helping you understand medicare open enrollment and your

my.viabenefits.com

Helping You

Understand Medicare Open

Enrollment and

Your Health

Reimbursement

Arrangement (HRA)

© 2020 Willis Towers Watson. All rights reserved.

Fall, 2020

©2020 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

willistowerswatson.com

22

Click on the ‘Red Box w/ Arrow’ to

expand the control panel if it isn’t already

expanded.

The ‘Questions’ drop-down will allow you to

type in your questions; click on

box with diagonal to expand;

this is not a chat box, but a questions box.

Note: we believe we will address about 85%

of your questions directly in this presentation –

in their most effective order for understanding.

Audio Challenges?• Do the ‘Sound Check’ and test your

‘Computer Audio’;

• Toggle between COMPUTER

AUDIO, NO AUDIO and back

* If still unsuccessful, please choose

‘Phone call’ and the # and Dial-In code

is right there

willistowerswatson.com 3© 2020 Willis Towers Watson. All rights reserved.

Today’s Presentation is Available Ongoing

Step1: Open your internet browser and type

my.viabenefits.com/PEBP in the address bar

Step 2: From the landing page, scroll down to

‘The Enrollment Experience’ subheading and click

on the link:

PEBP Retiree Medical Video Presentation

Online –

my.viabenefits

.com/PEBP

Online –

pebp.state.nv.

us


pebp.state.nv.us in the address bar

Step 2: From the landing page go to ‘Plans’,

‘Retiring Before Age 65 and Retiring After Age 65’,

then click on ‘Helpful Links’.

my.viabenefits.com

Helping You

Understand Medicare Open

Enrollment and

Your Health

Reimbursement

Arrangement (HRA)


Fall, 2020



55

Click on the ‘Red Box w/ Arrow’ to

expand the control panel if it isn’t already

expanded.

The ‘Questions’ drop-down will allow you to

type in your questions; click on

box with diagonal to expand;

this is not a chat box, but a questions box.

Note: we believe we will address about 85%

of your questions directly in this presentation –

in their most effective order for understanding.

Audio Challenges?• Do the ‘Sound Check’ and test your

‘Computer Audio’;

• Toggle between COMPUTER

AUDIO, NO AUDIO and back

* If still unsuccessful, please choose

‘Phone call’ and the # and Dial-In code

is right there







on the link:


Online –

my.viabenefits

.com/PEBP

Online –

pebp.state.nv.

us








777

Discussion Topics

Medicare — Plan Types

Via Benefits -- Who We Are

2

1

Via Benefits Enrollment Process

Health Reimbursement Arrangement (HRA)

Questions and Answers

3

4

5



8

8

Who We Are


Experience That Counts When You Need it Most

© 2020 Willis Towers Watson. All rights reserved. 9

Retirees from

hundreds of

employers

2 MIL

The first and

largest private

Medicare

company

#1

Enrollment

Season

15th

Insurance

providers

120+

my.viabenefits.com

Via Benefits

Online Call

10© 2020 Willis Towers Watson. All rights reserved.

Salt Lake City

Dallas

Salt Lake

City

PhoenixDallas

Monday – Friday

5:00am – 6:00pm Pacific

My.ViaBenefits.com/PEBP

24 hours a day/7 days a week TOLL FREE 1- 888-598-7545

my.viabenefits.com 11

Medicare — Plan Types



Plans and Insurers


Medicare Advantage

(Part C)

Medicare Supplement

(Medigap)

Prescription Drug

(Part D)

PLANS

INSURERS

Dental and Vision Plans Available

my.viabenefits.com

Your Supplemental Coverage OptionsMedicare Advantage with Prescription Drug (MAPD)


Medicare Advantage with

Prescription Drug coverage

(Part C)

MAPD

Health

Maintenance

Organization

HMO

Preferred

Provider

Organization

PPO

Hearing Aids

Vision

Dental

& More

Optional Supplemental

Benefits



14

Your Supplemental Coverage Options

Medigap Plans

Medigap

Prescription

Drug Plans

(Part D)

+

my.viabenefits.com

Medicare Supplement Insurance (Medigap)

Lettered policies in 47 states

(Exceptions -Minnesota, Wisconsin and Massachusetts)


Medicare Supplement Insurance (Medigap) Policies

Benefits A B D G K L M N

Medicare Part A coinsurance

and hospital costs100% 100% 100% 100% 100% 100% 100% 100%

Medicare Part B

coinsurance or copayment100% 100% 100% 100% 50% 75% 100% 100%

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

Part A hospice care

coinsurance or copayment100% 100% 100% 100% 50% 75% 100% 100%

Skilled nursing facility care

coinsurance100% 100% 50% 75% 100% 100%

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

Part B deductible

Part B excess charges* 100%

Foreign travel emergency

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

Source: CMSOut-of-Pocket limit

in 2021

*CT, MA, MN, NY, OH, PA, RI, VT $6,220 $3,110

Medicare

First-Eligible

Before 2020

ONLY

C F

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100% 100%

100%

80% 80%



16

Your Supplemental Coverage Options

Medigap Plans

Medigap

Prescription

Drug Plans

(Part D)

+



17

*Spouse/DP must also have a medical plan through Via Benefits in order to elect PEBP dental.

Plan Year 2021 PEBP Dental Plan RatesJuly 1, 2020 – June 30, 2021

State Retiree Non-State Retiree

Retiree only $40.44 $41.67

Retiree + Spouse/DP* $80.87 $83.33

PEBP Dental Option

▪ Medical plan through Via Benefits = option to elect the PEBP dental plan

▪ You will need to fill out an RBECF or log on to your E-PEBP Portal to enroll (or decline)

▪ PEBP Dental coverage will be effective for the entire plan year (July 1-June 30)

▪ Reimbursement will occur automatically, no need to submit a paper claim form

▪ In most cases the dental premium will be deducted from your PERS pension check

▪ No PERS pension check? Pay online or set up automatic payments through your E-PEBP Portal



18

18

Plans and Premiums Examples

Las Vegas, NVClark County89101

my.viabenefits.com

Plans for Clark County


Plan TypeNumber of

Plans

Offered

2021

Monthly

Premium

Insurers

[subject to change]

Medicare Advantage 29 $ 0 - $151

Humana, Aetna,

Senior Care Plus,

UHC, Anthem BCBS,

Cigna, Select Health

Medicare Supplement

(Medigap)24 $85 - $362

Aetna, Humana,

AARP/UHC,

Anthem BCBS

Part D 22 $7 - $95

Aetna,

ExpressScripts,

Humana, WellCare,

Mutual of Omaha,

UHC, Anthem BCBS

*not applicable to retirees with “Access only” coverage

my.viabenefits.com

Ancillary Plans for Clark County

20

Plan TypeNumber of

Plans Offered

2021

Monthly Premium

Insurers

[subject to change]

Vision 5 $6 - $18VSP, UVP,

Humana

Dental 12 $27 - $59

Humana, Ameritas,

MetLife, Cigna,

Guardian,

Renaissance


my.viabenefits.com

Medicare Advantage for Clark County

21

Benefit 2021 Cost

Premium $0

Network PPO

Deductible $0

Doctor Copay $5

Specialist Copay $35

Hospital Days 1 - 5 $295 per day

Emergency Room $90

Rx – DeductiblePreferred Retail Co-Pay Tiers (30 days)

$195 $0 / $10 / $47 / $100 / 29%

Preferred Mail Order Co-Pay Tiers

(90 days)$0 / $0 / $131 / $290


my.viabenefits.com

Medigap Plan F + Prescription Drug Plan

22

Based on a 75 year old male

Benefit 2021 Cost

Premium $208 ($201 Medical + $7 PDP)

Network Not Applicable

Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0


$445 (Except Tier 1)$0 / $19 / $46 / 49% / 25%


(90 days)$0 / $57 / $138 / 49%


my.viabenefits.com

Medigap Plan G + Prescription Drug Plan

23


Benefit 2021 Cost



Deductible $198 (2020)

Doctor Copay $0 $175 < $201

Specialist Copay $0

Hospital $0

Emergency Room $0


$0 $0 / $4 / $40 / 37% / 25%


(90 days)$0 / $10 / $100 / 37%




24

24


Carson City, NV89701

my.viabenefits.com

Plans for Carson City


Plan TypeNumber of

Plans

Offered

2021

Monthly

Premium

Insurers

[subject to change]

Medicare Advantage 9 $ 0 - $180Aetna,

Senior Care Plus

Medicare Supplement

(Medigap)24 $69 - $323

Aetna, Humana,

AARP/UHC,

Anthem BCBS

Part D 22 $7 - $95

Aetna,

ExpressScripts,

Humana, WellCare,

Mutual of Omaha,

UHC, Anthem BCBS


my.viabenefits.com

Ancillary Plans for Carson City

26

Plan TypeNumber of

Plans Offered

2021

Monthly Premium

Insurers

[subject to change]

Vision 4 $6 - $18 VSP, UVP

Dental 10 $32 - $64

Humana, Ameritas,

MetLife, Cigna,

Guardian,

Renaissance


my.viabenefits.com

Medicare Advantage for Carson City

27

Benefit 2021 Cost

Premium $0

Network HMO

Deductible $0

Doctor Copay $0



Emergency Room $120


$195 $5 / $12 / $41 / $94 / 33%


(90 days)$10 / $24 / $82 / $188


my.viabenefits.com


28


Benefit 2021 Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0


$445 (Except Tier 1)$0 / $19 / $46 / 49% / 25%


(90 days)$0 / $57 / $138 / 49%


my.viabenefits.com


29


Benefit 2021 Cost





Specialist Copay $0

Hospital $0

Emergency Room $0


$0 $0 / $4 / $40 / 37% / 25%


(90 days)$0 / $10 / $100 / 37%




30

30


Reno, NVWashoe County89512

my.viabenefits.com

Plans for Washoe County


Plan TypeNumber of

Plans

Offered

2021

Monthly

Premium

Insurers

[subject to change]

Medicare Advantage 16 $ 0 - $180

Aetna, Humana,

Anthem BCBS, UHC,

Senior Care Plus

Medicare Supplement

(Medigap)24 $69 - $323

Aetna, Humana,

AARP/UHC,

Anthem BCBS

Part D 22 $7 - $95

Aetna,

ExpressScripts,

Humana, WellCare,

Mutual of Omaha,

UHC, Anthem BCBS


my.viabenefits.com

Ancillary Plans for Washoe County

32

Plan TypeNumber of

Plans Offered

2021

Monthly Premium

Insurers

[subject to change]

Vision 4 $6 - $18 VSP, UVP

Dental 10 $32 - $64

Humana, Ameritas,

MetLife, Cigna,

Guardian,

Renaissance


my.viabenefits.com

Medicare Advantage for Washoe County

33

Benefit 2021 Cost

Premium $0

Network HMO

Deductible $0

Doctor Copay $0 - $10



Emergency Room $120


$0 $5 / $12 / $41 / $94 / 33%


(90 days)$10 / $24 / $82 / $188


my.viabenefits.com


34


Benefit 2021 Cost



Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0


$445 (Except Tier 1)$0 / $19 / $46 / 49% / 25%


(90 days)$0 / $57 / $138 / 49%


my.viabenefits.com


35


Benefit 2021 Cost





Specialist Copay $0

Hospital $0

Emergency Room $0


$0 $0 / $4 / $40 / 37% / 25%


(90 days)$0 / $10 / $100 / 37%




36

“Welcome to Medicare” Visit and Yearly “Wellness” Visits

During the first 12 months that you have Part B, you can get a “Welcome to Medicare” preventive visit.

This visit includes:

▪ A review of your medical and social history related to your health

▪ Education and counseling about preventive services, such as certain screenings, shots, and referrals for other care

▪ Every 12 months thereafter, you may

▪ schedule a Wellness Visit.

When you make your appointment, let your doctor’s office know that

you’d like to schedule your “Welcome to Medicare” or Yearly “Wellness”

preventive visit.

IMPORTANT! Do not call it a physical or it will not be covered as a

preventive benefit.



37

Medicare App

my.viabenefits.com

Prescription Drugs — 5 Tiers of Co-Pays


Tier 5 – Specialty drugs

Tier 1 – Preferred generic

Tier 2 – Non-preferred generic

Tier 3 – Preferred brand

Tier 4 – Non-preferred brand


Medicare Prescription Drug Coverage 2021


39

$3.70 for Generics

$9.20 for Brand Name

or 5% coinsurance

(whichever is greater)

25% for Brand Name

25% for Generics

Beneficiary Pays

$0-445

$4130

$6550

Total Cost

Full retail until

deductible is met

Copays for your plan

coverage

70% manufacturer

discounts count

towards TrOOP

Coverage Gap

(only 25% will reach)

Deductible

Initial Coverage

Catastrophic Coverage

(only 4% will reach)


Working with

Via Benefits


my.viabenefits.com

Via Benefits Online Easy to use, helps you understand your options, 24 hour availability


Your time is important. Take these steps online to maximize your time.

my.viabenefits.com 42© 2020 Willis Towers Watson. All rights reserved.

Create an online account. Add the following information to help narrow your

options when you shop online.

Your personal information: name, email,

address, and telephone number

Your prescription drugs details:

name, dosage, and frequency for

each medication

Your essential doctors – to be

included in network plans, like

Medicare Advantage

Your Medicare ID number (MICN) –

found on your Medicare card right

below your name


Schedule an Appointment


Online Call

2021 Medicare Open Enrollment Period

October 15 – December 7, 2020

my.viabenefits.com/PEBP

24 hours a day/7 days a week

Monday – Friday

5:00am – 6:00pm Pacific

TOLL FREE 1-888-598-7545


Shop & Compare allows you to view Medicare plans available in your area


▪ Sort plans

▪ Compare plans side by side




And if the Medicare Advantage plan offers Optional Benefits, you can clearly see

it in the results.


▪ Optional Supplemental

Benefits are offered for some

Medicare Advantage plans






Refine your choices with Help Me Choose



View plan options with

24 hours a day/7 days a week

access

For Placement Only


Target drug plans which cover your prescriptions



Enter your prescriptions

▪ Name

▪ Dosage

▪ Frequency

Discover the Part D plans which

cover your prescriptions and

estimate your annual out-of-

pocket costs by entering in the

prescription drugs you currently

take

Prescription Check




Fast, secure, easy


Can’t Enroll Online?

Call us and we’ll take it

from there!

TOLL FREE

1- 888-598-7545

Note: Plans and rates for

2021 are available in early

October 2020 – NOW!


Available 24 hours a day/7 days a week



my.viabenefits.com 49© 2020 Willis Towers Watson. All rights reserved.

Help & Support

Advocacy All Year Long

Shop & Compare

Prescription Checkup

Help Me Choose

Your plans will automatically renew

from year to year. No need to re-enroll

unless you want to make a change.

Online Help & Support

TOLL FREE

1-888-598-7545

During business hours

We’re here to assist you

when you need it



50

Medicare Open Enrollment Period (OEP)

Medicare OEP is different than PEBP’s

Open Enrollment which normally occurs in

May for a July 1st effective date.

Medicare Advantage OEP

▪ January 1 – March 31

▪ Provides an additional safeguard to

participants that feel they enrolled in

the wrong Medicare Advantage

(MA/MAPD) plan

▪ The following changes are allowed

during this time:

▪ Switch from current MA/MAPD

plan to a new MA/MAPD plan

▪ Disenroll from their current

MA/MAPD plan, and return to

original Medicare and enroll into a

stand-alone Prescription drug

plan

▪ This MA/MAPD OEP will not help those

that did not enroll/missed their Special

Enrollment Period (SEP) deadline

Medicare Open Enrollment Period (OEP)

▪ October 15 to December 7

▪ Provides an opportunity to change health

plan and prescription drug coverage.

▪ Changes made during OEP will become

effective January 1.

▪ If you want to make ANY changes to your

coverage, you MUST make your

changes through Via Benefits.

▪ Making changes outside of Via Benefits

will cause you to forfeit your monthly

HRA contribution, Basic Life Insurance

and PEBP dental (if applicable).

willistowerswatson.com 51

Health

Reimbursement

Arrangement (HRA)


my.viabenefits.com

Health Reimbursement Arrangement (HRA)

5252

If you are eligible

and qualify

PEBP will make a

MONTHLY

contribution to a

Health Reimbursement

(HRA) Arrangement

Tax-free

account

Used to reimburse you

for eligible health care

expenses – you pay first

and then get reimbursed

You may use

Funding to reimburse

yourself and your spouse

for eligible medical,

prescription drug, dental,

vision, Medicare Part B

premiums, as well as

eligible out-of-pocket

healthcare expenses*


▪ Unused HRA funds are available in future years

▪ Effective May 31, 2021, the available balance for the

HRA will be capped at $8,000. You can accrue more

than $8,000 throughout the plan year, however any

balances over $8,000 will be reduced to the $8,000

cap on May 31 of each year going forward.

*Subject to 365-day rolling

reimbursement request

submission deadline from the

date the service was incurred

my.viabenefits.com

Eligible Expenses

Common Eligible Expenses for Reimbursement*

53© 2020 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only.

Premiums

▪ Medicare Medical

▪ Prescription

▪ Dental

▪ Vision

▪ Medicare Part B

Most Common Expenses

▪ Office Visit Copays

▪ Physician Service Copays

▪ Prescription Copays

▪ Deductibles

▪ Co-Insurance

▪ Dental Treatments

▪ Eye Exams

▪ Eyeglasses

Other Eligible Expenses

▪ Artificial Limbs and Teeth

▪ Ambulance Hire

▪ Chiropractor

▪ Contact Lenses

▪ Hearing Aids and Batteries

▪ Immunizations

▪ Laboratory Fees

▪ Medical Supplies and Equipment

▪ Oral Surgery

▪ Osteopath

▪ Psychiatrist

▪ Stop Smoking Programs

▪ Vaccines

▪ Wheelchair

▪ X-Rays

*Note – this is not an all inclusive list of eligible expenses.

The fastest, most secure way to receive your reimbursement

Direct Deposit Set Up Options

▪ Fax

▪ Online (and Mobile App)

▪ Mail

Direct Deposit Authorization Forms

available by calling Via Benefits at

TOLL FREE 1-888-598-7545

Direct Deposit

©2018 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson and Willis Towers Watson client use only. 55willistowerswatson.com

▪ You pay your requested expense first

▪ Attach required documentation one time

▪ Available for premiums/Medicare Part B

premium expenses

▪ Submit via fax, mail, or online

▪ Enroll in a participating plan on Via

Benefits and activate functionality

▪ Pay premiums as required

▪ Available for plan premiums only

1

2

3

Auto-Reimbursement

Recurring Premium

Reimbursement


▪ One time request for all eligibleexpenses

▪ Attach required documentation


One-Time (Manual)

Reimbursement Request

Reimbursement Method

▪ Enroll in a participating plan on Via Benefits

and activate functionality

▪ Pay premiums as required

▪ Available for plan premiums onlyAuto-Reimbursement

▪ Call Via Benefits at 1-888-598-7545 to activate after receiving Funding Account

Welcome packet or you may activate on your account online or app

▪ Can take 6 weeks to receive first AR reimbursement

▪ May also be some delay January – March each year and when you enroll in a new plan

▪ Works for premium reimbursements only

▪ Available on most plans

▪ No paper forms required

▪ If you need your reimbursement sooner, you may simply fill out a one-time reimbursement

form

Option 1: Automatic Reimbursement (AR)

for Plan Premiums


Health Reimbursement Account

57

Automatic Monthly Premium Reimbursement

Up to the amount available in your HRA

YOU Your Bank

Reimburse (Direct Deposit or Check)

Insurance Provider

Set Up Automatic Withdrawal

Receipt of Payment

Premium



▪ Attach required documentation one time

▪ Available for premiums/Medicare Part B

premium expenses


Recurring Premium Reimbursement

▪ No longer requires separate Recurring Reimbursement

form. The Reimbursement Request Form will be used

▪ Can be used for Monthly plan premiums (i.e. vision) or

Medicare Part B premiums

▪ Submit once for the entire year or if premium

changes for any reason

May be submitted:

▪ Online

▪ Mobile App

▪ Fax

▪ Mail

▪ Submit with required supporting documentation

Option 2: Recurring Premium Reimbursement

All Recurring Premium Reimbursement

Request expire on 12/31 each year



59

Part B Premium Deducted From Social Security Pension

Recurring Reimbursement for Part B Premium

Appropriate supporting documentation:

▪ Social Security Benefit Awards Letter

or

▪ CMS Invoice for Medicare Part B

▪ Used for “one-time” expenses like Physician

coinsurance or copays, prescription copays,

prescription eyeglasses, etc.

▪ Complete all key data such as the date of

service, amount of reimbursement request,

type of service

▪ Submit with supporting documentation

▪ May be submitted:

▪ Online

▪ Mobile App

▪ Fax

▪ Mail


▪ One time request for all eligibleexpenses

▪ Attach required documentation


One-Time (Manual)

Reimbursement Request

Option 3: One-Time Reimbursement Request Form

Request additional forms by calling Via

Benefits at 1-888-598-7545 or online:

My.ViaBenefits.com/PEBP


Health Reimbursement Account

61

Manual Reimbursement


YOU

YOUR INSURANCE COMPANY

Receipt of

Payment

You may be reimbursed

up to the amount

available in the HRA!

HRA

YOUR INSURANCE COMPANY

Receipt of

Payment

YOU

▪ All expenses are subject to a 365-day rolling reimbursement

request submission deadline from the date the service was

incurred for the expense to be considered eligible

▪ Claims submitted after the 365-day rolling reimbursement

request submission deadline incurrence period will be

automatically denied.

Timely Filing of HRA Reimbursement Claims

my.viabenefits.com

Maximize Your Account

▪ Sign onto your online account

▪ Set up Direct Deposit

▪ Automate your reimbursements

▪ Go paperless

Sign in, Set Up, and Automate


my.viabenefits.com

Via Benefits Mobile App

With the mobile app, you can

▪ Check reimbursement status

▪ Check available balance

▪ Submit new reimbursement requests

▪ Take a picture and attach documents to

your reimbursement requests

All from your smartphone or tablet

▪ Available for iOS and Android

HRA Management on the go




65

Call the Customer Service Center if you

need help with the following:

▪ Available balance inquiries

▪ Auto-reimbursement process

▪ How to navigate the Via Benefits

website

▪ Inquiries related to Medicare Part B

Premiums

▪ Payment status, setting up Direct

Deposit

▪ Questions about a denied claim

HRA Assistance

Telephone assistance is always available through the Via Benefits Customer Service Center by calling 1-888-598-7545 Monday through Friday, 5:00 AM until 6:00 PM Pacific Time

If you have an escalation that has

not been resolved after speaking with

Customer Service you can set up an

appointment with an HRA Specialist

by calling 1-844-266-1395.

▪ Have you received some mail that is confusing?

▪ Are you moving?

▪ Is your current coverage being discontinued?

▪ Do you have questions about your HRA?

Be sure to call Via Benefits

Monday through Friday,

5:00 AM until 6:00 PM Pacific Time

1-888-598-7545

Medical Plan Enrollment is Required to Receive

Via Benefits HRA Funding

IMPORTANT: In order to maintain your PEBP benefits,

HRA funding qualification, Basic Life insurance and

PEBP Dental Plan (if applicable), you MUST STAY

enrolled in a medical plan with Via Benefits.



67

Contact InformationPublic Employees’ Benefits Program901 S. Stewart St. Suite 1001 Carson City, NV 89701 775-684-7000 or 1-800-326-5496

NEW – Find all important information as well as send us a secure message by logging on to your E-PEBP Portalwww.pebp.state.nv.us

Social Security Administration 1-800-772-1213 www.ssa.gov

Via Benefits1-888-598-7545www.My.ViaBenefits.com/PEBP


Go online now!


Or call us at 1-888-598-7545

Thank You!








on the link:


Online –

my.viabenefits

.com/PEBP

Online –

pebp.state.nv.

us






helping you understand medicare open enrollment and your

Documents