2nd Quarter 2014 Benefits Corner


By Al Horan

As you are probably aware, we try to keep you informed about what is happening with your Chevron benefits plans, your CRA programs as well as what’s happening in the benefits area. From time-to-time we supplement this column with updates that are sent to your local CRA Chapters. Typically, the updates are also posted on our website, www.chevronretirees.org. We would suggest that you periodically visit our website.

In the January issue of Encore we advised that the CRA Dental Program would be holding an Open Enrollment beginning in February and running through March. The Open Enrollment period was predicated upon the timely submission of membership data by Chapters and an approximate mailing date of January 15 for the Open Enrollment material. Unfortunately due in part to the late submission of membership data by some Chapters we have had to delay the distribution of Open Enrollment material until March. By the time you read this article, those members for whom Chapters submitted membership information should have received the material. Members who in prior years were afforded an opportunity to be covered by the CRA Dental Program will have up to 30 days to enroll. New CRA members will have up to 60 days.

We feel that you owe it to yourself and your family to carefully consider the CRA Dental Program since dental health plays an important role in our overall general health. Please remember that dental insurance is most cost effective when an individual is treated by a network provider. MetLife has more than 120,000 dentists participating in its network. It is one of the largest networks available.

In previous Benefits Corner articles and in supplemental communiqués, we have tried keeping you advised about what is happening with health care benefits and Health Care Reform. For the most part, the material focused on providing insight into changes taking place in the benefits area. We also attempted to clarify public information that is sometimes misleading. In these releases we generally only touched upon what is happening in the delivery of medical care by medical professionals.

Linda Bulla who is a member of the CRA Benefits Committee has prepared an article to give us a better understanding of changes that are starting to take place in the delivery of medical care. The key points are shown below. The full article can be found on the CRA website, www.chevronretirees.org in the Benefits Tips and Helpful Information series.

Linda who has been a member of the Committee for several years has more than 32 years’ working experience. During her career, she held management positions in hospitals and a medical school where she focused on inpatient and outpatient services, managed care, and physician management services. She holds two master’s degrees in social work and business management. We are very fortunate to have Linda as a member of our Committee.

Beginning in January 2014 certain sections of the Patient Protection and Affordable Care Act (ACA) that apply to medical providers became effective. The overall objective of the ACA is to provide a framework for more consistent and improved medical outcomes for patients while also culminating in reducing the cost of medical care. However, to achieve this goal medical providers face the following hurdles:

  • Physicians will need to decide how to introduce research driven data into their patient care practices and services. Financially they may experience a reduction in Medicare reimbursements that result from a new Medicare payment schedule.
  • Hospitals will need to ensure that they have appropriate procedures in place that foster an integrated approach to the care of patients by the hospitals and the physicians. Hospitals will also receive lower Medicare reimbursements; and they will be subject to penalties for avoidable Medicare readmissions occurring within thirty days.

Again, please visit our website to view the full article.

You may recall that beginning January 1, 2014 we are required to approve all new prescriptions, including new prescriptions for existing medications. If a prescription is filled by a local pharmacy, we approve the issuance when we pick up the medication. However, when a prescription is filled by mail order through ESI, we will be contacted by ESI to approve the processing of the request. If the insured is unavailable, ESI will leave a voice mail message requesting that their phone call be returned. Because of HIPAA requirements, the message may be vague. I can appreciate that retirees are generally concerned about scams. However, it is important that a member respond in a timely manner since the shipment of their medication can be delayed.

From time-to-time members have voiced concern about the size of the type of the warning on prescription bottles. The warning plus other vital information about a medication is typically supplied in the package that contains the medication. I strongly encourage everyone to read the insert since it contains important information. ESI is planning on addressing the size of the type. However, the modification is not expected in the near future.

Just prior to releasing this article, I received word that ESI will be issuing replacement member ID cards starting in April. The member ID numbers will remain the same. The card will have the ESI logo and it will replace the Medco ID card. When filling a prescription through a retail pharmacy, the pharmacy will need your member ID number. It is also helpful to have your ID card handy when phoning ESI to fill or inquire about a mail order prescription.

In previous Encore articles, we reported that Chevron has graciously agreed to extend vendor discounts that are available through the Chevron Recreation Program to retirees. Most of the discounts are currently available at chevrec.mybigcommerce.com. The exception is the Verizon cell phone discount, which is still being worked on by Chevron and Verizon.

Please accept our apologies for the delay. We can appreciate that the Verizon discount is of particular interest to many CRA members. As soon as the legal documents are executed by Chevron and Verizon, Verizon will be able to implement the administrative procedures that will allow facilities to extend the discount to retirees. We will keep you advised.

If you have any questions please let me know.