Helping You Prepare For Your Upcoming Medicare Enrollment€¦ · Current Age 65+ Medicare-eligible...

Orientation Meeting for Gerdau

St. Paul Union Retirees (July 2016)

OneExchange

Helping You Prepare For Your Upcoming

Medicare Enrollment

1

Welcome and What We’ll Cover Today

Introductions

Purpose of Meeting (General Concepts)

Background

What is changing and Why?

Who is impacted?

How it impacts you

Transitions Can Be A Good Thing!

OneExchange – For Your Benefit

A Deeper Dive – Benefit Advisors, Private Exchange,

Optimize Savings, Health Reimbursement for You

Next Steps

Questions and Answer

__________________________________________________________ The examples and information provided in this presentation by Gerdau and OneExchange are largely based on 2016

pricing and information. The plan options and costs are subject to change at any time. Nothing in this presentation is a

promise to provide benefits or specific coverage. The actual benefits will be based on the coverage option selected. Any

medical decisions are made by the participant. This presentation does not modify the ERISA Plan though which Gerdau

currently provides retiree medical benefits or commit Gerdau to provide any such benefits.

2

What’s Changing?

Objective: To offer our retirees sustainable, affordable coverage that

will meet each individual’s needs. We know one group plan does not

“fit all”.

The individual market trend increases have been in the single digits

for the last decade. Carriers are able to spread the risk over 48 Million

Medicare eligibles, thus keeping the market stable and sustainable.

Gerdau, with the help of OneExchange, has completed extensive

financial modeling comparing the incumbent Gerdau plans to the open

Medicare market which will allow flexible options, including access to

more comprehensive coverage and cost premium options to meet

multiple needs.

Effective January 1, 2017, Gerdau is changing the way we

currently provide retiree health care benefits for those who

are Medicare eligible.

3

Who is Impacted?

• The following groups of employees will transition to this more

flexible program as of January 1, 2017:

Current Age 65+ Medicare-eligible retirees* (retired as of June 1,

2016 or prior) with Gerdau retiree medical coverage; plus

Current Pre-Age 65 retirees* (as of June 1, 2016 or prior) with

Gerdau retiree medical coverage transition to this program upon

turning age 65.

• Note: coverage includes separate plan elections for retired

employees and covered spouses. Also, the transition does NOT

impact Medicare-disabled employees/retirees under age 65 nor

retirees with End Stage Renal Disease.

4

How This Affects You

What you pay Depends on the plan you choose and how you

elect to use your HRA monies

Choose the right level of coverage for you and

your spouse individually

How you enroll You enroll directly through OneExchange

You and your Medicare-eligible spouse enroll in

separate plans

Your support OneExchange will be your partner as you make

this decision and enroll in plans

OneExchange will provide ongoing support —

at no cost to you

5

About the OneExchange Retiree Healthcare Program

© 2016 Willis Towers Watson. All rights reserved. Proprietary and Confidential. For Willis Towers Watson client use only. 6

Towers Watson

over

100 years experience

First and Largest

private Medicare Exchange

Personalized options with plans from a nationwide network of carriers

More Choice, More Flexibility

– Better Value

Licensed advisor provides

guidance and ongoing advocacy

Over 1 million retirees served across

540+ employers

Our

10th annual enrollment season

Founded in 2004

No fees for

our service

OneExchange Service Centers


Operating hours:

Monday – Friday, 7:00 a.m. until 8:00 p.m. Central Time

100% Domestic Workforce No Outsourcing!

Salt Lake City,

UT

Dallas, TX

Phoenix, AZ

Plans and Partners


Wide selection of plans from leading national / regional carriers

Medicare Advantage

Medicare

Supplement

(Medigap)

Prescription Drug

(Part D)

All Plan Types

Dental Plans and Visions Plans

Helping You Prepare For Your

Upcoming Individual

Medicare Enrollment and Information

About Your Future Coverage

© 2016 Willis Towers Watson. All rights reserved.

Your Future Coverage


Primary Coverage

Medicare A and B

Additional Coverage (your choice)

Medicare Advantage with

Prescription Drug (MAPD) or

Medigap + Prescription Drug

Optional Coverage (your choice)

Dental Plans

Vision Plans

OPTION 1


Medicare Advantage Plan with Prescription Drug Coverage (MAPD)*

* Note that Medicare Advantage plans are generally network based plans.

MEDICARE

ADVANTAGE HMO PPO

OPTION 2


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

MEDIGAP

PLAN

PART D

PLAN

Medigap Plan + Part D Plan

MEDIGAP

PLAN


Medicare Supplement Insurance (MediGap) – Lettered Policies

Medicare Supplement Insurance (Medigap) Policies

Benefits A B C D F 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% 100% 100%

Medicare Part B coinsurance

or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Part A hospice care

coinsurance or copayment 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%

Skilled nursing facility care

coinsurance 100% 100% 100% 100% 50% 75% 100% 100%

Part A deductible 100% 100% 100% 100% 100% 50% 75% 50% 100%

Part B deductible 100% 100%

Part B excess charges 100% 100%

Foreign travel emergency

(up to plan limits) 80% 80% 80% 80% 80% 80%

Source: CMS Out-of-Pocket

limit in 2017

$4,960 $2,480

Part D Plans – 5 Tiers of Co-Pays


A prescription drug plan will typically

break the formulary into “tiers.” The

tiers correspond to the copayment or

coinsurance the beneficiary will pay.

Cost-sharing increases with the tier number.

Tier 1 is the least expensive, tier 4 or 5 is the

most expensive.

Tier descriptions:

Tier 1 preferred generic

Tier 2 non-preferred generic

Tier 3 preferred brand

Tier 4 non-preferred brand

Tier 5 specialty drugs or injectable medicine

Medicare Prescription Drug Coverage 2017


Catastrophic Coverage

Coverage Gap

Initial

Coverage Deductible

You Pay Full Retail

Until Deductible is Met

2017 - $0 to $400

You pay copays for

your plan coverage

for the first $3700 in

actual costs of

Medications

You pay 40% of Brand Name

and 51% of Generics until

your out of pocket costs

reach $4950; Pharmaceutical

contributions will count

towards the $4950 TrOOP

You Pay $3.30 for

Generics and $8.25 for

Brand Name or 5% -

whichever is greater

Only 25% reach

Donut Hole

Only 4% reach

Catastrophic


A Deeper Dive Into Our Process

The Transition Process


Simplified

Selection

Consultative

Process

Ongoing

Advocacy

Effortless

Enrollment

Education


Getting Started Guide:

Prepare for your enrollment

Pre-existing conditions will not

limit your plan selection*

Call as soon as Aug 15

1-855-872-6807

Medicare.OneExchange.com/Gerdau

Education


Enrollment Guide:

Understand your options

Review Medicare basics

What to expect during your

enrollment call

FAQs

Appointment confirmation

Call Toll Free

1-855-872-6807 as soon as Aug 15

Medicare.OneExchange.com/Gerdau

Benefit Advisors


Benefit advisors are available:

Monday – Friday, 7:00 a.m. until 8:00 p.m. Central Time

Licensed / Certified / Appointed

OneExchange University™

Average age 43

Objective & unbiased

100% domestic workforce

Decision Support Tools


Prescription

Profiler

medicare.oneexchange.com/Gerdau 24/7 access to your information

Load in your prescriptions - Shorten your time on the phone with us!

Decision Support Tools


Help Me Choose

Comparison Tool

Enrollment Process


Benefit Advisors can discuss coverage

options with anyone

Telephonic enrollment – 2 part process

100% of calls are recorded

We’ve got your BAC:

Benefit Advisors

Application Data Processors

Customer Service Reps

Selection Confirmation Notice


You may review the plan(s)

that you selected – will be

sent shortly after you enroll.

Personal Guidance


Navigation

Enrollment

Prescription

changes

Affordability

concerns

Reimbursement

issues

Late enrollment

HRA

Annual plan

review

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.

An Ongoing Advocate


Health Reimbursement Arrangement (HRA)


Tax-free account used to reimburse you

for eligible health care expenses — you pay first

and then get reimbursed

No Double-Dipping

Your 2017 $1,800 HRA funding will be available

January 2017

Unused funds DO roll

over

Gerdau will make an annual

contribution to a Health Reimbursement

Arrangement (HRA) for our retirees and spouses.

You may use HRA funding to reimburse

yourself for eligible medical, prescription

drug, dental, and vision premiums, as well as

eligible out-of-pocket healthcare expenses

Health Reimbursement Arrangement


You may be reimbursed up to the amount Gerdau has made

available in your HRA!




Reimbursement Options

Reimbursements are

up to the amount

available in the HRA

$ $

1

Automatic

Reimbursement (including recurring premiums)

Manual

Reimbursement

Participant

OneExchange Insurance

Carrier

Participant

OneExchange Insurance

Carrier


2016 Localized Slides – Ramsey County - 55119

Plans Available in Ramsey County- 2016


Examples only and subject to change

Plan Type Number of

Plans Offered

2016

Monthly

Premium

Carriers

(subject to change)

Medicare

Advantage 26 $39 - $229

Ucare, Humana,

BCBS of Minnesota, Medical

Medigap /

Medicare

Supplement

15 $147 - $372 AARP-UHC, Humana, BCBS,

Cigna, Loyal American Life

Part D 15 $18 - $111

AARP-UHC, BCBS, Humana,

WellCare, Coventry, Aetna,

Express Scripts, SilverScripts

Plans Available in Ramsey County - 2016


Examples only and subject to change

Plan Type Number of

Plans Offered

2016

Monthly Premium Carriers

Vision

1

$14

Vision Service Plan

(VSP)

Dental

5

$19 - $59

Humana, CarePPO,

Renaissance Dental,

MetLife

Medicare Advantage Plan


Example only and subject to change (75 year old male, 2016 sample rates)

Benefit Cost 2016

Premium $69

Network PPO

Deductible $0 in network -- $1,000 out of network

Doctor Copay $15

Specialist Copay $45

Hospital Days 1 - 5 $354 per day

Emergency Room $75

Rx – Deductible

Retail Co-Pay Tiers

$360

$4 / $15 / $47 / $100 / 25% 30 days

Mail Order Co-Pay Tiers $0 / $0 / $131 / $290 90 days

MN Extended Basic (F) + Prescription Drug Plan


Benefit Cost 2016

Premium $226 ($202 Medical + $24 PDP)

Network Not Applicable

Deductible $0

Doctor Copay $0

Specialist Copay $0

Hospital $0

Emergency Room $0

Rx – Deductible

Retail Co-Pay Tiers

$0

$3 / $13 / $37 / 43% / 33% 30 days

Mail Order Co-Pay Tiers $8 / $32 / $92 / 43% 90 days


2016: Coverage and Cost Comparison: Current Scenario

vs. Plan N or MN Extended Basic (Plan F)


Benefit/Cost Current Gerdau Plan

(Similar to Plan N)

Plan N with

Gerdau HRA

- No Lifetime Max

Plan F with

Gerdau HRA

-No Lifetime Max

Lifetime Maximum $500,000 Unlimited Unlimited

Network BCBSIL only Not Applicable Not Applicable

Deductible $125 $166 $0

Doctor Copay 20% Retiree/80% Plan $20 $0

Specialist Copay 20% Retiree/80% Plan $20 $0

Hospital 20% Retiree/80% Plan $0 $0

Rx – Deductible No deductible No deductible No deductible

HRA Credit $0 ($1,800) ($1,800)

Total Annual

Premium $992

$744: based on:

$2,256 premium ([$188

Medical + $24 PDP] X12)

less $1,800 HRA credit

$912: based on:

$2,712 premium ([$202

Medical+ $24 PDP] X12)

less $1,800 HRA credit



Next Steps

What You Need To Do:

No Action Required Right Now, but Soon


(Call as soon as August 15, 2016 and make sure to enroll Oct. 3 - Dec. 30, 2016)

Contact OneExchange at

1-855-872-6807 Call as soon as August 1st to complete

your profile and schedule an enrollment

appointment

You will need your Medicare card,

prescription list, and doctor and hospital

information We are Ready!


Questions and Answers

Frequently Asked Questions Q. Why is the effective date changing from our original letter; from 9/1/16 to 1/1/17?

A. Gerdau moved the date back for a number of reasons. This includes giving retirees more time

to plan for the transition and to coincide restarting any deductibles with the start of a calendar year.

This does mean there will be no $1,800 HRA funding for a pro-rata 2016 plan year, but

retirees will still receive the $1,800 HR funding in January 2017 for the 2017 plan year.

Q: I am a snowbird - Do you offer plans that cover me in multiple states ?

A: Medigap plans are accepted by every Medicare-participating provider in the U.S., with some

emergency benefits worldwide. If you travel frequently or live part of the year out-of-state, these

plans may be right for you. Part D plans provide nationwide coverage from participating pharmacies.

Medicare Advantage plans cover urgent and emergency services nationwide, but some may not

provide nationwide coverage for non-emergency services. If you live part of the year out-of-state,

these plans may not be right for you.

Q: How often will I be billed? By whom? Can I pay by check?

A: When you enroll in a new plan, you will need to begin making premium payments to the insurance

company in order to maintain your coverage. Some insurance companies may require the first

month’s premium payment during the application process. In this case, you should expect to make a

payment within a few days of your enrollment. Please have your billing information ready when you

make your enrollment call to OneExchange.

Most insurance companies give you several billing options for ongoing payments: direct billing,

paid by check each month, Electronic Funds Transfer from your checking account, or automatic

deduction from your social security check. You can choose to pay monthly, quarterly, or yearly.

39

Frequently Asked Questions Q: Will I be refused coverage due to a pre-existing condition?

A: No, you have a guaranteed issue window that is granted due to your upcoming loss of group coverage through Gerdau on December 31, 2016. If you decide to select a Medigap plan during the October 3, 2016 – December 30, 2016 enrollment period you cannot be denied coverage due to a pre-existing condition. If you decide to select a Medicare Advantage plan they are always guaranteed issue.

Q: Will I pay more? Can my policy be cancelled once I am enrolled because of my condition?

Can my rate be raised for that reason?

A: No, your policy cannot be cancelled once you are enrolled unless you do not pay your premiums and your rate will not be raised for medical reasons.

Q: If I don’t like the plan that I enrolled in, when can I change?

A: For Medicare Advantage plans, every year there is a Medicare Annual Enrollment Period during which you may investigate other medical and drug plans and potentially enroll in a different plan. You will receive notification from OneExchange of the Medicare Annual Enrollment Period (around October 15 - December 7 each year). For Medigap plans, you may change at any time, but there is the possibility of medical underwriting. At any time, we encourage you to give us a call and we will explore available options for you.

Medical underwriting-The process that an insurance company uses to decide, based on your medical history, whether to take your application for insurance, whether to add a waiting period for pre-existing conditions (if your state law allows it), and how much to charge you for that insurance.

40

Frequently Asked Questions Q: What if I have the option for other coverage (spouse, military) — if I don’t enroll with

OneExchange can I enroll later?

A: Yes, during the Annual Enrollment Period each fall. You will need to enroll into Medical or

prescription drug plan coverage to be eligible for the HRA funding

Q: I re-married after I retired — is my spouse eligible for OneExchange’s services?

A: Yes. OneExchange can assist your spouse with individual plan coverage consultation but

they will not be eligible for the program subsidy.

Q: Will my premium rates increase every year? If so, by how much?

A: In general, insurance premiums do increase every year. The increase in these individual plans

cost year-to-year can vary widely. We advise our enrollees to contact us review plan options

annually. The national average has been recently running about a 3-4% increase.

Q: Are there plans that will cover me when I travel domestically or internationally?

A: Medigap plans are accepted by every Medicare-participating provider in the U.S., with some

emergency benefits worldwide. If you travel frequently or live part of the year out-of-state,

these plans may be right for you. A few Medicare Advantage plans also have world wide

emergency coverage.

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Call on August 15, 2016 or After to Set up Your Appointment; and

Enroll October 3 – December 30, 2016

1-855-872-6807

Helping You Prepare For Your Upcoming Medicare Enrollment€¦ · Current Age 65+ Medicare-eligible...

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