Title: Open Enrollment Information Meeting
1Open Enrollment Information Meeting
- Plan Year
- Beginning
- August 1st
2Todays 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!
3Helpful Reminders
4To 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
641,000 Members
7Improved Benefits Info Online
- employee.phoenix.gov/hr
- Benefits Employment Services
- Training Development Support Services
- eCHRIS Self-Service - Retirees
FORMS DOCUMENTS WEBSITE LINKS UPDATES
8In the Mail
9OPEN ENROLLMENT
10Self 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
11215 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
12Request 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.
13Request 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
14When Is Open Enrollment?
- Tuesday, May 31
- to
- Wednesday, June 29
- at 5 p.m. sharp
15Premiums
- Medical Premiums
- CIGNA 0
- BCBS HMO 0
- BCBS PPO ? 8.8
- Dental Premiums
- DHMO 0
- DPPO 0
162011-12 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
17 Retiree and Dependent Status     Code   Full Premium and PEHP Premium    Qualified City Contribution Amount Â
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
182011 12 Retiree Dental Premiums
Total Monthly Premium
Dental PPO Â
Single 34.08
Retiree 1 75.72
Family 110.75
Dental HMO Â
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 20Current 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
21Medical 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
22Prescription 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
23- Eligibility for Children
- up to Age 26
24Eligible 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.
25Coverage 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.
26Coverage 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.
27- CIGNA Pharmacy Management Replaces CVS/Caremark
28CIGNA 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.
29A Comparison
- 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
30A Comparison
- 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
31ID 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.
32ID 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 .
33 34Im not sure what Im enrolled in.
- Go to eCHRIS Self-Service
- Log in
- Go to Benefits
- Click Current Benefits Summary
35I 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
36I 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.
37eCHRIS Help
- HR Center
- (602) 262-6608
- Located on the 1st floor of the Personnel
Building. - Benefits Office
- (602) 262-4777
- Located on the 4th floor of the Personnel
Building. - Password Help
- Call (602) 534-4357
38I dont want to change anything.
- Do nothing, and your current benefits will
continue August 1, 2011 July 31, 2012