“Creating A More Educated Georgia”1

Board of Regents of theUniversity System of Georgia

2011 Healthcare for Retirees

“Creating A More Educated Georgia”2

Agenda

Carrying Coverage into Retirement Coordination with Medicare Future Retirees Medicare Part B Medicare D – Pharmacy Benefits Prescription Plan Changes Alternative Network Healthcare Reform Tobacco Use Surcharge Cigna Life Insurance Plan Enhancements Premium Overview & Rate Information Coverage - Out-of-Country Retiree Option Change Period Qualifying Events Permissible Healthcare Plan Changes

“Creating A More Educated Georgia”3

Carrying Coverage into Retirement

Effective November 1, 2002, to be eligible for retirement from the University System

of Georgia (USG), an employee must meet one of the following four (4) conditions at

the time of his/her separation from employment, regardless of the retirement plan

elected by the employee:

An employee must have been employed by the USG for the last ten (10) years in a regular, benefitted position and have attained age 60; or

An employee must have at least 25 total years of benefitted service established with a State of Georgia sponsored retirement plan, of which the last five (5) years of employment must have been continuous and with the USG; or

“Creating A More Educated Georgia”4

Carrying Coverage into Retirement

An employee must have at least 30 total years of benefitted service established with a State of Georgia sponsored retirement plan, of which the last five (5) years of employment must have been continuous and with the USG; or

An employee must be deemed to be totally and permanently disabled, as documented through the receipt of disability benefits from Social Security or from the TRS, following 9.5 years of continuous service to the USG in a regular, benefitted position.

An individual who has retired from another State of Georgia sponsored

Retirement plan may not count such retirement service toward meeting the

eligibility criteria for retirement from the USG.

“Creating A More Educated Georgia”5

Coordination with Medicare

• BOR plan pays healthcare benefits after Medicare has paid their portion.

• A retiree age 65 or older has the option to select the PPO Plan, the HSA PPO (HDHP) Plan or the Kaiser Permanente Senior Advantage Plan.

“Creating A More Educated Georgia”

Future Retirees Medicare Part B

• All future retirees and spouses will be required to pay full cost of insurance for not enrolling in Medicare Part B.

• After January 1, 2011, all retirees and spouses reaching age 65 will have the option to either enroll in Medicare Part B or pay the full cost of system provided insurance.

• Current Medicare eligible retirees who are not enrolled will be grandfathered in and will continue to pay the $100 per month surcharge.

6

“Creating A More Educated Georgia”7

Medicare Part D – Pharmacy Benefits

• Medicare Part D provides subsidized drug coverage.• Kaiser Permanente Senior Advantage provides an

integrated benefit covering hospital, physician and drug costs.

• Kaiser Permanente will automatically serve as Medicare Part D provider to existing Kaiser Senior Advantage members.

• If you currently have an existing Part D plan and enroll in Senior Advantage, your existing Part D Plan will automatically be cancelled by Medicare.

• Customer service is available to answer your questions at

404-233-3700, or 1-800-232-4404.

“Creating A More Educated Georgia”

Prescription Plan Changes

The following Medco changes are effective January 1, 2011:• $5.00 co-pay increase for brand name drugs• Specialty Pharmacy Program – Effective January

1, 2011 for access to certain specialty medications, employees will be directed to use Accredo, Medco’s Specialty Pharmacy Program.

• Medicare B Coordination Program – Medco will work with BCBS to better manage the coordination of pharmacy benefits for USG retirees.

8

“Creating A More Educated Georgia”

Prescription Plan Changes(continued)

• Generic Waiver Co-Payment Program- New generic claims not filled within last 12 months- Any brand name prescription presented at mail- Any generic prescription moved to mail- Any new generic prescription submitted at mail- One patient can get more than one (1) waiver- Waivers are offered by patient/drug- Existing brand name prescription at mail which becomes available as generic during waiver period is not eligible to receive a co-pay waiver

9

“Creating A More Educated Georgia”

Alternative Network

• The new alternative network is a voluntary option for both PPO and HDHP plans

• The Blue Open Access POS Network is a statewide provider network in Georgia

• Blue Open Access members are not required to select a Primary Care Physician (PCP)

• Members will have access to specialty care directly from any In-Network Physician

10

“Creating A More Educated Georgia”

Healthcare Reform

• Dependent coverage to age 26 (no other employer coverage available)

• No health FSA/HRA/HSA reimbursement for non-prescribed drugs

• No lifetime dollar limits• No pre-existing condition limitations for

children up to age 19

11

“Creating A More Educated Georgia”

Tobacco Use Surcharge

A $50 per month tobacco use surcharge will be added to the monthly premium if you use tobacco products.• Smoking cessation classes are available•Tobacco surcharge will be removed when the employee completes the tobacco cessation requirements.•http://www.usg.edu/hr/benefits/health_insurance

12

“Creating A More Educated Georgia”

Cigna Life Insurance Plan Enhancements

• Terminal Illness Benefit to Basic and Voluntary Life Programs

• Identity Theft Program to Voluntary AD&D Program

• Cigna’s Health Reward Program• Cigna’s Will Preparation Program

13

“Creating A More Educated Georgia”

Premium Overview &Rate Information

14

Healthcare Plan % Increase Over 2010 Rates

BCBS PPO Traditional 9.7%

BCBS PPO Alternative Priced at 2010 rates

BCBS HDHP Traditional 9.7%

BCBS HDHP Alternative Priced at 2010 rates

BCBS HMO 9.7%

Kaiser HMO 8.3%

BOR Dental Employee paid 10%

Go to the following link for rate information:http://www.usg.edu/hr/benefits/health_insurance/

“Creating A More Educated Georgia”15

Coverage – Out-of-Country

Out-of-Country • BlueCard Worldwide

* Medical assistance for inpatient, outpatient, and professional

services from healthcare providers worldwide.* 24 hours a day, 7 days a week, 365 days a year* BlueCard Access Line 1-800-810-BLUE (2583) inside U.S. or call collect 1-804-673-1177 outside U.S.* Claim Form – 1-800-810-BLUE (2583) or www.bcbs.com/bluecardworldwide/index.html* Claim – Prescription Drugs BCBSGA, P.O. Box 7728, Columbus, GA 31908

“Creating A More Educated Georgia”16

Retiree Option Change Period

The USG retiree annual change period is generally held during the fall of each calendar year.

The USG retiree annual change period will coincide with the same 30 calendar-day time frame designated as the USG open enrollment period for active, eligible employees.

The institutional HR/Personnel Office, from which the individual retires, will advise the retiree of the specific dates for his/her annual change period.

A retiree will not be permitted to participate in the annual change periodunless he/she elected to take healthcare coverage into retirement at thetime of his/her separation from employment with the USG.

“Creating A More Educated Georgia”17

Retiree Option Change Period

During an annual retiree change period, an eligible retired employee mayelect to:

Drop or discontinue healthcare coverage; Participate in a different healthcare plan option; and/or Reduce his/her level of coverage.

During the annual change period, a retiree shall not be permitted to addHealthcare coverage, or, increase the level of coverage that he/she tookInto retirement, unless it is the result of one of four (4) qualifying

events.

Following institutional approval, any change in retiree healthcare coverage will become effective within 30 days of the qualifying event; not at the beginning of the next plan year.

“Creating A More Educated Georgia”18

Qualifying Events

A USG retiree will be permitted to make a change in the level of healthcare coverage that he/she took into retirement, if he/she has a qualifying event.

The change in retiree healthcare coverage must be consistent with the qualifying event.

A retiree will be required to provide proper documentation to justify a requested benefits coverage change to the institutional HR/Personnel Office from which he/she retired. A retiree must request a coverage change within 30 days of the qualifying event.

Appropriate documentation, specific to the qualifying event, must be presented to your campus HR/Personnel Office before a change in healthcare plan coverage will be granted or approved.

“Creating A More Educated Georgia”19

Qualifying Events

There will be only four (4) instances of a qualifying event that a USG institution

may consider in granting a change in the level of healthcare coverage for a USG

retiree:

Medicare eligibility; or The addition of a dependent(s) because of marriage, birth,

adoption or a Qualified Medical Child Support (QMSCO) ; or The loss of a dependent(s) health benefit coverage through a

change in a spouse’s group coverage, through COBRA coverage, through Medicare, or through Medicaid; or

A change in a spouse’s employment status that affects coverage eligibility under a qualified health plan.

Marriage or divorce.

“Creating A More Educated Georgia”20

Qualifying Events

PLEASE NOTE:

For each of the four (4) qualifying events that were previously identified, one must

file a timely request with the HR/Personnel Office from which he/she retired. For instances other than a qualified medical child support order (QMSCO), “timely” means within thirty (30) days of the qualifying event.

A failure to complete a change form within thirty (30) days of a qualifying event will

prohibit one from making such changes. Unless otherwise noted, the effective date

for changes in healthcare coverage will be the first day of the month following the

institutions approval.

“Creating A More Educated Georgia”21

Qualifying Events

A Qualified Medical Child Support Order (QMSCO) is a court-orderedremedy resulting from a divorce, legal separation, annulment, or change in legal Custody. A QMSCO requires that an individual Provide healthcare coverage for an enrolled dependent(s) that has been approved by the court. The court order and effective date of healthcare plan coverage for a court-designated enrolled dependent(s) must be presented to the institutional HR/Personnel Office from Which an individual retired, within ninety (90) days for the court’s decision.

“Creating A More Educated Georgia”22

Permissible USG Retiree Healthcare Plan Changes

Please be reminded that retiree healthcare premiums are not paid with pre-tax dollars. Therefore, a retiree may reduce his/her healthcare coverage, or, discontinue his/her healthcare coverage at any time during the plan year. If you wish to reduce your healthcare coverage, or,if you wish to discontinue your healthcare coverage, please submit your request in writing to the HR/Personnel Office from which you retired.

“Creating A More Educated Georgia”23

Questions ??