PEBB Retiree Insurance Public Employees Benefits Board Program

PEBB Retiree Insurance Public Employees Benefits Board Program Outreach & Training 2021 2

Public Employees Benefits Board (PEBB) Administered by the Health Care Authority (HCA) • Offers access to comprehensive health insurance to retiring public & school employees • Election Form A and any other required documents to enroll in or defer coverage must be received by the PEBB Program no later than 60 days after: • Employer-paid, COBRA, or continuation coverage ends If you miss the 60 -day election period, you lose all rights to enroll in or defer PEBB retiree insurance coverage unless you regain eligibility in the future 3

PEBB Retiree Benefits PEBB retiree insurance offers: • Medical (includes Vision) and Dental Insurance • Preferred Provider Organization (PPO) • Managed Care options (HMO) • Non-Medicare and Medicare plan options • Life Insurance 4 www. hca. wa. gov/assets/pebb/51 -0205 -retiree-enrollment-guide-2021. pdf The vision benefit is included in the medical plans.

2021 PEBB Retiree Enrollment Guide Call customer service to request a guide be mailed to you • 1 -800 -200 -1004 Or visit the PEBB website to access or print the guide and forms • www. hca. wa. gov/pebb 5 www. hca. wa. gov/assets/pebb/51 -0205 -retiree-enrollment-guide-2021. pdf

Agenda 1 6 Eligibility for Retiree Insurance 5 Life Insurance 2 Deferring Coverage Enrollment Process & 6 Premium Payment Options 3 PEBB Medical Plans 7 Making Changes 4 PEBB Dental Plans 8 Who to Contact

Eligibility PEBB Retiree Insurance WAC 182 -12 -171 7

PEBB Retiree Insurance Eligibility Department of Retirement Systems (DRS): TRS & SRS Plans 1 & 2 • Vested & eligible to retire when insurance coverage ends • Must immediately begin receiving pension payment Must apply to enroll or defer no later than 60 days after: • Employer paid coverage ends, or • Continuation Coverage ends • COBRA • Unpaid Leave 2021 PEBB Retiree Enrollment Guide, page 9 8

PEBB Retiree Insurance Eligibility Department of Retirement Systems (DRS): TRS & SRS Plan 3 • Vested & eligible to retire when insurance coverage ends • Not required to begin receiving pension payment Must apply to enroll or defer no later than 60 days after: • Employer paid coverage ends, or • Continuation Coverage ends • COBRA • Unpaid Leave 2021 PEBB Retiree Enrollment Guide, page 9 9

July Retirement Example Resignation effective date June 1 -30 June 30 Employer-paid SEBB benefits end 10 Retirement date July 1 PEBB Retiree Insurance begins

September Retirement Example Resignation effective date August 1 -31 August 31 Employer-paid SEBB benefits end 11 Retirement date September 1 PEBB Retiree Insurance begins

COBRA Bridge COBRA: An extension of some of your current employer’s benefits, paid by the employee, and generally available for up to 18 months. • Employees may use COBRA as a bridge to PEBB retiree insurance coverage eligibility if: • Employee does not meet the age requirement of the retirement plan when employment ends, and • Employee meets the years of service requirement at the time employment ends 12 www. hca. wa. gov/employee-retiree-benefits/retirees/cobra

COBRA Bridge Example Employer-paid coverage ends Age 63 ½ Enroll in COBRA up to 18 months Does not meet age requirement but does meet years of service requirement for retirement (pension). 13 Enroll in PEBB Retiree Insurance Now age 65 Meets both age and years of service requirement.

Deferring Enrollment PEBB Retiree Insurance WAC 182 -12 -200 & WAC 182 -12 -205 14

Deferring Enrollment Deferring means postponing your PEBB retiree insurance coverage to keep your eligibility to enroll later. • Retiree election form must be received by the PEBB Program no later than 60 days after employer-paid, COBRA, or continuation coverage ends • Election form needs to indicate: • • You are deferring, and The type of medical coverage you are enrolling in that allows you to defer 2021 PEBB Retiree Enrollment Guide, pages 22 -23 15

Enroll After Deferring The following are types of medical coverage you can enroll in that allows you to defer. You must provide proof of continuous enrollment to enroll later. • Employer based group medical • As an employee or dependent of an employee • A federal retiree plan (such as TRICARE) • As a retiree or dependent • Civilian Health & Medical Program of the Department of Veteran’s Affairs (CHAMPVA) • The Health Benefit Exchange (non-Medicare only) • Medicare Parts A and B, and a Medicaid plan that provides creditable coverage 16

Dependent Eligibility 17

Eligible Dependents • Spouse or State-registered domestic partner (SRDP) • Children up to age 26 • Biological children, stepchildren, legally adopted • Extended dependents • Niece, nephew, grandchild • Dependent child with a disability • Age 26 and older 2021 PEBB Retiree Enrollment Guide, pages 10 -11 18 Non-Medicare subscribers and those enrolling a SRDP must provide dependent verification.

Surviving Dependents In the event of the death of the retiree, the surviving eligible dependent(s) may continue, enroll in or defer retiree coverage • An eligible surviving spouse/SRDP may continue coverage indefinitely, so long as premiums are paid in full, and • The spouse/SRDP maintains enrollment in Medicare Parts A and B, if eligible • Dependents may continue coverage until they lose eligibility • PEBB Program WAC 182 -12 -260 The surviving eligible dependent(s) must notify PEBB Program no later than 60 days after the retiree’s death to continue, enroll in or defer retiree coverage 2021 PEBB Retiree Enrollment Guide, page 11 19

PEBB Medical Plans 20

Plan Availability Plan availability differs by plan type and place of residence • Information on plan availability can be found • 2021 Retiree Enrollment Guide (pgs. 29 -32) • PEBB website: Medical plans available by county page • 21 www. hca. wa. gov/employee-retiree-benefits/retirees/medical-plans-available-county

Retirees: Non-Medicare Medical Plan Options & Premiums 22

PEBB Non-Medicare Plans Managed Care Plans (HMO) • Kaiser Permanente WA • Kaiser Permanente NW • Kaiser plan availability varies by service area in Washington and surrounding states Preferred Provider Plan (PPO) • Uniform Medical Plan (UMP) administered by Regence Blue. Shield • Offers plans that provide nationwide & worldwide coverage, and • Plans whose coverage varies by service area in Washington 23

What is Covered? All non-Medicare plans cover the same basic health care services. • • • Hearing Vision Prescription Drugs Preventive Care Chiropractic Physical, Occupational, & Speech Therapy 2021 PEBB Retiree Enrollment Guide, pages 33 -42 24 • Office Visits • Primary Care • Urgent Care • Specialist • Mental Health • Ambulance and Emergency Room • Hospital Care • Inpatient • Outpatient

2021 Non-Medicare Medical Plan Premiums Subscriber Only Subscriber & Spouse Subscriber & Child(ren) Subscriber, Spouse, & Child(ren) Kaiser Permanente NW Classic $745. 66 $1, 485. 75 $1, 300. 73 $2, 040. 82 Kaiser Permanente NW CDHP $618. 76 $1, 226. 30 $1, 089. 00 $1, 638. 21 Kaiser Permanente WA Classic $775. 39 $1, 545. 22 $1, 352. 76 $2, 122. 58 Kaiser Permanente WA CDHP $619. 29 $1, 227. 86 $1, 090. 30 $1, 640. 54 Kaiser Permanente WA Sound. Choice $641. 43 $1, 277. 28 $1, 118. 32 $1, 754. 17 Kaiser Permanente WA Value $698. 96 $1, 392. 34 $1, 219. 00 $1, 912. 38 Medical Plans 2021 PEBB Retiree Enrollment Guide, page 7 25

2021 Non-Medicare Medical Plan Premiums Subscriber Only Subscriber & Spouse Subscriber & Child(ren) Subscriber, Spouse, & Child(ren) UMP Classic $691. 72 $1, 377. 86 $1, 206. 32 $1, 892. 47 UMP Select $623. 50 $1, 241. 43 $1, 086. 95 $1, 704. 88 UMP CDHP $618. 52 $1, 226. 31 $1, 088. 95 $1, 638. 41 UMP Plus - PSHVN $658. 79 $1, 312. 02 $1, 148. 71 $1, 801. 93 UMP Plus – UW Medicine ACN $658. 79 $1, 312. 02 $1, 148. 71 $1, 801. 93 Medical Plans 2021 PEBB Retiree Enrollment Guide, page 7 26

Consumer Directed Health Plans (CDHP) A CDHP is a high-deductible health plan with a health savings account (HSA) • The PEBB Program contributes to the HSA each month • $58. 34 per month for an individual subscriber • $116. 67 per month for a subscriber with one or more enrolled dependents • Subscribers may also contribute up to the HSA up to the IRS annual limit • $3, 550 per year for an individual subscriber • $7, 100 per year for a subscriber with one or more enrolled dependents • If age 55 or older, can contribute an additional $1, 000 per year • IRS annual limit includes PEBB Program and non-Medicare subscriber contributions and wellness incentives, if earned 2021 PEBB Retiree Enrollment Guide, pages 26 -27 27

CDHP with an HSA and Medicare Subscribers and their enrolled dependents may not be enrolled in both Medicare and a CDHP w/HSA • Subscribers who become Medicare eligible while enrolled in a CDHP w/HSA must change their medical plan • Changing medical plans after enrolling in Medicare will require the out-of-pocket maximum and annual deductible to start over • If any enrolled dependent enrolls in Medicare, the subscriber may: • Change medical plan, or • Remove the dependent who is enrolled in Medicare • These dependents will not be eligible to enroll in PEBB Continuation Coverage 2021 PEBB Retiree Enrollment Guide, pages 26 -27 28

Retirees Enrolled in Medicare Medical Plan Options & Premiums 29

Medicare Subscriber and any dependents enrolled in Medicare • Must submit copy of their Medicare card showing Parts A and B • Must maintain Parts A and B 2021 PEBB Retiree Enrollment Guide, page 16 30

PEBB Medicare Plans The PEBB Program offers three types of Medicare Plans 1. Medicare Advantage plans • Kaiser Permanente NW Senior Advantage • Kaiser Permanente WA Medicare Advantage • United Healthcare (UHC) PEBB Complete (new for 2021) • United Healthcare (UHC) PEBB Balance (new for 2021) 31

PEBB Medicare Plans The PEBB Program offers three types of Medicare Plans 2. Medicare Coordination of Benefits (COB) plans • Kaiser Permanente WA Original Medicare • UMP Classic Medicare 3. Premera Blue Cross Medicare Supplement (Medigap) plans • Plan G • Plan F (Closed to new enrollees as of January 1, 2020) 32

Kaiser Permanente WA & NW United Healthcare Uniform Medical Plan Coverages and Premiums 33

What is Covered? *All PEBB Medicare plans EXCEPT Premera Blue Cross Medicare Supplement Plan G All* medical plans cover the same basic health care services. • • • Hearing Vision Prescription Drugs Preventive Care Chiropractic Physical, Occupational, & Speech Therapy 2021 PEBB Retiree Enrollment Guide, pages 33 -42 34 • Office Visits • Primary Care • Urgent Care • Specialist • Mental Health • Ambulance and Emergency Room • Hospital Care • Inpatient • Outpatient

2021 Medicare Medical Plan Premiums Medical Plans Subscriber Only Subscriber & Spouse Subscriber, Spouse, & Children 1 Medicare Eligible 2 Medicare Eligible 3 Medicare Eligible Kaiser NW Senior Advantage $174. 41 $914. 50 $343. 27 $729. 48 343. 27 $1, 469. 57 $898. 34 $512. 11 Kaiser WA Classic - $946. 93 - $754. 47 - $1, 524. 29 $926. 01 - $177. 10 - $348. 64 - - $520. 18 Kaiser WA Sound. Choice - $812. 96 - $653. 99 - $1, 289. 85 $825. 54 - Kaiser WA Value - $870. 49 - $697. 14 - $1, 390. 53 $868. 68 - Kaiser WA Medicare Plan 2021 PEBB Retiree Enrollment Guide, page 6 35 Subscriber & Children

2021 Medicare Medical Plan Premiums Medical Plans Subscriber Only Subscriber & Spouse Subscriber, Spouse, & Children 1 Medicare Eligible 2 Medicare Eligible UMP Classic Medicare $336. 30 $1, 022. 45 $667. 04 $850. 91 $667. 04 UHC PEBB Balance $132. 93 $819. 08 $260. 29 Non-Medicare enrolled in Uniform Medical Plan Classic $647. 54 $260. 29 $1, 333. 68 $774. 90 $387. 65 UHC PEBB Complete $156. 81 $842. 96 $308. 05 $671. 42 $459. 29 2021 PEBB Retiree Enrollment Guide, page 6 36 Subscriber & Children $308. 05 1 Medicare Eligible 2 Medicare Eligible $1, 537. 06 $1, 181. 65 $1, 357. 56 $822. 66 3 Medicare Eligible $997. 77

Premera Blue Cross Medicare Supplement Plan G Coverages and Premiums 37

What is Covered? Premera Blue Cross Medicare Supplement Plan G coverage includes: • Hospitalization (Part A coinsurance + 365 additional days) • Medical Expenses (Part B coinsurance) • Generally, 20% of Medicare approved expenses • Skilled Nursing Facility Care • Hospice Care 2021 PEBB Retiree Enrollment Guide, pages 47 -50 38

What is Not Covered? Premera Blue Cross Medicare Supplement Plan G DOES NOT generally cover: × Hearing × Vision × Alternative Care × Acupuncture × Naturopathy × Prescription Drugs • Need to enroll in Part D prescription drug plan 2021 PEBB Retiree Enrollment Guide, pages 47 -50 39

2021 Medicare Medical Plan Premiums Medical Plans Premera Plan G Age 65+ Eligible by age Premera Plan G Under Age 65, Eligible by disability Subscriber Only Subscriber & Spouse 1 Medicare Eligible 2 Medicare Eligible: 1 retired 1 disabled $99. 92 $786. 07 $260. 31 $194. 27 $165. 96 $852. 11 $260. 31 $326. 36 2021 PEBB Retiree Enrollment Guide, page 7 40 Subscriber & Children Subscriber, Spouse, & Children 2 Medicare Eligible: 1 retired, 1 disabled 2 Medicare Eligible $614. 53 $1, 300. 67 $775. 67 $708. 88 $680. 57 $1, 366. 72 $775. 67 $840. 97 2 Medicare Eligible 1 Medicare Eligible Non-Medicare enrolled in Uniform Medical Plan Classic

PEBB Benefits & Medicare 41

PEBB Benefits & Medicare More information on PEBB medical plans with Medicare • Medicare and PEBB Program benefits on PEBB Retiree webpage 42 www. hca. wa. gov/employee-retiree-benefits/retirees/medicare-and-pebb-program-benefits

PEBB Benefits & Medicare More information on PEBB medical plans with Medicare • Medicare and PEBB Program benefits on PEBB Retiree webpage 43 www. hca. wa. gov/employee-retiree-benefits/retirees/medicare-and-pebb-program-benefits

PEBB Dental Plans 44

PEBB Dental Plans Managed Care Plans Retirees who elect dental coverage must: • Delta. Care • Enroll in medical coverage • Willamette Dental • Enroll all dependents on your account in dental • Maintain enrollment in dental for at least 2 years Preferred-provider (PPO) • You may change your plan each year • Uniform Dental Plan (UDP) 2021 PEBB Retiree Enrollment Guide, page 55 45

2021 Dental Plan Premiums Subscriber Only Subscriber & Spouse Subscriber & Children Subscriber, Spouse & Children Delta. Care $39. 53 $79. 06 $118. 59 Uniform Dental Plan $48. 00 $96. 00 $144. 00 Willamette Dental $44. 45 $88. 90 $133. 35 Dental Plans 2021 PEBB Retiree Enrollment Guide, page 8 46

PEBB Dental Plans Delta Dental of Washington administers both: • Uniform Dental Plan (PPO) • Delta. Care (managed care plan) The network of providers are different • Call the plan directly to verify which network your dentist participates in • UDP: 1 -800 -537 -3406 • Delta. Care: 1 -800 -650 -1583 • Willamette: 1 -855 -433 -6825 2021 PEBB Retiree Enrollment Guide, pages 3 -4 47

Life Insurance Administered by Met. Life 48

Life Insurance Options for continuing life insurance into retirement • Portability Choice: A individual term life insurance policy • Convert: A whole life policy • PEBB Retiree: A group term life insurance policy • Election form must be received by the PEBB Program no later than 60 days after • your SEBB basic life insurance coverage ends Dependents cannot be enrolled Contact Met. Life to discuss your options • 1 -866 -548 -7139 2021 PEBB Retiree Enrollment Guide, pages 57 -58 49

Enrollment Process & Premium Payment Options 50

Verify Your Retirement Eligibility Department of Retirement Systems (DRS) • Contact DRS about 6 months before your planned retirement date, or • Visit the DRS website to request an estimate of your retirement benefit or register for a retirement planning seminar • www. drs. wa. gov 51 1 -800 -547 -6657

Requesting Retiree Insurance Information Approximately 60 days before your coverage ends • Call the PEBB Program • 1 -800 -200 -1004 • Request a PEBB Retiree Enrollment Guide • Visit the PEBB website: • Print the guide/forms 52 www. hca. wa. gov/assets/pebb/51 -0205 -retiree-enrollment-guide-2021. pdf

Medicare Subscriber and any dependents enrolled in Medicare • Must submit copy of their Medicare card showing Parts A and B • Must maintain Parts A and B 2021 PEBB Retiree Enrollment Guide, page 16 53

Enrolling in Coverage To enroll in the UHC PEBB Complete or UHC PEBB Balance plan: • Forms must be received by the PEBB Program prior to the coverage effective date • If forms are received after retiree coverage is set to begin, you may not select a UHC plan until annual open enrollment or a special open enrollment event occurs To enroll in any other PEBB Retiree medical plan: • Forms must be received by the PEBB Program no later than 60 days after employerpaid, COBRA, or continuation coverage ends Election forms may be submitted to PEBB Program as early as 90 days before coverage ends. 2021 PEBB Retiree Enrollment Guide, pages 12 -13 54

Premium Payment & Options First premium payment is due to HCA no later than 45 days after your 60 -day election period ends 1. Pension deduction • You may get an invoice for first payment 2. Automatic bank withdrawal VEBA Reimbursement • Submit Electronic Debit Service Agreement form 3. Personal check or money order • Receive and pay a monthly invoice from HCA 2021 PEBB Retiree Enrollment Guide, pages 12 & 14 -15 55

Making Changes 2021 PEBB Retiree Enrollment Guide, pages 18 -20 56

Annual Open Enrollment During the month of November, subscribers may: • Change medical and/or dental plan • Return from deferring • Proof of continuous coverage required • Enroll in dental • Enroll or remove eligible dependents Required forms/documents must be received by the PEBB Program no later than the last day of annual open enrollment • Changes are effective January 1 of the following year 57

Special Open Enrollment Event A qualifying event triggers a Special Open Enrollment • Some examples Include: • Marriage or registration of a partnership • Divorce/dissolution • Required to remove a spouse/partner in the event of divorce/dissolution • Enroll in Medicare • Subscriber or dependent loses eligibility for other qualifying coverage Required forms/documents must be received by the PEBB Program later than 60 days after the date of the event 58 no

SEBB Employee Benefits & Medicare Planning to continue working past age 65? 59

SEBB Employee Benefits & Medicare Find information on how Medicare works with SEBB employee benefits • Medicare and SEBB benefits on PEBB School employee's webpage 60 www. hca. wa. gov/employee-retiree-benefits/school-employees/medicare-and-sebb-benefits

SEBB Employee Benefits & Medicare If age 65+, still working, and enrolled in SEBB benefits through your employer you may: • Sign up for Medicare Part A, and • Wait to sign up for Medicare Part B Contact the Social Security Administration 60 -90 days before your SEBB employee coverage ends • Enroll in Medicare Part B Social Security Administration: 1 -800 -772 -1213 61 www. hca. wa. gov/employee-retiree-benefits/school-employees/medicare-and-sebb-benefits

Who to Contact 62

Who to Contact Health Plans • How your health plan works or how claims are processed • What prescriptions are covered • What health care providers are part of your plan’s network Phone numbers for your health plan can be found: • Retiree Enrollment Guide: pages 3 -4 • PEBB website: www. hca. wa. gov/pebb-retirees • Benefits ID card 2021 PEBB Retiree Enrollment Guide, pages 3 -4 63

Who to Contact Medicare • 1 -800 -633 -4227 Social Security Administration • Medicare enrollment • 1 -800 -772 -1213 Statewide Health Insurance Benefits Advisors (SHIBA) • 1 -800 -562 -6900 • www. insurance. wa. gov/statewide-health-insurance-benefits-advisors-shiba 2021 PEBB Retiree Enrollment Guide, pages 3 -4 64

PEBB Customer Service Go to www. hca. wa. gov/pebb-retirees for help with: • Eligibility and enrollment • Changes to your account • Medicare enrollment, divorce, etc. • Changing your name, address or phone number • Enrolling or removing dependents • Finding forms • Eligibility complaints or appeals 2021 PEBB Retiree Enrollment Guide, pages 3 -4 65 1 -800 -200 -1004 Monday-Friday 8: 00 am – 4: 30 pm

Thank You! 66