Presentation is loading. Please wait.

Presentation is loading. Please wait.

1 2009 RETIREE LUNCHEON MARCH 23, 2009. 2 2009 Benefit Plan Update Medical Plan Changes –Non-network Option and HDHP Option now have unlimited Preventive.

Similar presentations


Presentation on theme: "1 2009 RETIREE LUNCHEON MARCH 23, 2009. 2 2009 Benefit Plan Update Medical Plan Changes –Non-network Option and HDHP Option now have unlimited Preventive."— Presentation transcript:

1 1 2009 RETIREE LUNCHEON MARCH 23, 2009

2 2 2009 Benefit Plan Update Medical Plan Changes –Non-network Option and HDHP Option now have unlimited Preventive Care Benefit physician must file with Medicare first –Full Time Student Status no longer required for Dependent Children up to age 25 –must satisfy eligibility plan provisions for dependent child –Added Medicare Crossover service

3 3 2009 Benefit Plan Update (continued) Dental Plan Changes –Increased benefit coverage for composite fillings –allows a benefit composite fillings regardless of tooth location –Salaried Retirees will now have access to continue Dental coverage as Post-65 Retiree –same coverage offering as Hourly program –Retirees pay 100% of the contribution

4 4 2009 Benefit Plan Update (continued) Vision Program –No Plan Design Changes –Full Time Student Status no longer required for Dependent Children up to age 25 –must satisfy eligibility plan provisions for dependent child

5 5 UPDATE ON COORDINATION OF BENEFITS

6 6 Medicare Crossover Highlights of Medicare Crossover Medicare Cross-Over is the process by which Medicare automatically forwards medical claims to UnitedHealthcare for processing Based on agreements with the Medicare Part B and Durable Medical Equipment (DME) claim processors UHC will be able to keep out-of-pocket balance current

7 7 Medicare Cross-Over is available to any Medicare-primary CITGO enrollee. It is available to both enrollees and their Medicare-eligible dependents, if they do not have group coverage from another source. Medicare pays first, then claims are submitted electronically to UnitedHealthcare. Process eliminates provider submission of claim to UHC after Medicare processing Medicare Crossover (continued)

8 8 Coordination of Benefits Medicare Part D Prescription Drug Plan (continued) If you enroll in Medicare Part D you and your covered dependents will no longer be eligible to participate in the CITGO Medical Plan The CITGO Prescription Drug program meets the requirement for creditable coverage Must be enrolled in Part A and B to be eligible for Medicare Part D

9 9 Coordination of Benefits Preventive Care Benefits Preventive care benefits are now eligible for a 100% benefit when not covered by Medicare. Routine screenings and immunizations are covered under the CITGO plan The 2009 Medicare Preventive Care benefits can be found on the Medicare website at http://www.medicare.gov/Publications/Pubs/pdf/10110.pdf http://www.medicare.gov/Publications/Pubs/pdf/10110.pdf

10 10 Coordination of Benefits Preventive Care Benefits (continued) Your physician must still file with Medicare for the CITGO plan to process the benefits as the secondary plan Filing with Medicare is required in order for the CITGO plan to process secondary benefits Because the CITGO plan is secondary to Medicare, the filing requirement applies even when Medicare is not going to pay a benefit

11 11 APPENDIX 2009 Retiree Health Benefits Overview

12 12 Retiree Medical Benefits Eligibility Requirement for Retiree Medical 10 Years Continuous Plan Participation while in active employment AND Meet one or more of the following: Age plus service equals 70 points OR Retire under Company retirement plan OR Age 55 or older and eligible to retire from the Pension Plan

13 13 Retiree Medical Benefits Eligibility (continued) Can waive and re-enroll at a future date –Enrollment allowed at Annual Election or when you have a Qualified Change in Status –No pre-existing condition exclusions –Enroll at Annual Election or Change in Status Other coverage primary Continue to receive important and critical benefits information you should always review.

14 14 Retiree Medical Benefits Spouse Eligibility CITGO Retiree becomes Medicare eligible before eligible spouse –Not eligible for network options –Coverage Non-Network Medical Option Eligible Spouse becomes Medicare eligible before CITGO retiree –Coverage for retiree remains the same –Medicare becomes primary payer for the spouse –Medicare coordination of benefits is applied

15 15 Retiree Medical Benefits Spouse Eligibility (continued) CITGO Retiree dies before eligible spouse –Coverage continues –Medical options depend on spouse’s eligibility for Medicare Eligible children –Eligible for coverage up to age 25 –Full Time Student Status no longer required for Dependent Children up to age 25 must satisfy eligibility plan provisions for dependent child

16 16 Retiree Medical Benefits when Retiree is NOT Medicare Eligible Same medical plan options as active employees CITGO is the primary plan CITGO secondary for dependents age 65 and over Includes same Prescription Drug Program available to Active Employees Retiree Medical Benefits

17 17 Retiree Medical Benefits Retiree Medical Benefits when Retiree is Medicare Eligible Medicare becomes the primary payor –Medicare Part A – Hospital –Medicare Part B – Medical Expenses CITGO becomes secondary not a supplement CITGO Plan provides a “carve-out” benefit and does not “supplement” CITGO primary for < age 65 dependents Includes full Prescription Drug Program

18 18 Prescription Drug Program Retiree Coverage is Same as Active Coverage CITGO is the primary plan for both Pre-65 and Post-65 Retirees except when –You enroll in Medicare Part D –You are enrolled as an Active Employee under another employer plan Prescription drug program benefits –not subject to deductible –not subject to annual or lifetime limits

19 19 Prescription Drug Plan Snapshot For Short-Term and Immediate Prescriptions Retail Pharmacy Program* Up to a 31 day supply. You pay 30% with $10 minimum a $200 maximum per prescription for Tier 1 and Tier 2. You pay 40% with $10 minimum and a $200 maximum per prescription for Tier 3. For Long-Term and Maintenance Medications Mail-Order Program* Up to a 90 day supply: · $25 for Tier 1 · $50 for Tier 2 · $75 for Tier 3

20 20 Retiree Dental Benefits Pre-65 and Post-65 Retiree Dental Applies to Hourly and Salaried Retirees Same as active employees CIGNA Preferred Provider Program (PPO) Retiree is responsible for 100% of the contribution for Retiree

21 21 Dental Benefits Snapshot BenefitsCovered ServicesCoverage - You Pay Preventive and Diagnostic Two oral examinations per year, routine cleaning and scaling, and X-rays. You pay 0% Basic Fillings, extractions, oral surgery, periodontics and endodontics You pay 20% after calendar year deductible Major Restorative Crowns, bridges and dentures You Pay 50% after calendar year deductible Orthodontic Braces and other appliance therapy You Pay 50% Deductible$50 per person per year Dental Maximum$1,500 per person per lifetime for orthodontia Orthodontic Maximum$1,500 per person per lifetime for orthodontia

22 22 Retiree Vision Benefits United Healthcare Vision - SPECTERA) Same coverage as Active Employees Provides coverage for routine eye exam, corrective lenses, eyeglass frames, contact lenses Discount available on progressive lenses In-network benefits available after applicable copay Out of Network benefits available Coverage available for your dependents

23 23 Vision Benefits Snapshot BenefitsIn-Network Covered ServicesYou Pay Comprehensive Vision ExamOnce Every 12 months by a network optometrist or ophthalmologist You pay $10 Materials You pay $25 Materials copay applies to the entire purchase of eyeglasses (lenses and frames), or contacts in lieu of eyeglasses Pair of lenses (for eyeglasses) once every 12 months for standard single, lined bifocal, lined trifocal, standard lenticular: FramesOnce every 24 months Elective Contact Lenses (in lieu of eyeglasses) Once every 12 months DeductibleNone Refractive Eye SurgeryDiscounts available from Spectera providers

24 24 Long Term Care Insurance Aetna insures the Long Term Care Personal care, health care and social services –Assistance with normal activities of daily living –Assistance if you have a serious Cognitive disorder such as Alzheimer’s Disease For more information: – Call Aetna at 1-800-537-8521 or – Learn more at the website: www.aetna.com/group/citgo

25 25 For More Information Log on to www.hr.citgo.com to view your benefit information using your Retiree PRNR For personal questions contact the Benefits HelpLine toll free at 1-888-443- 5707 You can also email: benefits@citgo.com About this Material This material provides an overview of CITGO’s Retiree benefits. The benefits described are governed by legal plan documents, contracts, and insurance policies. If a conflict should occur, the legal plan documents, acts, and insurance policies will prevail.www.hr.citgo.combenefits@citgo.com


Download ppt "1 2009 RETIREE LUNCHEON MARCH 23, 2009. 2 2009 Benefit Plan Update Medical Plan Changes –Non-network Option and HDHP Option now have unlimited Preventive."

Similar presentations


Ads by Google