PRE - MEDICARE AGE IN PRESENTATION 775-684-7000 PLAN YEAR 2021 or 1-800-326-5496 July 1, 2020 – June 30, 2021 www.pebp.state.nv.us
Today’s Topics PEBP and Via Benefits Forms PEBP’s Medicare Requirements PEBP Dental Plan Option 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
Approximately 2 months* before your 65 th 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) Medicare Effective Date RBECFs must be filled out and mailed or hand delivered to PEBP as they are barcoded. No faxes or emails will be accepted.
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 You or your spouse (or former spouse 💹 Social Security of 10 years) have at least 40 credits (10 years) of work in any job in which you paid Social Security taxes OR You are eligible for Railroad Retirement Benefits 01-01-2021 OR 01-01-2021 Please call the Social Security Administration You are under age 65 and approved (SSA) to verify your Medicare Eligibility for Social Security Disability Benefits 1-800-772-1213 Everyone age 65 or older can purchase Medicare Part B
PEBP’s Medicare Requirements • Medicare A+B card • Military identification card (front and back) TRICARE ACTIVE • Not required to enroll in Medicare until 60-90 days prior to retirement EMPLOYEE • PEBP Medicare requirements apply to SPOUSE/DP covered spouses and domestic partners CURRENTLY RETIRED Approaching 65th birthday • Enroll in premium-free Medicare Part A as eligible per Social NEWLY RETIRING AFTER AGE 65 Security (SSA) guidelines (60-90 days prior to retirement) • Must purchase Medicare Part B from SSA CURRENTLY RETIRED Under 65 and approved for Social Security Disability benefits (after 24 month waiting period)
Step 2 PEBP Enrollment Options Sending In Your Paperwork
Not required to enroll at Via Benefits Medicare A+B Copy of Medicare A+B card and TRICARE for Life and Military ID (front and back) TRICARE for Life to PEBP Mail RBECF to elect or decline dental Thank you for your service!
Not required to enroll in Medicare If Medicare is Active obtained, submit Active Employee copy of card Not yet Retiring to PEBP CDHP HSA will become HRA (if applicable)
Must enroll at Via Benefits No Covered Dependents Copy of or Medicare A+B Medicare A+B Participant and card to PEBP Dependent both have Medicare Newly retiring? Enroll in Medicare A+B 60-90 days prior to retirement Mail RBECF to elect or decline dental
Retiree may stay on PEBP PPO, EPO, or HMO with dependents OR Medicare A+B Covering Non-Medicare Dependent Retiree may enroll or Covering Dependents at Via Benefits Non-Medicare Participant Covering Medicare Participant Be sure to: OR - Send a copy of Medicare A+B card to PEBP - Mail RBECF to elect or decline dental Unsubsidized dependent(s) may stay on PEBP or terminate coverage
May remain on PPO, EPO, HMO MUST purchase Medicare Part B NOT Eligible for No Medicare Part A free Part A Obtain Social Monthly premium Security Eligibility Letter - lack reduced by $135.50 of credits after receipt of Medicare Part B card Complete RBECF submit all documents to PEBP
PEBP Dental Option • 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 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 *Spouse/DP must also have a medical plan through Via Benefits in order to elect PEBP dental.
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 • Read all material PEBP mails you, two months prior to your 65 th birthday. Develop an idea of what medical and pharmacy plan you would like to select Prepare • Call Via Benefits at 1-888-598-7545 to schedule and appointment with a certified licensed benefit advisor Call • Complete enrollment by calling and speaking to a licensed benefit advisor Enroll • Via Benefits will now manage your new plan and funding account. Wait 8-12 weeks for your funding packet to arrive from Via Benefits Wait
Steps 3 and 4 Who is Via Benefits? Your Future Coverage
Who is First and largest private Personalized options Medicare Market with plans from a Exchange Company nationwide network 120+ 15 th Year of Service Insurance Companies 9 out of 10 Retirees 1.9 Million Retirees reported they would work from 680+ employers with Via Benefits again Licensed Advisors Never any provide guidance and fees for services ongoing advocacy
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 Via Benefits Process 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
24/7 access to your information Want more information? Contact Via Benefits at 1-888-598-7545 https://My.ViaBenefits.com/PEBP
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 How Medicare Coverage Works Primary Coverage Medicare A and B
Medicare Advantage with Prescription Drug Coverage (MAPD) HMO PPO Medicare Advantage plans are generally network based plans. 25
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.
Medicare Supplement Insurance (Medigap): Lettered Policies Benefits A B D G K L M N Medicare Part A coinsurance and 100% 100% 100% 100% 100% 100% 100% 100% hospital costs (up to an additional 365 days after Medicare benefits are used) Medicare Part B coinsurance or 100% 100% 100% 100% 50% 75% 100% 100% copayment 100% 100% 100% 100% 50% 75% 100% 100% Blood (first 3 pints) Part A hospice care coinsurance or 100% 100% 100% 100% 50% 75% 100% 100% copayment 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 80% 80% 80% 80% (up to plan limits) Out-of-Pocket Source: CMS limit in 2021 $5,880 $2,940 • 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. Please discuss all of your options with a Licensed Benefit Advisor
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