The TRB Health Insurance Plan is changing as of July 1, 2018. Open enrollment will begin in mid-April and run until early May. Members will be receiving a preenrollment kit prior to April 1st. The pre-enrollment kit will include a full benefit plan description as well as “Opt-Out” instructions to remain in the Stirling plan.
The TRB will now be offering two options for your medical plan – (1) a Medicare Advantage (MA) plan through Anthem and (2) the current plan through Stirling Benefits.
The TRB has adopted a new base medical plan. The plan is an Anthem Blue Cross Medical Advantage PPO plan. This is a non-gatekeeper plan with national access to providers. Insurance companies that offer Medicare Advantage typically receive funds from the federal government and from this they will pay all expenses and member claims. In the case of the TRB, this is about $11,000 per member per year. In this plan, instead of having “Medicare” plus a supplement to pay extra costs, everything is provided by Anthem. (Stirling is the supplement in the current plan.)
Stirling Benefits operates as the administrator of the TRB plan. Stirling Benefits is paid a fixed rate per member per month from the HIPA account to administer the claims and provide customer service. Medicare is the first and primary payer and pays the majority of each claim. Once Medicare has paid their share, the Stirling TRB plan pays the difference out of the TRB health claim fund.
Medicare Advantage and Medicare Supplement (Stirling Plan) generally cover the same medical events. The Anthem Plan has what they describe as a large network, with out-of-network charges. The Stirling Plan has no network. You can see any Medicare provider anytime. Stirling will continue their current levels of coverage. Every retiree will need to consider for themself how these plans function for them as an individual.
Charts outlining both the Anthem and the Stirling Benefits Plan are below. Beginning July 1, 2018, the Anthem MA plan will be the base plan with a premium cost of $134 per month per person for the total package that includes drugs, dental, vision, and hearing. Stirling will remain as a “buy-up” option for that total package, and the premium will be $259 per month per person. The Rx plan remains the same regardless if a person moves to the new base plan or decides to stay with Stirling.
Finally, members will still have to pay Medicare part A and B premiums for either plan.
In April, you will have to choose which plan you wish to have. All members will have access to a pre-enrollment call center called “First Impressions”. This will be a dedicated phone number specific to TRB members. The staff will be trained on the TRB plan specifically and choices available. The First Impressions call center will be up and running towards the end of March. All member questions can be addressed via the First Impression call center. In addition, Anthem will be hosting in-person enrollment/education meetings during the month of April. Members will be receiving a full listing of meeting dates and locations.
Save the date — New Health Insurance Plans
SFCRTA will host a meeting on the new health insurance plans on March 14 at the Norwalk Inn (10:00 a.m.) Speakers will include Dr. Joe Fields, insurance consultant to the TRB and M. James Stirling, CEO Stirling Benefits. Bring your questions. Coffee will be served.
How did we get here?
For the last eight years, The State has not contributed their identified/legislated share to our health fund, underfunding it by almost $200 million. Legislators have cited the budget crisis as the reason for this underfunding. This results in increased costs for members, a constant search for more cost effective mechanisms to deliver services and has forced the TRB to find a less expensive alternative.
CLICK HERE to renew your membership information. Remember we have changed to a calendar year membership – January to December. Please join if you have not done so and encourage your friends to join as well. We need to continue to get our agenda out there over issues such as: the 25%/50% reduction on our state income tax, the state’s one-third contribution to out HIPA, the status of our pension, and social security, among others. Please remember to update your information, sign and enclose your check. We thank you for your continued support and will continue to work on your behalf.
Save the Date — Spring Luncheon
our spring luncheon will be May 9th at the Norwalk Inn. Our guest speakers will be: AARP Associate State Director Community Outreach, Erica Michalowski, M.S.W. and Detective Mark D. Solomon of the Greenwich Police Department and CT Financial Crimes Task Force addressing the topic of Senior Frauds and Scams.
Frank Cooper, President