State Retiree Health Benefits Program Department of Human Resource Management Office of Health Benefits

Eligibility Must be a retiring state employee receiving an immediate (not deferred) VRS annuity or periodic benefit from an ORP vendor Must have been eligible for state coverage as an active employee at the time of retirement (not Extended Coverage) Must enroll within 31 days of retirement date

Not Eligible Coverage is declined at retirement (except waiver) Enrollment is not completed within 31 days of retirement Retirement benefit is deferred Coverage is cancelled

Coverage Begins The first day of the first full month of retirement

Eligible Dependents Same as active employees, e.g., Legal spouse Unmarried biological, legally adopted or step- children Children in court- ordered sole permanent custody of retiree Adult children with a disability

Plan Choices Non-Medicare Plans Medicare Plans

Current Non-Medicare Plans COVA Care Basic or with optional benefits Out-of-Network (Medical & Behavioral Health) Expanded Dental Out-of-Network and Expanded Dental Vision, Hearing and Expanded Dental Out-of-Network, Vision, Hearing and Expanded Dental COVA HealthAware Basic or with optional benefits Expanded Dental and or Vision Regional Plan – Kaiser Permanente (Northern Virginia, Fredericksburg, MD, DC) COVA High Deductible Health Plan (HDHP) TRICARE Supplement Plan for military retirees and their spouses/surviving spouses

Current Medicare Plans Advantage 65 Advantage 65 with Dental/Vision Advantage 65-Medical Only Advantage 65-Medical Only with Dental/Vision

Retiree Group Members VRS Service Retirees VRS Disability Retirees ORP Retirees Local Retirees VSDP/LTD Participants Survivors Annuitant Non-Annuitant

Changes Allowed at Retirement Enroll from active waive into single coverage Decrease membership Waive to active/retiree coverage as dependent (and return in the future per plan provisions) Plan change Decline/cancel coverage – no return to program

Not Allowed at Retirement Increase in membership (unless there is a consistent, simultaneous qualifying mid-year event)

Allowable Changes After Retirement Changes Consistent with Qualifying Mid-Year Events Membership reduction (prospective) Cancellation (prospective) Open Enrollment (non- Medicare only) Medicare plan changes (prospective)

Required Change To a Medicare- coordinating plan immediately upon Medicare eligibility

Medicare Eligibility At age 65 Prior to age 65

Original Medicare Plan Medicare Part A – Hospital Insurance Medicare Part B – Medical Insurance Medicare Part D – Medicare Outpatient Prescription Drug Program

Premium Cost Retiree pays the full cost of coverage Health insurance credit if eligible

Premium Payment VRS Deduction (post-tax) for VRS retirees with monthly benefit sufficient to cover premium Direct Bill – all others Automatic Bank Draft or on-line payments for Anthem plan participants

Non-Medicare Plan Premiums - 7/1/16—6/30/17 PLANSingle Two- PersonFamily COVA Care Basic$677$1,254$1,817 CC w/Out of Network$693$1,276$1,847 CC w/Expanded Dental$706$1,309$1,901 CC w/Out of Net/Exp Dental$722$1,331$1,931 CC w/Vision/Hearing/Exp Dental$723$1,338$1,940 CC w/Out of Net/Vision/Hearing/Exp Dental $739$1,360$1,970

Non-Medicare Plan Premiums - 7/1/16—6/30/17 PLANSingle Two- PersonFamily COVA HealthAware$616$1,142$1,650 COVA HealthAware w/Exp Dental$644$1,197$1,733 COVA HealthAware w/Exp Dental & Vision $654$1,213$1,754 COVA HDHP$511$949$1,387 COVA HDHP w/ Exp Dental$539$1,004$1,470 Kaiser$595$1,095$1,595 TRICARE$61$120$161

Medicare Plan Premiums PLANSingle Advantage 65$311 Advantage 65 w/Dental & Vision$343 Advantage 65 – Medical Only$153 Advantage 65 – Medical Only w/Dental & Vision$185

How Does Advantage 65 Work – (2017)?

Advantage 65 Enhanced Medicare Part D Plan Formulary Deductible Tiers and Coverage Stages No “Doughnut Hole” Catastrophic benefit Excluded Drugs

Resources DHRM Web Site Retiree Fact Sheets