4th Quarter 2014 Benefits Corner


By Al Horan

In this article I would like to address Chevron’s Open Enrollment for 2015. I would also like to cover what we can expect under the Health Care Reform Act in 2015. Finally, I would like to share with you recent medical findings, and useful health care and financial information that is available from the Federal Government.

Our Chevron Health Care Plans

Chevron will conduct Open Enrollment for 2015 for their Medical and Dental Plans between October 20 and October 31. They expect to mail the Open Enrollment packages to retirees on or about October 8th. The package will contain a Retiree Open Enrollment Newsletter and an Open Enrollment Worksheet. Some retirees will receive a Medicare Part D creditable coverage notice and your worksheet will indicate if one is enclosed. Medicare participants will also receive Summary of Benefits & Coverage (SBCs) for your plans. (Non-Medicare participants will be able to download their SBCs from Chevron’s benefits website – hr2.chevron.com/retirees - or they can request a copy by calling Chevron’s Service Center at 1-888-825-5247.) The SBCs for non-Medicare retirees will comply with the required government format specified under the Health Care Reform Act. The format for Medicare retirees will be the same as last year since the Medicare plans are not required to use the standard format specified for non-Medicare Plans.

Chevron also advised that they do not expect significant changes to the benefit provisions of the Plans, excluding PPO Option 3 for non-Medicare retirees, nor do they expect any change in eligibility requirements to join a Chevron Plan. PPO Option 3 will be discontinued and replaced with a High Deductible Health Plan (HDHP). (Details will be contained in the Open Enrollment Package.) Further, at this time member contributions for 2015 have not been made available to us. However, we should remember that member contributions are a function of claims experience and the Company’s contribution. (Chevron’s maximum annual increase in their contribution is 4%). Under the Health Care Reform Act, a premium refund may be provided to a HMO plan if the insurer does not spend 80% to 85% of premiums on the direct care of patients, including efforts to improve the quality of their health. Insurers are required to rebate excess premiums if they fail to meet these standards. Chevron reported that none of their HMO plans generated a refund for 2014. It should be noted that this provision of the Health Care Reform Act does not apply to Chevron’s non-HMO Medical Plans because they are self-insured.

In deciding which Plan to join for 2015 you may wish to consider the following: (a) the state of each participant’s health; (b) the amount of medical care you each received over the last 12 months; (c) any anticipated medical care each of you expect to receive in 2015; and (d) each participant’s age since there is a greater chance of unexpected medical problems at advanced ages. In doing your review you may wish to consider that, to the extent you are eligible, Chevron’s Medicare Plus Plan provides the maximum level of benefits for Medicare participants and Chevron’s Option 1 Plan provides the maximum level of benefits for non-Medicare participants. (These two plans also have higher premiums than the other Chevron plan options.) Please note, Chevron mentioned that during Open Enrollment generally only about 10% of participants change their coverage. If you decide that you are satisfied with your existing coverage you need not do anything. With the exception of PPO Option 3 enrollees, you will be automatically reenrolled in the same Plan for 2015. If you are currently enrolled in PPO Option 3, you will automatically be enrolled in the new HDHP. Lastly, if you haven’t already done so we strongly encourage you to make arrangements with Chevron’s Service Center to have your monthly premiums automatically deducted from your bank account.

Government Insurance Exchanges

Just a reminder starting in 2014 individuals were eligible to purchase medical insurance through an Insurance Exchange, provided they were not covered by Medicare. The Exchanges offer a full array of health insurance products. Exchanges exist a both the Federal level and State levels. Currently, there are approximately 7.3 million individuals who enrolled as a result of the Health Care Reform Act. Approximately 85% of these individuals receive subsidies in the form of tax credits. As many insurance professionals expected, some individuals will see a sizeable increase in their premiums starting in 2015. Anyone who has coverage through an Exchange should consider explore alternative coverage to be sure that they have the best arrangement before agreeing to renew their existing coverage.

Individuals will be able to purchase medical coverage through an Exchange for 2015 starting November 15 and ending February 15, 2015. For enrollments that take place by December 15, coverage will be effective January 1, 2015. Later enrollments will have delayed effective dates. A delayed effective date could result in a break in coverage.

For Chevron non-Medicare retirees, an Exchange is an alternative way of purchasing health insurance for themselves and their eligible dependents. If coverage is purchased through an Exchange, Chevron will not contribute towards the cost of the insurance. Also, they may not cover their eligible dependents under a Chevron Plan while they are covered by another health insurance plan. However, the retiree should be able to reenroll in a Chevron Plan during a future Open Enrollment period. Finally, if the retiree should die while not covered by a Chevron Plan their dependents will not be able to rejoin a Chevron Plan in the future.

For information about the availability of health insurance through an Exchange, please phone the Health Insurance Marketplace. Their phone number is 1-800-318-2596 and they may be reached 24/7. Assistance may also be obtained from a Navigator who is an individual or organization that is available to help individuals determine which health insurance coverage will best satisfy their needs. Navigators are sanctioned by the Federal and State government agencies, e.g. State Insurance Departments in collaboration with Insurance Exchanges.

Tips and Helpful Information

I recently came across the following information which appeared in a current AARP publication. I thought that I would share it with you.

Niacin: “For 50 years, doctors have recommended high doses of the B vitamin niacin to lower cholesterol and help improve heart health. But two large studies show that niacin not only doesn’t reduce deaths from heart disease, it puts patients at risk for serious side effects, including infections and diabetes. ‘This is no longer a drug for routine use,’ says Northwestern University preventative cardiologist Donald Lloyd-Jones.” If you are taking niacin you may wish to discuss its continued use with your physician.

Arthritic Knee Pain: “Walking is the best and easiest way to avoid or reduce arthritic knee pain. Now a new study from Boston University suggests you need only 6,000 steps a day – about 60 minutes of walking – to stay fit to move as you age. Haven’t been active? Even 3,000 steps a day can help mobility.” Before undertaking this regimen you should consult your physician, if this would represent a significant change in your life style.

Alzheimer Prevention: In a two year study conducted by researchers in Finland and Sweden, it was concluded that participants who improved their diets, exercised their bodies and minds more, engaged in social activities and managed their heart risk factors did significantly better on memory tests, complex thinking, problem solving and other aspects of brain health.

Fasting: “Scientists now say there’s no reason for patients to fast for six to eight hours before testing for cholesterol levels. A New York University School of Medicine study finds that nonfasting readings are just as accurate as fasting ones.” Irrespective of the opinion of the scientists, you should be guided by your physician’s advice if you are scheduled for a cholesterol test.

In addition to the above material, I recently became aware that the Federal Government offers a free “Family Caregivers Kit” that provides a caregiver with useful financial and health care information. The Kit includes brochures and booklets that deal with medications, health scams, consumer protection, financial exploitation, and managing someone else’s money. Besides caregivers this information may be helpful to the retiree. To view or obtain a copy of the Kit please visit Promotions.USA.gov/dearabby.

If you have any questions about this article I can be reached by phone at 972-964-1787 or by email at awhoran@verizon.net.