PRE-MEDICARE AGE-IN PRESENTATION 775-684-7000 P LAN Y EAR 2020 or - - PowerPoint PPT Presentation

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PRE-MEDICARE AGE-IN PRESENTATION 775-684-7000 P LAN Y EAR 2020 or - - PowerPoint PPT Presentation

Dec 12, 2023 260 likes •679 views

PRE-MEDICARE AGE-IN PRESENTATION 775-684-7000 P LAN Y EAR 2020 or 1-800-326-5496 J ULY 1, 2019 J UNE 30, 2020 www.pebp.state.nv.us Todays Topics PEBP and Via Benefits Forms PEBPs Medicare Requirements PEBP Dental Plan Option

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PRE-MEDICARE AGE-IN PRESENTATION

PLAN YEAR 2020 JULY 1, 2019 – JUNE 30, 2020

775-684-7000

  • r 1-800-326-5496

www.pebp.state.nv.us

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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 Enrollment through Via Benefits PEBP’s Medicare Requirements PEBP Dental Plan Option

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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

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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

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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)

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Step 1

Enroll in Medicare PEBP’s Medicare Requirements

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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 of 10 years) have at least 40 credits (10 years) 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

01-01-2020 01-01-2020

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PEBP’s Medicare Requirements

  • Medicare A+B card
  • Military ID (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

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Step 2

PEBP Enrollment Options Sending PEBP Your Paperwork

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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

Newly retiring? Enroll in Medicare A+B 60-90 days prior to retirement

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Medicare A+B and TRICARE for Life

Thank you for your service!

TRICARE for Life

Not required to enroll at Via Benefits Copy of Medicare A+B card and Military ID (front and back) Mail RBECF to elect or decline dental and establish your HRA

Medicare A+B and TRICARE for Life

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Must enroll at Via Benefits Copy of Medicare A+B card to PEBP Mail RBECF to elect or decline dental

Medicare A+B

No Covered Dependents

  • r

Participant and Dependent both have Medicare

Newly retiring? Enroll in Medicare A+B 60-90 days prior to retirement

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Retiree may stay on PEBP PPO, EPO, or HMO with dependent Medicare eligible retiree may enroll at Via Benefits Unsubsidized dependent(s) may stay on PEBP or terminate coverage

OR AND

Covering Dependents

Medicare A+B Participant Non-Medicare Dependent Or Non-Medicare Participant Medicare A+B Dependent

  • r vice versa

Retiree only: Monthly premium reduced by $135.50 after receipt

  • f Medicare Part B card
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May remain

  • n PEBP PPO,

EPO or HMO MUST purchase Medicare Part B Obtain SSA Eligibility Letter (lack

  • f credits)

Complete RBECF submit all documents to PEBP Retiree only: Monthly premium reduced by $135.50 after receipt

  • f Medicare Part B card

No Medicare Part A NOT eligible for premium free Medicare Part A

MEDICAL (PART B) 01-01-2020

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PEBP Dental Option

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

Monthly PY20 PEBP Dental Rates

July 1, 2019 – June 30, 2020

State Retiree Non-State Retiree

Retiree only

$40.47 $41.18

Retiree + Spouse/DP*

$80.93 $82.37

  • 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
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Review

YOU’VE ALREADY: ✓Enrolled in Medicare A+B (Original Medicare) through Social

Security, as eligible. Medicare will be your primary coverage. └› Medicare A provides about 80% hospital coverage

Medicare B provides about 80% medical 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, establish

your Via HRA and change your status to “Medicare Eligible”.

Contact SSA to check your Medicare eligibility and complete enrollment.

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What to Do Next

Prepare

❑ Read all material PEBP and Via Benefits mails you and develop an idea of what medical and pharmacy plan you would like to select with Via Benefits

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

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Steps 3 and 4

Who is Via Benefits? Your Future Coverage

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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

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A Licensed Benefit Advisor will assist you to find a plan that meets your needs and fit your budget

Consultative Process

Advisors will explain the details of coverage and answer your questions

Simplified Selection

The insurance enrollment forms will be completed over the phone

Effortless Enrollment

Dedicated specialist are a phone call away to help you with your new healthcare coverage

Ongoing Advocacy

Via Benefits Process

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

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

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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 Medicare Open Enrollment unless you want to make a plan change. Call Via at 1-888-598-7545!

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Medicare Options

Medicare Advantage Plan with Prescription Drug vs Medigap + Prescription Drug

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Your Future Coverage

Primary Coverage Medicare A and B

How Medicare Coverage Works

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Medicare Advantage with Prescription Drug Coverage (MAPD)

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PPO HMO

Medicare Advantage plans are generally network based plans.

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Medigap + Part D

Medicare Supplement Insurance (Medigap)

Part D Prescription Drug Plan (PDP)

must purchase separate

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

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Benefits A B D G K L M N

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%

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 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 excess charges 100% Foreign travel emergency (up to plan limits) 80% 80% 80% 80% Out-of-Pocket limit in 2020 $5,880 $2,940

Source: CMS

Please discuss all of your options with a Via Benefits Licensed Benefit Advisor

Medigap Lettered Policies

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  • ANY changes to your coverage, MUST be made 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)

  • Plan Information is usually made available in October
  • Any changes made will become effective January 1
  • Medicare Open Enrollment is different than PEBP Open Enrollment

Medicare Open Enrollment

October 15 to December 7

1-888-598-7545

Benefits advisors are available Monday through Friday, 5:00 AM - 6:00 PM PST

The plans you select continue from year-to-year. No need to re-enroll unless you want to make a plan change during Medicare OE.

Medicare Open Enrollment provides you an opportunity to change health plans and/or prescription drug coverage.

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Step 5

Funding and Health Reimbursement Arrangements (HRA)

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What is an HRA?

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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 Use HRA funding to reimburse yourself for eligible medical, prescription drug, dental, vision, and Medicare Part B premiums

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CDHP HRA vs VIA 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 of

service (5-20 YOS) and retirement date

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

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How is my HRA Funded?

Effective July 1, 2019

PY 2020 HRA Contribution

Years of Service Contribution

5 $65 6 $78 7 $91 8 $104 9 $117 10 $130 11 $143 12 $156

PY 2020 HRA Contribution

Years of Service Contribution

13 $169 14 $182 15 $195 16 $208 17 $221 18 $234 19 $247 20 $260

  • PEBP will automatically establish your Exchange-HRA after your qualified medical plan through Via Benefits is effective
  • 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 and direct deposit forms and will normally arrive within 8-12 weeks from your effective date

Marty.Klinkhammer@standard.com

EXAMPLE HRA (18 YOS)

My Monthly HRA Allowance $234.00

Medigap Plan G (medical supplement)………........($124.00) Medicare Part D Plan (prescription drugs)……….............($22.00) Optional PEBP Dental………...........( $40.47)

Remaining Monthly HRA Balance $47.53

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Initial Funding Packet may take between 8-12 weeks from your effective date to be received ▪ Reimbursement Forms ▪ Pay for Your Expenses ▪ Submit for Reimbursement ▪ Automate your Premium Payment ▪ Website and Online Account Information ▪ 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

Via Benefits Funding Kit

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  • 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

  

Sign and date ALL forms!

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Automatic Reimbursement

Up to the amount available in your HRA

YOU Your Bank

Reimburse via Check

  • r Direct Deposit

Insurance Provider

Set Up AutomaticWithdrawal Receipt of Payment Premium

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

Direct Deposit Phone Online Mail Fax

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  • 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

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

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

Specific dates and locations are listed on the PEBP Website under Calendar of Events

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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

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Take it one step at a time! It’s as easy as 1-2-3 (4-5) Check off your steps as you go!

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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 – 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 1-888-598-7545 https://My.ViaBenefits.com/PEBP

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Thank you!