Retiree Open Enrollment focus · It’s here again! This May’s Open Enrollment is the opportunity for pre-Medicare retirees and Medicare retirees to make insurance changes. Any

Retiree Open Enrollment

focus What’s New in FY18? It’s here again! This May’s Open Enrollment is the opportunity for pre-Medicare retirees and Medicare retirees to make insurance changes. Any change will be effective July 1, 2017.

Good News!! Look forward to these enhanced services and coverage starting July 1st: Introducing Delta Dental’s Prevention First program. Beginning July 1st, the Prevention First program will be in place! Costs associated with preventive care and diagnostics (typically your cleanings, oral exams and X-rays) will NOT count against the $1,500 annual maximum. This means that your annual maximum benefit of $1,500 will go further in covering your other dental services such as fillings, crowns, and extractions. Your preventive services will still be covered at 100% by Delta Dental. We have heard your frustration with Cigna’s mail order pharmacy and now have a great alternative. Cigna introduces 90 Now, a new option for filling your 90-day prescriptions at a local pharmacy! Effective July 1st, 90 Now will enable you to get your 90-day medications from certain retail stores – including CVS, Target, Walmart Pharmacy, and Harris Teeter Pharmacy – for the same two copays as mail order drugs. If you currently use a preventive medication and pay $0 through mail order, you can now do the same at one of the select retail pharmacies and you still save money! 90 Now is only available at certain pharmacies. To see a full list, go to www.cigna.com/Rx90network. Our plan requires maintenance medications to be filled via Cigna Mail Order or the new 90 Now program.

Note: Specialty medications must still be filled through Cigna’s Specialty Pharmacy.

Premiums Premiums for Delta Dental and pre-Medicare plan health insurance (Cigna & Kaiser HMO) are increasing

July 1st. Please review the charts on pages 6 & 7 to see your new share of the monthly premium.

Premium changes for the Kaiser Medicare Plus plan and the AmWINS Medicare Supplement Plan will not be known until the Fall 2017. Any changes will not be effective until January 1, 2018.

Open Enrollment Information Meetings Tuesday, May 2nd, 10:30 AM — 12:30 PM

ACREA Luncheon Little Falls Presbyterian Church 6025 Little Falls Road, Arlington

Wednesday, May 17th , 1 PM to 3 PM

Central Library Auditorium 1015 N. Quincy Street, Arlington

Open Enrollment is May 10th to May 24th

P A G E 2

Are You Eligible for Open Enrollment?

Pre-Medicare retirees may: Switch from Cigna to Kaiser or vice versa Choose a different Cigna plan Add/drop eligible dependents Enroll in or cancel Delta Dental coverage

Medicare participants may: Switch from AmWINS to Kaiser Medicare Plus or vice versa Add/drop eligible dependents Enroll in or cancel Delta Dental coverage

How Do I Make Insurance Changes? Open Enrollment is from May 10th to May 24th.

Visit www.arlingtonva.us/retirement and click on “Open Enrollment” to

access all of the enrollment forms, rate charts, and plan summaries for our

health and dental plans.

To make changes, please fill out the appropriate enrollment form(s)

Submit completed forms via mail or email no later than May 24th:

Arlington County Human Resources OR Email: [email protected]

ATTN: Benefits Subject: Open Enrollment 2100 Clarendon Blvd., Suite 511 Arlington, VA 22201

All changes are effective July 1, 2017. No changes? Sit back and relax — there’s nothing for you to do! Questions? Call us at 703-228-3500 option 1 or email your questions to [email protected]

To participate in this Open Enrollment period, you must meet one of the criteria below:

Retiree and/or dependent who is currently enrolled in Cigna or Kaiser

Retiree and/or dependent who is currently enrolled in AmWINS or Kaiser Medicare Plus

Retiree who retired after 6/30/2008, who is not currently enrolled in a County plan, but who can demonstrate continuous medical coverage in another plan

What Can I Do During Open Enrollment?

P A G E 3

Pre-Medicare Plans Overview Kaiser Permanente Signature HMO Provides “one-stop” medical care at Kaiser

facilities throughout the DC metro area Preventive Care covered at 100% Coverage for non-Kaiser providers only in cases

of emergency Most economical plan in terms of monthly

premiums and copays Cigna All Cigna Plans Offer: Open Access Plus (OAP) network — a national

network of providers and facilities Preventive Care covered at 100% Emergency and Urgent Care covered 24/7

worldwide Prescription drug coverage is the same for all

three plans Three tiers: generic, preferred brand, non-

preferred brand New! Maintenance medications may be filled

using mail order OR the new Cigna 90 Now program. (See page 1.)

Certain preventive generic drugs are FREE via mail order or 90 Now. Review the Cigna formulary on the retiree website.

If your doctor prescribes a non-preferred brand name drug, you may be required to try a generic or preferred brand drug before the more expensive drug is authorized

Delta Dental Use any licensed dentist for your dental care Save money when you use a dentist who

participates in the Delta Dental Premier or Preferred network

The plan pays: 100% of reasonable and customary fees for

cleanings and x-rays (preventive care) 80% for Basic Services (e.g., fillings) 50% for Major Services (e.g., crowns) Annual calendar year deductible for Basic and

Major Services of $55 individual/$110 family Plan pays maximum of $1,500 per calendar year.

New! Costs of preventive care do not count toward the $1,500 annual maximum.

What are the differences between Cigna plans?

Open Access Plus In-Network (OAP IN) Coinsurance Choose doctors, health professionals and

facilities that are in the Cigna OAP national network (no coverage for out-of-network providers)

You pay 10% of the allowable cost for services; the plan pays for 90%

Lowest premiums of all Cigna plans No deductible Out-of-pocket maximum (OOPM) is $2,250

individual/$4,500 family* Open Access Plus IN (OAP IN) Copay Choose the doctors, health professionals and

facilities that are in the Cigna OAP national network (no coverage for out-of-network providers)

You pay a flat dollar copay for services No deductible Out-of-pocket maximum is $6,600 individual/

$13,200 family* Open Access Plus (OAP) Most expensive premiums across all plans Choose any doctors, health professionals or

facilities that are in or out-of-network Select a provider in the Cigna OAP network and

pay 10% of the allowable cost for services Pay a deductible when you use an out-of-

network provider; the County pays 70% of allowable charges after the deductible is met

Out-of-pocket maximums are: in-network $2,250 individual/$4,500 family; and out-of-network $3,250 individual/$6,500 family

*Monthly premium deductions do not count toward your out-of-pocket maximum To see if your provider is in the OAP network: Go to www.Cigna.com and Click on “Find a

Doctor” Fill in your search criteria and Click “Search” If “OAP” is listed under Plans Accepted, your

provider is in-network.

https://my.arlingtonva.us/portal/page/portal/AC_EMPLOYEE_BENEFITS/Health%20Plans/Kaiser%20Health%20Plan

Life Insurance Coverage and Rate Changes in

Your April 2017 Pension Payment Basic Life

If you turned 65 after April 1, 2016 your basic life insurance coverage reduced from $10,000 to $8,000 effective April 1, 2017.

Supplemental Life

If you turned 65 after April 1, 2016, your supplemental life insurance coverage reduces to $10,000 and the premium deduction will change accordingly in your April 2017 pension payment.

Supplemental life insurance premiums are based on your age and tobacco use. Rates are divided into five-year bands until you reach age 70.

If you have changed age bands since April 1, 2016 (e.g., age 59 to 60), your new deduction in April 2017 will reflect a higher premium.

Coming Soon!

Coming in May — Web Member Services is getting a new look and a new name! We think you’ll find the site easier to navigate. You’ll still use the same link: www.arlingtonva.us/retirement and your current Username and Password.

Turning 65? Welcome to Medicare! Retirees and their dependents who participate in the County health insurance plan must enroll in Medicare Part B when they turn 65 in order to continue on a County health plan. At age 65, Medicare becomes your primary health insurance, and the County plan provides access to coverage beyond traditional Medicare . Either plan is used in conjunction with Medicare Parts A and B, and provides you with Part D prescription drug coverage. Kaiser Medicare Advantage Plus: Plan A with D Only available to enrollees in the Washington, DC Metropolitan area. One-stop medical services at Kaiser facilities; referral required for network hospitals and specialists $15 copay for in-network Medicare-covered primary and specialist office visits $15 copay for diagnostic hearing exam; $15 copay for routine eye exams Retail prescription drug copays of $10 / $15/ $25 (Preferred mail order/

Preferred retail / standard retail) AmWINS Medicare Supplement See any provider who accepts Medicare No Part B deductible to meet $20 Primary and $40 Specialist office visit copays Coverage for routine hearing and vision exams Retail prescription drug copays of $10/$30/$55 (Tier 1, Tier 2, Tier 3)

P A G E 4

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2017 Medicare Plans Monthly Premiums - Retired before 1/15/12 Rates Effective January 1, 2017— December 31, 2017

P A G E 6

2017 Medicare Plans Monthly Premiums - Retired on or after 1/15/12

Coverage Level Medical

Retiree Share

Medical County

Share

Medical

Retiree Share

Medical

County Share

Retiree Share

(if not at Max.

Subsidy)

Dental

County

Share

1 on Medicare 24.74$ 222.68$ 39.60$ 356.40$ 7.24$ 28.96$

2 on Medicare 49.48$ 445.36$ 79.20$ 712.80$ 14.44$ 57.76$

1 on Medicare 42.56$ 204.86$ 68.11$ 327.89$ 9.41$ 26.79$

2 on Medicare 85.11$ 409.73$ 136.22$ 655.78$ 18.77$ 53.43$

1 on Medicare 69.28$ 178.14$ 110.88$ 285.12$ 13.03$ 23.17$

2 on Medicare 138.56$ 356.28$ 221.76$ 570.24$ 25.99$ 46.21$ -$

1 on Medicare 113.81$ 133.61$ 182.16$ 213.84$ 18.82$ 17.38$

2 on Medicare 227.63$ 267.21$ 364.32$ 427.68$ 37.54$ 34.66$

1 on Medicare 158.35$ 89.07$ 253.44$ 142.56$ 24.62$ 11.58$

2 on Medicare 316.70$ 178.14$ 506.88$ 285.12$ 49.10$ 23.10$

1 on Medicare 202.88$ 44.54$ 324.72$ 71.28$ 30.41$ 5.79$

2 on Medicare 405.77$ 89.07$ 649.44$ 142.56$ 60.65$ 11.55$

AmWINS Supplement

GROUP 5: Ch 21 & 46

10-14 years of service

Max. Subsidy $384

GROUP 4: Ch 21 & 46


Max. Subsidy $576

GROUP 3: Chapter 46


Max. Subsidy $768

GROUP 2: Chapter 46


Max. Subsidy $883

GROUP 1: Chapter 21

20+ yrs svc;

Chapter 46

25+ yrs svc

Max. Subsidy $960

GROUP 6: Ch 21 & 46


Max. Subsidy $192

Kaiser Medicare Delta Dental

Coverage Level Retiree

Share

Medical

County Share

Retiree

Share

Medical

County Share

Retiree Share

(If not at Max.

Subsidy)

Dental

County Share

1 on Medicare 24.74$ 222.68$ 39.60$ 356.40$ 7.24$ 28.96$

2 on Medicare 49.48$ 445.36$ 192.00$ 600.00$ 14.44$ 57.76$

1 on Medicare 42.56$ 204.86$ 68.11$ 327.89$ 9.41$ 26.79$

2 on Medicare 85.11$ 409.73$ 240.00$ 552.00$ 18.77$ 53.43$

1 on Medicare 69.28$ 178.14$ 110.88$ 285.12$ 13.03$ 23.17$

2 on Medicare 138.56$ 356.28$ 312.00$ 480.00$ 25.99$ 46.21$ -$

1 on Medicare 113.81$ 133.61$ 182.16$ 213.84$ 18.82$ 17.38$

2 on Medicare 227.63$ 267.21$ 432.00$ 360.00$ 37.54$ 34.66$

1 on Medicare 158.35$ 89.07$ 253.44$ 142.56$ 24.62$ 11.58$

2 on Medicare 316.70$ 178.14$ 552.00$ 240.00$ 49.10$ 23.10$

AmWINS SupplementKaiser Medicare Delta Dental

GROUP 1: Chapter 21

20+ yrs svc;

Chapter 46

25+ yrs svc

Max. Subsidy $600

GROUP 2: Chapter 46


Max. Subsidy $552

GROUP 3: Chapter 46


Max. Subsidy $480

GROUP 4: Ch 21 & 46


Max. Subsidy $360

GROUP 5: Ch 21 & 46


Max. Subsidy $240

P A G E 7

Pre-Medicare Plans Monthly Premiums – Retired before 1/15/12 Rates Effective July 1, 2017 – June 30, 2018

Coverage

Level

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share(if not at

Max. Subsidy)

Dental

County

Share

Single 29.76$ 492.93$ 168.74$ 545.16$ 103.84$ 545.16$ 397.14$ 545.16$ 7.24$ 28.96$

Retiree + Spouse/ Adult

Dependent 140.69$ 960.00$ 503.50$ 960.00$ 370.50$ 960.00$ 971.80$ 960.00$ 14.44$ 57.76$

Retiree + Child(ren) 128.46$ 841.25$ 319.11$ 930.19$ 205.61$ 930.19$ 765.91$ 930.19$ 15.64$ 62.56$

Family 635.26$ 960.00$ 1,181.70$ 960.00$ 987.00$ 960.00$ 1,866.90$ 960.00$ 22.02$ 88.08$

1 NonMedicare +

1 Medicare 54.50$ 715.61$ 208.34$ 901.56$ 143.44$ 901.56$ 436.74$ 901.56$ 14.44$ 57.76$

Single 66.73$ 455.96$ 209.63$ 504.27$ 144.73$ 504.27$ 438.03$ 504.27$ 9.41$ 26.79$


Dependent 217.69$ 883.00$ 580.50$ 883.00$ 447.50$ 883.00$ 1,048.80$ 883.00$ 18.77$ 53.43$


Family 712.26$ 883.00$ 1,258.70$ 883.00$ 1,064.00$ 883.00$ 1,943.90$ 883.00$ 28.63$ 81.47$

1 NonMedicare +

1 Medicare 109.28$ 660.82$ 277.74$ 832.16$ 212.84$ 832.16$ 506.14$ 832.16$ 18.77$ 53.43$

Single 128.36$ 394.33$ 277.77$ 436.13$ 212.87$ 436.13$ 506.17$ 436.13$ 13.03$ 23.17$


Dependent 332.69$ 768.00$ 695.50$ 768.00$ 562.50$ 768.00$ 1,163.80$ 768.00$ 25.99$ 46.21$


Family 827.26$ 768.00$ 1,373.70$ 768.00$ 1,179.00$ 768.00$ 2,058.90$ 768.00$ 39.64$ 70.46$

1 NonMedicare +

1 Medicare 197.64$ 572.47$ 388.65$ 721.25$ 323.75$ 721.25$ 617.05$ 721.25$ 25.99$ 46.21$

Single 226.97$ 295.72$ 386.80$ 327.10$ 321.90$ 327.10$ 615.20$ 327.10$ 18.82$ $17.38


Dependent 524.69$ 576.00$ 887.50$ 576.00$ 754.50$ 576.00$ 1,355.80$ 576.00$ 37.54$ $34.66

Retiree + Child(ren) 462.80$ 506.90$ 688.80$ 560.50$ 575.30$ 560.50$ 1,135.60$ 560.50$ 40.66$ $37.54

Family 1,019.26$ 576.00$ 1,565.70$ 576.00$ 1,371.00$ 576.00$ 2,250.90$ 576.00$ 57.25$ $52.85

1 NonMedicare +

1 Medicare 340.78$ 429.33$ 568.96$ 540.94$ 504.06$ 540.94$ 797.36$ 540.94$ 37.54$ $34.66

Single 325.57$ 197.12$ 495.84$ 218.06$ 430.94$ 218.06$ 724.24$ 218.06$ 24.62$ $11.58


Dependent 716.69$ 384.00$ 1,079.50$ 384.00$ 946.50$ 384.00$ 1,547.80$ 384.00$ 49.10$ $23.10

Retiree + Child(ren) 635.37$ 334.33$ 879.61$ 369.69$ 766.11$ 369.69$ 1,326.41$ 369.69$ 53.18$ $25.02

Family 1,211.26$ 384.00$ 1,757.70$ 384.00$ 1,563.00$ 384.00$ 2,442.90$ 384.00$ 74.87$ $35.23

1 NonMedicare +

1 Medicare 483.92$ 286.19$ 749.28$ 360.62$ 684.38$ 360.62$ 977.68$ 360.62$ 49.10$ $23.10

Single 424.18$ 98.51$ 604.87$ 109.03$ 539.97$ 109.03$ 833.27$ 109.03$ 30.41$ $5.79


Dependent 908.69$ 192.00$ 1,271.50$ 192.00$ 1,138.50$ 192.00$ 1,739.80$ 192.00$ 60.65$ $11.55

Retiree + Child(ren) 797.14$ 172.56$ 1,058.49$ 190.81$ 944.99$ 190.81$ 1,505.29$ 190.81$ 65.69$ $12.51

Family 1,403.26$ 192.00$ 1,949.70$ 192.00$ 1,755.00$ 192.00$ 2,634.90$ 192.00$ 92.48$ $17.62

1 NonMedicare +

1 Medicare 627.06$ 143.04$ 929.59$ 180.31$ 864.69$ 180.31$ 1,157.99$ 180.31$ 60.65$ $11.55

Kaiser HMO Cigna OAP IN Cigna OAP Delta Dental

GROUP 6:

Ch 21 & 46


Max. Subsidy $192

Cigna OAP IN

Coinsurance PlansCopay Plans

GROUP 1:

Chapter 21

20+ yrs svc;

Chapter 46

25+ yrs svc

Max. Subsidy $960

GROUP 2:

Chapter 46

23-24 years of

service

Max. Subsidy $883

GROUP 3:

Chapter 46

20-22 years of

service

Max. Subsidy 768

GROUP 4:

Ch 21 & 46

15-19 years of

service

Max. Subsidy $576

GROUP 5:

Ch 21 & 46

10-14 years of

service

Max. Subsidy $384

All rate charts may be found on the County’s website at www.arlingtonva.us/retirement and then by clicking on Open Enrollment.

https://careers.arlingtonva.us/retiree-insurance-plans-2/

P A G E 8

Pre-Medicare Plans Monthly Premiums – Retired on or after 1/15/12 Rates Effective July 1, 2017 – June 30, 2018

Open Enrollment is May 10th

to May 24th

Questions about Open Enrollment?

HR Benefits Customer Service at 703.228.3500, Option 1

Email [email protected]

Coverage

Level

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share

Medical

County

Share

Retiree

Share(If not at Max.

Subsidy)

Dental

County

Share

Single 29.75$ 492.94$ 168.74$ 545.16$ 103.84$ 545.16$ 397.14$ 545.16$ 7.24$ 28.96$


Dependent 500.69$ 600.00$ 863.50$ 600.00$ 730.50$ 600.00$ 1,331.80$ 600.00$ 14.44$ 57.76$

Retiree + Child(ren) 369.70$ 600.00$ 649.30$ 600.00$ 535.80$ 600.00$ 1,096.10$ 600.00$ 15.64$ 62.56$

Family 995.26$ 600.00$ 1,541.70$ 600.00$ 1,347.00$ 600.00$ 2,226.90$ 600.00$ 22.02$ 88.08$

1 NonMedicare +

1 Medicare 170.11$ 600.00$ 509.90$ 600.00$ 445.00$ 600.00$ 738.30$ 600.00$ 14.44$ 57.76$

Single 66.73$ 455.96$ 209.63$ 504.27$ 144.73$ 504.27$ 438.03$ 504.27$ 9.41$ 26.79$


Dependent 548.69$ 552.00$ 911.50$ 552.00$ 778.50$ 552.00$ 1,379.80$ 552.00$ 18.77$ 53.43$


Family 1,043.26$ 552.00$ 1,589.70$ 552.00$ 1,395.00$ 552.00$ 2,274.90$ 552.00$ 28.63$ 81.47$

1 NonMedicare +

1 Medicare 218.11$ 552.00$ 557.90$ 552.00$ 493.00$ 552.00$ 786.30$ 552.00$ 18.77$ 53.43$

Single 128.36$ 394.33$ 277.77$ 436.13$ 212.87$ 436.13$ 506.17$ 436.13$ 13.03$ 23.17$


Dependent 620.69$ 480.00$ 983.50$ 480.00$ 850.50$ 480.00$ 1,451.80$ 480.00$ 25.99$ 46.21$


Family 1,115.26$ 480.00$ 1,661.70$ 480.00$ 1,467.00$ 480.00$ 2,346.90$ 480.00$ 39.64$ 70.46$

1 NonMedicare +

1 Medicare 290.11$ 480.00$ 629.90$ 480.00$ 565.00$ 480.00$ 858.30$ 480.00$ 25.99$ 46.21$

Single 226.97$ 295.72$ 386.80$ 327.10$ 321.90$ 327.10$ 615.20$ 327.10$ 18.82$ 17.38$


Dependent 740.69$ 360.00$ 1,103.50$ 360.00$ 970.50$ 360.00$ 1,571.80$ 360.00$ 37.54$ 34.66$


Family 1,235.26$ 360.00$ 1,781.70$ 360.00$ 1,587.00$ 360.00$ 2,466.90$ 360.00$ 57.25$ 52.85$

1 NonMedicare +

1 Medicare 410.11$ 360.00$ 749.90$ 360.00$ 685.00$ 360.00$ 978.30$ 360.00$ 37.54$ 34.66$

Single 325.57$ 197.12$ 495.84$ 218.06$ 430.94$ 218.06$ 724.24$ 218.06$ 24.62$ 11.58$


Dependent 860.69$ 240.00$ 1,223.50$ 240.00$ 1,090.50$ 240.00$ 1,691.80$ 240.00$ 49.10$ 23.10$

Retiree + Child(ren) 729.70$ 240.00$ 1,009.30$ 240.00$ 895.80$ 240.00$ 1,456.10$ 240.00$ 53.18$ 25.02$

Family 1,355.26$ 240.00$ 1,901.70$ 240.00$ 1,707.00$ 240.00$ 2,586.90$ 240.00$ 74.87$ 35.23$

1 NonMedicare +

1 Medicare 530.11$ 240.00$ 869.90$ 240.00$ 805.00$ 240.00$ 1,098.30$ 240.00$ 49.10$ 23.10$

Single 424.18$ 98.51$ 604.87$ 109.03$ 539.97$ 109.03$ 833.27$ 109.03$ 30.41$ 5.79$


Dependent 980.69$ 120.00$ 1,343.50$ 120.00$ 1,210.50$ 120.00$ 1,811.80$ 120.00$ 60.65$ 11.55$

Retiree + Child(ren) 849.70$ 120.00$ 1,129.30$ 120.00$ 1,015.80$ 120.00$ 1,576.10$ 120.00$ 65.69$ 12.51$

Family 1,475.26$ 120.00$ 2,021.70$ 120.00$ 1,827.00$ 120.00$ 2,706.90$ 120.00$ 92.48$ 17.62$ 1 NonMedicare +

1 Medicare 650.11$ 120.00$ 989.90$ 120.00$ 925.00$ 120.00$ 1,218.30$ 120.00$ 60.65$ 11.55$

GROUP 6:

Ch 21 & 46

0-9 years of

service

Max. Subsidy $120

GROUP 4:

Ch 21 & 46

15-19 years of

service

Max. Subsidy $360

GROUP 5:

Ch 21 & 46

10-14 years of

service

Max. Subsidy $240

GROUP 2:

Chapter 46

23-24 years of

service

Max. Subsidy $552

GROUP 3:

Chapter 46

20-22 years of

service

Max. Subsidy $480

GROUP 1:

Chapter 21

20+ yrs svc;

Chapter 46

25+ yrs svc

Max. Subsidy $600

Copay Plans Coinsurance Plans

Kaiser HMO Cigna OAP IN Cigna OAP IN Cigna OAP Delta Dental

Documents

Retiree Open Enrollment focus · It’s here again! This May’s Open Enrollment is the opportunity for pre-Medicare retirees and Medicare retirees to make insurance changes. Any