:
15% generic, 25% preferred brand,
40% non-preferred brand
15% generic, 25% preferred brand,
50% non-preferred brand
15% generic, 25% preferred brand
Coverage Gap:
Coverage Gap:
Coverage Gap:
Same coverage,
same coinsurance level
15% copay for Tier 1 generic drugs, 40%
brand
51% generic
40% brand
Catastrophic Coverage:
Catastrophic Coverage:
Catastrophic Coverage:
100% coverage, you pay nothing
95% coverage, you pay 5%
95% coverage, you pay 5%
The Medicare Coverage Gap Discount Program will continue to provide manufacturer discounts on brand name drugs to Part D beneficiaries who reach the
Coverage Gap and are not already receiving “Extra Help.” A 50% discount on the negotiated price of preferred and non-preferred brand drugs (excluding the
dispensing fee) will be available from manufacturers that have agreed to provide the discount.
2017 Standard drug plan deductible on the individual market: $400, Initial Coverage limit: $3,700, True-Out-Of-Pocket Threshold: $4,950
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2017 Aetna Dental Plan – Optional
Preventive Service
100% coverage
Annual Deductible (basic and major services)
$100
Basic Services Coverage
50%
(fillings, standard crowns, extractions)
Major Services Coverage
50%
(root canal therapy, surgical removals, dentures)
Annual Benefit Maximum
$1,500
NOTES:
1.Twelve month waiting period applies for major services, but may be waived with evidence of continuing coverage.
2.One-time only opt-in opportunity.
3.Dental is only available when you enroll in a combination Medical/Rx coverage, or elect the stand-alone Rx Standard Plan
4. Please note: in the states of CA, OR, WA, the stand-alone Dental plan may be elected if the participant is enrolled in a Kaiser Permanente MAPD
Plan, and with evidence of existing coverage.
5. Dental not available in MD.
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Choosing Your Coverage
Jim has a chronic medical condition. He takes 3 brand
drugs, sees a specialist twice a year, and is sometimes in
the hospital. Consider:
 Medicare Premium Plan or SRM L Plan
 Rx High Plan
Mary is generally pretty healthy. She takes 2 generic
drugs, gets her annual check-ups, and sees a
specialist once a year for allergies.
Consider:
 Medicare Standard Plan or SRM K Plan
 Rx Standard Plan
For illustration purposes only. Emeriti does not provide advice about health insurance plans.
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Emeriti’s Open Enrollment
Insurance enrollment kits mailed in October
Open Enrollment dates:
Monday, November 14 – Friday, December 9
Call the Emeriti Service Center
1-866-363-7484 press option #1
Visit EmeritiHealth.org for more information
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Next Steps
1
Review insurance
enrollment kit,
mailed to your
residence
2
3
Change coverage.
Enroll on the phone
or online.
- Or Do nothing,
& be defaulted
into the plans
you had in 2016
1
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Working Together
Emeriti & TIAA
are working
together to connect
health & financial
well-being
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ThankYou
FOR JOINING US
1
4
Addendum
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How Primary Care Charge Works
Medicare
Advantage
Medicare
Advantage
Medicare
Advantage
Premium
Plus
Standard
Aetna SRM
Aetna SRM
Plan L
Plan K
Primary Care
Charge
$200
$200
$200
$200
$200
Medicare
Pays
$0
$0
$0
$160
$160
Aetna Pays
$185
$170
$185
$30
$20
You Pay
$15 copay
$30 coinsurance
$15 copay
(in- and out-ofnetwork)
(in-network)
(in-network)
$10
coinsurance
$20
coinsurance
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Important information
Emeriti Retirement Health Solutions provided this information and is responsible for its content.
Emeriti, TIAA, CBIZ Savitz, Aetna Life Insurance Company, and HealthPartners are independent
corporations and are not legally affiliated.
Emeriti Retirement Health Solutions is not an insurance company, insurance broker or insurance
provider.
FOR INSTITUTIONAL INVESTOR USE ONLY. NOT FOR USE WITH OR DISTRIBUTION TO THE PUBLIC.
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Interests in any retiree healthcare plan discussed herein are offered solely by the employer.
Teachers Insurance and Annuity Association of America (TIAA) will provide services to the plan and may
issue plan communications on behalf of the plan sponsor, in its capacity as a plan recordkeeper.
Investment, insurance and annuity products are not FDIC insured, are not bank guaranteed, are not
deposits, are not insured by any federal government agency, are not a condition to any banking service
or activity, and may lose value.
The TIAA group of companies does not provide legal or tax advice. Please consult with your legal
or tax advisor.
tiaa.org
© 2016 Teachers Insurance and Annuity Association-College Retirement Equities Fund (TIAA), 730 Third Avenue, New York, NY 10017
C33829