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1 Mary Kyle, Deputy Human Resources Director October 13, 2011.

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Presentation on theme: "1 Mary Kyle, Deputy Human Resources Director October 13, 2011."— Presentation transcript:

1 1 Mary Kyle, Deputy Human Resources Director October 13, 2011

2 Helpful Reminders

3 31 Days Benefit changes for qualified life events must be made within 31 days. Marriage, divorce, birth, loss of other group coverage, etc. If you forget, you are responsible for the medical, pharmacy and dental claims the ineligible dependent incurs.

4 Yes, you may re-enroll in City retiree medical coverage during Open Enrollment if you’ve had CONTINUOUS, COMPARABLE COVERAGE since the date you dropped the City’s coverage. Evidence of continuous, comparable coverage is required. Speak with a Benefits Analyst for details.

5 You are eligible for Medicare on the 1st day of the month you turn 65. You are eligible for Medicare if you are qualified for Social Security Disability Income (SSDI) for the previous two years. Medicare enrollment is automatic when disabled. You must provide a copy of your Medicare Card to the Benefits Office.


7 HR Center –(602) 262-6608 –Located on the 1 st floor of the Personnel Building. Benefits Office –(602) 262-4777 –Located on the 4 th floor of the Personnel Building. Password Help –Call (602) 534-4357

8 8 Keep your address updated

9 Provider networks are leased. –Provider reimbursement levels are set City pays a monthly fee to process claims and provide other services. City is billed for the amount paid to each doctor, hospital, lab, etc. –This is paid from the Health Care Benefits Trust

10 The total projected cost for medical and pharmacy coverage in the 2011 – 12 Plan Year for –Employees –Retirees –Covered family members 99.06% is spent directly on claims

11 HELP US PROVIDE QUALITY COVERAGE Pharmacy – Use Generics where possible to save money for you and for the plan Use mail order for maintenance medications Check retail locations for $4 generic medications Visit Urgent Care and Convenience Care Clinics instead of the Emergency Room when appropriate Keep yourself healthy Get annual physicals/check-ups Get an annual flu shot

12 Medical Co-Pays

13 ServiceCurrent Co-PayCo-Pay as of 8/1/11 PCP Office Visit$15$20 Eye Exam$5$10 Urgent Care$40$45 Emergency Room$125$140 Outpatient Surgery$75$80

14 Prescription Co-Pays Tier Retail Co-Pay 30 Day Supply Mail Order Co-Pay 90 Day Supply 90 Day Fill at Retail Generic $10 / 30 day supply$20 / 90 day supply $30 Preferred Name Brand $25 / 30 day supply$50 / 90 day supply $75 Non-Preferred Name Brand $40 / 30 day supply$80 / 90 day supply $120 14 To save yourself money as well as the plan, use generics where appropriate Mail order saves you money as well as the plan – 2 copays for 3 months of medication

15 CIGNA Pharmacy Management Replaced CVS/Caremark

16 Effective on August 1, 2011 For CIGNA and BlueCross/BlueShield plans. You should be using your CIGNA Pharmacy card at this point. Contact the onsite Pharmacy Representative in the Benefits Office for help

17 Retiree Medicare Meetings You are invited to a Medicare Information Meeting hosted by the City of Phoenix Benefits Office and the Area Agency on Aging. Learn about the basics of Medicare from an impartial subject matter expert. Find out how the City’s coverage integrates with Medicare. No R.S.V.P. necessary. Bring your spouse, family member or friend. We look forward to seeing you there.

18 Retiree Medicare Meetings Tues., October 18 9:30 – 11:30 a.m. Weds., November 9 9:30 – 11:30 a.m. Thurs., November 17 9:30 – 11:30 a.m. Goelet Beuf Senior Center 3435 W. Pinnacle Peak Rd. Phoenix, AZ 85027 602-534-9743 Washington Activity Center 2240 W. Citrus Way Phoenix, AZ 85015 602-262-6971 So. Mountain Senior Center 212 E. Alta Vista Rd. Phoenix, AZ 85040 602-262-4093 We’re sorry if you can’t make it to one of these meetings. Information will be available online at

19 Wellness Wellness programs help to control medical premium costs. The City is introducing a Health Risk Assessment incentive for employees. Wellness program options and incentives for retirees will be reviewed and implemented in 2012.


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