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FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM

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FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM – GOAL IS TO PROVIDE MEDICARE ELIGIBLE RETIREES WITH HIGH–QUALITY BENEFITS.

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FBMC BENEFITS MANAGEMENT INC. – PROVIDES ADMINISTRATIVE SERVICES, ENROLLMENT, BILLING, ELIGIBILITY AND PREMIUM REMITTANCE.

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM MEDICARE OPTIONS FOR 2015 • MEDICARE SUPPLEMENT PLANS A, F AND N • MEDICARE PART D BASIC & COMPREHENSIVE • MEDICARE ADVANTAGE PLANS • United Healthcare 

Zero premium

 Comprehensive option 3 national PPO • Health First 

HMO Zero Premium

 Group Plus A HMO  Group HMO POS

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM NON MEDICARE BENEFITS OPTIONS FOR 2015 • HUMANA DENTAL • DAVIS VISION • IDENTITY THEFT- INDIVIDUAL OR FAMILY • IT TECHNICAL SUPPORT

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM ENROLLMENT PROCESS MEDICARE BENEFITS – DIRECTLY WITH MEDICARE PROVIDERS • CALL MEDICARE PROVIDER FOR A COMPLETE NEEDS ASSESSMENT • HEALTH FIRST VIA PAPER ENROLLMENT • UHC EITHER TELEPHONIC OR PAPER

NON-MEDICAL BENEFITS – PAPER ENROLLMENT FORM • SEND TO FBMC

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM AFTER YOU HAVE ENROLLED •

MEDICARE PROVIDER WILL SEND A WELCOME PACKAGE WITH ID CARDS – SEND FBMC A FILE WITH ENROLLMENT INFORMATION.

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FBMC WILL SET UP IN OUR SYSTEM –ESTABLISH PAYMENT METHOD AND SEND CONFIRMATION NOTICE.

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM PREMIUM PAYMENT OPTIONS • FRS DEDUCTION - COMPLETE AND RETURN FORM TO FBMC • ACH DEDUCTION – COMPLETE AND RETURN FORM TO FBMC • DIRECT BILL – VIA CHECK

FLORIDA SCHOOL RETIREE BENEFITS CONSORTIUM AUTO ENROLLMENT PROCESS • CURRENT 65 AND OVER RETIREES WITH CIGNA BPS COVERAGE WILL BE AUTO ENROLLED IN THE UHC MEDICARE ADVANTAGE OPTION 3 PLAN IF NO ENROLLMENT ELECTION OR NOTIFICATION OF OTHER COVERAGE IS RECEIVED BY FBMC.

• CURRENT 65 AND OVER RETIREES WITH THE BPS OFFERED DENTAL AND/OR VISION COVERAGE WILL BE AUTO ENROLLED IN THE HUMANA OR DAVIS BENEFIT AT THE SAME LEVEL IF NO ENROLLMENT ELECTION OR NOTIFICATION TO CANCEL IS RECEIVED BY FBMC.

Brevard County School Board Employer Group Medicare Advantage Prescription Drug Plans Applicable Disclaimers – Last 2 Slides

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Let’s talk about …  Plans offered in 2015  Network updates  Special programs  Why choose Health First Medicare Advantage Plans?  Who is eligible to enroll?  How do I enroll? .  Need assistance

2015 Group Medicare Advantage Plans In 2015, Health First Health Plans will offer three (3) Group Medicare Advantage plans to Brevard County School Board retirees who reside in Brevard and Indian River counties:  Rewards HMO – NEW in 2015  Group Plus A HMO  Group HMO-POS Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

2015 Plan Highlights Rewards HMO

Group Plus A HMO

Group HMO-POS

Monthly Premium

$0

$154.00

$195.00

Gym membership

$0

$0

$0

Annual Well exam

$0

$0

$0

$10/$35

$10/$20

$15/$25

Urgent Care

$45

$10

$15

Labs/x-rays

$0/$35

$0

$25

Specialty Imaging

$275

$150

$150

Emergency Room

$65

$50

$50

Inpatient Hospital

$260/ day (1-7)

$250/admit

$150/day (1-5)

PCP/SPEC

Out of Network Y0089_MPINFO4404 (10/14)

Not covered except for renal dialysis, urgent and emergency care School Board Medicare Advantage Presentation 2015

20%

2015 Plan Highlights Rewards HMO

Group Plus A HMO

Group HMOPOS

Pharmacy Benefits Tier 1: Preferred Generics

$0

$0

$0

Tier 2: Non-Preferred Generics

$10

$10

$10

Tier 3: Preferred, Brand Name

$45

$25

$45

Tier 4: Non-Preferred, Brand Name

$90

$45

$90

Tier 5: Specialty

33%

$90

33%

No Coverage

Full Coverage

Tiers 1 and 2

Coverage Gap

After your total yearly drug costs reach $2,960, you will receive limited coverage by the plan on certain drugs. You will pay no more than 45% on brand name drugs and 65% of the plan’s costs for generic drugs until your yearly out-of-pocket drug costs reach $4,700. Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Help with Drug Costs  Apply for Pharmaceutical Assistance Programs  Consider lower-cost drugs, such as generic drugs and products

over the counter

 Use pharmacies that offer discount programs Remember to talk to your doctor or pharmacist about options that are right for you and be sure to review your Part D Explanation of Benefits.

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

2015 Plan Highlights Rewards HMO

Group Plus A HMO

Group HMO-POS

Additional Benefits

Dental Services

 $40 for Medicarecovered dental benefits

 $0 for Medicarecovered dental benefits  $200 allowance  Any dentist

 $0 for Medicare-covered dental benefits  $100 allowance  Any dentist

Vision Services

$40 exam

$15 exam $125 allowance

$25 exam $250 allowance

Hearing Services

$40 exam

$15 exam $250 allowance

$25 exam $250 allowance

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Network Updates  Parrish Medical Center  North Brevard Medical Group  Expanded network effective December 2014  In-network access  Orange, Osceola, Seminole, Volusia, Flagler counties  3000 additional providers  Florida Hospital facilities and physicians Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Special Programs  Healthy Living Program – 1-800-308-5848  Lifestyle Coach  Disease Management (Asthma, diabetes, CHF, etc.)  24 Hour Nurse Advice Line – Nurse 24  Fitness Membership at no additional cost  Complex Case Management  Diabetic Eye Exam Clinics  Flu Shot Clinics  Medication Therapy Management Program Applicable disclaimers are listed in the last slide. Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Why choose Health First Medicare Advantage Plans?  Convenience – Parts A, B and D all in one plan  Low premium  Emergency & Urgent Care worldwide  Enhanced benefits i.e., Dental allowance  Some prescription drug coverage in the gap  Gym membership – SILVER SNEAKERS  Friendly, local, nationally recognized service  Group product - no additional premium invoices Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Who is eligible to enroll?  You must live in our service area 6 months of the year in:  Brevard County  Indian River County  Be eligible for Medicare Part A and enrolled in Medicare Part B  Continue to pay the Part B premium  Not have End Stage Renal Disease (ESRD)  No Underwriting

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

How do I enroll?  Already enrolled  No action needed  Change your plan  Fill out new enrollment form or plan change form  Enroll in the plan  Fill out enrollment form  Copy of Medicare card  Don’t forget to sign it!  Return form and copy of card to Health First Health Plans in the envelope provided Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Need Assistance  By phone: 1-800-716-7737 TTY 1-800-955-8771 8 am – 8 pm; 7 days a week  On the web: www.myHFHP.org  One Senior Place: 8085 Spyglass Hill Road, Suite 119 Viera, FL 32940 8:30 am to 5 pm; Monday – Friday  Walk-in:

Y0089_MPINFO4404 (10/14)

6450 U.S. Highway 1 Rockledge, FL 32955 8 am – 5 pm; Monday – Friday School Board Medicare Advantage Presentation 2015

Disclaimers Health First Health Plans is an HMO plan with a Medicare contract. Enrollment in Health First Health Plans depends on contract renewal. Other Pharmacies, Physicians, and Providers are available in our network. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. Limitations, co-payment, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. This information is available for free in other languages. Please call our customer service number at 1.800.716.7737 or TDD/TTY relay 1.800.955.8771. From October 1 - February 14, we’re available seven days a week 8 a.m. to 8 p.m. If you call after hours, you can leave a message and we'll return your call the next business day.

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

Disclaimers Salud First Health Plans es un plan HMO con un contrato de Medicare. Inscripción en salud First Health Plans depende de la renovación de contrato. Farmacias, médicos y otros proveedores están disponibles en nuestra red. La información de beneficio es un breve resumen, no una descripción completa de los beneficios. Para obtener más información, póngase en contacto con el plan. Limitaciones, copagos y restricciones pueden aplicar. Beneficios, formulario, red de farmacias, prima y/o co-copagos/coseguro pueden cambiar el 1 de enero de cada año. Debe continuar pagando su prima de Medicare parte B. Esta información está disponible de forma gratuita en otros idiomas. Por favor llame a nuestro número de servicio al cliente al 1-800-7167737 o TDD/TTY relé 1: 800. 955. 8771. Desde el 1 de octubre - 14 de febrero, estamos disponibles los siete días a la semana de 8 a 20 Si llama después de horas, usted puede dejar un mensaje y retornaremos a su llamada al siguiente día hábil.

Y0089_MPINFO4404 (10/14)

School Board Medicare Advantage Presentation 2015

2015 Florida School Retiree Benefit Consortium Dental Benefits Plan Guide 2014

Who is Humana? Humana is a Fortune 100 company focused on making sure that every decision we make helps to improve the health and well-being of our members, our associates, the communities we serve, and our planet. As a new Humana member, you’re among friends who truly care about your well-being. We appreciate the value of personal service and customer satisfaction.

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A Healthy Mouth = A Healthy You • Oral health is not just about teeth It's about the whole body • The extraordinary prevalence of periodontal disease makes its impact on systemic health very important • Cumulative healthcare costs were 21 percent higher for patients with severe periodontal disease than those with no periodontal disease • Early detection is the key to treating the disease and preventing potentially serious health conditions

26

Oral health impacts your overall health Stroke – Researchers report that older adults who have higher proportions of four periodontal-disease-causing bacteria inhabiting their mouths also tend to have thicker carotid arteries, a strong predictor of stroke and heart attack. Diabetes – Periodontal disease is the “sixth complication” of diabetes. Recent studies also confirm that periodontal (gum) disease disrupts glycemic control. Almost one out of every 10 healthcare dollars spent in the U.S. goes toward direct medical costs for diabetes. Sources: National Institute of Dental and Craniofacial Research.

Heart Disease – Studies suggest that there is potential for oral microorganisms, such as periodontopathic bacteria, and their effects to be linked with heart disease. Heart disease and stroke add $432 billion per year to the cost of healthcare. Premature births – As many as 18 percent of preterm, low birth weight babies born in the U.S. each year may be attributed to oral infections. The average medical care costs for a premature/low birth-weight baby are more than 10 times as high as a newborn without complications. 27

Dental Florida Schools Retiree Benefits Consortium (FSRBC) is pleased to offer you four choices of dental coverage during Open Enrollment Period (OEP). The plans are through Humana. Select the plan that best suits your needs: • • • •

Low High Low High

PPO Plan PPO Plan DHMO Plan (HD205) DHMO Plan (HS195)

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Dental DHMO Pre-paidd A copay-based network-only offering that requires selection of a primary care dentist. Each family member on your plan can choose their own dentist. Because services are prepaid, you have clear upfront costs. There are no yearly maximums, no deductibles, and no waiting periods.

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Dental - DHMO •

You have the freedom to select any participating general dentist as your primary care dentist. To select a dental provider from our network, simply visit HumanaDental.com. Once there, you can also check your benefits, email us and get a new or temporary ID card. If you prefer, contact us at 1-800-342-5209.

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Life without claim forms! With the HumanaDental Prepaid plan you pay your dentist directly, when applicable.

•

Your primary dentist will provide all of your routine dental care and you will pay any copayment or discounted charges at the time of service. 30

Low DHMO Plan (HD205) • • • • • • •

You choose your Primary Care Dentist No deductibles or coinsurance Unlimited annual maximum No referrals required Preventive Services available at no charge Schedule of member copays for non specialist services Specialist services (endodontic, oral surgery) at 25% discount level (not included in the co-pay arrangement)

31

High DHMO Plan (HS195) • • • • • • •

You choose your Primary Care Dentist No deductibles or Coinsurance Unlimited annual maximum No referrals required Preventive services available at no charge Schedule of member copays Specialist covered as any other provider at copay level

32

Dental Dental PPO

A coinsurance-based plan that offers higher coverage in-network than out-ofnetwork, with the best savings received from in-network providers.

When you have the Dental PPO plan, our in-network dentists provide dental services at a negotiated discounted rate. You’ll have lower out-of-pocket costs for services received from in-network dentists. 33

Low PPO Plan • • • • • • •

No referrals required In-Network providers offer benefits at a lower out of pocket cost Members can also choose to go out-of-network and choose their own provider Nationwide network Annual maximum per person on the plan: $800 Preventive Services available at no charge Prosthetics, Extractions, and Root Canals covered as Major services

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High PPO • • • • • • • •

No referrals required Members can choose to go out-of-network and choose their own provider In-Network and Out-of-Network benefits paid at same coinsurance Nationwide Network Annual maximum per person on the plan: $1,500 Preventive services available covered at 100% Preventive Services covered at 100% Prosthetics, Extractions, and Root Canals covered at 50%

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New Dental Plans Comparison HD205

HS195

Low PPO

High PPO

Deductible (In/Out of Network)

n/a

n/a

$50/$150 (In) $100/$300 (Out)

$50/$150 (In) $50/$150 (Out)

Office Visit

$5

$0

100%

100%

X-rays

$0

$0

100%

100%

Fillings

$30-$90

$0-$65

70% After Deductible

80% After Deductible

Periodontal Maintenance

$45

$40

50% After Deductible

50% After Deductible

Orthodontia 18

25% Discount

$1,850 $1,850

20% Discount

20% Discount

Implants

Not covered

Not covered

Not covered

No covered

Unlimited

Unlimited

$800

$1,500

Annual Max

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Manage your plan at MyHumana Use MyHumana to manage your plan, understand your benefits, and take charge of your dental health.

As a Humana Dental member, you can: • • • • • • •

Find network dentists Check claims history and status View coverage details Review plan benefit details Order a replacement identification card View estimates for services Exchange secure messages with Humana

Registration is simple

Have your Humana Dental identification card ready and go to Humanadental.com. Click on “Register,” then follow the instructions. 37

Lifestyle Discounts

Making it easier to take better care of yourself Available to all Dental Members (at no cost)

What is It? • • • • • • •

Cosmetic Procedures Lasik Acupuncture and Massage Weight Loss Teeth Whitening ID Theft Prescription Savings program

Advantages • • • •

Savings from 15-70% Strengthens member’s well-being and enriches their lives Allows for more choices & savings for health & wellness procedures No cost to member

Value Add 38

Thank you!

39

Florida School Retiree Benefit Consortium Effective January 1, 2015

The Survey Says…

Source: Jobson Optical’s 2012 Consumer Perception Report

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

41

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

$575 Savings with Davis Vision Average Retail Cost

With Davis Vision

Eye Examination Bifocal Spectacle Lenses (uncoated plastic)

$98 $55

$10 Copay $15 Copay

Frame (Fashion or Designer Frame from Davis Vision Collection)

$175

$0

Premium Progressives (Varilux®, etc.)

$240

$90

Tint

$20

$0

Scratch-Resistant Coating

$40

$0

Standard Anti-Reflective (AR) Coating

$62

$35

$30+

$0

$720+

$145

Service & Materials

One-Year Breakage Warranty

Total:

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

43

Find A Better You At 

In-store labs where 50% of all prescriptions are fulfilled in about an hour



Over 2,100 inventoried frames; nearly 80% covered-in-full with the $180 Plan Frame Allowance at Visionworks only



50% discount off additional pairs

Source: Consumer Reports, 2012

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

44

Florida Retired School Employee Benefit In-Network Benefits

Designer Vision Plan

Frequency – Once Every: Eye Examination inclusive of Dilation (when professionally indicated) Spectacle Lenses Frame Contact Lens Evaluation, Fitting & Follow-Up Care Contact Lenses (in lieu of eyeglasses) Copayments Eye Examination Spectacle Lenses Contact Lens Evaluation, Fitting & Follow-Up Care Eyeglass Benefit - Frame

Option I 12 Months 12 Months 24 Months 12 Months 12 Months $10 $15 /1 $0 Up to $130 OR /2 Up to $180 Allowance /3 Plus a 20% discount on any overage

Non-Collection Frame Allowance (Retail): /4

Davis Vision Frame Collection (in lieu of Allowance): Fashion level Designer level Premier level Eyeglass Benefit - Spectacle Lenses Clear plastic single-vision, lined bifocal, trifocal or lenticular lenses (any size or Rx) Tinting of Plastic Lenses Scratch-Resistant Coating /5 Polycarbonate Lenses (Children / Adults) Ultraviolet Coating Anti-Reflective (AR) Coating (Standard / Premium / Ultra) /6 Progressive Lenses (Standard / Premium / Ultra ) High-Index Lenses Polarized Lenses Plastic Photosensitive Lenses Scratch Protection Plan: Single Vision / Multifocal Lenses Contact Lens Benefit (in lieu of eyeglasses)

Included Included $25 copayment Member Charges Included Included Included $0 / $30 $12 $35 / $48 / $60 $50 / $90 / $140 $55 $75 $65 $20 / $40 Up to $130 /3 Plus a 15% discount on any overage /3 15% Discount

Non-Collection Contact Lenses: Materials Allowance - Evaluation, Fitting & Follow-Up Care – Standard & Specialty Lens Types /3 Collection Contact Lenses (in lieu of Allowance): Materials - Disposable - Planned Replacement - Evaluation, Fitting & Follow-up Care Medically Necessary Contact Lenses (with prior approval) - Materials, Evaluation, Fitting & Follow-Up Care

4 boxes/multi-packs 2 boxes/multi-packs Included Included

1/

Copayment applies to Collection Contact Lenses only.

2/ Enhanced

allowance available at all Visionworks locations nationwide.

3/ Additional

discounts not applicable at Walmart, Sam’s Club or Costco locations.

4/ Collection

is available at most participating independent provider offices. Collection is subject to change. Collection is inclusive of select torics and multifocals.

5/ Polycarbonate

lenses are covered in full for dependent children, monocular patients and patients with prescriptions +/- 6.00 diopters or greater.

6/ Category

includes digital free-form progressive

lenses.

One-year eyeglass breakage warranty included

Out-of-Network Reimbursement Schedule: up to Eye Examination: $40 Frame: $50

Single Vision Lenses: $40 Bifocal/Progressive Lenses: $60

Trifocal Lenses: $80 Lenticular Lenses: $100

Elective Contact Lenses:$105 Medically Necessary CL: $225

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

For more details about the Davis Vision plan, just log on to the Open Enrollment section of the Member site at: www.davisvision.com or Call 1.877.923.2847 and enter Client Code: 4951

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

THANK YOU

**CONFIDENTIAL & PROPRIETARY** Not for distribution outside of Davis Vision and client/broker/consultant relationship

Brevard County School Board Benefits Partnership

Who is Ocenture? •

•

Who are we? – Technology & product-build company – Incepted in 2000 (HQ: Jacksonville, FL) – Our focus: • “peace of mind”, technology based products • a better product with more features • best-of-breed product delivery quality • best-in-class technical and customer care • very attractive customer retail pricing Following this business strategy has given us the privilege to… – service 2MM product users – receive Inc. 500 recognition three of the last four years – be an A+ rated BBB accredited company – product partner with many recognizable companies, like…

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What do all these companies have in common? TJ Maxx Target Neiman-Marcus Snap Chat Twitter Stub Hub Home Depot US Chamber of Commerce Apple JP Morgan 50

What do all these companies have in common? TJ Maxx Target Neiman-Marcus Snap Chat Twitter Stub Hub Home Depot US Chamber of Commerce Apple JP Morgan They all experienced major data breaches in 2014…130MM+ profiles 51

Types of Identity Theft outside a major data breach Mail Theft Skimming Social Engineering Shoulder Surfing Pharming Phishing Vishing SMSishing Spear Phishing Malware Based Phishing 52

Types of daily Identity Theft outside a major data breach Mail Theft Skimming Social Engineering Shoulder Surfing Pharming Phishing Vishing SMSishing Spear Phishing Malware Based Phishing These attack types are finding a victim every 3 seconds in the US 53

IDENTITY THEFT PROTECTION (no longer an option)

54

Ocenture Identity Theft Protection What typically happens (in your name) in the event of ID Theft? Bank accounts are drawn against Credit card accounts are opened/used Cellular services are opened/used Tax Returns are filed (obviously requesting a refund) Non-financial related criminal acts are performed Spamming/Phishing e-mails are sent in your name Remedying an ID Theft infiltration takes an average of 150+ hours and $3,000 in legal fees…more important, a lot of unnecessary anxiety 55

Ocenture Identity Theft Protection 360-degree approach to protecting you: Protection: Advanced Identity Monitoring, Computer Protection Software Detection: Historical Reporting, Alerts, Monthly Disposition Restoration: Full-service Restoration, $1MM Insurance Policy* Coverage, 24/7 Lost Wallet Assistance

* Policy underwritten by Lloyd’s of London (AM Best A+ Rated) 56

What the School Board has negotiated for you

57

WHOLE HOME TECHNOLOGY SUPPORT

58

Ocenture Whole Home Technology Support Who helps you when… you get a virus on your computer your computer is running incredibly slow you’re having trouble downloading an app on your iPhone you can’t get your pictures to load on your Facebook page you’re having trouble DVRing a show you can’t get your Wi-fi service enabled your can’t format the memory card on your new digital camera you can’t get the stereo sound to amplify on your new flat screen you can’t open a file attachment in your email

59

?

Ocenture Whole Home Technology Support Why not have us… 24/7 phone or chat access, 365 days a year Tier II & Tier III level Technicians Three supported languages – English, Spanish, French Technicians available to come to your home, if needed Online access to our Knowledge Base developed over 12-years Free online assessment of your computer to improve performance

!

60

What the School Board has negotiated for you

61

PRODUCT or ENROLLMENT QUESTIONS?

62

2015 FLORIDA SCHOOL RETIREE BENEFIT CONSORTIUM DENTAL BENEFITS PLAN GUIDE

2014

WHO IS HUMANA? Humana is a Fortune 100 company focused on making sure that every decision we make helps to improve the health and well-being of our members, our associates, the communities we serve, and our planet. As a new Humana member, you’re among friends who truly care about your well-being. We appreciate the value of personal service and customer satisfaction.

64

A HEALTHY MOUTH = A HEALTHY YOU • Oral health is not just about teeth It's about the whole body • The extraordinary prevalence of periodontal disease makes its impact on systemic health very important • Cumulative healthcare costs were 21 percent higher for patients with severe periodontal disease than those with no periodontal disease • Early detection is the key to treating the disease and preventing potentially serious health conditions

65

ORAL HEALTH IMPACTS YOUR OVERALL HEALTH Stroke – Researchers report that older adults who have higher proportions of four periodontal-disease-causing bacteria inhabiting their mouths also tend to have thicker carotid arteries, a strong predictor of stroke and heart attack. Diabetes – Periodontal disease is the “sixth complication” of diabetes. Recent studies also confirm that periodontal (gum) disease disrupts glycemic control. Almost one out of every 10 healthcare dollars spent in the U.S. goes toward direct medical costs for diabetes. Sources: National Institute of Dental and Craniofacial Research.

Heart Disease – Studies suggest that there is potential for oral microorganisms, such as periodontopathic bacteria, and their effects to be linked with heart disease. Heart disease and stroke add $432 billion per year to the cost of healthcare. Premature births – As many as 18 percent of preterm, low birth weight babies born in the U.S. each year may be attributed to oral infections. The average medical care costs for a premature/low birth-weight baby are more than 10 times as high as a newborn without complications. 66

Dental Florida Schools Retiree Benefits Consortium (FSRBC) is pleased to offer you four choices of dental coverage during Open Enrollment Period (OEP). The plans are through Humana. Select the plan that best suits your needs: • • • •

Low High Low High

PPO Plan PPO Plan DHMO Plan (HD205) DHMO Plan (HS195)

67

DENTAL DHMO Pre-paidd A copay-based network-only offering that requires selection of a primary care dentist. Each family member on your plan can choose their own dentist. Because services are prepaid, you have clear upfront costs. There are no yearly maximums, no deductibles, and no waiting periods. 68

DENTAL - DHMO •

You have the freedom to select any participating general dentist as your primary care dentist. To select a dental provider from our network, simply visit HumanaDental.com. Once there, you can also check your benefits, email us and get a new or temporary ID card. If you prefer, contact us at 1-800-342-5209.

•

Life without claim forms! With the HumanaDental Prepaid plan you pay your dentist directly, when applicable.

•

Your primary dentist will provide all of your routine dental care and you will pay any copayment or discounted charges at the time of service. 69

LOW DHMO PLAN (HD205) • • • • • • •

You choose your Primary Care Dentist No deductibles or coinsurance Unlimited annual maximum No referrals required Preventive Services available at no charge Schedule of member copays for non specialist services Specialist services (endodontic, oral surgery) at 25% discount level (not included in the co-pay arrangement)

70

HIGH DHMO PLAN (HS195) • • • • • • •

You choose your Primary Care Dentist No deductibles or Coinsurance Unlimited annual maximum No referrals required Preventive services available at no charge Schedule of member copays Specialist covered as any other provider at copay level

71

DENTAL Dental PPO

A coinsurance-based plan that offers higher coverage in-network than out-of-network, with the best savings received from innetwork providers.

When you have the Dental PPO plan, our in-network dentists provide dental services at a negotiated discounted rate. You’ll have lower out-of-pocket costs for services received from in-network dentists. 72

LOW PPO PLAN • • • • • • •

No referrals required In-Network providers offer benefits at a lower out of pocket cost Members can also choose to go out-of-network and choose their own provider Nationwide network Annual maximum per person on the plan: $800 Preventive Services available at no charge Prosthetics, Extractions, and Root Canals covered as Major services

73

HIGH PPO • • • • • • • •

No referrals required Members can choose to go out-of-network and choose their own provider In-Network and Out-of-Network benefits paid at same coinsurance Nationwide Network Annual maximum per person on the plan: $1,500 Preventive services available covered at 100% Preventive Services covered at 100% Prosthetics, Extractions, and Root Canals covered at 50% 74

NEW DENTAL PLANS COMPARISON HS205

HS195

Low PPO

High PPO $50/$150 (In) $50/$150 (Out)

Deductible (In/Out of Network)

n/a

n/a

$50/$150 (In) $100/$300 (Out)

Office Visit

$5

$0

100%

100%

X-rays

$0

$0

100%

100%

Fillings

$30-$90

$0-$65

70% After Deductible

80% After Deductible

Periodontal Maintenance

$45

$40

50% After Deductible

50% After Deductible

Orthodontia 18

$1,900 $1,900

$1,850 $1,850

20% Discount

20% Discount

Unlimited Not covered

Unlimited Not covered

Not$800 covered

$1,500 No covered

Annual Max Implants

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MANAGE YOUR PLAN AT MYHUMANA Use MyHumana to manage your plan, understand your benefits, and take charge of your dental health.

As a Humana Dental member, you can: • • • • • • •

Find network dentists Check claims history and status View coverage details Review plan benefit details Order a replacement identification card View estimates for services Exchange secure messages with Humana

Registration is simple

Have your Humana Dental identification card ready and go to Humanadental.com. Click on “Register,” then follow the instructions.

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LIFESTYLE DISCOUNTS

MAKING IT EASIER TO TAKE BETTER CARE OF YOURSELF Available to all Dental Members (at no cost)

What is It? • • • • • • •

Cosmetic Procedures Lasik Acupuncture and Massage Weight Loss Teeth Whitening ID Theft Prescription Savings program

Advantages • • • •

Savings from 15-70% Strengthens member’s well-being and enriches their lives Allows for more choices & savings for health & wellness procedures No cost to member

Value Add 77

THANK YOU!

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Brevard County Public Schools- Retiree Open Enrollment Meeting Oct/Nov 2014

Florida School Retiree Benefits Consortium Y0066_140723_131007 Approved

CHOICE starts here.

Why We’re Here • Effective 01/01/2015, Brevard County Schools will be offering additional health care plan choices to retirees who are eligible for Medicare and age 65 and older • You and your eligible post-65 spouse may each enroll in individual health plan(s) that are a good fit for your needs • Open Enrollment Period ends 11/21/2014

OPEN ENROLLMENT MEETING

Medicare Supplement Insurance Plans

Medicare Prescription Plans (Part D)

STEP 1: LEARN ABOUT YOUR OPTIONS

UnitedHealthcare Prescription Drug Plans (Part D) Costs All Medicare Part D plans are set up in drug payment stages. Each stage tells you the amount you pay and the amount your plan pays for covered medications.

Initial Coverage

You pay co-pay or co-insurance for each covered drug, depending on plan.

Coverage Gap

You pay 45% of brand name drug prices and no more than 65% generic drug prices.

Catastrophic Coverage

Your plan will pay most of the cost for your drugs

Total Drug Costs: The amount you pay (or others pay on your behalf) and the plan pays for prescription drugs. This does not include premiums. Out-of-Pocket Costs: The amount you pay (or others pay on your behalf) for prescription drugs This does not include premiums

OPEN ENROLLMENT MEETING

STEP 1: LEARN ABOUT YOUR OPTIONS

Two Plans That May Fit Your Needs

Comprehensive ($84.18)

Premium ($155.31)

Tier 1 Copay

$2-$10

$2-$7

Tier 2 Copay

$45

$30

Tier 3 Copay

$75

$60

Tier 4 Copay

33%

$75

Gap Coverage

Tier 1 $2-$10 Tier 2-4 45%

Full coverage

Mail Order 90 day supply

2x copay

2x copay OPEN ENROLLMENT MEETING

Medicare Advantage Plans (Part C)

STEP 1: LEARN ABOUT YOUR OPTIONS

Medicare Advantage Plans (Part C) Coverage Medicare Advantage plans combine coverage for hospital stays with coverage for doctor visits, outpatient care, preventive care and often extra benefits like vision, dental, wellness and hearing exams. Many plans include Part D prescription drug coverage, too. Certain Medicare Advantage plans allow you to add a standalone prescription drug plan.

+

+

+

Medicare Part A

Medicare Part B

Medicare Part D

Additional Benefits

Hospital

Doctor and outpatient

Prescription drug coverage is included in some plans

Vision, hearing, dental and wellness programs are often included

OPEN ENROLLMENT MEETING

CHOICE starts here.

Your doctors (PPO) • Large network of doctors, specialists and hospitals. • There’s a chance your doctor is already part of our network. To find out, consult our online Provider Directory at www.UHCRetiree.com. • If your doctor is in the network, he or she must accept this plan if you are a current patient. If your doctor is not in our network, he or she may choose not to treat you unless it is an emergency. • If you need help finding a doctor, we're here to help. Just call us.

OPEN ENROLLMENT MEETING

CHOICE starts here.

Group Medicare Advantage Plans MAPD NPPO (UHC Plan 3)

MAPD PPO Plus Zero Premium

Network

Non-Network

Network

Out-of Network

0 $2,500

0 $2,500

$0 $4,500

$0 $10,000

$5 $15 $35 $65 $15

$5 $15 $35 $65 $15

$10 $40 $35 $65 20%

$35 $60 $35 $65 40%

$175 per admit

$175 per admit

$275 copay per days 1-6, $0 copay days 7 and beyond

40%

Physical/Speech Therapy Chiropractic (Medicare Covered) Annual wellness exam (Medicare Covered)

$20

$20

10%

40%

$15

$15

Not Covered

Not Covered

$0

$0

$0

40%

Routine Immunizations

$0

$0

$0

$0

20%

20%

20%

40%

$500

$500

$500

$500

Deductible Out of Pocket Max Primary Care Physician (PCP) Specialist Urgent Care Emergency Services Outpatient Surgery

Inpatient Hosptial Stay

Durable Medical Equipment Hearing aid allowance every 36 months

OPEN ENROLLMENT MEETING

CHOICE starts here.

Group Medicare Advantage Plans

MAPD NPPO (UHC Plan 3)

MAPD PPO Plus Zero Premium

Tier 1

$5

$7

Tier 2

$30

$40

Tier 3

$60

$90

Tier 4 Mail Order 90 day supply

$80 Tier 1 $0 Tier 2 $60 Tier 3 $120 Tier 4 $180

$90 Tier 1 $14 Tier 2 $80 Tier 3 $180 Tier 4 $180

Gap Coverage

Full Coverage

45% Brand/65% Generic

OPEN ENROLLMENT MEETING

CHOICE starts here.

Fitness program Stay physically fit and active at no additional cost. Join SilverSneakers and enjoy: • Staying active with SilverSneakers® Fitness Program. Choose a fitness center from more than 11,000 participating locations. [(Find the nearest location at www.silversneakers.com).

• Classes, cardio equipment, resistance machines, free weights and heated pools (at certain locations). Amenities may vary at each location. • Many women-only locations, including Curves®, nationwide.

Don’t live near a fitness center? SilverSneakers Steps is a personalized fitness program for members who can't get to a SilverSneakers location. Once you enroll in Steps, you may select one of the four kits that best fits your lifestyle and fitness level-general fitness, strength, walking or yoga. The Steps wellness tools can help you be active at home or on the go.

OPEN ENROLLMENT MEETING

CHOICE starts here.

NurseLineSM You’re never alone. Whether you have questions about a medication or have a health concern in the middle of the night, with NurseLine a nurse answers your call 24 hours a day.

Services include: • Help choosing a new doctor • Tips on how to help control diabetes, blood pressure or high cholesterol • Reviewing your medications and looking for generic options • Connecting you with community resources for exercise • Easy ways you can add fruits and vegetable to your diet • Tips to help you quit smoking

OPEN ENROLLMENT MEETING

CHOICE starts here.

Hearing program Hearing aids starting at $599 each, depending on the model you choose. Hearing loss is the third most common chronic health condition among older Americans, and 40% of people age 65 or older are hearing impaired1

Services include: • Custom programmed hearing aids can address your personal hearing needs • Batteries and ear tubes/wax guards, provided at no additional cost, that last most users six months • 70-day no-risk trial period • One-year manufacturer’s warranty • The convenience of delivery right to your home 1 “Epidemiology

of Hearing Loss Study” by the University of Wisconsin School of Medicine and Public Health

The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the UnitedHealthcare grievance process. OPEN ENROLLMENT MEETING

Questions? We’re here to help. Dedicated Customer Service representatives are trained to identify

your specific needs and match them to Florida School Retiree Benefit Consortium’s UnitedHealthcare’s portfolio of health plan options. Before you call: •

Have your Medicare ID card on hand and list of prescription drugs

•

Think about how much you want to spend on your new plan(s) Would your rather pay a lower premium and copay for services as you use them. Or pay a higher premium and have little to no cost of services

•

Have your doctors’ names and addresses ready. Would you change doctors of provider if it meant you could save Healthcare costs?

•

Do you travel out of state? Out of county?

OPEN ENROLLMENT MEETING

Questions?

Call us on the dedicated Florida School

Retiree Benefit Consortium toll-free number:

1-877-776-1466, TTY 711 8 a.m. – 8 p.m. local time, 7 days a week OPEN ENROLLMENT MEETING

Disclaimers The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. UnitedHealthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers. You do not need to be an AARP member to enroll. AARP encourages you to consider your needs when selecting products and does not make specific product recommendations for individuals. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. You must continue to pay your Medicare Part B premium.

OPEN ENROLLMENT MEETING

Disclaimers You are not required to use OptumRx to obtain a 90-day supply of your maintenance medications, but you may pay more out-of-pocket compared to using OptumRx, your plan’s Preferred Mail Service Pharmacy. Prescription orders sent directly to OptumRx from your doctor must have your approval before OptumRx can send your medications. This includes new prescriptions and prescription refills. OptumRx will contact you, by phone, to get your approval. At that time you may also tell OptumRx to automatically fill any future prescriptions they receive directly from your doctor(s) for up to one year. If OptumRx is unable to reach you for approval your prescription will not be sent to you. Refunds may be available for prescriptions you did not approve and did not want. You may request a refund or cancel your approval by calling OptumRx at 1-800-791-7658, (TTY 711), 8 a.m .– 8 p.m. CT, Monday – Friday. New prescriptions should arrive within ten business days from the date the completed order is received by the Mail Service Pharmacy. Completed refill orders should arrive in about seven business days. OptumRx will contact you if there will be an extended delay in the delivery of your medications. OptumRx is an affiliate of UnitedHealthcare Insurance Company. Drugs and prices may vary between pharmacies and are subject to change during the plan year. Prices are based on quantity filled at the pharmacy. Quantities may be limited by pharmacy based on their dispensing policy or by the plan based on Quantity Limit requirements; if prescription is in excess of a limit, copay amounts may be higher.

SPRJ19000 OPEN ENROLLMENT MEETING

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change each plan/benefit year. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party. Plans are insured or covered by UnitedHealthcare Insurance Company or one of its affiliates, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. United Pharmacy Saver Drugs and prices may vary between pharmacies and are subject to change during the plan year. Prices are based on quantity filled at the pharmacy. Quantities may be limited by pharmacy based on their dispensing policy or by the plan based on Quantity Limit requirements; if prescription is in excess of a limit, co-pay amounts may be higher. Other pharmacies are available in our network. Members may use any pharmacy in the network, but may not receive Pharmacy Saver pricing. Pharmacies participating in the Pharmacy Saver program may not be available in all areas. SilverSneakers SilverSneakers® is a registered mark of Healthways, Inc. Consult a health care professional before beginning any exercise program. Availability of the SilverSneakers program varies by plan/market. Refer to your Evidence of Coverage for more details. NurseLine This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, co-payments and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change each plan/benefit year. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or by another third party. Plans are insured or covered by UnitedHealthcare Insurance Company or one of its affiliates, a Medicare Advantage organization with a Medicare contract and a Medicare-approved Part D sponsor. Enrollment in the plan depends on the plan’s contract renewal with Medicare. United Pharmacy Saver Drugs and prices may vary between pharmacies and are subject to change during the plan year. Prices are based on quantity filled at the pharmacy. Quantities may be limited by pharmacy based on their dispensing policy or by the plan based on Quantity Limit requirements; if prescription is in excess of a limit, co-pay amounts may be higher. Other pharmacies are available in our network. Members may use any pharmacy in the network, but may not receive Pharmacy Saver pricing. Pharmacies participating in the Pharmacy Saver program may not be available in all areas. Mail Order Pharmacy You are not required to use OptumRx to obtain a 90-day supply of your maintenance medications, but you may pay more out-of-pocket compared to using OptumRx, your plan’s Preferred Mail Service Pharmacy. Prescription orders sent directly to OptumRx from your doctor must have your approval before OptumRx can send your medications. This includes new prescriptions and prescription refills. OptumRx will contact you, by phone, to get your approval. At that time you may also tell OptumRx to automatically fill any future prescriptions they receive directly from your doctor(s) for up to one year. If OptumRx is unable to reach you for approval your prescription will not be sent to you. Refunds may be available for prescriptions you did not approve and did not want. You may request a refund or cancel your approval by calling OptumRx. New prescriptions should arrive within ten business days from the date the completed order is received by the Mail Service Pharmacy. Completed refill orders should arrive in about seven business days. OptumRx will contact you if there will be an extended delay in the delivery of your medications. NurseLine This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.