Retiree Benefits Book 2020 - Human Resources

City of Baltimore Retiree Benefits Book

2020

Open Enrollment November 1 - November 15

See Inside for "WHAT'S NEW in 2020"

New Dental Plan for Non-Medicare retirees New Life Insurance Vendor New Enrollment Process

See page 5 for more information

Table of Contents

Section

Section 1

Section 2 Section 3

Section 4 Section 5 Section 6

Contents

Cover Page Table of Contents New and Important Information Important Contacts What's New for your 2020 Benefits? Alex, our Virtual Benefits Advisor New Enrollment Process for Retirees Qualifying Life Events/ Family Status Change Dependent Eligibility /Required Documentation

Medicare Information Important Information About Medicare Kaiser Permanente your Medicare Advantage Plan Medicare MBI# replace the Medicare HIC# CMS allows removal of Part D drugs from Formulary Retiree Contribution Schedule Graduated Retiree Contribution Schedule 2020 Retiree Premium Contributions Monthly 50% Retiree Contribution (15 or More Years of Service) 80% Retiree Contribution (10-14 Years of Service) 100% Retiree Contribution (5-9 Years of Service) Prescription Drug Plan Monthly Premium How To Determine Your Monthly Prescription Drug Cost Non-Medicare Retirees - Medical Plan Comparison Chart Retiree Without Medicare Benefit Comparison Chart Medicare Retirees ? Medical Plan Comparison Chart Retiree With Medicare Benefit Comparison Chart Dental, Rx, Vision & Life Benefits New Dental HMO and PPO Plans Prescription Drug Plan Copays Vision Plan and Benefits Basic Life Benefits Basic Life Beneficiary Form Back Cover

Page

1 2 3 4 5 6 7-8 9 10 11 12-16 17-18 19 20 21 22-23 24-25 26 27 28 29 30 31 32-36 37 38-40 37 42-44 45-46 47-48 49 50 51

Page 2

Section 1

New and Important Information

Page 3

Retiree Contacts

Phone Numbers & Websites

Provider

BlueChoice Advantage PPO (Non-Medicare Retirees) CareFirst Medicare Supplemental Kaiser Permanente HMO CareFirst Caremark/CVS (Non-Medicare) Silver Script Medicare Prescription Plan National Vision Administrators (NVA)

MetLife TASC FSA

United Concordia Dental

Phone Number

Insurance Companies

Website

1-800-535-2292



1-800-535-2292 1-866-248-0715 1-800-241-3371 1-877-878-1678 1-800-672-7723 1-866-492-6983 1-800-422-4661

1-866-851-7568





e-

mybenefits



Baltimore City Retirement System (ERS) Fire & Police Retirement (FPR) Maryland State Retirement (Pension Information)

Baltimore City Medicare Rx Plan (Medicare Part D)

Employee Benefits Division Employee Benefits Division (TTY)

Document Upload to Employee Benefits

Retirement Agencies

1-877-273-7136 1-888-410-1600

w

1-800-492-5909

sra.state.md.us/

Employee Benefits Division

410-396-1780

410-396-5830 TTY 711 (Maryland)

410-396-5830





7E. Redwood Street, 20th FL Baltimore, MD 21202

Employee Benefits Division

Phone: 410-396-5830 Fax: 410-396-5216



Medicare/CMS/ SSA

Medicare Service Center

Centers for Medicare & Medicaid Services (CMS)

Social Security Administration

1-800-MEDICARE (800-633-4227) TTY: 877-486-2048

Local: 410-786-3000 TTY Toll-Free: 1.866-226-1819

TTY Local: 410-786-0727 1-800-772-1213

TTY 1-800-325-0778



Page 4

Information About Your Benefits for 2020

Please read the information provided in this benefit book.

What's New for 2020

New Dental Benefits for non-Medicare retirees enrolled in Bluechoice PPO is provided through the United Concordia DHMO plan. Dental Benefits for Non-Medicare retirees that live outside of MD and PA is provided thorough the Low Option United Concordia PPO plan.

See Dental schedules on pages 42-44

Visit cityofbaltimore to find a dentist in your area

The City of Baltimore moved to a new enrollment platform called ADP Benefits Marketplace (BenMark) effective May 6, 2019. Retirees and beneficiaries will not have direct online access to the BenMark System. See page 7-8 for more information.

MetLife will be the New Life Insurance vendor effective 1/1/2020. See pages 4950 for more information.

Retirees may upload their information directly to Employee Benefits.

Document Upload

Uploading Your Enrollment forms, and Dependent Documents has been made easy. You now have the option to "Upload Required Documents" directly to the Office of Employee Benefits by using the following link and follow all the necessary steps; . See page 8 for more information

Diabetic Supplies

See Page 8 for more information.

Reminder: The City of Baltimore's Diabetic Services, Supplies and Medication is covered under the Medical Plans and the Prescription Drug plans. Contact your plan directly for information. Medical Plans Cover -Diabetic test supplies and services Prescription Drugs Plan Cover - Diabetic Medication and Diabetic Insulin/medical supplies used to inject insulin.

CareFirst Medicare Supplemental

Plan

Dental Coverage

Reminder: Effective January 1, 2017, the City's CareFirst Medicare Supplemental plan pays 80% of the 20 % balance due after Medicare. The City will no longer pay 100 % after Medicare. The retiree must pay the remaining balance.

The New Dental Vendor is United Concordia, under the DHMO plan, you must select a dentist or one will be automatically assigned to you. Visit cityofbaltimore to find a dentist in your area Retirees enrolled in Kaiser Medicare Advantage Plan have dental coverage. Please contact Kaiser for more information. Reminder: Retirees enrolled in the CareFirst Medicare Supplemental Plan are not eligible for dental benefits.

Page 5

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