Open Enrollment for Endowed Retirees

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Hello. And thank you for your time today. We're going to spend time reviewing the Cornell University 2026 benefit information for retirees and their dependents. Our agenda for this discussion is to cover what's changing for 2026. We'll look at the plans for retirees that are not Medicare eligible yet. And then we'll look at the plans for those who are Medicare eligible.

We'll look at prescription drug benefits for all of the plans, and we'll look at information to support you when you're enrolled in one of the retiree plans. And we'll finish up with open enrollment instructions for 2026. We'll start off with what's changing for the upcoming year for 2026, on the retiree pre Medicare health plan and the retiree 8020 plan. The deductibles, the out-of-pocket maximums and the co-pays or coinsurance will remain the same. On the Medicare Advantage PPO plans the co-pays and the plan design will stay the same as well. But there are two administrative changes that I do want to bring to your attention. One is a change that's specific to our members with diabetes. Aetna is changing from one preferred vendor, which is currently life scan to two preferred vendors for 2026 Accu-Chek through Roche and true through Truvada. This change will give you two choices now for your diabetic supplies. These brands of products can be widely found at all of your current pharmacies and similar to life Scan. The copay for the supplies with these two companies is a zero cost share. The second change is a Medicare required update to the annual out-of-pocket limit for 2026. On the Aetna Medicare Advantage pharmacy plan. The catastrophic phase of your drug coverage will be reached when you have met $2,100 out-of-pocket for your covered Medicare Part D drugs in 2025, that amount was $2,000. There will be an increase to the retiree and family rates, as shown on the page. And as a reminder, if you have sick leave credit, it will continue to offset your individual retiree coverage rates.

We're going to start today with the retiree pre Medicare health plan that includes drug coverage through Optum X. The retiree pre Medicare health plan provides coverage for retirees who are under age 65 and not Medicare eligible. This plan also covers spouses, domestic partners, dependents of retirees who are under age 65 and also not eligible for Medicare. The Cornell University Retiree Pre Medicare Health Plan, also known as NP, uses Aetna's national point of service POS to network of providers. The plan provides benefits whether you utilize a participating Aetna network provider or not, but the benefits are greater if you access providers within the Aetna network. The plan has an annual deductible, which is the amount that the member must pay out of pocket before the plan begins to cover services, and an out-of-pocket maximum, which represents the maximum dollar amount a member is responsible for paying within the calendar year. When your share of expenses reaches the annual out-of-pocket maximum, the plan pays eligible covered expenses at 100% for the remainder of the calendar year. When you have an office visit with a physician or a specialist that participates in the Aetna network, the deductibles waived and you are responsible for a $20 co-pay that is paid to the provider at the time of your visit. If you're visiting a provider that does not participate in Aetna's network, you are responsible for 20% of the cost of the visit after you meet the plan's annual deductible. With the exception of office visits, you're responsible for either 10% or 20% of the costs for most other services, depending on whether the provider or the facility that you use participates in Aetna's network. The app also provides prescription drug benefits through Optum X.

We'll now take a look at the options available for retirees that are age 65 and older, retirees that are 65 and older who are Medicare eligible are eligible for the retiree post 65 plans. This includes your spouse's domestic partners or dependents that are 65 and older, and are Medicare eligible individuals that are under age 65 covered by a retiree plan who are eligible for Social Security disability insurance benefits are also eligible for Medicare after a qualifying period of 24 months. Once enrolled in Medicare benefits, you will also be eligible for these retirees post 65 plans.

On the previous slides, when I mentioned Medicare benefits, I'm referring to the benefits on the left side of the screen. The government Medicare plan is also referred to as original Medicare. It's made up of Medicare Part A, which helps with hospital costs, and Medicare Part B, which helps with doctor's costs. One of your plan options, called the retiree 8020 plan, is a coordination plan with Medicare Part A and B on the right side of the screen, you see Medicare options that are sold by private insurance companies such as Aetna, Medicare Part C is also called Medicare Advantage. Medicare Advantage plans combine the benefits covered by Medicare Part A and B, and includes prescription drug coverage benefits all together in one package. And Medicare Advantage plans include additional benefits that are not part of original Medicare. There are also companies that have standalone pharmacy plans called Medicare Part D, but with the Medicare Advantage plan that we offer through Cornell, your part D benefits are included and you do not and should not enroll in a separate part D plan.

We're going to review the highlights of the 8020 plan through Aetna. Please note that in order to receive the most reimbursement, you should be enrolled in Medicare Parts A and B. In addition, if you plan to cover a spouse or domestic partner that is over the age of 65 or otherwise eligible for Medicare due to disability, in order for them to receive the most reimbursement, they should also be enrolled in Medicare Parts A and B, any dependents you wish to cover who are under the age of 65 and not required to be enrolled in Medicare will be covered under the Aetna retiree pre Medicare health plan that was reviewed earlier in the presentation. When you are enrolled in the retiree 8020 plan, there is not a network of participating providers. You're able to see any doctor you choose for services covered by Medicare. It is recommended that your provider participate with Medicare to ensure that they are eligible to receive reimbursement. There is not a requirement to get referrals to see a specialist, and you do not need to declare a primary care physician in order to obtain coverage. This plan has no waiting periods for preexisting conditions, and it offers additional coverage for inpatient hospital stays in addition to what Medicare covers. There is also coverage for care received when traveling anywhere within the United States, as well as outside of the United States, and prescription drug coverage for this plan is provided by Optum. The retiree 8020 plan coordinates coverage with original Medicare Parts A and B when you're enrolled in this plan, Medicare is the primary coverage, which means claims should be processed by Medicare before they're processed by Aetna. After Medicare processes the claim, the claim is automatically sent to Aetna on your behalf to apply towards the retiree 8020 plan benefits. After both Medicare and Aetna process your claim, you'll receive an explanation of payment showing the details of the benefits applied by each plan. You have a 550 deductible on the Aetna Retiree 8020 plan that will apply if Medicare reimbursed the provider 80%. Coinsurance at no. Will review to determine if there is additional reimbursement up to that 80%. You'll reimburse your provider 20% until you pay $3,550 out-of-pocket. That is your out-of-pocket maximum in a calendar year.

When you're enrolled in the retiree 8020 plan, you will have three ID cards that you must present when seeking care for medical visits. You'll present your Medicare identification card as the primary coverage, and you'll also present your Aetna Medical ID card so the doctors are aware that you have secondary coverage through the retiree 8020 plan. And for prescription services, you'll present your Optum ID card at the pharmacy.

Next, we'll review the highlights of the Medicare Advantage plan. Please note that this plan requires you to be enrolled in both Medicare Parts A and B, and in addition, if you plan to cover a spouse or domestic partner that is over age 65, they must also be enrolled in Medicare Parts A and B, any dependents that you wish to cover who are under the age of 65 and are not required to be enrolled in Medicare will be covered under the Aetna Retiree pre Medicare Health plan that was reviewed earlier in the presentation. When you're enrolled in the Medicare Advantage Plan, Act now becomes your primary payer of your insurance claims. Medicare assigns us to administer your part A and part B benefits. You'll show your Aetna Medicare Advantage ID card for all medical visits, services as well as prescriptions. In addition to covering all Medicare approved services. The Medicare Advantage plan also includes benefits beyond what original Medicare covers, such as health advocacy programs, personalized nurse support, and much more. We have a large network of doctors and hospitals. We have over 1.3 million doctors in our nationwide network, and over 43 hospitals participating across the country. You also have the flexibility to go out of network and see providers that are not contracted with Aetna. However, your out-of-pocket costs will be higher for those visits outside of our network. This plan has no waiting period for preexisting conditions, and this plan also includes coverage for emergency and urgent care received while traveling anywhere within the United States, as well as outside of the United States. And this plan includes prescription drug coverage through Aetna. When you're enrolled on the Aetna Medicare Advantage plan, you have one ID card that you show for your doctor's visits, tests, and when at the pharmacy picking up your prescriptions, you can see the sample on the right side of the screen. And then on the left side of the screen is an example of an explanation of benefits for someone on the Medicare Advantage plan. Since Aetna processes the claims on behalf of Medicare, all claims come to Aetna and you'll get one monthly explanation of benefits for your medical and for your pharmacy coverage.

Now let's take a look at the two plan options side by side. The next two slides show the retiree 8020 and the Medicare Advantage plans side by side. There's a few key differences between the plans to be aware of. And as I mentioned earlier today, the benefits have stayed the same since 2025. On the retiree 8020 plan, claims must be processed by Medicare first before they can be considered for benefits. Under the 8020 plan on the retiree 8020 plan, there is no network of providers that you are required to use and to use in order to receive a higher benefit, but on the Medicare Advantage plan, there is a network of providers that, when used, help you receive a higher benefit. Both plans include an annual out-of-pocket maximum, which is the most that a retiree would pay out of pocket in any one calendar year for their medical services, and each plan includes benefits for preventative care, doctors visits and hospital visits. Ambulance services, urgent care and emergency room services are covered. The Medicare Advantage plan includes a 100% coverage for diabetic supplies when obtained through Accu-Chek or True under the retiree 8020 plan, retirees are extent responsible for 20% of the cost of diabetic supplies. Also to note, skilled nursing facility stays have a 20% coinsurance on the retiree 8020 plan and on the Medicare Advantage plan. There is a zero copay for days one through 20 and a $75 copay for days 21 through 100. The skilled nursing facility is designed to deliver professional nursing and therapy services daily in an inpatient setting. They will work to teach, train and help you adapt to your current skilled care needs. Both plans also include coverage for hearing aid equipment on the retiree 8020 plan. You have $3,000 per hearing aid per year, a per year available once every three years while on the Medicare Advantage plan, you have $500 available to you every 36 months for hearing aids. So again, on the retiree 8020 plan, you have $3,000 per hearing aid per year available once every three years. And then on the Medicare Advantage plan, you have $500 available to you every 36 months for hearing aids. I'll also mention that both plans include prescription drug coverage on the retiree 8020 plan. Coverage is provided by Optum and on the Aetna Medicare Advantage plan. Drug coverage is provided through Aetna.

These are some claim examples showing you how an office visit claim works for the retiree. 8020 plan. On the left side of the screen, and how the same claim works on the Medicare Advantage plan on the right side and in the lower section. Another example shows how a hospital claim visit is paid. The Cornell Retiree 8020 plan is secondary to Medicare. In most cases, the plan will only make a payment when the Aetna allowable amount is greater than the Medicare allowed amount. However, in the event that the Aetna annual out-of-pocket maximum on the Cornell 8020 plan has been met, Aetna will pay the balance for eligible covered medical expenses after Medicare at 100% in all cases, regardless of whether Aetna makes a claim payment or not. The balance after Medicare's payment accumulates towards the annual deductible and out-of-pocket maximum on the Medicare Advantage plan, each visit or medical service has a set copay amount for what you will pay for that visit. If you seek services from an in network doctor. So in example one, on the top of the screen on the left side, the member has the retiree 8020 plan the office visit lab X-ray claim. The cost is $500. The Medicare allowable is $350. In this example, the member has met their 2025 part B deductible of $257. Medicare pays 80% of the $350, which is $280, and in this example, the member has met their out-of-pocket maximum of $3,550 for the year. And therefore, the retiree 8020 plan pays the remaining $70, and the member owes zero. Now, in this same example, but on the right side of the screen, the member has the Medicare Advantage plan. The office visit lab X-ray claim cost is $500. Medicare allows $350. Aetna pays $325, as the member would have a $25 office visit. Copay. Now let's look at example two at the bottom, starting on the left with the retiree 8020 plan. This example is showing a member that had an inpatient hospital stay. This example on the left is only showing how the hospital room expenses covered. The hospital inpatient claim is $40,000. Medicare allows $32,000. In this scenario, the member did not meet their retiree 8020 out-of-pocket maximum of $3,550. Therefore, the member owes their part a deductible of $1,676. That's the 2025 part a deductible amount. In the same example, let's look at the member that has the Medicare Advantage plan on the right hand side. The hospital claim is also $40,000. Medicare allows $32,000. This member has a $250 copay for their inpatient hospital stay. So Aetna pays the remaining $31,750. One thing to note with Medicare Advantage, the $250 inpatient hospital copay per day covers the member for all services that happened during that hospital stay. It covers the room, the doctors, labs, tests, etc. and I do just want to point out that the Medicare Part A and B amounts for 2026 have not yet been released by Medicare.

Now let's take a look at your pharmacy benefits. If you're enrolled on the retiree 8020 plan, your prescription benefits will be through Optum. And then if you're enrolled on the Aetna Medicare Advantage plan, your prescription benefits are through Aetna. Both plans have no deductible, and each plan will have a formulary of drugs that are covered by the plan. Within the formulary, the drugs are broken down into different classes, known as tiers. Tier one are generic drugs, and you'll pay $5 for a 30 day supply, or $10 for a 90 day supply. Tier two are preferred brand name drugs, and you'll pay $30 for a 30 day supply or $60 for a 90 day supply. Tier three are Non-Preferred brand or specialty drugs, and you'll pay $50 for a 30 day supply or $90 for a 90 day supply. Please note that all of the drugs are not. All drugs are eligible to be written as a 90 day supply. But if your drug can be written that way and it's a maintenance medication, it will save you money. Both plans offer mail order for your maintenance medications. The Aetna Medicare Advantage plan also allows you to do a 90 day fill at the retail pharmacy, and the Aetna Medicare Advantage plan has an annual out-of-pocket maximum of $2,100 for your Medicare Part D drug drugs in 2026. Once you reach that amount, you move into the catastrophic phase and you pay $0 for your Medicare Part D covered drugs through the remainder of the year. While the co-payment structure is designed to be the same across both plan options, the formularies are different. So medications may or may not be covered or may fall into different tiers between the two different plans. Please contact the prescription plan vendor for more details on your specific medications.

There's a few more things that you need to know in regards to prescription drug benefits. The plan has drug coverage rules. The first one you see is prior authorization. You would see a PDA in the formulary. That means that some drugs require your doctor to first show a medical need for you to use a drug before your plan will cover it. Some drugs may also have quantity limits, and you would see a q l in the formulary. That means that there is a restricted amount of drug that you can get at one time, and that is usually for your safety. You also have some drugs that might need to take part in step therapy or at. That means that you have to try another drug on the plan's formulary before you can move to another drug. These are things that your doctor will work with the insurance company for in order to provide you with your prescriptions. If you are considering changing plans for 2026, you may want to review your specific, prescriptions between the two. Pharmacy plans.

We value your total health, and we want to help you reach your full potential in life, however you define it. We have you covered wherever you are on your health journey because healthier happens together. I want to share some of the additional benefits and programs that are available to you as Aetna members. Health care support is available to you in a variety of different ways, not just in a traditional doctor's office setting. Virtual care, also called telehealth or telemedicine, can be a fast and convenient alternative to in-person care. Can't get to a provider's office for a visit? While with virtual care, you can get certain types of care online or by phone, check with your primary care provider or specialist to see if they offer virtual visits that meet your needs. Another option, if you're unable to get in to see your doctor, is the Teladoc Health. They are able to connect you with board certified doctors at any time. They can treat many non-emergency medical issues by phone or over video, and this might help you avoid urgent care and emergency room visits, which can be costly and time consuming. It's easy to use, and you can speak with a doctor on demand within minutes, or you can schedule your visit at a time that's convenient for you. Sometimes you just need a quick answer to a health question, and with the 24 hour nurse line, you can speak with a registered nurse about a variety of health topics whenever you need to. You can call as many times as you need and it's at no additional cost to you. You can call day or night for help with such things as deciding whether to visit a doctor. Or maybe you need to get to an urgent care center. They can help you with understanding some symptoms that you're having. They can help you manage chronic conditions, and they can help you learn about treatment options and medical procedures. The telephone number for the 24 hour nurse line is located on the back of your Aetna ID card. With the Medicare Advantage plan. You do have one additional option, and that is the CVS Minuteclinic Virtual Care video visit. You can visit with a licensed provider over video within minutes, and they can help you with common illnesses, chronic conditions, and mental health visits. Care management is a proactive approach where we provide personalized support to improve health outcomes, reduce hospitalizations, and manage costs. In some situations, we assign a nurse case manager to help qualified members follow treatment plans. Coordinate care among multiple providers and manage medications. This care is part of the pre 65 retiree plan and the Medicare Advantage plan. The next two programs are components of the Medicare Advantage plan. Only a healthy home visit through Signifie Health is an added layer of care to help you manage your health in the comfort of your own home. During this annual visit, a medical provider will either come to your home or meet with you virtually online. Whichever you prefer, they can discuss any health concerns. They'll complete a fall risk assessment. They'll recommend screenings, and they'll create a personalized care plan with you. Remember, this doesn't take the place of an appointment with your regular primary care doctor, but you can feel free to ask them any health questions that you have. And afterwards, your primary health doctor will get a summary of the visit. The Healthy Home visit is included with your plan at no additional cost. And I do just want to mention that it is an optional choice. You also have the resources for living program, where a caring consultant can connect you with a wide range of cost effective and reliable services in your area. This might include, getting help within your home, transportation, maybe social and recreational activities, setting you up for caregiver support, and much, much more. You would only pay the cost of service if you decide to use it. This is a service that's similar to an employee assistance program.

Now, with all of that said, now is your time to make changes for this upcoming benefit year. Open enrollment is from October 20th 7th to November 14th, and during this time you can switch between Medicare plan options. You can add or drop eligible dependents. Please note that you may need documentation. Or you can cancel your coverage. If you're making a change for January 1st of 2026, you will need to take action through the Aetna Retiree Service Center. Your open enrollment window will be open from October 27th through November 14th. If you do not take action, you will continue your enrollment in the same plans that you have currently. I will also mention that if you're newly eligible to Medicare, now or throughout the year, you will receive enrollment materials from Aetna with your plan options. If you're thinking about changes for 2026, let us help you. You might want to ensure that your doctors accept your plan, and you also want to make sure that your current prescriptions are covered. You can reach the Aetna Retiree Service Center by phone. Our representatives are there Monday through Friday from 8 a.m. to 8 p.m. Eastern time. If you're comfortable with the computer, you can self-service by visiting WW w at not retiree plans.com. Or you just might want to call your doctor's billing office and you can give them the plan name, and they can tell you if they accept that plan or not. When and if you're ready to make a change, you can go online through the Aetna Retiree Benefits website, or you can call the Aetna Retiree Service Center. And again, changes do need to be made during the open enrollment window from October 20th 7th to November 14th. If you have questions, I have the Aetna Retiree Service Center phone number on the next slide. And the representatives are ready and available to answer your questions one last time. The telephone number to reach our Aetna Retiree Service Center is 1-800-338-4533. And again, they're there Monday through Friday from 8 a.m. to 8 p.m. eastern time. I want to thank you for your time and attention today. I hope you found this information beneficial, and I want to wish you a happy and healthy year ahead.