Human Resources - Retiree Benefits

Administration Division

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Retiree Questions & Answers

Posted: January 15, 2016

Question: (subject: Dental Premiums-Reimbursable)

Can I get my USG Dental premiums reimbursed? If so, how do I get them dental premiums reimbursed?

USG Response:

Yes, your USG dental premiums are a reimbursable expense. You must submit a Premium Auto Reimbursement Claim form and submit proof of premium payment. You can either access the Premium Auto Reimbursement Claim form from your on-line account https://retiree.aon.com/usg or contact Aon Retiree Health Exchange, and we will mail the claim form to your home address.

You will also need to submit proof of premium payment with a cancelled check (front and back of cancelled check), a receipt from USG, or your checking account statement showing the premium deduction.


Posted: January 15, 2016

Question: (subject: Spouse HRA access)

Can a spouse log-in to their HRA account, submit claim forms and, make changes to HRA?

USG Response:

Yes, with the retirees permission, your spouse may log in to your account using your username and password and submit claim forms and manage your HRA account.


Posted: January 15, 2016

Question: (subject: Providing Documentation)

What documentation is needed for HRA reimbursable claims?

USG Response:

Depending upon the type of premiums or expenses you are asking to be reimbursed for determines the documentation.

Monthly Premium Reimbursement requires a Premium Auto Reimbursement Claim form along with a copy of the front and back of cancelled check, receipt from carrier, or a photo copy of your bank statement showing the premium deduction.

If you pay your premium other than monthly such as quarterly, semi-annual or annual you must submit a manual claim form along with a copy of the front and back of cancelled check, receipt from carrier, or a photo copy of your bank statement showing the premium deduction.

Part B premiums, you will fill out a Premium Auto Reimbursement Claim form along with a photo copy of your Social Security Statement showing your Part B Premium deduction.

For out of pocket expenses such as co-payments, co-insurance or deductibles you will submit a manual claim form along with your receipt of payment. You are able to submit manual claim forms on a monthly, quarterly, semi-annual or annual basis.

All claim forms can be found on-line or you may call Aon Retiree Health Exchange to mail you the claim forms. You will also be able to upload proof of payments along with claim forms, or by faxing or mailing the reimbursement request to YSA.


Posted: January 15, 2016

Question: (subject: Required documentation - Auto Reimbursement)

Is documentation needed for auto reimbursement?

USG Response:

If you do not want to wait up to 60 days for the first reimbursement to be made you would submit a Premium Auto Reimbursement Claim Form. Also, any time you are submitting an Auto Reimbursement Claim Form you must submit proof of premium payment using a copy of the front and back of cancelled check, receipt from carrier, or a photo copy of your bank statement.


Posted: January 15, 2016

Question: (subject: Catastrophic HRA)

What is the Catastrophic HRA? How do I know if I met it?

USG Response:

USG is providing a “Catastrophic HRA” - which is a special account that can be used in the situation where an individual reaches the catastrophic level of coverage under the Medicare Part D design. This is the point, after meeting the donut hole, where you begin paying 5% of the covered prescription drug costs in that year. This special account can be used only for these prescription drug costs. In 2016, USG will cover the full amount of any expenses you incur in the catastrophic phase of coverage, but in future years, the amount of coverage will gradually decrease until 2020 when the donut hole has been closed. The Catastrophic HRA account is independent of the HRA account.


Posted: January 15, 2016

Question: (subject: ID Cards)

When will I receive my cards? What do I do if I haven’t received them yet?

USG Response:

If you have not received your cards from the carrier that you enrolled through, please call the Aon Retiree Health Exchange and we can connect you to the carrier and obtain your policy number, until you receive your cards in the mail.


Posted: January 15, 2016

Question: (subject: Paying Premiums)

How do I make changes to how I am paying the premium?

USG Response:

If you are interested in changing your premium payment method and you have received your insurance cards from the carrier you enrolled through you can simply call the customer service phone number listed on the back of the card and change your premium payment options.


Posted: January 15, 2016

Question: (subject: Premiums Increases)

How can the premium go up mid-year if I signed a contract?

USG Response:

All insurance plans the carriers have the right to raise their premiums at any time. This statement was read to you when you enrolled into your new coverage.


Posted: January 15, 2016

Question: (subject: Premiums Increases)

Will premiums keep increasing each year on my birth date?

USG Response:

If you enrolled in a Medigap plan and depending upon the carrier you enrolled with, your premiums could go up each year as you age.


Posted: January 15, 2016

Question: (subject: Prescription Drugs costs)

I paid $160 for my first two prescriptions and I can’t afford this. How can I reduce my costs? (in-network provider)

USG Response:

Depending upon your plan, you may be paying your deductible first. Once you have met your deductible the cost of your prescriptions may go down depending upon the cost of your prescriptions. You can also decrease the out of pocket cost of your prescriptions by using the preferred pharmacies to fill your prescriptions or by using generic drugs verses brand name drugs.

Also, please remember that you may have these out of pocket expenses reimbursed by your HRA by filling out a manual claim form and submitting with proof of payment.


Posted: January 15, 2016

Question: (subject: Using HRA Funds)

If the retiree has greater expenses than their spouse, can the retiree use part of the spouse’s funds for reimbursement of their expenses?

USG Response:

Yes, your HRA is a joint account (one bucket of money) to be used by both the retiree and spouse.


Posted: January 15, 2016

Question: (subject: HRA Funds)

What happens to the spouses HRA funds if the retiree passes away?

USG Response:

If the retiree passes the spouse will have access to the retirees current years remaining balance until exhausted, and the spouse will receive their individual HRA contribution moving forward.


Posted: January 15, 2016

Question: (subject: Changing Plans)

Can I change my plan at the end of the year?

USG Response:

Yes, you may change your plans each year during the Open Enrollment Period which is October 15th through December 7th of each year. Aon Retiree Health Exchange will send you a post card reminding you of the Open Enrollment Period. Simply call the exchange and set up an appointment with your Benefits Advisor who will assist you in the enrollment for your new plan.


Posted: January 15, 2016

Question: (subject: Medigap Plan G- Guarantee Issue)

Does Medigap Plan G have guaranteed issue?

USG Response:

No, Plan G does not have guaranteed issue. If you are interested in this plan please make sure to call your Benefits Advisor to assist you through the process.


Posted: January 5, 2016

Question:

How can I set up direct-deposit for reimbursement of my monthly premiums?

USG Response:

If you want to setup direct deposit into your checking account, this must be set up separately after January 1st, even if you gave Aon your banking information for the premium direct debit during your enrollment call.

To setup direct deposit, you can go online using the instructions below or you can call your Benefits Advisor.

  • Log on to the YSA website https://retiree.aon.com/usg.
  • Select “My Account” at the top.
  • Select “The HRA” on the left.
  • Select “Manage My University System of Georgia Account” (in green) toward the bottom.
  • On the right under “Take Action” select “Edit Your Profile.”
  • Under the “Direct Deposit Information” section select “Add.”
  • Enter your bank account information in the appropriate fields. (Your routing and account numbers can be found on the bottom of your checks.)

Posted: December 3, 2015

Question:

If my out-of-pocket maximum for drugs this year is $1,100 under the USG Pharmacy Plan, why did my Benefits Advisor tell me that my out-of-pocket costs will be more than this in 2016?

USG Response:

In the USG plan today, Medicare retirees enrolled in the Comprehensive Care plan are enrolled in the USG SilverScripts Medicare Part D prescription drug plan. In all Medicare Part D prescription drug plans, there are four coverage stages, explained below. In 2015, USG added additional coverage to the SilverScripts plan to limit the retiree’s out-of-pocket costs to $1,100.

In 2016, USG is providing a Catastrophic HRA to limit retirees out of pocket prescription drug costs. The amount of out of pocket costs will vary by retiree and the prescription drugs that he or she takes. However, once a retiree meets the catastrophic coverage level, USG will reimburse the retiree for their out of pocket prescription drug costs for the rest of the year. The majority of retirees will not reach the coverage gap or catastrophic coverage levels.

Retirees have a few steps they can take to reduce their out of pocket prescription drug costs. They are the following:

  • Check with your physician to see if you can take generics or alternative drugs (We understand this is not always possible)

  • Consider using a different pharmacy

  • Leverage any available mail order programs for maintenance medications

  • Work with the pharmaceutical company to see if they have assistance or additional discount programs.

Your Aon Benefits Advisor help you with these options and also can provide the pharmaceutical company’s phone number or web address.

The following are the Medicare Part D plan levels:

Deductible: 100% paid by beneficiary, if applicable

Initial Coverage: Beneficiary pays co-payments/co-insurance for each drug. Once the beneficiary and plan have paid $3,310, (the combined amount plus the deductible) towards covered drugs, the beneficiary will reach the coverage gap.

Coverage Gap/Donut Hole: Once the beneficiary reaches the coverage gap in 2016, he/she will pay 45% of the plan’s cost for covered brand-name prescription drugs. Pharmaceutical companies discount the drugs 50% and the plan pays 5%. The discount will come off of the price that the plan has set with the pharmacy for that specific drug and will count towards the beneficiary’s out of pocket costs for the year. For generic drugs, Medicare will pay 42% of the price during the coverage gap. The beneficiary will pay the remaining 58% of the price. The co-insurance for generic drugs during the coverage gap will decrease each year until it reaches 25% in 2020. For generic drugs, only the amount paid by the beneficiary will count towards the out of pocket costs for the year. In 2016, once the beneficiary’s total out of pocket has reached $4,850 (for covered drugs), he/she will enter the catastrophic coverage level.

Catastrophic: This is point where the beneficiary will pay $2.95 for generics or $7.40 for brand named drugs or 5% of the full cost of the drugs whichever is greater. USG provides reimbursement for out of pocket prescription drug costs in this level.

The limits and thresholds may change each year. Your Aon Benefits Advisor will be able to tell you what stages you will move through throughout the year and how much you will pay in each stage based on the drugs you currently take. What you pay out of pocket for drugs that are not covered under your Medicare Part D plan will not count towards your Medicare Part D plan coverage limits and thresholds for the year.

More information about Medicare Part D plans is also available on the Medicare website at: https://www.medicare.gov/part-d/costs/part-d-costs.html

Important notes:

  • Because of the pharmaceutical discounts in the coverage gap stage, retirees on average pay $2,800-$3,000 out-of-pocket before moving into the catastrophic level of coverage, however this will vary retiree by retiree and their specific prescriptions

  • Once a retiree falls in the catastrophic level of coverage, USG will provide reimbursement to the retiree for all out of pocket expenses through a Catastrophic HRA; the retiree will receive a notice in the mail from their prescription drug plan that they have reached the catastrophic coverage level and will need to reach out to their Aon Benefits Advisor to begin receiving reimbursements

  • The process restarts each year on January 1

  • Some retirees, depending on their prescriptions, will have more than $1,100 in out-of-pocket prescription drug costs in 2016. However, many retirees will pay less in medical premiums (after the USG reimbursement) and less in medical out of pocket costs in 2016 than they did in 2015 which can be used towards additional prescription drug costs they may have

  • Each year, plan benefits, prescription drug formularies and premiums change; this is true for the USG plan as well as the individual marketplace


Posted: November 24, 2015

Question:

Some insurance carriers on the Aon exchange are requiring the first month’s premium as a part of the enrollment process. Is this standard for all insurance carriers?

USG Response:

While it’s not standard process for all insurance carriers on the Aon exchange, some insurance carriers may require payment of the first month’s premium. During the enrollment process, the Benefits Advisor will make the retiree aware if the insurance carrier requires payment of the first month’s premium.


Posted: November 24, 2015

Question:

If the retiree enrolls in an exchange plan that requires the first month’s premium during the enrollment process, will this expense still be eligible for reimbursement from the Health Reimbursement Account (HRA)?

USG Response:

Yes. If you were required to pay the first month’s premium prior to January 1, 2016 as a part of the enrollment process in an Aon exchange plan, the premium payment will be eligible for reimbursement.


Posted: November 23, 2015

Question:

Why are some retirees being required to provide a Notice of Creditable coverage or a Notice of Group Plan Coverage Termination, in order to enroll in supplemental healthcare coverage and/or prescription drug coverage?

USG Response:

Retirees who decide to enroll in supplemental healthcare coverage outside of the Aon Retiree Health Exchange may receive a request from the new insurance carrier to provide proof that their coverage through a group plan is ending. The insurance carrier needs this verification to determine eligibility for Guarantee Issue into the new supplemental healthcare plan.

For retirees enrolling in supplemental healthcare coverage through the Aon Retiree Health Exchange, Aon has already notified all of the carriers on the exchange that USG retirees are eligible for Guarantee Issue and they will not need this verification.

Also, retirees enrolled in the Consumer Choice HSA plan may be asked to provide a copy of the prescription drug coverage Creditable Coverage notice. This notice may be requested even if the retiree is enrolling in coverage through the Aon Retiree Health Exchange and is based on how questions answered when completing the enrollment application.


Posted: November 23, 2015

Question:

How can I obtain these coverage notices to provide to the insurance carrier if they are requested?

USG Response:

These coverage notices are available on the Retiree Benefits website at: http://www.usg.edu/hr/benefits/retiree_benefits


Posted: November 13, 2015

Question:

What items are eligible for reimbursement under the Health Reimbursement Account (HRA)?

USG Response:

Retirees will be eligible to be reimbursed for the following items:

  • Medicare Supplement (Medigap) Premiums; Prescription Drug Premiums; Medicare Advantage Premiums;
    • regardless whether the coverage is purchased within the Aon Retiree Health Exchange or outside of the Aon Retiree Health Exchange;
    • If coverage is purchased outside of the Aon Retiree Health Exchange, automated reimbursement will not be available and paper claim forms will need be submitted to receive the reimbursement; information about how to file paper claims will be included in the Welcome Kit
    • Retirees must enroll in at least one plan through the Aon Retiree Health Exchange to be eligible for the USG contribution to the HRA ($2,736), either a Medicare Supplement (Medigap) plan, Prescription Drug plan, or Medicare Advantage plan;
    • We recommend that retirees purchase all of their supplemental coverage through the Aon Retiree Health Exchange because of the level of expertise and support provided by Aon and because of the service commitments in place between the University System of Georgia and Aon
  • Medicare Part B Premiums
  • Vision/Dental Premiums
  • Out-of-Pocket Medical/Prescription Drug/Vision/Dental expenses (such as co-pays and co-insurance)
  • Medicare income penalties

Over the counter medication expenses, such as pain relievers and cold medications, will be eligible for reimbursement only with a health care provider’s prescription or statement of medical necessity.

The University System of Georgia elected to provide the most flexibility as possible for reimbursement from the Health Reimbursement Account. Retirees will be eligible to be reimbursed up to the extent allowed under federal tax law. A complete list of expenses allowed by the IRS is documented in IRS Publication 502 available on the IRS website at: (https://www.irs.gov/pub/irs-pdf/p502.pdf) https://www.irs.gov/pub/irs-pdf/p502.pdf.

Examples of ineligible expenses include but are not limited to:

  • Clothing
  • Cosmetic procedures
  • Dental bleaching or other teeth whitening
  • Electronic tooth brush replacement brushes
  • Hair transplants
  • Late payment interest
  • Lens replacement insurance
  • Missed appointment fees
  • Pill bags
  • Vitamins for general well-being

This information and other detailed information about the Health Reimbursement Account will be mailed to all retirees in December as part of the HRA/Your Spending Account Welcome Kits.


Posted: November 13, 2015

Question:

Why is there a requirement that a retiree enroll in one coverage on the Aon Retiree Health Exchange in order to receive the USG contribution to the Health Reimbursement Account?

USG Response:

The strategy for retiree healthcare that was developed and is now being implemented was carefully and thoughtfully planned to make sure our retiree’ best interests were represented throughout the enrollment process. In 2016, retirees must purchase one plan through the Aon Retiree Health Exchange in order to receive the USG HRA funding ($2,736 as approved by the Board). This could be a Medicare supplement plan, a prescription drug plan or a Medicare Advantage plan. This means, today, retirees have the flexibility to purchase plans outside of the Aon Retiree Health Exchange as long as one plan is purchased through the Aon Retiree Health Exchange.

We partnered with Aon to make sure our retirees would have the enrollment support and resources they need through experienced, licensed benefits advisors. These benefits advisors are able to review and discuss multiple carriers and multiple plan options, up to 12 carrier choices within the Atlanta area, during the appointment to help retirees make the best plan enrollment decision. The plans offered through the Aon Retiree Health Exchange are thoroughly vetted, A+ rated plans with the staying power in the marketplace.

Just as important, the Aon Retiree Health Exchange will provide USG retirees on-going advocacy services to assist with claim denials, billing disputes, and coordination of care. This is a valuable service not offered through local brokers.

Partnering with Aon ensures the system office stays connected with retirees and it gives us the ability to advocate on our retirees’ behalf. Without this leverage, if a retiree had a problem with their enrollment or issue with their coverage, the USG office would not be able to help them.

Finally, each year, the System Office will evaluate the needs of retirees and the performance of the vendor partners and will work closely with the USG Retiree Advisory Council to provide us with recommendations regarding the strategy.

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