helping you prepare for your upcoming benefits changes · a: no, you have a guaranteed issue window...

Covance Medicare Eligible

Retiree Meeting

October 10th

Helping You Prepare For Your Upcoming

Benefits Changes

1

What We’ll Cover Today

What is changing and why

What you need to do

Introducing Willis Towers Watson’s OneExchange

Understanding the Individual Medicare marketplace

Next steps

Questions and Answers

2

What Is Changing: Health Coverage

You will be able to select from a wide range of individual medical and

prescription drug plans

Covance has partnered with OneExchange — a leader in Medicare

coordination and transition services — to help you make health care

decisions in the individual Medicare marketplace

OneExchange’s U.S.-based Benefit Advisors will provide you and your eligible

dependent(s) with personal support, information and the tools necessary to

choose and enroll in plans that meet your health and financial needs

Covance Retirees will be responsible for the premiums associated with

any coverage selected

As a result of changes in the individual Medicare marketplace, effective

January 1, 2017, Covance is changing the way it provides

access to retiree health care coverage for both Non-Medicare and Medicare-

eligible retirees and their eligible dependent(s). New coverage elected will

be effective January 1, 2017.

3

Why This Approach?

The individual Medicare marketplace offers greater choice and flexibility

The individual Medicare marketplace has changed significantly and now offers a broad

array of individual options

Many affordable choices exist — and, in many cases, provide more value

Each retiree can select the plans that best suit his or her needs and

financial situation

OneExchange will be your advocate to help you find the plan that best

fits your needs

4

Why OneExchange? Your Lifetime Advocate, Benefit Advisor and Partner

Service is provided at no cost to you!

A leader in Medicare coordination and transition services to help you make health care decisions in the

individual Medicare marketplace

OneExchange’s US-based Benefit Advisors are licensed, certified and appointed

advisors, available by phone to help explain your options, answer your questions and

complete the enrollment process.

Objective information about the individual plans available, including the costs and features of all plan

options, will be available

Ongoing Support:

Claims Issues and Appeals

Network Questions

Plan Change

5

Next Steps

6

Depends on the plan you choose

Individual Medicare options give you the ability to choose the right

level of coverage for you and your dependent individually

What you pay

How you enroll

Your support

You will have more plan options to choose from

You will review plan options and enroll directly through your

OneExchange advisor, or online if you choose

You and your Medicare-eligible dependent will each enroll in an

individual Medicare plan

OneExchange will:

Provide you with information about the plans available and

provide tools, resources and support

Partner with you as you make this decision and enroll in plans

Take Action: What You Need to Do

Enroll in Medicare Part B if not already enrolled

Contact OneExchange at 1-866-356-9550

Schedule an enrollment appointment with a U.S.-based Benefit Advisor to

learn more about the individual plan options available to you

Benefit Advisors are available Monday through Friday from 7 a.m. to 8 p.m.

Central Time or online at Medicare.OneExchange.com/Covance

Enroll in your new coverage

Choose a new individual Medicare plan for you and your Medicare eligible

dependents

Enroll through OneExchange between October 3 and December 30, 2016

7

© 2016 Willis Towers Watson. All rights reserved.

Helping You Prepare For Your

Upcoming Medicare Enrollment

OneExchange

© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson client use only. 9

Who We Are

Your Future Coverage

OneExchange – For Your Benefit

A Deeper Dive – Benefit Advisors, Private Exchange,

Optimize Savings

Next Steps

Questions and Answer

OneExchange Health Insurance Marketplace


Towers Watson

over

100 years experience

First & Largest

private Medicare Exchange

Personalized options with plans from a nationwide network of carriers

More Choice, More Flexibility

– Better Value

Licensed benefit advisor

provides guidance & ongoing

advocacy

Over 1.5-million retirees served across

540+ employers

Our

12th annual enrollment season

Founded in 2004

No fees

for our

service

OneExchange Service Centers


Operating hours:

Monday – Friday, 7:00 a.m. until 8:00 p.m. Central Time

100% Domestic Workforce No Outsourcing!

Salt Lake City,

UT

Dallas, TX

Phoenix, AZ

Medicare Advantage, Medicare Supplement (MediGap)

and Part D Prescription Drug, Dental and Vision Plans


OneExchange offers plans from national and regional carriers



How Medicare coverage works

Primary Coverage

Medicare A and B

Additional Coverage (your choice)

Medicare Advantage with

Prescription Drug (MAPD) or

Medigap + Prescription Drug

Optional Coverage (your choice)

Dental Plans

Vision Plans

Your Medicare Options


Option 1: MAPD: Medicare Advantage + Part D Prescription Drug plan

* Note that Medicare Advantage plans are generally network based plans.

MAPD HMO PPO

Your Medicare Options


Option 2: Medicare Supplement Insurance (MediGap) and

Part D Prescription Drug plan

Medicare

Supplement

Insurance

Part D

Prescription

Drug Plan

Note: You may need to pay your first premium when you enroll in coverage.


Medicare Supplement Insurance (MediGap) – Lettered Policies

Medicare Supplement Insurance (Medigap) Policies

Benefits A B C D F G K L M N

Medicare Part A coinsurance

and hospital costs (up to an

additional 365 days after

Medicare benefits are used)

100% 100% 100% 100% 100% 100% 100% 100% 100% 100%

Medicare Part B coinsurance

or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Part A hospice care

coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Skilled nursing facility care

coinsurance 100% 100% 100% 100% 50% 75% 100% 100%

Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100%

Part B deductible 100% 100%

Part B excess charges 100% 100%

Foreign travel emergency

(up to plan limits) 80% 80% 80% 80% 80% 80%

Source: CMS Out-of-Pocket

limit in 2017

$4,960 $2,480

Part D Plans – 5 Tiers of Co-Pays


A prescription drug plan will typically

break the formulary into “tiers.” The tiers

correspond to the copayment or

coinsurance the beneficiary will pay.

Cost-sharing increases with the tier

number.

Tier 1 is the least expensive, tier 4 or 5 is

the most expensive.

Tier descriptions:

Tier 1 preferred generic

Tier 2 non-preferred generic

Tier 3 preferred brand

Tier 4 non-preferred brand

Tier 5 specialty drugs or injectable

medicine

Medicare Prescription Drug Coverage 2017


Catastrophic Coverage

Coverage Gap

Initial

Coverage Deductible

You Pay Full Retail

Until Deductible is Met

2017 - $0 to $400

You pay copays for

your plan coverage

for the first $3700 in

actual costs of

Medications

You pay 40% of Brand Name

and 51% of Generics until

your out of pocket costs

reach $4950; Pharmaceutical

contributions will count

towards the $4950 TrOOP

You Pay $3.30 for

Generics and $8.25 for

Brand Name or 5% -

whichever is greater

Only 25% reach

Donut Hole

Only 4% reach

Catastrophic


A Deeper Dive Into Our Process

The OneExchange process


Consultative

Process

Simplified

Selection

Effortless

Enrollment

Ongoing

Advocacy

Education


Enrollment Guide:

Understand your options

Review Medicare basics

What to expect during your

enrollment call

FAQs

Appointment confirmation

Benefit Advisors


Licensed / Certified / Appointed

OneExchange University™

Average age 43

Objective & unbiased

100% domestic workforce

Benefit advisors are available:

Monday – Friday, 7:00 a.m. until 8:00 p.m. Central Time

Decision Support Tools


Prescription Profiler

Medicare.OneExchange.com/Covance 24/7 access to your information

Load in your prescriptions - Shorten your time on the phone with us!

Decision Support Tools


Help Me Choose

comparison tool

Enrollment Process


We’ve got your BAC:

Benefit Advisors Benefit Advisors can discuss

coverage options with anyone

Application Data Processors Telephonic enrollment –

2 part process

Customer Service Reps 100% of calls are recorded

Enrollment Process


Review the plan(s) that you selected

– the selection confirmation letter

will be sent shortly after you enroll.

This letter only confirms that your

applications have been submitted.

Selection Confirmation Letter

Personal Guidance


Navigation

Enrollment

Prescription

changes

Affordability concerns

Late enrollment

Annual plan review

The plans you select continue on year to

year. No need to re-enroll in the fall

unless you want to make a plan change.

An Ongoing Advocate


Next Steps

What You Need To Do: Action Required!


Make sure you have your

Medicare card when you call

Contact OneExchange

1-866-356-9550 Call now to complete your profile and schedule

an enrollment appointment

You will need your Medicare card, prescription

list, and doctor and hospital information

Make an appointment to enroll

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Frequently Asked Questions (FAQ)

Frequently Asked Questions Q: Will I be refused coverage due to a pre-existing condition?

A: No, you have a guaranteed issue window that is granted due to your

upcoming loss of group coverage through Covance on January 1, 2017.

If you decide to select a Medigap plan during the October 3 – December

30, 2016 enrollment period you cannot be denied coverage due to a pre-

existing condition. If you decide to select a Medicare Advantage plan

they are always guaranteed issue.

Q: Will I pay more? Can my policy be cancelled once I am enrolled because

of my condition? Can my rate be raised for that reason?

A: No, your policy cannot be cancelled once you are enrolled unless you

do not pay your premiums and your rate will not be raised for medical

reasons.

Frequently Asked Questions Q: How often will I be billed? By whom? Can I pay by check?

A: When you enroll in a new plan, you will need to begin making premium

payments to the insurance company in order to maintain your coverage.

Some insurance companies may require the first month’s premium

payment during the application process.

In this case, you should expect to make a payment within a few days of

your enrollment. Please have your billing information ready when you

make your enrollment call to OneExchange.

Most insurance companies give you several billing options for ongoing

payments: direct billing, paid by check each month, Electronic Funds

Transfer from your checking account, or automatic deduction from your

social security check. You can choose to pay monthly, quarterly, or

yearly.

Frequently Asked Questions

Q: I am a snowbird - Do you offer plans that cover me in multiple states ?

A: Medigap plans are accepted by every Medicare-participating provider in the

U.S., with some emergency benefits worldwide. If you travel frequently or

live part of the year out-of-state, these plans may be right for you. Part D

plans provide nationwide coverage from participating pharmacies. Medicare

Advantage plans cover urgent and emergency services nationwide, but

some may not provide nationwide coverage for non-emergency services. If

you live part of the year out-of-state, these plans may not be right for you.

Q: Are there plans that will cover me when I travel domestically or

internationally?

A: Medigap plans are accepted by every Medicare-participating provider in the

U.S., with some emergency benefits worldwide. If you travel frequently or

live part of the year out-of-state, these plans may be right for you. A few

Medicare Advantage plans also have world wide emergency coverage.


Q: If I don’t like the plan that I enrolled in, when can I change?

A: For Medicare Advantage plans, every year there is a Medicare Annual

Enrollment Period during which you may investigate other medical and

drug plans and potentially enroll in a different plan. You will receive

notification from OneExchange of the Medicare Annual Enrollment Period

(e.g. 2016: October 15 - December 7). For Medigap plans, you may

change at any time, but there is the possibility of medical underwriting.

At any time, we encourage you to give us a call and we will explore

available options for you.

Medical underwriting-The process that an insurance company uses to

decide, based on your medical history, whether to take your application

for insurance, whether to add a waiting period for pre-existing conditions

(if your state law allows it), and how much to charge you for that

insurance.


Q: Will my premium rates increase every year? If so, by how much?

A: In general, insurance premiums do increase every year. The increase in

plan cost year-to-year can vary widely. We advise our enrollees to

contact us and compare other plans if you experience rate increases in

the 10-15% range. The national average is 3-4%.


Q: What is the Part A deductible?

A: Part A hospital inpatient

deductible and coinsurance:

You pay:

$1,288 deductible for each benefit

period

Days 1-60: $0 coinsurance for each

benefit period

Days 61-90: $322 coinsurance per

day of each benefit period

Days 91 and beyond: $644

coinsurance per each "lifetime

reserve day" after day 90 for each

benefit period (up to 60 days over

your lifetime)

Beyond lifetime reserve days: all

costs

Q: What is the Part B deductible?

A: Part B outpatient and other

service deductible and

coinsurance

$166 per year

After your deductible is met, you

typically pay 20% of the Medicare-

approved amount for most doctor

services (including most doctor

services while you're a hospital

inpatient), outpatient therapy,

and durable medical equipment.


Q: What is a Part B deductible excess charge?

A: Medicare Part B excess only applies if you go to a physician or medical

facility that does not accept Medicare assignment. Assignment means

that the doctor, provider (medical facility), or supplier agrees (or is

required by law) to accept the Medicare-approved amount as full

payment for covered services. Thus, if you are evaluated by a physician

that does not accept Medicare assignment, then the physician is

allowed to have an “excess charge.” The excess charge is the amount

the physician, supplier or medical facility charges that is above the

amount Medicare has deemed reasonable and customary charges for a

specific procedure or doctor office visit.


Call Now, We Are Ready!

1-866-356-9550

Medicare.oneexchange.com/Covance

Thank you!

helping you prepare for your upcoming benefits changes · a: no, you have a guaranteed issue window...

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