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Dominion Retiree Medical
HR and Executive Briefing
August 2013
A New Approach to Retiree Medical Benefits
Providing Options to Medicare Eligible Retirees
Information for Retirees
© 2013 Dominion
© 2013 Dominion 2
Agenda
© 2013 Dominion 2
• A Message from Tom Farrell
• New Approach
• Benefits to Change
• Who‘s Affected
• Introducing Extend Health
• Transitioning from current coverage
• What you need to do
• Your questions
© 2013 Dominion 3
Tom Farrell
Chairman, President & CEO
Dominion
© 2013 Dominion 4
New Approach
© 2013 Dominion
Dominion provides more choices to our non-union retirees
age 65 and older and will continue to subsidize the cost of
coverage.
This new approach offers the following enhancements:
• Catastrophic Coverage: 100% reimbursement for eligible prescription drug expenses incurred beyond a certain dollar amount
• Dedicated and licensed benefits advisors to help with plan choices
• Multiple plans, many at lower cost
• Annual stipend funded into a Health Reimbursement Account (HRA), indexed over time to reflect medical cost increases
Transition begins January 2, 2014 with a 3-month open
enrollment period. Coverage is effective April 1, 2014.
© 2013 Dominion 5
Why This Approach
Benefits to Retirees
More plan options, many at lower cost
Protection in the event your prescription drug costs are high
A financial subsidy that is indexed to reflect increases in medical costs
Dedicated and licensed benefits advisors who will help you choose the
best plan for you and provide ongoing advocacy for claim issues
Benefits to Dominion
Ability to ensure affordable high-quality, ongoing coverage to retirees
Immediate and long-term reduction in health care costs
© 2013 Dominion 5
© 2013 Dominion 6
Who’s Affected: Non Union Retirees
© 2013 Dominion 6
Retirees 65 and Older and their covered spouses
• Retired on or after Jan. 1, 1993
• Transition to Extend Health exchanges
• Some exceptions apply
Retirees Pre-65 and their covered spouses
• Continue coverage under the current Dominion retiree medical plan until age 65
• Transition to Extend Health when reach age 65
• Some exceptions apply
Future Retirees and their covered spouses
• Offered medical plans from the exchange when they reach age 65.
© 2013 Dominion 7
Who’s Affected: Those with HMOs
Retired on or after 2-1-10
Eligible to enroll
through Extend Health
Cost of coverage will be
subsidized by Dominion
with annual stipend
Retired after 12-31-95 & before 2-1-2010:
• Ineligible for the stipend
• Offered Extend Health services to help them shop for a plan
• Retirees in parts of Pennsylvania, Ohio, and Arizona
– Currently offered Medicare HMOs (not traditional retiree coverage)
– Legacy of the CNG merger; Dominion does not subsidize this cost
• Three future exchange scenarios based on retirement date
Retired between 1-1-93 & 12-31-95: One time choice
• Remain in subsidized HMO
• Enroll through Extend Health and receive an annual stipend
Present this slide
only for meetings
taking place in
HMO territory
© 2013 Dominion 8
Over time, Dominion retiree medical plan design
has changed, with more cost shifting to the retiree
• Stipends are reflective of the portion that Dominion pays
• Those who retired years ago will have a higher stipend than
those who retired more recently, or those who will retire in the
future
• With HRA funding from Dominion, most retirees will be able to
purchase insurance that provides equivalent or better
benefits, with many plans available at a lower cost
© 2013 Dominion 9
2014 Retiree Stipends
Retirement Date Other Criteria
Retiree
Annual
Stipend
Spouse
Annual
Stipend
Before 1-1-1993 None Stay on the Dominion plan
1-1-1993 to 12-31-2000
Dominion retiree (excludes
pre-merger CNG retirees) $2,800 $2,400
1-1-1993 to 12-31-2000 Pre-merger CNG retiree $2,000 $1,800
1-1-2001 to 12-31-2004 None $2,000 $1,800
This version
applicable in non-
HMO territory
© 2013 Dominion 10
2014 Retiree Stipends
Retirement Date Other Criteria
Retiree
Annual
Stipend
Spouse
Annual
Stipend
After 12-31-2004
Age 55 or older on 12-31-2004 $2,000 $1,800
After 12-31-2004 Age 53 or 54 on 12-31-2004 $1,800* $1,300*
After 12-31-2004
Age 50 - 52 on 12-31-2004 $1,500* $1,150*
After 12-31-2004 Age 45 - 49 on 12-31-2004 $1,300* $1,000*
This version
applicable in non-
HMO territory
* Reduced if less than 30 years of service
© 2013 Dominion 11
2014 Retiree Stipends
Retirement Date Other Criteria Retiree
Annual
Stipend
Spouse
Annual
Stipend
Before 1-1-1993
None Stay on the current plan
1-1-1993 to 12-31-1995 Choice or Medicare HMO or traditional
coverage
$2,000 $1,800
On or after 2-1-2010
Age 55 or older on 12-31-2004 $2,000 $1,800
On or after 2-1-2010
Age 53 or 54 on 12-31-2004 $1,800* $1,300*
On or after 2-1-2010
Age 50 - 52 on 12-31-2004 $1,500* $1,150*
On or after 2-1-2010 Age 45 - 49 on 12-31-2004 $1,300* $1,000*
* Reduced if less than 30 years of service
© 2013 Dominion 12
How Can Retirees Pay Less: Example: “Average” Age 75 in 2014 with 30 years of service
Example of Richmond, VA retiree aged 75 requiring an ambulance with overnight hospitalization, cardiologist and primary care provider visits, and prescription drugs for their heart and cholesterol
Notes: Actual changes in total costs will depend on each individual’s circumstance, stipend cannot be used to reimburse drug out of pocket cost, stipend amount varies based on age, years of service, and retirement date
Cost Item (Annual) Current Plan
Full Coverage Medigap, and Rx
Plan
Medicare Advantage Plan
(HMO)
Medicare Advantage Plan
(PPO)
Medicare Part B Premium $1,259 $1,259 $1,259 $1,259
Medical Plan Premium / Contribution
$485 $2,597 $0 $600
Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above
Medical Out-of-Pocket Costs $1,042 $0 $955 $1,135
Drug Out-of-Pocket Costs $240 $472 $500 $500
Stipend N/A ($2,000) ($2,000) ($2,000)
Total Costs $3,026 $2,816 $714 $1,494
Decrease in Total Costs Decrease of $210 Decrease of $2,312 Decrease of $1,532
© 2013 Dominion 13
How Can Retirees Pay Less: Example: “High Medical Cost” Scenario Age 75 in 2014 with 30 years of service
Example of Richmond, VA retiree aged 75 requiring major medical services including surgery, a 9 day hospitalization, several follow-up specialist visits and drugs to manage a heart condition
13
Cost Item (Annual) Current Plan
Full Coverage Medigap, and Rx
Plan
Medicare Advantage Plan
(HMO)
Medicare Advantage Plan
(PPO)
Medicare Part B Premium $1,259 $1,259 $1,259 $1,259
Medical Plan Premium / Contribution
$485 $2,597 $0 $600
Drug Plan Premium N/A, incl. above $488 N/A, incl. above N/A, incl. above
Medical Out-of-Pocket Costs $1,816 $0 $3,400 $3,795
Drug Out-of-Pocket Costs $360 $896 $1,000 $1,000
Stipend N/A ($2,000) ($2,000) ($2,000)
Total Costs $3,920 $3,240 $3,659 $4,654
Decrease in Total Costs Decrease of $680 Decrease of $261 Increase of $734
Notes: Actual changes in total costs will depend on each individual’s circumstance, stipend cannot be used to reimburse drug out of pocket cost, stipend amount varies based on age, years of service, and retirement date
© 2013 Dominion 14
What do you need to do?
If either you or your spouse are age 65 or will turn age 65
between now and April 1st, action is required.
If either you or your spouse are not age 65 and will not turn
age 65 between now and April 1st, no action is required at
this time.
© 2013 Dominion 15
Introducing Extend Health
Extend Health, a Towers Watson company, is the largest private
Medicare exchange that
• Provides a wide selection of carriers and coverage options • Works with many companies and unions • Provides customized support for retiree needs
Dominion will offer private Medicare exchanges to non-union participants
age 65 and older through Extend Health, a private health insurance
exchange.
Again, these are not the same exchanges
that are now open to everyone
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
The Industry’s Largest Medicare Exchange
• Extend Health works with many companies and unions
– DuPont, Southern States, Media General, Ford, Alliant Energy, IBEW, First Energy, CSX, Advance Auto Parts, City of Chesapeake, IBM and Time Warner
– Companies utilizing this approach continue to grow
• Largest private Medicare exchange
– Serving more than 300 companies, including 50 in the Fortune 500
• Wide selection of plans
– 90+ national and regional carriers, including Anthem
• Customized support for retiree needs
– Retirees receive one-on-one help from licensed benefit advisors to choose their plans and ongoing advocacy with claim issues
Extend Health, a Towers Watson Company
• Towers Watson acquired Extend Health in May 2012
• Next year, we will become fully integrated with our parent
company. We will drop Extend Health from our name and
become Towers Watson’s OneExchange
• We will send you a notice to let you know when the
change is complete
Look for the Towers Watson and OneExchange logos:
18
towerswatson.com © 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.
Next year, we are changing our name!
© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.
Plans & Partners
All Medicare Plan Types
• Medicare Advantage
• Medicare Supplement
(aka Medigap)
• Prescription Drug (Part D)
Dental / Vision Over 90
National/Regional
Carriers
19
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
The Process
20
.
.
.
Educate
Evaluate / Enroll
Manage
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Gather information
• (e.g. prescriptions)
• Pre-existing conditions will
not limit your plan selection*
• Give us a call
855-238-0483
www.ExtendHealth.com/Dominion
Education Getting Started Guide
* except end-stage renal disease
21
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Education Enrollment Guide
Prepare you for your
enrollment discussion
• Review Medicare
basics
• Appointment
confirmation letter
22
© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.
Decision Support Tools
Help Me
Choose
Prescription
Profiler
www.ExtendHealth.com/Dominion
23
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Licensed Benefit Advisor
• 100% domestic workforce
• Objective advocacy
• Neutral compensation
• Extend University
• Licensed, certified, appointed
• Average age 43
Hours of Operation
Monday – Friday 8 a.m. – 9 p.m. Eastern Time
Evaluate and Enroll
24
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Enrollment Process
• Benefit Advisors can discuss coverage options with anyone – need to speak to the participant to complete the enrollment
• Once you have made a coverage selection, enrollment is conducted via telephone
• 100% of calls are recorded
25
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare and You
26
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Your Future Coverage
27
Primary • Medicare A
• Medicare B
Additional
• Medigap
• Medicare Advantage
• Part D
Optional • Dental
• Vision
Your
Future
Coverage
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Plan Types
28
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Plan Types
29
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Prescription Drug Coverage
30
Initial Coverage.
Coverage Gap.
.Catastrophic Coverage
You Pay
• Deductible an co-pays for our plan
• Coverage for the first $2850 in actual cost of medications
You Pay
• 47.5% of Brand Name and 72% of Generics
• Until your out of pocket cost reach $4550
You Pay
• $2.55 for Generics and $6.35 for Brand Name
• Or 5% whichever is greater
Additional financial support provided by Dominion for retirees with
significant pharmacy claims
Benefit reimburses any prescription drug costs incurred after the
Medicare Part D TrOOP maximum is reached for a retiree or eligible
dependent within the plan year
If you qualify, contact Extend Health for assistance
What is Medicare Part D TrOOP?
TrOOP is the true out-of-pocket maximum that includes the cost
of prescription drugs incurred during the year — including any
deductible, coinsurance co-pays and payments made in the
coverage gap, or “doughnut hole.” Premiums do not count
toward TrOOP. The 2014 amount is $4,550.
31
Catastrophic Coverage
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only. 32
Location Specific Plans
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Richmond, Hampton
Henrico, and Virginia Beach City or County
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
8 $0 - $81
Medigap/
Medicare
Supplement
14 $58 - $202
Part D 17 $13 - $115
33
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $41
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
34
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $40
Network PPO
Deductible $1000
Doctor Copay $15
Specialist Copay $40
Hospital $260 co-pay per day - days 1-7
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply
Mail Order $0/ $0/ $125/ $275 90 day supply
35
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $218 ($202 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
36
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Chesterfield County
(VA)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
8 $0 - $81
Medigap/
Medicare
Supplement
14 $60 - $218
Part D 17 $13 - $125
37
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $41
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
38
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $50
Network PPO
Deductible $1000
Doctor Copay $15
Specialist Copay $40
Hospital $260 co-pay per day - days 1-7
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply
Mail Order $0/ $0/ $125/ $275 90 day supply
39
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $218 ($202 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
40
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Charlottesville City (VA)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
4 $0 - $81
Medigap/
Medicare
Supplement
14 $60 - $216
Part D 17 $13 - $115
41
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $41
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
42
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $62
Network PPO
Deductible $500
Doctor Copay $15
Specialist Copay $40
Hospital $275 co-pay per day - days 1-6
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $6/ $16/ $45/ $95/ 33% 30 day supply
Mail Order $0/ $0/ $125/ $275 90 day supply
43
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $218 ($202 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
44
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Cuyahoga County (OH)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
20 $0 - $165
Medigap/
Medicare
Supplement
24 $79 - $259
Part D 18 $13 - $119
45
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $36
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
46
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $39
Network PPO
Deductible $500
Doctor Copay $5
Specialist Copay $30
Hospital $150 co-pay per day - days 1-5
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $4/ $20/ $42/ $85/ 33% 30 day supply
Mail Order $10/ $50/ $105/ $255 90 day supply
47
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $234 ($218 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
48
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Allegheny County (PA)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
13 $40 - $224
Medigap/
Medicare
Supplement
11 $92 - $348
Part D 16 $13 - $169
49
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $39
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
50
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $40
Network PPO
Deductible $1250
Doctor Copay $10
Specialist Copay $50
Hospital $200 co-pay for each stay
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $10/ $45/ $95/ 33% 30 day supply
Mail Order $20/ $112/ $285 90 day supply
51
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $281 ($258 Medigap + $23 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $12/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $24/ $80/ $180 90 day supply
52
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Kewaunee County (WI)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
4 $0 - $112
Medigap/
Medicare
Supplement
12 $120 - $231
Part D 15 $13 - $137
53
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$27 - $39
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
54
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $42
Network PPO
Deductible $1000
Doctor Copay $10
Specialist Copay $40
Hospital $264 co-pay per day - days 1-7
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $6/ $15/ $45/ $95/ 33% 30 day supply
Mail Order $0/ $0/ $125/ $275 90 day supply
55
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $232 ($188 Medigap + $44 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $4/ $7/ $40/ $85/ 33% 30 day supply
Mail Order $0/ $7/ $115/ $250 90 day supply
56
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Plans Available in Fairfax County (VA)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
6 $0 - $81
Medigap/
Medicare
Supplement
14 $58 - $202
Part D 17 $13 - $115
57
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$22 - $41
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
58
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $77
Network PPO
Deductible $750
Doctor Copay $15
Specialist Copay $40
Hospital $250 co-pay per day - days 1-7
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $7/ $45/ $95/ 33% 30 day supply
Mail Order $14/ $90/ $190 90 day supply
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Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $218 ($202 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
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Plans Available in Harrison County (WV)
Plan Type Number of
Plans Offered
2014
Monthly Premium
Medicare
Advantage
15 $0 - $170
Medigap/
Medicare
Supplement
15 $73 - $229
Part D 17 $13 - $169
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Ancillary Coverage
Plan Type
Number of
Plans
Offered
2014
Monthly Premium Company
Vision 1
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses,
lenses and frames
Vision Service Plan
(VSP)
Dental 1
$19 - $36
$50 deductible
$1,000 annual maximum
Delta Dental,
Humana
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© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medicare Advantage Plan
Benefit Cost
Monthly Premium $40
Network PPO
Deductible $1000
Doctor Copay $15
Specialist Copay $40
Hospital $260 co-pay per day - days 1-7
Emergency Room $65 co-pay if not admitted
Rx Deductible $0
Rx Tiers $6/ $18/ $45/ $95/ 33% 30 day supply
Mail Order $0/ $0/ $125/ $275 90 day supply
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© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Medigap Plan F and PDP (75 yr old male)
Benefit Cost
Monthly Premium $218 ($202 Medigap + $16 PDP)
Network Any doctor that accepts Medicare
Deductible $0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Rx Deductible $0
Rx Tiers $0/ $16/ $40/ $90/ 33% 30 day supply
Mail Order $0/ $32/ $80/ $180 90 day supply
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© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only. 65
Health Reimbursement
Arrangement Account
Auto-Reimbursement Auto-Reimbursement
How the Process Worksent
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
What Is An HRA
• Tax-advantaged account used to reimburse you for eligible health care expenses
• You must meet Dominion’s eligibility requirements to qualify for HRA
• Your HRA funds will be available April 1, 2014
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Health Reimbursement Arrangement (HRA)
extendhealth.com 67
Dominion
allocates
benefit dollars
to each retiree’s
HRA account
HRA
Account
Retirees are
reimbursed for
eligible health
care expenses
using HRA
benefit dollars
Participant works
through Extend
Health to enroll
in individual
coverage
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Reimbursement options
68
• One time or recurring claims forms
• Fill out form
• Attach required documentation
• Submit via Mail, Fax or Web
• Available for all expense types
1.
Paper Claims
• Enroll in a participating plan
• Ask to select option
• Pay premiums as required
• Available for plan premiums only
2.
Automatic
Reimbursement
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
How to File a Paper Claim
Participant pays plan premium or
co-pays
Participant fills out claim form, attaches required information
Extend Health verifies receipt of
payment and eligibility
Extend Health reimburses participant
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© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Extend Health HRA Claim Form
Remember,
You can be
Reimbursed for
Part B by sending
in your statement
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© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
How Auto-Reimbursement Works
Participant pays plan premium to
insurance company
Insurance company forwards receipt of payment to Extend
Health
Extend Health verifies receipt of
payment and eligibility
Extend Health reimburses participant
71
© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.
• Service offered by Extend Health
• Available on most plans
• Works for premium reimbursement only
• No claim form is required
• Can take 2-3 billing cycles to initiate
• If you need your reimbursement sooner, simply
file a paper claim. The form and instructions
will be provided in your HRA Welcome Kit
Auto-Reimbursement (AR)
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Next Steps
How This Affects You
• May change – depending on what coverage you choose
• Company contribution to your HRA = Up to $200 per
month ($100 for retiree and $100 for one dependent)
• You will work with Extend Health to enroll in a plan that
meets your medical and prescription needs. We will also
help you establish your Health Reimbursement Account
• Extend Health Advisors will help you understand the costs
associated with your coverage – premiums, co-payments,
deductibles and all other costs
What you
pay
How you
enroll
Your
support
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Between January and April, 2014
• During the transition:
• You will keep your existing medical plan
• Your deductible will be waived (except for those currently
enrolled in Medicare HMO)
• Your HRAs will be prorated in 2014 to reflect 9 months
coverage
• Beginning December 10, 2013 you can call Extend Health
with questions
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Next Steps
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Next Steps
77
Review
Gather
Call
The Getting Started Guide
Prescription and
Doctor Information
Extend Health – One Exchange
855-238-0483
© 2013 Extend Health, a Towers Watson company. All rights reserved. Proprietary and Confidential. For Extend Health and Extend Health client use only.
Post Enrollment Customer Service
Advocacy and support services
Toll Free number to contact Extend Health
representative 855-238-0483
• Direct support for claims issues, appeals
and network questions
• Renewal process – ability to pick new
coverage for future years – not locked into
this year’s choice
• Ongoing enrollment services
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Questions
Recommended