Any of you know me?
Ingrid Timmer and, a senior account manager.
I, I'm dedicated to the university
of Vermont and Veba
and I attend to any issues.
Benefit issues for UVM
faculty, staff and retirees.
very excited to have,
the retirees coming back to Vermont to advantage.
And, next slide please.
Caitlin.
And today
we are going to go over,
Vermont to advantage and do an introduction.
We will do a basics of Medicare and eligibility.
We will look at your UVM
customized benefits.
The enrollment process,
additional benefits that you have with this plan.
Frequently asked questions and resources.
I know we're going to have a lot of questions, so let's us Caitlin said.
Let's keep the questions to to the end.
I'll go through these slides as quickly as I can,
and then we will address all your questions.
Okay. Thank you.
And as I said
before, welcome back to Vermont Blue Advantage.
we're very excited to have the UVM
retirees coming back for 2025.
for those of you who had coverage with us,
you are familiar with the access to the National Blue Network,
which is a very comprehensive network
throughout the United States and international.
Also.
we are delighted
that, we are presenting to you customized benefits,
enhanced benefits from when you were with us.
that I think you are going to enjoy.
Next slide please.
Let's look
at the Medicare basics and eligibility.
So Medicare as we all know
is a federal health insurance program, which is administered
by the Centers of Medicare and Medicaid.
In order for you to qualify for Medicare.
You need to be aged 65
and older and eligible to receive Social Security.
There are other, instances
for people that are under 65 that they're
either permanently disabled and have receive Social Security
disability benefits or people with,
certain conditions that qualify for Medicare coverage.
Medicare has four parts
part A, which is the hospital coverage,
part B, which is the physician coverage,
and Hardy, which is the drug coverage.
Part C is the Medicare advantage.
So it involves part A, B, D to form part C, which is the benefit
the plan, platform
that you are enrolled in.
Next slide please.
In order
to enroll in UVM Medicare Advantage plan,
we need to follow certain CMS eligibility requirements.
You need to reside in the United States,
be enrolled in Medicare Part A and B.
You need to continue to pay your premium
for part B as you're doing today.
And you can only be enrolled
in one Medicare Advantage plan at a time.
So you cannot have UVM Medicare
Advantage plan and your spouse's Medicare Advantage plan.
Or you cannot have this Medicare Advantage plan.
And the Medicare Advantage plan that you saw an ad on television.
Okay.
Next slide please.
Okay.
Let's look at UVM benefits.
Just remember that UVM benefits
are specifically for UVM retirees.
They do include some nice enhancements such as hearing and vision.
And we will go over those in a little bit.
And you have one plan with one insurance card
for both your medical and your pharmacy.
something that you need to be aware of,
that this is the time of year where Medicare Advantage plans.
This is the annual enrollment period where Medicare Advantage
plans are promoted on television.
And, don't confuse this advertising
with your new UVM BBA plan.
This is UVM is the only one who can provide this plan to you.
Okay.
And it's not, available in the individual market.
Next slide please.
Okay, let's look at the benefits.
Now. Okay.
I Ingrid, this is leave Townsend speaking.
I just want to speak to some things that I'm seeing.
Come up in the chat about people not being able to see the slides.
I think the majority of people can see the slides,
but you may have to change the view
on your personal, computers
when you log into the teams meeting link.
we are sharing the slides.
And so I just wanted to let the group know.
as Caitlin mentioned, she can see the slides.
and I have confirmed with a few other people.
So for those individuals that are having a hard time,
you might want to switch to a different view.
Perhaps you have Ingrid's image blown up.
and you may have to click into the slides button to make them bigger.
Hopefully that can provide a bit of guidance.
Sorry for the interruption. Thank you.
Hey. Sounds good.
All right.
so these are the benefits, and this is a very high level overview.
You will have access to benefit designed in detail
when we have the enrollment kit ready, which,
we are expecting to have it in the next couple days.
And UVM
is going to,
UVM is going to,
load those slides until the,
their HR portal.
So, Caitlin, I'm seeing right now.
Yes. Joyce, I think, accidentally
you are sharing your screen.
Leave if you can reshare.
I think it will.
Steal it back. There you go.
There we go.
okay.
So, as I was saying, these are very high level
benefit, breakdowns.
And UVM will upload the enrollment
kits on the H.R,
website for retirees.
And you will have detailed descriptions of the benefits.
We are also mailing,
an enrollment kit that you will receive with.
again, very detailed information.
And also you will receive an ID card.
So this is just a high level overview.
You're going to have effective one 125.
You are going to have an overall deductible of $1,000.
It resets every year in January.
The medical out-of-pocket maximum is $2,000.
Preventive care is covered at zero copay,
and there are over 30
screenings that are covered under this preventive care.
So your annual visit with your provider for your well check.
also any screenings that you do such as mammograms
PSA, call and ask ups,
they're all covered at 100%.
So zero copay
your primary care visit.
So any routine care with your primary care provider
there's a $25 office visit copay.
And just remember every
every dollar that goes towards to your deductible.
And then every dollar that you pay in copay,
they accumulate towards that $2,000 out of pocket max.
So if, for example,
you end up, going to the hospital,
and the bill, you know, you're in the hospital for three days,
the bill is $17,000.
You are going to pay the $1,000 deductible.
And then, and that's all you pay for that,
for that or that hospital stay.
And then the plan will pay for the rest.
So that plan will pay for $16,000,
your, specialist copay.
So that would be psychiatry, urgent care.
Carol Proctor, that has a $30 copay.
Next screen.
Emergency room is a $100 copay,
inpatient and outpatient care in a hospital.
The deductible applies the same for home
health, rehabilitation, and skilled
nursing facility,
medical equipment and supplies,
and part B drugs, both deductible.
And then the 20% coinsurance applies.
Once you meet that $2,000 out-of-pocket maximum,
then things will be covered at 100% with no member costs.
Share.
And regardless
of whether you have met your deductible and your out-of-pocket maximum or not,
any diabetic equipment and supply
has a $0 copay.
Okay.
And, additional benefits that you have are silver sneakers,
which is the, free fitness center membership.
And you can go to silver sneakers that.
Com and then you enter your zip code or the city of state that you live in,
and you can find those facilities so you can access,
classes.
You can access facilities with equipment that are part of the silver sneakers.
network.
You also have access to vision
through our partner VSP.
There's a $0 copay for that vision exam.
And then you have a $250 allowance
for vision materials.
Hearing exams.
we are offering them through our partner nations hearing
again, $0 copay for hearing exams.
And the
hearing aid benefit is $3,000
every 24 months.
And we also have our partner Optum X
who will be managing
the prescription drug program.
And this has a $150 deductible
and then co-pays of $5 for generic,
25 for preferred brand
and $40 for Non-Preferred brand.
We will, talk about prescription
drugs in the next slide in more detail.
So prescription drugs,
most of the pharmacies are part of the network.
For example, Walgreens owns CBS,
Hannaford's Costco.
They're all part of the pharmacy benefit
manager network.
the pharmacy benefit manager,
again, is Optum, our X,
and you have a $150 pharmacy deductible,
and your out-of-pocket maximum is 750.
So once you meet the deductible every year,
then you pay the co-pays based on that prescription that you get,
whether it's generic preferred brand or not preferred brand.
And once you meet
the $750 out-of-pocket maximum,
then there is, a $0 copay.
And at any point in time
when you're getting, insulin, insulin products,
you only pay $35
for a one month supply for each covered
insulin product.
Next slide.
So I mentioned
most of the pharmacies are in the network.
And what we are currently doing is that we are working
with your current pharmacy benefit manager, Express Scripts,
to transfer prior approval authorizations
for non narcotic medications.
You don't have to do anything for that.
And you also
if there's a prescription that is not part of our formulary
and you need to change prescriptions,
you also have a 90 day
transition film.
So meaning that you
once we start January of 2025,
you still have 90 days to change a medication.
If your medication is not in the formulary,
what you will receive from us
is a letter letting you know if there's any type
of formulary disruption.
So if we see that
a member is taking a medication
that with a prescription and
name brand, that is not part of our formulary,
and there are other prescription drugs
under that same category of drugs,
then we will send you a letter saying there's a disruption.
You need to change your medications if you want them covered by insurance,
and you need to work with your provider to change
to, medication that your provider
and you select.
And if you are using mail order through Express Scripts,
we're also working with Express Scripts to transfer those prescriptions,
to, to Optum
so that, you can have those under your account.
You will need to set your account because we can't
transfer your credit card information.
So you will need to set them up.
But we've already
moving any prescription that
is non narcotic on the 90 day,
mail order plan that you have
with Express Scripts.
Next slide.
Thank you.
To stay reminder that you will have
absolutely great access to the National Blue
Cross Blue shield network of providers.
And you have a lot of flexibility because you are going to be able
to see both providers that are part of the Vermont Blue Advantage Network,
the Blue Network, and also providers that participate with Medicare.
As long as the provider participate with Medicare,
then they those claims, those providers can bill us
and we can process those claims.
If you see a provider that it's out of network,
the only time that those providers will see you,
either out-of-network or providers that are not contracted,
the only time that those providers will see you
is if it's an emergency, so urgent or emergency situations,
you just get yourself to the nearest hospital, nearest provider
and they, they will see you and those claims will be processed.
And the next slide,
we have some frequently asked questions and some resources.
so you will receive an enrollment kit
that UVM will have available
for you in the next few days.
It's being finalized before
it gets loaded into the UVM
H.R retiree website,
and you will have, also a welcome kit
that you will receive in the mail that comes from Vermont Blue Advantage.
You will have a member benefit chart and other
CMS required materials.
In addition to that, you will have your new ID card,
which you need to use at the pharmacy
and going to your doctor's to the hospital.
Effective January 1st, 2025.
When you receive your new card,
just know that on the back of the ID card, you're going to have important
phone numbers for you to call.
Customer service.
And, the customer service that you're calling
is our highly trained customer service in Michigan.
That is CMS compliant,
and their operations are focused on
working with the senior market.
And additional tools for you?
we have an, a phone number
for you to call if you have any questions between
November 1st and November 30th.
And this is a transition call
center, where you can, talk about questions
that you might have with the benefits when you review your enrollment kit.
And you can call them anytime from 8 a.m.
to 5 p.m., Monday through Friday.
And then starting December 1st,
you can call
our Medicare Advantage service specialists.
And we are there to serve you
from eight in the morning until 8 p.m..
And, we are there to help you with any questions
that you have on your benefit.
There's a third number, and that is specifically for prescription
drug questions.
I, I highly,
highly recommend that, if you have any questions
between November 1st and November 30th to go ahead and call that first number
and any questions after that, call
that second number that's on the screen.
And we also have that number for specific
prescription drug questions.
We also have a website Vermont Blue advantage.com.
And we are also going to have a specific website
for Vermont Blue Advantage
UVM members with all of your member benefits information
in terms of premiums.
That's something that you need to ask UVM.
And And I think that was the last slide
before we open it up for
questions and answers.