Open Enrollment - Retirees

• Benefits Bash, Wednesday, November 6: During this event, the Benefits Team and providers will be available for questions in a fun and festive environment. Providers will have materials and giveaways, and there will be prizes for attendees. Events will take place from 9 a.m. to 3 p.m. in University Center East (UC) 2217-2219. A full schedule can be found online.   

    

  Help Sessions: If assistance is needed, a member of the Benefits Team will be available to help you. Below are the dates the Benefits Team will be available. You may schedule a virtual or in-person meeting by calling 812-461-5466 or by emailing benefits@usi.edu.  

  • Wednesday, November 6: 9 a.m. - 3 p.m. – UC East Rooms 2217-2219 
  • Friday, November 15: 9 a.m. - 3 p.m. – WA166 HR Conference Room 

    

  Presentations: United Healthcare and Amwins will host presentations to provide education about the Medicare Advantage plans. One will be in person during our Benefits Bash November 6 in UC East 2220, and the other will be online November 11. You can find a full schedule for the workshops you want to attend by visiting the Retiree Benefits - Open Enrollment website.  

  • Virtual: 10/30/2024 at 2 p.m.  – 2025 Open Enrollment Presentation and Q & A 
  • In-person: 11/6/2024 at 9 a.m. – USI Medicare Advantage Plans
  • Virtual: 11/11/2024 at 2 p.m.  – USI Medicare Advantage Plans

    

  Flu Shots: The USI Nursing Program, in partnership with the USI Deaconess Clinic, will provide flu shots. The flu shots will be available from 9 a.m. to 3 p.m. Wednesday, November 6 in UC East, 2217-2219 (Bring a copy of your insurance card).  

Due to high plan utilization in 2024 and a projected rise in healthcare costs in 2025, premiums are increasing for the 2025 plan year. The rise in cost is driven by inflation, higher medical service costs, increased utilization among the aging population, and a backlog of postponed care from the COVID-19 pandemic. Additionally, the Inflation Reduction Act of 2022 requires Medicare Part D plans to change out-of-pocket maximums to $2,000 annually. As a result, the United Healthcare Core Medicare Advantage Plan out-of-pocket maximum for prescriptions will decrease by $250 from $2,250 to $2,000 and the United Healthcare Buy-up Medicare Advantage Plan out-of-pocket maximum for prescriptions will increase to $2,000.   Although the Buy-up plan has an increase in the amount of out-of-pocket for prescriptions, CMS has changed their methodology as to how the out-of-pocket maximum is reached.  The calculation of the out-of-pocket maximum may now be reached faster because the cost of the medication is counted towards the out-of-pocket maximum.

In the example below the member paid $240 for the year, but the out-of-pocket max was reached because of the new methodology.

For Example:

*Example only prices will vary

Despite the increase, premiums are still significantly lower than before we transitioned to the United Healthcare Medicare Advantage program in 2021. 

New rates are listed in the attached 2025 Retiree Rates document.    

•  Non-Medicare eligible retirees can now change plans and do not have to correspond with Medicare eligible partners/dependents.
• Medicare eligible retirees can change plans and do not have to correspond with partners/dependents.
• Pre-65 UMR Core PPO Plan: Deductibles, co-pays, coinsurance, and maximum out–of-pocket maximums for Core PPO plan remain unchanged. 
• Pre-65 Surest PPO Plan: Each year, Surest evaluates providers and adjusts co-pays based on their performance.
  • To find the co-pays for 2025, members can visit the member website or app.
  • If eligible, but not a member yet, please visit the pre-member website at surest.com/Indiana/access-login for more information. 
• United Healthcare Core Medicare Advantage Plan: Deductibles, co-pays, coinsurance, and maximum out–of-pocket maximums for the plan will decrease to $2,000.
• United Healthcare Buy-up Medicare Advantage Plan: Deductibles, co-pays, coinsurance, and maximum out–of-pocket maximums for the plan with increase to $2,000.
• Pre-65 CVS Caremark Prescription Plan: The prescription plan will still be managed by CVS Caremark, but there will be a new plan number and a 30% copay for specialty brand medications. This change enables the University to introduce a Specialty Co-pay Assistance Program, which allows members to obtain co-pay assistance directly from the drug manufacturer. In most cases, this means members will pay less than their previous copay, and at a minimum, their costs will remain the same.
• WellBridge Surgical: If the time comes and a member needs surgery, WellBridge Surgical is available to Pre-65 UMR Core and Surest members at no member cost. Learn More about Wellbridge Surgical in the Benefit Enrollment Guide on the Retiree Benefits - Open Enrollment website.
• Dental: There are no premium increases or plan design changes to the Dental plan. Paramount Dental will continue to be the provider.

• Inform the Benefits Team of any changes you wish to make
• If you do not need to make changes, no action is needed
• Complete the Amwins election form and mail using return envelope or fax to 888-883-0774
• Remember to update Amwins with any billing changes
• Remember to update beneficiaries at TIAA and with USI    

Amwins is the company that handles eligibility and billing for the university retiree plans. Once an eligible employee reaches retirement, they will set up payment with Amwins. 

Please update the Direct Payment Authorization Form and send to Amwins. 

United Healthcare is the company that provides the University's retirement health plans. The University offers a Medicare Advantage plan to eligible retirees. 

The United Healthcare Medicare Advantage Plan, like other advantage plans, requires retirees to enroll in and pay for Medicare plans A and B. The UHC Medicare Advantage plan enhances and bundles the plans together so that providers only need to bill one insurance plan. Learn more about the Medicare Advantage Plans at medicare.gov and in.gov/ship/.

No, the retiree must be enrolled in health and/or dental coverage for the spouse to have coverage.

The Medicare Advantage plans are single plans, and beginning in 2025, retirees spouse's plan can be different than the retirees plan.

But retiree must still maintain coverage for spouse to be covered. 

If a retiree passes away, the surviving spouse may continue coverage as long as premiums are paid. Surviving dependents may continue until age 26. 

As your 65th birthday approaches, you will receive a enrollment packet from Amwins. Once you receive it, you will need to elect the plan you want. You will also need to make sure you enroll in Medicare A and B in order to enroll in the University's Medicare Advantage plan.  

If an eligible employee is not yet eligible for Medicare then they will remain on the UMR or Surest Health Plan until they are eligible. Once they are eligible they will automatically switch to the Medicare Advantage Plan.  

The HouseCalls program is not required and does not take the place of your primary doctor. Think of a HouseCalls visit as an extra layer of care. It gives
you valuable one-on-one time you don’t always get in the
doctor’s office. Plus, we share details about your visit with
your regular doctor. 

Prescriptions costs can be high, but there are ways to save. Retirees can contact United Healthcare to ensure they are using the Preferred Pharmacy Network and consider using the Home Delivery 90 day supply for maintenance drugs. In addition retirees can check on the best places to get prescriptions by visiting the following price comparison websites. 

GoodRx - Compare prices and get coupons for prescriptions. Good Rx coupons can be used instead of insurance. The pharmacy can tell you which is the better deal. Click on the link for more information.

BlinkHealth -  Compare prices and get coupons for prescriptions. Blink Health coupons can be used instead of insurance. The pharmacy can tell you which is the better deal. Click on the link for more information.

Extra Help - Medicare beneficiaries can qualify for Extra Help paying for their monthly premiums, annual deductibles, and co-payments related to Medicare Part D (prescription drug coverage). You can apply online or call 800-772-1213. 

Paramount Dental (formerly HRI) is the current dental provider for the University. 

Vision is not offered as a retirement benefit but can be extended by 18 months through COBRA once you retire.  

Once retiree's are eligible for Medicare, they must enroll in Part A and B Medicare. Retirees can make an appointment and go in person the the SSA office (make appointment 30 days in advance) or they can enroll online. The video below is a helpful resource to the online enrollment option. 

How to enroll in Medicare:

https://www.youtube.com/watch?v=9s8B1jvDI68

Medicare Advantage (also known as “Part C”) is a type of Medicare health plan offered by a private company that contracts with Medicare. The University partnered with United Healthcare to provide a Medicare Advantage plan to eligible USI retirees.

Original Medicare covers inpatient hospital and skilled nursing services – Part A - and doctor visits, outpatient services and some preventative care – Part B. 

Medicare Advantage plans bundle the original Medicare plans and provide coverage for all the above (Part A and Part B), and also includes prescription drug coverage (Part D). 

When you receive care you only need to provide your Medicare Advantage plan card. Keep your original Medicare cards somewhere safe. With the Medicare Advantage plans provided by the University, the claims only has to go through the Advantage plan, it is not going through original Medicare.

The University Medicare Advantage plan is a custom plan designed by the University.    

If enrolled in one of the Medicare Advantage Plans, there is a $0 copay for SilverSneakers®, a health and fitness program designed for Medicare plan members. It includes a standard monthly membership at participating fitness locations plus online classes, workshops and more.

Call or go online to learn more and to get your SilverSneakers ID number.

Call:

1-888-338-1722, TTY 711

Online:
SilverSneakers.com/StartHere.