In this issue:
Open enrollment is the time each year when Colorado PERA retirees and benefit recipients have the opportunity to add health care, dental, or vision coverage for themselves and their eligible dependents. If you are already enrolled in PERACare coverage, open enrollment is your once-a-year opportunity to change between plans and/or add eligible dependents to your plan.
When is Open Enrollment?
Open enrollment begins October 1 and ends on Thursday, November 7, 2013. This means that all enrollment requests must be received or postmarked on or before the November 7 deadline. You may submit your enrollment form in person or via mail, fax, or online. Changes submitted during open enrollment become effective on January 1, 2014.
Will I Need To Take Any Action During Open Enrollment?
You will want to review the open enrollment information carefully, since there will be some changes to benefits and premiums in many of the PERACare plans. Benefits and premiums are still being finalized, and will be available in early September.
If you are enrolled in PERACare and decide that you want to stay in the same plan(s) as shown in your open enrollment letter from PERA, you don’t have to do anything. We will keep you enrolled in your current plan(s).
If you would like to change your existing coverage, add new coverage, or add a dependent, you will need to submit a PERACare Enrollment/Change Form to PERA during open enrollment before the November 7, 2013, deadline.
PERA is preparing a new Open Enrollment Guide, a simplified version of the open enrollment packet sent to enrollees in the past. If you are currently enrolled in a PERACare plan, watch your mail in September for your 2014 Open Enrollment Guide. The guide will include your personalized letter showing your PERA subsidy and your 2014 premiums for the coverages in which you are currently enrolled.
Colorado PERA invites you to attend an open enrollment meeting in October to learn more about the PERACare program. Find the meeting most convenient for you on the schedule below and mark your calendar.
Meeting areas will be open from 9:00 a.m. to 12:30 p.m. Presentation times are as follows:
- PERACare 2014
9:30 a.m. to 10:30 a.m.
- PERACare and Medicare
11:00 a.m. to 12:30 p.m.
Want to “attend” a PERACare meeting without leaving home? PERA will be taping the open enrollment presentations. They can be viewed on the PERA Web site at www.copera.org beginning October 1.
There is plenty to do during a PERACare open enrollment meeting. In addition to attending one of the specific presentations, you may also:
- Talk with PERACare Insurance Division staff
- Talk with representatives from each PERACare insurance carrier
- Drop off your PERACare Enrollment/Change Form
- Get a free flu shot if you are an Anthem or Rocky Mountain Health Plans enrollee. The following health plan identification is required:
- Anthem pre-Medicare enrollees (under age 65) need their Anthem ID card
- Anthem Medicare Supplement enrollees need their Medicare card
- Rocky Mountain Health Plans enrollees need their RMHP ID card
- Kaiser and UnitedHealthcare enrollees may receive a flu shot for $25
- Colorado PERA mails open enrollment packets to retirees and benefit recipients currently covered by a PERACare plan. Mailings are staged throughout the month, so don’t worry if you receive your packet earlier, or later, than your PERA friends and neighbors.
- PERA posts 2014 open enrollment materials on PERA’s Web site on September 13, so you can preview plans and premiums before your packet arrives in the mail.
- Retirees and benefit recipients who are not enrolled in PERACare can order an open enrollment packet either online or by calling PERA’s Customer Service Center.
- PERA staff and PERACare carrier representatives conduct open enrollment meetings around Colorado during October. See the meeting schedule.
- Open enrollment meeting videos will be available on www.copera.org so you can view the presentations in the comfort of your own home.
- November 7 is the deadline and last possible date for retirees and benefit recipients to submit open enrollment requests to PERA.
What Plans Does PERACare Offer?
PERACare offers health care plans with prescription drug coverage, as well as dental and vision plans. Retirees and benefit recipients can choose any or all of these coverages. (You do not have to be enrolled in health care in order to enroll in a dental and/or vision plan.)
PERACare’s plans are available to all retirees and benefit recipients. Dependents can be enrolled in any plan(s) in which the retiree/benefit recipient is enrolled.
The following plans will be offered through PERACare in 2014:
Health Care Plans
Anthem Blue Cross and Blue Shield
Cigna Dental HMO* and PPO
|*||Available in certain geographic areas. Rocky Mountain Health Plans and UnitedHealthcare are available only to Medicare enrollees.|
Are Any of the Carriers Changing in 2014?
All of the carriers shown above are continuing with PERACare for another three-year cycle. There will be only one carrier change; the prescription drug benefit in the Anthem plans will be handled by Express Scripts rather than Caremark.
During the past year, Colorado PERA, working with its health care consultant, conducted a comprehensive review of all of the PERACare plan offerings. PERA went “to the market” to find the best PERACare carrier partners. PERA looked for carriers that would offer excellent service to PERA retirees, while also delivering affordable and quality plans.
What did we find? Our current PERACare carriers continue to be the best-in-class, and there will be only one carrier change for the 2014-2016 contract cycle.
Will I be able to cover my spouse under PERACare?
Yes, you can cover your spouse in any PERACare coverage in which you are enrolled. You may hear that some plans will no longer offer coverage to spouses beginning in 2014, when the new health care exchanges open for business. But PERACare will continue to allow retirees to enroll eligible spouses and dependents. (Eligibility for spouses and dependents is set in state law and cannot be removed without a change in state law.)
Thinking about using Colorado PERA’s Web site for PERACare information? Beginning in mid-September, here’s what you’ll find on www.copera.org.
- Access www.copera.org and you’ll find copies of all PERACare program booklets including plan premiums, enrollment/change forms, the meeting schedule, links to provider directories for the plans, and links to other helpful information.
- Sign in to your PERA account and you can complete and submit your enrollment/changes to PERACare coverage online. It’s easy, secure, and quick. You’ll receive an e-mail confirmation that PERA has received your request.
Once open enrollment starts on October 1, you’ll be able to find information in a number of places. You can read PERACare publications, come to a PERACare meeting, view a meeting on Colorado PERA’s Web site, view information and materials online, or call PERA’s Customer Service Center.
Read PERACare Materials
If you are already enrolled in a PERACare plan, you will receive an open enrollment packet from PERA in September. This year, PERA is introducing a simplified Open Enrollment Guide that replaces the comprehensive PERACare Health Benefits Program booklet that you have received in the past. The guide is designed to give you all of the information you need for the upcoming plan year in one place—including a list of the contact information for the carriers, the benefit changes for 2014, premiums, detailed plan information, and a PERACare Enrollment/Change Form.
As in the past, PERA will continue to publish its PERACare Health Benefits Program booklets for pre-Medicare (under age 65) and Medicare (over age 65) plans. These booklets are designed for those not currently enrolled in PERACare, but considering adding PERACare coverage. The booklets include plan descriptions and premiums, as well as general information about enrolling and choosing a plan.
View PERACare on the Web
PERACare open enrollment information is also on the Web at www.copera.org. You can view electronic versions of PERA’s printed materials, see the open enrollment meeting schedule, view the open enrollment presentations, and print copies of PERACare forms. You can also link to physician directories and other health-care related information.
If you have set up your secure retiree account access, you can also enroll or make changes online. (Get help setting up your account access.)
Attend a PERACare Meeting
For those who prefer to learn about PERACare in-person, PERA offers open enrollment meetings around the state during October. In addition to attending the general presentations about PERACare, you can talk to staff from PERA and the PERACare carriers at the open enrollment meetings.
Call PERA or the PERACare Carriers
If you have questions once you’ve reviewed the open enrollment materials, you can call PERA’s Customer Service Center and talk to PERA staff about open enrollment, plans, and premiums. For detailed questions about plan benefits, you can call the PERACare carriers. (All phone numbers, Web addresses, and contact information will be published in the PERACare Health Benefits Program booklets and Open Enrollment Guides.)
PERACare open enrollment information is still being finalized, so you won’t find it yet—it is released in September.
As a result of Colorado PERA’s competitive bid process over the past year, a new PBM has been chosen for enrollees in PERA’s plans with Anthem Blue Cross and Blue Shield. Anthem will continue to administer the medical portion of the plans. The prescription benefit which is currently administered by Caremark will be transitioned to Express Scripts. More information about the transition will be provided during open enrollment, but for now, here is a brief preview.
Express Scripts and Caremark are the two giant PBMs in the industry, and PERA has worked with both PBMs throughout the history of PERACare. During this round of bidding, Express Scripts’ pricing offer was an improvement over the other bidders’ offers, including Caremark’s. Express Scripts is committed to offering excellent service to PERACare enrollees and has served PERA well in the past. (Express Scripts was our PBM from 1994 to 2001, when we moved back to Caremark.)
Express Scripts and Caremark have extensive, nationwide pharmacy networks as well as mail order (home delivery) options. All retail pharmacies (such as Walgreens, King Soopers, Safeway, and independent local pharmacies) that are in Caremark’s network are in Express Scripts’ network. PERA is working with Caremark and Express Scripts to make the transition as easy as possible, and will provide detailed information to Anthem enrollees during open enrollment.
The Affordable Care Act (Obamacare) established health insurance exchanges —also known as “marketplaces”—in each state. Colorado’s marketplace is called Connect for Health Colorado. The marketplace is scheduled to open for business on October 1, but you can view general information now on its Web site at www.connectforhealthco.com. Each state has its own marketplace, so if you live outside of Colorado, you’ll want to follow developments on your state’s marketplace.
Through the marketplace, individuals under age 65 will be able to compare and purchase private insurance plans that meet federal and state standards. The plans in the marketplace are not likely to mirror PERACare plans or other group or individual plans, so an “apples-to-apples” comparison may be challenging and extensive. Early information indicates that over 100 different plans might be sold in the Colorado marketplace. Plans and premiums can vary based upon geographic region, age, and smoking status. (Note that within PERACare, these factors do not affect your premium.) Federal subsidies may be available to lower income individuals purchasing coverage through the marketplace. The PERACare subsidy is not transferable to the marketplace; per state law, it applies only to health care coverage purchased through Colorado PERA.
Will the health insurance exchanges include Medicare plans?
No, the exchanges are available to individuals under age 65 only. Once you are on Medicare, you already have guaranteed coverage through Medicare. The exchanges were designed to offer that same level of protection to individuals who are not yet eligible for Medicare.
Pre-Medicare (under age 65) Anthem HMO Plan
The current HMO plan offered through Anthem will be replaced by Anthem’s new, smaller network HMO plan. The new network is called the Pathway network. It includes about one-half of the doctors in Anthem’s current HMO network, and is able to capture significant pricing discounts and thus offer a lower premium. Enrollees in Anthem’s current HMO plan will be transitioned to Anthem’s PPO #1 plan effective January 1, 2014, so that they can continue to have access to a broad network of doctors. Because Anthem’s new Pathway HMO plan will offer comparable coverage with a limited network of doctors, however, we encourage all Anthem enrollees to consider the advantages of this new HMO plan. If you have a primary care doctor who is in the new Pathway network, you might be able to save considerably on monthly premiums by moving to this new plan. Details will be provided in the open enrollment materials.
Medicare (over age 65) Health Care Plans
Kaiser Permanente continues to expand its Medicare service area. For 2014, Kaiser is expanding its Northern Colorado service area to include Larimer and Weld counties. Kaiser will now be available in the Denver/Boulder metro area (defined by ZIP code), Southern Colorado (El Paso, Fremont, Pueblo, and Teller counties) and Northern Colorado (Larimer and Weld counties).
Rocky Mountain Health Plans (RMHP)
Rocky Mountain Health Plans will be adding a new benefit in 2014—a $5,000 out-of-pocket annual maximum. The out-of-pocket maximum limits the amount that an enrollee would have to pay for covered services. All of the Medicare HMO plans will now offer this additional protection from catastrophic costs to enrollees.
Prescription drug benefit changes for Anthem and RMHP Plans
In response to health care reform and new options available, Colorado PERA is changing the “behind-the-scenes” structure of how it delivers the prescription drug benefit in its Anthem and RMHP plans. PERA will now be using the Medicare Part D benefit option. The Part D option is currently being used in PERACare’s Kaiser Permanente and UnitedHealthcare Medicare plans. With the change to Part D for Anthem and RMHP in 2014, all of the PERACare Medicare plans will be Part D plans. Detailed information about this change will be included in open enrollment materials.
Need to Set Up Your Account Access on www.copera.org?
View a simple tutorial video.
To set up your secure account access, you will need to use your PERA Personal Identification Number (PIN). If you don’t have a PERA PIN (or forgot yours), just call PERA’s Customer Service Center and order a new one. Once it arrives, you can set up your account access, including a User ID and password.
It will take several business days to receive your new PERA PIN, so you may want to order a new PIN today and avoid any possible last-minute delays.
At Colorado PERA, October means PERACare open enrollment. And PERACare open enrollment means it’s time to think about your health care options and if you want to make any changes for 2014.
You’ll have plenty of time to review your options, both within PERACare and outside of PERACare. Most retirees don’t make any changes during open enrollment, so you’re in good company if you decide to keep your current plans.
Start reviewing PERACare materials when they become available in September. If you want to add PERACare coverage or make any changes to your existing coverage, you may submit your request to PERA any time during September or October.
The last day to submit open enrollment requests for 2014 is November 7, 2013.