The Department of Central Management Services (CMS) has awarded contracts to the winning vendors of the following Medicare Advantage plan options for members of the State Employees Group Insurance Program:
- Aetna Life Insurance Company - a Medicare Advantage HMO Plan;
- Humana Health Plan - a Medicare Advantage HMO Plan;
- Humana Benefit Plan - a Medicare Advantage HMO Plan for the counties of Livingston and Knox; and
- UnitedHealthcare - a nationwide Medicare Advantage PPO
The enrollment period for the Medicare Advantage plans has been set for November 12 through December 13, 2013. The effective date of the new plan will be February 1, 2014. In order to be included in the group who will be offered one of the Medicare Advantage plans, members must meet BOTH of the following criteria:
- The member must be enrolled in Medicare Parts A and B, AND
- If the member has dependents on his/her coverage, ALL of the covered dependents must also be enrolled in both Medicare Part A and B.
- If the member has a dependent on his/her coverage who is not enrolled in Medicare Parts A and B, the member will not be included in the group of members set to be offered a Medicare Advantage plan. The member and dependents will all remain in the current health plan.
- If the member RESIDES outside of the United States, the member will not be included in the group set to be offered a Medicare Advantage plan. The member will remain in the current health plan.
- The cut-off age for the enrollment period this fall is set for members turning the age of 65 on or before September 30, 2013. Members who will be 65 on October 1, 2013, or after will be included in the group set to be offered a Medicare Advantage plan during the fall of 2014. These members will remain in their current health plan until January 2015.
IMPORTANT: The federal Medicare enrollment period begins October 15th and concludes December 7th, 2013. That means non-State sponsored Medicare Advantage and Medicare Supplement plans are also sending information to our members during the same enrollment period that the State will be sending its Medicare Advantage plan information. In order for members to avoid mistakenly electing a non-State plan during this enrollment period and inadvertently losing their State of Illinois insurance coverage, members should only review information packets that have the State of Illinois retiree Medicare Advantage logo. Although the logo is not yet ready for the initial letter, it will be included on all future communications pieces both from the Department and from the selected vendors. In addition to these communications, the Department is developing a separate website for retirees which will be dedicated just to you.
The initial letter was mailed the week of October 21st to all affected State members, the Department of Central Management Services’ Bureau of Benefits will be sending additional communications and an enrollment packet prior to the November 12th enrollment start date. It is imperative that members complete the enrollment form completely, including the federally required RESIDENTIAL STREET ADDRESS section. Although many retirees use a post office box to receive their mail, federal Medicare requires a RESIDENTIAL STREET ADDRESS in addition to the post office box address.
How much will the new Medicare Advantage Plan cost?
Retirees in the State Employees Group Insurance Program will pay 1% of their annuity for Medicare Advantage coverage through June 2014. Beginning July 2014 that percentage will increase to 2% of their annuity for Medicare Advantage. State retirees with less than 20 years of service will also continue pay 5% of the health plan cost for every year less than 20. Premiums for the new Medicare Advantage plans will be lower than the current health plans; therefore, members who have less than 20 years of service should see a decrease in the cost of their coverage.
What happens to a member’s other State-offered plan benefits, like dental, vision and life insurance? Will a member still have them when changing to a Medicare Advantage plan?
Yes, members will continue to have the same dental, vision, and life plan benefits from the same plan administrators that they are currently enrolled.
Will a member be able to make changes to his/her coverage during the annual Benefit Choice Period held in May each year?
No. Retirees who become part of the State-sponsored Medicare Advantage group of members have a new annual enrollment period in the fall of each year to coincide with the federal Medicare calendar plan year. Although the effective date of coverage this year will be February 1st, future plan years will have an effective date of January 1st for any plan changes. Any plan changes that were allowed during the Benefit Choice Period held in May will now be allowed during the fall enrollment period instead.
Do the State-sponsored Medicare Advantage plans include prescription coverage?
Yes, all of the Medicare Advantage plans being offered have prescription drug coverage included with no gap (i.e., donut hole).
Are there any special programs being offered through these Medicare Advantage plans?
Yes, each Medicare Advantage plan offers a variety of wellness/clinical programs, such as the Silver Sneakers® fitness program. Although the programs vary by health plan vendor, some examples include various wellness programs, disease management programs, case management programs, discount programs, medication therapy management and meal programs.
How will a member know which State-sponsored Medicare Advantage plans will be offered in his/her Illinois county?
A map of the plans offered in each of the Illinois counties has been developed. This map is also included in the State of Illinois enrollment kit.
What if I don’t make a change or send in an enrollment form?
Members who do not send a completed enrollment form to their retirement system by the due date of December 13th, will not be enrolled in one of the State-sponsored Medicare Advantage plans, nor will they remain in their current health plan. These members will have original Medicare coverage only. If the member is a state retiree, they may enroll in a State-sponsored Medicare Advantage plan during a future fall enrollment period and would have coverage effective the following January.
Members are encouraged to check back to this website and the retiree website (referenced above) often as information will be posted once it is known. The Department of Central Management Services, again, thanks you for your patience through this implementation process.