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11/9/2016
1
The webinar is now online. The 1st presentation will begin at 2:00 pm ESTThe 2nd presentation will begin at 4:30pm EST
• Please print out the following materials to reference during the presentation.1. Handout version of this presentation – for taking notes and jotting down questions as we proceed
• http://www.adventistretirement.org/retiree/sharp/look under Webinars for the 2017 Pre‐Retirement Webinar.
A recording of one of these webinars will be posted on our website next week.
QuestionsPlease type your questions in the Question section of the menu. We will answer most
questions at the end of the webinar.
11/9/2016
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Thinking About Retirement
Particularly Healthcare!
Today’s Webinar
• Invitees: Age 55+ Active Employees of a Participating Employer
• Goals:– To provide information regarding how the church does Retirement Healthcare Assistance for qualifying Retirees
– To provide information on the transition process
– To explain Medicare provisions
– To explain the Dental/Vision/Hearing Option
• Not a General Pre‐Retirement Plan
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The Healthcare Plan
Healthcare in Retirement
• Beneficiary of Plan(s) or
• Spouse of Beneficiary under Joint and Survivor (J&S) and
• With 15+ Years of Church Service Credit
Eligibility
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• Medicare A – Hospital –
– Sign up when age 65 even if covered
• Medicare B – Medical
– Sign up when you are going to lose your coverage or age 65 whichever is later
• Medicare C – Medicare Advantage
• Medicare D – Prescription Drug Plans
Medicare Is Essential
Retirees Incur Expenditures Not Covered by Medicare such as:
Outpatient Prescription Drugs
Dental, Vision, Hearing
Medicare 2016 Co‐Pays and Deductibles Outpatient Co‐Pay 20% Outpatient Deductible $166.00 Inpatient $1,288/admission deductible Inpatient $322/day co‐pay, days 61‐90 Inpatient $644/day co‐pay, days 91+ SNF $161/day co‐pay, days 21‐100
Isn’t Medicare Enough?
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SHARP‘s Health Reimbursement Account (HRA) is like an Airport VoucherYour flight’s been cancelled. You’ve been given a meal voucher at the airport for a fixed dollar amount. You can order a Rich Meal, a Moderate Meal or a Simple Meal.
If you order Rich, you will exceed the value of your meal voucher and will have to pay some from your own pocket. If you don’t spend the whole voucher, the restaurant is going to keep the voucher for your next meal!
Retirement Plan Will Pay. . .
Years of Qualifying Church Service
DVH Annual Contribution per Member
HRA Annual Contribution per Member
Total Annual Contribution per Member
35+ $780 $1,620 $2,400
30‐34 $696 $1,464 $2,160
25‐29 $612 $1,308 $1,920
20‐24 $528 $1,152 $1,680
15‐19 $444 $ 996 $1,440
What can I get for my $1,620 or $2,400 per year?
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SHARP Enrollment Form
Both 65+ w 35+ Years SC
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Both 65+ with 26 Years SC
2017 Plan Earned Credit for Pre‐MC
Years of Qualifying ChurchService
Monthly Earned Credit per Participant
Monthly Earned Credit for pre‐26 Child
35+ $640 $130
30‐34 $570 $115
25‐29 $490 $100
20‐24 $415 $80
15‐19 $340 $65
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Pre‐Medicare: Early Retirement w 40+ Years
Pre‐Medicare: Retiree Early Ret. withLess than 40 years
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Pre‐Medicare: Both <65 with a child under 26, 39 Yrs SC.
Provided by SHARP since 2002
Over 11,000 Retirees are currently participants in SHARP DVH Option
2016 Maximums◦ Dental $2,200
◦ Vision $ 400
◦ Hearing $2,200 with One Year Lookback
Provided by Retirement with Payroll Deductions
Hold The Phone! What about Dental/Vision/Hearing?
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• Network or ‘Any Dentist’
• Deductible – Annual or One‐Time
• Delay before Coverage
• Annual Maximum
• Preventative or Restorative
Market Alternatives to DVH
• I pay the net. DVH is cheap for the coverage I get. Only $25 each for a 35+ year Retiree and Eligible Spouse. Or,
• I pay the gross. DVH total cost is actually $90 per month. If I opt out, annually $1,080 is available for Exchange options.
Two Ways to Look at SHARP’s DVH
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Both 65+ with DVH, 35+ Years Service Credit
HRA Contribution Retiree Spouse
Annual HRA Plan Contribution
$2,400 $2,400
Less DVH Earned Credit $780 $780 Net Annual HRA Contribution $1,620 $1,620
Both 65+ without DVH
HRA Estimate Retiree SpouseAnnual HRA Plan Contribution
$2,400 $2,400
Less DVH Earned Credit $0 $0 Net Annual HRA Contribution $2,400 $2,400
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Retiree 65+, Spouse 63, 35+ Years SC
HRA Estimate Retiree SpouseAnnual HRA Plan Contribution $2,400 NA
Less DVH Earned Credit$780 NA
Net Annual HRA Contribution $1,620 NA
• Legacy Pension Plan Allows Retirement at age 59 ½ years of age.
• Current DC Plan Allows Retirement at age 59 ½ years of age.
• But you probably can’t afford to retire before age 65 UNLESS You have 40+ Years of Service Credit
Early Retirement
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CHANGING GEARS
Now Let’s Look at the Medical Part of Age 65+ Retirees
• Authorized by Medicare
• Operated by a third party on our behalf
• Plan makes Tax Free contribution
• You Select your Insured Plan(s)
• You pay the Premium to the Carrier
• HRA reimburses you
Health Reimbursement Account
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• HRA’s will be set up for Retirees– Usually Joint Account if Married to an Eligible Member
– Not joint if both are retirees.
• Annual Contribution to the HRA based on Qualifying Years of Church Service
• HRA Reimbursement for Plan Premiums & Other Expenses
• Unused Balance can be Rolled Over to Next Year
• Catastrophic Rx Protection
HRA Contributions 2017
• Original Medicare
– Part A Hospital
– Part B Medical (Outpatient, Lab, etc)
• Medigap Plans
– Work with Original Medicare, but with enhancements and safety nets. Plans A‐N.
• Medicare Advantage Plans• Replace Original Medicare. Network based. You may have to change physicians.
– Prescription Drug Plans (Medicare D)
Medicare Options
11/9/2016
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Features A B C D F G K L M N
Medicare Part A Coinsurance and Hospital Costs (up to 365 days after Medicare Benefits are used up)
Medicare Part A Deductible
50% 75% 50%
Skilled Nursing Facility Care Copay/Coinsurance 50% 75% Part A Hospice Care oinsurance or Copayments
50% 75%
Medicare Part B Deductible
Medicare Part B Coinsurance (Generally 20%)
50% 75%
Medicare Part BExcess Charges
Blood(First 3 Pints)
50% 75%
Foreign Travel Emergencies(up to Plan Limits)
80% 80% 80% 80% 80% 80%
Medigap Chart
Note: Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission (as of 2016 and subject to change)
For illustrative purposes only
MEDICARE ADVANTAGE PLANS
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• Private company contracts with Medicare to provide Part A and Part B benefits.
• Usually network based, PPO or HMO. Out of network rules vary. You may pay more.
• You go off of Original Medicare.
• Most include prescription drug coverage
• Some have a Zero $ Premium
• Copays and Deductibles are Plan specific
Medicare Advantage Plan (MA/MAPD)
• The following examples are screen shots from the Retail options and not specific to our Aon group plan options.
• Examples are all 2016 rates.
• Retiree must purchase some product from the Aon Retiree Exchange in order to receive any contribution to the HRA.
Caveat!
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• Lincoln, NE Search for Options
• Medicare Eligible 65+ Retiree
• 4 Prescription Drugs
– Atorvastatin Calcium Tier 2
– Methotrexate Sodium Tier 2
– Savella Tier 3
– Warfarin Sodium Tier 1
Aon Website
www.PresentationPro.com
Lincoln, NE
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*Premium Only. Does not include medical copays or deductibles.
35 Year Retiree, DVH Opt Out
Lincoln, NE Medicare Advantage Plans
Humana PPOAdvantraHMO
Humana HMO
Annual Premium* $1,308 $2,256 $0
Rx CoPays $1,370 $3,766 $1,361
Retiree Costs $2,678 $6,022 $1,361
Plan Contribution $2,400 $2,400 $ 2,400
Net Retiree Costs $ 278 $3,622 ($1,039)
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*Premium Only. Does not include medical copays or deductibles.
20 Year Retiree, DVH Opt Out
Lincoln, NE Medicare Advantage Plans
Humana PPOAdvantraHMO
Humana HMO
Annual Premium* $1,308 $2,256 $0
Rx $1,370 $3,766 $1,361
Retiree Costs $2,678 $6,022 $1,361
Plan Contribution $1,680 $1,680 $1,680
Net Retiree Costs $ 998 $4,342 ($319)
*Premium Only. Does not include medical copays or deductibles.
35 Year Retiree, DVH Opt In
Lincoln, NE Medicare Advantage Plans
Humana PPOAdvantraHMO
Humana HMO
Annual Premium* $1,308 $2,256 $0
Rx $1,370 $3,766 $1,361
Retiree Costs $2,678 $6,022 $1,361
Plan Contribution $1,620 $1,620 $1,620
Net Retiree Costs $1,058 $4,402 ($259)
11/9/2016
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*Premium Only. Does not include medical copays or deductibles.
20 Year Retiree, DVH Opt In
Lincoln, NE Medicare Advantage Plans
Humana PPOAdvantraHMO
Humana HMO
Annual Premium* $1,308 $2,256 $0
Rx $1,370 $3,766 $1,361
Retiree Costs $2,678 $6,022 $1,361
Plan Contribution $1,152 $1,152 $1,152
Net Retiree Costs $1,526 $4,870 $239
LET’S TRY MEDIGAP
Original Medicare with Enhancements
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• ‘F’ Pays 100% Hospital and Dr. Visit Deductible
• ‘L’ Pays 100% Hospital Deductible, 0% Dr. Visit Deductible, 75% Dr. Visit Copays, and has $2,480 /year max out of pocket limit
• ‘A’ Pays Hospital Deductible, no Dr. Visit CoP
• None include Rx. (Have to purchase separately)
Medigap Comparisons
*Premium Only. Does not include medical copays or deductibles.
35 Year Retiree, DVH Opt In
Lincoln, NE Medigap Plans
BC/BS “F”Transamerica
“L” Aetna “A”
Annual Premium* $1,628 $1,115 $1,349
Rx Premium# $ 484 $ 484 $ 484
Retiree Premium Costs $2,112 $1,599 $1,833
Plan Contribution $1,620 $1,620 $1,620 Net Retiree Annual Premium Costs $ 492 $ 21 $ 213
#UnitedHealthcare $360 deductible
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*Premium Only. Does not include medical copays or deductibles.
20 Year Retiree, DVH Opt In
Lincoln, NE Medigap Plans
BC/BS “F”Transamerica
“L” Aetna “A”
Annual Premium* $1,628 $1,115 $1,349
Rx Premium# $ 484 $ 484 $ 484
Retiree Premium Costs $2,112 $1,599 $1,833
Plan Contribution $1,152 $1,152 $1,152
Net Retiree Costs $960 $447 $681
#UnitedHealthcare $360 deductible,
FORGET THE SUPPLEMENTS!
I just want Original Medicare!
11/9/2016
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You have to buy something through our exchange in order to qualify for an HRA Contribution.
You have to buy an Rx Plan
You may wish to buy DVH as well – not thru exchange.
Pay for your own Medicare Deductibles and CoPays
Remember!
PRESCRIPTION DRUG PLANSIf you choose a Medigap option, you will need a separate Rx plan.
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• Methotrexate Sodium Tier 2 or 3
• Simvastatin Tier 1
• Warfarin Sodium Tier 1
Des Moines, IA Rx Only Options
*.
35 Year Retiree, DVH Opt In
Des Moines Rx Only
Wellmark BlueUnitedHealthcare Saver
Humana Walmart
Annual Premium
Retiree Premium Costs $421 $484 $221
Plan Contribution $1,620 $1,620 $1,620 Net Retiree Annual Premium Costs $1,199 $1,136 $1,399
11/9/2016
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*.
20 Year Retiree, DVH Opt In
Des Moines Rx Only
Wellmark BlueUnitedHealthcare Saver
Humana Walmart
Annual Premium
Retiree Premium Costs $421 $484 $221
Plan Contribution $1,152 $1,152 $1,152Net Retiree Annual Premium Costs $731 $668 $931
SOME GENERAL EXAMPLES
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• Joint HRA for Retiree and Spouse
– (Unless both are Retirement Beneficiaries)
• Both can join SHARP DVH or opt out
• Both will select local Medicare and/or Rx options to be Reimbursed from HRA
Retiree 65+, Spouse 65+
HRA for Retiree Retiree may join SHARP DVH or opt out
Retiree will select Medicare and Rx options to be paid from HRA
J&S Spouse receives Pre‐Medicare Earned Credit based on years of Retiree’s Service Credit
Spouse may select from SHARP◦ Pre‐Medicare Medical◦ Pre‐Medicare DVH◦ Pre‐Medicare Rx
Retiree 65+, Spouse ‐65
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Spouse may join SHARP DVH or opt out
Spouse will select Medicare and Rx options to be paid from HRA
Retiree may select from SHARP Pre‐Medicare Medical Pre‐Medicare DVH Pre‐Medicare Rx
No Assistance for Retiree or Spouse (EC or HRA) if ‐65 Retiree has less than 40 years Service Credit. Very Expensive Option
Retiree ‐65, Spouse 65+
No HRA
Retiree & Spouse may select from SHARP Pre‐Medicare Medical
Pre‐Medicare DVH
Pre‐Medicare Rx
No Assistance (EC or HRA) if ‐65 Retiree has less than 40 years Service Credit.
Very Expensive Option
Retiree ‐65, Spouse ‐65
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• 65+
– SHARP DVH (Lifetime decision)
– Medicare Advantage including Rx
– Medigap Plan with Stand‐alone Rx Plan
• Pre‐65
– Medical
– Rx
– DVH
Decisions
Questions on Healthcare