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What’s changing?
• TCU changed the way it provides medical benefits to Medicare-primary retirees and their
Medicare-primary dependents.
• Retiree’s medical benefits will be managed through a Health Reimbursement Arrangement account (HRA).
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• Provides Medicare-eligible retirees with:

Greater flexibility in how to use health care dollars


A broader range of plan options
The possibility that new coverage will cost less than current coverage
• Enables TCU to continue supporting retirees during a time of uncertainty surrounding the rising cost of medical insurance and services
• Enables TCU to predict and budget for health care costs more accurately
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What you pay
• Medical premiums and out-of-pocket costs will vary depending on the coverage you choose.
How to enroll
Your support
• You will work with OneExchange to enroll in a plan that meets your medical and Rx needs.
• TCU will establish your Health Reimbursement
Account. This account will be administered by
OneExchange
• OneExchange Advisors will help you understand the costs associated with your coverage – premiums, copayments, deductibles and all other costs.
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Medicare 101
•
Everything you wanted to know about Medicare, but were afraid to ask!
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• A Health insurance program for
– People 65 years of age and older
– Some people with disabilities
– People with End Stage Renal Disease (ESRD)
• Administered by CMS
• Enrollment handled by Social Security Administration or Railroad
Retirement Board
Key Terms
Medicare Part A = Hospital Coverage – administered by CMS
Medicare Part B = Medical Coverage – administered by CMS
Medicare Part C = Medicare Advantage Plans
– private plans – group or individual market
Medicare Part D = Prescription Drug Coverage
– private plans – group or individual market
Medicare Supplement (Medigap)
– private plans – group or individual market

Premiums:
• Most people do not pay a monthly Part A premium because they or a spouse have 40 or more quarters of Medicare-covered employment.
– $254.00 for 30-39 quarters of Medicare-covered employment.
– $461.00 for people who have less than 30 quarters of Medicare employment.

Foreign citizens and Americans who worked abroad
Coverage:
• Medicare Part A covers:
– Hospital Stays
– Skilled Nursing Facility (SNF)
– Home Health Care
– Hospice Care
– Pints of blood received at a hospital or skilled nursing facility during a covered stay

Coverage:
• Doctors’ services (physician office and some hospital settings)
• Limited Chiropractic Services
• Outpatient Services:
• Diagnostic tests- clinical Lab o (xray, MRI, CAT, EKT, nutritional therapy, etc…)
• Other medical services o Durable medical equipment (DME)- prosthetic, wheelchair etc. o Diabetic Supplies o Ambulance service o
Initial Enrollment Period: o When turning 65.
3 months before, the month of, and three months after 65 th B-Day. (7 month window )

Late Enrollment Penalty
A person that is eligible for Medicare but opts out of Part B may be subject to a 10% per year Part B penalty
• Penalty is waived if beneficiary has coverage through a group policy based on active employment
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For employers with 20 or more employees, group coverage is primary for
Medicare beneficiaries who are still active, and Medicare is secondary. Therefore, active beneficiaries don’t have to enroll in Part B and will not be penalized when they decide to retire. When they decide to retire, beneficiaries should enroll in Part B three months prior. This will insure that they can enroll in a Medicare Supplement plan and have it effective as soon as their group coverage ends.
• If active and covered under the group health plan, employee does not enroll in Medicare Part B or select a Medicare supplemental plan(s) until they retire or lose coverage.

Original Medicare-
FFS (Fee For Service)
Part A
• Hospital
• Institutional
Part B
• Doctors
• Supplies
• Outpatient
• Professional
OR
MA-PD
Medicare
Advantage
(MA)
PFFS PPO HMO
+ Part D
Drugs
Added Optional Coverage
Medicare
Supplement
(Medigap Plans)
Fills in Medicare payment “gaps” in coverage
+ Part D
Drugs
(Stand
Alone)

• Medicare Part D is optional prescription drug coverage for everyone with Medicare Part A or B
• PDP’s are run by private insurance companies approved by
Medicare (Like MA plans)
• If beneficiaries decline to enroll in a Medicare drug plan when they are first eligible, they may be penalized. (1% of national average per month)
• Beneficiaries sign up when they first become eligible for
Medicare, or during the AEP

One
Helping You Prepare For Your Upcoming Medicare Enrollment
TOWERS WATSON
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
Who We Are

Transitions Can Be A Good Thing!

OneExchange – For Your Benefit

A Deeper Dive – Benefit Advisors,
Private Exchange, Optimize Savings,
Health Reimbursement for You

Next Steps

Questions & Answers
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Transitioning the way access is provided to retiree health benefits for Medicare-eligible retirees and their Medicare-eligible dependents
• OneExchange has been chosen after an extensive evaluation of choices
• OneExchange will help you with total care in transitioning over to more-effective individual Medicare health insurance
• The private exchange offers greater choice and flexibility; many affordable choices exist and in many cases provide more value at a lower cost than an employer group plan
• Ongoing support – at no cost to you
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Towers Watson over
100 years experience
Hundreds of thousands of retirees served across
300+ employers
Licensed advisor provides guidance and lifetime advocacy
Personalized options with plans from a nationwide network of carriers
Founded in 2004
No added fees for our services
In the middle of our
9th annual enrollment season
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17 towerswatson.com
First and
Largest private Medicare Exchange

White-Glove Service
Consultative
Process
Simplified
Selection
Effortless
Enrollment
Lifetime
Advocacy
Consultative
Process:

Your Benefit
Advisor will determine coverage needs and thoroughly research your options
Selection Process:

Your Benefit Advisor will provide the guidance you need to easily understand your Medicare options
Enrollment
Process :

100% paperless, telephonic
 enrollment
Secure and efficient
Advocacy:

Specialized and focused; trained in insurance,
Medicare and issue resolution towerswatson.com

Salt Lake City, UT
100% Domestic Workforce
- NO Outsourcing!
Dallas, TX
Operating hours:
Monday-Friday 7am-8pm CT
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Medicare Supplement
(Medigap)
All Medicare Plan Types
Medicare Advantage Prescription Drug
(Part D)
A few examples of the carriers on our Medicare exchange:
Multiple plans available to you from national/regional carriers towerswatson.com

Announcement
& Education
Evaluation &
Enrollment
Ongoing
Communications
& Advocacy towerswatson.com
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Enrollment Guide
Prepare for your enrollment consultation
• Review Medicare basics
TOLL FREE
medicare.oneExchange.com/TCU
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• Help Me
Choose
• Prescription
Profiler
24/7 access to your information
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Hours of
Operation
Monday – Friday
7 am – 8 pm CT

Licensed / Certified / Appointed

OneExchange University ™

Average age 43

Objective & unbiased

100% domestic workforce
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
Benefit Advisors can discuss coverage options with anyone

Telephonic enrollment – 2 part process

100% of calls are recorded
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• Allows BAs to Have More Time for Consultations
• Ensures Accuracy of Application Submissions
Licensed / Certified / Appointed by
Departments of Insurance; the experts in probing health plan needs and helping to recommend the right plan
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Trained in carrier enrollment applications; the experts in accurately filling out the paperless applications to optimize firsttime acceptance by the carriers
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Features: Sent once a participant has enrolled into a plan
Confirms all plan selections and enrollments
• Carrier Name
• Plan Name
• Confirmation Number
• Premium
• Coverage Effective Date
• Whether or not they have selected Automatic
Reimbursement
What Happens Next
• Expectations on Carrier correspondence, including ID
Cards
• Subsidy Packet
• Automatic Reimbursement
• Direct Deposit
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Drug Coverage (MAPD)*
* Note that Medicare Advantage plans are generally network based plans
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28

Note: You may need to pay your first premium when you enroll in coverage
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You Pay Full
Retail Until
Deductible is Met
You pay 45% of Brand
Name and 65% of
Generics until your out of pocket costs reach
$4700; Pharmaceutical contributions will count
Out Of Pocket costs
Deductible towerswatson.com
Initial
Coverage
Coverage
Gap
Catastrophic
Coverage
Only 25% reach
Donut Hole
Only 4% reach
Catastrophic
You pay copays for your plan coverage for the first $2960 in actual costs of
Medications
You Pay $2.65 for
Generics and
$6.60 for Brand
Name or 5% whichever is greater
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What you pay
• Depends on the plan you choose
• Choose the right level of coverage for you and your spouse individually
How you enroll • You enroll directly through OneExchange
• You and your Medicare-eligible spouse enroll in separate plans
Your support • OneExchange will be your partner as you make this decision and enroll in plans
• OneExchange will provide ongoing support
- at no cost to you
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31

Local Plan Slides towerswatson.com
Note: 2014 rate examples; 2015 rates will be available in the October 2014 time frame
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32

Plans Available in Dallas and Tarrant Counties
Plan Type
Number of
Plans Offered
2014
Monthly Premium
Carriers
Medicare Advantage 19 $0 - $89
Coventry, Humana,
AARP, Aetna, Scott
& White, CIGNA
Health Spring
Medigap /
Medicare Supplement
16 $66 - $306
AARP, Humana, BC
BS TX
Prescription Drug
(Part D)
17 $13 - $127
Note: 2014 rate examples; 2015 rates will be available in the October 2014 time frame
AARP, Aetna,
CIGNA, Express
Scripts, Humana,
Silver Script,
WellCare
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33 towerswatson.com

Also Available in Dallas & Tarrant Counties
Plan Type
Vision
Dental
Number of
Plans Offered
1
4
2014
Monthly Premium
Company
$14 per person per month
Annual eye exam: $5
Coverage for eye glasses, lenses and frames
Vision Service Plan
(VSP)
$16 - $46
$50 - $75 deductible
$750 - $1500 annual maximum
Delta Dental,
Humana,
MetLife Dental towerswatson.com
Vision plans and Dental plans are not Medicare plans
Note: 2014 rate examples; 2015 rates will be available in the October 2014 time frame
© 2014 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.
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Benefit
Premium
Cost
$34
2014
Network
Deductible
PPO
$0
Doctor Copay $10
Specialist Copay $40
Hospital $300 copay per days: 1-7
Emergency Room $65 unless admitted to the hospital
Deductible
Rx
Mail Order
$0
$0/ $2/ $39/ $85/ 33%
$13/ $18/ $110/ $238
30-day supply
90-day supply
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(75 year old male)
Benefit
Premium
Cost
$220 ($202 Medical + $18 PDP)
2014
Network
Deductible
Any doctor who accepts Medicare
$0
Doctor Copay $0
Specialist Copay $0
Hospital $0
Emergency Room $0
Deductible
Rx
Mail Order
$0
$0/ $15/ $40/ $90/ 33%
$0/ $30/ $80/ $180
30 day supply
90 day supply
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36

Health Reimbursement Arrangement
(HRA)
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• Tax-free account used to reimburse you for eligible health care expenses – you pay first and then get reimbursed
• If you are eligible, your former employer will make an annual contribution to a Health Reimbursement Account
(HRA)
• You may use HRA funds to reimburse yourself for eligible medical expenses which include premiums that you pay coverage for (including Medicare Part B) and certain out-of-pocket expenses
• Your HRA funds will be available on the first of the month of your retirement, prorated for the year. On Jan 1 st of the next year, you receive the full annual amount.
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If you are eligible, reimbursements are made up to the amount available in your HRA towerswatson.com
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39

Reimbursement Options
1.
Automatic
Reimbursement
[including recurring claims]
2.
Manual
Reimbursement
If you are eligible, reimbursements are made up to the amount available in your HRA
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40 towerswatson.com

•
•
•
•
•
•
Service offered by OneExchange
Available on most plans
Works for premium reimbursement only
No claim form is required
Can take 2-3 billing cycles to initiate
If you need your reimbursement sooner, simply file a paper claim. The form and instructions will be provided in your
Funding and Reimbursement Guide
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Next Steps
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• You MUST enroll in Medicare Part B if not already enrolled
– contact the SSA
• Contact OneExchange at your toll free #
• Make a first contact call now and schedule an enrollment appointment
• Enroll in your new coverage
• Call us during your scheduled appointment time
• You are guaranteed coverage
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Review Enrollment Guide
Gather Medicare card,
Prescriptions and
Doctors/Hospital information
Call OneExchange
1-888-429-8490
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A lifetime advocate:









Navigation
Enrollment
Claim issues
Denied policies
Affordability concerns
Prescription
Late enrollment
HRA
Annual plan review
© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

Experience First and largest Medicare Exchange; private
Satisfaction
99% client retention rate
Average retiree satisfaction 9.2/10.0
Relationship As life happens, we are here for you
Technology Most automated connections, across 90 carrier partners
Size and
Strength
300 employers and 500,000 retirees being served
People
Objective and personal touch through stringent training processes and CMS compliance criteria
© 2013 Towers Watson. All rights reserved. Proprietary and Confidential. For Towers Watson and Towers Watson client use only.

We Are Ready For Your Call
1-888-429-8490
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