SHARP Corner – June 2014 - Adventist Retirement€¦ · · 2015-05-19discuss the pros and cons...
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Reflections • January 2013 | 1 (Continued on page 2 ) Reflections • June 2014 | 1 SHARP Corner – June 2014 e National Institutes of Health posted this information on their website (www.nih.gov) in April 2014. The Sting of Shingles If you’ve ever had chickenpox, you may be at risk for a painful disease called shingles as you grow older. Shingles is a sometimes-agonizing skin rash and nerve disease that’s caused by a virus. Shingles usually affects adults after age 50, although it can strike at any age. Shingles is caused by the varicella-zoster virus—the same virus that causes chickenpox. Once you’ve had chickenpox, the virus stays with you for life, hidden and inactive in your nerve cells. Your immune system helps keep chickenpox from returning. But later in life, the virus can re-emerge and cause shingles (also known as herpes zoster). Fortunately, a vaccine called Zostavax can help prevent shingles or decrease its severity. It’s been approved by the U.S. Food and Drug Administration (FDA) for people ages 50 and older. e shingles vaccine is available by prescription. If you’re considering the shingles vaccine, be sure to discuss the pros and cons of the vaccine with your doctor, and check with your insurance provider about coverage. SHARP Plan 2014 - THE SHINGLES VACCINE IS AVAILABLE TO SHARP Rx OPTION PARTICIPANTS ONLY As in previous plan years the shingle vaccine is only paid if the retiree or eligible spouse is already a participant in the SHARP Rx Option. e Zostavax vaccine is available as a tier 2 drug under the Express Scripts Medicare D plan. It is available at retail or mail order. e copay will be the Tier 2 copay for brand name drugs. If you have additional questions regarding purchase of the vaccine please contact the Express Scripts Medicare customer service number listed on your Express Scripts prescription identification card. SHARP Explanations of Benefits medical document: e ARM third party payer, WebTPA, will only produce an Explanation of Benefits (EOB) for medical, dental, vision or hearing services if there is a dollar amount that you owe. If the retiree is enrolled in the Base Option, Medicare pays 80%. If the Medicare 20% coinsurance has been applied to the Base Option $2100 deductible when the claim is processed at WebTPA then the retiree will receive an EOB showing what was applied to the deductible. e EOB should then match what the doctor or provider bills you. Once the Base Option deductible is met WebTPA will no longer produce an EOB for you since you will now owe nothing to the doctor or provider. SHARP will be paying the Medicare 20% coinsurance.
Transcript of SHARP Corner – June 2014 - Adventist Retirement€¦ · · 2015-05-19discuss the pros and cons...
Reflect ions • January 2013 | 1
(Continued on page 2 )
Reflect ions • June 2014 | 1
SHARP Corner – June 2014
The National Institutes of Health posted this information on their website (www.nih.gov) in April 2014.
The Sting of ShinglesIf you’ve ever had chickenpox, you may be at risk for a painful disease called shingles as you
grow older. Shingles is a sometimes-agonizing skin rash and nerve disease that’s caused by a virus. Shingles usually affects adults after age 50, although it can strike at any age. Shingles is caused by the varicella-zoster virus—the same virus that causes chickenpox. Once you’ve had chickenpox, the virus stays with you for life, hidden and inactive in your nerve cells. Your immune system helps keep chickenpox from returning. But later in life, the virus can re-emerge and cause shingles (also known as herpes zoster).
Fortunately, a vaccine called Zostavax can help prevent shingles or decrease its severity. It’s been approved by the U.S. Food and Drug Administration (FDA) for people ages 50 and older. The shingles vaccine is available by prescription. If you’re considering the shingles vaccine, be sure to discuss the pros and cons of the vaccine with your doctor, and check with your insurance provider about coverage.
SHARP Plan 2014 - THE SHINGLES VACCINE IS AVAILABLE TO SHARP Rx OPTION PARTICIPANTS ONLY
As in previous plan years the shingle vaccine is only paid if the retiree or eligible spouse is already a participant in the SHARP Rx Option. The Zostavax vaccine is available as a tier 2 drug under the Express Scripts Medicare D plan. It is available at retail or mail order. The copay will be the Tier 2 copay for brand name drugs. If you have additional questions regarding purchase of the vaccine please contact the Express Scripts Medicare customer service number listed on your Express Scripts prescription identification card.
SHARP Explanations of Benefits medical document: The ARM third party payer, WebTPA, will only produce an Explanation of Benefits (EOB) for medical, dental, vision or hearing services if there is a dollar amount that you owe.
If the retiree is enrolled in the Base Option, Medicare pays 80%. If the Medicare 20% coinsurance has been applied to the Base Option $2100 deductible when the claim is processed at WebTPA then the retiree will receive an EOB showing what was applied to the deductible. The EOB should then match what the doctor or provider bills you. Once the Base Option deductible is met WebTPA will no longer produce an EOB for you since you will now owe nothing to the doctor or provider. SHARP will be paying the Medicare 20% coinsurance.
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If the retiree is enrolled in the MCx Option there is no deductible to meet. Medicare pays 80% and SHARP pays the Medicare 20% coinsurance. WebTPA does not produce an EOB.
If you have services or treatments that Medicare does not cover, or you use a doctor who does not accept Medicare assignment, the doctor will ask for your payment of those services. SHARP does not pay on medical services or treatment that Medicare does not cover or when you use a doctor who does not accept Medicare assignment.
Remember that you have the option to create an online account with WebTPA at www.webtpa.com and then have full access to your claim history and can view how each claim has been paid.
Express Scripts: Please remember in any communication you have with Express Scripts to use your identification number from
your Express Scripts card. By doing this you will have better success being identified at Express Scripts as a SHARP member.
Remember, if you contact Medicare/Centers for Medicare and Medicaid Services for prescription information they will know nothing about SHARP and will assist you with original Medicare products, plans and services. As a consumer under the federal rules you do have the option to work directly with Medicare for your healthcare needs. SHARP does not assist with any direct Medicare plan C-F enrollment or costs.
Preventive Care List: Appendix A, pages 53-56 in the 2014 Standard SHARP document.
At RestEach quarter we publish a list of those who have passed to their rest. We no longer provide the ages of the
deceased. Long time readers will note that we have previously also listed the names of new beneficiaries. We have decided to stop doing this after complaints from some individuals who felt their privacy had been invaded. Therefore only the deceased will be listed. Thanks for your understanding.
Aalborg, Dale C. (CO)Abrams, Edna M. (WA)Aguilar, Elias P. (CA)Altman, T. Joyce (MD)Alvarez-Altman, Robert
(NY)Alvarez, Felimon V (CA)Armstrong, Mary Bradley
(NC)Austin, Samuel W Jr. (CO)Bailey, Ralph P. (TX)Bailey, Wanda (CA)Blackburn, Orville Phillip
(AR)Blankvoort, Cornelia E.
(CO)Bonner, Lillie M. (IL)Bowen, Hazel K. (MD)Bradwell, Jenola T. (FL)Braman, Delwin R (MA)Brantley, Alice E. (AL)Brett, Ronald William (CA)Burdge, Roy (NJ)Burton, Gordon L. (NC)Campbell, Donald V. (OH)
Carpenter, Mary S. (NC)Cashatt, James B. (OR)Cereno, Feliza (FL)Claussen, Betty June (MI)Clegg, Ernest J. Jr. (ME)Clendaniel, William Wilson
(FL)Coleman, Gary W. (FL)Collier, Virginia M. (CA)Cornell, Mildred L. (WA)Cross, Jessie I. (CO)Dale, Dick E. (TN)Dassenko, Jack (WA)Davis, Macie (GA)Dickey, Cherie B. (PA)Dry, John M (MI)Dudley, Etta Mae (TN)Dunston, Teddy L. (MN)Eager, Mabuta A. (MI)East, Marjorie M. (KS)Ervin, Virginia (MD)Felder, Leroy (DC)Fleming, Barbara Jean (TX)Forrest, William J. (CA)Foster, Roberta M. (OH)
Francis, Josephine T. (MD)Frank, Elizabeth (OH)Frazier, Shirley K. (FL)Fulinara, Julita M. (CA)Gallant, Daryl L. (ME)Galveso, Margaret (HI)Gerst, Albert H. (TN)Gray, Donald L. (CA)Gully, Eugene (GA)Hainey, Robert R. (IN)Hall, Ramona P. (OR)Hamil, Roy L. (TN)Harris, Robert M. (MO)Hawkes, William F. (MI)Hernoud, Leonard J. (NE)Herrick, Doris Brock (MO)Herzel, Edward F. (NC)Hess, Jerry (NC)Hevener, Clifford (VA)Hewes, Warren C. (TX)Hoover, Karen F. (IL)Hosten, Joyce B. (FL)Hunt, June Louise (CA)Hutchins, F. Lucille (OR)Jackson, Lillie P. (OH)
Jenson, Clara Belle (TN)Johnson, Erma J. (NE)Jones, Robert M. (CA)Kahler, Myrna L. (MO)Kaplan, Florence (CA)Kendrick, Elaine P. (TX)Keppel, John C. (IN)Kinsey, Martha V. (FL)Knapp, Richard W. (WI)Krenrich, Georgene (FL)Kungel, Helen (CO)Lange, Richard C. (ID)Lee, Mary Lois (FL)Leggett, Ida Lee (TN)Leonhardt, Vada (NE)Lindo, Godfrey (MD)Lindsey, Prudence N. (GA)Lowry, Beth (TX)Lujan, Irene R. (CA)Marsh, Nora Dunn (CA)Mattausch, Everett G. (CO)McBeth, Keith L. (FL)McCarthy, Norma (FL)McGhee, Naomi L. (WA)Meier, Margaret Ruth (OH)
Payroll Distribution Dates:December 24January 27
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AdventistRetirement
PlansDel Johnson Administrator
Lyn Wick Associate Administrator
Ray Jimenez Associate Administrator
Lisa Turpen Associate Administrator
Beth Roberts Assistant Administrator
Adventist Risk Management: 1-800-447-5002 Healthcare Claims Queries
SHARP: 301-680-5036 Email: [email protected]
Healthcare Eligibility Queries
Submit all claims to: Adventist Risk Management—SHARP
PO Box 1928 Grapevine, TX 76099-1928
Express Scripts: 1-800-841-5396 Express Scripts Medicare PDP: 1-866-838-3974
Verify pharmacy benefit and pharmacy participation
Payroll: 1-888-838-8955 Bulletin Board of Payroll Information
NAD Retirement Department Fax: 301-680-6190
Email: [email protected] 12501 Old Columbia Pike
Silver Spring, MD 20904-6600
Barbara Yowell: 301-680-6244 Lost checks, direct deposits,
1099R, tax withholding, verification of benefits for loans,
housing, Medicaid
Shirley Jones: 301-680-6249 General Retirement Office Information Reporting a death, change of address,
disability reviews
Checks/EFT Released
This Month: June 27Next Month: July 25
PAYROLL BULLET IN BOARDMiller, William Robert (OR)Mills, Joy E (TN)Mitchell, Mary F. (TN)Moats, Mary J. (KS)Mohr, Gretta J. (OR)Morsette, Mary B. (TN)Moses, Keith W. (CA)Moyer, Dorothy M. (TN)Nguyen, De Thi (CA)O’Reilly, Virginia P. (OH)Oberholtzer III, John W
(GA)Oetman, Ella (MI)Olson, Catherine Mavis
(OR)Park, Young D. (CA)Pedro, Liberato P. (CA)Petry, Henry Baldwin (OK)Pidoux, Carlos A. (MI)Pierce, Rachel May (HI)Powell, Rodney D (OH)Ramsey, Marjorie (OR)Ratledge, Charles L. (HI)Reaves, Jean M. (FL)Reed, Mae G. (CA)Reed, Ralph E. (MD)Rehberg, Susan (CA)Reinke, Beatrice F. (OR)Rennard, Joseph (VA)Rivas, Mary E. (CA)Robertson, Frances A (TN)Robinson, Arthur W. (CO)Rodriguez, Alfonso M. (FL)Rohleder, Jimmie L. (TX)Running, Leona G. (MI)Sather, Anne M. (CA)Satonica, Daniel (MI)Schaak, Bernice E. (WA)
Schlereth, Dorothy A. (MI)Schultz, Arlene D. (CO)Scott, David E (KS)Siebuhr, LaVerne Mae (CO)Smalling, Sharon A. (MO)Sonnycalb, Carol Lyne (OH)Spaulding, Ferol Mae (WA)Spear, Ronald D. (WA)Spence, Felicitas (TN)Steck, Jacqueline (FL)Stiles, Jack Clinton (GA)Sutphin, Doris M. (CA)Taniguchi, Masato (HI)Taylor, Charles R. (TN)Taylor, Elizabeth A (OR)Thomas, Joye F. (CA)Tibbetts, Audrey E. (CA)Tidwell, R. B. (TN)Timmerman, Edith (WI)Tomer, Philip E. (CO)Trombetta, Charlene (TX)Troy, Owen A. (MI)Tucker, Alma E. (CA)Tuttle, Eva F. (IL)Van Noty, Elwood Earl (CA)Villasista, Corazon (HI)Vogt, William W. (NC)Vorraso, Ella K. (OH)Weber, Ellen J. (ID)West, Pitman (KY)Westman, Emma A. (ND)Whitaker, Joe H. (OH)Wilcox, Audrey F. (FL)Willey, Ruby I. (OK)Winchester, Altha Louellen
(CA)Zamorano, Edgardo (AZ)
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General Conference of SDANAD Retirement Plans12501 Old Columbia PikeSilver Spring, MD 20904-6600
