Welcome! Whether you are a new enrollee Examples of Examples of - - PowerPoint PPT Presentation

Welcome!

 Whether you are a new enrollee

• r currently going through our

annual open enrollment held each fall, you now have the

• pportunity to enroll in benefits.

Please understand the decisions you make now will remain in effect for the entire plan year unless you experience a qualifying life event

 A qualifying life event will allow

someone to change or enroll in coverage mid-year

 Marsh, our plan administrator,

must be notified within 30 days

• f the event date

Examples of Examples of Qualifying Life Events Qualifying Life Events

 Gaining or losing a dependent



Marriage



Divorce



Birth / Adoption



Involuntary loss of other insurance coverage



HCTC eligibility coverage

Plan Year: 1.1.2013 – 12.31.2013

Overview

New for 2013!....................................................... Eligibility……………………………………………. Medical & Rx Benefits……………………………. Health Savings Accounts………………………… Medicare……………………………………………. Dental Benefits……………………………………. Vision Benefits…………………………………….. Voluntary Life Benefits…………………………... Enrollment............................................................ Questions?.............................................................

New for 2013!

What’s Staying the Same?

 Continued partnerships!

Continued partnerships!

 Blue Cross Blue Shield of Michigan will continue to administer

the pre-65 and pre-65 Medicare disabled medical/prescription

 Continued partnership with Blue Cross Blue Shield of Michigan

pre- & post-65 dental benefits

 The Hartford will continue to administer the post-65

medical/prescription benefits

 Same great vision benefits through Superior Vision  Continued DSRA-BT subsidy

DSRA-BT subsidy available for retirees who are

not eligible for HCTC

 Health Coverage Tax

Health Coverage Tax Credit (HCTC) Credit (HCTC) for retirees who are

age 55-64 & draw pension benefits from the PBGC

What’s New in 2013?

 Introduction of a new option

new option for our post-65

members which allows Medicare eligible retirees a “hybrid” solution and choice between the medical/prescription plans option through The Hartford or an “individual” Medicare supplement, Medicare Advantage and Part D prescription plan in your area

 New

New voluntary life insurance carrier, Reliance

Standard, for our Delphi salaried retirees only

 Lower monthly premiums

Lower monthly premiums

 One-time open enrollment opportunity

One-time open enrollment opportunity

Eligibility

Retirees

 As a salaried and hourly retiree member, you are

eligible for the medical/prescription

medical/prescription, dental dental, and vision vision

benefits unless you have previously terminated coverage

 Salaried retiree members are also eligible for

voluntary life insurance voluntary life insurance

For further details about coverage termination, please refer to the “Eligibility” section in the

2013 Guide to Benefits for Pre-65 Members 2013 Guide to Benefits for Pre-65 Members

Spouse / Domestic Partner

 As a Retiree, your legal

spouse or domestic partner is also eligible for

medical/prescription medical/prescription, dental dental,

and vision

vision benefits

 Spouse/domestic partner

must have the same medical/Rx coverage as the Retiree if both are enrolled and in the same age category:

 Under Age 65  Post-65  Surviving Spouse  Surviving spouse is eligible

for medical/prescription, dental, and vision coverage

 Former Spouse  Marsh will send an

enrollment kit to the former spouse who is required to provide a statement from the PBGC confirming that he/she has become a pension recipient in their own right due to the divorce.

Child(ren)

 Dependent children are

eligible for

medical/prescription medical/prescription, dental dental,

and vision

vision benefits

 Child(ren) can remain

• n the coverage through

the end of the calendar year during which they were no longer eligible

 i.e. March 29th birthday

can continue until December 31st

 Child(ren) must have

same medical/Rx coverage as the retiree

Definition of Definition of Dependent Child Dependent Child

 A dependent child is defined as an

unmarried child up to age 19 (or, if a full-time student, until the earlier of age 25 or student status ends)

Disabled Child Disabled Child

 A disabled child is not subject to the

age limitation but cannot be on Medicare (child must have been on coverage prior to becoming disabled if beyond maximum age limitations)

 A disabled child on Medicare must enroll

in the BCBSM Medicare Disabled COMP plan

For More Information

 For further details

including what happens upon termination of coverage, refer to the

2013 Guide to Benefits 2013 Guide to Benefits for Pre-65 Members for Pre-65 Members

Medical & Rx Benefits

Deductible Deductible

A dollar value that you are responsible to pay for a covered medical expense before the coinsurance begins.

Understanding T erminology

Coinsurance Coinsurance

Once you have satisfied your deductible, you will begin to pay coinsurance. In other words you will pay a % – such as 20% of the claim and the plan will pick up the rest – such as 80%.

Understanding T erminology

Out-of-Pocket Maximum Out-of-Pocket Maximum

The most you will be responsible for out-of- pocket for during the calendar year. This includes your deductible and coinsurance.

Copay Copay

A fixed fee paid for office visits and prescription

• drugs. For the BRONZE medical plan, copays
• nly apply to prescriptions drugs after the

deductible has been met.

Embedded v. Non-Embedded Deductibles

EMBEDDED EMBEDDED NON- NON- EMBEDDED EMBEDDED

GOLD SILVER BRONZE Individual Deductible $250 $500 $2,000 Family Deductible $250 per person (capped at $500) $500 per person (capped at $1,000) $4,000

If you cover dependents on this medical plan option, the entire family deductible of $4,000 must be met before benefit plan coverage takes effect – by any

• ne or combination of family

members. If you cover dependents, under the GOLD or SILVER medical plans, when any one individual family member reaches the individual deductible in expenses, their benefit plan coverage takes effect.

Your Deductibles, cont’d

$

NON-EMBEDDED

Individual Family

Medical cov’d 100%

EMBEDDED

Medical cov’d 100%

Individual Family

$ $ $ $

Retirees Under Age 65

Blue Cross Blue Shield of Michigan

Your Rx Benefit, cont’d

$2,000 / $4,000 Medical $$$ Rx $$$ Medical cov’d 80% Rx copays $15 / $50 / $70 $1,000 / $2,000

2013 BRONZE PLAN 2013 BRONZE PLAN

Retirees Post-65

Group Retiree Insurance Plan (GRIP)

IMPORTANT IMPORTANT

 If you are a resident of

Kansas, Maryland, Montana, New York, or Oregon and will be a new enrollee with an effective date of 1/1/2012 and later, a unique plan is available to you

 Further details will be

Further details will be discussed on the next discussed on the next slide slide

Retirees Post-65

Senior Medical Insurance Plan (SMIP)

IMPORTANT IMPORTANT

 This plan is only

available for residents of Kansas, Maryland, Montana, New York, or Oregon

 This applies to

new enrollees

• nly with

effective dates of 1/1/2012 and later

Retirees Post-65

“Individual” Medicare Plans

 New for 2013

New for 2013, post-65 will also be allowed to choose

from “individual” Medicare supplements, Medicare Advantage, & Part D prescription plan options in their area

 Opportunity to consider all

all health plan coverage

• ptions

 Chance to tailor the selection to best fit personal &

best fit personal & unique health care needs unique health care needs

Retirees Post-65

“Individual” Medicare Plans, cont.

cont.

 Call Marsh at 1-877-336-DSRA (3772)

1-877-336-DSRA (3772) to speak with a

specialized counselor who will…

 …Search individual plans by your zip code  …Compare and advise you which plans may make

sense for you

 …Provide written plan information and enrollment

materials

 …Confirm your enrollment in a new plan (if selected)  …Provide ongoing support services to you once you

are enrolled in a new plan

For More Information

 For further details

about the pre-65 medical plan options including rates, refer to the 2013 Guide to

2013 Guide to Benefits for Pre-65 Benefits for Pre-65 Members Members

 For additional

information about the post-65 medical plan

• ptions & rates, refer to

the 2013 Benefit Choice

2013 Benefit Choice Guide for Post-65 Guide for Post-65 Members Members

 Carrier plan summaries

can also be found on

• ur website –

www.dsrabenefittrust.net www.dsrabenefittrust.net

Health Savings Accounts

NOTE: The following slides only apply to the BRONZE

BRONZE medical plan

Health Savings Accounts (HSA)

 Bank account for eligible

health care expenses

 You may open a HSA at the

bank of your choice!

 Money is yours  You own the account  You name a beneficiary for the

funds

 You control when it’s spent  You can change your

contributions throughout the year

 Triple tax savings  Tax credit for contributions to

the account

 Tax-free earnings  Tax-free withdrawals for

qualified medical expenses, as per IRS cod 213(d)

What is a HSA? Benefits of HSAs

HSA Eligibility & Contributions

 You must be enrolled in a qualified

High Deductible Health Plan

 The BRONZE

BRONZE medical plan is

the only qualified plan

 You cannot

cannot be enrolled in another

health plan elsewhere:



e.g.:



Spouse’s employer-sponsored non-qualified HDHP



Individual health plan



Medicare enrollment



Retiree military benefit plan (e.g. TRICARE)

 Once you set up your HSA, you

can begin making deposits into your account by check or cash

 Keep track of your contributions

so you can deduct them from your income tax return

 The IRS maximums for 2013 are

as follows: Eligibility Contributions

HSA Distributions



As long as the money is used for an eligible expense, HSA funds are tax-free



If money used for non-eligible expenses, a 20%

20% penalty applies

(unless you are over age 65), along with applicable taxes Visit www.irs.gov to view a full list of eligible expenses!

HSA Distributions

 MEDICAL

MEDICAL



Out-of-pocket expenses (like deductibles, coinsurance)



Hospital, lab, and diagnostic services



Diabetic supplies



Chiropractic care



Prescription drugs

 DENTAL

DENTAL



Artificial teeth



Dental treatment (like cleanings, fillings, extractions, orthodontics)

 VISION

VISION



Contact lenses, eyeglasses, and reading glasses



Eye exams



Laser eye surgery

 Health insurance premiums  Medigap premiums  Cosmetic surgery  Over-the-counter products for

general health (e.g. vitamins, toothpaste, lotion)

 T

eeth whitening

 Over-the-counter medications

without a prescription Eligible Expenses Ineligible Expenses For a complete list of eligible expenses, visit www.irs.gov

Using Your HSA

Always present your Always present your medical ID card medical ID card



Ensures you are getting the in-network discounted rate



Expenses track toward your deductible

Pay for your services Pay for your services



Use your HSA debit card –OR–



Pay out-of-pocket, allowing you to build up the funds in your HSA

Member Name: John Doe Group #: 000000 Member ID #: 000000000000

Medical ID Card

Member Name: John Doe Group #: 000000 Member ID #: 000000000000

Medical ID Card

Sample HSA Consumer Experience

Doctor Service

• 1. Consumer

visits doctor

• 2. Doctor submits claim to

BCBSM

• 3. BCBSM applies benefits and

notifies doctor of the amount the consumer is responsible for paying

• 5. Doctor sends

bill to consumer

• 6. Consumer uses HSA funds

to pay doctor

• 4. BCBSM

sends consumer an Explanation

• f Benefits

(EOB)

EOB

YOU

YOU

HSA

Sample HSA Consumer Experience

Pharmacy Service

• 1. Consumer visits

pharmacy to fill a prescription

• 2. Pharmacy connects to

BCBSM to determine consumer’s benefit

• 3. BCBSM determines

consumer’s benefits “real-time” and passes back to pharmacy the amount the consumer is responsible for paying 4. Pharmacy provides consumer with prescription and charges them the appropriate amount 5. Consumer uses HSA funds to pay pharmacy YOU

YOU

HSA

Setting Up Your HSA

 In order to make HSA

contributions, you must set up your account

 You may open a HSA at

the bank of your choice!

 YOU are responsible for

YOU are responsible for setting up your own HSA setting up your own HSA

HSA Financial Institution

 Fees

Fees

 Is there a set up fee?  Is there a monthly maintenance fee?

 Distribution access

Distribution access

 Will I be issued a debit card or

checks?

 Will I be able to access my funds via

an ATM?

 Interest rate

Interest rate

 Will my money gain interest over

time?

 Investment options

Investment options

 Can I invest my money?  Is there an account minimum?  What investment funds are available?

 Online access

Online access

 Will I be able to access my funds

• nline?

 Reporting

Reporting

 What type of statements will I

receive? How often?

Contact your bank or financial institution to see if they offer HSAs

Stay educated.

Why do HSAs work?

 Tax Savings

Tax Savings

Triple tax savings opportunity through contributions to your HSA, investments made with HSA money, and using HSA money for qualified medical expenses

 Consumerism

Consumerism

Become more engaged and buy health care like you might buy a TV, car, etc.

Tax Savings

TRIPLE Tax Savings TRIPLE Tax Savings

1.

Contributions you make to your HSA are tax deductible

2.

If you make investments with your HSA funds, any interest and investment earnings are tax-free

3.

Qualified medical expenses paid for with your HSA funds are tax-free

Consumerism:

Shop Smart

Where do you buy your meds? Where do you buy your meds?

Did you know that brand-name prescription drug prices vary at each pharmacy? Shop smart and research the prices for your prescription drugs before purchasing them. If you can, switch to generic prescription drugs! Many retail pharmacies offer special prices for generics.

CVS CVS Kroger roger Walgreen’ algreen’s KMart KMart

Lipitor

(10mg 30- day supply) $73.59 $57.81 $11.92 $54.58

Consumerism:

Shop Smart Retail Rx Options Retail Rx Options

Here are a few merchants that have established low-cost prescription drug programs:

More than 300 generic prescription drugs at only $4 for a 30-day supply; select drugs at only $10 for a 90-day supply Over 360 generic prescription drugs at only $4 for a 30- day supply; select drugs at only $10 for a 90-day supply Over 500 generic prescription drugs at only $5 for a 30- day supply and $10 for a 90-day supply Offers a FREE 14-day supply of selected generic antibiotics with a prescription and 5 leading brands of pre-natal vitamins for FREE More than 300 generic prescription drugs for only $4 for a 30-day supply, or get a 90-day supply for only $10

Consumerism:

Make Smart Decisions



Practice prevention

prevention – it

pays off



Keep up-to-date on

immunizations and immunizations and tests tests

 Eat smart & exercise

Eat smart & exercise

– the benefits of living well

 Use the emergency room

emergency room

• nly for real emergencies

 Save money by requesting

generic drugs generic drugs

 Double-check bills

Double-check bills from

your doctor

For More Information

 For basic information

about Health Savings Accounts, refer to the

2013 Guide to Benefits 2013 Guide to Benefits for Pre-65 Members for Pre-65 Members

 For further details, refer

to the Health Savings

Health Savings Account FAQ Account FAQ which can

be found on the DSRA-BT website

Medicare

What is Medicare?

Medicare Cost & Enrollment

 Part A

Part A is free if you or your

spouse have worked & paid Social Security taxes for at least 10 years

 Part B

Part B has a monthly premium

that is based on your incomes

 Part C

Part C monthly premium is

determined by the individual insurance carrier or HMO

 Part D

Part D monthly premium is

determined by the drug plan provider & the prescriptions you take

 T

wo ways to enroll:

• 1. Automatic enrollment

happens whenever you sign up to receive Social Security income

• 2. Active enrollment occurs

when you call Social Security to enroll or enroll online at www.socialsecurity.gov

 You can enroll during your Initial

Enrollment Period or Special Enrollment Period

Cost Enrollment Regardless of when you enroll, Medicare is always effective on the 1st day of the month

Initial & Special Enrollment

 Your initial Medicare effective

date is the first day of the month

• f your 65th birthday. If you

want Medicare to be effective when you turn 65, your Initial

Initial Enrollment Period Enrollment Period is 7 months

long and begins with the 3rd month BEFORE the month of your 65th birthday and lasts during the month OF your 65th birthday through the 3 months AFTER your 65th birthday

 Once you lose active employee

coverage, you have a protected right to enroll in Medicare, called a Special Enrollment

Special Enrollment Period Period

 Your Special Enrollment Period

begins at the end of active employment or the end of health plan coverage, whichever

• ccurs first, and lasts for

8 months

 But wait......

But wait......

Initial Enrollment Special Enrollment

Special Enrollment Period, con’t.

 Although you have an 8-month Special

Enrollment Period to enroll in Medicare Parts A and B, you only have a

60 day Special Enrollment Period 60 day Special Enrollment Period to

enroll in a Part C (Medicare Advantage) plan, a Part D drug plan and purchase a Medicare supplement

 You must have at least Part A BEFORE

you can enroll in a Part D drug plan

 You must have both Parts A and B

BEFORE you can purchase a Medicare Advantage plan or buy a Medicare supplement

It is better to think of your Special Enrollment Period as 60 days

At Age 65:

Initial & Special Enrollment

 If you plan to retire or reduce

your working hours so that you aren’t eligible for your employer’s group health plan, you can enroll in Medicare Parts A, B, C and D during your Initial Enrollment Period

 If you delay past your Initial

Enrollment Period, you may have to pay a penalty for that delay unless you qualify for a Special Enrollment Period, which is described next Initial Enrollment Special Enrollment

If you enroll during the 3 months before your 65th birthday, your Medicare will be effective the first day of the month in which you turn 65. If you enroll during the month of your 65th birthday (or any of the next 3 months), your Medicare will be effective the first day of the next month.

After Age 65:

Initial & Special Enrollment

 If you (or your spouse) are

still working and covered in an employer’s group health plan, due to active employment, you do not have to enroll in any part of Medicare until you lose that coverage

 Once you lose active employee

coverage, you have a protected right to enroll in Medicare

 Your Special Enrollment Period

begins at the end of active employment or the end of health plan coverage, whichever

• ccurs first, and lasts for

8 months Initial Enrollment Special Enrollment Medicare will be effective the first day of the month after you enroll

Medicare Coverage Choices

QUESTIONS? QUESTIONS?

Retirees may contact a counselor at 1-877-336-DSRA (3772) for assistance with selecting a Medicare supplement, Medicare Advantage plan, and Part D plan

Medicare Part D

 Medicare Part D is prescription drug

prescription drug coverage coverage

 Added in 2005 in order to address complaints that

prescription drug costs were not covered by Original Medicare

 Once you are enrolled in any part of Medicare, you are

required required to have drug coverage

 You can buy Part D drug coverage one of three ways:

1. Standalone 2. As part of a Medicare Advantage plan 3. As part of the DSRA-BT post-65 medical/prescription plan

Medicare Part D, con’t.

 T

• join a Medicare prescription drug plan, you

must have Medicare Part A and/or Part B

 T

• get prescription drug coverage through a

through a Medicare Advantage Plan Medicare Advantage Plan, you must have both Parts

A and B

 T

• get prescription drug coverage (with medical

supplement coverage) through the DSRA-BT post-65

through the DSRA-BT post-65 medical/prescription plan medical/prescription plan, you must have both Parts

A and B

For more information about Medicare Part D, contact a Marsh at 1-877-336-DSRA (3772) to speak with a specialized counselor

Medicare Part D, con’t.

 The cost of Medicare Part D plans are

specific to the types of drugs you are taking

 Plan monthly premiums can range from

$15 to over $300

 If your Part D drug coverage is with your

Medicare Advantage plan, your cost is bundled into the cost of that plan

 In addition to monthly premiums, plans

can have a deductible, copays and co-insurance

The cost of your DSRA-BT post-65 medical/Rx plan includes prescription drug coverage as well as medical supplement coverage

Medicare Supplement Policy

 Medicare supplement

policies pay for Medicare covered expenses and services that are not paid by Medicare, like deductibles and co- pays

For more information about Medicare supplements, contact a Marsh at 1-877-336-DSRA (3772) to speak with a specialized counselor

Medicare Supplement Policy, con’t.

The post-65 DSRA-BT Medicare options provide medical supplement coverage close to the standardized Plan D.

Medicare Advantage Plans

 Medicare Advantage

(Medicare Part C) (Medicare Part C) plans

are health plans that are approved by Medicare but run by private insurance carriers and HMOs

 Many Medicare Advantage

plans include prescription drugs (Part D)

 When you join a Medicare

Advantage plan, you are

substituting the plan for substituting the plan for Original Medicare Original Medicare (Parts A

and B and D, if the Medicare Advantage plan includes prescription drug coverage)

 You must continue to pay

your Medicare Part B premium in addition to

in addition to any

premium charged by the Medicare Advantage plan.

For more information about Medicare Advantage plans, contact a Marsh at 1-877-336-DSRA (3772) to speak with a specialized counselor

Medicare Advantage Plans, con’t.

 In most cases, when you

enroll in a Medicare Advantage plan, you must stay enrolled for that calendar year

 In certain situations, you may

be able to join, switch, or drop a Medicare Advantage Plan

 There is a special Medicare

Advantage Disenrollment Period that allows people to disenroll from a Medicare Advantage plan back to Original Medicare.

 January 1 through February

14 of each year Note: If your doctor drops from your plan’s network, you can’t change plans until the next Open

• Enrollment. Open Enrollment begins October 15 and

ends December 7 for a January 1 effective date.

For More Information

 For further details

about Medicare, refer to the

2013 Benefit Choice 2013 Benefit Choice Guide for Post-65 Guide for Post-65 Members Members

 Check out other

Medicare resources, such as www.medicare.gov

www.medicare.gov or www.socialsecurity.gov www.socialsecurity.gov

Dental Benefits

Dental

Vision Benefits

Vision

Voluntary Life Benefits

Voluntary Life

Delphi hourly retirees are not eligible for this voluntary benefit One-time opportunity to take advantage of the guarantee issue during our 2013 open enrollment period

Enrollment

2013 Open Enrollment: 2013 Open Enrollment:

Enrollment Process

 If you do not want to make any

changes, no action

no action is required is required

The new premium levels will go into effect January 1,

• 2013. (For rate information, refer to the 2013 Guide to

2013 Guide to Benefits for Pre-65 Members Benefits for Pre-65 Members or the 2013 Benefit 2013 Benefit Choice Guide for Post-65 Members Choice Guide for Post-65 Members. Rates can also be

found on the benefit enrollment form.)

Enrollment Process

 If you wish to make a change to your elections

during our annual open enrollment period

annual open enrollment period or due to

a life qualifying event

life qualifying event, please follow these simple

steps…

Enrollment Process

#1 #1

 Complete the

benefit enrollment form benefit enrollment form

 There are 6 variations:

 <65 & Not HCTC

Eligible

 <65 & HCTC Eligible  <65 & Medicare Disabled  <65 QFM Whose Retiree

Spouse is Age 67+

 Post-65 GRIP  Post-65 SMIP

Enrollment Process

#2 #2

 If you are newly eligible

newly eligible for the HCTC for the HCTC, complete

the IRS Form 13441- A Monthly Health Coverage Tax Credit (HCTC) Group Registration

 If you are already

already enrolled in the HCTC enrolled in the HCTC

and want to change your benefit elections for 2013, complete the IRS Form 13704 Monthly HCTC Registration Update

All HCTC forms should be returned to Marsh; DO NOT return the HCTC forms to the address listed on the form

Enrollment Process

#3 #3

 Return all forms – including the HCTC forms

– to Marsh, our plan administrator:

Mail: Marsh, a service of Seabury & Smith PO Box 14464 Des Moines, IA 50306 Email: customerservice@marshpm.com Overnight Mail: Marsh, a service of Seabury & Smith ATTN: Application Processing 12421 Meredith Dr. Urbandale, IA 50398 Fax: (515) 365-1520

All HCTC forms should be returned to Marsh; DO NOT return the HCTC forms to the address listed on the form

Billing

 If you elect any of the benefit plans, you will be billed

monthly by Marsh, our plan administrator

 Payments can be made via direct bill or electronic

funds transfer (for non-HCTC insured only)

Members are highly encouraged to set up an automatic electronic-funds transfer to make health premium payments

Billing – HCTC Members

 If you are enrolled in the HCTC, you will make your

payments directly to the HCTC program

 Payments can be made via direct bill or electronic

payment at http://arcout.com/hctc

http://arcout.com/hctc

Members are highly encouraged to set up an automatic electronic-funds transfer to make health premium payments If you are applying for HCTC coverage, you will pay the full monthly premium to Marsh until you are registered in the HCTC program and begin receiving invoices from the IRS

Premium Payments Received After the Due Date

 If you do not pay your monthly premium by the 1st of the

month* for which coverage is provided, you run the risk of your coverage being terminated

terminated

 If premiums are not paid by the due date,

coverage will be terminated as of the last day of the coverage will be terminated as of the last day of the preceding month preceding month

 All benefits including medical, dental and prescription drug coverage

will cease and no claims will be paid. * NOTE: HCTC covered members need to meet the HCTC premium payment due date, which is usually 7-10 days before the 1st of the month.

Questions?

Questions?

 If you have questions

about the benefit plans or the enrollment process, please contact Marsh,

• ur plan administrator

Download this contact sheet at

www.dsrabenefittrust.net www.dsrabenefittrust.net

1-877-336-DSRA (3772) 1-877-336-DSRA (3772)

Thank You!