Happy New Year!
What’s new and what’s not
Let’s start with what is not new. Our dental insurance remains with CIGNA. Our dental insurance cards are the same ones we have been using. There is no need to inform your dentist; keep using the card and information you already have for dental care.
Everything else about our health insurance is new and there is a lot that you will need to pay attention to in this transition to UnitedHealthCare and OptumRx. Note, if you received a new Anthem card, that was an error. You do not have Anthem coverage. The SFCRTA Leadership Team held a meeting via Zoom on January 11, 2022, and insurance information dominated our conversation and concerns. Any clarification we are attempting to provide is current as of that date and it takes a bit of time for this newsletter to get to you, so please recognize that some aspects of the transition appear to be in flux. We are trying to provide what we know at this time about issues we have encountered and resources we have found.
Remember that anytime this newsletter contains a website address, you may go to our website, SFCRTA.com, click on News, and select this edition of the Newsletter, where you will find clickable links. We are making an effort to get the Newsletter posted on the website by the time you receive it in the mail.
First, it has been reported that some people are not sure which of the two insurance plans they have. The Association of Retired Teachers of Connecticut has posted a very helpful explanation, with pictures of the different cards, that can let you identify your insurance plan. They also explain that people who have selected the Medicare Advantage plan will only use the single Medical Coverage and Drug Coverage card and their CIGNA card while people who have selected the Medicare Supplement plan will use their Original Medicare card, the Medical Coverage card, the Prescription Drug card, and the CIGNA card. The pictures and explanation are available at ARTCT.org by scrolling down the home page until the green Updates section and selecting Learn More in the Insurance Information box. Here is the link to information.
The ARTCT.org site contains more helpful information and explanation about our new health insurance. They address questions that were submitted by members during this transition process. They have actively monitored this process on our behalf.
Now that you have identified which card you have and how to use it/them, we have a concern to report for people who have the Advantage plan. Our cards do not indicate that our Advantage Plan is a PPO. As we learned during the presentations, a PPO or Preferred Provider Organization, is a much more expansive program. We have already heard, as of early January, that someone was denied service because their medical provider didn’t believe they had a PPO plan. We can’t advise you about how to correct such a problem other than to realize that you might encounter it and will need to contact UHC or take other steps to clear up the confusion. It certainly would have been easier for all to have PPO indicated on the card.
You will need to provide your new insurance coverage every time you use medical services. Do you have your medical health insurance information on a website like mychart or hartfordhealthcare? If so, and you are comfortable using the computer, you can scan the front and back of your card and upload it on the site. If this method doesn’t work for you, be sure to show your new cards the next time you use any of those facilities.
Our prescription coverage is definitely new. We no longer participate in ExpressScripts. Some members who went to pick up prescriptions at the pharmacy found they were denied because they had not yet updated their prescription coverage as OptumRx. If you use a local pharmacy for any medication, you may go in now and update your coverage information with them so it is ready when you need to use it. You may also update your profile on OptumRx to include your address and payment information for your Advantage prescriptions.
We are most concerned for our members about the transition of prescription coverage because this is the most complicated aspect of our transition. We were told that any medications for which we had open refills from ExpressScripts would be automatically transferred to OptumRx. It has been the experience of our Leadership Team members that this transfer should be closely monitored. How can you do this? Register at OptumRx.com. Set up your account. See what they have listed for your medications. Many of us found some items were missing and made calls to correct prescription information. There have been reports of customer service representatives being extremely helpful in making the corrections, however, there have also been many reports that, when checking back later, prescription accounts still were not correct. Sometimes medications that were listed are no longer listed, etc. The message here is that during this transition, you will need to stay on top of the process to see that you receive the medication you need at the time you need it. Here is a helpful hint- Go back to your ExpressScripts account to make a list of every medication and when you last received it so you will know when you need to get it refilled. If you aren’t comfortable with the computer, look directly at your medication container (with a magnifying glass for tiny print) and check the date it was filled. Pay special attention to any medication you should be receiving in January.
Use this number to contact OptumRx directly- 877-889-6358. You may register and update your account via phone if you prefer that over using the computer.
Advantage Plan Topics
Here is a special note about use of the UHC Advantage plan for those who are new to an Advantage plan. There may be members who switched to an Advantage plan for the first time because of the dramatic (and unexplained) rate changes. We heard that the Supplement plan provides peace of mind, but may not have understood what the Advantage plan means as it is used. One of the main differences is prior authorization. These are services for which your provider may have to obtain prior authorization in order for them to be covered. The summary of benefits in the Explanation of Coverage document marks these items with a “1” to reference the need for prior authorization. Surprisingly, it includes services such as vaccines since receiving a vaccine includes the cost of the vaccine itself and the administration. The ARTC insurance information website includes a list of 25 services that may require prior authorization. That information from ARTC follows:
Q.‐Can you tell me the procedures I would need pre‐approval for under the UHC Advantage Plan? A.-The twenty-five plus prior authorization services which you may be subject to on the UHC Advantage plan are listed on the ARTC website. Look under the heading AGENDA and HEALTH INSURANCE on the pull-down menu to find it. The ARTC website is available to members and non-members. There is more information available there. This list of prior authorizations was compiled from the UHC Summary of Benefits posted on the UHC/TRB retiree page.
The person who works for the TRB overseeing benefits is someone who can provide help for members who have a problem with UHC or OptumRx that you were not able to resolve by working directly with them. Her name is Amanda Harley and her contact information is 959-867-6380 or Amanda.Harley@ct.gov
The retired teacher representative to the TRB who was on the Insurance Selection Committee may be able to provide clarification and assistance. His name is Bill Murray and his contact information can be found on ARTCT.org, selecting Board and scrolling to the bottom.
A clearinghouse for concerns or problems with our health insurance or its transition is being established by the Association of Retired Teachers of Connecticut. It would be helpful to everyone if you forward any problems with the new insurance to the executive director of ARTC, Tammy Gowash. Her contact information is email@example.com
Not eligible for Medicare?
Not to forget those retired teachers who are not eligible for Medicare and thus, not participants in the UHC plans, here is information provided on the ARTC website that offers an explanation of how this came to be.
Why are all health plans just for people on Medicare? There are some of us who did not qualify for Medicare, for one reason or another, and our premiums keep escalating.
Only those who have paid into Medicare are eligible for these Medicare based plans. Since 1986 active teachers have paid into Medicare and therefore have become eligible for these plans. According to the TRS History posted on the TRB website, the TRS had offered an insurance plan in the past but the Connecticut Teachers’ Retirement System’s “(CTRS’) plan had an extremely poor experience rating and thus experienced high premiums since its entire group consisted of retired and disabled members who, as a rule, had more claims covering longer periods of hospitalization than would otherwise be experienced by younger and more homogeneous groups. The CTRS plan therefore became a Medicare Supplement Plan only.” If you are under 65 years of age and are on your former Board of Education’s group plan your town will receive a subsidy of $110 towards the cost of your insurance. Once you reach 65 years the subsidy is increased to $220 for those who are ineligible for Medicare and remain on your Board of Education plans.
In Other News
Connecticut State Income Tax
Remember that you are able to deduct 50% of all income you receive from the TRB on your Connecticut State Income Tax. This deduction is thanks to the persistent efforts of the ARTC, the only group that lobbied on our behalf to make it happen.
Per the 2021 Connecticut Resident Income Tax Return Instructions, a taxpayer is allowed a subtraction modification of 50% of the income received from the State Teachers’ Retirement System. This deduction happens on line 45 of the state tax form, but there is no such deduction for Federal Income Tax. The entire amount received from the TRB must be included as income for Federal tax purposes.
Scholarship applications for students pursuing a future career in education are now available and can be found on the following websites:
- The Glenn Moon Scholarship application is on the Association of Retired Teachers of Connecticut (ARTC) website, artct.org
- The Southern Fairfield County Retired Teachers Book Award application is on our (SFCRTA) website, sfcrta.com
Please help spread the word to encourage qualified high school students from our eight towns to apply.
One of the Connecticut Senators from our area, Will Haskell, has announced he will not seek reelection for a third term. You may recall that he attended two of our meetings and took an interest in our concerns. He represents the 26th District, which includes Bethel, New Canaan, Redding, Ridgefield, Weston, Wilton, and Westport. He plans to attend law school and is the author of the newly published book 100,000 First Bosses: My Unlikely Path as a 22-Year-Old
Lawmaker: One of America’s Youngest State Senators. The 100,000 bosses refers to the population of a Connecticut Senate district, approximately 100,000. Perhaps this is not the last we will hear of him.
Social Security Fairness
Many of our members continue to be penalized by the WEP and the GPO provisions. You can keep current through the website ssfairness.org. A quick look reveals that there are 243 Cosponsors in the House of Representatives for HR 82, but only 37 Cosponsors in the Senate for S1302. The largest obstacle has been getting the bill out of the House Ways and Means Committee. While the penalized teachers worked in only 15 states, there are state employees from 26 states and federal employees who are impacted, too. Additionally, many of these retired employees live across the country, so the geographic impact is larger than some legislators understand. Stay tuned and provide information to educate them when called to do so.
Medicare in Jeopardy?
In early 2020, under the previous administration in Washington, the Center for Medicare and Medicaid proposed changing the way Medicare works, currently a Fee For Service (FFS) model, and encouraging private entities to take on all responsibility as Direct Contracting Entities (DCEs). Consideration of these changes continues. They would operate similarly to Advantage plans with the stated intent of paying providers for outcomes rather than services. Why do these proposals concern retirees? First is that the design offers large profits to the DCEs, as much as 40% of the money they are given by Medicare to oversee health care. Next, if Medicare FFS disappears, it reduces any incentive for Advantage plans to offer extra benefits. There are different models being proposed, but it seems important to pay attention to proposals for changes to Medicare.
Contributions to the Teachers’ Pension Fund
Connecticut had a budget surplus and was able to contribute an additional $904 million to the Teachers’ Pension Fund in 2021, which now has a 58% funding level. Again, ARTC advocated on our behalf for this. If you have not joined ARTC, please consider doing so.
Retired Teachers Re-employment
Gov. Lamont announced on January 12, that he has signed an executive order related to the COVID-19 emergency declarations (Executive Order No. 14E) that modifies certain state laws in order to provide school districts with greater flexibility to address the current teacher shortage caused by the recent spike in COVID-19 infections by relaxing certain statutory limits on the availability of retired teachers.
The order takes two actions:
- It allows school boards to reemploy or continue to employ retired teachers, even if they reached the maximum limit permitted under state law while receiving retirement benefits by excluding the period between July 1, 2021, and February 15, 2022, from the salary determination.
- It modifies certain statutes that allow school districts to hire retired teachers for a maximum of two school years in districts designated as a subject shortage area or identified as a priority school district by excluding the period between July 1, 2021, and February 15, 2022, from being included when calculating that two-year maximum eligibility period.
“This executive order is a critical step to providing much-needed resources to ensure we keep students in the classroom and provide them with an in-person education,” Lamont said. “We are fortunate to have retired teachers available to provide some relief for their colleagues who continue to do great work for school children across our state. We will continue to utilize all tools at our disposal to provide for a safe and meaningful classroom education for students.”
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Our membership goes from – January to December. If you have not yet joined, click here for our membership renewal information for 2022. Remember: Numbers matter and we still face many important issues regarding our pension and health insurance.
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