2017 Healthcare Enrollment Guide
for City of Memphis Medicare Eligible Retirees

January 23, 2017

Dear City of Memphis Retirees & Surviving Spouses:

We recognize that the City of Memphis has put you in a difficult and uneasy situation, but the Memphis Fire Fighters Association (MFFA) is not only committed to finding the best healthcare options available for post-65 retirees and their spouses, but also to provide additional support. The MFFA has partnered with LABOR FIRST, a Retiree Benefit Administrator and Retiree Advocacy company that specialized in servicing the healthcare needs of retirees of organized labor.

We have teamed up with LABOR FIRST to offer two group Medicare Supplement plans and a group Medicare Part D Prescription plan which offers full donut hole coverage. A common complaint we’ve heard from post-65 retirees is that they could not find Medicare Part D Prescription plans that covered through the donut hole. We found a plan that does just that. We endorse and support these plans as an option for Post-65, Medicare retirees of the City of Memphis and are available for all post-65 retirees of the City. These are not exclusive to Fire Retirees only.

For those who are enrolling into Medicare Part B after age 65, the city has advised they will be paying the late enrollment penalty to Medicare on your behalf. These plan offerings will supplement your Medicare Parts A & B once you are enrolled in Medicare Part A and B.

With these plan offerings, the city has agreed to payroll deducting these premiums and remitting them to us for transmittal to the insurance company. By doing so, Public Safety retirees can still claim the $3,000 tax credit under the HELPS ACT, a federal law that reduces your taxable income by up to $3,000 for healthcare premium deductions coming from your pension check. This will allow you to have some savings on your taxes and will possibly increase any refund you may receive.

Enclosed in this packet is information on the plan offerings and information concerning enrolling into these plans if you so choose. Questions can be directed to LABOR FIRST at the number and website provided.

Sincerely,

Thomas Malone, President
IAFF Local 1784 Memphis Fire Association
Office Tel: (901) 386-3129

Who is Labor First?

Labor First is a Retiree Benefits Administrator & Advocacy Company that specializes in retiree healthcare, specifically for the union marketplace. Our dedicated Retiree Advocates are here to not only assist members with enrollment, but to provide ongoing retiree support with the sponsored MFFA Medical and Prescription Drug plans for the life of the plan.

MEDICAL SUPPLEMENT BENEFIT SUMMARY

Medical Supplement Pricing
(Premiums per person per month)
Option 1:
Plan F
Premium
Option 2:
Plan N
Premium
Ages 65 – 69 $169.00 $138.00
Ages 70 – 74 $183.00 $152.00
Ages 75 – 79 $205.00 $174.00
Ages 80 + $220.00 $189.00
Ages 64 & Under $292.00 $246.00

PART A Benefits & Coverage Levels:

Hospital Coverage Plan F Coverage Plan N Coverage
Part A Deductible of $1,316 in 2017 Covered at 100% Covered at 100%
Part A Coinsurance: Days 61-90 all but $322 per day, Days 91-150 all but per $644 a day Covered at 100% Covered at 100%
Additional 365 days of coverage after Medicare benefits are used Covered at 100% Covered at 100%
Skilled nursing facility care: Days 1-20 Covered at 100% Covered at 100%
Skilled nursing facility care: Days 21-100 all but $161 per day Covered at 100% Covered at 100%
Blood (first 3 pints) Covered at 100% Covered at 100%

PART B Benefits & Coverage Levels:

Physician Coverage Plan F Coverage Plan N Coverage
Part B Deductible $183 in 2017 Covered at 100% Member pays 100%
Part B Coinsurance: Medicare pays 80% of charges Covered at 100% $20 office copay and up to $50 E.R. copay
Part B Excess Charges (Charges above Medicare approved amount) COVERED NOT COVERED
Foreign travel Emergency Coverage Emergency care outside U.S: covered at 80% coinsurance of the billed charges after a $250 deductible annually Emergency care outside U.S: covered at 80% coinsurance of the billed charges after a $250 deductible annually
MEDICAL SUPPLEMENT PROVIDER: UNITED AMERICAN
MEDICAL NETWORK: PLAN ACCEPTED AT ANY PROVIDER / FACILITY THAT ACCEPTS MEDICARE NATIONWIDE

PHARMACY: PRESCRIPTION DRUG BENEFIT SUMMARY

Prescription Drug Pricing
(Premiums per person per month)
RX Plan
All Ages $114.34

*RX Benefits & Coverage Levels:

RX Plan
Prescription Deductible $0
Retail 30 Day Supply
Tier 1 (Generics) $15
Tier 2 (Preferred Brands) $60
Tier 3 (Non-Preferred Brands) $100
Tier 4 (Specialty) 33%
Retail 90 Day Supply**
Tier 1 (Generics) $45
Tier 2 (Preferred Brands) $180
Tier 3 (Non-Preferred Brands) $300
Tier 4 (Specialty) N/A
Mail-Order 90 Day Supply**
Tier 1 (Generics) $30
Tier 2 (Preferred Brands) $120
Tier 3 (Non-Preferred Brands) $200
Tier 4 (Specialty) N/A
Part D Coverage Specifications
Part D Coverage Gap Full Coverage
Catastrophic Coverage Covered 100%***
All Other Non-Part D Drugs Covered
PRESCRIPTION DRUG PROVIDER: EXPRESS SCRIPTS (ESI)
PHARMACY NETWORK: OVER 66,000 PHARMACIES NATIONWIDE. INCLUDES ALL MAJOR PHARMACIES (i.e. FRED’S, WALGREENS, CVS, KROGER AND RITE AID)
* A more detailed benefit description can be available upon request
** 90 Day Supplies: Some drugs not available at 90 day supplies
*** Catastrophic Phase Coverage: $0.00 Member copay for all drug Tiers

HOW TO ENROLL


  1. Complete the included Selection Form & Application and return in the enveloped provided. (Postage Stamp Required)
  2. Included in your return envelope a check or money order for your first month’s premium.
    You will be enrolled in pension deduction for month two and ongoing after that. If you have any questions on the calculation on your full premium, please call 855-244-8844.

FREQUENTLY ASKED QUESTIONS

You are still eligible to enroll in these plans, even if you previously enrolled in a sponsored plan or an Individual Plan!!!

If you have enrolled in a Medicare Supplement plan you will need to call the carrier and cancel the policy.
In MOST cases, we are able to automatically dis-enroll you from an MAPD or Part D prescription drug plan. We do recommend you contact the carrier as well to ensure dis-enrollment is processed with Medicare.

  1. Does this plan have a Medical Network?
    No, the Facility or Provider just needs to accept Medicare in order to accept this plan. Additionally, referrals are not required under this United American (UA) Plan.
  2. Do I still need my Medicare Card?
    Yes, you should show your provider your Medicare card and your United American card. The claim will automatically be processed by Medicare and UA. You will receive and EOB from both.
  3. When does my Medical premium change if I have a Birthday?
    If you have a birthday that places you into a higher age bracket during the plan year, your premium increase will not go into effect until the start of the new year. i.e.: Birthdate is July 3, 2017, premium increase would begin January 1, 2018. (The shown rates are for 2017 only.)
  4. How do I know which Medical plan to choose?
    Based on your age bracket and Doctor utilization one of the three plan options may be more suited to your needs. If you frequent the Doctors often or prefer no extra out-of-pocket expense after your premium each month, we recommend choosing the Plan F without the deductible.
  5. Are my drugs covered?
    Most likely yes. This is a much more comprehensive drug plan than individual part D plans. You will receive an abridged Formulary with your Welcome Kit and cards. Note: There are several classes of drugs that are note covered such as lifestyle drugs.
  6. Can I go to the same Pharmacy?
    Most likely yes. There should be little to no pharmacy disruption. You do NOT need new prescriptions for retail pharmacy fills. However, you will see the most cost savings using Express Scripts Mail Order Facility.
  7. Is there a Mail Order Pharmacy?
    Yes, but you will need new prescriptions if you prefer to use the Mail Order Service. The Express Scripts Mail Order Facility number for members is (888) 345-2560. You can have your Doctor Fax Prescriptions to (800) 837-0959.
  8. Can I still go to the VA for my drugs?
    Yes.
  9. Will my prescriptions transfer from the old plan?
    No, you will need to obtain all new scripts from your Provider if you are using Mail Order. If you use a retail Pharmacy you do not need new prescriptions.
  10. Do I need Prior Authorizations again for certain prescription medicines?
    Yes. Particular drugs require Prior Authorizations or may have quantity limits. This is standard in all Medicare type part D plans. Please contact Labor First if you have questions at 1(855)244-8844.
  11. Can I obtain more detailed information on the RX plan?
    Yes. Upon request an ESI pre-enrollment guide can be provided.
  12. When will I receive my card/ Welcome Kit?
    Cards and Welcome Kits should be received around End of February or early March based on your enrollment date. Members and covered Spouses/Medicare Eligible Dependents will each receive their own cards and kits. UA Medicare supplement packets and ESI Rx packets are mailed separately and at different times.
  13. Do I get to use my Tax Credit if I am a retired “Public Safety Officer”?
    Yes, the City will be participating in HELPS so you can continue to receive the Federal tax-credit.
  14. Will my premium change?
    Yes, Premiums change on a yearly basis every January. Since these are group rated plans the increases tend to be smaller than seen in individual plans. Labor First will negotiate with the carriers each year to keep the costs as low as possible.

APPLICATION FORMS

PAPER ENROLLMENT GUIDE

(1) SELECTION FORM

  • A form is required for each person.
  • Please check the colun and your age bracket for the option you would like to enroll in.

(2) APPLICATION

  • A form is required for each person.
  • Fill in all required information such as: name, date of birth (DOB), social security number, address and Medicare information.
  • Sign and date the bottom of the second page.

(3) PENSION DEDUCTION FORM

  • One form is required for each household.
  • The person whose name is on the pension check should complete and sign this form.

To complete enrollment, please follow one of the options below to submit your forms.

Forms can be faxed to: (856) 437-4550 or
Emailed to: RetireeFirst@laborfirst.com or
Mailed to: 3000 Midlantic Drive, Suite 101, Mount Laurel, NJ 08054


For further information, please call
(855) 244-8844