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Open Enrollment Information Meeting

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I m not sure what I m enrolled in. Go to eCHRIS Self-Service Log in Go to Benefits Click Current Benefits Summary employee.phoenix.gov/hr * I want to ... – PowerPoint PPT presentation

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Title: 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
8
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.

13
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

16
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
17
  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
18
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

20
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
23
  • Eligibility for Children
  • up to Age 26

24
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.

25
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.

26
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.

27
  • CIGNA Pharmacy Management Replaces CVS/Caremark

28
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.

29
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

30
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 .

33
  • 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

36
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.

37
eCHRIS 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

38
I dont want to change anything.
  • Do nothing, and your current benefits will
    continue August 1, 2011 July 31, 2012
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