AGE IN PRESENTATION 775-684-7000 PLAN YEAR 2021 or 1-800-326-5496 - - PowerPoint PPT Presentation

PRE - MEDICARE AGE IN PRESENTATION

PLAN YEAR 2021 July 1, 2020 – June 30, 2021

775-684-7000

• r 1-800-326-5496

www.pebp.state.nv.us

Today’s Topics

❔ PEBP and Via Benefits Forms Enrollment Options Who is Via Benefits CDHP HRA vs Via Benefits HRA How the Via Benefits HRA Works Importance of Maintaining Enrollment through Via Benefits PEBP’s Medicare Requirements PEBP Dental Plan Option

Approximately 2 months* before your 65th birthday, PEBP will mail you:

• Happy Birthday Letter
• PEBP and Medicare Guide

(Also available interactively online)

• Retiree Benefit Enrollment

and Change Form (RBECF)

* If not received about 6 weeks prior to your birthday month please call PEBP Member Services to be sure it is on its way

Retiree Benefit Enrollment and Change Form (RBECF)

RBECFs must be filled out and mailed or hand delivered to PEBP as they are barcoded. No faxes or emails will be accepted.

Medicare Effective Date

It’s as easy as 1-2-3 (4-5)

Contact the Social Security Administration and enroll in Medicare Part A (as eligible) and purchase Medicare Part B Mail or walk in a copy of your Medicare card to the PEBP Office. Mail PEBP the original signed RBECF Call Via Benefits to schedule an appointment and set up your online profile Call Via Benefits and complete your medical plan enrollment Wait for your funding packet to arrive from Via Benefits

(this can take between 8-12 weeks from your effective date)

Step 1

Enroll in Medicare PEBP’s Medicare Requirements

Premium-Free Medicare Part A

Everyone age 65 or older can purchase Medicare Part B

You are under age 65 and approved for Social Security Disability Benefits You are eligible for Railroad Retirement Benefits You or your spouse (or former spouse

• f 10 years) have at least 40 credits

(10 years) of work in any job in which you paid Social Security taxes

💹

OR OR

Please call the Social Security Administration (SSA) to verify your Medicare Eligibility

1-800-772-1213

Social Security

01-01-2021 01-01-2021

PEBP’s Medicare Requirements

• Medicare A+B card
• Military identification card (front and back)
• Not required to enroll in Medicare

until 60-90 days prior to retirement

• PEBP Medicare requirements apply to

covered spouses and domestic partners

• Enroll in premium-free Medicare

Part A as eligible per Social Security (SSA) guidelines

• Must purchase Medicare

Part B from SSA

ACTIVE EMPLOYEE SPOUSE/DP CURRENTLY RETIRED Approaching 65th birthday NEWLY RETIRING AFTER AGE 65 (60-90 days prior to retirement) CURRENTLY RETIRED Under 65 and approved for Social Security Disability benefits (after 24 month waiting period) TRICARE

Step 2

PEBP Enrollment Options Sending In Your Paperwork

Not required to enroll at Via Benefits

Copy of Medicare A+B card and Military ID (front and back) to PEBP

Mail RBECF to elect or decline dental

TRICARE for Life

Thank you for your service!

Medicare A+B and TRICARE for Life

Not required to enroll in Medicare

If Medicare is

• btained, submit

copy of card to PEBP

CDHP HSA will become HRA (if applicable)

Active Employee

Active Not yet Retiring

Must enroll at Via Benefits Copy of Medicare A+B card to PEBP Mail RBECF to elect or decline dental Newly retiring? Enroll in Medicare A+B 60-90 days prior to retirement

Medicare A+B

No Covered Dependents

• r

Participant and Dependent both have Medicare

Retiree may stay

• n PEBP PPO,

EPO, or HMO with dependents Retiree may enroll at Via Benefits

Unsubsidized dependent(s) may stay on PEBP or terminate coverage Be sure to:

• Send a copy of Medicare

A+B card to PEBP

• Mail RBECF to elect or

decline dental

OR OR

Covering Dependents

Medicare A+B Covering Non-Medicare Dependent

• r

Non-Medicare Participant Covering Medicare Participant

Monthly premium reduced by $135.50 after receipt of Medicare Part B card

May remain on PPO, EPO, HMO

MUST purchase Medicare Part B

Obtain Social Security Eligibility Letter - lack

• f credits

Complete RBECF submit all documents to PEBP

No Medicare Part A

NOT Eligible for free Part A

PEBP Dental Option

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

Monthly PY21 PEBP Dental Plan Rates

July 1, 2020 – June 30, 2021

State Retiree Non-State Retiree

Retiree only

$40.44 $41.67

Retiree + Spouse/DP*

$80.87 $83.33

• Via Benefits medical plan = option to elect PEBP dental
• Mail in RBECF to enroll (or decline) in PEBP dental
• Dental coverage effective for the entire plan year
• Automatic reimbursement, no paper claim required
• Monthly dental premium will be deducted from your PERS pension
• No PERS pension? Pay online or set up automatic payments through your E-PEBP Portal

Review

YOU’VE ALREADY:

✓Enrolled in Medicare A+B (Original Medicare) through Social

Security, as eligible └›Medicare A provides about 80% hospital coverage and Medicare B

provides about 80% medical coverage Medicare will be your primary coverage

✓ Provided proof of your Medicare enrollment by sending a copy of

your Medicare A+B card to PEBP

✓ Mailed your RBECF to elect or decline PEBP dental and changed

your status to “Medicare Eligible”

What to Do Next

Prepare

• Read all material PEBP mails you, two months prior to your 65th birthday.

Develop an idea of what medical and pharmacy plan you would like to select

Call

• Call Via Benefits at 1-888-598-7545 to schedule and appointment with a

certified licensed benefit advisor

Enroll

• Complete enrollment by calling and speaking to a licensed benefit advisor

Wait

• Via Benefits will now manage your new plan and funding account.

Wait 8-12 weeks for your funding packet to arrive from Via Benefits

Steps 3 and 4

Who is Via Benefits? Your Future Coverage

Who is

120+ Insurance Companies 15th Year of Service 1.9 Million Retirees from 680+ employers Licensed Advisors provide guidance and

• ngoing advocacy

9 out of 10 Retirees reported they would work with Via Benefits again

First and largest private Medicare Market Exchange Company Personalized options with plans from a nationwide network Never any fees for services

Via Benefits Process

Consultative Process

• A Licensed Benefit Advisor will assist you and recommend

plans that meet your needs and fit your budget

Simplified Selection

• Advisors will explain the details of

coverage and answer your questions

Effortless Enrollment

• The insurance enrollment forms will be

completed over the phone

Ongoing Advocacy

• Dedicated specialist are a phone call away to

help you with your new healthcare coverage

Want more information? Contact Via Benefits at 1-888-598-7545

https://My.ViaBenefits.com/PEBP 24/7 access to your information

When to Call Via Benefits

Via Benefits is Your Ongoing Advocate

Navigation Update personal information Questions and concerns Affordability concerns Billing Issues Carrier and provider issues HRA reimbursement issues Annual plan review

The plans run Jan-Dec. No need to re-enroll during fall open enrollment unless you want to make a plan change 1-888-598-7545

Medicare Options

Medicare Advantage Plan with Prescription Drug vs Medigap + Prescription Drug

Your Future Coverage

Primary Coverage Medicare A and B How Medicare Coverage Works

Medicare Advantage with Prescription Drug Coverage (MAPD)

25

PPO HMO

Medicare Advantage plans are generally network based plans.

Medicare Supplement Insurance

+

Part D Prescription Drug Plan (PDP)

Medigap

Prescription Drug Plans (Part D)

+

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

Benefits A B D 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% Medicare Part B coinsurance or copayment 100% 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 copayment 100% 100% 100% 100% 50% 75% 100% 100% Skilled nursing facility care coinsurance 100% 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: CMS Out-of-Pocket limit in 2021 $5,880 $2,940

Medicare Supplement Insurance (Medigap): Lettered Policies

Please discuss all of your options with a Licensed Benefit Advisor

• If you choose Plan G, this means you must pay for Medicare-covered cost (coinsurance, copayments, and deductibles) up to the deductible amount of $2,340 in 2020 before your policy pays anything
• For plans K and L after you meet your out-of-pocket yearly limit and your yearly Part B deductible ($196 in 2020), the Medigap plan pays 100% of covered services for the rest of the calendar year.
• Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in inpatient admission.

• Medicare Open Enrollment* provides an opportunity to change

health plans and/or prescription drug coverage. Information for Open Enrollment is normally made available in October.

• Changes made during the Medicare Open Enrollment

period will become effective January 1.

• If you want to make ANY changes to your coverage,

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, PEBP dental and any voluntary products (if applicable).

*Medicare Open Enrollment is different than PEBP’s Open Enrollment

Medicare Open Enrollment October 15 to December 7

1-888-598-7545

Benefits advisors are available Monday through Friday, 5:00 AM until 6:00 PM Pacific Time 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.

Step 5

Funding and Health Reimbursement Arrangements (HRA)

What is a Heath Reimbursement Arrangement (HRA)?

30

Your HRA funding will be available within 8-12 weeks and monthly thereafter Unused funds DO roll over*

*Subject to 365-day rolling reimbursement request submission deadline

If you are eligible, PEBP will make a monthly contribution to a Health Reimbursement Account (HRA) Tax-free account Pay first and then you get reimbursed

You may use HRA funding to reimburse yourself for eligible medical, prescription drug, dental, vision, and Medicare Part B premiums, as well as eligible

• ut-of-pocket healthcare expenses

Via Benefits HRA vs Consumer Driven Health Plan HRA

PEBP offers two types of HRAs: Consumer Driven Health Plan (CDHP/PPO)

• Funded on an annual basis on July 1st
• Funded according to participant tier: $700 retiree

and $200 per covered dependent (maximum 3)

• Once transitioned to Via Benefits, remaining

funds are no longer available

Via Benefits HRA

• Funded on a monthly basis
• Funded according to the retirees’ years
• f service (5-20 YOS) and retirement date
• Funds capped at $8,000 starting May 31, 2021

➢ You will not get to keep the

CDHP HRA when you enroll through Via Benefits

➢ Any HRA money left on the

HealthSCOPE Visa debit card will revert back to the State

How is my HRA Funded?

Effective July 1, 2020

PY 2020 HRA Contribution

Years of Service Contribution

10 $130 11 $143 12 $156 13 $169 14 $182 15 $195

PY 2020 HRA Contribution

Years of Service Contribution

16 $208 17 $221 18 $234 19 $247 20 $260

PY 2020 HRA Contribution

Years of Service Contribution

5 $65 6 $78 7 $91 8 $104 9 $117

✓ PEBP will automatically establish your Exchange-HRA once you have enrolled in a qualified medical plan through Via Benefits ✓ Once established, you will receive the Via Benefits-HRA funding kit with information on how to use the Exchange-HRA ✓ The kit will include claim forms and a direct deposit form and will normally arrive within 8-12 weeks from your effective date ✓ Medicare Exchange HRA balances will be capped at $8,000 on May 31, 2021. Although members can accrue more than $8,000 throughout the plan year, any balances over $8,000 will be reduced to the $8,000 cap on May 31, 2021

▪ Pay for your expenses ▪ Important Documents ▪ Submit for Reimbursement ▪ Website and your Online Account ▪ Automate your Premium Payment ▪ PEBP Dental is Automatically Reimbursed ▪ Understand your Explanation of Payment Statement ▪ You must submit all claims to Via Benefits within one year from date of service ▪ Initial Funding Packet may take between 8-12 weeks from your effective date to be received

Managing your Reimbursement Funds

• You pay your requested expense first
• Fill out required Via Benefits Claim Form
• Premiums and Medicare Part B premium

Reimbursement Options

• Enroll in a participating plan
• Available for plan premiums only
• You pay your premium to carrier directly first
• Ask Via Benefits to turn on auto-reimbursement

Auto-Reimbursement Recurring Premium Reimbursement

• Fill out paper form to request reimbursement

for all eligible expense types

• Attach required documentation
• Submit via fax, mail, or online

One-Time (Manual) Reimbursement Request

  

Step 2

How Option #1 Works

St Step 2 St Step 3 St Step 4 St Step 1

Participant pays plan premium directly to insurance company

Via Benefits reimburses participant via check or direct deposit up to allowed monthly amount

Via Benefits verifies receipt

• f payment and eligibility

Insurance company forwards receipt of payment to Via Benefits

Automatic Reimbursement

• Phone
• Fax
• Online
• Mail

Direct Deposit Authorization Forms available at www.My.ViaBenefits.com/PEBP

Direct Deposit

Onsite HRA Assistance

A Via Benefits HRA Specialist will be available one week per month to assist participants with:

Call 1-844-266-1395 to set up an individual appointment regarding your HRA

• What supporting documents are required to request reimbursement
• Recurring claims, including Medicare Part B Premiums
• How to read the Explanation of Payment (EOP)
• How to navigate the Via Benefits website
• One-time reimbursement requests
• Auto-reimbursement process
• Available balance inquiries

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

Check the calendar of events

• n the PEBP website for

specific dates and locations

Medical Plan Enrollment is Required to Receive Via Benefits HRA Funding

• Received mail that seems confusing?
• Is your coverage being discontinued?
• Have questions about your HRA?
• Moving?

Enrollment is Required

Be sure to call Via Benefits!! 1-888-598-7545

IMPORTANT: In order to maintain your PEBP benefits, HRA, Basic Life insurance, PEBP dental, and any voluntary products (if applicable), you MUST STAY enrolled in a medical plan with Via Benefits.

Summary

Contact the Social Security Administration and enroll in Medicare Part A (as eligible) and purchase Medicare Part B Mail or walk in a copy of your Medicare card to the PEBP Office. Mail PEBP the original signed RBECF Call Via Benefits to schedule an appointment and set up your online profile Call Via Benefits and complete your medical plan enrollment Wait for your funding packet to arrive from Via Benefits

(this can take between 8-12 weeks from your effective date)

Contact Information

Public Employees’ Benefits Program 901 S. Stewart St. Suite 1001 Carson City, NV 89701 775-684-7000 or 1-800-326-5496 E-PEBP Portal– Find all important information as well as send us a secure message by logging on to your portal www.pebp.state.nv.us Social Security Administration 1-800-772-1213 www.ssa.gov Via Benefits (toll free) 1-888-598-7545 https://My.ViaBenefits.com/PEBP

Thank you!