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Open Enrollment for Endowed Retirees

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Monday, October 30 - Friday, November 17, 2023

Join Cornell benefits experts for online or in-person presentations to answer your open enrollment questions.

Online Webinar

Wednesday, November 1, 2023

10 - 11 am

Join by phone: +1 646 876 9923, Meeting ID: 938 4969 8901

Join by Zoom 


In-Person / Online Presentations

Wednesday, November 15, 2023

395 Pine Tree Rd (East Hill Office Building), Suite 140

Session 1: 9 - 10 am

Join by phone: +1 646 876 9923; Meeting ID: 995 7239 8173

Join by Zoom (Session 1)

Session 2: 11 am - 12 pm

Join by phone: +1 646 518 9805, Meeting ID: 987 0468 5822

Join by Zoom (Session 2)


 Recorded Presentation

Video Transcript

[Captions auto-generated]

00:00:00:00 - 00:00:20:15
Unknown
My name is Gordon Barker and I am part of the benefits team here at Cornell University. I'm joined by a number of colleagues from my team, Amanda Jemison, Emily Bruce, so busy cogs and we have some important guests from Aetna, Carey Allen, Melanie Walker and Tori Bell.

00:00:20:17 - 00:00:43:24
Unknown
Carey and Melanie and Tori. I promised them they would get a chance to speak, and so we'll have them help us out in just a few slides, but I will kick it off. Welcome, everyone, to the Cornell University. Open enrollment at retiree informational meeting today. We're going to share some hopefully very valuable information on our retiree health plans here at Cornell.

00:00:44:01 - 00:01:21:00
Unknown
Our population attending this seminar or webinar is a little varied, so we will be talking first about benefits in retirement, our current plans and what's happening to them, our health care plans, what's happening to them with one one renewal. And then at the very end, if we have anyone on who is not yet a retiree from Cornell but is is trying to gather information, we'll have a couple of slides at the very end for how you transition into retirement, but we'll keep those at the end so that the rest of the population who's already retired can leave us.

00:01:21:02 - 00:01:44:07
Unknown
So let's kick off the presentation. Let me show you what we're talking about today. So we are going to start talking on what's changing for 2024. There not a lot of changes, but we want to share with you some added benefits in a number of our plans. We'll also talk about what's happening with our utilization and our premiums going into 2024.

00:01:44:09 - 00:02:12:03
Unknown
Before we start, I just want to mention that if you have questions as we go along, we would ask that you put them into the Q&A portion of this webinar. You see there's a button down at the bottom of your screen that says Q&A. And if you add your questions there, the team will review them and we'll try to cover them within the presentation if we can or will have a question period at the very end also.

00:02:12:05 - 00:02:40:04
Unknown
So we'll start with what's changing for 2024 and then we'll dig into the plans themselves, our pre 65 retiree health insurance plan, and then we'll start talking about post 65 coverage, how Medicare works and what plan options we have at Cornell. Then we'll transition over to how to make changes for 2024. And again, we'll have a really valuable point of time for questions and answers.

00:02:40:06 - 00:03:10:18
Unknown
Then we'll talk about transitioning For anyone who wants to stay on transitioning from active to retiree. So Pat Show today, So I'm going to jump into the next slides. So what's changing for 2024 this year? We have some really important news to share on some added benefits in each of our plans. So we're going to start on the left hand column here, what we call our page plan.

00:03:10:20 - 00:03:36:13
Unknown
That's our pre Medicare health plan. So if you left us and are between the ages of 55 and 64, this would be the plan that you're in. Or if you have a spouse who's in those age brackets, this is the plan They would be in a couple improvements in this plan that are really important to notice. A number of our health plans historically for active and retirees have been about rehabilitative services.

00:03:36:13 - 00:04:06:03
Unknown
So when someone loses the ability to do something, helping them get that ability back, what we're pleased to see added in a number of our active and retiree plans this year is habilitation of therapy related to physical needs, speech needs, occupational needs. And so we've added habilitation of therapy into our to non Medicare Advantage plan. There was already some coverage in the Medicare Advantage.

00:04:06:03 - 00:04:24:16
Unknown
So this is primarily a change for the pre 65 and the 8020 plan and again, rehabilitative physical speech and occupational therapy for those who were perhaps born or developed a condition that took away an ability for certain physical activities or speech

00:04:24:16 - 00:04:46:08
Unknown
We're also adding an autism variation on this benefit. So adults or children diagnosed with autism, similar to our active plans, our pre 65 plan is adding some coverage there and you'll hear us talk about ambulance services in a couple of plans today for the pre 65 plan.

00:04:46:10 - 00:05:18:14
Unknown
Just want to clarify that both emergency and non-emergency ambulance use will be covered now with a 90% reimbursement after deductible, but it will be covered in and out of network. So if you're taking if you're using an out-of-network ambulance service, that 90% could be a little bit Yorkshire could be a little bit higher. When we talk about the pre Medicare health plan, because keep in mind, this is the only insurance plan that's covering individuals not yet Medicare eligible.

00:05:18:16 - 00:05:42:20
Unknown
We did see a fair amount of utilization shown over the past year. We look back over the last two years, but over the past year in particular, a real spike in utilization. Because of that, we still are committed to providing very affordable care to our retirees. And Cornell is still picking up 90% of individuals coverage here, a little bit more than 90%.

00:05:42:22 - 00:06:18:05
Unknown
But we do need to share some of the cost increases that are going to go into effect in January of 24. So if you have individual retiree coverage, the base cost for this plan is going up about $6 a month, about 73, $74 a year for family coverage. It's about $31 a month. But as we're talking about these increases in coverage, I want to point out that you shouldn't forget, for most retirees, they have a sick leave credit that is still applying sick leave credits.

00:06:18:05 - 00:06:42:20
Unknown
When you leave, Cornell, continue with you for the rest of your life. And so with a sick leave credit calculation for individual coverage, this addition can be potentially offset more by your sick leave credit everyone should have received. I'm hoping by now a package from Aetna to their homes that talks about the plan coverage is in much more detail than we're doing here.

00:06:42:22 - 00:07:10:00
Unknown
And included in that package is your individualized calculated rate, which takes into account your sick leave credit. So again, for rates I can't that we're just talking about additional to the overall cost here. Your rate will be determined based on your sick leave credit for the retiree 8020 plan and the Medicare Advantage plan. We'll talk more about this in a few minutes.

00:07:10:00 - 00:07:43:09
Unknown
But keep in mind, Medicare is the primary carrier for retirees who are Medicare eligible. Then we have plans that basically add on to that Medicare coverage. So we'll start first with the retiree 8020 plan. I mentioned rehabilitative therapy under this plan that affiliated therapies, therapy for speech, physical needs, occupational needs is covered at 80% after deductible in this plan actually had a pretty good year or 24 months of utilization.

00:07:43:11 - 00:08:07:02
Unknown
So we're pleased to say that this plan is only going up by less than a dollar a month for an individual and just a little bit over $4 a month for a family. Same note here, though, about sick leave credit. This is the increase in overall cost, but sick leave credits can reduce that based on your own individual sick leave credit base.

00:08:07:04 - 00:08:33:12
Unknown
Finally, we'll go over to the Medicare Advantage plan. Again, this is for folks who have chosen this special mapped plan. We'll talk more about it. It's offered through Aetna and it covers both your Medicare benefits for Part A and B, your prescription benefits and some added benefits. So under the MAP plan, something that's new for 24 is a big benefit.

00:08:33:14 - 00:09:08:20
Unknown
This wasn't covered under map D before. It's now available if there is hair loss due to chemotherapy, it's a $0 co-payment and you can receive up to $400 reimbursement against the cost of a wig. Now this is new under MPD plan. Just want to point out this note down that for both the pre 65 and 8020, the coverage is for various diagnoses and it can be up to $1,000 reimbursement per wig, but it's also subject to co-insurance and deductible.

00:09:08:22 - 00:09:37:21
Unknown
Something else that's added as of one one under the AMA PD plan. Over here is the emergency transportation. The emergency transportation now is going to be covering you for both in the US and international coverage so you can be reimbursed for emergency transportation usage. There is, under this plan a $25 co-pay and then the balance would be covered under the plan.

00:09:37:23 - 00:10:01:23
Unknown
The other important note that's a little bit different for Medicare Advantage this year. We just want you to watch your mail. So in addition to the Aetna package you received probably in late November, up to mid-December, you'll start to get new Medicare Advantage ID cards. These cards are being issued new, but it does not change any of the aspects of the plan.

00:10:01:23 - 00:10:25:00
Unknown
It doesn't change your ID number, but we just want you to be on the lookout that these new cards will be coming in for the Medicare Advantage plan. Again, here we look at our experience and the experience across the populations enrolled in this plan. And we did see a need to increase costs for both Cornell and for retirees under this plan.

00:10:25:00 - 00:11:07:11
Unknown
Individual coverage overall, prices going up a dollar 43 a month. Family 717 a month. And again, the same sickly credit message is important to understand. Your sick leave credit is calculated for you on your premium and in the Aetna documents you received, it will confirm what your costs will be for 2024. So there's are changes again, other than utilization, which I know it's always hard to have any kind of increase increase in costs during our retiree years, but we're very pleased to be able to offer additional services and keep the very comprehensive plans that we have for our retirees.

00:11:07:13 - 00:11:33:22
Unknown
So let's drill down a little bit and talk about those plans. We'll start by talking about the pre Medicare health plan. And people are under this plan. If you're a retiree who is younger than 65 and not in any other way, Medicare eligible or enrolled, it's also covering spouses, domestic partners or dependents who are younger than 65 or not get Medicare eligible.

00:11:33:24 - 00:11:57:10
Unknown
So keep in mind at Cornell, we look at the ages of you, your spouse and any dependent children, and that determines the plan options that you have. Just a reminder about how the pre Medicare, the pre 65 plan works. As we go through this slide, I'm going to define a few terms and then we'll see these terms as we talk about the other plans also.

00:11:57:12 - 00:12:33:22
Unknown
So let's start with this. Deductibles, firm annual deductible. A deductible is the first expense in a calendar year that ends up being your responsibility. And so that means this deductible has to be met before any reimbursement will come from your insurance policies. For the Cornell plan, the pre 65 plan in-network if you're using in network services, there's a $150 individual deductible and a $300 family deductible, and that resets each calendar year.

00:12:33:24 - 00:13:04:22
Unknown
So going into 2024, as it starts, you may see that you have an initial cost for claims that are submitted because you do need to meet their deductible. Now if you choose to go out-of-network. And this would mean the vast majority of physicians that were physicians and facilities that we offer within the country that are in, you could choose to go to a physician or facility that doesn't accept that insurance, in which case your deductible is a little bit higher, $300.

00:13:04:22 - 00:13:31:02
Unknown
The first $300 for an individual, the first $600 for the family unit before the plan would start paying benefits. So deductible. Think of this as the first of the year. For most people, those first expenses very often will go to fulfill the deductible after the deductable. All is in that you have a plan design that covers either percentages of costs or with copayments.

00:13:31:02 - 00:13:58:18
Unknown
So you have a share in the cost. The concept of out-of-pocket maximum is a security blanket almost for us in these plans. Out-of-pocket maximum means in a calendar year, the most that you would ever have to pay for allowed services. So we talked about deductible being the first thing you're responsible for when we talk about copayments or coinsurance is as we'll talk about in the next couple lines.

00:13:58:20 - 00:14:24:05
Unknown
As you pay those, those credits go against a pool of your out-of-pocket maximum. So a good peace of mind for our retirees. As you know, if you're an individual who's using in network services, the most you would have to pay in a calendar year is $2,000. After you've matched that to that out-of-pocket maximum, the plan would cover at 100%.

00:14:24:07 - 00:14:48:03
Unknown
So it's 2000 for individual, 4000 for a family. If you go in network, it's slightly higher if you go out of network. So keep in mind, this isn't something you know you're going to pay. This is just the cap on how much you would have to pay if you had a lot of services in a calendar year. So let's look at services.

00:14:48:09 - 00:15:14:11
Unknown
So first, if we talk about seeing a primary physician or a specialist or in-network specialists or primary physicians under the pre 65 plan, it's a $20 co-pay with no deductible. So each time you visit, it's $20 and then the rest is covered at 100% by the plan. Similarly, as we talked about before, if you choose to go out of network, you're out of pocket.

00:15:14:11 - 00:15:35:12
Unknown
What you will pay will go slightly up. So we really encourage you and all of our plans to try to find participating in network doctors wherever possible. If you do need to go out of network to see a primary physician or a specialist, keep in mind the plan is going to be picking up 80%. You would be paying 20% of the cost.

00:15:35:14 - 00:16:06:07
Unknown
And that is after you meet these deductibles that are listed above. Most other services within the plan have a straight formula. So in-network for anything that's not a primary office visit. Basically, there's a 10% cost share. Once that deductibles then met and the plan pays the balance. Similarly, if you go out of network, there's a 20% cost share and the plan pays the balance.

00:16:06:09 - 00:16:30:19
Unknown
When we talk about prescription drug coverage and I'll come back to this again a little bit later in the presentation, we don't want our retirees picking plans based on prescription drug coverage. So we've been working very carefully to make sure that our prescription coverage is similar across all of our retiree plans. So we're going to start here in the pre 65 plan.

00:16:30:21 - 00:16:53:17
Unknown
Basically, our program is set up to allow you to get up to a 30 day supply at the retail pharmacy that you attend physically or you get mail order on certain medications. If you are able to get those in a 90 day supply. We have a kind of a break in the cost for you. So our pharmacy benefits work in a three tier system.

00:16:53:19 - 00:17:28:15
Unknown
If you are diagnosed and need to have a generic prescription filled. Those are the the most reasonably priced and still applicable across physicians needs for plans. Generic prescriptions will cost you $5 at the pharmacy for a 30 day supply or a $10 if you use mail order for a 90 day supply. And I know I'm talking just to my pre 65 attendees today, but these are going to look very familiar because it's the same design if you're in one of our post 65 plans.

00:17:28:17 - 00:18:02:10
Unknown
So generics would cost you $5 retail $10 mail order for two months, three months supply only a two month payment. The second tier is our preferred brands. These are drugs that are primarily created by one major manufacturer and they're considered to be the preferred provider of those drugs. If you get a preferred brand drug, you will pay $30 for the 30 day supply at the pharmacy or $60 for a 90 day supply through mail order.

00:18:02:12 - 00:18:31:08
Unknown
Finally, what we call non-preferred brand here, but I'd like to call it something slightly different when we talk about this third tier, this non-preferred brand. This is when there are multiple manufacturers of a drug, but one or two of them produce the same drug at a much lower cost. That one or two would be put into the preferred brand category and all the others that make the exact same drug but at a higher cost would be considered the non-preferred brand.

00:18:31:08 - 00:18:54:07
Unknown
This is part of what's called the formulary and that gets set every January one and July one. So within the formulary, if you end up taking the most expensive drugs when there are alternatives, you pay more. You pay $50 at retail for a 30 day supply and you pay $90 for those three at three months supply through mail order.

00:18:54:09 - 00:19:38:10
Unknown
So this has not changed from prior years. You just wanted to share it with you. Again, just as a recap of our plan design. So let's do a little bit of a discussion now for the other folks in our population today, those who are over 65 who are on Medicare. So this again, is for retirees, 65 or older who are Medicare eligible for those spouses, domestic partnership dependents who are 65 or older, Medicare eligible or for anyone under 65 that might become eligible for Medicare because of Social Security, disability insurance or any other kinds of qualifying event that puts them into Medicare.

00:19:38:12 - 00:20:04:22
Unknown
So post 65 plans, we have two plans to talk about. But before that, I'd like to just talk a little bit about Medicare. So you are probably receiving this time of year. We all seem to get them tons of information in the mail telling you they know the best coverage for you. They've got Medicare plans. They've got all sorts of things that they're offering you, and it can become very confusing.

00:20:04:24 - 00:20:38:08
Unknown
So we want to cover a little bit about Medicare plans and then talk about how they work within our retiree coverage. So as many of you already know, Medicare Part A is a federal government plan created that we pay into through tax dollars. And Medicare Part A basically covers hospital costs. And for our retiree plans, Medicare Part A is an important component in the whole plan that we offer, because if you're over 65, Medicare pays first.

00:20:38:10 - 00:21:02:23
Unknown
So Medicare Part A helps with hospital costs. This one is free. You don't pay for this. As a retiree, Medicare Part B is the portion of Medicare that covers tests and labs and physician costs. Medicare B is what you do pay a premium for to the government, and that premium may be paid directly by you or might be coming out of your Social Security pension.

00:21:03:00 - 00:21:29:21
Unknown
Part B again, for our plans, an important component if you're over 65 because they pay first before our plan benefits kick in. Now there are certain plans. We put them under private here. I just give you a little bit of counsel on these. So there is a part of Medicare called Part C, and that actually is the part of Medicare that covers Medicare Advantage plans.

00:21:29:23 - 00:21:54:04
Unknown
So just want to be very clear. We're going to talk about an Aetna Medicare Advantage plan as something we offer to post 65 retirees. And we'll talk more about it. But the thing to remember is that one plan acts as Medicare for people enrolled in it. So the Medicare part A and part B costs are covered under that plan.

00:21:54:06 - 00:22:19:18
Unknown
In addition, under that plan, what's considered to be a part D cost, which is prescription drugs, is all covered under a medicare Advantage plans. We'll talk more about our plans and where drugs fit in and that sort of thing. But just so you know, from the nomenclature Part C are these very special combined plans. Part D is something that traditional Medicare didn't cover for a number of years.

00:22:19:18 - 00:22:44:16
Unknown
It's their coverage for prescription drug plans. And again, we're going to talk about our plans and how prescription drugs are covered. So they're not technically a part D plan that you'd be buying from the government. We'll talk about how that works. And then you may hear things mentioned about supplement plans that try to fill in gaps. Again, we'll talk about our plans and give you a couple of cautions.

00:22:44:18 - 00:23:08:19
Unknown
If you're thinking you're going to pursue one of these plans that you get in the mail or online. So let's using that as a background, talk about our actual plans. So we offer two options to our retirees who are aged 65 or older. The first is our retiree 8020 plan, and basically the 8020 plan works with an Aetna network.

00:23:08:20 - 00:23:37:19
Unknown
So we have Aetna doctors across the country and you can use any licensed doctor or hospital. There's no restrictions on it. But Medicare, because they're going to pay the first portion of this does have restrictions. So for Medicare is portion Medicare strongly encourages you to find a doctor who accepts Medicare because that's the first and sometimes larger portion of your bill.

00:23:37:21 - 00:24:00:22
Unknown
So if we think about it, there's almost a two plan or three plan process for those. And we'll talk about this in a minute. There's Medicare portion, there's the 8020 portion, and there's prescription drugs. So it's important to understand how each of those parts work. You're not required to pick one physician under the 8020 plan. You can go to any physician's at any time.

00:24:00:24 - 00:24:31:06
Unknown
Basically, Medicare is going to cover again a lot of the hospital stay. But this 8020 coverage gives some additional coverage on hospital stays. There's no waiting periods when you go into the 8020. So if you were to switch into it from another plan, one one, you get coverage right from day one. And what's important is a difference in the 8020 plan is international coverage is there for both medical and non-medical emergencies.

00:24:31:08 - 00:24:59:15
Unknown
So that's an important component for some of our retirees who might be spending a considerable amount of time abroad. We'll talk about that in relation to the Medicare Advantage. So those are kind of the basics. Again, no changes here on what it's covering, but just wanted to cover the basics of this plan. So I kind of mentioned this once before, but let's let's cover it in a different visual.

00:24:59:17 - 00:25:27:07
Unknown
So when we're talking about taking the 8020 plan, you really have four different components. You have Medicare Part A who's going to pick up your hospital bills first, you have Medicare Part B that's going to look at lab fees and doctors bills first. Then you're you're going to have the retiree 8020 plan. That's also going to look at those bills to see if it will pay anything more than Medicare paid.

00:25:27:09 - 00:25:52:05
Unknown
And then our fourth piece of the puzzle is our prescription drug coverage. Now, it's important to know under the 8020 plan, you do end up with three ID cards. So most people who enroll in Medicare have a medicare card. It tells that they're enrolled in Part A and part B Occasionally, this is asked for at physician's offices, not so much anymore.

00:25:52:05 - 00:26:16:04
Unknown
They really want to be able to protect their identity. And so very often they can just look you up pretty quickly and tell that you're on Medicare. But you do have that Medicare card. You also have an Aetna ID card for this 8020 plan. And that's going to be important to show your physicians also so that your doctor's office, where possible, will do all of your billing in the right order for you.

00:26:16:06 - 00:26:54:15
Unknown
And then separately, under this plan, you continue to have an Optum prescription drug card. If you've left our active service recently or within the last ten years or so, Optum has been your prescription drug card as an active employee. And this same card, the same benefit is applied to retirees in the 8020 plan. So when we talked about a minute ago about who's first, keep in mind I did this this arrangement on 8020, Medicare Part A and part B pays first and then the Cornell retiree 8020 plan pays second.

00:26:54:17 - 00:27:19:12
Unknown
The concept of this plan, if you look at the name up here, 8020 is in combination of Medicare and the Aetna portion, you should be getting reimbursed for 80% of your costs, with 20% coming back to you as a responsibility. So that 8020 is just like our active plans, just like many plans across the country, they're going to pay 80% of the cost.

00:27:19:14 - 00:27:49:00
Unknown
Now, there is another aspect to this. You could sign up with Medicare Direct, and Medicare Direct can make the claims processing a little bit easier because your Medicare portion and your Aetna portion can all be submitted for you and to each location. And Medicare Direct just in case you're not familiar with it or not enrolled in it, and you're already in the 8020 plan, you can enroll in this through Aetna.

00:27:49:06 - 00:28:23:08
Unknown
You would call a specific number at Aetna or you can go online with that and you can work through this process to connect your plans so that when there are expenses, they can automatically be submitted to Medicare first and then paid by the plan. So let's talk about the second option for our 65 and older Medicare eligible retirees, and that is the Medicare Advantage plan, the Aetna Medicare Advantage plan that also has prescription drug coverage.

00:28:23:10 - 00:28:50:20
Unknown
So let's go back to that. Since we just talked about a puzzle piece. Let's talk about them again here. So what's what's happening in Medicare Advantage is everything works together. And Aetna processes. So Aetna is in an agreement with the federal government to be a medicare Advantage provider, which means they take on some of the responsibility that the government would do through the Medicare programs.

00:28:50:22 - 00:29:21:14
Unknown
So there is one ID card that you use and now is to process what normally would be paid by Part A and part B They do that work for the government. It also includes the prescription coverage that would normally be Part D, and then there's some added benefits that are in for Medicare Advantage. Medicare Advantage has doctors and hospitals more than a million in the US network and more than 4000 hospitals.

00:29:21:16 - 00:29:45:19
Unknown
But this is another important thing for Medicare Advantage. To get benefits from the plan, you need to use doctors who don't just accept Medicare but accept Medicare Advantage. And that's pretty easy for them to tell you. So if you were going into this plan, if you're in this plan, you really want to find providers who are Medicare Advantage providers.

00:29:45:21 - 00:30:21:13
Unknown
So there are certain additional benefits that comes in addition to part in Part B, That's why we see additional benefits here. So there's health added advocacy programs, there's some in-home nursing visits to kind of evaluate your home. There's personalized support. All of those are baked into this coverage and it does provide coverage when you're international. But the difference between this plan and 8020 is coverage international generally under MPD because of the Medicare rules will only be covered as it's an emergency situation.

00:30:21:15 - 00:30:48:08
Unknown
So emergency non-emergency covered under the a20 specifically emergency internationally covered here. Just talking about international, if you're spending some time abroad. So let's take a moment and kind of compare these two plans. I get this question every year. I've been doing these for seven people say, is Cornell trying to push me one way or another? We are not.

00:30:48:08 - 00:31:06:12
Unknown
We we enjoy that. You have choice. We want you to have choice. So let's talk about these post 65 choices you have. I know this chart looks a little busy. I'm going to try to make it as as clear as we can. We're going to talk about some that we talked about a few minutes ago on the pre 65.

00:31:06:12 - 00:31:36:02
Unknown
So I'll just reiterate those. What you see here is the retiree 8020 plan, and that works after Medicare and B, make their payments. It comes into this plan. And then we have over here the Medicare Advantage plan. It's a PPO, which means it's a preferred provider network. And that's why you see in-network costs versus out-of-network costs. So let's start with deductible.

00:31:36:02 - 00:32:00:20
Unknown
Our old friend, the money that you pay first in a calendar year before the plan will pay anything under the 8020 Medicare plan, there is the first $550 of expense each year. Is your responsible money. So it will it will track that for you. It will know when you've hit it, and then payments will start coming from the plan.

00:32:00:22 - 00:32:32:03
Unknown
If we compare that to the Medicare Advantage because of its unique relationship and design with the government, there is no deductible, in-network or out-of-network on the Medicare Advantage plan. So that might be a consideration for you. As you think about the two plans, let's talk about out-of-pocket maximum. Remember, this is if something really catastrophic happened, if you had a lot of expenses, what's the most you would have to pay in a calendar year?

00:32:32:05 - 00:33:05:02
Unknown
Here's where there's a bit of a difference. Also, remember, there's a deductible first under the 8020 plan and then your cap for out-of-pocket expenses is another 3000. So $3,550 on this plan is the most you would have to pay out-of-pocket in a calendar year. No. On the Medicare Advantage plan, you will see that those numbers are higher. So the cap on what you would pay is higher, but it's also providing a little more coverage in certain areas.

00:33:05:02 - 00:33:23:15
Unknown
So you wouldn't have as much out of pocket. But it is an important thing for you to think about. If you look back over the past year or two, if you had been a retiree that long, look at what your costs have been and this would be for some people a deciding factor on this, I think I need to have that cap lower.

00:33:23:17 - 00:33:49:15
Unknown
I might want to consider this plan. No judgment here. I'm not giving you advice. Just you'd want to look at your own situation. One of the things that I think is so important to notice and understand from Cornell's plans, we do not have benefit plans for retirees that suddenly max out and say, you don't get any more coverage because you've used a lot of it in your retirement years.

00:33:49:17 - 00:34:11:00
Unknown
So maximum is is there a point at which the coverage will stop because you've used it a lot? And in each of our plans, that does not apply. That's going to be important. If you were to ever to go out and shop the market to see what somebody else was offering you, you really want to look lifetime maximums.

00:34:11:00 - 00:34:42:10
Unknown
They do exist in some plans that you would hit a cap and then you wouldn't get benefits anymore. Not in our plans. Okay. Specialty specialist care. Primary care Under the 8020 plan, if you go to a medicare doctor, you'd be responsible for 20% of the cost of that office visit under the Medicare Advantage. If you use an in network Medicare Advantage, remember, that's a specific network of doctors.

00:34:42:12 - 00:35:11:19
Unknown
You'd only pay $25 if you go outside that network. Similar to the 8020, you'd be responsible for 20% of the costs. Now, when we talk about preventive services like those checkups, like those other services, you might get to ensure good on the 8020 plan, those are covered with a 20% co-pay, but you don't have to meet the deductible first.

00:35:11:19 - 00:35:40:19
Unknown
So those kick off right away, but your share is 20%. And as far as those types of services, there is a maximum on what you would you would receive in the plan. So that's a two year maximum resets every two years. So we talk about preventive services under the Medicare Advantage, no cost to you if you use a medicare Advantage participating doctor, if you go out-of-network, it's 20%.

00:35:40:21 - 00:36:07:08
Unknown
And just as you receive on the 8020 plan. So we've tried to build this over the years, you're going to see that this column for out-of-network is going to be pretty similar to the 8020 plan. So the advantage scenario is that pan of Medicare Advantage is certainly in the in network doctor costs that are in this column. So other services pretty standard for the 8020 plan.

00:36:07:08 - 00:36:39:16
Unknown
Remember the concept is insurance is 80%, you pay 20%. So when we talk about inpatient hospital, outpatient hospital, E.R., urgent care, ambulance and diabetic supplies, 20% is your share of that cost. The rest is picked up by the plan through Medicare and Aetna. If we look at those lines, as you see under Medicare Advantage, they vary a little bit and they vary often very different, very greatly in the Met and the in-network out-of-network.

00:36:39:18 - 00:37:22:21
Unknown
So if you're inpatient at the hospital you on and you go to a medicare Advantage participating hospital, $250 is the flat payment that you would owe regardless of how long you stay. If you go out of network, you're going to pay 20% for the cost during your whole stay outpatient. We mentioned 20% over here. So if you're just doing some outpatient quick in out services and you're using a medicare Advantage in network solution, No dollars out-of-pocket in-network, 20%, you pay out-of-network E.R. services.

00:37:23:02 - 00:37:56:02
Unknown
MPD, we said was 20%. If you use those services under Medicare Advantage, it's a flat $50. Whether you go in network or out of network, it's urgent care rather than emergency room. You go to an urgent care facility, 8020 again, 20% co-pay. If you go to in-network urgent care under Medicare Advantage, $25 copay if you go out-of-network also $29 co-pay.

00:37:56:04 - 00:38:29:20
Unknown
Ambulance 20% here, $25 in network at Medicare Advantage and 20% cost share. If you go out-of-network diabetic supplies covered under the 8020 at 20% you or your share. If you use life scan products, they're considered the in-network solution and mapped based no cost share. But if you use another service, it's 20% again similar to the 8020 have skilled nursing facilities.

00:38:29:22 - 00:38:57:17
Unknown
Let's talk about these a little bit skilled nursing facilities. There is a certain level of care that's needed. And so this is not nursing home, This is not hospice. This is where there's an actual medical service being delivered. So skilled nursing facilities under the 8020 plan, there's a 100 day maximum coverage and you pay 20% the cost for those 100 days.

00:38:57:19 - 00:39:30:03
Unknown
Under MPD, there's still the 100 day maximum, but you pay nothing for the first 20 days and you pay $75 for the remaining days, up to 177 out-of-network 20%. And you see a pattern here. There's a lot of 20% cost shares here. Now, prescription drug coverage, we're going to come back to this. But just the difference between the two plans is not the plan design, but the difference is who's handling the claims.

00:39:30:05 - 00:40:00:24
Unknown
So for 8020, it's through Optum with an optumrx x drug card, through Medicare Advantage, it's through the Medicare Advantage card. But again, we'll talk about specifics of those drug plans. Let's talk about a couple claims examples, and I will spend a little bit of time on this. I know we're down to the last 15 minutes or so, so when I want to cover these fairly quickly, these are just point in time examples.

00:40:00:24 - 00:40:31:03
Unknown
These may or may not ever apply to you. But in going to a physician's office, we're going to compare the 8020 plan to the Medicare Advantage. So let's say that the cost for the lab work there was $500 for the visit and the lab work. Medicare under the 8020 would cover $360, would allow $350 as a charge and would cover that at $280.

00:40:31:05 - 00:41:01:14
Unknown
In this case, the 8020 plan, if you've already met your deductible, would pay $70 for that. So that plan so there's no cost in this particular scenario. On the Medicare Advantage side here, let's say that the cost was $475. Medicare only allows to 85 and they pay to 60 of it. You can't be balance billed between the difference.

00:41:01:19 - 00:41:29:20
Unknown
So cost is just the difference between what they allowed and what they paid. So in this example, $25 under Medicare Advantage in hospital confinement, if you have to stay in the hospital. And here again, we're just talking about the hospital costs, not any doctor's visits, other services within that hospital under the 8020 plan. In this example, cost of the hospital state was $40,000.

00:41:29:22 - 00:42:03:09
Unknown
But Medicare only allows 32,000. And now that they pay $30,368 in this particular case, because 80% was already allowed and covered, there's no payment from the plan. So in that hospital stay example, the retiree pay one $632. Again, it's hard to look at this because we don't have days listed. There's a lot more nuance to this, but it gives you the concern about what would happen.

00:42:03:09 - 00:42:34:16
Unknown
It would be 81, the Medicare Advantage plan. Here. We're talking about a cost of $35,000. Medicare allowed 21 and paid 20,750. In this case, under Medicare Advantage, the member would owe $230. If you you're thinking about changing plans. If you're thinking about whether now is the time to go to a different plan for January, I'd really encourage you to look at your services over the past year.

00:42:34:16 - 00:43:09:23
Unknown
What have you had to have occur? What did you pay out of pocket? And then compare that to how the other plan would work. I covered this before, but I want to cover it really high level. Again, just to restate the obvious, we don't want you picking a post 65 plan because of your prescription drug design. So what you'll see in both the 8020 and the Medicare Advantage, the design for from Cornell is the same no deductible under either plan.

00:43:10:00 - 00:43:31:17
Unknown
If you take generic drugs, it depends on whether you take it retail from the pharmacy, get it sold retail or get it mail order. That's $5, $10. The same on either plan preferred brand. We talked about that being the kind of a major supplier at the best cost. That's going to be 30 or $60 regardless of the plan.

00:43:31:19 - 00:43:57:01
Unknown
And then if you go outside that to a more expensive drug, 1590 the same and either plan our plans be very specifically designed at Cornell. So there was no donut hole, there's no gap in this coverage. You get this coverage throughout the calendar year. A couple things that you should consider, because every drug plan is a little bit different.

00:43:57:03 - 00:44:24:17
Unknown
And that would be if you're on drugs that require prior authorization or if they're going to limit how much you can get at a time that's quantity limits or if they're going to say you need to go through a process to get to the preferred drug, these are important aspects in any drug program. So again, if you're thinking about a change, you should pull together your list of medications.

00:44:24:19 - 00:44:53:20
Unknown
Contact the Navratri Service Center and have them clarify how those drugs are covered in each plan. So those are just important things to think about. If there's something special with the drugs you're taking. So at this point, I want to invite Carrie Allen and Melanie Walker back. I want to have them walk through the process with Aetna on how to make open enrollment changes for 2024.

00:44:53:22 - 00:45:14:18
Unknown
Carrie, Melanie, can you join us again? Yep, we're here. Thanks, Gordon. Okay, I'm going to drive for you, so just tell me if I go too slow or too fast. So how to make changes, right? Retirees, This information is in packets that you got in the mail, too, but we want to reiterate it here. Okay, great. Thank you, Gordon.

00:45:14:18 - 00:45:33:01
Unknown
Hello, everybody. Thank you for having me here today. I do want to start off saying that if you are happy with your current coverage, you do not need to do anything. Your coverage will continue into 2024. But I'm here today to help you if you wish to make a change for 2024, now is your time to do it.

00:45:33:03 - 00:45:55:01
Unknown
And as Gordon said, we went through both of the different plans that are offered, but our retiree service center is happy to help you if you have questions as you're thinking about your benefits for 2024, the customer service representative, they're also happy to help you look up providers to see which plan with Aetna that your providers are contracted with.

00:45:55:07 - 00:46:20:09
Unknown
And they're there from Monday through Friday, from 8 a.m. to 6 p.m. across all time zones. You're also welcome to use our public retirees site to look up doctors on your own. And you could always ask the billing department at your provider's office. I know when I go to my doctor, they usually ask me for my insurance, They ask for the company name and they ask for the plan name.

00:46:20:09 - 00:46:42:14
Unknown
And then they usually know right away or not if they participate. So when you go online, you can go to Aetna retiree plans dot com. You actually can even just go to Aetna dot com as well and that is where you can find a directory of our doctors and be able to look that information up online. So we want to make it easy for you.

00:46:42:15 - 00:47:15:12
Unknown
You can do it yourself online or you can give us a call. Okay next slide. Gordon So open enrollment is happening right now. It actually opened on Monday of this week and you have until November 17th and you can call the Aetna Retiree Service Center if you want to make enrollment changes or you can go to the retiree benefits website if you want to make changes, if you've already set up your account, you would access the site that you see here on the screen.

00:47:15:12 - 00:47:41:14
Unknown
Aetna retiree health dot com slash Cornell and you would enter your username and your password once on the site there is a banner along the top for open enrollment and it reads select your benefits. Now and that's where you would review your benefit information and where you can elect your changes for 2024. Now, I know we have a variety of folks on the phone today watching our presentation.

00:47:41:16 - 00:48:06:22
Unknown
If you've not yet registered for the site and you do need to register, you would visit the website that's showing here on the screen Aetna retiree health dot com slash Cornell you would choose register now and you would complete the registration fields in order to do your registration. It's important that you enter your first name and your last name as it appears on your enrollment materials.

00:48:06:24 - 00:48:35:06
Unknown
For example, if you're enrollment was addressed to Robert but you go by Bob, you would actually use Robert in your registration process. And then after you complete your registration, you'll have access to the website and you won't need to go through the registration process again. Next time you'll log in using your username and passwords. And also your eligible dependents can log in under the retiree account to access the website.

00:48:35:08 - 00:49:02:19
Unknown
Also, once you're enrolled, you can set up your payment options. You have many different options for paying your premium. You can pay by checking or savings account. You can pay each month or set up monthly payments. You can also use a debit or credit card and also pay each month. Or you can set up automatic monthly payments or you can pay by check where you get a paper bill in the mail each month and payment coupons.

00:49:02:23 - 00:49:23:07
Unknown
Or you can go online and do bill pay. You would set up this option through your bank and your bank would send the payment on your behalf. And if you set up reoccurring payments from your bank account, debit card or credit card, the payments are processed on the fifth of the month after you set up your authorization for that.

00:49:23:09 - 00:49:45:24
Unknown
And as a reminder, the Retirees Service Center, the phone number is listed on the screen here today, can also help you in setting up your reoccurring payments for you. And just one more reminder. If you do not make a change, your benefits will renew for the plan that you have now. Okay, Gordon, I have one final item that I just want to bring to your attention today.

00:49:46:01 - 00:50:13:10
Unknown
As an Aetna member, you have access to a wealth of information online. So the website that I just showed was for making your enrollment changes and setting up payments. But you also have a different website where you can go on and see your Aetna information. So if you're already enrolled with us and you haven't set it up yet, I would highly recommend registering for your Aetna Secure member website.

00:50:13:12 - 00:50:41:03
Unknown
Once you register, you set up a username and password. When you use this site, you'll see your specific benefit information and that's a large company. We have a lot of plans and when you access your site through this website, it'll eliminate all the other Aetna benefits that are out there and give you just your benefits. So you view your claim status, you can see explanation of benefits statements, you can look up a provider from here.

00:50:41:03 - 00:51:01:03
Unknown
You can even print a temporary ID card or request a replacement. And you also have access to set up an app on your phone. If you would like to do that. We have the Aetna Health app where you're able to log in right through your phone as well, using the same username and password.

00:51:01:03 - 00:51:13:09
Unknown
So we're going to just jump through these last couple of slides to transitioning for anyone who's considering trends or who's coming up on a transition from active to retiree.

00:51:13:11 - 00:51:42:07
Unknown
Some important timing considerations. About three months before you retire from Cornell, you do need to meet with the benefits office. You do also need to begin your process for enrolling in Medicare Parts A and B if you are 65 or older or otherwise Medicare eligible about one month before retirement, you should have your Medicare Part A and B and if resolved, you can have the effective date the next month.

00:51:42:07 - 00:52:07:07
Unknown
But you really want to make sure it's all set up before you move to retirement after the first of the month following when you retire is when your retiree health care plans kick in. So, again, picking those plans with Aetna is going to be very, very important to do before their effective date. You get an enrollment booklet from Aetna.

00:52:07:09 - 00:52:39:12
Unknown
We do that for pending retirees. So once we notified them of your separation, you will get information from them. One thing to keep in mind, if you qualify as a retiree when you move to retiree status, Cornell doesn't want you to have a break in coverage, so we will automatically default you into the 8020 plan. You still have a period of time in which you can choose to change that to, the Medicare Advantage within 90 days of retirement.

00:52:39:14 - 00:53:02:21
Unknown
But we want you to have coverage. So we're going to put you in the 8020 plan, effective the first of the month following your retirement and then using the plan they mentioned a little bit earlier today. But Aetna will produce invoices for you or you can set up automatic payment, that sort of thing to happen to make this process run a bit smoother.

00:53:02:23 - 00:53:32:22
Unknown
And remember that once your health care coverage change is as a Cornell retiree, the next time you go to the doctor, you're going to want to show them your new cards so they don't continue to bill your active health plan. So we like to say, you know, there's really important stuff no later than three months before retirement. But we have lots of people come to us to start attend ten sessions and that sort of thing as much as six months before.

00:53:32:24 - 00:53:57:14
Unknown
And then a couple of quick things as a reminder to comparison of coverage. If you're transitioning, remember that as far as coordination of benefits if someone has an active health plan, at the same time they have a retiree health plan, the active health plan is primary, except if you're still active and you're over 65, we don't require you to enroll in Medicare.

00:53:57:14 - 00:54:36:05
Unknown
You shouldn't be sending claims to Medicare while you're active and an active plan for active health. Just a reminder, there's three choices each year for retiree health. There's one plan for pre 65, two choices post 65. As far as the doctors and networks, whether you're in our active plans or in our retiree plans, you've heard us say a number of times you want to make sure that your doctor is at all possible, is participating in the active plan you're in, and then you want to make sure you understand if they're participating in Medicare or Medicare Advantage.

00:54:36:07 - 00:55:02:22
Unknown
On the retiree side, if you're over 65, we take your premiums from your paychecks while you're active. You end up paying through Aetna Retirees Solutions when you're no longer active. But Aetna has they're just different areas and it has customer service groups dedicated to you both during your active coverage years and your retiree coverage. So I know we covered it really quickly.

00:55:02:22 - 00:55:32:18
Unknown
We spend a lot of time talking to retirees in transit or active people in transition. So you want to follow a little bit. There's a retiree website on Cornell's website. So that's also there to kind of help you through the process. So I do want to thank everyone for attending. Thank you. My apologies for going over, but we wanted to cover your questions and get to your answers.

00:55:32:20 - 00:56:03:13
Unknown
And again, for the individuals that we couldn't get to your questions, please, now that those can go through the Aetna Retirees Service Center. And with that, I am going to thank you all. Did you all a good day and we look forward to seeing you on other side of retiree open enrollment with coverage. 411. Thank you. Thank you to our Aetna partners for presenting and answering questions.

00:56:03:13 - 00:56:12:01
Unknown
Thank to our h.r. Benefits department for processing this through and for me. I thank all of you and have a great day.


Questions?

  • For questions about your Aetna health plan coverage, open enrollment deadlines, meeting dates, and retiree premiums, please contact:
    Aetna Retiree Service Center: 1-800-338-4533 (TTY: 711)
    available Monday through Friday, 8 a.m. to 8 p.m. EST
  • For questions about your Prescription Drug Plan coverage through OptumRx (if you have the Retiree 80/20 Plan or the RPHP Pre-Medicare Plan), use the contact info below:
    Optum Rx: 1-866-533-6977 available 24/7