UM System Retiree Health Benefits Virtual Town Hall

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UM System Retiree Health Benefits Virtual Town Hall

– [Marshall] Thank you for tuning in for today’s town hall I’m Marshall Stewart, UM’s System Chief Engagement Officer and MU Vice Chancellor for Extension and Engagement I’m happy to be with you today and to be your moderator for this important event Your support and engagement makes such a difference for our system, and we’re very appreciative of that Today’s town hall is meant to provide you with an opportunity to learn more about the UM-sponsored retiree health plans for 2021 Before we begin, it is my pleasure to introduce to you UM System President and MU Chancellor, Dr. Mun Choi, to take a few moments to share with you some words of greetings Dr. Choi? – Hi, how are you? Thank you very much for joining me Let me share with you what we’re going through So if you can hold on a second There are student protestors outside of Jesse Hall and they want me to move the Jefferson statue They want me to correct the institutional racism they say that exists at the university I am not going to move the Jefferson statue And while there are policies in place in society that we must address, this university has been committed since 2015 and even before, in creating an inclusive environment And I want everyone to know that And while the challenges that we face as a university this year are not new, it is very pointed because we have so many different things that are happening with the pandemic, with the (indistinct) financial challenges, and also significantly heightened tensions around social injustice But I have to say that I’m so proud of the team and some of the team members you could see on the screen who have been dedicated to supporting the mission of this university and doing the hard work to make the university better in every way And I also want to thank all of you for your support I received many notes of support during the past six months as we were undergoing some significant challenges But knowing that many of you spent decades supporting the mission of the university, those words are very meaningful for me and my staff members The issues that we’re facing are not going away anytime soon The pandemic is here in various forms for the foreseeable future The financial challenges that we face are real And that is why we have been good stewards to ensure that the university’s business can continue And there’s nothing more important than teaching and learning And our faculty, staff, and students have been very resilient in that regard There are many universities that made knee-jerk reactions or had knee-jerk reactions and pivoted to online learning very early on because of rise in cases The most prominent is University of Delaware The university that’s smaller than Mizzou that is facing a $250 million shortfall this year because they are going all remote $250 million dollars for size of university like ours would mean significant and pervasive layoffs during a period in which we have a pandemic, and people will be laid off without health insurance That’s something that is unacceptable to me and to members who are the leaders who are joining me today So we’re going to manage this pandemic, we’re going to manage the financial challenges, we’re going to listen to students, faculty, staff, and community members who challenge us to become more inclusive, more inclusive And we will continue with that approach And if we are going down the wrong path or if we’re making some boneheaded moves, I know that this group, this group is not shy about telling me or anyone else So please, do let me know I wish I could stay for the rest of the town hall, but I want to attend to the protest that’s happening outside And so I hope you understand Have a great weekend, everyone Thank you for your support Stay safe, stay strong, stay resilient

And we hope to see you in-person very soon So take care – Thank you, President Choi My name is Marsha Fischer I’m the Associate Vice President of Human Resources And I’ve had a chance to meet many of you over the last several years It struck me as we were just having this conversation, I really miss seeing you It’s so great to see so many people have turned out and we can see on the ticker box of participants on a beautiful Friday afternoon with the sun shining It means a lot that you chose to spend this time with us and we appreciate it And this has certainly been a year of unexpected challenges for all of us And that includes the university And we’re always working to adapt to the changing landscape of healthcare And this year, it took some additional focused attention with the challenges that were created by COVID So, one of the important processes that we do, and I’ve talked to this group about it before, is our annual plan review And primarily the focus of today’s discussion is around the health benefits and the plans And it was particularly important this year And it was important for us to proactively manage cost and secure a strong benefit for our university community And every year when we do this plan design we work with TRAC, total rewards advisory committee, and the UM System Office of Finance, and our vendor partners in a collaborative effort to be able to have meaningful benefits that are affordable I want to just remind those of you who may not be familiar with TRAC, and you probably are, it’s comprised of members of faculty and staff from each university, and the hospital, and retirees And if I have any of my TRAC member retirees out there I want to say thank you Anyone who served on this group, and Betsy, I bet you’re out there, knows that it’s an important group It’s not always easy work And we do ask people to give up their time and work through tough issues with you So I want to say thank you It helps us do our work better and we appreciate your engagement with that So in 2021, medical and dental and vision will all be through the same benefit administrator There are changes to the plan this year as they are in every year, and that’s to keep our benefits sustainable So I’ll give you one example, and then I know my team is going to go through more details throughout the town hall But unrelated to COVID, the non-Medicare eligible retirees and their dependents have experienced an increasing claim cost And those increasing costs creates special challenges since 90%, really more than 90%, of the retiree premiums are directly tied to member use So during the annual review process, again, with TRAC and others, the benefit team was able to offset a portion of that increase through the adjusted plan designs So it did result in lower premium increases than we had originally projected, which is is good And additionally, the plan design, we also look to find other solutions And you’ll hear about some of those today So for example, virtual visits So I’ll let my team get into kind of some more of those details that I think you’ll be interested in hearing about, but I hope you find this beneficial I want to remind you that I am an email away and I have a great team that I work with on a daily basis And we’re always here to answer your questions and make sure that you’re feeling supported as a retiree of the university As the president and chancellor said, we recognize the many years of service that you put into the institution, and now it’s our turn to do that And we want to be treating you with the respect that you deserve Before I turn it over to Marshall, I just want to say thank you to my team who has led on the benefits side by Carol Wilson, and they put in on a daily basis, thinking about these issues of how do we best serve our employees, and our retirees, and still work within the framework of what we have to work? And it’s not always easy work And so Carol, I want to publicly say in front of everybody, thank you for all that you do Marshall, I’ll turn it over to you – And let me say thank you, Marsha, for your remarks and opening this up I also want to extend thanks to Dr. Choi for obviously a lot going on in his world right now, but taking time to be with this group I know it means a lot to those of you that are part of the retiree associations And we appreciate the collaboration that we see and the support that you are doing

as leaders to host this event And we’re glad to partner with you in that Retirees’ Association represent and advocate for the needs and interest of retirees of the University of Missouri And we encourage all of you to reach out and engage with your campus retiree associations for educational opportunities, social programs, and to stay up-to-date with the university news that matters most to you Now, to give a quick overview of the agenda today, I want to, first of all, share with you that some of our benefit experts will provide an overview of some of the things going on in terms of the retiree annual enrollment process and UM-sponsored retiree health plans for 2021 Many attendees have submitted questions ahead of time And our experts will answer some of those questions as they present in their presentations, and others during the Q&A portion, after their presentations are over We’ll also be taking some questions live So if you enter those in, we’ll certainly get to as many of those as we possibly can You can send those questions in any time during this town hall And again, we’ll go through those We know we won’t get probably to all of them, but we will do all we can to get those that we can during the town hall We’ll also try to follow up with you appropriately to make sure that we answer any questions you may have, as it’s already been said by Marsha and Dr. Choi So with that, let me introduce the experts And I’m going to turn the show over to them Let them go at it for a little while here Today, we’re happy to welcome Kathy Stuck, the Strategic Human Resources Consultant We also have Caroline Murphy, who is with United Healthcare, the Nurse Liaison We are also glad to have David Scinto, who is a healthcare Medicare Advantage Representative We have Bob Eisele, Express Scripts Representative with us today And we also have Carol Wilson, who is Benefits Director, as has already been said, of the UM system Carol, thanks for being here And I want to start by letting you start telling our colleagues about the retiree plans for 2021 So with that, I’ll give it to Carol Wilson – Thank you so much for that welcome, Marshall As Marshall mentioned, I’m Carol Wilson, and I’m the Director of Benefits for the UM system Before I share the 2021 plans, I want to remind you that retiree annual enrollment runs from October 26th through November 6th this year Retiree annual enrollment is a period when you can change your medical plans, add or drop vision coverage, or decrease your insurance coverage If you choose to take of these actions, you will need to submit your completed 2021 annual enrollment retiree benefits change form to the university no later than November 6th Soon, you will receive your insurance-related information in the mail, and it will include instructions for submitting the form via email, fax, or mail If you decide that you want to continue with your current enrollments, you don’t need to do anything at all Your current enrollments will roll over to 2021 If you have questions after the town hall ends, or if you want additional information as we get closer to annual enrollment, check out our website or reach out to our HR Service Center, and we’ll put the links in the chat for you Before we start talking about medical plans, I want to mention that our dental, vision, and life insurance will see no plan or premium changes for next year However, premiums and continued eligibility for enrollment in life insurance plans may change due to your age If you want to learn more about eligibility, check out our website, and we’ll also add those links to the chat as well Now, to medical plans As you probably know, there are two sets of UM-sponsored plans, those available to Medicare-eligible retirees and their eligible dependents and those available to non-Medicare retirees and their eligible dependents The Medicare eligible retirees may choose between one of two available UM-sponsored group Medicare Advantage plan options, the base plan or the enhanced plan Or you can get general information about these plans online And we’ll drop that link into the chat I’d like to share some good news that the federal government has repealed the federal health insurer insurer fee that was applied to group Medicare health plans That change has been reflected in lower premiums for the Medicare Advantage Plans As a reminder, premiums for retirees are determined by your age and years of service at retirement To address the ongoing rise in the cost of healthcare and to keep premiums as low as possible, the deductible and out-of-pocket costs have been adjusted

for prescription drug coverage 2021 deductibles and out-of-pocket maximums for the Medicare and prescription plans are reflected in the table on the screen Some additional changes you’ll see if you’re a Medicare retiree, Medicare-eligible retiree, come in the form of program updates David Scinto, our UHC Medicare Advantage Representative, is here to share some of these updates and how they’ll benefit you I’ll turn it over to you, David – [David] Perfect. Thank you, Carol And good afternoon, everyone I’m excited to share that starting in 2021, the hearing aid benefit will be offered exclusively through United Healthcare Hearing UHC Hearing offers a broad array of brand name and private-labeled hearing aids On average, retirees are just 8.4 miles away from a local provider, and an out-of-network provider can be used for the hearing exam benefit Ordering is simple through UHC Hearing, too You can either get your order in-person from your UHC Hearing provider, or hearing aids can be shipped to your home UHC Hearing provides cost savings, too, with 80% off industry price The hearing aid benefit amount will remain the same, a $500 allowance every three years To learn more about UHC Hearing and locations, please visit our website And we’ll put that link in the chat for everyone Starting in 2021, we will be changing the fitness vendor from Silver Sneakers to Renew Active Anyone in the base or enhanced plan is eligible to participate in Renew Active It will offer many of the same benefits Silver Sneakers provided, but with some additional enhancements Renew Active offers a free gym membership at one of an extensive network of fitness locations around the country, and many other resources to benefit your health, physically, mentally, and socially You can find more information on the Renew Active webpage If you are a Medicare Advantage Plan member and you want to continue using your fitness discounts, you must register with Renew Active Your Silver Sneakers enrollment will not automatically transfer, although Renew Active will know that you are eligible to take part in the Renew Active program When you register, you won’t receive an ID card Instead, you’ll need to get a confirmation code that you’ll be able to use when you go to gyms or attend classes You can do this either by going online and signing into the member website and clicking on the health and wellness section, or calling customer service at (866) 899-5903 and asking for a Renew Active code And finally, if you’re a Medicare-eligible retiree or dependent, there are a few additional support programs I’d like you to know about Participants in the Medicare Advantage base and enhanced plans have access to HouseCalls, NurseLine and renew rewards House calls is an annual in-home preventative healthcare visit where a provider will come to you to review your medical history and current medications and answer health questions HouseCalls is not available in all areas And I do want to point out, especially in this point in time, not all house calls are being done in-person Many of them are being done telephonically That is dependent upon, of course your, your area, any local or state restrictions So HouseCalls is available, though maybe not in person, telephonically And that will, of course, change as the situation progresses NurseLine, which has been around for quite some time, gives you access to registered nurses who can answer your health questions any time, 24 hours a day, seven days a week And finally, Renew Rewards lets you earn gift cards by completing certain healthcare activities, such as an annual physical Carol, I believe that you are back to you – Thanks David In 2021, we continue to have to UM-sponsored plan options for non-Medicare eligible retirees and their eligible dependents These include the Retiree Health PPO Plan and the Retiree Healthy Savings Plan You can view the most current plan benefits and cost information on our website As Marsha mentioned, the medical plans for non-Medicare eligible retirees and their dependents have experienced increasing claim costs 90% of premiums pay for care for our members The remaining 10% pays for our vendors, who process claims and manage the administration of our plans For the pre-65 plan, costs are rising faster than the premium, but there are certain actions we can take to address the rising plan costs These include increased premiums, increased cost share through deductibles, coinsurance, and copays, decreased administrative costs Our first effort is target administrative costs In 2021, we reduced them by about 5%,

or more than $12 million dollars Then, to further address the increase, we made medical plan changes that helped us keep premiums lower than we originally projected Changes to the Retiree Health PPO Plan in 2021, include an increase in annual deductibles, out-of-pocket limits, and co-insurance amounts for both self and family coverage Annual in-network deductibles will be $700 for self and $1,700 for family coverage Annual out-of-pocket limits will be $3,400 for self and $6,800 for family coverage And finally, co-insurance amounts after the deductible is met will be 30% for either self or family coverage The out-of-network coverage figures are also here on the screen There will be no changes to prescription drug coverage for the Retiree Health PPO Plan For the Retiree Healthy Savings Plan, the combined medical and prescription deductibles will change for both self and family coverage Next year, the annual medical deductible will be 1,750 for self, and 3,500 for family coverage The out-of-network deductible will be $3,500 for self and 7,000 for family coverage That covers the plan design changes for the Retiree Health PPO and Retiree Healthy Savings Plan But now, I’ll ask Caroline Murphy to share some information about support programs Caroline? – Thank you, Carol Hello, everyone And thank you for letting me join you today I am Caroline Murphy, Onsite Nurse Liaison with the University of Missouri System I work with active faculty and staff to help support them with their health, medical, and preventive care questions Participants in the Retiree Health PPO Plan or Retiree Healthy Savings Plan will have access to Real Appeal, a weight loss program that’s entirely online The program is available at no additional cost for those with a BMI of 23 or greater Participants will receive a transformation coach for personal support, digital tools, and a success kit with items to support them in their journey like scales, recipes, and workout DVDs As a reminder, there are some benefits that are available to both Medicare-eligible and non-Medicare eligible retirees and dependents Virtual doctor visits are available so you can speak with providers using a computer or other device They are a great option for when your doctor is not available, if you get sick while traveling, or if you’d like to skip a visit to the doctor’s office and receive treatment for a non-emergency health condition from your home Most visits take about 10 to 15 minutes and doctors can write a prescription if needed, that you can pick up at your local pharmacy Virtual visits for behavioral health concerns are also available There are also some tips that everyone can benefit, and these tips will have you keep your brain sharp First, teach yourself something new Doing something unfamiliar and out of your comfort zone can help you strengthen your brain as you learn and develop new skills Make the task challenging To be beneficial, it needs to require mental effort For example, learn to play a challenging new piece of music Find a skill you can build on Look for activities that allow you to start at an easy level and work your way up as your skills improve Pick something that’s rewarding The more interesting and engaging, the more likely you’ll be to continue doing it Learning how to make pottery, playing chess, speak a foreign language, dance the tango, or master your golf swing would all be beneficial Tip two is that physical exercise helps your brain stay sharp It increases oxygen to your brain and reduces the risk for disorders such as diabetes and cardiovascular disease Aerobic exercise is especially good for keeping your blood pumping Exercise in the morning to start your day This primes your brain for learning throughout the day Tip three is to get on a regular sleep schedule Go to bed at the same time every night and get up at the same time each morning Avoid all screens for at least an hour before bed Blue light from TVs, tablets, phones, and computers suppresses hormones like melatonin that make you sleepy Cut back on caffeine Try reducing your intake or cutting it out entirely if you suspect it’s keeping you up Tip four is to foster relationships to stimulate stimulate your brain Humans have a difficult time thriving in isolation And our current COVID-19 pandemic has made this particular step challenging Having meaningful friendships and a strong support system are important to emotional health And also to brain health Researchers found that people with the most active social lives had the lowest rate

of memory decline So start socializing and get creative if you have to Connect virtually, start a Zoom call, Skype, use FaceTime or Messenger to connect with friends and family Tip five for staying sharp, feed your brain Omega-3 fatty acids are particularly beneficial for brain health Many fish like salmon, tuna, halibut, trout, mackerel, sardines, and herring are a rich source of Omega-3s Non-fish sources include seaweed, walnuts, spinach, broccoli, pumpkin, pumpkin seeds, and soybeans Limit calories and sources of saturated fat, such as whole milk, butter, cheese, cream, ice cream, and red meat Research shows that diets high in saturated fat increase your risk of dementia and impair concentration and memory Eat more fruit and vegetables Produce is packed with antioxidants, substances that protect your brain cells from damage Colorful fruits and vegetables are particularly good antioxidant super food sources Visit your local farmer’s market or start your own garden And your last tip is that if you feel that your memory has taken an unexplainable dip, there may be an underlying health or lifestyle problem It’s not just dementia or Alzheimer’s disease that can cause memory loss There are many diseases, mental health disorders, and medication that can interfere with memory If it’s been a year since your last checkup or you notice you’re having memory issues, schedule an appointment so your primary care provider can support you Before we wrap up, we’re going to check out a couple of fun brain teasers that are examples of how you can keep your brain sharp How many animals do you see here? And the next one, do you see a baby? – I want to thank our experts for the overview of the retiree health plans for 2021 Now we’ll address some of the questions you submitted ahead of the town hall And we hope to open up for additional questions as well as our time allows Please use the Q&A function for anything you’d like to ask for the panelists to address, and we’ll try to get to those as best we can, knowing full well that there’ll be some we simply won’t get to because of time But again, as we can get back to you later, we’ll definitely do that, too, making sure you have some good communication on things that may still be hanging out there Carol, we’re going to start with a process question from someone who will be turning 65 in March 2021 The retiree asks, “What steps do I need to take to transition over to a Medicare-eligible plan, and when?” – Sure. That’s a great question In order to transition to the University Medicare Advantage Plan, apply for a Medicare no earlier than three months before your March 1st eligibility date The application process can be completed through your local Social Security office or online The university Medicare Advantage Plans include enrollment in an eligible part D prescription plan So you only need to enroll in Medicare A and B As you approach your enrollment date, the university will send you an informational packet regarding the Medicare Advantage Plans That packet will include an enrollment form you will need to return to us, along with a copy of your Medicare card And you can get more details on our retiree website – This one is also for you, Carol, one of our most popular questions What does retiree health insurance cover when traveling abroad? – Oh, sure. I’ll take this one So if you are a non-Medicare eligible retiree, your plan will provide out-of-network coverage when you’re traveling abroad The way you pay for your service may be different depending on where you are or the type of coverage you receive In some countries, healthcare providers may require you pay upfront before starting the treatment Keep careful records so you can submit them for reimbursement when you get home And then David, can you speak to the travel coverage for the Medicare-eligible retirees? – Sure. Let me just make sure I’m not, nope, I’m not on mute, good Yes, I can. Thank you, Carol In 2020, we actually did add the foreign travel benefit to the Medicare Advantage Plan These plans do provide $200,000 worth of lifetime coverage for services received overseas Retirees do need to pay for their services wherever they are receiving them outside of the country, and then submit for reimbursement from UHC

It’s important to note the travel allowance is specific to medical services and does not include prescription drug coverage All plan covered medical services are included under the foreign travel allowance – All right, our next question is gonna be for Bob We have a prescription drug related question here Will retirees receive the reduced price for insulin that was mentioned in the Medicare handbook? – Yeah, great. Thank you for the question As of now, this is not included in the UM plan at this point The insulin cap was proposed in the executive order from President Trump in late July and primarily focuses focuses on and benefits the Medicaid space Information and regulations related to the executive order and Medicare have not been provided or established by CMS or HHS at this point, but Express Scripts will provide additional information as it becomes available – So now we’ve got another question for Carol If I’m working full-time at another university and enrolled in their health plan, does that negatively impact my retirement coverage? – No, there is no negative impact on your university retiree health plan coverage if you’re enrolled in another health plan However, that active group plan is your primary insurance coverage, which means medical claims will be sent to your active group plan first Any claim balances that are left will be in coordination of benefits processed by United Healthcare Please keep in mind if you become Medicare-eligible, you are still required to enroll in Medicare part A and B in order to maintain enrollment in the university retiree plan – All right. Thank you Here’s another question about Renew Active for David How will our transition from Silver Sneakers to Renew Active impact ARC membership for retirees living in the Columbia area? Are Renew Active locations only centered around the university campuses, or will there be other resources in more rural areas? – Perfect. Thank you Renew Active does provide an extensive network of gyms and fitness locations across the United States The program works to find opportunities that fit your style, including popular local and national gyms, fitness locations, and community organizations If your favorite location is not in the Renew Active network, you can reach out to Renew Active or customer service and the program will invite that location to join the program Renew Active does cover a fitness membership to the ARC at no extra cost for interested and enrolled Columbia area retirees – And Carol, this next question, I think’s for you Are there a cost-saving techniques for purchasing eyeglasses and especially frames? – Oh, sure EyeMed, our vision benefit administrator allows participants to use our benefits at thousands of in-network store locations as well as several online stores Using EyeMed, you can buy frames, prescription lenses, contacts, and even sunglasses, online from home There are many online network options, including LensCrafters, Target Optical, and more Online eyewear stores can help you compare prices and choose frames that work for you And following up that question, Carol, here’s a COVID-19 question for you How should a retired person keep up with the changing information on COVID-19 testing if they think they may have been exposed but don’t have symptoms? – Yeah, if you’re concerned that you have been exposed to COVID-19 or if you’re experiencing symptoms associated with COVID-19, it’s best to reach out to your primary care provider or a public health professional for guidance on when and how to get tested If you are tested, the CDC notes that you should isolate at home, pending test results – And again, this one’s back to Bob is using Express Scripts prescription mailing the only way to fill my prescription for three months at a time, rather than month-by-month? – Yeah, no, thanks for the question Sure Retirees interested in receiving 90-day prescriptions can work with Express Scripts and receive their medications through our home delivery pharmacy But also, the university hospitals and pharmacies continue to offer 90-day prescriptions at the same cost as if they were purchased from the Express Scripts mail order service – And to change this up a little bit, Kelley, here’s one for the future A narrow network option, such as the one that is provided for employees, for retirees, would be wonderful Is there any chance of that? – We are not specifically looking at the narrow network at this time And that is because we probably would have been further along had it not been for the pandemic, but are beginning of concerted effort to really look at the market as a whole for pre-65 retirees The options in the market haven’t developed as quickly

as we would have liked them to And so we’re really going to take time looking at all our options first So we don’t have any specific plans at this time to head toward a narrow network plan – All right And we’ve got a last question for you, Carol, at this point, before we go into some other questions that are coming in on the chat What is involved in adding dental, vision, or hearing benefits to our current plan? – Sure. If you’d like to add or drop vision coverage, you can do that only during the annual enrollment period, through the process that we discussed at the beginning of the presentation Dental coverage must be elected at the time of retirement and cannot be elected later However, if you elected it at retirement, you can choose to reduce your coverage or drop it at any time If you choose to drop coverage, it cannot be reinstated at a later date – And we had one follow-up question to that, Carol Does the vision policy cover hearing as well? – Yes Hearing aid coverage is included in the vision benefit However, regardless of enrollment status, all retirees and their dependents have access to hearing aid discounts available through EyeMed and Amplifon You can learn more about the free discount program by visiting the EyeMed website – Okay And with the remainder of our time, we’re going to try to cover some questions that have been coming in via the Q&A function So there’s a few questions here I’m already getting, and we’re going to try to get to just as many as we can This one is back for you, Carol Retired after 30 years, now I have a full PPO health insurance with coverage for 22-year-old daughter I’ll turn 65 years old next July and go on Medicare with MU’s supplemental health insurance I would like to maintain daughter on health insurance until she’s 26 Will MU’s supplemental insurance still be able to cover my daughter? – Yes, she can still remain on our plans until 26 Even though you’re in the Medicare plans, she will stay in the retiree plans The pre-65 retiree plans – All right, we’ve got another question Again, I’m going to open this up for any of our panelists that want to jump in On death, will my spouse continue with the same insurance? – I can take that Yes. The spouse will continue with the same insurance – Okay And another question just came in and it’s probably for you as well, Carol How did the deductible limits compare to 2020? – Are we talking for, I’m assuming the pre-65 deductibles? In 2020, the pre-65 deductible was 350 – Okay. And, we had another question come in here How are retiree premiums calculated for both Medicare-eligible retirees and non-Medicare retirees? – David, do you want to take the Medicare one? – Sure. So, I can speak to that Well, actually, Carol is that specific to the premiums that retirees are paying? ‘Cause I think the rate that we provide may be different for the retirees, is that right? – Right ‘Cause they’re subsidized at the retiree level But how does United Healthcare calculate the premium? The overall premium? – Oh, sure So, the overall premiums are based upon the two plans So we, of course, have the base plan Then, we have the enhanced plan or the buy-up plan They are rated on their own experiences between the two plans So for those people enrolled on the base plan, we rate that based on how it’s performing and we underwrite it accordingly And the same is true for the buy-up plans there was no change in the premium for 2021 And actually for the buy-up plan, due to the repeal of the Affordable Care Act, we did see a decrease in that because the plan is performing overall quite well – And on the non-Medicare retirees, we look at claims for the past three years and our experience over that, changes in the market, and we work with actuaries, we work with consultants, and there’s quite a process to go through to set those premiums – Okay. We got a question coming up here on prescriptions And the question is, what controls or determines the cost of prescriptions? – I can, this is Bob I can take a shot at that So the cost of prescriptions are determined by typically the manufacturer of the prescriptions And it’s not uncommon, unfortunately, to see the cost for those prescriptions go up,

sometimes once a year and other times, twice a year But what Express Scripts does is we negotiate guaranteed discounts with our retail pharmacies and with our own mail order to try to keep those costs as low as possible But that’s typically, it’s driven, the manufacturer sets the price of the medication and then we negotiate discounts off of that price to try to get the best deals possible for the university and their members – Great. Great answer Thank you for sharing Here’s a question, and I’m gonna throw this out to the panel again, that’s related to virtual visits versus in person visits And the question is, what is the cost of a virtual visit for the different plans? And then second part, another part of that, is it the same as an in-person visit in terms of cost? And then, how is that related to costs that are covered, or are those costs covered as related to COVID-19 in this new environment we’re in? So lots of pieces there, virtual versus in-person, and then are there any ramifications related to COVID-19 that may have adjusted that cost as well? – I can take the non-Medicare retirees, David, if you, again, want to do the Medicare retirees on virtual visits Medicare retirees on the virtual visits, if you’re in the PPO plan, it’s subject to your regular copay If you’re in the Healthy Savings Plan, I believe the cost of virtual visit is 45 to $50 And Marshall, can you repeat the rest of the question? – Yeah, it’s, what is the cost of virtual visits for different plans? And is it the same as an in-person visit? And then the another piece of this, is it covered if it’s related to COVID-19? – It is covered if it’s related to COVID-19, and I honestly can’t speak if it’s the same cost as a regular visit I’m not sure what the cost is of a regular visit – Okay. That’s one of those things that we can find out So we’ll definitely make note of that and we’ll try to get some information out to folks on that David, this question actually is directed to you So just so you can perk up your years there I have two Renew Active locations within five miles Do I have to choose one or can I go to both? – Oh, perfect Yeah, so this works very similarly to the ways Silver Sneakers did previously, where you are able to interchange the facilities that you want to go to So you can choose between them when you feel like going to one, versus when you feel like going to the other, you are not locked into one facility – David, they added a second question kind of related to that Does Renew Active have online videos like Silver Sneakers did? – It does. Yes, it does Especially in the current COVID environment, that was something that they rolled out very quickly So there are online virtual resources for fitness classes as well – Okay, here’s a little broader question, again, throwing out to the panel What, if any, changes will there be for Medicare-eligible retirees? For Medicare-eligible retirees, any changes? – So I will grab that to start So the main two changes in both the buy-up and the base plan are the fact that on both plans, we are moving from Silver Sneakers to Renew Active The second change is that the United Healthcare Hearing benefit will now be in-network only So you do want to make sure you’re purchasing your hearing aids from in-network hearing providers, if you want to take advantage of that allowance that is included in the plan Outside of that, there are no changes to the cost shares for any of the services on either the buy-up or the base plan So there’s really no change in the core benefit It’s really just the change in the fitness vendor and the hearing benefit – Okay, let’s go to a different question here The website indicates a change in prescription drug deductibles from 75 to 250, in that range This deductible currently does not apply to prescriptions ordered through Express Scripts mail order Will this decision continue through 2021? – Yeah, this is Bob. I can take that Yes The deductible for 2021 will only apply, or it won’t apply to mail order So that will continue for 2021 – Okay. Here’s a question about traveling internationally Will medical evaluations be covered when traveling internationally? – Well, it would be covered on the non-Medicare side under the out-of-network coverage level

David, you want to talk about Medicare? – Yeah, I was gonna say, it would be covered as well under the international travel benefit for the Medicare plan as well – Okay And we’re pausing here for a second as more questions are now coming in So if you’ll bear with me a second, they’re still coming in So I’m having to wait for the, I can see them coming, but it’s not showing itself yet Here’s one, David and Carol, I live in a rural area and due to a disability, I can not get to a doctor What do you recommend for this kind of health care issue? – Well, the virtual visit is a perfect way for this individual – Okay – David, do you have any other? – Yeah, I was actually gonna gonna say the same thing That is the perfect example of a good reason to use the virtual visit program – Okay Do the Medicare plans cover any support for home health care or assisted living? – They do cover, or the Medicare Advantage Plans do cover home health care, that is an included Medicare benefit The only type of facility that Medicare covers is a 100-day limit on skilled nursing facility But if you find yourself permanently housed in a facility, Medicare does not pay towards a nursing home However, if you are on Medicaid at the same time, if that’s something that you find yourself able to enroll into, that does pay toward longterm care facilities, but Medicare, at this point, does not – All right. Here’s a question regarding the life insurance Can life insurance be added for a dependent during the annual enrollment period? – Through an eligibility verification, yes – Okay Here’s a different question around related to a child’s coverage Does a child’s coverage continue after the parent’s death like the spouse’s continuing coverage does? – I will have to check our plan document on that one to give a definite answer I’ll get back on that one – All right Here’s here’s a question that was answered a little bit earlier, but they’d like for you to hit this one more time Can you please cover the changes in Medicare-eligible retiree plans again? So there were some questions about the Medicare-eligible retiree plans in terms of what changes they’re looking at for this year – Sure So, to mimic what we mentioned earlier, the two changes on the retiree plans are going to, or on the Medicare retiree plans, are going to be the change to Renew Active from Silver Sneakers and then the change to in-network only hearing aid benefits through United Healthcare Hearing And Carol, I don’t know if there’s anything you wanted to add to that – Yep. I can The out-of-pocket max on the prescription is moving from 32.50 to 41.30, and then the deductible from 75 to 200 – And Carol, you might mention the cost of the plans There’ve been a number of questions on the cost of the Medicare Advantage Plans – Right So with the change that we made on the prescription side, we were able to lower the premium on the Medicare plan So the base plan without any subsidy, was $128 this year, or 208 for the buy-up In 2021, it’s going down to 120 for the base and 187 for the buy-up So we were able to reduce those premiums – Okay. Here’s a question on medication Is it possible to guarantee that a medication will be the same price throughout an entire year? – Yeah, I can take that Unfortunately, no The cost of the meds are often, like I said, determined by the manufacturer And in a co-insurance situation where you’re paying a percentage of that cost, you will see, you’ll be exposed to those fluctuations So, unfortunately, there’s not a way to guarantee that those costs will stay the same throughout the year – Okay Here’s a question in terms of health savings accounts, are they allowed for individuals after they qualify for Medicare? – You can, no, you can not If you are in a Medicare plan, if you are collecting social security,

you can not contribute to a health savings account – Here’s another question in terms of a rural resident who has questions about diabetes And in terms of the supplies they need, they live in a rural area with poor mail delivery service What safeguards are in place for this individual to protect medications and equipment they may need due to their condition? – I can answer So I think the problem with, I’m not sure if I understand the mail service part, but we do provide medications through home delivery We do take precautions for making sure that any temperature-controlled medication is taken care of, meaning we will pack that medication in a cooler with ice, and we have a way to determine the temperature of where we’re delivering the medication so we can make sure that those are packed appropriately so that the medication stays good and doesn’t get exposed to heat So that’s something that we can do through home delivery But of course also there’s the option if there’s a local pharmacy, if the member prefers to fill at a local pharmacy, they can do so as well – All right Here’s a question regarding the Silver Sneakers transition and wanting to know if the Silver Sneakers instructor will automatically be a part of the Renew Activity In other words, will they go with the new program? – So, no So any of the Silver Sneakers functions in terms of any personnel they may have doing online presentations or online courses, that’s specific to Silver Sneakers, so chances are they would not also be involved in the Renew Active program – All right Here’s a question kind of related to that The only gym in my area is a YMCA Would they recognize Renew Active? And if not, can that be reconsidered? – So, yes, to the reconsidered part If they’re not currently taking Renew Active, we do have the ability to reach out to those facilities to see if they would like to join the program You can check the facilities in your area on Again, that’s Or feel free to call customer service They can look up the facilities in your area as well So if you don’t see that YMCA as taking Renew Active, we can certainly reach out to that facility to see if they would like to join – And same topic, so we’ll just stay right with this Does this change from Silver Sneakers to Renew Active take effect at the end of this calendar year? Is that the time of the transition? – Correct. It goes into effect January 1st of 2021 – All right We’re gonna move over now to hearing benefits Can you use the three-year benefit all in one year? For example, $1,500 at once will buy you hearing aids once every three years So is that possible? – So that benefit is specifically a $500 hearing aid allowance every three years So it is not $500 per year It is $500 every three years – Right And that’s exactly what they were asking there, too Great response. Thank you – Sure – Yeah, I think they’re probably happy with that one This is one related to cataract surgery, and the question is, is cataract surgery covered under Medicare Advantage Plan? – So the answer is yes, cataract surgery is covered under the Medicare Advantage Plans Additionally, after you receive cataract surgery, Medicare does cover one pair of lenses and frames, if you need any vision correction after the cataract surgery So that is included as well on both the buy-up and the base plan – Okay. Well, I think our panelists have certainly taken tremendous amounts of questions here, and I want to thank all of our participants today for participating in such a great way It’s definitely been engaging in terms of seeing the many questions come in, and I know there’s many questions we haven’t gotten to So what we’ll commit to do is certainly have our teams here go through those, try to put some good answers in terms of framing around those so that we can get information out to our retirees I do want you to know how much we appreciate you Carol, and the rest of our panelists for joining all of us as we try to share and stay connected with our important retirees And we appreciate the engagement we have in the university, so many different partners This wraps up our town hall for today And I’d like to mention that along the way, as, again, these questions that have come in, we will be making that available shortly online, and we’ll make sure will be send you an email so you’ll know where that content is

So as soon as we have it ready, we’ll let you know, and communicate that to you so you can go there and look for those questions and those answers that you are looking for You’ll also be receiving an individualized benefits statement from the UM system in the mail shortly The mailing will include your personalized benefit options as well as your premiums It will also include a list of additional events and resources where you can get more information about the plans and the benefits available to you Again, really important that you take advantage of these opportunities And again, I think that’ll be a place where you can get probably a lot more answers to some of the questions that’ll even pop up between now and maybe later on today and later this weekend, as you think back on this particular town hall In the meantime, you can review existing insurance information at UM’s system website, or if you have followup questions, you can contact the HR service center at [email protected] I want to thank you again for joining us I want to thank you for your continuing commitment to the University of Missouri, and we look forward to seeing you again in the spring Thank you