your retiree health care coverage is changing: important · pdf fileconfidential | 2 •...
TRANSCRIPT
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1 CONFIDENTIAL |
Your Retiree Health Care Coverage Is Changing: Important Information!
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2 CONFIDENTIAL |
• Reed Elsevier will no longer offer group retiree health care
coverage to retirees and their dependents, age 65 and
older
• You must take action and enroll in new coverage by April
30, 2013 to have continuous coverage on May 1, 2013
• RE has partnered with Extend Health – not an insurance
company – to help retirees understand, evaluate and
choose the best plan
Danielle Shanes, VP Reed Elsevier US Benefits
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3 CONFIDENTIAL |
• Predicability: Achieves more predictability in company
costs ... And costs to you.
• Competitive marketplace: You get the opportunity to take
advantage of evolving retiree health care marketplace.
• Choice: You get more options that better meet unique
health care and financial situations.
• Expertise: Extend Health is in the business of helping
retirees select and enroll in coverage that meets their
needs – Reed Elsevier is not.
• Resources and Support: Personal retiree benefits
advisors, ongoing help and advice.
Why Is Reed Elsevier Making This Change?
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4 CONFIDENTIAL |
How This Affects You
• Your costs may change, depending on what coverage you
choose.
• Your monthly premium will be paid directly to the insurance
company you select
• Advisors will help you understand your coverage –
networks, premiums, co-payments, deductibles and any
other costs.
• Decision-making information, tools and a website, as well
as advocacy support, are available to you.
• Extend Health will help you enroll in a plan by April 30,
2013 that meets your medical and prescription drug needs.
• Extend Health will help you establish your Health
Reimbursement Account
Coverage
costs
Enrolling in
coverage
Deciding on
coverage
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5 CONFIDENTIAL |
Introducing Extend Health The Industry’s Largest Medicare Exchange
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6 CONFIDENTIAL |
• Independent company
• Partner with 80+ health plan carriers
• Objective and Trusted US based benefit
advisors
• Focused on helping each participant make an
informed and confident decision
Who is Extend Health?
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7 CONFIDENTIAL |
Why Extend Health
• We are experienced in helping people just
like you
• Our services are at no cost to you
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8 CONFIDENTIAL |
A Sample of Other Clients
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9 CONFIDENTIAL |
Plans & Partners
All Medicare Plan Types
• Medicare Advantage
• Medigap (supplement)
• Prescription Drug (Part D)
Vision
Dental
Select Carriers
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10 CONFIDENTIAL |
Educate
Evaluate/Enroll
Manage
The Process
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11 CONFIDENTIAL |
• Prepare you for
enrollment discussion
• Review Medicare basics
• Pre-existing conditions will not
limit your plan selection*
• Give us a call: 1-888-724-5575
• www.ExtendHealth.com/
reedelsevier
* except end-stage renal disease
Education Enrollment Guide
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12 CONFIDENTIAL |
Decision Support Tools
• Help Me
Choose
• Prescription
Profiler
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13 CONFIDENTIAL |
Licensed Benefit Advisor
• 100% domestic workforce
• Objective advocacy
• Neutral compensation
• Extend University
• Licensed, certified, appointed
• Average age 41
Hours of Operation
Monday – Friday
8 a.m. – 9 p.m.
Eastern Time
Evaluate and Enroll
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14 CONFIDENTIAL |
Enrollment Process
• Benefit Advisors can discuss coverage options with anyone – need to speak to the participant to complete the enrollment.
• Once you have made a coverage selection, enrollment is conducted via telephone.
• 100% of calls are recorded.
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15 CONFIDENTIAL |
Medicare and You
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16 CONFIDENTIAL |
Your Future Coverage
Primary Coverage
Medicare A & B
Additional Coverage (Your Choice)
Medicare Advantage with
Prescription Drug (MAPD)
Medigap + Prescription Drug
Optional Coverage (your choice)
Dental and Vision
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17 CONFIDENTIAL |
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18 CONFIDENTIAL |
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19 CONFIDENTIAL |
Initial Coverage You pay
Deductible and co-pays for your plan
Coverage for the first $2970 in actual cost of meds
Coverage Gap – Donut Hole You pay
47.5% of brand drugs and 79% of generics
until out of pocket costs reach $4750
Catastrophic Coverage You pay
$2.65 for generics and $6.50 for brand
or 5% whichever is greater
Medicare Prescription Drug Coverage
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20 CONFIDENTIAL |
Auto-Reimbursement
How the Process Works
Health Reimbursement Arrangement
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21 CONFIDENTIAL |
What Is An HRA?
• Tax-advantaged account used to reimburse you for eligible health care expenses
• You must meet Reed Elsevier’s eligibility requirements to qualify for HRA
• Your HRA funds will be available May 1, 2013
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22 CONFIDENTIAL |
Reed Elsevier
allocates
benefit dollars
to HRA
account of
eligible
participant
Participant
HRA
Account
Administered by
Extend Health
Participant works
through Extend
Health to enroll in
individual coverage
Participant is
reimbursed for
healthcare
expenses using
HRA benefit
dollars
Health Reimbursement
Arrangement: How It Works
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23 CONFIDENTIAL |
How to File a Paper Claim
Participant pays plan premium or
co-pays
Participant fills out claim form, attaches required information
Extend Health verifies receipt of
payment and eligibility
Extend Health reimburses customer
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24 CONFIDENTIAL |
Extend Health HRA Claim Form
Remember,
You can be
Reimbursed for
Part B by sending
in your statement
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25 CONFIDENTIAL |
How Auto-Reimbursement Works
Participant pays plan premium to
insurance company
Insurance company forwards receipt of payment to Extend
Health
Extend Health verifies receipt of
payment and eligibility
Extend Health reimburses participant
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26 CONFIDENTIAL |
• Auto-Reimbursement (AR) is a service offered by Extend
Health
• Auto-reimbursement only applies to premiums paid, not
expenses
• Auto-reimbursement is NOT available on all plans
• Forms and instructions provided in the HRA Welcome Kit
What is Auto-Reimbursement?
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27 CONFIDENTIAL |
Next Steps
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28 CONFIDENTIAL |
Next Steps
Review “Getting Started Guide”
Gather Medicare Prescriptions and Doctor information
Call Extend Health:
(888)724-5575
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29 CONFIDENTIAL |
Post Enrollment Customer Service
Advocacy and support services • Toll Free number to contact Extend Health
representative
• Direct support for claims issues, appeals and
network questions
• Renewal process – ability to pick new coverage for
future years – not locked into this year’s choice
• Ongoing enrollment services
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30 CONFIDENTIAL |
Questions