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An Economical Solution to Providing Retiree Medical Insurance Benefits.

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Presentation on theme: "An Economical Solution to Providing Retiree Medical Insurance Benefits."— Presentation transcript:

1 An Economical Solution to Providing Retiree Medical Insurance Benefits

2 Retiree Medical Insurance Coverage Unfortunately, Medicare doesn’t cover everything  Unfortunately, Medicare doesn’t cover everything  there are deductibles and coinsurance costs there are deductibles and coinsurance costs that must be paid As a result, many retirees look to their former Employer to provide Retiree Medical coverage after they retire Many retirees depend on Medicare as their only source of health insurance when they retire

3 Retiree Medical Insurance Coverage However, as the cost of providing these benefits continues to increase, many employers are reducing Retiree Medical Insurance Coverage or have eliminated it all together

4 Why is Retiree Medical so costly? Increasing Costs of Prescription Drugs Increasing Costs of Prescription Drugs GAS and/or FAS 106 Liability is still a concern GAS and/or FAS 106 Liability is still a concern Growing Retiree Population Growing Retiree Population High Utilization of this Benefit High Utilization of this Benefit Increasing Costs of Health Care Services Increasing Costs of Health Care Services

5 The Solution! TAGCO Associates, LP has the economical solution:

6 The TAGCO Multiple Employer Trust offers Employers…...a choice of Retiree Medical Insurance Plans underwritten by The Hartford* Insurance Plans underwritten by The Hartford* …andplans developed for retired …and plans developed for retired employees and their spouses age 65 and older *The Hartford ® is The Hartford Financial Services Group, Inc. and its subsidiaries, including issuing companies Hartford Life Insurance Company and Hartford Life and Accident Insurance Company.

7 …Offers Group Retiree Medical Coverage to retired employees and their spouses 65+ who are enrolled in Medicare Parts A & B …Requires a minimum participation of 2 retired lives …Allows employers to choose from 10 different Retiree Medical Insurance Plans and 2 or more Medicare Part D Employer PDP Options 2 or more Medicare Part D Employer PDP Options The TAGCO Multiple Employer Trust

8 TAGCO Associates, LP will customize a specific plan for employers with 250+ retirees The TAGCO Multiple Employer Trust

9 How does the TAGCO MET make Retiree Medical Insurance Plans more economical? The TAGCO MET allows for a minimum participation of 2 retired lives and group rating is most often less costly than individual rating The TAGCO MET also allows for rating across companies within the same industry, which most often reduces rates

10 What else makes Retiree Medical Insurance Coverage more economical? Retiree Medical Insurance Plans integrate with Medicare so employers can shift benefit costs on retired employees and spouses age 65+ from their current group health insurance coverage Retiree Medical Insurance Plans may help reduce annual premium expense as well as long-term GASB and/or FASB 106 liability

11 Additional Employer Advantages No enrollment forms* necessary on TAGCO MET Plans with 35% or more Employer contribution * Enrollment forms are necessary for both Mandatory and Voluntary Plans in Florida TAGCO MET Plans are generally more economical than the employer’s group medical coverage

12 Retiree Advantages Guaranteed Issue to employees/retirees, spouses and surviving spouses Pre-existing conditions clause waived if currently insured Medicare Part D Employer PDP Options and fully insured Rx coverage available

13 Freedom to choose Doctors and Hospital Freedom to choose Doctors and Hospital TAGCO MET Retiree Advantages Electronic Claims Processing Electronic Claims Processing 30 Day Free Look 30 Day Free Look Foreign Travel Medical Coverage Foreign Travel Medical Coverage Crossover Claims with Medicare Crossover Claims with Medicare

14 TAGCO MET Group Eligibility Employers with 250 or fewer retirees have a choice of Mandatory Retiree Medical Insurance Plans (35% or more Mandatory Retiree Medical Insurance Plans (35% or more Employer paid) Mandatory Retiree Medical Insurance Plan (35% or Mandatory Retiree Medical Insurance Plan (35% or more Employer paid) that include CMS creditable Rx coverage more Employer paid) that include CMS creditable Rx coverage Voluntary Retiree Medical Plans (less than 35% Employer paid) Voluntary Retiree Medical Plans (less than 35% Employer paid)

15 TAGCO MET Medicare Part D “Rx” Options Accepted nationwide Accepted nationwide at participating pharmacies at participating pharmacies Attractive retail and mail Attractive retail and mail order Co-Pays order Co-Pays Medicare Part D group rated Medicare Part D group rated Employer PDP Employer PDP First dollar coverage thru First dollar coverage thru Medicare Part D deductible Medicare Part D deductible and donut hole and donut hole Cont.

16 *This Medicare Part D Option is a separate plan and is NOT underwritten by The Hartford. Affordable Retail Brand and Generic Co-Pays Affordable Retail Brand and Generic Co-Pays Plan design and formulary options Plan design and formulary options Attractive Mail order Co-Pay options Attractive Mail order Co-Pay options TAGCO MET Medicare Part D Options* offer Unlimited annual maximum Unlimited annual maximum

17 The TAGCO MET Retiree Medical Plans are underwritten by The Hartford* The Hartford *The Hartford ® is the Hartford Financial Services Group and it’s subsidiaries, including issuing companies Hartford Life Insurance Company and Hartford Life and Accident Insurance Company. The Hartford has been in the Senior Medical business The Hartford has been in the Senior Medical business for more than 20 years for more than 20 years The Hartford still retains its first Senior Medical Insurance The Hartford still retains its first Senior Medical Insurance Plan client Plan client Security and Stability of The Hartford Industry Ratings as of 03/24/10: A.M. Best A Moody’s A3 Standard & Poor’s A Fitch A-

18 TAGCO MET Approved States

19 TAGCO MET PLANS & OPTIONS Cont. TAGCO MET Standard Plus Mandatory Plans without Rx Standard Plus Plan 3138* Pays the Medicare Part A and B deductible(s), Part B coinsurance and provides for excess coverage on unassigned Medicare claims; Plan pays for Part A additional 365 days. Plan 3138 is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE

20 TAGCO MET PLANS & OPTIONS TAGCO MET Standard Plus Mandatory Plans without Rx Standard Plus Plan 3136* Pays the Medicare Part A and B deductible(s) and Part B coinsurance; Plan does not pay for excess coverage on unassigned Medicare claims; Plan pays for Part A additional 365 days. Plan 3136 is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE

21 TAGCO MET Standard Plus Voluntary Plans without Rx Standard Plus Plan 3141* Pays the Medicare Part A and B deductible(s), Part B coinsurance and provides for excess coverage on unassigned Medicare claims; Plan does not pay for Part A additional 365 days; Plan 3141 is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is age and gender banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE TAGCO MET PLANS & OPTIONS

22 TAGCO MET Standard Plans without Rx Standard Plan 3733* Pays the Part A and B deductible(s); Plan pays 10% (50%) of Part B coinsurance up to $1,000 out-of-pocket expense by the insured; thereafter, it pays 100% of Part B coinsurance; Plan pays for Part A additional 365 days; Plan pays 100% for excess coverage on unassigned Medicare claims; Plan is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite and age and gender banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE Cont. TAGCO MET PLANS & OPTIONS

23 TAGCO MET Standard Plans without Rx Standard Plan 3734* Has a calendar year deductible of $500; such deductible applies to all Plan benefits; Plan pays the Part A deductible, but does not pay the Part B deductible; Plan pays 10% (50%) of Part B coinsurance up to $1,000 out-of-pocket expense by the insured; thereafter, it pays 100% of Part B coinsurance; Plan pays for Part A additional 365 days; Plan does not pay for excess coverage on unassigned Medicare claims; Plan is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite and age and gender banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE Cont.

24 TAGCO MET PLANS & OPTIONS TAGCO MET Standard Plans without Rx Standard Plan 3735* Pays the Part A and B deductible(s); Plan pays 16% (80%) of Part B coinsurance up to $500 out-of-pocket expense by the insured; thereafter, it pays 100% of Part B coinsurance; Plan pays for Part A additional 365 days; Plan pays 100% for excess coverage on unassigned Medicare claims; Plan is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite and age and gender banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE

25 Cont. TAGCO MET PLANS & OPTIONS TAGCO MET Standard Plans without Rx Standard Plan 3736* Has a calendar year deductible of $500; such deductible applies to all Plan benefits; Plan pays the Part A deductible, but does not pay the Part B deductible; Plan pays 16% (80%) of Part B coinsurance up to $1,000 out-of-pocket expense by the insured; thereafter it pays 100% of Part B coinsurance; Plan pays for Part A additional 365 days; Plan does not pay for excess coverage on unassigned Medicare claims; Plan is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite and age and gender banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE 65 AND MEDICARE ELIGIBLE

26 TAGCO MET PLANS & OPTIONS Public Employer Plans without Rx Public Employer Plan 3139 (01)* Pays the Medicare Part A and B deductible(s), Part B coinsurance and provides for excess coverage on unassigned Medicare claims; Plan pays for Part A additional 365 days; Plan provides for skilled nursing facility benefits; Plan 3139 (01) is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE Cont.

27 TAGCO MET PLANS & OPTIONS Public Employer Plans without Rx Public Employer Plan 3141 (01)* Pays the Medicare Part A and B deductible(s), Part B coinsurance and provides for excess coverage on unassigned Medicare claims; Plan does not for pay Part A additional 365 days; Plan provides for skilled nursing facility benefits; Plan 3141 (01) is fully insured and underwritten by Hartford Life &Accident Insurance Company and does not include Rx coverage; Plan is age banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE

28 Public Employer Plans without Rx Public Employer Plan 3137 (01)* Pays the Medicare Part A deductible, Part B coinsurance and provides for excess coverage on unassigned Medicare claims; Plan does not pay Part B deductible; Plan does not pay for Part A additional 365 days; Plan does not pay skilled nursing facility benefits; Plan 3137 (01) is fully insured and underwritten by Hartford Life & Accident Insurance Company and does not include Rx coverage; Plan is composite rated and age banded rated; *THIS CHART DESCRIBES COVERAGE THAT IS ONLY AVAILABLE TO PERSONS WHO ARE AT LEAST 65 AND MEDICARE ELIGIBLE TAGCO MET PLANS & OPTIONS

29 TAGCO Associates, LP Is A Texas Based Insurance Agency Providing The National Marketplace With Group Retiree Medical And Rx Insurance Expertise Who Is TAGCO Associates, LP? TAGCO Associates, LP (830) 336-3700 (800) 866-8056 Post Office Box 4133 Bergheim, TX 78004


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