Health Insur. & STRS

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OEA-R Report of December 2006 meeting

Contact Information: STRS Board, January 2007

Constance Ramser, Chair
Contributing Member
5615 West Blvd., NW
Canton, OH 44718
330-499-1326
ramserc@strsoh.org
 
Jeff Chapman, Vice Chair
Retired Member
275 East Broad Street
Columbus, OH 43215
chapmaje@strsoh.org
 
Mary Ann Cervantes
Contributing Member
275 East Broad Street
Columbus, OH 43215
cervantm@strsoh.org
 
Thomas W. Johnson
Appointed Member
275 East Broad Street
Columbus, OH 43215
 
Taiyia Hayden
Contributing Member
4443 Landmark Road
Groveport, OH 43125-8924
614-830-0277
haydent@strsoh.org
 
John Lazares
Contributing Member
275 East Broad Street
Columbus, OH 43215
513-967-8786 (or) 513-703-1197
 
Dr. Dennis Leone                                                             Dennis Leone's STRS Report March 2007
Retired Member
45 Timberlane Drive
Chillicothe, OH 45601
740-779-1398
dennisleone@roadrunner.com
 
Mark Meuser
Contributing Member
804 Cherry Bottom Rd.
Gahanna, OH 43230
meuserm@strsoh.org
 
Dr. Steven Puckett
Superintendent Representative for Dr. Susan Tave Zellman
Ohio Departments Bldg.
25 S. Front St.
Columbus, OH 43215

 

Treasurer's Appointment Appointed Member - TBA
House & Senate Appointment Appointed Member - TBA
 
More STRS contact information here (Note: some may be outdated)
Find your state legislators here

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Health Insurance

This link will take you to the ORTA website which has listed the
health care monthly premiums for STRS retirees.
 

From: "Asbury, Damon" <AsburyD@strsoh.org
To: "molly janczyk" <mollyjanczyk@hotmail.com
Date: Mon, 8 May 2006 15:30:25 -0400

Molly:

I've been waiting to reply to you until I had some additional information to help explain the estimates for health care premiums for 2007.
 As you know these are still estimates at this time and subject to further discussion.  I asked Sandy Knoesel for some information about
actual premiums costs and expected costs to help prepare this response.

For a non-Medicare eligible benefit recipient with 30 years experience:

In 2004, the total monthly cost for health care for a 30 year non-Medicare benefit recipient was $541.  Of this amount, the benefit
recipient paid a monthly premium of $135.  In 2005, the total monthly cost went to $575, and the member premium went to $144 -- a 7% increase.
In 2006, the total cost rose to $605 and the member premium was scheduled to rise to $151 -- a 5% increase.  But, the board capped the
increase to 3%, so the premium was actually $148.  In 2007, based on projected claims experience, we estimate the total cost to be $678, with
the member premium to be $170.  This is 15% over the $148 the member paid last year, or 12.5% over the $151 premium which would have been in
place if the 3% cap had not been put in place.

For a non-Medicare eligible spouse:

In 2004, the total monthly cost for health care for this spouse was $427.  Of this amount, the benefit spouse paid the full monthly premium
of $427.  In 2005, the total monthly cost went to $486, and again, the spouse paid the full premium -- a 14% increase.  In 2006, the total cost
rose to $588 and the spouse premium was scheduled to rise to $588 -- a 21% increase.  But, the board capped the increase to 3%, so the premium
was actually $501.  In 2007, based on projected claims experience we estimate the total cost to be $659, with the spouse premium to be $659.
This is 32% over the $501 the spouse paid last year, but 12% over what they would have paid if the 3% cap had not been put in place.  Thus, the
spouse actually paid $1044 less last year than what the actual trend should have cost.

So the 12% is the projected trend increase from 2007 over what the actual trend should have been in 2006.  The fact that only a 3% increase
was applied in 2006, instead of the actual 21% trend, does make the actual out-of-pocket cost to be the estimated 32%.

The Board will be receive additional information at the May meeting concerning possible plan design changes and the impact adverse selection
which could result in some changes to the above information.
 

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For Medicare A & B members, Medicare is primary for hospital (Part A) and physician/outpatient services (Part B) with STRS paying secondary.  For the individuals that are Medicare Part B only, STRS is primary for hospital services and Medicare Part B is primary for physician/outpatient services with STRS paying secondary on those services.
 
Also, just to point out, anytime a person is eligible for Medicare and does not enroll, the STRS Ohio benefits are reduced by the amount that Medicare would have paid for the services.
 
Sandra L. Knoesel Deputy Executive Director - Member Benefits
(614) 227-2880

Aetna Basic PPO or Aetna Plus PPO                                    1-800-645-5677

Caremark  (Pharmacy)                                                         1-877-827-7320 

new prescription fax number for doctor                                  1-877-278-0328

The quickest way to have your prescription refilled is to have your physician's office fax a new prescription directly to our
pharmacy at 1-877-278-0328 or they can call the pharmacy at 1-877-278-0347.  Please make sure your physician's office includes
your name, date of birth and ID number from your insurance card on the faxed information.  Keep in mind that members cannot fax
the prescription.  You must have your physician fax the prescription or it will be invalid.

Of course, you always have the option of mailing your new prescriptions in to the pharmacy if you prefer to the following address:

Caremark
PO Box 830070
Birmingham, AL  35283-0070

Caremark and Medicaid article

PBM Caremark Agrees To Pay $137.5M To Settle Kickback Charges

Delta Dental Customer and Claims Services Department         1-866-349-1286

Medical Mutual Basic PPO or Medical Mutual Plus PPO        1-800-854-8139

STRS

VSP Vision Plan Member Services                                        1-800-877-7195

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