2022 Health Insurance & PharmacyWebinar for State and Local Retirees 2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 1
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How to Participate
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 3
Tech Check
Can you see the presentation?
Can you hear the host?
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 4
Ground Rules • You are automatically muted
• Only the host(s) and panelist(s) will engage in active discussion, and will be muted when not actively speaking
• Enter all questions via the question function • All general benefits-related questions are welcome • No personally identifiable information (PII) or protected health
information (PHI) allowed
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 5
Agenda • Retiree Health Insurance & Pharmacy 2022 Overview
• Member Resources
• Q&A Session
This session will be recorded for records retention purposes
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 6
Medical & Pharmacy for Retirees • Premiums & Rate Contributions
• Health Plan Offerings
• Medical Benefit & Limit Changes
• Reminders
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 7
Open Enrollment Period
September 27 to October 22, 2021
Mailed applications must be postmarked by October 22, 2021
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 8
2022 Premium Summary
The Group Insurance Board approved a modest premium increase for plan year 2022
• Rate impacts vary by program option
Full premium rates available on ETF website or in the 2022 Decision Guides
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 9
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Reminder: LAHP Premium Increase • For 2022, 30% increase in addition to health plan premium
increase for non-Medicare LAHP members • Non-Medicare LAHP premiums not enough to pay expected
claims • Non-Medicare LAHP premiums too low for included benefits
• Full premiums available in LAHP Decision Guide (ET-2156) and on the ETF website
Non-Medicare LAHP Only 2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 10
ASPIRus· HEALTH PLAN
New Health Plan: Aspirus • Aspirus Health Plan is newly Covered Counties:
available for plan year 2022 • Clark • Portage • Florence • Price • Covers select counties in north-• Forest • Shawano central Wisconsin • Iron • Taylor
• Key providers include: • Langlade • Vilas • Aspirus Health • Lincoln • Waushara
• Marathon • Wood • Ascension North & Central • Oneida • ThedaCare • Bellin Health
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 11
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Network Change: Quartz Community
Network offering change – Quartz Community split • Quartz Central • Quartz West
Members currently enrolled in Quartz Community should select a new health plan
Quartz – UW Health network not impacted by this change
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 12
New Network: Quartz Central • One of two networks replacing Covered Counties:
Quartz Community in 2022 • Adams • Lafayette • Columbia • Marquette
• Covers middle and eastern parts of • Dodge • Richland Wisconsin outside of Dane County • Fond du Lac • Rock
• Grant • Sauk • Key providers include: • Green • Walworth • Aurora Health System • Green Lake • Waukesha
• Iowa • Waushara • ProHealth Care • Jefferson • Wood
• ThedaCare • Juneau
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 13
New Network: Quartz West • One of two networks replacing Covered Counties:
Quartz Community in 2022 • Buffalo • La Crosse • Chippewa • Monroe • Covers western counties in • Clark • Pepin Wisconsin • Crawford • Trempealeau
• Key provider system: • Eau Claire • Vernon • Jackson
• Gundersen Health System clinics and providers
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 14
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2022 State Maintenance Plan (SMP)
State: 1 SMP county
Local: 7 SMP counties
Direct member questions about SMP to WEA Trust
What is SMP? Per state statute, ETF must offer a standard supplementary plan design option – the State Maintenance Plan – in any county that doesn’t have: • A minimum of one health plan with premium
rates that are classified as Tier 1 or in the lowest annual premium rate threshold determined by ETF, and
• Satisfy all provider access qualifications established by ETF, which ensure members can receive care within a reasonable distance on a county-by-county basis
SMP counties are evaluated on an annual basis
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 15
Medical Benefit Changes
Minor medical benefit changes for plan year 2022
• Adding coverage for medically necessary corrective jaw surgeries
• Removing timeframe requirement for tooth extractions or dental repairs due to accidents
• Updating and specifying telemedicine coverage
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 16
Telemedicine Coverage Changes • New service category definitions and cost-sharing added for
telemedicine – visit ETF website for details
Service Category Cost: Non-HDHP Plans Cost: HDHP Plans E-Visit $0 Deductible, then $0 Telehealth Visit $15 or $25, depending upon Deductible, then $15 or $25,
provider specialty depending upon provider specialty
Telephone Visit $15 or $25, depending upon Deductible, then $15 or $25, provider specialty depending upon provider
specialty 2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 17
Limit Changes
Updating medical maximum out-of-pocket limit to matchannual federal maximum
• Individual: $8,700 / Family: $17,400
Applying all medical benefits to maximum out-of-pocket limit
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 18
. NAVITUS PHARMACY BENEF ITS RE INVENTED™
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Pharmacy Benefit Change
Continuous Glucose Monitors (CGM) coverage will be allowed under the pharmacy benefit in 2022
CGM coverage will be available under both the medical and pharmacy benefit
Non-Medicare Only 2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 19
Retiree Gym Membership Availability WEA Trust – for the IYC Medicare Plus plan design – will continue to offer the Silver Sneakers gym membership for 2022
UnitedHealthcare – for the IYC Medicare Advantage plan design – will transition to Renew Active effective January 1, 2022
Limited Participation – Retirees Only
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 20
Reminder: COVID-19 Vaccine Covered
COVID-19 vaccines are safe, effective, and widely available
There is no cost for the COVID-19 vaccine
The latest information about health benefits and COVID-19 is available on the ETF website
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Resources • 2022 Open Enrollment Preview
Video
• Open Enrollment Webinars
• Member Resources
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• 2-minute overview of 2022 changes to health benefits 2022 Open • Applies to all members Enrollment • Available to view here: etf.wi.gov/video/etf-2022-open-Preview Video enrollment-preview
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2022 Health Benefit Webinars ETF Benefit Webinars • Throughout open enrollment
• Health Insurance & Pharmacy Benefits for Active Members
• Health Insurance & Pharmacy for Retirees
• Dental & Supplemental Programs
• Pre-Tax Savings Accounts • Wellness Program
Benefit Vendor Q&A Webinars • All health plans and vendors
participating • Throughout open enrollment
• Registration required via ETF website • No PII/PHI permitted • See ETF website at etf.wi.gov/health
for session details and to register
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Topics
Upper Respiratory Infections
Health Benefits Education Center • New website section with
information and resources about common conditions • Headache and migraine • Upper respiratory infections • Resources for sick children
• To learn more, visit etf.wi.gov/health-benefits-education
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Heallth Benefits D cision Guid,e
C'ett 2022 Health Benefits Decision Guide
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2022 Health Benefits Decision Guid
Decision Guides • Retirees should have received a
hard copy Decision Guide by mail
• If you did not receive a copy, please contact ETF to request one
• Decision Guides and the Application/Change Form for Retirees and COBRA Continuants available on ETF’s website
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 26
Member Resources • ETF website
• Health landing page – etf.wi.gov/health
• Important Changes for 2022 • State employees • Local employees – same for all Local Program Options • See meeting materials for PDF versions
• Health Plan and Vendor contact information • 2022 Decision Guides
2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 27
Next StepsOpen Enrollment: September 27 – October 22, 2021
• Visit the ETF website or attend an ETF webinar for more information about health benefits changes for plan year 2022
• Contact the vendor or your employer benefits specialist with specific questions
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Q&A Session 2022 Health Insurance & Pharmacy for Retirees – Open Enrollment Webinar 30
Q&A Session – Time to Wrap Up
We have time for one last question…
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Thank You wi_etf etf.wi.gov
608-266-3285 1-877-533-5020ETF E-mail Updates
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