Open Enrollment Information Meeting

1
Open Enrollment Information Meeting

• Plan Year
• Beginning
• August 1st

2
Todays Topics

• What is Open Enrollment
• When is Open Enrollment
• Premiums
• Medical Co-Pays
• Covering Children up to Age 26
• New Pharmacy Management Vendor
• Optional Life Insurance
• New Maximums
• Add up to 50,000 with no health history!

3
Helpful Reminders
4
To Re-enroll

• You may re-enroll in City retiree medical
  coverage during Open Enrollment if you have
• CONTINUOUS, COMPARABLE COVERAGE
• since the date you dropped the Citys coverage.
• Evidence of continuous, comparable coverage is
  required.

5

• Open Enrollment Communication

6
41,000 Members
7
Improved Benefits Info Online

• employee.phoenix.gov/hr
• Benefits Employment Services
• Training Development Support Services
• eCHRIS Self-Service - Retirees

FORMS DOCUMENTS WEBSITE LINKS UPDATES
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In the Mail
9
OPEN ENROLLMENT

• Medical Dental

10
Self Funding

• Provider networks are leased.
• Provider reimbursement levels are set
• City pays a monthly fee to process claims and
  provide other services.
• City is billed for the amount paid to each
  doctor, hospital, lab, etc.
• This is paid from the Health Care Benefits Trust

11
215 Million

• The total projected cost for medical and pharmacy
  coverage in the 2011 12 Plan Year
• Employees Retirees
• 99.06 is spent directly on
• claims

12
Request for Proposal (RFP) Process

• The City issued RFPs in late 2010 for
• Medical, Dental, Pharmacy Management
• The last time these RFPs were issued 2004
• Responses were received from
• 5 medical vendors
• 9 dental vendors
• 9 pharmacy management vendors
• Selection committees reviewed RFP responses and
  interviewed finalists.

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Request for Proposal (RFP) Process
Request for Proposal (RFP) Process

• Vendors were evaluated on
• Ability to meet current and future plan designs
• Customer service and support
• Cost
• OUTCOME
• Medical and Dental Plans No change

CIGNA Pharmacy Management replaces CVS/Caremark
on August 1st
14
When Is Open Enrollment?

• Tuesday, May 31
• to
• Wednesday, June 29
• at 5 p.m. sharp

15
Premiums

• Medical Premiums
• CIGNA 0
• BCBS HMO 0
• BCBS PPO ? 8.8

• Dental Premiums
• DHMO 0
• DPPO 0

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2011-12 Retiree Medical Premiums
    Retiree and Dependent Status 2011-2012 Monthly Retiree Medical Premiums 2011-2012 Monthly Retiree Medical Premiums 2011-2012 Monthly Retiree Medical Premiums 2011-2012 Monthly Retiree Medical Premiums
    Retiree and Dependent Status   Code   CIGNA HMO   BCBS HMO   BCBS PPO
    Retiree and Dependent Status   0 change 0 change 8.8 increase
Single Retiree or survivor not on Medicare A 640.87 562.04 581.82 was 526.42
Family Retiree and 1 or more dependents not on Medicare B 1,774.61 1,547.42 1,604.39 was 1,444.73
Family Retiree not on Medicare, all dependents on Medicare C 1,187.07 1,034.13 1,072.44 was 964.97
Single Retiree or survivor on Medicare D 547.76 480.35 497.29 was 449.92
Family Retiree with Medicare, any dependent not on Medicare E 1,071.41 932.27 966.89 was 869.23
Family Retiree and all dependents on Medicare F 1,040.54 905.72 939.52 was 844.78
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  Retiree and Dependent Status         Code     Full Premium and PEHP Premium       Qualified City Contribution Amount  
Single Retiree or survivor not on Medicare A CIGNA 745.87 BCBS HMO 667.04 BCBS PPO 672.46 105
Family Retiree and 1 or more dependents not on Medicare B CIGNA 2,149.61 BCBS HMO 1,922.42 BCBS PPO 1,938.01 375
Family Retiree not on Medicare, all dependents on Medicare C CIGNA 1,447.07 BCBS HMO 1,294.13 BCBS PPO 1,304.59 260
Single Retiree or survivor on Medicare D CIGNA 637.76 BCBS HMO 570.35 BCBS PPO 575.01 90
Family Retiree with Medicare, any dependent not on Medicare E CIGNA 1,316.41 BCBS HMO 1,177.27 BCBS PPO 1,186.65 245
Family Retiree and all dependents on Medicare F CIGNA 1,275.54 BCBS HMO 1,140.70 BCBS PPO 1,149.97 235
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2011 12 Retiree Dental Premiums
Total Monthly Premium
Dental PPO  
Single 34.08
Retiree 1 75.72
Family 110.75
Dental HMO  
Single 18.36
Retiree 1 33.17
Family 58.46
Deduction automatically taken from monthly pension check. Deduction automatically taken from monthly pension check.
19

• Medical Co-Pays

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Current Co-Pays
Service Current Co-Pay
Primary Care Physician Office Visit, Convenience Care Clinic 15
Specialist Office Visit 35
Lab, Radiology 0
Routine Physicals 0
Behavioral Health Office Visits 10
Eye Exam 5
Inpatient Hospitalization 100/day, max. 300
Generic Medication 10
Preferred Brand Name Medication 25
Non-Preferred Brand Name Medication 40
21
Medical Co-Pay Changes
Service Current Co-Pay Co-Pay as of 8/1/11
PCP Office Visit 15 20
Eye Exam 5 10
Urgent Care 40 45
Emergency Room 125 140
Outpatient Surgery 75 80
22
Prescription Co-Pays Do Not Change
Prescription Co-Pays Prescription Co-Pays Prescription Co-Pays Prescription Co-Pays
  Tier Retail Co-Pay 30 Day Supply Mail Order Co-Pay 90 Day Supply 90 Day Fill at Retail
  Generic 10 / 30 day supply 20 / 90 day supply 30
Preferred Name Brand 25 / 30 day supply 50 / 90 day supply 75
Non-Preferred Name Brand 40 / 30 day supply 80 / 90 day supply 120
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• Eligibility for Children
• up to Age 26

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Eligible Child

• The term child includes a biological child,
  adopted child, child placed for adoption,
  stepchild, qualified domestic partners child, or
  a child living with you for whom you have either
  permanent legal custody.
• Student status is not required.

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Coverage for Children to Age 26

• Medical Dental
• Beginning August 1, 2011 the maximum age for
  eligible children changes from age 23 to age 26.
• Eligibility for Coverage
• Cannot have access to other group coverage, for
  example, through their employer or their spouses
  employer.

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Coverage for Children to Age 26

• Children who were removed from City coverage at
  age 23 will NOT be automatically re-enrolled.
  The employee must take action during Open
  Enrollment.
• It is always the retirees responsibility to know
  when a child no longer qualifies for coverage.

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• CIGNA Pharmacy Management Replaces CVS/Caremark

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CIGNA Pharmacy Replaces CVS/Caremark

• Takes effect on August 1st
• For CIGNA and BlueCross/BlueShield plans.
• If you are impacted by this change you will
  receive information in the mail. Please open and
  read it.

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A Comparison

• CVS/Caremark

• CIGNA Pharmacy Mgmt.

• 60,000 pharmacies nationally
• Walgreens
• CVS
• Walmart
• Target
• Costco
• Safeway
• Frys
• Bashas

• 60,000 pharmacies nationally
• Walgreens
• CVS
• Walmart
• Target
• Costco
• Safeway
• Frys
• Bashas
• CIGNA Medical Group

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A Comparison

• CVS/Caremark

• CIGNA Pharmacy Mgmt.

• Customer Service
• 24/7
• Home Delivery
• 90 Day Fill at Retail
• Large chain stores
• 3 co-pays
• Onsite Representative
• Online support at mycigna.com

• Customer Service
• 24/7
• Mail Order
• 90 Day Fill at Retail
• Large chain stores
• 3 co-pays
• Onsite Representative
• Online support

31
ID Cards

• Everyone will receive new medical ID cards.
• Everyone will receive new Pharmacy ID cards.
• You will receive new ID cards in the mail
• in late July.

32
ID Cards

• Continue to use your CVS/Caremark pharmacy ID
  card through July 31st .
• Give your pharmacist your CIGNA Pharmacy
  Management ID card the first time you fill a
  prescription on or after August 1st .

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• eCHRIS Self-Service

34
Im not sure what Im enrolled in.

• Go to eCHRIS Self-Service
• Log in
• Go to Benefits
• Click Current Benefits Summary

35
I want to make a change.

• Use eCHRIS Self-Service
• Log in
• Go to Benefits
• Click Benefits Enrollment
• Make Change(s)
• SUBMIT
• Changes must be submitted by 500 p.m. on
  Wednesday, June 29th

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I want to make a change,
but I cant use eCHRIS.

• If you have a computer, but eCHRIS seems
  overwhelming, ask the HR Center or the Benefits
  Office for help.
• If you are unable to use eCHRIS and would like to
  make a change, contact the Benefits Office before
  5 p.m. on June 29th.

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eCHRIS Help

• HR Center
• [phone]
• Located on the 1st floor of the Personnel
  Building.
• Benefits Office
• [phone]
• Located on the 4th floor of the Personnel
  Building.
• Password Help
• Call [phone]

38
I dont want to change anything.

• Do nothing, and your current benefits will
  continue August 1, 2011 July 31, 2012