 Hello, and welcome to Open Enrollment 2024! This presentation is the long program for retirees under the age of 65. I will cover all our benefits through this presentation. Open Enrollment will begin October 9 and end October 27, 2023. If you are making no changes for 2024, you do not need to do anything. All your coverages will carry over exactly as they are. We will be using our online system, cfwbenefits.com, to enroll. The Enrollment deadline for all plans is October 27 at 11.59 p.m. I do not recommend you wait until the last possible minute as the window will close at 11.59 p.m. All changes you make will be effective January 1, 2024. First, some insurance terms that I will be using during this presentation. First is copayment. Copayment is the flat dollar amount you will pay at the provider's office. On the health center plan, it is the amount you would pay at your primary care doctor's office or if you are not visiting a health center or at a specialist office. This also applies to the DHMO plan where all dental visits are covered by the copay. Second is the deductible. This is just like your car insurance deductible. This is the amount of money you would pay before the insurance kicks in. If you are on the consumer choice plan, all services apply to the deductible before the insurance pays. If you are on the health center plan, the deductible only applies when doing surgeries or things like complex imaging. Third is co-insurance. Once you've met your deductible, then you pay a co-insurance. This is a percentage of the bill you are responsible for. Both our health center and consumer choice plans are 80-20 plans, which means you pay 20% of the bill and the city pays 80% of the bill. Finally, all this wraps together to be the total out-of-pocket maximum. Once you've reached your total out-of-pocket maximum, you no longer pay for services at provider's offices or pharmacies. We'll be offering the same two plans for 2024, the health center plan and the consumer choice plan. The health center plan has the free primary care at the health centers and co-payments for specialists and providers who are not at the health centers. They have lower deductibles and lower out-of-pocket maximums. We have a national network and there are physicians available nationwide. The consumer choice plan is our high deductible health plan. You must meet the deductible before the insurance will pay for your medical services. There's a health savings account that goes with the consumer choice plan and you are able to use the health centers at a discounted rate. Preventive care on both plans is covered 100%, so getting your annual well adult exam, a well child exam and a well woman exam are all covered on both plans. However, one thing to be aware of is that on the consumer choice plan, if you talk about an issue you're having or if your doctor orders additional tests, those will have a charge. For example, my provider requests I get a vitamin D test done. This is a diagnostic test, not a preventive test. And if I were on the consumer choice plan, I would pay for the test. On the health center plan, you can go to the health centers for free. Otherwise, all other primary care providers, including pediatricians and OBGYNs are covered with a $30 copayment. Specialists such as dermatologists, cardiologists, etc., are covered with a $50 copayment. This is a reduction in co-pays from 2023. We do use the Aetna Choice Point of Service 2 Open Access Network. And there is no coverage for out-of-network providers, except in emergencies or certain surgery situations. Those on both plans can use our health centers. For those on our health center plan, all visits at the health centers are covered 100%. We currently have three primary centers supported by five satellite locations. One of the biggest benefits of the health centers is same day or next day appointments. The health centers are not walk-in or drop-in clinics. These are health centers staffed with physicians and nurse practitioners. For those on the consumer choice plan, you can still go to the health centers, but the cost is a $60 contracted rate if you are going for an illness or injury visit or else 100% for your well adult visit. The five satellite locations are around the Fort Worth area, including in Keller, Burleson and Bedford. The cost are still covered at 100% for those on the health center plan and a $60 contracted rate for those on the consumer choice plan. One thing to note is that some satellite providers offices have services that are not covered by our contract, such as Keller has an x-ray machine. If you're on the consumer choice plan and they do an x-ray, you will be charged the contracted rate for an x-ray. The satellite locations may or may not have the same day or next day appointments available. They do not hold appointments open for City of Fort Worth employees. 2023 saw the retirement of two long-term health center providers, Dr. Reeves and Sherry Pierce. Both were Hugley providers. We now have Patricia Menevedes-Neep working at Hugley. We moved from the Monkreef location in June of 2023 and the downtown Fort Worth health center is now called Magnolia and is located at 1320 Hemphill Street, Suite 350. Starting in November, Dr. Courtney Campbell will be the primary care provider there. We are also opening a new health center at the Police Officers Association building at 100 North Forest Park Boulevard, Suite 120. This is across Forest Park from the new City Hall. This facility will open in November and Dr. Mario Mejia will be the provider there. As I mentioned, the consumer choice plan has that high deductible. For 2024, the individual deductible has increased to $3200 to comply with IRS regulations. The family deductible is remaining at $5400. You do have to meet the deductible before the insurance starts to pay for claims, which includes pharmacy claims. With the consumer choice plan, you get the health savings account. The city continues to seed the HSA for you. We will contribute $540 for an individual or $1,000 for the family. The maximum you can contribute to the HSA has increased for 2024. As an individual, you can contribute up to $4150 and $8300 for the family. However, this maximum does include the city's contribution. So the maximum you can contribute from your paycheck will be $3,610 for the individual and $7,300 for the family. In big news, we have always appreciated the opportunity to help you with your services. We have also replaced accolade with alight. You may or may not remember that we had Compass three years ago. They changed their name from Compass to alight. We are basically returning to them after three years with accolade. They will help you with benefits navigation such as cost estimates and bill reviews. you with surgery support, including what to expect before and after a surgery. Throughout the past several years, we have added a number of special programs to the plan. We offer Teledoc, which provides virtual visits. Through Teledoc, you have the option of seeing a provider for an urgent issue or scheduling an appointment in the future. If you decide to use Teledoc for mental health visits, you would receive the same mental health provider each visit. We started offering hinge health at the end of last year. Hinge health is virtual physical therapy, both if you've been prescribed by your physician or just to work out a minor issue. We have been offering surgery plus for several years. They offer bundled billing for non-emergent surgeries. Their bread and butter are musculoskeletal surgeries. However, they can also see for a hernia or a hysterectomy. They are also our sole provider for bariatric surgeries. A Rosti is our soft tissue rehab provider. They do a combination of physical therapy, muscle manipulation, and kinesthetic taping to help you feel better faster after a soft tissue injury. HelloHeart provides blood pressure cuffs and an app to help you track your blood pressure. You can then provide this information to your doctor on your annual visit to help keep better track of your blood pressure. And now, they also offer cholesterol support as well. Finally, we have VERDA, which we introduced two years ago. VERDA helps with diabetes support and reversal, as well as weight loss support. Through coaching and diet, they can help you get off your diabetes medications. Optum will continue to be our Pharmacy Benefits Manager for 2024. Under the Health Center plan, there is a $100 deductible, which begins January 1. After that, costs are on a co-insurance basis with a minimum and maximum. On the Consumer Choice Plan, everything hits the deductible and then co-insurance. For both plans, if you take a maintenance medication, you need to do either mail order or get your three-month prescriptions from Walgreens. There are some medications, opioids, for example, where providers will not allow you to pick up the medication on a 90-day supply. That's fine. And you can continue to pick up your medications on the limited 30-day supply. On the Health Center plan, medications have a 20% co-insurance with a minimum and maximum cost. This means if you are prescribed a generic medication that is $200, you only pay the maximum of $20. If your generic medication costs less than $10, a Z-PAC, for example, you would pay that dollar amount. But for a medication that is $15, you would pay $10. The minimums and maximums for mail order or Walgreens are 2.5 of the generic minimum and maximum, so you can save a little money with mail order or Walgreens. The city will continue to contribute to the health savings account on your behalf. We will contribute $540 for the individual or $1,000 for the family coverage. The benefit of the health savings account is that it is pre-tax money. And as long as you use it for qualified medical expenses, you never pay taxes on the money. You own the HSA. This means if you ever leave the city's benefits or change from the Consumer Choice Plan to the Health Center Plan or a spouses plan, any money in the HSA, including the city's contribution, is yours. There is no documentation needed when you use the HSA money. Health equity will never ask you for receipts regarding your expense. However, you should hold on to the receipts in the event you are ever audited by the IRS. 100% of your money in the account rolls over from year to year. So whatever you don't spend will be in there year after year, which will allow you to grow your account. Once you have a minimum of $1,000, you can also start investing your HSA money to increase your account. Once you've reached 65, you can take the funds out without a penalty for non-medical expenses, but you would still pay the taxes. To ensure no penalty and no taxes, you need to use it for a qualified medical expense. One other thing to realize about the HSA is that it is more like your checking account. You can only take out what you've put in. So if you had a bill for $700 in January, but all that's in there is the city's $540 contribution, all you would be able to pay would be the $540. You would have to pay the other $160 from your own funds and reimburse yourself later. We still have the wellness program with Virgin Pulse. The premium incentive is still in place. The deadline to complete the three required items to not receive the penalty is August 31 of each year. The three required items are a physician screening form, the member health assessment, and the tobacco affidavit. All three of these are available on the Virgin Pulse website or app. The reason we do this is to ensure that you are seeing a primary care doctor and developing a relationship with one. The goal is to find medical conditions before they are a problem. It is always better to find cancer in stage one than in stage three or stage four. To earn the premium incentive, you need to do a member health assessment through Virgin Pulse, a tobacco affidavit, or a tobacco journey if you smoke cigarettes, cigars, or a pipe, or vape, or use chewing tobacco. Finally, you go to your primary care physician to receive your annual exam. If you cover your spouse, your spouse also has to do these three activities. The deadline for this program is August 31 of each year. If you did not complete your requirements in 2023 for 2024, you will see the additional premium shown here when you log into cfwbenefits.com. If you believe that you completed the requirements and it is showing on the benefits portal, please contact the benefits office. The city partners with weight management companies, such as WonderHealth and Weight Watchers. Employees and their spouses are eligible to participate in either program if they are on the city's health insurance plan. Weight Watchers can be enrolled in at any time. WonderHealth has periodic enrollment periods. We still offer the same dental options. We have the DPPO plan with the high and low option. On both options, preventive services are covered 100% and have a $50 deductible per person. The annual maximum, which on dental is the maximum the dental insurance will pay, is $1,000 on the low option and $2,000 on the high. Basic restorative care, that's things like your cavities and simple extractions, are covered 80% on the high option and 50% on the low. Major care, bridges, crowns, inlays, onlays are covered 50-50 on both plans. Both plans cover orthodontia and implants. There's a lifetime maximum on orthodontia for the low and high option. On the low option, it is $1,000. On the high option is 1,500. We also still offer the DHMO plan. This plan has no deductible or annual maximum. You can get all the dental work you need done. However, there is a very limited network and you must choose a primary care dentist. Everything is paid out on a copay basis, so you know walking in to the dentist's office how much those copayments are. This plan does cover orthodontia for adults and children, but does not cover implants. We have an exciting new offering from IMED for 2024. We are now able to offer a high and low vision plan. On the high plan, there's a slightly better contact lens and frame allowance as well as lower copays for progressive lenses. In addition to the new high option, IMED is offering a better benefit if you go to plus providers. You can identify a plus provider when searching for a doctor online. Primarily, plus providers will be chain providers such as target optical or lens crafters. When searching for providers, we are the insight network. The wellness office is there to support your whole well-being. They offer exercise classes, workshops, seminars, and webinars, as well as special events such as periodic blood drives and the heart walk. If you or your covered spouse will be turning 65 in 2024 and will be eligible for Medicare, please call the Social Security Office about three months prior to your 65th birthday to enroll in parts A and B. Once you receive your card, please send a copy of it to the benefits office to enroll in the city's Medicare Advantage Plan. If you were hired before 1986 and only ever worked for the city, you may not be eligible for Medicare on your own. Please contact the benefits office and we can walk through an application to get you enrolled in the Medicare Plan. As a retiree, if you do not enroll in part B, when you reach age 65, you will be charged a 10% penalty by Social Security. You can find more information online, including information about meetings and more information about the plans. We will be enrolling online through the benefits portal, www.cfwbenefits.com. If you are adding people to your dental and or vision plans who have not been previously covered, you will need to upload proof documents to verify relationships. Remember, if you are making no changes for 2024, you do not have to do anything. All coverage will carry over as it is. The member portal is at cfwbenefits.com. If you've never gone online before, you would need to click register. If you have questions, you can reach out to the benefits office at 817-392-7782 or come in and see us in the lower level of City Hall.