Health Newsletter for Al A s k A CA r e Members Health...
Transcript of Health Newsletter for Al A s k A CA r e Members Health...
Number 7, January 2009 A l a s k a D i v i s i o n o f R e t i r e m e n t a n d B e n e fi t s
H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
Health Plans
MattersHealthTracks: $100 incentive for better health
(for active employees only)
A sasteponthepathtobetterhealth,theAlAskACAreEmployeeHealthPlan,asofJanuary1,2009,beganto offeractive employeesa$100 incentivetocompletea
PersonalHealthAssessment.AspartofthenewHealthTracksHealth Improvement ProgramsponsoredbyAlAskACAre,theHealthQuotientsmPersonalHealthAssessment(PHA)providesyouwithasummaryofyourhealthandwillhelpyouunderstandyourpersonalhealthstrengthsandareasyoucantargetforimprovement.ItwillalsocustomizetheWebMD® PersonalHealthManager,allowingyoutomakebetteruseoftheavailablehealthmanagementtools.
AlAskACAreEmployeeHealthPlanmemberscanlogintotheWebMD®portalat:www.webmdhealth.com/sponsors/alaskacare.htm.Thisportalisapersonalizedwebpagefeaturingtoolsandresourcesthatsupportassessment,education,andpositivelifestylechangesthatcanenhancethequalityofyourlife.
Bynow,youshouldhavereceivedaletterfromCommissionerKreitzeraboutthenewHealthTracksprogram,alongwithcompletelog-ininstructionsforregisteringandaccessingtheWebMD®PersonalHealthManager.
Toqualifyforthe$100incentive,youmustcompletethePHAno later than February 15, 2009.(Yourspouse,enrolledsame-sexpartnerandeligibledependentsage18andoverarealsoencouragedtoparticipateintheprogram,butthe$100incentiveisavailableonlytoyou,theAlAskACAreEmployeeHealthPlansubscriber.)Andremember,allinformationintheassessmentandthePersonalHealthSummaryispersonal,confidential,andprotectedbystateandfederallaw;youremployerwillneverseeyourindividualresults.
January 2009
I N S I D EHealthTracks: $100 Incentive for Better Health ... 1Medicare Corner ................................................2Introducing Cameryn Flynn, HealthTracks Program Coordinator ................................. 2Premiums Increase for Retiree Health Plan ......3Routine Physical Exam a Great Employee Benefit .........................................................4Notice—Statement of Rights Under Newborns’ and Mothers’ Health Protection Act ............ 4Notice—Women’s Health and Cancer Rights Act ... 5Notice—Special Enrollment Rights ..................... 5Notice—Your Prescription Drug Coverage and Medicare .................................................... 624/7 Nurse Health Line ......................................8
WebMD®
H e a l t h M a n a g e r
Health
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H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
“Medicare Corner”isaregularfeatureofHealth Matters.
Corner
www.state.ak.us/drb
R emember,whenitcomestoprescriptiondrugcoverage, asamemberofAlaskaCareyoualreadyhavecomprehensive prescriptiondrugbenefitsthroughyourAlAskACAreHealthPlan.
MedicarePartDisintendedtoprovideprescriptiondrugcoverageforthosewhoeitherhavenocoverageorwhosecoverageisinadequatefortheirneeds.
YourAlAskACAreHealthPlanprovides,onaverage,prescriptiondrugbenefitsthatareatleastasgoodasthebenefitsofferedunderMedicarePartD.
IfyouenrollinMedicarePartD:
• Youwillpayanadditionalestimatedmonthlypremiumof$29 • AlAskACArebecomesyoursecondaryprescriptiondrugplan
Seepages6and7foracompletedescriptionofyourprescriptiondrugprogramandMedicare.
Introducing Cameryn Flynn— HealthTracks Program Coordinator
Medicare Part D—Prescription Drug Coverage and You
PremerahashiredCamerynFlynntoworkastheHealthTracksProgramCoordinator.ShewillactasPremera’sliaisonwiththeStateandwillbethepointpersonforansweringanyquestionsandconcernsaboutthePersonalHealthAssessmentortheHealthTracksProgram.
BornandraisedinthefoothillsoftheMontanaBitterrootMountains,CamerynattendedGonzagaUniversityinSpokanetoobtainherdegreeinBusinessAdministration.ShealsoholdsaMastersinPsychologyfromAntiochUniversity.Cameryn’spriorworkhistoryincludesworkingincitygovernment,socialservices,aswellasthehospitalandinsuranceindustries.
Tostayinshape,CamerynenjoyscyclingonherTrekmountainbike,hiking,kayakingandcrosscountryskiing.ShemovedtoJuneaufromSeattlein2006.
TocontactCameryn,[email protected].
FormoreinformationandtoanswersomeofthequestionsyoumayhaveabouttheHealthTracksprogram,pleaseviewthefrequentlyaskedquestions(FAQs)atthisweblink:http://www.state.ak.us/drb/ghlb/insurancebenefitsactive.shtml
H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
Number 7, January 2009 A l a s k a D i v i s i o n o f R e t i r e m e n t a n d B e n e fi t s
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Premiums Increase for Retiree Health Plan
Retireehealthplanpremiumsforplanyear2009willincrease.Thenewpremiumsformedicalanddental-vision-audio(DVA)coverage,effectiveJanuary1,2009,arelistedbelow:
ThefederalConsolidatedOmnibusBudgetReconciliationAct(COBRA)ensuresthatyouand/oryourdependentshavetheopportunitytocontinueyourhealthcoverageincertaincircumstanceswhereitwouldotherwiseend.Youareeligibletopurchasethesamecoverageyouhadatthetimeyourcoverageended.BelowaretheRetireeCOBRApremiums,whichwillincreaseforplanyear2009.
Medical Premium DVA Premium Individual only $631 $57 Individual & spouse or same-sex partner $1,262 $113 Individual & child(ren) $891 $102 Individual, spouse or same-sex partner, and child(ren) $1,523 $160
Medical Premium DVA Premium Individual only $643.75 $58.25 Individual & spouse or same-sex partner $1,287.25 $115.25 Individual & child(ren) $909.00 $104.00 Individual, spouse or same-sex partner, and child(ren) $1,553.50 $163.25
Retiree COBRA Health Continuation Premiums:
NOTE: All of the premiums listed above are effective January 1, 2009. Premiums are subject to change.
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H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
www.state.ak.us/drb
Routine Physical Exam a Great Employee Benefit
Didyouknowthat,asanactivememberoftheALASKACAREEmployeeHealthPlan,oneannualroutinephysicalexamiscoveredeachplanyearaspartofyourhealthbenefit?Only20percentof
employeememberstookadvantageofthisbenefitlastyear.Alsocoveredareanylabs,proceduresortestsorderedbythephysicianaspartoftheexamandcompletedwithin30daysoftheexamdate.
Ifyouhavealreadymetyourannualdeductiblewhenyouhaveyourexam,theplanwillpaytheappropriatecoinsuranceamount.Ifyouhavemetbothyourdeductibleandout-of-pocketlimit,theallowedamountoftheexamwillbecovered.Theaveragecostofanannualexamasofthiswritingis$270,dependingonyourlocationandothervariables.
Preventivecarecanleadtobetterhealthbyfindingandtreatingpossiblehealthproblemsearlyandmayalsohelpyoukeepyourhealthcarecostsundercontrol.
Foradescriptionoftheroutinephysicalexamcoverageprovidedbyyourhealthplan,pleaseseepage45inyourSelect Benefits Insurance Information Booklet.
Notice– Statement of Rights Under the Newborns’ and Mothers’ Health Protection Act
Underfederallaw,grouphealthplansandhealthinsuranceissuersoffering
grouphealthinsurancecoveragegenerallymaynotrestrictbenefitsforanyhospitallengthofstayinconnectionwithchildbirthforthemotherornewbornchildtolessthan48hoursfollowinga
vaginaldelivery,orlessthan96hoursfollowingadeliverybycesareansection.However,theplanorissuermaypayforashorterstayiftheattendingprovider(e.g.,yourphysician,nursemidwife,orphysicianassistant),afterconsultationwiththemother,dischargesthemotherornewbornearlier.
Also,underfederallaw,plansandissuersmaynotsetthelevelofbenefitsorout-of-pocketcostssothatanylaterportionofthe48-hour(or96-hour)stayistreatedinamannerlessfavorabletothemotherornewbornthananyearlierportionofthestay.
Inaddition,aplanorissuermaynot,underfederallaw,requirethatyou,yourphysicianorotherhealthcareproviderobtainauthorizationforprescribingalengthofstayofupto48hours(or96hours).However,youmayberequiredtoobtainprecertificationforanydaysofconfinementthatexceeds48hours(or96hours).Forinformationonprecertification,contactyourplanadministrator.
H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
Number 7, January 2009 A l a s k a D i v i s i o n o f R e t i r e m e n t a n d B e n e fi t s
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Notice– Women’s Health and Cancer Rights Act
SignedintolawinOctober1998,theWomen’sHealthandCancerRightsAct(WHCRA)
includesprotectionsforpersonswhoelectbreastreconstructioninconnectionwithamastectomy.
UndertheAlAskACArehealthplan,anypersonwhoreceivesbenefitsforamedicallynecessarymastectomymayalsoreceivebenefitsfor:
reconstructionofthebreastonwhichthemastectomywasperformed;
surgeryandreconstructionoftheotherbreasttoproduceasymmetricalorbalancedappearance;
prostheses(orbreastimplants);
treatmentofphysicalcomplicationsofallstagesofmastectomy,includinglymphedemas.
Ifyouhavequestionsaboutcoverageofamastectomyandreconstructivesurgery,pleasecallPremeraCustomerServiceat877-762-9597.
Notice– Special Enrollment Rights
Ifyouhaveanewdependentasaresultofmarriage,birth,adoption,orplacementforadoption,youare
abletoenrollyournewdependents,providedthatyourequestenrollmentwithin30daysafterthemarriage,birth,adoption,orplacementforadoption.
Ifyouhaveachangeinfamilystatusyoumayalsobeeligibletomakenewelections.Pleaseseepage9oftheSelect Benefits Insurance Information Booklet orpage8oftheRetiree Insurance Information Bookletforalistingofchangesinstatusrecognizedbytheplan.
Ifyouoryourcovereddependentsloseyourhealthcoverage,youalsohavetherighttocontinuethesamelevelofcoverage(knownasCOBRA)youhadatthetimecoverageterminated,providedyoupaythepremiums.CallyourPlanAdministratortoll-freeat800-821-2251orat907-465-8600formoreinformation.
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Notice–Your Prescription Drug Coverage and Medicare
Please read this notice carefully and keep it where you can find it.Thisnotice
hasinformationaboutyourcurrentprescriptiondrugcoveragewithAlAskACAreandprescriptiondrugcoverageavailableforpeoplewithMedicare.ItalsoexplainstheoptionsyouhaveunderMedicareprescriptiondrugcoverageandcanhelpyoudecidewhetherornotyouwanttoenroll.Attheendofthisnoticeisinformationaboutwhereyoucangethelptomakedecisionsaboutyourprescriptiondrugcoverage.
1. Medicareprescriptiondrugcoveragebecameavailablein2006toeveryonewithMedicarethroughMedicareprescriptiondrugplansandMedicareAdvantagePlansthatofferprescriptiondrugcoverage.AllMedicareprescriptiondrugplansprovideatleastastandardlevelofcoveragesetbyMedicare.Someplansmayalsooffermorecoverageforahigherpremium.If you purchase Medicare prescription drug coverage, your AlAskACAre plan will become your secondary prescription drug plan.
2. TheStateofAlaskahasdeterminedthattheprescriptiondrugcoverageofferedbytheAlAskACAreplanis,onaverageforallplanparticipants,expectedtopayoutasmuchasthestandardMedicareprescriptiondrugcoveragewillpayandisconsideredcreditablecoverage.
Because your existing coverage is on average at least as good as standard Medicare prescription drug coverage, you can keep your AlAskACAre coverage and not pay extra if you later decide to enroll in Medicare prescription drug coverage.
IndividualscanenrollinaMedicareprescriptiondrugplanwhentheyfirstbecomeeligibleforMedicareandeachyearfromNovember15ththroughDecember31st.BeneficiariesleavingemployercoveragemaybeeligibleforaspecialenrollmentperiodtosignupforaMedicareprescriptiondrugplan.
Youshouldcompareyourcurrentcoverage,includingwhichdrugsarecovered,withthecoverageandcostoftheplansofferingMedicareprescriptiondrugcoverageinyourarea.
PleasecontactusformoreinformationaboutwhathappenstoyourcoverageifyouenrollinaMedicareprescriptiondrugplan.Medicareprescriptiondrugcoverage,ifelected,wouldbecomeyourprimarycoverageforprescriptiondrugsandyourAlAskACAreprescriptiondrugplanwouldbecomethesecondarycoverage.There is no additional premium cost for prescription drug coverage for those who remain covered by AlAskACAre.
Benefits Provided by your AlAskACAre Prescription Drug Plan (active plan):
All drugs Up to 30-day supply 31-90 day supplyCopay 20% 20%Minimum $8.00 $16.00Maximum $50.00 $100.00
Benefits Provided by your AlAskACAre Prescription Drug Plan (retiree plan):
Per 90-day or 100-unit supplyBrand $8.00Generic $4.00Brand Mail Order $0.00Generic Mail Order $0.00
H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
TheMedicarePartDprescriptiondrugbenefitusesadrugformularytodeterminewhichdrugsarecoveredandatwhatratetheyarepaid.TheadditionalpremiumcostforprescriptiondrugcoverageunderMedicarePartDisestimatedtobe$29permonth.
Prescription Drug Benefits Provided by the Medicare Part D plan:
Coverage Ranges Percent Your Benefit Covered Your Cumulative Stages From To by Part D Cost CostAnnual Deductible $0 $295 0% $295 $295Initial Coverage Limitation $295.01 $2,700 75% $601 $896Coverage Gap $2,700.01 $6,154 0% $�,��� $�,��0Catastrophic Coverage $6,154.01 NO 95% MAX.
Greater of 5% or $2.40 generic and $6 brand
YoushouldalsoknowthatifyouloseyourcoveragewithAlAskACAreanddon’tenrollinMedicareprescriptiondrugcoverageafteryourcurrentcoverageends,youmaypaymore(apenalty)toenrollinMedicareprescriptiondrugcoveragelater.
Ifyougo63continuousdaysorlongerwithoutprescriptiondrugcoveragethatisatleastasgoodasMedicare’sprescriptiondrugcoverage,yourmonthlypremiummaygoupatleast1percentpermonthforeverymonththatyoudidnothavethatcoverage.Forexample,ifyougo19monthswithoutcoverage,yourpremiummayalwaysbeatleast19percenthigherthanwhatmanyotherpeoplepay.YoumayhavetopaythishigherpremiumaslongasyouhaveMedicareprescriptiondrugcoverage.Inaddition,youmayhavetowaituntilthefollowingNovembertoenroll.
For more information about this notice or your current prescription drug coverage
ContacttheDivisionofRetirementandBenefitsforfurtherinformationat907-465-8600ortollfreeat800-821-2251.
H e a l t h N e w s l e t t e r f o r A l A s k A C A r e M e m b e r s
Varies depending on the amount of drugs you purchase
NOTE:Youwillreceivethisnoticeannuallyandatothertimesinthefuture,suchasbeforethenextperiodyoucanenrollinMedicareprescriptiondrugcoverage,andifthiscoveragethroughAlAskACArechanges.Youalsomayrequestacopy.
For more information about your options under Medicare prescription drug coverage
MoredetailedinformationaboutMedicareplansthatofferprescriptiondrugcoverageisinthe“Medicare&You”handbook.You’llgetacopyofthehandbookinthemaileveryyearfromMedicare.YoumayalsobecontacteddirectlybyMedicareprescriptiondrugplans.FormoreinformationaboutMedicareprescriptiondrugplans:
• Visitwww.medicare.gov,
• CallyourStateHealthInsuranceAssistanceProgram(1-800-478-6065tollfreeorinAnchorageat269-3680)forpersonalizedhelp,
• Call1-800-MEDICARE(1-800-633-4227).TTYusersshouldcall1-877-486-2048.
Number 7, January 2009 A l a s k a D i v i s i o n o f R e t i r e m e n t a n d B e n e fi t s
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Alaska Division of Retirement and BenefitsPO Box 110�0�Juneau, AK 99�11-0�0�
PRESORTEDFIRST CLASS MAILU.S. POSTAGE PAID
DIvISIOn OFRETIREMEnT
AnD BEnEFITS
www.state.ak.us/drb
Alaska Division of Retirement and
Benefits
Health Mattersis published quarterly by the Division of Retirement and
Benefits.
State Office Building 333 Willoughby Ave.,
6th Floor PO Box 110203
Juneau, AK 99811-0203
Patrick ShierDirector and
AdministratorBarbara Kelly
Editor
Toll free: 1-�00-��1-���1
Benefits (907) 465-8600 Fax: (907) 465-4668 TDD hearing impaired:
(907) 465-2805
The Alaska Department of Administration complies with Title II of the 1990 Americans with Disabilities Act (ADA). This health newsletter is available in alternative communication formats upon request. To make necessary arrangements, contact the ADA Coordinator for the Division of Retirement and Benefits, at (907) 465-4460 or contact the TDD for the hearing impaired at (907) 465-2805.
Disclaimer:Information in this newsletter summarizes the plan provisions, is supplemental only, and does not supersede the applicable Information Booklet’s provisions.
Health Plans
Take Good Care of Yourself!
1-���-�99-�0�0��/� Health Line
to speak with a registered nurse about your nonemergency health concerns
Free to AlAskACAre members
Forpeoplewithlimitedincomeandresources,extrahelppayingforaMedicareprescriptiondrugplanisavailable.InformationaboutthisextrahelpisavailablefromtheSocialSecurityAdministration(SSA).Formoreinformationaboutthisextrahelp,visitSSAonlineatwww.socialsecurity.gov,orcallthemat1-800-772-1213(TTY1-800-325-0778).
Remember:Keepthisnotice.IfyouenrollinoneofthenewplansapprovedbyMedicarewhichofferprescriptiondrugcoverage,youmayberequiredtoprovideacopyofthisnoticewhenyoujointoshowthatyouarenotrequiredtopayahigherpremiumamount.
AlAskACAre—Plan Administrator;1-800-821-2251
Prescription Drug Coverage and Medicare Notice—
(cont’d from page 7)