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Welcome to Public Safety Retirement System Open Enrollment 2008

Welcome to Public Safety Retirement System Open Enrollment 2008. Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare. Updates for 2008 Plan Options Benefits Medicare Non-Medicare Enrollment and Contact Information

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Welcome to Public Safety Retirement System Open Enrollment 2008

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  1. Welcome to Public Safety Retirement System Open Enrollment 2008 Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  2. Updates for 2008 Plan Options Benefits Medicare Non-Medicare Enrollment and Contact Information Questions Agenda

  3. No rate increase on all plans Senior Supplement - Medicare Part D Changes TDE $2,510 TrOOP $4,050 PPO RX copays $20/$40 New ID cards for all Medicare and PPO members SecureHorizons Brand (no change for PSPRS) Updates for 2008 Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  4. Plan Options Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  5. MedicareComplete HMO (Secure Horizons) Medicare eligible retirees/dependents living in Cochise, Coconino, Graham, Greenlee, La Paz, Maricopa, Pima, Pinal, Santa Cruz, Yavapai and YumaCounties Senior Supplement Medicare eligible retirees/dependents living nationwide Medicare Eligible Medical Plans Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  6. Health Maintenance Organization (HMO) Non-Medicare eligible retirees/dependents using providers in Maricopa, Pima and Pinal Networks Preferred Provider Organization (PPO) Non-Medicare eligible retirees/dependents living in the state of Arizona Indemnity Non-Medicare eligible retirees/dependents living outside the state of Arizona Non-Medicare Medical Plans Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  7. Additional Programs Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  8. Offered to all medical plans Membership at participating fitness centers at no additional cost Group exercise classes designed to increase strength, flexibility and energy Senior Advisor at each fitness center Social events Steps Program for the Rural Areas SilverSneakers Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  9. Offered to all medical plans Unlimited telephonic access to geriatric experts Personalized research into and screening of community programs Assistance in making and coordinating care arrangements Six hours of geriatric care management services annually Caregivers Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  10. Benefit Overview Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  11. Must have Medicare Parts A & B Automatically enrolled with Medicare Part D Sign Statement of Understanding Select a Primary Care Physician (PCP) Select a Hospital Network PCP Referral to Specialists MedicareComplete HMO (SecureHorizons) Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  12. MedicareComplete HMO (SecureHorizons) • Outpatient Services • Primary Care Physician $15 copayment • Specialist $30 copayment • Lab You pay nothing • Standard X-Rays You pay nothing • Specialized Scans $50 copayment

  13. MedicareComplete HMO (SecureHorizons) • Outpatient Services • Urgent Care $15 copayment • Emergency Room $50 copayment (waived if admitted) • Ambulance $25 copayment

  14. Hospitalization Inpatient $100 copay per admit Mental Health $100 copay per admit; 190 days lifetime maximum Skilled Nursing No copay; limit of Facility100 days per benefit period MedicareComplete HMO (SecureHorizons) Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  15. Prescription Drug Benefit Formulary Applies Unlimited Annual Maximum Retail 30 day supply Tier 1 $20 copayment Tiers 2, 3 & 4 $40 copayment Mail Order90 day supply Tier 1 $40 copayment Tiers 2, 3 & 4 $80 copayment MedicareComplete HMO (SecureHorizons) Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  16. MedicareComplete HMO (SecureHorizons) • Optical Benefits • Routine Care - Spectera Providers • Eye Exam $20 copayment • Frames $130 allowance/yr • Lens Covered 100% Or • Contact Lenses $105 allowance/yr • Medically Necessary – Contracted Medical Providers • Eye Exam $15 copayment

  17. MedicareComplete HMO (SecureHorizons) • Hearing Benefits • Medically Necessary Hearing Exam $30 copayment • Routine hearing exams Not covered • Hearing Aids Not Covered • See page 13of ASRS/PSPRS brochure for discounts on routine hearing exam and hearing aids – Please note this is not an insurance benefit

  18. Senior Supplement • Must have Medicare Parts A & B • Automatically enrolled in Medicare Part D • ID cards - • Medical (including vision) • Prescription Drugs – UnitedHealth Rx

  19. Senior Supplement • Freedom to use any provider who accepts Medicare • Medicare is primary insurance • Senior Supplement helps pay for deductibles and coinsurance not covered by Medicare (based on schedule of benefits up to policy limit) • Calendar Year Deductible - $100

  20. Senior Supplement • Medical Services - Physician services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests and durable medical equipment • After Satisfying the Calendar Year Deductible,Plan pays the Part B deductible • Plan pays 20% of Medicare approved amounts • Plan pays 50% of outpatient Mental Health services

  21. Senior Supplement • Hospitalization • After Satisfying the Calendar Year Deductible,Plan pays the Part A Deductible and the daily coinsurance rates after the 61st day • After you have exhausted the Medicare covered days, Plan pays 100% of Medicare eligible expenses for 365 additional lifetime days

  22. Senior Supplement • Limitations • Inpatient Mental Health – 190 days lifetime maximum • Skilled Nursing Facility – 100 days per benefit period

  23. Prescription Drug Benefit Open Formulary Retail30 day supply Tier 1 $10 copayment Tiers 2, 3 & 4 $35 copayment Mail Order 90 day supply Tier 1 $20 copayment Tiers 2, 3 & 4 $70 copayment UnitedHealth RX for Group PDP Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  24. UnitedHealth RX for Group PDP • Prescription Drug Benefit continued • Copays applies to the first $2,510 of prescription drug cost per person. • After $2,510 in Total Drug Expenditures (TDE), you are responsible for 100% of drug cost until $4,050 in True Out of Pocket (TrOOP) is met; • Then you pay $2.25 generic, $5.60 brand name or 5% of the cost; whichever is greater

  25. UnitedHealth RX for Group PDP How Medicare Part D Prescriptions works: Applied to Your Applied to Cost of RXTDECopayTrOOP $100→$100$35→$35 $ 50→$150$10 → $45 ↓ ↓ $2,510100% ↓ ↓ when TrOOP adds up to $4,050 generic $2.25 or 5% brand $5.60 or 5%

  26. Senior Supplement • Optical Benefits - Routine& Medical • Eye Exam $20 deductible • In-Network – 100% after Spectera Vision deductible Providers • Out-of-Network $80 allowance after deductible

  27. Senior Supplement • Optical Benefits • Frames & Lenses OR Contact Lenses • In-Network • Frames $130 allowance/yr • Lenses Covered 100% Or • Contact Lenses $105 Allowance/yr • Out-of-Network • Frames & Lenses Or Contacts $100 Allowance/yr

  28. Senior Supplement • Hearing Benefits • Hearing Exam Medically Necessary • Hearing Aids Not Covered • See page 13of ASRS/PSPRS brochure for discounts on routine hearing exam and hearing aids – Please note this is not an insurance benefit

  29. Enrollment and Contact Information Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  30. PSPRS enrollment form Statement of Understanding – if enrolling in the MedicareComplete HMO (SecureHorizons) plan Forms to Submit Confidential property of UnitedHealthcare. Do not distribute or reproduce without the express permission of UnitedHealthcare.

  31. How to Reach PacifiCare Customer Service Phone Numbers Listed on Back of ID cards and on the inside cover of the ASRS/PSPRS Open Enrollment Guide www.pacificare.com www.securehorizons.com

  32. Non-Medicare HMO • Select a Primary Care Physician (PCP) • Select a Network • PCP Referral to Specialists • Self Referral for Mental Health, GYN, Optical and Hearing

  33. Non-Medicare HMO • Outpatient Services • Primary Care Physician $20 copayment • Specialist $40 copayment • Lab You pay nothing • Standard X-Rays $20 copayment • Specialized Scans $150 copayment

  34. Non-Medicare HMO • Outpatient Services • Urgent Care $40 copayment • Emergency Room $75 copayment (waived if admitted) • Ambulance You pay nothing

  35. Non-Medicare HMO • Hospitalization • Inpatient You pay 30% • Outpatient Surgery You pay 30% • Mental Health You pay 30% • Out of Pocket Maximum (Inpatient or Outpatient Hospital coinsurance applies) • $3,000 Individual • $9,000 Family

  36. Non-Medicare HMO • Prescription Drug Benefit • Formulary Applies • Unlimited Annual Maximum • Retail 30 day supply • Generic $20 copayment • Brand Name $40 copayment • Mail Order 90 day supply • Generic $40 copayment • Brand Name $80 copayment

  37. Non-Medicare HMO • Optical Benefits • Eye Exam $40 copayment • Frames $50 allowance • Lens $50 allowance Or • Contact Lens $100 allowance • Hearing Benefits • Hearing Exam $40 copayment • Hearing Aids $200 allowance per calendar year

  38. Non-Medicare PPO • In Area PPO rates are for retirees and dependents living in Maricopa, Pima and Pinal counties • Out of Area PPO rates are for retirees and dependents living in all other counties in Arizona

  39. Non-Medicare PPO • Freedom to use any licensed provider • In-Network Providers paid at contracted rate • Out-of-Network Providers paid at Usual, Customary and Reasonable (UCR)

  40. Non-Medicare PPO • Calendar Year Deductible • $500 per person • $1,000 per family • $75 Emergency Room Deductible • $250 Out-of-Network Hospital deductible per admission

  41. Non-Medicare PPO • In-Network Out of Pocket • $2,000 per person • $4,000 per family • Out-of-Network Out of Pocket • $6,000 per person • $12,000 per family • Lifetime maximum benefit • $2,000,000

  42. Non-Medicare PPO In Network Out of Network • Office Visit $15 copay* 60% including preventative • Coinsurance 80% 60% • Emergency Room 80% 60% • Ambulance 70% 70% *lab and x-ray subject to deductible and coinsurance

  43. Non-Medicare PPO • Prescription Drug Benefit • Formulary Applies • Unlimited Annual Maximum • Retail 30 day supply • Generic $20 copayment • Brand Name $40 copayment • Mail Order 90 day supply • Generic $40 copayment • Brand Name $80 copayment

  44. Questions?

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