Direct Bill Open Enrollment Plan Year 2020

1. Direct BillOpen Enrollment Plan Year 2020

2. Agenda • Introductions and Announcements • Open Enrollment • Major Changes • Non-Medicare Plan Coverage Details • Medicare Plan Coverage Details • Questions to Ask Yourself • Open Enrollment Portal Instructions • Direct Bill Call Center • Resources

3. Open EnrollmentOctober 16 – November 15, 2019 • All changes take effect January 1, 2020 • Any changes made will be effective for all of 2020 • Your chance to make any change to your current insurance • Adding dependents • Changing medical coverage • Waiving medical & keeping dental

4. Open EnrollmentOctober 16 – November 15, 2019 • Any change made outside of this time period requires a “qualifying event” • Remember: If you or a dependent are enrolled in Medicare you must have a “Split Enrollment” • If you want to cancel all of your health insurance you will need to contact our office at 1-866-541-7100, this cannot be done in the MAP system

5. Canceling Coverage • A member is able to cancel all coverage during the year by giving written notice, then coverage will be canceled the last day of the month in which the state is notified. Coverage for spouse and/or dependents will be cancelled as well. • A member CANNOT cancel mid-year: • Medical & keep dental and/or vision • Dental & keep medical and/or vision • Vision & keep medical and/or dental These changes can ONLY be made during Open Enrollment

6. Center for Medicare & Medicaid Services (CMS) Decision Starting January 1, 2020 the Supplemental Plan C & C Select will no longer be available to people new to Medicare. BUT if you are already Medicare eligible then the Supplemental Plan C & C Select will always be an option for you to select.

7. Health Insurer Fee (HIF) The Affordable Care Act (ACA) imposed a Health Insurer Fee beginning in 2014. This fee was suspended by Congress in 2017 & 2019. This fee will apply for 2020 & beyond. Due to this fee premium rates will increase for the following plans • Aetna Medicare Freedom PPO ESA • Aetna Medicare Liberty PPO ESA • Aetna Medicare Elite PPO ESA

8. Health Care Commission (HCC) Decisions • The HCC voted to be able reduce the premiums for the non-Medicare plans • The HCC voted to award the contract for the Part D Plans the state offers to EnvisionInsurance • The HCC voted to add another Part D plan, so the state will be offering 3 Part D plans • ENVISION Premier Part D • ENVISION Value Part D • ENVISION Classic Part D NEW

9. Open Enrollment Plan Year 2020 This year members enrolled in the plans listed below and want those plans to continue for Plan Year 2020 DO NOT need to do anything and your current coverage will continue for Plan Year 2020 • Aetna and BCBS Non-Medicare plans A, C, J, N or Q • Aetna Medicare Advantage Freedom, Liberty or Elite PPO ESA with Aetna Standard Part D • Kansas Senior Plans C, C Select, G, G Select, or N without Part D

10. Open Enrollment Plan Year 2020 For members currently enrolled in one of the Aetna Medicare Advantage plans (Freedom, Liberty or Elite) with either Aetna Premier or Aetna Value Part D, you will need to make a change in coverage for Plan Year 2020. The Aetna Medicare Advantage Freedom, Liberty & Elite PPO ESA plans will only be offered with the Aetna Standard Part D for Plan Year 2020 If a member does not make an election they will be enrolled in their current medical plan with the Aetna Standard Part D for Plan Year 2020

11. Open Enrollment Plan Year 2020 For members currently enrolled in one of the Kansas Senior plans (C, C Select, G, G Select or N) with either Aetna Premier or Aetna Value Part D coverage, you will need to make a change in coverage for Plan Year 2020

12. Open Enrollment Plan Year 2020 . Listed below are your options: • Enroll in one of the plans offered by EnvisionInsurance • Envision Premier Part D • Envision Value Part D • Envision Classic Part D NEW • Waive Part D through the state and enroll in a Part D out on the Private Market

13. Open Enrollment Plan Year 2020 If a member does NOT make an election they will be enrolled in the same medical coverage they currently have and then they will be enrolled in the same Part D they had with Aetna but with the new Part D vendor EnvisionInsurance. So if member was enrolled in Aetna Premier Part D that coverage ends 12/31/2019 and member will be enrolled in Envision Premier Part D effective 01/01/2020

14. Selecting Your Non-Medicare Health Plan • Pick a plan design (A, C, J, N or Q) • Which plan design is right for you? • Premiums, Deductibles, Co-insurance • Review the provider networks • Review plan claim example online: • http://www.kdheks.gov/hcf/sehp/default.htm

15. PlanA Network Non-Network * Non covered services & discount tier drugs do not count toward Deductible, Co-insurance or OOP Max.

16. Plan C Network Non-Network *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max.

17. Plan J Network Non-Network *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max.

18. Plan N Network Non-Network *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max.

19. Plan Q Network Non-Network *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max.

20. Plan Year 2020 Retiree/Direct Bill Non-Medicare Medical & Drug Rate Chart

21. Plan Year 2020 Retiree/Direct Bill Dental and Vision Rate Chart

22. Telehealth • All plans include the Telehealth benefits • Aetna is offering the Teledoc Service • BCBS is offering the Amwell Service • Virtual Office Visits with licensed medical providers via the internet or your smart phone • Convenient access: Providers available 24/7 • Lower member OOP cost than Urgent Care or ER visits

23. Plan C, J, N and Q Prescription Drug Plan • Rx continues to be offered by CVS Caremark • Uses same Preferred Drug List as Plan A • Claims subject to deductible for each plan • After the deductible has been met, Co-insurance tiers apply: • Uses same Co-insurance tiers as Plan A • 20% Generic • 40% Preferred Brand Name Drugs • 65% Non Preferred Brand Name Drugs

24. Preferred Lab Benefits • Available with both medical carriers • Plan A - 100% coverage for eligible outpatient lab services • Plans C, J, N, Q - Discounts on eligible outpatient lab services until deductible met, then paid at 100% BCBS Members: The local BCBS plan of the physician that ordered the lab test will process the lab claim. If your provider is outside of the BCBS of Kansas area, Stormont Vail may not be a network provider and the claim may be subject to non network benefits.

25. Quest Diagnostics Stormont Vail Health • Statewide preferred lab vendor • List of collection sites: www.labcard.com • Your doctor can draw the sample and send to Quest • Access your results quickly and easily by going to the patient portal and app • Regional preferred lab vendor: Topeka, Emporia, Manhattan, Carbondale, Wamego • Labs drawn at Cotton O’Neil locations may be included if by network providers • Show your medical ID card to access benefit TOLL FREE - 800-637-4716TOPEKA AREA - 785-354-1150

26. Delta Dental • Plan pays for 2 exams & cleanings per year Enhanced Basic

27. Surency Vision Benefits

28. Medicare Advantage Plan Options • Aetna Medicare Freedom, Liberty & Elite PPO ESA (Extended Service Area) with Aetna Standard Part D • These plans are available for Direct Bill members enrolled in Medicare Part A and Part B • A copy of your Medicare card is required

29. Aetna Medicare Freedom, Liberty & Elite PPO ESA Plans Additional benefits offered with these plans: • Offer more benefits than Medicare • No referrals needed • Access to providers nationwide • Money each year toward hearing aids • Resources for Living • SilverSneakers

30. Aetna Medicare Freedom, Liberty & Elite PPO ESA Plans • Medicare Advantage Plans • Takes the place of Medicare Part A and Part B • You are still responsible for Part B premium • Still have deductibles and co-payments • Enrollment in private Part D prescription plan = loss of ALL State of Kansas Health benefits

31. Aetna Medicare Freedom, Liberty & Elite PPO ESA Plans 31

32. Aetna Medicare Freedom, Liberty & Elite with Standard Part D • Coverage Gap or the “Donut Hole” • Begins when you and your plan have paid $4,020 toward your medications. • Once you reach the coverage gap, you are responsible for the cost of the brand name and some generic medications. • Catastrophic Coverage • Begins when your Out-of-Pocket cost reaches $6,350

33. Medicare Supplemental Plan Options • Kansas Senior Plan C • Kansas Senior Plan C Select • Kansas Senior Plan G • Kansas Senior Plan G Select • Kansas Senior Plan N • With or without Envision Part D—Premier, Value & Classic-new options • These plans are available for Direct Bill members enrolled in Medicare Part A and Part B • A copy of your Medicare card is required

34. Kansas Senior Plan C Select and Kansas Senior Plan G Select To be eligible to enroll in one of these new plans you must live in a Select county. Here are those counties: Atchison, Brown, Butler, Chase, Chautauqua, Clay, Cowley, Doniphan, Douglas, Elk, Greenwood, Harper, Harvey, Jackson, Jefferson, Kingman, Leavenworth, Marion, Marshall, Osage, Pottawatomie, Pratt, Reno, Riley, Sedgwick, Shawnee, Sumner, Wabaunsee or Washington. You would also need to use a network hospital for any planned inpatient services.

35. Kansas Senior Plan CMedicare Supplement Plan

36. Kansas Senior Plan C SelectMedicare Supplement Plan

37. Kansas Senior Plan GMedicare Supplement Plan

38. Kansas Senior Plan G SelectMedicare Supplement Plan

39. Kansas Senior Plan NMedicare Supplement Plan

41. EnvisionInsurance Part D One of the EnvisionInsurance Part D plans can be added to the Kansas Senior Supplemental plans • Envision Premier Part D • Envision Value Part D • Envision Classic Part D NEW

42. EnvisionInsurance is a national Medicare Part D provider, serving over 650,000 members through our product, EnvisionRxPlus. We have over a decade of experience providing Medicare Part D to members across the country. • Approved to offer Medicare plans across the country • Serving over 650k members across the country (Individual Part D since 2006; Group Part D since 2009) • Over 60k pharmacies nationwide, including mail order

43. EnvisionInsurance Part D • Plans have same pharmacy network and formularies (Preferred Drug List). • Be sure to review the formulary and verify which plan will be best for you based on the medications you take regularly. • Remember to take advantage of copays savings by getting 90-day supplies when possible! • Both Envision Premier and Classic pay through the coverage gap or “donut hole.” • Specialty medication: 30-day fill only.

44. EnvisionInsurance Part D • All State of Kansas drug coverage is considered creditable coverage. • Coverage that is as good as or better than Medicare prescription drug coverage. • You MUST have creditable drug coverage to avoid the Late Enrollment Penalty through Medicare. • VA and Tricare are considered creditable coverage.

45. EnvisionInsurance Part D – PREMIER Available to those enrolled in one of the BCBSKS Senior Plans

46. EnvisionInsurance Part D – PREMIER Available to those enrolled in one of the BCBSKS Senior Plans

47. EnvisionInsurance Part D – Value

48. EnvisionInsurance Part D – Value Available to those enrolled in one of the BCBSKS Senior Plans

49. EnvisionInsurance Part D – Classic-NEW

50. EnvisionInsurance Part D – Classic-NEWAvailable to those enrolled in one of the BCBSKS Senior Plans