WEBVTT

2bdc3cb3-e527-4dd1-b912-8fc39971b2a9-0
00:00:00.040 --> 00:00:04.954
Help you as you move through,
through the end of the open enrollment

2bdc3cb3-e527-4dd1-b912-8fc39971b2a9-1
00:00:04.954 --> 00:00:08.800
session as well as into the new plan year
and beyond.

e717f68b-7367-4e49-b882-6c9fcba98881-0
00:00:08.880 --> 00:00:13.281
And then whatever time we have left,
we will do our best to address any

e717f68b-7367-4e49-b882-6c9fcba98881-1
00:00:13.281 --> 00:00:16.400
remaining questions that weren't answered
in chat.

39afa745-8d0f-4441-a83b-15507a0bf3fd-0
00:00:16.400 --> 00:00:19.767
So one more quick slide on likely why
you're here,

39afa745-8d0f-4441-a83b-15507a0bf3fd-1
00:00:19.767 --> 00:00:24.587
which is what is changing for you,
the retirees at Calvert County Public

39afa745-8d0f-4441-a83b-15507a0bf3fd-2
00:00:24.587 --> 00:00:26.040
Schools for next year.

9c604992-20c9-494f-bb66-b6a4e3cd645f-0
00:00:27.720 --> 00:00:29.360
So a couple of things to note.

51615453-bad2-456c-ad69-a9fc8c39dd3f-0
00:00:29.720 --> 00:00:34.156
You should have already received some
communications from both Calvert County

51615453-bad2-456c-ad69-a9fc8c39dd3f-1
00:00:34.156 --> 00:00:37.056
Public Schools,
a letter and some frequently asked

51615453-bad2-456c-ad69-a9fc8c39dd3f-2
00:00:37.056 --> 00:00:39.786
questions,
as well as a 2026 Healthcare Benefit

51615453-bad2-456c-ad69-a9fc8c39dd3f-3
00:00:39.786 --> 00:00:41.720
Guide from Care First in the mail.

9f46cb2d-528e-49fb-a0b7-b06ec8766b96-0
00:00:42.080 --> 00:00:46.346
Both of those communications do contain
really important information about this

9f46cb2d-528e-49fb-a0b7-b06ec8766b96-1
00:00:46.346 --> 00:00:46.720
change.

d8cd4cf1-9445-4450-91f3-87f26a227337-0
00:00:46.720 --> 00:00:49.200
We will be reviewing it here today though
as well.

7b4454b0-e2f3-488a-b2c4-c50ff934de3e-0
00:00:49.520 --> 00:00:53.912
But first and foremost,
it's just important to note that for 2026,

7b4454b0-e2f3-488a-b2c4-c50ff934de3e-1
00:00:53.912 --> 00:00:58.895
your medical and prescription drug
benefits are going to be offered under a

7b4454b0-e2f3-488a-b2c4-c50ff934de3e-2
00:00:58.895 --> 00:01:04.008
group Medicare Advantage plan from Care
1st called the Medicare Advantage PPO

7b4454b0-e2f3-488a-b2c4-c50ff934de3e-3
00:01:04.008 --> 00:01:07.024
Plan,
and that plan will be effective January

7b4454b0-e2f3-488a-b2c4-c50ff934de3e-4
00:01:07.024 --> 00:01:07.680
1st, 2026.

50752d03-8cb6-466a-a231-441b8b728f68-0
00:01:08.200 --> 00:01:13.823
As Susan mentioned at the top of the hour,
this plan is a very exclusively designed

50752d03-8cb6-466a-a231-441b8b728f68-1
00:01:13.823 --> 00:01:17.840
health plan for Calvert County Public
School retirees only.

d15b30f8-9bde-4f2a-a9ed-d7e584b0bb58-0
00:01:18.040 --> 00:01:19.920
So no one else can purchase this plan.

a66157ce-cabc-4c84-9a8a-ecc1a4bea508-0
00:01:19.920 --> 00:01:24.280
It's not available on the market unless
you worked for and retired from Calvert

a66157ce-cabc-4c84-9a8a-ecc1a4bea508-1
00:01:24.280 --> 00:01:25.480
County Public Schools.

de49bca7-f15e-4c10-ba30-39f11b6e8dd3-0
00:01:25.800 --> 00:01:29.882
It was designed to closely mirror your
current medical and prescription drug

de49bca7-f15e-4c10-ba30-39f11b6e8dd3-1
00:01:29.882 --> 00:01:30.360
benefits.

46b0ce4e-e142-40e0-8ad0-3e8f209ebadb-0
00:01:30.360 --> 00:01:44.286
And we'll go through some side by I will
be talking a little bit more about what

46b0ce4e-e142-40e0-8ad0-3e8f209ebadb-1
00:01:44.286 --> 00:01:49.960
that means in just a few minutes.

9ad62ca3-2f41-4f7d-850f-71a4294b78af-0
00:01:50.880 --> 00:01:55.063
Now, because of this change,
your current health plans that you're

9ad62ca3-2f41-4f7d-850f-71a4294b78af-1
00:01:55.063 --> 00:01:59.560
enrolled in today will no longer be
offered starting January 1st, 2026.

9943cba7-6905-43ce-aea0-fa1d7c13301b-0
00:02:00.000 --> 00:02:04.290
If you're enrolled in the group retiree
health care coverage today,

9943cba7-6905-43ce-aea0-fa1d7c13301b-1
00:02:04.290 --> 00:02:09.464
you will automatically be moved into this
new Care First group Advantage plan for

9943cba7-6905-43ce-aea0-fa1d7c13301b-2
00:02:09.464 --> 00:02:10.600
January 1st, 2026.

3ffed65b-bbbd-4847-a7f2-6e5a3184914e-0
00:02:10.600 --> 00:02:14.992
So there is no action for you to take if
you're already enrolled in the retiree

3ffed65b-bbbd-4847-a7f2-6e5a3184914e-1
00:02:14.992 --> 00:02:16.200
health coverage today.

48ff8bbb-a3d6-4ef2-b696-b5d766784c89-0
00:02:16.880 --> 00:02:20.579
Now, due to this change,
you will be receiving a new Care First

48ff8bbb-a3d6-4ef2-b696-b5d766784c89-1
00:02:20.579 --> 00:02:25.320
Member ID card in the mail that should
come in the first week or two of December.

54c38d71-8883-4ab5-9619-762ef39c82db-0
00:02:25.760 --> 00:02:29.776
And that's the card that you'll begin
using when you're at the doctor's office

54c38d71-8883-4ab5-9619-762ef39c82db-1
00:02:29.776 --> 00:02:31.760
or at the pharmacy starting in January.

f0bb60c5-92d6-4fbf-8f93-73f65f817f8e-0
00:02:32.840 --> 00:02:36.262
Also due to this change,
you will now have the support from a

f0bb60c5-92d6-4fbf-8f93-73f65f817f8e-1
00:02:36.262 --> 00:02:40.567
dedicated team of advocates at Retiree
First who specialize in retiree health

f0bb60c5-92d6-4fbf-8f93-73f65f817f8e-2
00:02:40.567 --> 00:02:44.651
care and specialize in helping you
navigate not only the health care plan

f0bb60c5-92d6-4fbf-8f93-73f65f817f8e-3
00:02:44.651 --> 00:02:47.080
from Care First,
but the healthcare system.

43c92cbd-b126-4a26-9d15-b6d2096ef569-0
00:02:47.640 --> 00:02:52.041
Retiree First is not part of Care First,
even though we both have first in the

43c92cbd-b126-4a26-9d15-b6d2096ef569-1
00:02:52.041 --> 00:02:52.320
name.

bc3060f9-0b49-4f2d-a18d-ad64185ca4e6-0
00:02:52.880 --> 00:02:57.547
We are partners and we work very closely
together to serve retirees throughout the

bc3060f9-0b49-4f2d-a18d-ad64185ca4e6-1
00:02:57.547 --> 00:02:58.560
state of Maryland.

54e32408-41d4-43c7-a748-fd3c242b581b-0
00:02:58.560 --> 00:03:02.190
So you're in excellent hands and I'm very
much looking forward to letting Diana

54e32408-41d4-43c7-a748-fd3c242b581b-1
00:03:02.190 --> 00:03:03.960
speak more to what they can do for you.

95c2563e-72f7-414b-bacb-e472ffc7b639-0
00:03:05.040 --> 00:03:09.534
The other thing I want to note is that
the plan year for your new medical and

95c2563e-72f7-414b-bacb-e472ffc7b639-1
00:03:09.534 --> 00:03:13.280
prescription drug benefits is January 1st
through December 31st.

9f50b09b-58ef-41cb-8804-ac62d3e25b4a-0
00:03:13.280 --> 00:03:17.755
So we follow a calendar year for your
Medicare Advantage benefits and I believe

9f50b09b-58ef-41cb-8804-ac62d3e25b4a-1
00:03:17.755 --> 00:03:20.440
that is different than your health plans
today.

8d6c0590-104d-4808-95ab-0b6bf2b8afbb-0
00:03:20.440 --> 00:03:25.560
So I just wanted to point that out now,
a couple of things that aren't changing.

f5eb7fcc-7f38-45bd-982e-c98db03b6c2d-0
00:03:25.680 --> 00:03:28.800
Your vision and dental benefits will not
change.

6f7fcb4e-af99-421f-a342-eb7feaea804d-0
00:03:28.800 --> 00:03:33.177
You'll continue to be enrolled in the
plans that you are enrolled in today and

6f7fcb4e-af99-421f-a342-eb7feaea804d-1
00:03:33.177 --> 00:03:36.280
will be receiving a separate vision and
or dental card.

f5cae07a-92e8-412b-9cdb-18a0fe2bb485-0
00:03:36.760 --> 00:03:41.386
You will also continue to pay your
premiums through Calvert County Public

f5cae07a-92e8-412b-9cdb-18a0fe2bb485-1
00:03:41.386 --> 00:03:43.200
Schools just like you do now.

5383a776-eb9b-4d54-871c-c6099f3abdce-0
00:03:43.200 --> 00:03:45.680
So that process will stay the same.

0a96924f-6a74-473e-8443-aeaaf202f8c9-0
00:03:46.960 --> 00:03:50.215
So I've already teed them up a few times,
but I really,

0a96924f-6a74-473e-8443-aeaaf202f8c9-1
00:03:50.215 --> 00:03:54.866
I'm going to at this point turn things
over to Diana to talk through the member

0a96924f-6a74-473e-8443-aeaaf202f8c9-2
00:03:54.866 --> 00:03:56.960
advocate services that they provide.

dd8c4a33-4685-4012-a8a6-7659f24ece2d-0
00:03:57.360 --> 00:04:01.538
They are a white glove service that go
above and beyond for members like you and

dd8c4a33-4685-4012-a8a6-7659f24ece2d-1
00:04:01.538 --> 00:04:04.840
are there to help you through every,
every step of the journey.

53d59646-6026-4ca5-a259-d2fda241361a-0
00:04:04.840 --> 00:04:07.944
So Diana,
I am going to turn it over to you and let

53d59646-6026-4ca5-a259-d2fda241361a-1
00:04:07.944 --> 00:04:08.960
you take it away.

a3e1bdd6-ec73-49d4-95f9-de491299a310-0
00:04:09.840 --> 00:04:10.080
Great.

c9c9a376-4d29-4779-b76f-6fce328ce9d4-0
00:04:10.320 --> 00:04:11.800
Thank you so much, Lindsay.

f2fd6abf-4287-42dd-8906-309ee462ab74-0
00:04:12.400 --> 00:04:14.040
My name is Diana Klimak.

5f26e410-17c6-4082-b3b0-205229fdaf60-0
00:04:14.040 --> 00:04:17.840
I am the client service manager for
Calvert County Public Schools.

b78824b1-fde5-4170-acf3-e2ad546da00f-0
00:04:18.520 --> 00:04:23.080
So just a little bit of information about
us here at Retiree First.

aec629c7-8a07-48d9-b7d3-66647aee32ac-0
00:04:23.600 --> 00:04:29.750
We are headquartered here in New Jersey
and we are here to provide the navigation

aec629c7-8a07-48d9-b7d3-66647aee32ac-1
00:04:29.750 --> 00:04:35.900
through healthcare for the retirees like
yourselves and making a Medicare process

aec629c7-8a07-48d9-b7d3-66647aee32ac-2
00:04:35.900 --> 00:04:37.400
a little bit easier.

c64464ea-91bc-4ce6-ab90-04f02c87f80c-0
00:04:37.640 --> 00:04:43.534
We will advocate on your behalf as far as
any type of issues that may come across

c64464ea-91bc-4ce6-ab90-04f02c87f80c-1
00:04:43.534 --> 00:04:47.991
with the insurance carrier,
the provider offices, pharmacies,

c64464ea-91bc-4ce6-ab90-04f02c87f80c-2
00:04:47.991 --> 00:04:53.886
and any type of government agencies such
as the Centers for Medicare and Medicaid

c64464ea-91bc-4ce6-ab90-04f02c87f80c-3
00:04:53.886 --> 00:04:57.840
Services, CMS,
also known as and with Social Security.

7e02b61f-4558-4f4b-bdcd-18fd704cd121-0
00:04:57.840 --> 00:05:02.879
So if you need some assistance as far as
where to begin, what the first steps are,

7e02b61f-4558-4f4b-bdcd-18fd704cd121-1
00:05:02.879 --> 00:05:07.250
you would want to reach out to us
directly and we can guide you through

7e02b61f-4558-4f4b-bdcd-18fd704cd121-2
00:05:07.250 --> 00:05:08.040
that process.

c42c4b17-54f6-4ab9-8668-df6278de5dc6-0
00:05:08.040 --> 00:05:11.830
We know that navigating it can be quite
confusing,

c42c4b17-54f6-4ab9-8668-df6278de5dc6-1
00:05:11.830 --> 00:05:17.925
especially if you're turning 65 and you
receive a lot of information from outside

c42c4b17-54f6-4ab9-8668-df6278de5dc6-2
00:05:17.925 --> 00:05:18.520
vendors.

1ab3b7b0-f6ba-4056-acde-498fda931888-0
00:05:19.240 --> 00:05:20.400
Next slide please.

9fc47a33-005c-47ca-9161-1fdd1b2864cd-0
00:05:22.800 --> 00:05:26.600
So our advocates put our retirees first.

2a05370e-b062-4fb2-9324-7dcecc241da9-0
00:05:26.920 --> 00:05:32.562
We currently have 160 plus in house US
based retiree advocates that are

2a05370e-b062-4fb2-9324-7dcecc241da9-1
00:05:32.562 --> 00:05:38.440
available Monday through Friday,
8:00 AM to 5:00 PM Eastern Standard Time.

9861a2c4-c763-457e-8f5a-6b1536edd184-0
00:05:39.080 --> 00:05:42.360
All of our advocates receive extensive
training.

1ed2671a-3aca-44da-a13e-5d0005b923a9-0
00:05:42.760 --> 00:05:48.861
Many of them have previously worked in
healthcare or in the pharmacy world,

1ed2671a-3aca-44da-a13e-5d0005b923a9-1
00:05:48.861 --> 00:05:54.000
so they are well versed in what could be
happening or going on.

b00fb974-6c1b-4a92-9171-c96d5df47926-0
00:05:54.000 --> 00:05:55.680
Where you need further assistance.

f93fcff4-9093-4cff-bca4-dc715318d86f-0
00:05:56.520 --> 00:05:59.600
Our advocates are some of our advocates,
I should say,

f93fcff4-9093-4cff-bca4-dc715318d86f-1
00:05:59.600 --> 00:06:03.576
are bilingual and can partner with a
HIPAA compliance service offering

f93fcff4-9093-4cff-bca4-dc715318d86f-2
00:06:03.576 --> 00:06:05.760
translation in over 300 plus languages.

1b7b6db2-27e0-4804-bcbb-9f9ddeb38480-0
00:06:06.600 --> 00:06:12.480
The retirees will receive a dedicated
group phone number and advocate team.

aa47f578-3be5-4ccb-97e5-dad59ab3d6e1-0
00:06:12.640 --> 00:06:17.050
So basically what that means is when you
call into us,

aa47f578-3be5-4ccb-97e5-dad59ab3d6e1-1
00:06:17.050 --> 00:06:23.304
you do have to just hit one number,
usually just any number just to get to us

aa47f578-3be5-4ccb-97e5-dad59ab3d6e1-2
00:06:23.304 --> 00:06:29.398
due to robo calls because we do get
several calls that come in that are not

aa47f578-3be5-4ccb-97e5-dad59ab3d6e1-3
00:06:29.398 --> 00:06:30.280
real calls.

aac9c0ec-a7e3-45a7-b853-e18d71ba0369-0
00:06:30.600 --> 00:06:33.320
And then you will reach our team of
advocates.

d6b03ed3-552b-430d-b0ef-894703cdf7f9-0
00:06:33.600 --> 00:06:40.318
They will be able to assist in real time
with any type of issues throughout

d6b03ed3-552b-430d-b0ef-894703cdf7f9-1
00:06:40.318 --> 00:06:47.480
outbound calls with completion calls from
basically start to finish on anything.

e781ebbf-8d88-410b-86b0-bfa61f092480-0
00:06:47.800 --> 00:06:51.862
We can educate you on your healthcare
plan including preventative care,

e781ebbf-8d88-410b-86b0-bfa61f092480-1
00:06:51.862 --> 00:06:55.699
any additional health benefits that are
offered through care First,

e781ebbf-8d88-410b-86b0-bfa61f092480-2
00:06:55.699 --> 00:07:00.156
which will be many and you'll see when
Lindsay comes back on what is available

e781ebbf-8d88-410b-86b0-bfa61f092480-3
00:07:00.156 --> 00:07:01.680
and we can assist you with.

d4b60c9d-3e54-4fd0-81f4-65608887d645-0
00:07:02.040 --> 00:07:08.753
We also support the retirees as far as
with issue resolution, gaps in care,

d4b60c9d-3e54-4fd0-81f4-65608887d645-1
00:07:08.753 --> 00:07:14.671
closures, Wellness visits,
and it's all done in real time with our

d4b60c9d-3e54-4fd0-81f4-65608887d645-2
00:07:14.671 --> 00:07:16.879
Medicare backed training.

74405e1e-6b01-4105-9522-95730393e0fa-0
00:07:18.600 --> 00:07:19.360
Next slide.

7fdc2c25-5786-4ea3-9c24-5266a5f89f92-0
00:07:22.240 --> 00:07:27.280
Basically we are service when you need it,
that you need.

71cd9fc2-0e85-4d9f-a611-b6fd9154431a-0
00:07:27.520 --> 00:07:33.100
If something comes up and you're not sure,
we have some questions here on the left

71cd9fc2-0e85-4d9f-a611-b6fd9154431a-1
00:07:33.100 --> 00:07:38.680
that just basically are normal everyday
questions you know that retirees may have.

21772e31-c6af-4d35-b4cd-24649a1aa0d4-0
00:07:38.960 --> 00:07:42.960
I received a bill and I'm unsure if these
services should be covered.

7bc6b0ed-63f1-4bf8-b756-015fcf365459-0
00:07:43.280 --> 00:07:45.200
I need help finding a specialist.

fc81170f-3d0b-42e8-8eda-f0551acc0f9c-0
00:07:45.640 --> 00:07:47.200
I need help making an appointment.

928d953b-c156-4204-8eb6-0dfe7fbd2659-0
00:07:48.200 --> 00:07:49.120
I have a benefit.

31642d09-48ce-43e4-b521-75faa42ce539-0
00:07:49.120 --> 00:07:53.160
I'm not really sure you know what it
means and how do I take advantage of it.

ffda2475-d88f-447f-949a-9cb022aec4d6-0
00:07:54.120 --> 00:07:59.160
I want to know if there's a specific drug
on my formulary that my doctor prescribed

ffda2475-d88f-447f-949a-9cb022aec4d6-1
00:07:59.160 --> 00:08:00.240
and is it covered?

1960e364-82b2-43a0-8899-856bbda5b5d5-0
00:08:00.600 --> 00:08:04.320
I'm at the pharmacy and it costs more
than it should.

ac662e78-c376-4513-9a71-621cae436729-0
00:08:04.880 --> 00:08:05.880
Can you assist me?

99428f45-ae73-4c18-940e-722d5115b677-0
00:08:06.320 --> 00:08:07.240
We can.

f549303e-eec5-4c11-825e-98dabd1473b5-0
00:08:07.240 --> 00:08:10.823
Our advocates can outreach to the
providers,

f549303e-eec5-4c11-825e-98dabd1473b5-1
00:08:10.823 --> 00:08:16.080
assist with medical prior authorizations,
medical reimbursements.

743654d5-176e-45a2-bcd2-f2ce0d830850-0
00:08:16.080 --> 00:08:18.680
Whereas maybe you're getting a bill and
you're not sure.

dbabf7d8-54b2-4369-93ed-37702f719dea-0
00:08:18.840 --> 00:08:23.720
What we want you to do is always reach
out to us first before paying anything

dbabf7d8-54b2-4369-93ed-37702f719dea-1
00:08:23.720 --> 00:08:25.160
that you are unsure of.

0af2d1ad-dab5-486d-a749-71c6f2a418d6-0
00:08:25.520 --> 00:08:27.680
We can assist with benefit questions.

6a28a9d4-1008-4506-b899-dd2613753ec5-0
00:08:27.760 --> 00:08:33.103
If you're having an issue with the
pharmacy getting a co-pay to go through

6a28a9d4-1008-4506-b899-dd2613753ec5-1
00:08:33.103 --> 00:08:36.880
or the specific medication,
we can assist with that.

ca84c1b3-9d23-4718-b112-c1bc98268289-0
00:08:37.160 --> 00:08:40.480
We can assist with your mail order if you
choose to go that route.

e3da465e-459d-4359-95dd-9d71ec875ba5-0
00:08:41.040 --> 00:08:45.780
Any type of formulary issues where you
would like to know if a particular drug

e3da465e-459d-4359-95dd-9d71ec875ba5-1
00:08:45.780 --> 00:08:48.420
is being covered,
If it was covered before,

e3da465e-459d-4359-95dd-9d71ec875ba5-2
00:08:48.420 --> 00:08:49.560
now it's maybe not.

7c423284-9d2e-4d32-bc10-782fd52e4596-0
00:08:49.560 --> 00:08:51.320
Is there an alternative available?

8b73127c-3838-4ef2-8b30-693fded3d7e4-0
00:08:51.600 --> 00:08:53.600
We can certainly assist you with that.

faea7d7e-8fcb-4527-9ced-411ec16c4dcc-0
00:08:54.840 --> 00:08:58.509
Like I had mentioned about the medical
prior authorizations,

faea7d7e-8fcb-4527-9ced-411ec16c4dcc-1
00:08:58.509 --> 00:09:02.480
there are also some medications that
require prior authorization.

efeb116e-3a0f-4f46-b64f-05b5ba38aa53-0
00:09:02.720 --> 00:09:06.593
We can assist with that by again,
reaching out to your doctor,

efeb116e-3a0f-4f46-b64f-05b5ba38aa53-1
00:09:06.593 --> 00:09:11.144
making sure that they're getting
everything taken care of for you so that

efeb116e-3a0f-4f46-b64f-05b5ba38aa53-2
00:09:11.144 --> 00:09:14.280
you're able to get what you need when you
need it.

4c329480-25a3-4c18-b390-ce262abb535d-0
00:09:15.400 --> 00:09:20.249
We also have a house call appointment
scheduling so we can assist, you know,

4c329480-25a3-4c18-b390-ce262abb535d-1
00:09:20.249 --> 00:09:24.280
with your going forward and getting those
appointments for you.

de9f4fa0-dee2-470e-97e4-a9a5a38e5b81-0
00:09:25.080 --> 00:09:25.800
Next slide.

2c2f6706-edea-49fe-b3c4-55d26838e3e4-0
00:09:28.840 --> 00:09:33.449
So this is just a, a,
just an interaction of basically how

2c2f6706-edea-49fe-b3c4-55d26838e3e4-1
00:09:33.449 --> 00:09:40.090
everything starts with we'll just say Joe,
the retiree gives us a call and he has an

2c2f6706-edea-49fe-b3c4-55d26838e3e4-2
00:09:40.090 --> 00:09:42.200
issue with a authorization.

e70bf907-e52e-4c38-8e22-933b743ef1a2-0
00:09:42.200 --> 00:09:46.200
He's not sure if it's the prescription is
covered or not.

79e34c7c-d619-45f9-9c5d-5892cdae58af-0
00:09:46.200 --> 00:09:47.600
The pharmacist is saying not.

0cb727cf-a6d3-497d-965a-802f750d0002-0
00:09:48.040 --> 00:09:49.480
So they reach out to us.

d9baa311-5461-442e-8b87-1776b0a0fa5e-0
00:09:49.720 --> 00:09:55.207
Our advocate will gather the information
and then start the process of reaching

d9baa311-5461-442e-8b87-1776b0a0fa5e-1
00:09:55.207 --> 00:10:00.077
out to the provider's office,
providing the information to them on how

d9baa311-5461-442e-8b87-1776b0a0fa5e-2
00:10:00.077 --> 00:10:05.291
to submit a prior authorization and
assist the provider with any process if

d9baa311-5461-442e-8b87-1776b0a0fa5e-3
00:10:05.291 --> 00:10:06.319
it's necessary.

4b709089-a3aa-4eb9-8435-687ce126c082-0
00:10:07.000 --> 00:10:10.974
The advocate will then reach back out to
Joe, our retiree,

4b709089-a3aa-4eb9-8435-687ce126c082-1
00:10:10.974 --> 00:10:14.274
let them know what the update is and the
status,

4b709089-a3aa-4eb9-8435-687ce126c082-2
00:10:14.274 --> 00:10:19.191
and then follow up with the prior
authorization with the carrier and the

4b709089-a3aa-4eb9-8435-687ce126c082-3
00:10:19.191 --> 00:10:21.279
provider if it's been obtained.

94a290ce-4c75-45ce-971e-3bf1a87e85d2-0
00:10:21.600 --> 00:10:26.162
Once a decision has been made,
the advocate will then contact the

94a290ce-4c75-45ce-971e-3bf1a87e85d2-1
00:10:26.162 --> 00:10:29.688
pharmacist,
let them know they can now process the

94a290ce-4c75-45ce-971e-3bf1a87e85d2-2
00:10:29.688 --> 00:10:35.080
medication and we'll ask for, you know,
to confirm what the co-pay amount is.

96cbc94c-2513-492e-a663-7d9e27880d4a-0
00:10:35.480 --> 00:10:38.142
We then reach back out to Joe,
the retiree,

96cbc94c-2513-492e-a663-7d9e27880d4a-1
00:10:38.142 --> 00:10:42.440
letting him know that he can pick up his
prescription when it's ready.

bff094ba-a427-415b-89d5-53e271631348-0
00:10:42.720 --> 00:10:45.538
And then once that prescription is picked
up,

bff094ba-a427-415b-89d5-53e271631348-1
00:10:45.538 --> 00:10:50.440
we do do a completion call to confirm
that everything went OK with the process.

8bc154c6-36bc-407c-ab11-0e7a1ea44ddc-0
00:10:51.680 --> 00:10:52.400
Next slide.

ff65886f-16c1-4c1b-929f-0fe78a319d41-0
00:10:55.320 --> 00:11:00.953
So this is just some of a wall that we
have here in our New Jersey office that

ff65886f-16c1-4c1b-929f-0fe78a319d41-1
00:11:00.953 --> 00:11:06.160
shows some testimonials that we have
received from all over our clients.

4606f8df-c3b6-440e-b41a-e377d575a9c3-0
00:11:06.600 --> 00:11:11.461
But the ones that are listed here are
basically from our Maryland retirees and

4606f8df-c3b6-440e-b41a-e377d575a9c3-1
00:11:11.461 --> 00:11:14.600
I'm just going to read a few of them here
for you.

d435f633-a306-4108-9175-b1f24f85360c-0
00:11:15.800 --> 00:11:19.896
One of them basically says here,
my husband recently talked multiple times

d435f633-a306-4108-9175-b1f24f85360c-1
00:11:19.896 --> 00:11:23.883
with Jamie to resolve a persistent
billing issue with a physical therapy

d435f633-a306-4108-9175-b1f24f85360c-2
00:11:23.883 --> 00:11:24.320
company.

00ab8a23-e9a5-4357-9357-78745695d953-0
00:11:24.480 --> 00:11:29.440
She was an excellent advocate and even
more persistent than the PT company.

b525c586-6b02-4442-abe5-96bcb29e42e3-0
00:11:30.320 --> 00:11:33.675
After at least 5 attempts by May to
resolve this problem,

b525c586-6b02-4442-abe5-96bcb29e42e3-1
00:11:33.675 --> 00:11:36.800
Samantha was able to solve it in a matter
of minutes.

c34ee623-bccd-4403-a08e-4a0bc3fe90ba-0
00:11:37.080 --> 00:11:37.600
Thank you.

473b9435-bbb8-4e5d-ade8-5e2145af388c-0
00:11:38.520 --> 00:11:43.960
I was stunned as to the same day response
and solving my questions and concerns.

157c08f5-37de-4eea-b974-871e58609d2e-0
00:11:44.520 --> 00:11:47.673
And again,
this is what we want to stress that we

157c08f5-37de-4eea-b974-871e58609d2e-1
00:11:47.673 --> 00:11:49.440
want you to reach out to us.

08961ac4-d570-4b1d-9768-eec2cef960a5-0
00:11:49.480 --> 00:11:53.560
If you're comfortable, you know,
trying to resolve the issue, that's great.

d95e0e72-20c9-40c3-844d-d21c0db6b76c-0
00:11:53.600 --> 00:11:54.960
We don't have a problem with that.

79d64974-c963-4acf-9f32-d41b6c7b14a6-0
00:11:54.960 --> 00:11:58.850
But if you find that you need assistance
or you don't want to do this,

79d64974-c963-4acf-9f32-d41b6c7b14a6-1
00:11:58.850 --> 00:12:00.440
that is what we are here for.

fca229c3-c037-4c4c-9516-35c6fa87e0af-0
00:12:00.440 --> 00:12:01.960
We want you to reach out to us.

0d0b8142-a257-49e6-8b50-609de99165e8-0
00:12:01.960 --> 00:12:06.160
If you have questions on current
prescriptions, current doctors,

0d0b8142-a257-49e6-8b50-609de99165e8-1
00:12:06.160 --> 00:12:09.520
you can certainly give any of our
advocates a call.

3b6ac7c6-14a4-477c-be86-f377061bb05b-0
00:12:09.800 --> 00:12:10.720
Give us a list.

d6b5a69b-8649-47c2-842b-40d9811b6e6f-0
00:12:10.840 --> 00:12:12.200
We will research it for you.

aee6d65b-1f5b-4c4b-9aa1-b381b0e26d00-0
00:12:12.200 --> 00:12:17.411
We will get back to you and let you know
know how to proceed, you know,

aee6d65b-1f5b-4c4b-9aa1-b381b0e26d00-1
00:12:17.411 --> 00:12:19.800
for the upcoming year next slide.

21bac72c-1ef7-4d15-b9e7-6b1edaf05459-0
00:12:22.480 --> 00:12:25.440
So these are just some ways that you can
reach out to us.

b987fe26-d810-4cd6-aeed-64718c326298-0
00:12:25.560 --> 00:12:34.440
You have a dedicated local phone number
of 443-988-0662.

49978f40-fe3b-4e82-b7eb-d9612a9c759f-0
00:12:34.840 --> 00:12:44.320
There is a toll free number of 8554306219
and again the advocates are available.

599d2ab7-0bd7-4dc4-a9f4-1ad0d8e16b65-0
00:12:44.320 --> 00:12:48.720
Eastern Standard Time Monday through
Friday, 8:00 AM to 5:00 PM.

cc388ad7-4c3d-441a-89d5-60f8e2ef0a0d-0
00:12:49.320 --> 00:12:58.200
We have a dedicated website of www.
retireefirst.com/calvert County.

d2985c2b-9465-47d0-97b5-3d9a8e0a34fa-0
00:12:58.360 --> 00:13:04.879
PS We also want to let you know that we
do have an emergency and after hours line

d2985c2b-9465-47d0-97b5-3d9a8e0a34fa-1
00:13:04.879 --> 00:13:10.126
available so that if you're at the
pharmacy and there's an issue,

d2985c2b-9465-47d0-97b5-3d9a8e0a34fa-2
00:13:10.126 --> 00:13:16.406
we do have a managerial staff that is
watching this and will be able to assist

d2985c2b-9465-47d0-97b5-3d9a8e0a34fa-3
00:13:16.406 --> 00:13:17.519
you with this.

78630bde-e002-430b-bd13-8517a6cc557d-0
00:13:18.480 --> 00:13:19.800
Thank you so much, Lindsay.

2a5efd9a-c0ad-40b5-81f1-ee09eba41d80-0
00:13:20.440 --> 00:13:23.360
Thanks, Diana,
and appreciate that overview.

4db45a9a-41cc-4681-8965-c0e9951d2025-0
00:13:23.360 --> 00:13:27.070
I think we hear from our retirees quite a
bit that they really,

4db45a9a-41cc-4681-8965-c0e9951d2025-1
00:13:27.070 --> 00:13:30.374
really enjoy using retiree first services,
that they're,

4db45a9a-41cc-4681-8965-c0e9951d2025-2
00:13:30.374 --> 00:13:32.520
they're here for you for that reason.

c6ee4bba-848f-40e0-922e-7332f90c6d78-0
00:13:32.960 --> 00:13:34.840
So please don't hesitate to call.

e7ba741d-00c7-4821-a8c3-14f1dc695029-0
00:13:34.840 --> 00:13:37.480
We often hear retirees say, well,
I don't want to bother anyone.

6f7d0bc1-db52-4c15-8255-677a07b8c376-0
00:13:37.480 --> 00:13:40.040
Well, they're,
they're here to be bothered, right?

4fe828ce-4493-4f96-b9f2-c8bdd94a78b1-0
00:13:40.040 --> 00:13:41.120
And it's not a bother.

2978de55-921c-4411-a0f4-5f7443182304-0
00:13:41.400 --> 00:13:43.280
They're here for your questions.

49a9532f-b599-429a-8d83-eecc6a3d8a05-0
00:13:43.280 --> 00:13:44.320
They're here to assist.

46baa477-d4e9-41e9-b505-f10a8816ddf3-0
00:13:44.320 --> 00:13:48.029
And I think we said this before,
but this isn't just for the next few

46baa477-d4e9-41e9-b505-f10a8816ddf3-1
00:13:48.029 --> 00:13:48.400
months.

9f1b67de-257e-4a6a-8a30-0e1947eb102e-0
00:13:48.680 --> 00:13:52.022
You have access to this,
this team of advocates through the life

9f1b67de-257e-4a6a-8a30-0e1947eb102e-1
00:13:52.022 --> 00:13:53.000
of the health plan.

d9216d3c-6a6e-4a4d-9072-b453cd5e204e-0
00:13:53.000 --> 00:13:57.600
So certainly they're a huge support when
you're getting ready to use the new plan.

f72a96d1-3998-4b27-8d6a-91a9bec73908-0
00:13:57.600 --> 00:14:00.380
But when you're in the new plan next year
and beyond,

f72a96d1-3998-4b27-8d6a-91a9bec73908-1
00:14:00.380 --> 00:14:02.080
you can always call them as well.

2aeeea83-28c4-4df9-86ef-e98c943000ef-0
00:14:02.080 --> 00:14:03.400
So again, thank you, Diane.

cca34749-217d-4b3c-9165-4403b60d5d56-0
00:14:03.400 --> 00:14:04.000
I appreciate it.

f7dd2c51-dfc1-48b6-bedf-5a05a2033faf-0
00:14:04.000 --> 00:14:05.440
Absolutely, absolutely.

e6ece9c5-f689-4b1f-bc52-8a7e60b3a179-0
00:14:06.720 --> 00:14:11.188
So switching gears a little bit here,
I want to provide some background on

e6ece9c5-f689-4b1f-bc52-8a7e60b3a179-1
00:14:11.188 --> 00:14:12.320
Medicare Advantage.

5ebc6ab0-79bb-44f9-85bd-a65d82038394-0
00:14:12.320 --> 00:14:14.680
What are Medicare Advantage plans?

9c2dab9a-f870-42ec-9608-3e7a6f44d17a-0
00:14:15.160 --> 00:14:17.884
Well,
Medicare Advantage plans are also known

9c2dab9a-f870-42ec-9608-3e7a6f44d17a-1
00:14:17.884 --> 00:14:21.201
as Part C plans,
and these are health plan options that

9c2dab9a-f870-42ec-9608-3e7a6f44d17a-2
00:14:21.201 --> 00:14:25.880
are approved by Medicare and administered
by private companies like Carefirst.

e91909ff-a54e-4b0a-b70f-699c82c9522f-0
00:14:26.360 --> 00:14:30.182
Medicare Advantage plans are part of the
federal Medicare program,

e91909ff-a54e-4b0a-b70f-699c82c9522f-1
00:14:30.182 --> 00:14:34.120
and Medicare pays companies a certain
amount for each member's care.

5805a5c2-2fd6-4149-99f4-a0980f97cf09-0
00:14:34.760 --> 00:14:39.107
Medicare Advantage plans are required to
offer all of the same benefits as

5805a5c2-2fd6-4149-99f4-a0980f97cf09-1
00:14:39.107 --> 00:14:42.527
Original Medicare,
and that's inclusive of both Part A and

5805a5c2-2fd6-4149-99f4-a0980f97cf09-2
00:14:42.527 --> 00:14:45.309
Part B,
and typically include prescription drug

5805a5c2-2fd6-4149-99f4-a0980f97cf09-3
00:14:45.309 --> 00:14:47.279
coverage as well, which is Part D.

67638e11-39f8-48d6-b72f-59bcec6c0dcb-0
00:14:47.520 --> 00:14:52.107
So Medicare Advantage plans essentially
bundle your Medicare Part A, Part B,

67638e11-39f8-48d6-b72f-59bcec6c0dcb-1
00:14:52.107 --> 00:14:55.146
and Part D all into one plan that's
called Part C,

67638e11-39f8-48d6-b72f-59bcec6c0dcb-2
00:14:55.146 --> 00:14:58.840
which really doesn't make sense why they
ordered it that way,

67638e11-39f8-48d6-b72f-59bcec6c0dcb-3
00:14:58.840 --> 00:15:03.667
but just wanted you to know that it is a
comprehensive plan that includes all of

67638e11-39f8-48d6-b72f-59bcec6c0dcb-4
00:15:03.667 --> 00:15:04.680
those components.

c375277c-73f1-4144-bd07-1eb3464efed7-0
00:15:05.440 --> 00:15:09.955
Medicare Advantage plans also offer
additional additional benefits and perks

c375277c-73f1-4144-bd07-1eb3464efed7-1
00:15:09.955 --> 00:15:14.412
beyond what original Medicare covers,
and this includes things like routine

c375277c-73f1-4144-bd07-1eb3464efed7-2
00:15:14.412 --> 00:15:18.400
hearing aids in home health assessments,
fitness benefits and more.

8b266781-8379-4c6b-8ea0-d20c3162ed91-0
00:15:18.400 --> 00:15:22.680
And we'll get into some more details
about those extras in just a little bit.

62ab1e2f-6691-42e7-998f-372f447b578e-0
00:15:23.560 --> 00:15:26.428
Now, I do want to note,
and I mentioned this earlier,

62ab1e2f-6691-42e7-998f-372f447b578e-1
00:15:26.428 --> 00:15:30.890
it's really important for you to be aware
that the new Care First plan that's being

62ab1e2f-6691-42e7-998f-372f447b578e-2
00:15:30.890 --> 00:15:33.599
offered to you is a group Medicare
Advantage plan.

3cbbc755-06b9-4cfc-9147-d80874108aeb-0
00:15:34.200 --> 00:15:38.915
This is different from all of the various
individual Medicare Advantage plans that

3cbbc755-06b9-4cfc-9147-d80874108aeb-1
00:15:38.915 --> 00:15:43.459
are out on the market that you may have
heard about from a neighbor or a cousin

3cbbc755-06b9-4cfc-9147-d80874108aeb-2
00:15:43.459 --> 00:15:44.880
or someone that you know.

6d10623d-b7ae-49b3-a5f3-1e8c4f0ef014-0
00:15:45.760 --> 00:15:50.776
Individual Medicare Advantage plans are
available to Medicare eligible people who

6d10623d-b7ae-49b3-a5f3-1e8c4f0ef014-1
00:15:50.776 --> 00:15:55.609
do not have the benefit of being offered
retiree coverage through their former

6d10623d-b7ae-49b3-a5f3-1e8c4f0ef014-2
00:15:55.609 --> 00:15:56.160
employer.

019ecc19-97c6-439c-8878-2cb801165b8e-0
00:15:56.160 --> 00:16:00.214
So these plans are different,
they are designed differently and some of

019ecc19-97c6-439c-8878-2cb801165b8e-1
00:16:00.214 --> 00:16:04.213
the things that make them different
include generally limited provider

019ecc19-97c6-439c-8878-2cb801165b8e-2
00:16:04.213 --> 00:16:04.720
networks.

31f87ad6-8c92-46ed-adf9-f23a3c21e690-0
00:16:05.000 --> 00:16:09.153
We tend to see higher co-pays and
deductibles on these individual Medicare

31f87ad6-8c92-46ed-adf9-f23a3c21e690-1
00:16:09.153 --> 00:16:10.040
Advantage plans.

140afbae-a7cb-4d4a-b117-dee75289322d-0
00:16:10.600 --> 00:16:14.200
The drugs that are covered under these
plans tend to be more limited.

de25bd53-eb19-48c3-952c-0b635f66be79-0
00:16:14.480 --> 00:16:18.002
And most,
I think importantly is the annual out of

de25bd53-eb19-48c3-952c-0b635f66be79-1
00:16:18.002 --> 00:16:22.560
pocket maximums that are included on
those plans are fairly high,

de25bd53-eb19-48c3-952c-0b635f66be79-2
00:16:22.560 --> 00:16:24.840
generally between 6000 and $8000.

81e3b54e-1b00-4ff4-b14d-79d3afc24046-0
00:16:25.280 --> 00:16:28.455
So you may see advertisements out there
saying hey,

81e3b54e-1b00-4ff4-b14d-79d3afc24046-1
00:16:28.455 --> 00:16:32.241
there's an individual Medicare Advantage
plan for you for $0.

81e3b54e-1b00-4ff4-b14d-79d3afc24046-2
00:16:32.241 --> 00:16:34.440
00 premium and those plans do exist.

784d0687-7d64-4580-8b24-d584360a9f54-0
00:16:34.440 --> 00:16:38.014
The reason why they're $0.
00 premium though is because you're going

784d0687-7d64-4580-8b24-d584360a9f54-1
00:16:38.014 --> 00:16:40.605
to be paying more out of pocket in those
co-pays,

784d0687-7d64-4580-8b24-d584360a9f54-2
00:16:40.605 --> 00:16:43.040
deductibles and annual out of pocket
maximums.

614ddd83-aeb8-439b-a4f2-161c960f87f9-0
00:16:43.080 --> 00:16:48.522
So as we noted a couple of Times Now,
this is not the plan that we're talking

614ddd83-aeb8-439b-a4f2-161c960f87f9-1
00:16:48.522 --> 00:16:49.360
about today.

2ecd256c-c678-404e-a8dd-f79473b8fd31-0
00:16:49.360 --> 00:16:54.360
You have a group Medicare Advantage plan
designed exclusively for Calvert County.

7f2ed57b-d123-41a9-8f6e-a10f3c537184-0
00:16:54.640 --> 00:16:58.975
It has very rich benefits that we'll
cover in just a few slides and it is not

7f2ed57b-d123-41a9-8f6e-a10f3c537184-1
00:16:58.975 --> 00:17:02.200
something that anybody else can purchase
from the market.

843efcf8-870a-4f0b-8404-fca12c262509-0
00:17:02.200 --> 00:17:04.320
So just really wanted to make that
distinction.

285ee46d-8508-4e1a-8186-8e125d2c4224-0
00:17:04.320 --> 00:17:08.159
I don't know that many people are aware
that there even are group versus

285ee46d-8508-4e1a-8186-8e125d2c4224-1
00:17:08.159 --> 00:17:10.000
individual Medicare Advantage plan.

38016ef7-658b-4158-a73e-b211e815c4e8-0
00:17:10.000 --> 00:17:15.054
So please learn that kind of distinction
and know that your plan is different and

38016ef7-658b-4158-a73e-b211e815c4e8-1
00:17:15.054 --> 00:17:17.520
just very robust rich coverage included.

edd92cf3-2671-4c31-a6a9-f62efec0b708-0
00:17:19.320 --> 00:17:23.024
Now the goal of this slide really I
wanted to highlight some of the high

edd92cf3-2671-4c31-a6a9-f62efec0b708-1
00:17:23.024 --> 00:17:26.932
level differences between the current
plan that you're in and group Medicare

edd92cf3-2671-4c31-a6a9-f62efec0b708-2
00:17:26.932 --> 00:17:27.440
Advantage.

b5ebaf51-8634-4887-8f82-4a7098cc4875-0
00:17:27.760 --> 00:17:32.640
So today's plan are set up with what's
called primary and secondary coverage.

e05a4bbf-fe04-4ba4-b25c-98ab96c9ff26-0
00:17:32.720 --> 00:17:36.597
Your primary coverage refers to your
Medicare Parts A and Part B,

e05a4bbf-fe04-4ba4-b25c-98ab96c9ff26-1
00:17:36.597 --> 00:17:41.297
and your secondary coverage refers to
your employee plan plus your prescription

e05a4bbf-fe04-4ba4-b25c-98ab96c9ff26-2
00:17:41.297 --> 00:17:42.120
drug coverage.

449e7ef1-c46c-402a-a3a7-ca704581124e-0
00:17:42.400 --> 00:17:45.271
So when you're going to the doctor or at
the pharmacy,

449e7ef1-c46c-402a-a3a7-ca704581124e-1
00:17:45.271 --> 00:17:49.240
you are showing your Medicare card and
you're showing your Care First card.

173f6038-5dad-4a0c-863f-a297c2fc5e21-0
00:17:49.640 --> 00:17:52.379
So because of this coordination of
benefits, A,

173f6038-5dad-4a0c-863f-a297c2fc5e21-1
00:17:52.379 --> 00:17:56.545
a really close coordination is required
between Care 1st and Medicare to

173f6038-5dad-4a0c-863f-a297c2fc5e21-2
00:17:56.545 --> 00:17:58.200
administer the plan benefits.

6b63de43-525b-4152-8c88-e142df33a204-0
00:17:58.680 --> 00:18:01.720
This is different under the Group
Medicare Advantage plan.

ce41a959-f660-4ae9-a894-10aa1869dc8e-0
00:18:02.320 --> 00:18:07.320
The Group Medicare Advantage plan bundles
all of the Medicare Part A, Part B,

ce41a959-f660-4ae9-a894-10aa1869dc8e-1
00:18:07.320 --> 00:18:12.000
and Part D into one plan and is now your
primary and your only coverage.

8342eeb7-06e9-4752-92ed-9abe6e348727-0
00:18:12.000 --> 00:18:15.084
So when you go to the doctor or the
pharmacy in January,

8342eeb7-06e9-4752-92ed-9abe6e348727-1
00:18:15.084 --> 00:18:18.440
you're only going to be showing your
Medicare Advantage card.

3393509d-6f47-481c-8130-b7bbe349f93b-0
00:18:19.280 --> 00:18:23.080
Another difference to point out is the
list of drugs.

aa391553-ffa9-421a-bae4-902c82f79afc-0
00:18:23.080 --> 00:18:27.151
The formulary that is included in your
current plan is going to be different

aa391553-ffa9-421a-bae4-902c82f79afc-1
00:18:27.151 --> 00:18:30.800
than the list of covered drugs in the
group Medicare Advantage plan.

038194a9-bd6a-40a6-b884-4f0765a769b1-0
00:18:31.040 --> 00:18:36.156
The main reason for that is the group
Medicare Advantage drug list is designed

038194a9-bd6a-40a6-b884-4f0765a769b1-1
00:18:36.156 --> 00:18:37.840
specifically for retirees.

9ff3a6bd-325a-4d67-b67c-70faf6e7c3d2-0
00:18:37.840 --> 00:18:42.730
And every year a team looks at the the
list of drugs that are covered to ensure

9ff3a6bd-325a-4d67-b67c-70faf6e7c3d2-1
00:18:42.730 --> 00:18:46.520
that they are safe and effective for
individuals 65 and over.

b52fa00b-d9cf-4dde-897b-df24052ba926-0
00:18:46.520 --> 00:18:50.901
So we'll talk about the drug benefits in
just a bit and you'll hear how extensive

b52fa00b-d9cf-4dde-897b-df24052ba926-1
00:18:50.901 --> 00:18:53.572
they are,
but wanted to point out that difference

b52fa00b-d9cf-4dde-897b-df24052ba926-2
00:18:53.572 --> 00:18:54.000
as well.

f7a82245-6980-472d-9c5f-76371fe3d1b5-0
00:18:55.800 --> 00:18:57.600
The next slide is a pretty quick one.

98702b3c-cc1d-4261-ad5c-206cb35496fa-0
00:18:57.600 --> 00:19:00.280
Just a refresher on some plan terminology.

a40d9b0e-42fe-46fc-9ad2-5950a6a7f960-0
00:19:00.840 --> 00:19:03.301
As we're talking about your benefits
under the new plan,

a40d9b0e-42fe-46fc-9ad2-5950a6a7f960-1
00:19:03.301 --> 00:19:06.799
I would just want to make sure we're all
on the same page about what these terms

a40d9b0e-42fe-46fc-9ad2-5950a6a7f960-2
00:19:06.799 --> 00:19:09.519
mean and it'll help you understand your
plan benefits as well.

6cdfc7e4-7194-4fbd-b81b-30fe33d3260a-0
00:19:10.080 --> 00:19:11.760
So we'll start with a co-pay.

7bfb9eb2-d55d-4467-a2be-c5dc6f2c456b-0
00:19:11.840 --> 00:19:16.491
This is an amount that you pay as your
share of the cost for a medical service

7bfb9eb2-d55d-4467-a2be-c5dc6f2c456b-1
00:19:16.491 --> 00:19:19.553
or supply,
say a doctor's visit or if you're at the

7bfb9eb2-d55d-4467-a2be-c5dc6f2c456b-2
00:19:19.553 --> 00:19:21.320
hospital or prescription drug.

4a46fd07-767f-4d9c-b3c7-a1b2e3696a73-0
00:19:21.720 --> 00:19:23.480
co-pays are set amounts.

e4e627b4-3d29-44a0-8aa5-d30382256687-0
00:19:23.760 --> 00:19:28.880
For example, it could be $5,
it could be $10 rather than a percentage.

e27e14ac-1946-45d3-810e-e7971e2e3818-0
00:19:29.760 --> 00:19:34.193
Co-pays for the commonly most commonly
utilized benefits will be printed on the

e27e14ac-1946-45d3-810e-e7971e2e3818-1
00:19:34.193 --> 00:19:35.800
front of your member ID card.

d96c8bbd-28a3-44af-8345-4c3540af2200-0
00:19:36.520 --> 00:19:41.380
A coinsurance is an amount that you may
be required to pay that's expressed as a

d96c8bbd-28a3-44af-8345-4c3540af2200-1
00:19:41.380 --> 00:19:44.920
percentage, so for example,
20% of your share of the cost.

1585d016-f1b3-4f59-8fa2-a685d3dfa89f-0
00:19:45.400 --> 00:19:49.542
Coinsurance is a little bit tricky to
help you understand what you're actually

1585d016-f1b3-4f59-8fa2-a685d3dfa89f-1
00:19:49.542 --> 00:19:53.737
going to be paying when you're at the
doctor's office and that's simply because

1585d016-f1b3-4f59-8fa2-a685d3dfa89f-2
00:19:53.737 --> 00:19:55.520
every provider has different fees.

5fcd07f3-3b42-4eb3-9e09-1fd29ff750f9-0
00:19:56.080 --> 00:20:00.215
So you'll note when we go through the
plan design for the Group Advantage plan

5fcd07f3-3b42-4eb3-9e09-1fd29ff750f9-1
00:20:00.215 --> 00:20:03.461
that the bulk of your benefits are
co-pays, not Co insurance,

5fcd07f3-3b42-4eb3-9e09-1fd29ff750f9-2
00:20:03.461 --> 00:20:07.753
so that you're able to know ahead of time
what you're going to be responsible for

5fcd07f3-3b42-4eb3-9e09-1fd29ff750f9-3
00:20:07.753 --> 00:20:08.120
paying.

292c6590-2a20-4a7a-a205-aa796357a045-0
00:20:08.280 --> 00:20:09.000
So you can help.

21b301f3-27f4-47d5-9811-4afbf5dbc5a7-0
00:20:09.480 --> 00:20:13.965
I can help you plan and just be more
aware ahead of time what the cost will be

21b301f3-27f4-47d5-9811-4afbf5dbc5a7-1
00:20:13.965 --> 00:20:14.760
out of pocket.

6385f465-3bdf-4b3e-b331-4e6d4a06264d-0
00:20:15.640 --> 00:20:18.920
Last but not least is what's called an
annual out of pocket maximum.

286f1a2e-eadf-416e-b861-28b29a55393c-0
00:20:19.360 --> 00:20:23.553
And this is the maximum dollar amount
that you'll pay out of pocket in your

286f1a2e-eadf-416e-b861-28b29a55393c-1
00:20:23.553 --> 00:20:28.023
co-pays and or Co insurance in a calendar
year for your Medicare covered medical

286f1a2e-eadf-416e-b861-28b29a55393c-2
00:20:28.023 --> 00:20:28.520
expenses.

6e3c696e-8e65-4a50-85d2-f65130accc91-0
00:20:28.840 --> 00:20:32.478
Once this amount is met,
the plan Care First will pay 100% for

6e3c696e-8e65-4a50-85d2-f65130accc91-1
00:20:32.478 --> 00:20:37.040
your Medicare covered medical expenses
for the remainder of the calendar year.

d9cd3e43-eb2f-4c6b-9f4c-cd2924a07887-0
00:20:37.440 --> 00:20:41.760
This annual out of pocket maximum resets
at the beginning of every year.

0d966ac3-8b17-4823-8562-41e9cc60c51e-0
00:20:42.600 --> 00:20:46.663
There is also a separate out of pocket
maximum for prescription drugs and we'll

0d966ac3-8b17-4823-8562-41e9cc60c51e-1
00:20:46.663 --> 00:20:49.000
get into those numbers in just a few
minutes.

8473b4ca-acce-4b09-9c89-46a99057ed2b-0
00:20:50.160 --> 00:20:53.532
Before we do though,
I wanted to touch on our provider network

8473b4ca-acce-4b09-9c89-46a99057ed2b-1
00:20:53.532 --> 00:20:57.601
because we certainly understand how
important it is that you have access to

8473b4ca-acce-4b09-9c89-46a99057ed2b-2
00:20:57.601 --> 00:21:01.563
your doctors and the, you know,
facilities that you've been going to that

8473b4ca-acce-4b09-9c89-46a99057ed2b-3
00:21:01.563 --> 00:21:04.080
you're able to continue to go to those
places.

5ca64d9f-4c86-4223-84b8-ffd224522afb-0
00:21:04.600 --> 00:21:08.897
So the first thing I want to note on this
slide is that the Care First Group

5ca64d9f-4c86-4223-84b8-ffd224522afb-1
00:21:08.897 --> 00:21:11.520
Advantage plan is what's called a passive
PPO.

1db885b0-1feb-4280-a4cc-7cff70ed4b6f-0
00:21:11.640 --> 00:21:16.236
And what this means is that you're able
to see both in network and out of network

1db885b0-1feb-4280-a4cc-7cff70ed4b6f-1
00:21:16.236 --> 00:21:19.320
Medicare providers and you'll pay the
same cost share.

36b98e83-0bdd-4f82-99be-a44b68056f1b-0
00:21:19.720 --> 00:21:24.543
So this is different than a lot of other
more typical PP OS out there where if you

36b98e83-0bdd-4f82-99be-a44b68056f1b-1
00:21:24.543 --> 00:21:28.030
go out of network,
you tend to pay more in order to be able

36b98e83-0bdd-4f82-99be-a44b68056f1b-2
00:21:28.030 --> 00:21:32.040
to see those out of network providers,
sometimes substantially more.

cdf1a217-bbf3-4927-ad50-4d99c50b794a-0
00:21:32.560 --> 00:21:35.600
That is not the case for the Group
Advantage PPO plan.

f46b6606-62be-430c-883e-ab433ec50d88-0
00:21:35.600 --> 00:21:38.686
So again,
you're able to access and see in and out

f46b6606-62be-430c-883e-ab433ec50d88-1
00:21:38.686 --> 00:21:42.560
of network Medicare providers and your
co-pay will be the same.

cf84d3b6-3e31-47d1-9a30-3993ad83831a-0
00:21:43.280 --> 00:21:46.741
So just know that,
that gives you a lot of access to a lot

cf84d3b6-3e31-47d1-9a30-3993ad83831a-1
00:21:46.741 --> 00:21:49.440
of doctors, not just locally,
but nationally.

da469728-97db-4183-bee9-d9c28a2be18d-0
00:21:50.600 --> 00:21:53.382
Now on the kind of bottom half of the
slide here,

da469728-97db-4183-bee9-d9c28a2be18d-1
00:21:53.382 --> 00:21:57.777
we've got 3 categories of providers that
you have access to under the new Care

da469728-97db-4183-bee9-d9c28a2be18d-2
00:21:57.777 --> 00:21:59.280
First Group Advantage plan.

988c2221-75e8-463a-a447-94f36173c1cd-0
00:21:59.920 --> 00:22:04.770
The first are local providers that Care
First has contracted with directly here

988c2221-75e8-463a-a447-94f36173c1cd-1
00:22:04.770 --> 00:22:07.680
in the Maryland,
DC and Northern Virginia area.

70d37604-0cda-472a-b87d-62b1579df2bc-0
00:22:08.040 --> 00:22:11.720
Those providers are part of the Care
First Medicare Advantage PPO network.

963782b1-c575-4e43-a000-c69432512aeb-0
00:22:12.280 --> 00:22:16.385
You also have access to nationwide
providers through our network sharing

963782b1-c575-4e43-a000-c69432512aeb-1
00:22:16.385 --> 00:22:20.546
arrangement that we have in place with
other Blue Cross Blue Shield plans

963782b1-c575-4e43-a000-c69432512aeb-2
00:22:20.546 --> 00:22:21.840
throughout the country.

46bd2607-8616-4314-b049-a36f995bd7a8-0
00:22:22.280 --> 00:22:25.204
So there is something called a Blue Cross
Blue Shield,

46bd2607-8616-4314-b049-a36f995bd7a8-1
00:22:25.204 --> 00:22:29.244
Medicare Advantage PPO network that all
the various Blues plans who operate

46bd2607-8616-4314-b049-a36f995bd7a8-2
00:22:29.244 --> 00:22:30.840
throughout the US are part of.

87b82d1d-8d82-4a5d-a283-ecf62f5f52b7-0
00:22:31.080 --> 00:22:36.105
And that's what enables you to see
doctors outside of the local care first

87b82d1d-8d82-4a5d-a283-ecf62f5f52b7-1
00:22:36.105 --> 00:22:38.920
market and still be considered in network.

105ba1a1-0825-4ea8-a4bf-7af23e790b26-0
00:22:39.760 --> 00:22:43.709
Last but not least,
you have access to out of network doctors

105ba1a1-0825-4ea8-a4bf-7af23e790b26-1
00:22:43.709 --> 00:22:48.360
as long as they accept Medicare and are
willing to bill the health plan.

236813c4-ef8c-456b-9ffd-6a24f5c389f5-0
00:22:50.280 --> 00:22:53.417
Now on this slide,
I just wanted to show a sample member ID

236813c4-ef8c-456b-9ffd-6a24f5c389f5-1
00:22:53.417 --> 00:22:57.809
card so you have an idea of what the card
will look like when it's mailed to you in

236813c4-ef8c-456b-9ffd-6a24f5c389f5-2
00:22:57.809 --> 00:22:58.280
December.

76be0bc0-6b2e-410c-b211-b934ab4e4c52-0
00:22:58.280 --> 00:23:00.951
It's probably very similar to your care
first card today,

76be0bc0-6b2e-410c-b211-b934ab4e4c52-1
00:23:00.951 --> 00:23:02.840
but a couple of things to point out here.

e96b80a7-ba9d-491e-b772-1785d82d3045-0
00:23:03.240 --> 00:23:07.360
This is the only card that you'll need to
show the doctor or the pharmacy.

f121ca10-69bc-42d6-ba94-ce01665d965e-0
00:23:07.360 --> 00:23:10.864
Starting in January,
you will no longer need to show that red,

f121ca10-69bc-42d6-ba94-ce01665d965e-1
00:23:10.864 --> 00:23:14.201
that Medicare red,
white and blue card in order to use this

f121ca10-69bc-42d6-ba94-ce01665d965e-2
00:23:14.201 --> 00:23:14.480
plan.

5919081f-ce53-47d3-adb2-539dd199490d-0
00:23:14.800 --> 00:23:18.912
Now certainly keep it somewhere safe
where you know where it's at for in the

5919081f-ce53-47d3-adb2-539dd199490d-1
00:23:18.912 --> 00:23:21.956
future, but again,
your care First Medicare Advantage ID

5919081f-ce53-47d3-adb2-539dd199490d-2
00:23:21.956 --> 00:23:24.360
card will be the only card you need to
show.

c58c52a4-6909-43a9-b9be-7246ceb4b5b0-0
00:23:25.200 --> 00:23:28.868
Also included here on the slide are a
couple of stats just about the size of

c58c52a4-6909-43a9-b9be-7246ceb4b5b0-1
00:23:28.868 --> 00:23:29.440
our network.

d99ca9bd-9066-425e-b764-ccb836d28233-0
00:23:30.000 --> 00:23:34.240
So one thing to point out is 98% of
providers in the United States

d99ca9bd-9066-425e-b764-ccb836d28233-1
00:23:34.240 --> 00:23:35.760
participate in Medicare.

e4e15171-6323-41f9-8261-ffc9ff60586a-0
00:23:36.000 --> 00:23:39.502
So as I've mentioned previously,
this plan allows you to see out of

e4e15171-6323-41f9-8261-ffc9ff60586a-1
00:23:39.502 --> 00:23:43.313
network providers as long as they
participate in Medicare and 98% of them

e4e15171-6323-41f9-8261-ffc9ff60586a-2
00:23:43.313 --> 00:23:44.240
in the country do.

09aca31a-83fd-46cc-af42-b466cf36d96f-0
00:23:44.240 --> 00:23:44.520
So.

d16bc387-2ff5-4867-8af9-91c59c96aaec-0
00:23:44.520 --> 00:23:47.586
Again,
really broad access both in and out of

d16bc387-2ff5-4867-8af9-91c59c96aaec-1
00:23:47.586 --> 00:23:48.120
network.

e428aa68-fa07-41f3-a968-4e5c67420e0e-0
00:23:48.120 --> 00:23:51.864
As part of this plan,
now locally we have over 8000 primary

e428aa68-fa07-41f3-a968-4e5c67420e0e-1
00:23:51.864 --> 00:23:55.484
care doctors, 57,
000 specialists and 55 hospitals in the

e428aa68-fa07-41f3-a968-4e5c67420e0e-2
00:23:55.484 --> 00:23:58.230
Maryland,
DC and Northern Virginia area who

e428aa68-fa07-41f3-a968-4e5c67420e0e-3
00:23:58.230 --> 00:24:03.223
participate in the Care First Medicare
Advantage PPO network and that number is

e428aa68-fa07-41f3-a968-4e5c67420e0e-4
00:24:03.223 --> 00:24:04.160
always growing.

bb3f8866-6bb2-4ba9-9ee4-4b83a75e4aef-0
00:24:04.320 --> 00:24:08.953
We have a really dedicated team in our
provider networks area who are always on

bb3f8866-6bb2-4ba9-9ee4-4b83a75e4aef-1
00:24:08.953 --> 00:24:13.240
the lookout for new doctors and new
facilities to bring into our network.

a4bb0efe-a69b-4768-841e-26a1889aa724-0
00:24:14.120 --> 00:24:17.066
And then as a reminder,
you do also have access to that

a4bb0efe-a69b-4768-841e-26a1889aa724-1
00:24:17.066 --> 00:24:20.960
nationwide Blue Cross Blue Shield
Medicare Advantage PPO network as well.

1b4f1fc5-0bde-410a-a01b-e55676b78ed2-0
00:24:21.600 --> 00:24:25.288
So at the bottom of your member ID card
circled here in red,

1b4f1fc5-0bde-410a-a01b-e55676b78ed2-1
00:24:25.288 --> 00:24:26.800
you'll see it says MAPPO.

cedf17db-2c3b-4798-8fba-23ca97f4d4d8-0
00:24:27.160 --> 00:24:31.024
And this is the symbol that all Blue
Cross Blue Shield plans throughout the

cedf17db-2c3b-4798-8fba-23ca97f4d4d8-1
00:24:31.024 --> 00:24:33.160
country use that are part of this network.

deaf880c-a5ed-446f-9d8a-e804ae90c7c5-0
00:24:33.520 --> 00:24:38.154
This will be able to basically tell your
provider when you are showing your office

deaf880c-a5ed-446f-9d8a-e804ae90c7c5-1
00:24:38.154 --> 00:24:42.733
this card for the first time that you're
part of this Blue Cross Blue Shield plan

deaf880c-a5ed-446f-9d8a-e804ae90c7c5-2
00:24:42.733 --> 00:24:44.800
and that you have very rich coverage.

f5268add-64c5-4239-8ba4-24390c1f1ba6-0
00:24:45.000 --> 00:24:46.840
So just wanted to point that out.

25098a7f-6e68-4666-812a-e11d2ea3b597-0
00:24:47.720 --> 00:24:50.038
Now,
just to provide one additional

25098a7f-6e68-4666-812a-e11d2ea3b597-1
00:24:50.038 --> 00:24:53.322
reassurance as it relates to our provider
network,

25098a7f-6e68-4666-812a-e11d2ea3b597-2
00:24:53.322 --> 00:24:58.023
we conducted an analysis of all the
providers that Calvert County Public

25098a7f-6e68-4666-812a-e11d2ea3b597-3
00:24:58.023 --> 00:25:03.239
School retirees visited in 2024 and we
compared those to our network of Medicare

25098a7f-6e68-4666-812a-e11d2ea3b597-4
00:25:03.239 --> 00:25:08.520
Advantage PPO providers and found that
96% of them do participate in our network.

03ba32c8-b633-4a01-92fe-0fc134f1f441-0
00:25:08.520 --> 00:25:11.532
So really high overlap,
which hopefully will provide that

03ba32c8-b633-4a01-92fe-0fc134f1f441-1
00:25:11.532 --> 00:25:14.129
reassurance that if you're seeing a
doctor today,

03ba32c8-b633-4a01-92fe-0fc134f1f441-2
00:25:14.129 --> 00:25:18.025
there's a very good chance you're going
to be able to continue seeing them

03ba32c8-b633-4a01-92fe-0fc134f1f441-3
00:25:18.025 --> 00:25:19.480
tomorrow under the new plan.

1a0a42b7-1897-4965-a923-cccbae9b346f-0
00:25:20.040 --> 00:25:24.388
You'll see that there are also some
provider types where we have even higher

1a0a42b7-1897-4965-a923-cccbae9b346f-1
00:25:24.388 --> 00:25:28.058
than 96 percentage match rates,
things like nurse practitioners,

1a0a42b7-1897-4965-a923-cccbae9b346f-2
00:25:28.058 --> 00:25:29.640
emergency medicine and more.

442018fc-3219-4072-a2a9-33074dfbc645-0
00:25:29.640 --> 00:25:31.880
So really, really broad access.

727dca5b-f7fd-4b69-907f-d0dc4498e7c4-0
00:25:32.000 --> 00:25:35.411
And then on the right,
we just wanted to highlight some of the

727dca5b-f7fd-4b69-907f-d0dc4498e7c4-1
00:25:35.411 --> 00:25:39.040
providers in the Calvert County area that
are part of our network.

795f5a93-770c-47b7-a042-a98449fa6410-0
00:25:39.040 --> 00:25:44.001
Again, this is not an all inclusive list,
but just wanted to bring forward some of

795f5a93-770c-47b7-a042-a98449fa6410-1
00:25:44.001 --> 00:25:48.724
those in the local area that are part of
our network that you may be seeing or

795f5a93-770c-47b7-a042-a98449fa6410-2
00:25:48.724 --> 00:25:50.040
have seen in the past.

dd9180f5-a993-4217-8588-f27f10588d0e-0
00:25:52.280 --> 00:25:56.670
So I'm going to switch gears now and get
into those details as they pertain to

dd9180f5-a993-4217-8588-f27f10588d0e-1
00:25:56.670 --> 00:26:01.061
your new medical and prescription drug
benefits under the Group Advantage plan

dd9180f5-a993-4217-8588-f27f10588d0e-2
00:26:01.061 --> 00:26:01.839
from Care 1st.

04647c3d-b0e1-4d05-af85-042043c7ec6b-0
00:26:02.240 --> 00:26:06.200
So a couple of things to tee up before I
move to the next slide.

031205df-9b18-4986-a68a-656a307fc51d-0
00:26:06.640 --> 00:26:11.047
You're going to see that we are comparing
one of the three plans that are currently

031205df-9b18-4986-a68a-656a307fc51d-1
00:26:11.047 --> 00:26:14.720
offered to retirees today to the new Care
First Group Advantage plan.

693cf189-c7ab-49e3-a21c-7a754e84db92-0
00:26:14.720 --> 00:26:19.196
So that will hopefully allow you to see
pretty easily the changes from plan to

693cf189-c7ab-49e3-a21c-7a754e84db92-1
00:26:19.196 --> 00:26:22.880
plan and also help prepare you for the
new Group Advantage plan.

fde8f013-764d-4736-bec0-8204b5454089-0
00:26:23.440 --> 00:26:27.320
I'll also point out that not all benefits
are going to be listed.

16d5042c-a0da-4008-ab35-6fe6117bf0c1-0
00:26:27.320 --> 00:26:30.592
So if you're looking for something in
particular and don't see it,

16d5042c-a0da-4008-ab35-6fe6117bf0c1-1
00:26:30.592 --> 00:26:31.520
please don't panic.

6ee6c989-a463-4e3d-bbfb-afdaaedfd046-0
00:26:31.520 --> 00:26:35.535
It does not mean that it's not covered,
but we really just wanted to highlight

6ee6c989-a463-4e3d-bbfb-afdaaedfd046-1
00:26:35.535 --> 00:26:38.840
the most commonly utilized medical
benefits for this comparison.

a1da046c-2fe5-44d1-9619-f00290c7e6bd-0
00:26:39.560 --> 00:26:44.524
Last point I'll make before I get into it
is that we did design the Group Advantage

a1da046c-2fe5-44d1-9619-f00290c7e6bd-1
00:26:44.524 --> 00:26:49.074
plan to mirror very closely your current
plans because there are three plans

a1da046c-2fe5-44d1-9619-f00290c7e6bd-2
00:26:49.074 --> 00:26:52.266
offered today,
there's a range of co-pays that you're

a1da046c-2fe5-44d1-9619-f00290c7e6bd-3
00:26:52.266 --> 00:26:52.680
paying.

fb504928-328f-4c00-a8ac-bc8d91ec0f99-0
00:26:52.680 --> 00:26:57.278
So we really tried to strike a balance
when we designed the Group Advantage plan

fb504928-328f-4c00-a8ac-bc8d91ec0f99-1
00:26:57.278 --> 00:27:01.480
and assigned co-pays that were close to
the average of those three plans.

68c44515-8dd1-4c4c-8024-9f60c0389b4e-0
00:27:01.480 --> 00:27:04.868
So what that means is depending on the
plan you're in today,

68c44515-8dd1-4c4c-8024-9f60c0389b4e-1
00:27:04.868 --> 00:27:09.035
you're gonna see in some cases lower
co-pays and others you may see higher

68c44515-8dd1-4c4c-8024-9f60c0389b4e-2
00:27:09.035 --> 00:27:09.480
co-pays.

14bf6df1-ef30-4cbf-be3c-90abcced8a8f-0
00:27:09.840 --> 00:27:12.639
However,
overall the group advantage plan has a

14bf6df1-ef30-4cbf-be3c-90abcced8a8f-1
00:27:12.639 --> 00:27:17.420
pretty low medical out of pocket maximum
and your prescription drug out of pocket

14bf6df1-ef30-4cbf-be3c-90abcced8a8f-2
00:27:17.420 --> 00:27:19.519
maximum is going down significantly.

8deb2d0b-34d4-4bd0-b347-d6894863acb7-0
00:27:19.520 --> 00:27:24.002
So those protections are in place and I
think they're going to be a a nice change

8deb2d0b-34d4-4bd0-b347-d6894863acb7-1
00:27:24.002 --> 00:27:24.440
for you.

e7f161c6-2588-414c-ac1a-1b310f3c199a-0
00:27:25.240 --> 00:27:29.181
So without further kind of amp up of what
this slide looks like,

e7f161c6-2588-414c-ac1a-1b310f3c199a-1
00:27:29.181 --> 00:27:34.032
on this slide we're going to show the
three current plans offered in the Orange

e7f161c6-2588-414c-ac1a-1b310f3c199a-2
00:27:34.032 --> 00:27:39.125
columns and then the group advantage plan
is on the far right with the green header

e7f161c6-2588-414c-ac1a-1b310f3c199a-3
00:27:39.125 --> 00:27:40.520
and the bolded co-pays.

990a5e21-cb87-4876-bdc8-1adce5e51126-0
00:27:40.880 --> 00:27:45.022
So first thing I want to note is that
there is no medical deductible in the new

990a5e21-cb87-4876-bdc8-1adce5e51126-1
00:27:45.022 --> 00:27:46.680
Care First group advantage plan.

b0dc3d72-795d-4038-92db-05719e66e6bd-0
00:27:47.640 --> 00:27:52.777
Your out of pocket maximum for your
medical expenses in a calendar year is

b0dc3d72-795d-4038-92db-05719e66e6bd-1
00:27:52.777 --> 00:27:53.120
$500.

a96ed320-34dc-4f06-bae6-db40ace5fef0-0
00:27:53.120 --> 00:27:55.417
Again,
that's going to be once you hit that

a96ed320-34dc-4f06-bae6-db40ace5fef0-1
00:27:55.417 --> 00:27:58.081
amount and your co-pays for your medical
expenses,

a96ed320-34dc-4f06-bae6-db40ace5fef0-2
00:27:58.081 --> 00:28:02.258
then care First will pick up 100% of the
cost for the remainder of the calendar

a96ed320-34dc-4f06-bae6-db40ace5fef0-3
00:28:02.258 --> 00:28:02.520
year.

50b56cf4-cea1-4446-8c3a-7ff95084aed1-0
00:28:03.400 --> 00:28:06.613
Your co-pays are pretty low though,
so there's a chance you might not,

50b56cf4-cea1-4446-8c3a-7ff95084aed1-1
00:28:06.613 --> 00:28:09.917
you know, even hit that amount,
but it is there to serve as a protection

50b56cf4-cea1-4446-8c3a-7ff95084aed1-2
00:28:09.917 --> 00:28:10.280
for you.

402a6929-3516-45a8-9634-561e786c4878-0
00:28:11.560 --> 00:28:16.307
Your PCP co-pay is $0.
00 and it's a $5 co-pay to see a

402a6929-3516-45a8-9634-561e786c4878-1
00:28:16.307 --> 00:28:17.240
specialist.

e765e067-3c1f-4ca1-bb25-46600a51c594-0
00:28:17.520 --> 00:28:22.196
I do want to note that these are the same
co-pays regardless of if you see your

e765e067-3c1f-4ca1-bb25-46600a51c594-1
00:28:22.196 --> 00:28:25.880
provider in the office in person or if
you see them virtually.

a1d8717f-39b2-49a2-826d-f201ac798b29-0
00:28:25.880 --> 00:28:28.511
So if you have a preference one way or
the other,

a1d8717f-39b2-49a2-826d-f201ac798b29-1
00:28:28.511 --> 00:28:30.880
just know that the co-pays will be the
same.

bbcf605d-a448-4544-91f5-a503d013f77e-0
00:28:31.680 --> 00:28:35.920
You also have a $5 co-pay for physical,
speech and occupational therapy.

b7499531-e4e5-47d9-986b-d3a7edaa68a0-0
00:28:36.840 --> 00:28:41.388
Next slide is set up the same way with
those 3 current plans in orange,

b7499531-e4e5-47d9-986b-d3a7edaa68a0-1
00:28:41.388 --> 00:28:45.494
the new plan in green,
you're going to see that you will pay $0.

b7499531-e4e5-47d9-986b-d3a7edaa68a0-2
00:28:45.494 --> 00:28:50.233
00 under the new plan for inpatient
hospitals visits and you'll have a $10

b7499531-e4e5-47d9-986b-d3a7edaa68a0-3
00:28:50.233 --> 00:28:52.759
co-pay for outpatient hospital services.

a74dc785-0d2a-4871-9c91-27dd69d0c9d0-0
00:28:53.280 --> 00:28:58.524
Your emergency room co-pay is $30 and
that amount will be waived if you are

a74dc785-0d2a-4871-9c91-27dd69d0c9d0-1
00:28:58.524 --> 00:29:04.320
admitted to the hospital within 24 hours
and your urgent care center co-pay is $15.

139ed9ed-6c45-4a9c-9cb7-d2e50a8ef53d-0
00:29:04.480 --> 00:29:08.500
Lastly,
you've got a $5 co-pay on your labs and

139ed9ed-6c45-4a9c-9cb7-d2e50a8ef53d-1
00:29:08.500 --> 00:29:09.840
your X-rays Now.

98efcbca-39e6-437a-a244-4d9810967b05-0
00:29:09.840 --> 00:29:14.322
Not included on the slide,
but worth a mention is that the new Care

98efcbca-39e6-437a-a244-4d9810967b05-1
00:29:14.322 --> 00:29:19.464
First Group Advantage plan also includes
worldwide and emergency and urgently

98efcbca-39e6-437a-a244-4d9810967b05-2
00:29:19.464 --> 00:29:22.760
needed services up to a $50,
000 maximum benefit.

eceadfc5-89a9-4af9-87cf-a33b9656632d-0
00:29:23.200 --> 00:29:27.634
So really important to note here that
this pertains to services that are

eceadfc5-89a9-4af9-87cf-a33b9656632d-1
00:29:27.634 --> 00:29:32.494
rendered in either an emergency room or
urgent care setting only when traveling

eceadfc5-89a9-4af9-87cf-a33b9656632d-2
00:29:32.494 --> 00:29:32.920
abroad.

f3e1a410-3c03-4690-a9e4-a37dbcd58c2f-0
00:29:33.240 --> 00:29:37.687
So if you happen to be on a trip and you
found yourself in a situation where you

f3e1a410-3c03-4690-a9e4-a37dbcd58c2f-1
00:29:37.687 --> 00:29:41.641
had to go to the emergency room,
what would happen is you would pay for

f3e1a410-3c03-4690-a9e4-a37dbcd58c2f-2
00:29:41.641 --> 00:29:46.253
those services upfront and then you would
submit them to Care 1st for reimbursement

f3e1a410-3c03-4690-a9e4-a37dbcd58c2f-3
00:29:46.253 --> 00:29:48.560
up to that $50,000 maximum benefit amount.

6491eebd-c5a7-4bb1-b0bf-73bff951896b-0
00:29:49.600 --> 00:29:54.304
This does only apply though to services
that are performed in the emergency room

6491eebd-c5a7-4bb1-b0bf-73bff951896b-1
00:29:54.304 --> 00:29:55.640
or urgent care setting.

68f70755-ab4d-4d42-a177-4afa9428e6b7-0
00:29:55.640 --> 00:29:59.915
So God forbid you're travelling and
you're admitted to a hospital in another

68f70755-ab4d-4d42-a177-4afa9428e6b7-1
00:29:59.915 --> 00:30:00.360
country.

ad8b9063-2ea0-4234-853d-ebcf16292b1d-0
00:30:00.640 --> 00:30:04.129
The services that are provided once
you're admitted as a patient are not

ad8b9063-2ea0-4234-853d-ebcf16292b1d-1
00:30:04.129 --> 00:30:06.280
included or covered as part of this
benefit.

e38ea98a-1762-4283-a269-e9f72705377b-0
00:30:06.280 --> 00:30:10.720
So we do like to tell members that it's a
nice safety blanket to have.

fb2b928e-3f67-4570-b400-d587b0c08a2f-0
00:30:10.720 --> 00:30:15.217
It certainly does provide some protection,
but if you're going to be travelling out

fb2b928e-3f67-4570-b400-d587b0c08a2f-1
00:30:15.217 --> 00:30:19.392
of the country for an extended period of
time or if you go out of the country

fb2b928e-3f67-4570-b400-d587b0c08a2f-2
00:30:19.392 --> 00:30:22.069
quite often,
you they want to consider purchasing

fb2b928e-3f67-4570-b400-d587b0c08a2f-3
00:30:22.069 --> 00:30:24.800
additional medical travel protection just
in case.

9a875127-6462-4e35-9cc8-cc365086bc56-0
00:30:27.040 --> 00:30:30.960
So now I want to pause for just a minute
and talk about prior authorization.

25b4b37f-7e81-467f-9ede-503658407c50-0
00:30:30.960 --> 00:30:35.355
This is something that we often get
questions on from our retirees and so we

25b4b37f-7e81-467f-9ede-503658407c50-1
00:30:35.355 --> 00:30:40.150
wanted to address it in the webinar today
and also just provide transparency around

25b4b37f-7e81-467f-9ede-503658407c50-2
00:30:40.150 --> 00:30:44.032
what prior authorization is and the
services that may require prior

25b4b37f-7e81-467f-9ede-503658407c50-3
00:30:44.032 --> 00:30:47.799
authorization as part of the New Care
First Group Advantage plan.

06aa8d60-93fa-42ba-afef-0816fc94ae14-0
00:30:48.360 --> 00:30:51.342
So to start,
I just want to provide a definition,

06aa8d60-93fa-42ba-afef-0816fc94ae14-1
00:30:51.342 --> 00:30:55.816
which is that prior authorization is a
health plan's approval to provide a

06aa8d60-93fa-42ba-afef-0816fc94ae14-2
00:30:55.816 --> 00:30:58.559
service or to fill a prescription in
advance.

693a4d45-5914-47f5-918a-8f80f1deda9f-0
00:30:58.560 --> 00:31:02.965
The intent of prior authorization,
which is I think really important here,

693a4d45-5914-47f5-918a-8f80f1deda9f-1
00:31:02.965 --> 00:31:07.605
the intent is to help ensure that the
care that is being provided is medically

693a4d45-5914-47f5-918a-8f80f1deda9f-2
00:31:07.605 --> 00:31:11.600
necessary and that the plan is not paying
for unnecessary services.

d1c41eb9-227f-4ca4-8849-12b51ee0f2c1-0
00:31:11.960 --> 00:31:15.292
Unfortunately,
the Medicare system has a lot of fraud

d1c41eb9-227f-4ca4-8849-12b51ee0f2c1-1
00:31:15.292 --> 00:31:16.280
and abuse in it.

682d87f0-fbf5-409d-9195-619b8b981375-0
00:31:16.520 --> 00:31:19.280
It's a shame,
but it is something that we're aware of.

b30400ee-5264-4820-9d70-525f3420f68e-0
00:31:19.520 --> 00:31:23.188
And prior authorization is just one of
the ways in which we want to have a

b30400ee-5264-4820-9d70-525f3420f68e-1
00:31:23.188 --> 00:31:26.905
double check to make sure before we pay
out that the services provided were

b30400ee-5264-4820-9d70-525f3420f68e-2
00:31:26.905 --> 00:31:29.840
needed and that they were actually
provided by your doctor.

a2bdaa27-49ee-4d0b-bf3f-baafe5dae52f-0
00:31:29.840 --> 00:31:33.494
So again,
that's the intent really behind prior

a2bdaa27-49ee-4d0b-bf3f-baafe5dae52f-1
00:31:33.494 --> 00:31:34.560
authorization.

83921ad7-64b0-4fd2-a102-c67f2ce1c787-0
00:31:35.520 --> 00:31:40.712
If a service requires prior authorization,
it's the responsibility of the provider

83921ad7-64b0-4fd2-a102-c67f2ce1c787-1
00:31:40.712 --> 00:31:45.904
to process that request with care 1st and
to coordinate that for you ahead of your

83921ad7-64b0-4fd2-a102-c67f2ce1c787-2
00:31:45.904 --> 00:31:46.280
visit.

db3b6602-0185-457c-b6df-e13ebb4a9acc-0
00:31:46.280 --> 00:31:49.600
This is not something that you,
the member should have to worry about.

8b64a67c-620b-49f1-8f03-b3c47ffedb08-0
00:31:51.000 --> 00:31:55.601
Also another thing to note is if you are
seeing an out of network provider,

8b64a67c-620b-49f1-8f03-b3c47ffedb08-1
00:31:55.601 --> 00:31:57.720
prior authorization does not apply.

f53b26a2-d8c5-41fb-9cd1-0472bad6aacd-0
00:31:57.800 --> 00:32:00.901
The the real reason there is if they're
out of our network,

f53b26a2-d8c5-41fb-9cd1-0472bad6aacd-1
00:32:00.901 --> 00:32:04.726
we don't have a contract with those
doctors and therefore we can't really

f53b26a2-d8c5-41fb-9cd1-0472bad6aacd-2
00:32:04.726 --> 00:32:07.880
enforce any roles or policies that we
have as a health plan.

964faa89-fa6c-4544-8ebf-d75c3d91208a-0
00:32:07.880 --> 00:32:11.920
So again, if you're out of network,
prior authorization does not apply.

4a97d9fc-6a18-4fda-a6f6-13bdd127991f-0
00:32:12.760 --> 00:32:15.252
Now,
if we happen to say that we will not

4a97d9fc-6a18-4fda-a6f6-13bdd127991f-1
00:32:15.252 --> 00:32:18.990
cover your services,
you or your provider do have the right to

4a97d9fc-6a18-4fda-a6f6-13bdd127991f-2
00:32:18.990 --> 00:32:23.263
appeal our decision and there is a a
process by which those appeals are

4a97d9fc-6a18-4fda-a6f6-13bdd127991f-3
00:32:23.263 --> 00:32:25.400
regularly reviewed and responded to.

60218a04-a6f5-4d0c-a141-800448a2e964-0
00:32:26.440 --> 00:32:28.747
Now,
Care First does set our prior

60218a04-a6f5-4d0c-a141-800448a2e964-1
00:32:28.747 --> 00:32:32.440
authorization policies based on guidance
from Medicare.

e63f6f47-d7cc-4ac2-9178-9580fd5af6ae-0
00:32:32.440 --> 00:32:36.924
So we really do follow Medicare's lead
here when we determine which types of

e63f6f47-d7cc-4ac2-9178-9580fd5af6ae-1
00:32:36.924 --> 00:32:39.080
services require prior authorization.

275eb3a3-f9ad-4fab-80d5-7236ba569965-0
00:32:39.400 --> 00:32:44.066
And on the bottom of the slide here
you'll see some of those services that

275eb3a3-f9ad-4fab-80d5-7236ba569965-1
00:32:44.066 --> 00:32:47.551
include hospital services,
skilled nursing home health,

275eb3a3-f9ad-4fab-80d5-7236ba569965-2
00:32:47.551 --> 00:32:52.404
prosthetic devices, physical therapy,
Medicare covered chiropractic services,

275eb3a3-f9ad-4fab-80d5-7236ba569965-3
00:32:52.404 --> 00:32:55.640
non emergent ambulance rides,
and medical supplies.

870e14c4-d38b-4572-9ac8-350338a0164a-0
00:32:56.280 --> 00:33:00.501
Prior authorization is something that
Retiree First is also a great resource to

870e14c4-d38b-4572-9ac8-350338a0164a-1
00:33:00.501 --> 00:33:01.240
help you with.

af5e40ef-382b-4833-89f4-202051f17b15-0
00:33:01.840 --> 00:33:03.751
Again,
it really should be the provider

af5e40ef-382b-4833-89f4-202051f17b15-1
00:33:03.751 --> 00:33:05.520
coordinate coordinating this for you.

d0df1ddf-5fc9-4ec3-a025-fefb310151ca-0
00:33:05.760 --> 00:33:08.201
However,
if you run into a situation where you

d0df1ddf-5fc9-4ec3-a025-fefb310151ca-1
00:33:08.201 --> 00:33:12.407
know you want to check on the status of
prior authorization or maybe you want to

d0df1ddf-5fc9-4ec3-a025-fefb310151ca-2
00:33:12.407 --> 00:33:15.472
get ahead of it,
Retiree First is a wonderful resource for

d0df1ddf-5fc9-4ec3-a025-fefb310151ca-3
00:33:15.472 --> 00:33:15.680
you.

a965f858-b4c9-4098-b53f-a0492914aef1-0
00:33:17.840 --> 00:33:21.701
Now included on this slide is the
prescription drug benefits that are

a965f858-b4c9-4098-b53f-a0492914aef1-1
00:33:21.701 --> 00:33:23.080
included in the new plan.

2d254317-500e-42c7-bc59-1aecc15b5822-0
00:33:23.080 --> 00:33:25.800
Again,
side by side against your current health

2d254317-500e-42c7-bc59-1aecc15b5822-1
00:33:25.800 --> 00:33:27.840
plans that you're enrolled in today.

a5c46779-fabc-49c5-a4df-34699675ddf6-0
00:33:28.120 --> 00:33:29.640
So same set up with the slide.

a31626bd-a38a-4dcb-aba5-efc3a6b20119-0
00:33:29.640 --> 00:33:34.120
You're going to see the new benefits are
on the far right in the bolded copy.

565d8954-97d7-4056-8e06-e3f1b45f36f6-0
00:33:34.560 --> 00:33:38.640
So a couple of things here to note before
I get started.

cd51e3af-d8e8-465b-b241-a7fdf466106b-0
00:33:38.800 --> 00:33:41.842
First,
there is no prescription drug deductible

cd51e3af-d8e8-465b-b241-a7fdf466106b-1
00:33:41.842 --> 00:33:42.920
in your new plan.

1ee0e4a4-9015-4ceb-82dd-c38b2d87f685-0
00:33:42.920 --> 00:33:45.840
So that's the same as the plans you're in
today.

83f21003-9254-46a1-ae0c-e37e082f69af-0
00:33:46.640 --> 00:33:51.541
The out of pocket maximum for your
prescription drug coverage in a calendar

83f21003-9254-46a1-ae0c-e37e082f69af-1
00:33:51.541 --> 00:33:56.700
year is $2100 and you're going to see
that is quite a bit lower than the out of

83f21003-9254-46a1-ae0c-e37e082f69af-2
00:33:56.700 --> 00:34:01.280
pocket maximums for your plans today that
range between 4600 and 6200.

84e7ecc1-235c-457f-af7e-4028ab88d6f7-0
00:34:01.280 --> 00:34:04.000
So that will hopefully be a welcome
change.

46427872-cf16-47a6-bdb8-0a8b85bafa21-0
00:34:05.080 --> 00:34:09.937
Then you're going to see that your
co-pays for your drugs will fall into one

46427872-cf16-47a6-bdb8-0a8b85bafa21-1
00:34:09.937 --> 00:34:12.840
of five tiers of drugs on our drug
formulary.

d61d927f-0892-4b0e-b88d-2db3e2fb7991-0
00:34:12.880 --> 00:34:16.400
And the co-pays are really the same as
the co-pays you pay today.

f7e66113-113b-4fef-8ca7-254960e57131-0
00:34:16.400 --> 00:34:20.601
So you're going to have an $8 co-pay for
your generic medications,

f7e66113-113b-4fef-8ca7-254960e57131-1
00:34:20.601 --> 00:34:25.554
you'll have a $15 co-pay for preferred
brand and then you'll have a $30 co-pay

f7e66113-113b-4fef-8ca7-254960e57131-2
00:34:25.554 --> 00:34:28.000
for non preferred and speciality drugs.

a9061a3e-1e85-4be4-a954-a85a848d46a9-0
00:34:28.520 --> 00:34:34.680
These co-pays are for a 30 day supply of
either that you obtain at the retail

a9061a3e-1e85-4be4-a954-a85a848d46a9-1
00:34:34.680 --> 00:34:37.760
pharmacy or at the mail order pharmacy.

bef15182-b808-4808-a9ea-75da140a416f-0
00:34:37.760 --> 00:34:43.261
If you choose to use mail order,
you do also have access to 60 and 90 day

bef15182-b808-4808-a9ea-75da140a416f-1
00:34:43.261 --> 00:34:45.640
supplies of medications as well.

381680ca-027f-47dd-93ec-12f341056e3a-0
00:34:46.440 --> 00:34:48.760
So just be aware that that's available to
you.

235e4987-b0a1-43d0-8705-b86a643acacd-0
00:34:49.880 --> 00:34:52.949
Mail order is,
is the really the way to go for those

235e4987-b0a1-43d0-8705-b86a643acacd-1
00:34:52.949 --> 00:34:57.640
routine medications that you're taking on
a regular basis for health conditions.

5b33745f-1299-4520-afc5-84546b8966f1-0
00:34:58.040 --> 00:35:01.924
You will get a 90 day supply of your
medication for one,

5b33745f-1299-4520-afc5-84546b8966f1-1
00:35:01.924 --> 00:35:03.560
one time the copay here.

418764a0-df78-464d-8365-0bcb230997ec-0
00:35:03.560 --> 00:35:08.227
So if you're getting a generic drug,
you'll pay $8 for a 90 day supply versus

418764a0-df78-464d-8365-0bcb230997ec-1
00:35:08.227 --> 00:35:11.040
$8 for a 30 day supply at the retail
pharmacy.

a977da83-5f57-4314-a893-816337b2ea5a-0
00:35:11.040 --> 00:35:13.480
So really do encourage you to set that up.

094e4a7e-206b-4373-900e-cee82099481c-0
00:35:13.960 --> 00:35:18.672
If you do use mail order today,
it should transfer over to the new care

094e4a7e-206b-4373-900e-cee82099481c-1
00:35:18.672 --> 00:35:20.440
First group Advantage plan.

2c2f60fc-be11-4fbc-a816-2b12c4f7440e-0
00:35:20.680 --> 00:35:25.077
And I would say this process is fairly
seamless for over 90% of our members that

2c2f60fc-be11-4fbc-a816-2b12c4f7440e-1
00:35:25.077 --> 00:35:26.760
move to a group advantage plan.

d84aef83-d260-4234-909d-b15790a833d9-0
00:35:27.080 --> 00:35:29.795
However,
we do like to recommend that you call

d84aef83-d260-4234-909d-b15790a833d9-1
00:35:29.795 --> 00:35:34.417
retiree first or the pharmacy number on
the back of your ID card just to ensure

d84aef83-d260-4234-909d-b15790a833d9-2
00:35:34.417 --> 00:35:38.000
ahead of the plan start in January that
it did transfer over.

3f4a1573-82d8-4847-b437-4a610c8c90bb-0
00:35:38.000 --> 00:35:41.616
It's always good to just to make sure
that you're all set up to go if you're

3f4a1573-82d8-4847-b437-4a610c8c90bb-1
00:35:41.616 --> 00:35:45.280
mail using mail order that that process
will continue without any disruption.

0c3a2265-0b42-4828-89a0-8648abd08f62-0
00:35:46.480 --> 00:35:50.897
We work with CVS to administer the
prescription drug benefits for the Care

0c3a2265-0b42-4828-89a0-8648abd08f62-1
00:35:50.897 --> 00:35:55.785
First Group Advantage plan and we do use
one of their most expansive drug lists or

0c3a2265-0b42-4828-89a0-8648abd08f62-2
00:35:55.785 --> 00:36:00.320
formularies that they have to offer,
which is called the expanded formulary.

998c4792-aa42-42c6-bd57-a1d0c1c6b14c-0
00:36:00.880 --> 00:36:04.510
However,
while we do use CVS for these benefits,

998c4792-aa42-42c6-bd57-a1d0c1c6b14c-1
00:36:04.510 --> 00:36:09.400
you are not required to use ACVS Pharmacy
to get your drugs from.

bac97b19-e2bb-4861-ac34-8ee79624d71b-0
00:36:09.840 --> 00:36:13.162
In fact,
our pharmacy network includes over 60,

bac97b19-e2bb-4861-ac34-8ee79624d71b-1
00:36:13.162 --> 00:36:18.008
000 different pharmacies nationwide,
including major chains like CVS,

bac97b19-e2bb-4861-ac34-8ee79624d71b-2
00:36:18.008 --> 00:36:22.923
Walgreens, Walmart, Costco, Wise Cost,
I already said Costco, Safeway,

bac97b19-e2bb-4861-ac34-8ee79624d71b-3
00:36:22.923 --> 00:36:26.800
Medicine Shoppe,
and Giant Pharmacy just to name a few.

98cbd981-caac-49f7-951f-9cb0b029cb58-0
00:36:27.440 --> 00:36:32.320
It also includes access to independent
owned and operated pharmacies as well.

d1d74e53-575b-4b9c-bf86-3888218d61fa-0
00:36:32.320 --> 00:36:33.600
So very broad coverage.

a8540602-ff61-49b4-95cf-eb26eea15423-0
00:36:33.600 --> 00:36:36.280
Again, you do not have to go to CVS alone.

198632e6-c5b8-4d9d-bc56-b13b837da149-0
00:36:36.280 --> 00:36:38.480
You can go to most places.

61590cf4-2f81-4e5f-8928-f9ef0fbc945d-0
00:36:39.200 --> 00:36:41.894
And then lastly,
I mentioned this at the start,

61590cf4-2f81-4e5f-8928-f9ef0fbc945d-1
00:36:41.894 --> 00:36:46.105
but the drug list is going to be
different than the list of drugs that you

61590cf4-2f81-4e5f-8928-f9ef0fbc945d-2
00:36:46.105 --> 00:36:48.799
have available to you under your current
plans.

3998efe5-bcec-4737-ab2d-5f0f44c6bea4-0
00:36:49.200 --> 00:36:53.928
We did do an analysis and we looked at
the formulary and the medications on your

3998efe5-bcec-4737-ab2d-5f0f44c6bea4-1
00:36:53.928 --> 00:36:58.597
current formularies next to our group
Advantage formulary and found very little

3998efe5-bcec-4737-ab2d-5f0f44c6bea4-2
00:36:58.597 --> 00:36:59.239
disruption.

37ccbde2-f8fa-48f7-8570-50cb94ae3ee1-0
00:36:59.240 --> 00:37:04.825
I think less than 2% of folks with the
drugs that they're taking will not be on

37ccbde2-f8fa-48f7-8570-50cb94ae3ee1-1
00:37:04.825 --> 00:37:06.920
the group Advantage formulary.

3990361d-d65f-4409-8962-1ed96481596c-0
00:37:06.920 --> 00:37:09.360
So it's a very low impact.

0784e1a5-31dd-4007-b9a7-60be97538b1b-0
00:37:09.840 --> 00:37:14.193
If you are one of those few folks whose
drugs are not on our formulary,

0784e1a5-31dd-4007-b9a7-60be97538b1b-1
00:37:14.193 --> 00:37:17.640
you will be receiving a communication
from us very soon.

2e63cb4d-52bf-46ff-a94e-9fa5a5ba9057-0
00:37:17.640 --> 00:37:22.417
I believe the letter mailed out on Friday
that will notify you of this change and

2e63cb4d-52bf-46ff-a94e-9fa5a5ba9057-1
00:37:22.417 --> 00:37:23.000
next step.

f4cb3768-537b-44c7-8ce6-9dfdf91f39c3-0
00:37:23.000 --> 00:37:25.480
So just please be aware that that is
coming.

76641ca8-109c-442c-9f24-fefe349dc425-0
00:37:25.720 --> 00:37:29.680
Again, should only be to a few,
a few subset of members here.

be65c1f0-5616-4cf3-a77d-931c4a1a98bc-0
00:37:31.320 --> 00:37:34.762
Now what will happen,
something that we do offer is part of

be65c1f0-5616-4cf3-a77d-931c4a1a98bc-1
00:37:34.762 --> 00:37:35.680
this transition.

3a114124-a3eb-4433-a69b-b79b4cfbd8ea-0
00:37:35.920 --> 00:37:40.230
If you happen to be one of those few
folks whose drugs are not covered on our

3a114124-a3eb-4433-a69b-b79b4cfbd8ea-1
00:37:40.230 --> 00:37:43.160
formulary,
we offer what's called a transition fill.

8fdbde12-9691-4379-9406-1340fa1618c8-0
00:37:43.480 --> 00:37:48.795
And this allows you to get a one time 30
day supply of that medication when you

8fdbde12-9691-4379-9406-1340fa1618c8-1
00:37:48.795 --> 00:37:51.520
join the new plan within the 1st 90 days.

f17cc977-06b7-4300-abb1-671c437dc077-0
00:37:51.520 --> 00:37:54.043
So you'll able,
you'll be able to continue to get that

f17cc977-06b7-4300-abb1-671c437dc077-1
00:37:54.043 --> 00:37:56.200
drug and you'll have a 30 day supply
provided.

74835af9-7acf-499a-b248-cecd2d78eb0a-0
00:37:56.760 --> 00:37:59.237
Again,
at that time you and your provider will

74835af9-7acf-499a-b248-cecd2d78eb0a-1
00:37:59.237 --> 00:38:03.505
be notified that the drug is not on our
formulary and you'll be recommended some

74835af9-7acf-499a-b248-cecd2d78eb0a-2
00:38:03.505 --> 00:38:04.560
alternatives to try.

bfb0e792-3a2c-4506-8e3c-8ebe011f83ce-0
00:38:05.440 --> 00:38:09.360
Now we do understand that alternatives
are not for everyone.

af30aae0-4c09-480f-93f9-1d06026230b6-0
00:38:09.360 --> 00:38:12.850
And so there is something called an
exception request that can be made

af30aae0-4c09-480f-93f9-1d06026230b6-1
00:38:12.850 --> 00:38:16.586
especially if you've already tried
different drugs or alternatives and they

af30aae0-4c09-480f-93f9-1d06026230b6-2
00:38:16.586 --> 00:38:17.520
don't work for you.

5d0390df-5e8b-46e2-bd6b-ad7e4546db1e-0
00:38:17.520 --> 00:38:20.165
So again,
there are processes in place and we

5d0390df-5e8b-46e2-bd6b-ad7e4546db1e-1
00:38:20.165 --> 00:38:23.040
recognize that not all drugs work for all
people.

cca9e308-ff64-4f64-84b9-8c71af871843-0
00:38:23.960 --> 00:38:26.638
Again,
this policy really just is meant to give

cca9e308-ff64-4f64-84b9-8c71af871843-1
00:38:26.638 --> 00:38:29.148
you more time to transition to the new
plan,

cca9e308-ff64-4f64-84b9-8c71af871843-2
00:38:29.148 --> 00:38:33.612
to adjust to any changes that may occur,
and to set you up for coverage for the

cca9e308-ff64-4f64-84b9-8c71af871843-3
00:38:33.612 --> 00:38:34.839
rest of the plan year.

eb6afbbb-5c58-47c5-a669-8ab7c3a0f7f1-0
00:38:37.600 --> 00:38:42.281
So the next section in today's webinar is
really looking at the extras that are

eb6afbbb-5c58-47c5-a669-8ab7c3a0f7f1-1
00:38:42.281 --> 00:38:46.611
included in your plan beyond those
medical and prescription drug benefits

eb6afbbb-5c58-47c5-a669-8ab7c3a0f7f1-2
00:38:46.611 --> 00:38:47.840
that we just covered.

86d97134-7c9c-462a-9057-b579db8a7275-0
00:38:48.520 --> 00:38:50.422
I do want to mention that the next few
slides,

86d97134-7c9c-462a-9057-b579db8a7275-1
00:38:50.422 --> 00:38:51.960
it's going to be a lot of information.

3656799c-642f-458e-aacc-3a803b90efbf-0
00:38:51.960 --> 00:38:55.294
It's already been quite a bit of
information that I've thrown at you,

3656799c-642f-458e-aacc-3a803b90efbf-1
00:38:55.294 --> 00:38:57.866
so just know that everything that I'm
about to cover,

3656799c-642f-458e-aacc-3a803b90efbf-2
00:38:57.866 --> 00:39:00.199
you're going to be getting communications
about.

01325e99-f435-4f4c-a50a-13398ce4527c-0
00:39:00.400 --> 00:39:04.769
Specifically your welcome brochure that
you'll be mailed in December is going to

01325e99-f435-4f4c-a50a-13398ce4527c-1
00:39:04.769 --> 00:39:06.280
outline all of these things.

07e3c361-16ea-400b-a308-9d027de06e8b-0
00:39:06.280 --> 00:39:09.018
So you don't need to memorize anything
today,

07e3c361-16ea-400b-a308-9d027de06e8b-1
00:39:09.018 --> 00:39:13.782
but just wanted to tee up what some of
these extras are so that you're aware of

07e3c361-16ea-400b-a308-9d027de06e8b-2
00:39:13.782 --> 00:39:14.080
them.

6ff77869-cd65-4dbf-bb63-c7e12af47efa-0
00:39:14.400 --> 00:39:19.005
And if you're interested in any of them,
you'll get more information about how to

6ff77869-cd65-4dbf-bb63-c7e12af47efa-1
00:39:19.005 --> 00:39:22.320
kind of enact those coverages once you're
in the new plan.

4b9e1cc1-a3ab-4f08-84f8-bfc82a90c613-0
00:39:23.000 --> 00:39:25.600
So let's start with routine hearing.

da7c772e-6810-4678-a9af-e7a81e26a17c-0
00:39:25.920 --> 00:39:30.952
So part of your group Advantage plan
includes access to hearing aids through

da7c772e-6810-4678-a9af-e7a81e26a17c-1
00:39:30.952 --> 00:39:33.240
our partner called Nations Hearing.

cbbecc24-a27e-4350-97ca-6e45607807ea-0
00:39:33.760 --> 00:39:36.708
Now as part of this benefit,
you'll pay $0.

cbbecc24-a27e-4350-97ca-6e45607807ea-1
00:39:36.708 --> 00:39:39.791
00 for an annual routine hearing exam and
$0.

cbbecc24-a27e-4350-97ca-6e45607807ea-2
00:39:39.791 --> 00:39:43.880
00 for a hearing aid fitting if you need
those hearing aids.

5ce24e53-bea9-4637-9e19-b9e57927ea17-0
00:39:44.440 --> 00:39:50.158
Now depending on which technology level
of hearing aid that you are wanting to

5ce24e53-bea9-4637-9e19-b9e57927ea17-1
00:39:50.158 --> 00:39:53.560
purchase, you will pay $0.
00 per hearing aid.

b91a8695-0477-4e71-9237-6782c219d8ab-0
00:39:53.560 --> 00:39:57.790
If you select a hearing aid from one of
the first 3 technology levels,

b91a8695-0477-4e71-9237-6782c219d8ab-1
00:39:57.790 --> 00:40:00.828
either the Entry,
Basic or Prime technology level,

b91a8695-0477-4e71-9237-6782c219d8ab-2
00:40:00.828 --> 00:40:04.582
there is co-pays associated with the
higher technology levels,

b91a8695-0477-4e71-9237-6782c219d8ab-3
00:40:04.582 --> 00:40:07.800
including the Preferred,
advanced and Premium levels.

a25674c2-bf53-44be-8386-d0d926775479-0
00:40:08.800 --> 00:40:14.101
But you'll see that most of our members,
I believe it's over 75% of them do find a

a25674c2-bf53-44be-8386-d0d926775479-1
00:40:14.101 --> 00:40:16.720
hearing aid on one of the first 3 levels.

2cb5d35b-5918-4d0f-a94c-09a5d5187fd3-0
00:40:17.040 --> 00:40:21.638
The way that nations has explained it to
us is that those more advanced technology

2cb5d35b-5918-4d0f-a94c-09a5d5187fd3-1
00:40:21.638 --> 00:40:25.240
level of hearing aids just tend to have
more bells and whistles.

cd5499fd-dc04-4489-aed5-b856fb896cfc-0
00:40:25.240 --> 00:40:28.789
So if you're someone that likes to have
your hearing aids paired with your

cd5499fd-dc04-4489-aed5-b856fb896cfc-1
00:40:28.789 --> 00:40:32.196
smartphone or your app and really just
have everything synced together,

cd5499fd-dc04-4489-aed5-b856fb896cfc-2
00:40:32.196 --> 00:40:35.840
those types of kind of bells and whistles
are what we're talking about here.

88299aeb-61f9-473a-b5ad-c88cff3b674c-0
00:40:35.840 --> 00:40:38.908
But most of our members find something
that is, you know,

88299aeb-61f9-473a-b5ad-c88cff3b674c-1
00:40:38.908 --> 00:40:42.560
not only works for them but works well
for them on the 1st 3 levels.

3287d0b4-50c4-4ed3-8ced-2153b82698b8-0
00:40:43.400 --> 00:40:48.398
Now you're able to search our directory
at our website, carefirst.

3287d0b4-50c4-4ed3-8ced-2153b82698b8-1
00:40:48.398 --> 00:40:52.800
com/learn Group MA to find an in network
hearing provider.

295b9013-0396-4551-9fb7-df4553448de1-0
00:40:52.800 --> 00:40:55.751
And you can look at the Medicare
Advantage Hearing PPO network

295b9013-0396-4551-9fb7-df4553448de1-1
00:40:55.751 --> 00:40:56.360
specifically.

0a63baf8-a6f9-4030-8cf4-55e98f6e5b6e-0
00:40:56.880 --> 00:41:01.593
You can also call retiree first and have
them search the directory for you to get

0a63baf8-a6f9-4030-8cf4-55e98f6e5b6e-1
00:41:01.593 --> 00:41:04.640
you set up and ready to go with a
nation's provider.

0e594392-a9f0-4dba-88a3-980291caf75d-0
00:41:04.640 --> 00:41:07.452
So again,
a really great resource and use of

0e594392-a9f0-4dba-88a3-980291caf75d-1
00:41:07.452 --> 00:41:11.640
retiree First is having them find
providers and reach out for you.

33587da4-de85-4333-9eab-a32817ef285a-0
00:41:14.520 --> 00:41:19.043
The next slide here is just on our
fitness program that we are offering our

33587da4-de85-4333-9eab-a32817ef285a-1
00:41:19.043 --> 00:41:19.520
members.

d559f597-078b-4788-b1d3-16b3b637a0f1-0
00:41:19.520 --> 00:41:21.560
It's available through Silver Sneakers.

c3ececde-55e4-4339-8b20-4e9721c3f2a9-0
00:41:21.560 --> 00:41:26.320
This is 1 benefit that we often hear our
retirees excited to hear that we offer.

604c269e-4ca0-4ade-a696-b7c58b3eaaca-0
00:41:26.960 --> 00:41:31.668
So basically if you are ever interested
in joining a gym or if you're already a

604c269e-4ca0-4ade-a696-b7c58b3eaaca-1
00:41:31.668 --> 00:41:34.905
member of a gym,
we do recommend that you go to Silver

604c269e-4ca0-4ade-a696-b7c58b3eaaca-2
00:41:34.905 --> 00:41:39.319
Sneakers website and look at their
network of locations nationwide because

604c269e-4ca0-4ade-a696-b7c58b3eaaca-3
00:41:39.319 --> 00:41:43.144
if they're in network,
it means you can see and visit those gyms

604c269e-4ca0-4ade-a696-b7c58b3eaaca-4
00:41:43.144 --> 00:41:45.440
without having to pay a membership fee.

2c399114-42b0-4940-a80e-669f9d424c1d-0
00:41:45.640 --> 00:41:50.014
So I've listed just a few in the Calvert
County area on the slide here,

2c399114-42b0-4940-a80e-669f9d424c1d-1
00:41:50.014 --> 00:41:54.996
but just know again that there are Silver
Sneakers facilities nationwide and that

2c399114-42b0-4940-a80e-669f9d424c1d-2
00:41:54.996 --> 00:41:56.880
you can use multiple locations.

126b8706-6264-4948-a586-01879277ed73-0
00:41:57.520 --> 00:42:00.965
So if you're working out or if you'd like
to get started,

126b8706-6264-4948-a586-01879277ed73-1
00:42:00.965 --> 00:42:05.658
definitely get get on Silver Sneakers
website or call us and we'll get you set

126b8706-6264-4948-a586-01879277ed73-2
00:42:05.658 --> 00:42:07.560
up with how to use that benefit.

b10e0253-be8a-4f59-ac0c-92ca22758bd8-0
00:42:07.880 --> 00:42:11.440
All you'll really need is your new member
ID card for you to access this.

c1fa1e72-9547-4953-a393-db0d2ac8b698-0
00:42:11.440 --> 00:42:12.520
So it's pretty easy.

9b1f633d-b514-445a-b365-47adf46042cf-0
00:42:13.080 --> 00:42:17.499
They do offer virtual classes as well if
that's something that's of interest to

9b1f633d-b514-445a-b365-47adf46042cf-1
00:42:17.499 --> 00:42:17.720
you.

45888520-da29-493d-a46d-dc50241333ae-0
00:42:17.720 --> 00:42:20.515
So again,
more information will be coming in your

45888520-da29-493d-a46d-dc50241333ae-1
00:42:20.515 --> 00:42:22.360
welcome brochure on this program.

160e8b9d-8448-432d-b283-d7a3155fabd2-0
00:42:24.480 --> 00:42:27.960
Closenit is a virtual care service that's
offered through the plan.

08a64fe9-3657-4d55-8ac3-190aa6d36c38-0
00:42:28.360 --> 00:42:33.167
This allows you to connect with
clinicians 24/7 through through your

08a64fe9-3657-4d55-8ac3-190aa6d36c38-1
00:42:33.167 --> 00:42:36.720
phone, through a tablet,
or through your computer.

97df708f-789f-48fc-b2a6-b90caec6373e-0
00:42:37.400 --> 00:42:42.195
This is not the only virtual care
provider that you can see as part of your

97df708f-789f-48fc-b2a6-b90caec6373e-1
00:42:42.195 --> 00:42:43.520
Group Advantage plan.

393d5c6e-a0ab-4627-b564-df7b5b9a2009-0
00:42:43.520 --> 00:42:45.600
It's just one that we like to promote.

652db567-88aa-4185-834f-43c0f237a65d-0
00:42:46.440 --> 00:42:50.752
One of the reasons why is because they do
more than just urgent care visits

652db567-88aa-4185-834f-43c0f237a65d-1
00:42:50.752 --> 00:42:51.320
virtually.

60b0c2c7-bdcb-4419-8f8c-1124a4a8f928-0
00:42:51.320 --> 00:42:55.515
They also offer primary care services,
behavioral health services,

60b0c2c7-bdcb-4419-8f8c-1124a4a8f928-1
00:42:55.515 --> 00:42:57.520
and diet and nutrition services.

2fc48b8c-f1c4-44f7-beee-b06aebb669a4-0
00:42:57.920 --> 00:43:00.040
So again, this is a really great option.

a6a109a7-19c3-4391-8e35-a7cd78333962-0
00:43:00.480 --> 00:43:04.120
It's not meant to replace any of your
existing relationships with your doctors.

2883588f-474d-4bd7-9b68-b1c330a73da6-0
00:43:04.120 --> 00:43:08.380
But if you find yourself maybe not being
able to get into your doctor's office as

2883588f-474d-4bd7-9b68-b1c330a73da6-1
00:43:08.380 --> 00:43:11.758
quickly as you would like,
or if you want to try out some of the

2883588f-474d-4bd7-9b68-b1c330a73da6-2
00:43:11.758 --> 00:43:14.720
behavioral health or diet services
through this service,

2883588f-474d-4bd7-9b68-b1c330a73da6-3
00:43:14.720 --> 00:43:19.032
it's available to you and you'll pay the
same co-pay as if you were visiting those

2883588f-474d-4bd7-9b68-b1c330a73da6-4
00:43:19.032 --> 00:43:20.280
providers in the office.

473908c5-2cf6-4122-95ad-2b99ac5c7a2d-0
00:43:23.080 --> 00:43:25.762
Now,
we also partner with a company called

473908c5-2cf6-4122-95ad-2b99ac5c7a2d-1
00:43:25.762 --> 00:43:29.880
Porter to offer our members a variety of
in home health services.

0077d746-c080-4ea7-a48c-178a0c1e7a80-0
00:43:30.400 --> 00:43:34.654
This company can do all kinds of things,
including coming into your home to make

0077d746-c080-4ea7-a48c-178a0c1e7a80-1
00:43:34.654 --> 00:43:38.173
sure you're getting the necessary
preventive screenings and health

0077d746-c080-4ea7-a48c-178a0c1e7a80-2
00:43:38.173 --> 00:43:40.800
assessments that are are necessary for
your care.

22559aa1-376e-4d00-9939-f05a209fd817-0
00:43:40.840 --> 00:43:45.106
That can be really helpful if you are
someone that maybe has challenges getting

22559aa1-376e-4d00-9939-f05a209fd817-1
00:43:45.106 --> 00:43:49.053
to and from your doctor's office,
if transportation is a concern for you,

22559aa1-376e-4d00-9939-f05a209fd817-2
00:43:49.053 --> 00:43:53.426
or if you've just been discharged from a
hospital or skilled nursing facility and

22559aa1-376e-4d00-9939-f05a209fd817-3
00:43:53.426 --> 00:43:57.000
need some assistance sort of settling
back into your home routine,

22559aa1-376e-4d00-9939-f05a209fd817-4
00:43:57.000 --> 00:43:59.880
where there's a really great option for
that as well.

b889cf69-1631-4f2f-9c89-d890863509d2-0
00:44:00.200 --> 00:44:03.080
They can also help schedule your doctor's
appointment.

65c239e4-28ce-47e8-9e68-6c88a5cf2163-0
00:44:03.080 --> 00:44:06.920
They can help facilitate access to
necessary medical equipment,

65c239e4-28ce-47e8-9e68-6c88a5cf2163-1
00:44:06.920 --> 00:44:09.680
they can help arrange transportation as
well.

ae0ff22e-c453-4f30-8f64-fea218e7c073-0
00:44:09.960 --> 00:44:14.020
And they can also connect you to
community resources that may be, you know,

ae0ff22e-c453-4f30-8f64-fea218e7c073-1
00:44:14.020 --> 00:44:17.600
something you're not aware of that could
help your situation, too.

bd57098b-9394-458c-87ac-6327269742e5-0
00:44:18.240 --> 00:44:22.068
One thing Porter does as well is they'll
come into your home and if you're

bd57098b-9394-458c-87ac-6327269742e5-1
00:44:22.068 --> 00:44:24.467
interested,
they will provide kind of a safety

bd57098b-9394-458c-87ac-6327269742e5-2
00:44:24.467 --> 00:44:28.040
assessment and look for potential risks
that you may not be aware of.

26f89eb4-cd66-4c5a-909b-a0945d619242-0
00:44:28.520 --> 00:44:32.723
They'll identify them and they'll help
connect you with community resources to

26f89eb4-cd66-4c5a-909b-a0945d619242-1
00:44:32.723 --> 00:44:34.000
help solve them as well.

87ee3387-9ce8-4542-8a4e-b3697b7a5128-0
00:44:34.000 --> 00:44:39.520
So Porter is not a required kind of
service that you have to do.

018c1fc6-9003-4451-a799-2ba4382344e6-0
00:44:39.520 --> 00:44:43.025
It's just it's a nice to to know wanted
you to be aware if this is a,

018c1fc6-9003-4451-a799-2ba4382344e6-1
00:44:43.025 --> 00:44:45.680
something that would interest you or your
situation.

8ddc8514-b05a-4e87-bb2e-2dd7c0f53f8f-0
00:44:45.680 --> 00:44:48.920
It is part of the Care First Group
Advantage plan.

4599cb21-756c-42b0-a457-95290bbf6243-0
00:44:50.600 --> 00:44:55.030
Now we do offer a number of other care
management related services through other

4599cb21-756c-42b0-a457-95290bbf6243-1
00:44:55.030 --> 00:44:55.960
partners of ours.

819164ae-e3ea-4d5c-a64d-1dcda265898e-0
00:44:55.960 --> 00:45:00.440
So this slide is really meant to show who
are those partners and why might they be

819164ae-e3ea-4d5c-a64d-1dcda265898e-1
00:45:00.440 --> 00:45:01.520
reaching out to you.

e8cbbf72-5aab-450a-9b7d-385885fccbe5-0
00:45:01.560 --> 00:45:04.360
This will help hopefully help you know
ahead of time.

4abad0c1-1b21-4f23-946f-d5eedfd8d3ca-0
00:45:04.640 --> 00:45:06.788
You know,
if someone calls me and they say they're

4abad0c1-1b21-4f23-946f-d5eedfd8d3ca-1
00:45:06.788 --> 00:45:09.273
from Adhere Health,
that they're an actual partner of ours

4abad0c1-1b21-4f23-946f-d5eedfd8d3ca-2
00:45:09.273 --> 00:45:11.000
and, and here's why they're reaching out.

2ac4476e-408a-41ef-b14b-d1daa949679e-0
00:45:11.000 --> 00:45:16.920
So we do work with Adhere and CVS to
provide medication reminders for our

2ac4476e-408a-41ef-b14b-d1daa949679e-1
00:45:16.920 --> 00:45:17.560
members.

1916507e-6c1d-4f00-9428-0daf50ccc188-0
00:45:17.560 --> 00:45:20.893
If you take a lot of medications and need
help managing those,

1916507e-6c1d-4f00-9428-0daf50ccc188-1
00:45:20.893 --> 00:45:22.640
they can support you in that way.

a0a8886f-8690-42c3-975c-e96de94bd87e-0
00:45:22.680 --> 00:45:27.540
They also can review your medications and
really look for drug related risks and

a0a8886f-8690-42c3-975c-e96de94bd87e-1
00:45:27.540 --> 00:45:29.640
interactions to really avoid those.

a8d1add7-e6e1-49aa-9e30-a966c2d99e4c-0
00:45:30.240 --> 00:45:33.641
Porter, we already mentioned,
that's the in home health partner that

a8d1add7-e6e1-49aa-9e30-a966c2d99e4c-1
00:45:33.641 --> 00:45:36.600
can come in and do a number of things in
your home for you.

0f391808-ade3-4914-98c6-14df1bfe947c-0
00:45:37.120 --> 00:45:41.956
We also have a quality team of clinicians
on staff here at Care First who can help

0f391808-ade3-4914-98c6-14df1bfe947c-1
00:45:41.956 --> 00:45:46.560
with things like appointment scheduling,
acquiring medical equipment and more.

1e3b0d5f-c228-4240-a13b-e206bbeebb99-0
00:45:47.360 --> 00:45:52.086
And then we do work with and make
available a variety of at home screening

1e3b0d5f-c228-4240-a13b-e206bbeebb99-1
00:45:52.086 --> 00:45:54.040
or testing kits if you qualify.

7b976d9b-b7dd-4c79-b9cc-36654b6fff59-0
00:45:54.040 --> 00:45:56.761
So again,
just a lot of different ways to get you

7b976d9b-b7dd-4c79-b9cc-36654b6fff59-1
00:45:56.761 --> 00:45:59.755
connected with care,
to make sure that you are getting

7b976d9b-b7dd-4c79-b9cc-36654b6fff59-2
00:45:59.755 --> 00:46:04.327
comprehensive care and you're able to get
access to all of these things through the

7b976d9b-b7dd-4c79-b9cc-36654b6fff59-3
00:46:04.327 --> 00:46:04.599
plan.

1c915790-f117-4412-bb8f-445859528629-0
00:46:06.600 --> 00:46:10.320
Blue 365 is our health and Wellness
discount program.

44025e81-1aec-4c21-8845-acf11fcc2e7e-0
00:46:10.320 --> 00:46:12.680
This is available to all Blue Cross Blue
Shield members.

c50f608e-6e73-4958-8d07-4df150b7fa9b-0
00:46:12.680 --> 00:46:17.180
So you may possibly be using this website
today if you're not aware of it,

c50f608e-6e73-4958-8d07-4df150b7fa9b-1
00:46:17.180 --> 00:46:20.240
it's a good one to to write down and come
back to.

9a9614f2-e414-4e8b-aed7-f4a195f2903b-0
00:46:20.840 --> 00:46:24.340
Basically,
it is a discount program on a variety of

9a9614f2-e414-4e8b-aed7-f4a195f2903b-1
00:46:24.340 --> 00:46:26.360
health and Wellness retailers.

848afe67-a1eb-419b-99ec-adb19c6cc5ac-0
00:46:26.360 --> 00:46:29.327
But you'll see on the slide here,
there's more than just health and

848afe67-a1eb-419b-99ec-adb19c6cc5ac-1
00:46:29.327 --> 00:46:29.720
Wellness.

f7218daf-1e81-40f9-836d-dd7761529af6-0
00:46:30.040 --> 00:46:33.706
There's some travel, some car rentals,
Chewy, if you get your,

f7218daf-1e81-40f9-836d-dd7761529af6-1
00:46:33.706 --> 00:46:36.384
your pet food or pet medicines through
Chewy,

f7218daf-1e81-40f9-836d-dd7761529af6-2
00:46:36.384 --> 00:46:39.120
we've seen discounts come through the
website.

a832dd94-8f81-4ed9-8cae-3d6640f759d5-0
00:46:39.120 --> 00:46:41.560
They're usually between 20 and 40%.

b5293aab-58a4-4103-a9da-6617f259c26b-0
00:46:41.560 --> 00:46:43.400
So it's, it's worth a look.

6821a988-14d2-49e1-a9c4-68233c941568-0
00:46:43.400 --> 00:46:45.863
If you're in the market to purchase
something,

6821a988-14d2-49e1-a9c4-68233c941568-1
00:46:45.863 --> 00:46:50.005
it's a good idea to just bookmark this
site and see what kind of deals are out

6821a988-14d2-49e1-a9c4-68233c941568-2
00:46:50.005 --> 00:46:50.320
there.

4c30f536-5c31-4864-bbef-ce8a7ea4554b-0
00:46:50.320 --> 00:46:52.480
So the website is listed on the slide.

d6bb08db-43df-4b4b-bae2-1879891fabae-0
00:46:52.480 --> 00:46:55.431
And again,
it will be in your welcome brochure as

d6bb08db-43df-4b4b-bae2-1879891fabae-1
00:46:55.431 --> 00:46:58.560
well for you to take a look at if you're
interested.

28a2c8b3-8304-4f76-a0fb-5bdbcd6e7f28-0
00:47:00.480 --> 00:47:04.000
Last but not least is our 24 hour nurse
advice line.

33255815-c852-43e4-abcd-411d71942490-0
00:47:04.280 --> 00:47:07.840
This is something that will be printed on
the back of your member ID card.

75661ea3-67dd-482e-9c11-8d5413e8d8cf-0
00:47:07.840 --> 00:47:11.920
So that will be coming again in December
and that number will be available there.

4a44a58d-df60-44c8-b2f0-4257b0e32b19-0
00:47:12.280 --> 00:47:18.190
It's staffed by registered nurses 24/7
and it's a great option if you just have

4a44a58d-df60-44c8-b2f0-4257b0e32b19-1
00:47:18.190 --> 00:47:19.520
general questions.

5f72b9ac-1633-4c18-ba66-b3b24ce10e1f-0
00:47:19.520 --> 00:47:23.701
Maybe you recently got a health diagnosis
and you just want to ask some questions

5f72b9ac-1633-4c18-ba66-b3b24ce10e1f-1
00:47:23.701 --> 00:47:24.160
about it.

54b1cbb7-dcaa-4307-aca6-cab502fa38d4-0
00:47:24.160 --> 00:47:28.591
And it's sort of a general nature if
you're maybe trying to decide where to go

54b1cbb7-dcaa-4307-aca6-cab502fa38d4-1
00:47:28.591 --> 00:47:33.360
for care, need help choosing between, say,
an urgent care center or another setting.

28feee31-566c-4ea6-9921-f8b82f13e01a-0
00:47:33.360 --> 00:47:37.840
That's all really great examples of of
ways to utilize this, this nurse line,

28feee31-566c-4ea6-9921-f8b82f13e01a-1
00:47:37.840 --> 00:47:42.377
certainly not a good phone number to call
if you're in an emergency situation,

28feee31-566c-4ea6-9921-f8b82f13e01a-2
00:47:42.377 --> 00:47:46.857
but it is there where you can just pick
up the phone and call if maybe you're

28feee31-566c-4ea6-9921-f8b82f13e01a-3
00:47:46.857 --> 00:47:51.280
more comfortable doing that versus maybe
connecting virtually to a provider.

f73e687b-e1e2-432a-9280-4f1ef7d1a7f7-0
00:47:53.280 --> 00:47:56.704
All right now to close out,
we've got just a couple of more slides

f73e687b-e1e2-432a-9280-4f1ef7d1a7f7-1
00:47:56.704 --> 00:47:56.960
left.

cb28eb93-54a1-4523-b290-2493458af37c-0
00:47:56.960 --> 00:47:59.400
Thank you for for hanging in there so far.

e59bd1de-be0a-491f-85d8-27a61d67fe00-0
00:48:00.080 --> 00:48:03.920
Really just wanted to leave you with some
resources and reminders.

2b1c040b-ce5c-44b8-b61a-75f3f5ad55c7-0
00:48:03.920 --> 00:48:07.360
So again,
we recognize this is a ton of information.

6485274b-c9f9-4e6f-b799-60fada812ced-0
00:48:07.920 --> 00:48:10.880
Anytime you make a change in your life,
whether it's you know,

6485274b-c9f9-4e6f-b799-60fada812ced-1
00:48:10.880 --> 00:48:14.497
your health plan or something else,
you probably are going to have questions

6485274b-c9f9-4e6f-b799-60fada812ced-2
00:48:14.497 --> 00:48:17.880
and we want to leave you with the
resources to address those questions,

6485274b-c9f9-4e6f-b799-60fada812ced-3
00:48:17.880 --> 00:48:19.760
you know, outside of of today's webinar.

55eecd0b-d48f-4e3f-8a2f-a8f7be4bc8eb-0
00:48:20.120 --> 00:48:24.968
So the first thing I wanted to mention
that you'll have access to as part of the

55eecd0b-d48f-4e3f-8a2f-a8f7be4bc8eb-1
00:48:24.968 --> 00:48:28.800
group Advantage plan once you're a member
is our member portal.

aaf3b6f0-e65b-47be-a5e7-99df325b3b3e-0
00:48:28.800 --> 00:48:30.080
That's called my Account.

80c896e7-74e8-45e6-abd1-a5d715eb016e-0
00:48:31.040 --> 00:48:34.360
This is also available to your current
health plans as well.

12eb1d6b-3b83-4244-a7cf-5e917f211ef9-0
00:48:34.360 --> 00:48:39.512
So the my account portal is where you can
go online to access your personalized

12eb1d6b-3b83-4244-a7cf-5e917f211ef9-1
00:48:39.512 --> 00:48:40.800
healthcare benefits.

d7205795-2921-4528-8fac-ffe7bb63610f-0
00:48:40.920 --> 00:48:45.460
You can review your claims,
you can access electronic copies of your

d7205795-2921-4528-8fac-ffe7bb63610f-1
00:48:45.460 --> 00:48:47.040
explanation of benefits.

6eb8efff-e716-4633-8b5e-5baf9db7ed30-0
00:48:47.360 --> 00:48:50.242
You're able to, you know,
do all kinds of things,

6eb8efff-e716-4633-8b5e-5baf9db7ed30-1
00:48:50.242 --> 00:48:53.240
including viewing and printing your
member ID card.

2e1b524d-9de5-42ab-824e-a6f28e304bfc-0
00:48:53.240 --> 00:48:57.253
So if you find yourself in a a situation
where maybe you've misplaced yours and

2e1b524d-9de5-42ab-824e-a6f28e304bfc-1
00:48:57.253 --> 00:48:59.460
you need it for an upcoming doctor's
visit,

2e1b524d-9de5-42ab-824e-a6f28e304bfc-2
00:48:59.460 --> 00:49:02.320
you can go online and you can print one
out temporarily.

1651c4b8-e94d-45c2-961b-74dbf8a38dc8-0
00:49:03.160 --> 00:49:07.277
My account is really helpful in a number
of ways if you like to manage your

1651c4b8-e94d-45c2-961b-74dbf8a38dc8-1
00:49:07.277 --> 00:49:09.120
information electronically online.

5e73ac36-e906-4eb7-9b25-b4a88659bdee-0
00:49:10.080 --> 00:49:12.574
Again,
if you're in my account and using that

5e73ac36-e906-4eb7-9b25-b4a88659bdee-1
00:49:12.574 --> 00:49:15.122
today as part of your current Care First
plan,

5e73ac36-e906-4eb7-9b25-b4a88659bdee-2
00:49:15.122 --> 00:49:17.399
there is nothing else that you need to do.

7f597cfb-313b-4929-b233-87c7608dc691-0
00:49:17.600 --> 00:49:22.119
Your new Group Advantage plan benefit
information will automatically be pulled

7f597cfb-313b-4929-b233-87c7608dc691-1
00:49:22.119 --> 00:49:26.581
into the website when you log in once
you're enrolled in the Care First Group

7f597cfb-313b-4929-b233-87c7608dc691-2
00:49:26.581 --> 00:49:27.440
Advantage plan.

51e2d7ee-0466-43f4-b0f3-2c789c1d05e0-0
00:49:27.440 --> 00:49:30.300
So again,
you do not need to do anything different

51e2d7ee-0466-43f4-b0f3-2c789c1d05e0-1
00:49:30.300 --> 00:49:32.880
if you're already a user of my account
today.

65116ba4-a7a1-4f3f-842c-0930352c8e3f-0
00:49:33.280 --> 00:49:36.178
If you are not using my account and are
interested,

65116ba4-a7a1-4f3f-842c-0930352c8e3f-1
00:49:36.178 --> 00:49:39.077
we've got the website here on the slide,
carefirst.

65116ba4-a7a1-4f3f-842c-0930352c8e3f-2
00:49:39.077 --> 00:49:43.537
com/myaccount and that welcome brochure
is going to list the two or three steps

65116ba4-a7a1-4f3f-842c-0930352c8e3f-3
00:49:43.537 --> 00:49:47.439
that you will need to take to get
registered and set up with a login.

c725f549-c467-4a85-932b-7b13c8b3e5be-0
00:49:47.440 --> 00:49:50.089
So again,
we do encourage the use of this if you

c725f549-c467-4a85-932b-7b13c8b3e5be-1
00:49:50.089 --> 00:49:54.360
are someone that likes to go online and
really manage all your stuff that way.

8cfd5413-f417-4b99-9118-a10da6928c3f-0
00:49:56.680 --> 00:49:59.839
So we've talked a little bit about those
member communications,

8cfd5413-f417-4b99-9118-a10da6928c3f-1
00:49:59.839 --> 00:50:03.788
kind of what's going to be coming in the
mail from us in the next few weeks and

8cfd5413-f417-4b99-9118-a10da6928c3f-2
00:50:03.788 --> 00:50:04.480
into December.

a9871bb8-cef1-437d-8e69-af0125b8058c-0
00:50:04.880 --> 00:50:08.671
So what will happen when you're open
enrollment ends is you will start to

a9871bb8-cef1-437d-8e69-af0125b8058c-1
00:50:08.671 --> 00:50:12.514
receive confirmation of enrollment
letters in the mail that basically just

a9871bb8-cef1-437d-8e69-af0125b8058c-2
00:50:12.514 --> 00:50:15.127
say, you know,
you're now enrolled in the plan and

a9871bb8-cef1-437d-8e69-af0125b8058c-3
00:50:15.127 --> 00:50:17.279
Medicare has approved welcome to the plan.

1ed3a3c6-ee55-4aef-b836-2b349008e33d-0
00:50:17.560 --> 00:50:21.660
That letter then triggers us sending out
that welcome package that includes the

1ed3a3c6-ee55-4aef-b836-2b349008e33d-1
00:50:21.660 --> 00:50:24.480
welcome brochure that I've mentioned here
a few times.

c7e50d28-b308-479c-b82e-6f9f1ccb5d7f-0
00:50:25.000 --> 00:50:27.960
You can see on the slide,
this is the cover of the welcome brochure.

9f7765ca-0f16-4891-8a86-54d602665ef5-0
00:50:27.960 --> 00:50:30.560
So you'll know what it looks like when
it's coming in the mail to you.

02550576-b88d-40fe-8803-984d0147cf7b-0
00:50:30.840 --> 00:50:34.444
And it's going to come in a very similar
envelope and package as your 2026

02550576-b88d-40fe-8803-984d0147cf7b-1
00:50:34.444 --> 00:50:36.800
Healthcare Benefit guide that was mailed
to you.

590bd02d-9603-495a-8372-5cee10896be3-0
00:50:36.800 --> 00:50:38.360
So a bigger envelope.

b6795145-f8b7-4391-a5eb-40537aa48e0a-0
00:50:38.600 --> 00:50:40.000
Just be on the alert for that.

50037d4d-ee95-4462-8d7c-8c837918d735-0
00:50:40.240 --> 00:50:43.469
And then of course,
you're going to receive that member ID

50037d4d-ee95-4462-8d7c-8c837918d735-1
00:50:43.469 --> 00:50:46.480
card again in the first week to two weeks
of December.

a6916b41-c40b-41d7-a73f-c201af46aba6-0
00:50:47.160 --> 00:50:52.738
Also on this slide is another website for
you For more information, it's carefirst.

a6916b41-c40b-41d7-a73f-c201af46aba6-1
00:50:52.738 --> 00:50:54.000
com/learn Group MA.

b1f1dce2-a911-42f0-8b2a-078fffc1a198-0
00:50:54.480 --> 00:50:58.080
This website is a great one to to
bookmark and come back to.

b926314e-d66e-4ed6-8ed3-d1ab1cb54fef-0
00:50:58.560 --> 00:51:02.094
Once you go to the website,
you'll Scroll down and you'll see

b926314e-d66e-4ed6-8ed3-d1ab1cb54fef-1
00:51:02.094 --> 00:51:05.400
basically 3 links to search the providers
in our network.

cd626e35-ae33-4c39-ba87-57caa9759de4-0
00:51:05.440 --> 00:51:09.599
You can search the drugs on our formulary
and you can search the pharmacies in our

cd626e35-ae33-4c39-ba87-57caa9759de4-1
00:51:09.599 --> 00:51:10.000
network.

7432371d-92d2-46bb-a498-54ba90974141-0
00:51:10.000 --> 00:51:14.688
So it's a very easy tool for you to be
able to do some of that searching on your

7432371d-92d2-46bb-a498-54ba90974141-1
00:51:14.688 --> 00:51:14.920
own.

1483d219-214d-4fd9-b06b-ebf73ddd1899-0
00:51:15.200 --> 00:51:19.200
And you'll be able to access all of those
directories and look UPS on this website.

b720c52c-c20c-4912-ad19-84b50f0e7842-0
00:51:19.800 --> 00:51:22.480
You do not need to create an account or
login.

b4b8205d-e811-4fa0-97e5-20b362d12176-0
00:51:22.480 --> 00:51:23.840
So this is, it's a nice one.

53fa68c3-6311-4adf-a7d6-063e162269ff-0
00:51:23.840 --> 00:51:26.567
It's one less account for you to have to
manage,

53fa68c3-6311-4adf-a7d6-063e162269ff-1
00:51:26.567 --> 00:51:31.187
but also you can also have retiree First
do all of the things I just mentioned for

53fa68c3-6311-4adf-a7d6-063e162269ff-2
00:51:31.187 --> 00:51:31.800
you, right?

a5af603e-327f-461d-9c7a-6394d7cfdc27-0
00:51:31.800 --> 00:51:35.403
You can call them to make sure that your
doctors are in network,

a5af603e-327f-461d-9c7a-6394d7cfdc27-1
00:51:35.403 --> 00:51:40.061
to do outreach if they're out of network,
to look up your drugs and to find a local

a5af603e-327f-461d-9c7a-6394d7cfdc27-2
00:51:40.061 --> 00:51:40.560
pharmacy.

c6cee0c0-6a24-4289-80ff-2fc8c01a6c26-0
00:51:40.560 --> 00:51:44.280
So if you're someone that likes to do it
yourself, this is the website for you.

73415a12-36b0-4e51-a79c-a95a40b8eb88-0
00:51:44.560 --> 00:51:46.995
Otherwise,
call Retiree First and they can do that

73415a12-36b0-4e51-a79c-a95a40b8eb88-1
00:51:46.995 --> 00:51:47.760
legwork for you.

e42bdcca-a008-4028-b3ff-d6a17dc427af-0
00:51:50.320 --> 00:51:52.901
Now,
because the new plan is a group Medicare

e42bdcca-a008-4028-b3ff-d6a17dc427af-1
00:51:52.901 --> 00:51:56.099
Advantage plan,
there are specific rules that we have to

e42bdcca-a008-4028-b3ff-d6a17dc427af-2
00:51:56.099 --> 00:51:58.400
follow from Medicare and Social Security.

6560ff6d-0546-45ab-9ccf-6c5342497b62-0
00:51:58.400 --> 00:52:03.855
So I'm going to just touch on a couple of
these requirements to make sure we're all

6560ff6d-0546-45ab-9ccf-6c5342497b62-1
00:52:03.855 --> 00:52:04.960
on the same page.

95891270-e122-43fd-9526-981b7a86aca7-0
00:52:04.960 --> 00:52:08.337
But first and foremost,
for you to be enrolled in the new group

95891270-e122-43fd-9526-981b7a86aca7-1
00:52:08.337 --> 00:52:11.714
Medicare Advantage plan,
you must be retired from the group and

95891270-e122-43fd-9526-981b7a86aca7-2
00:52:11.714 --> 00:52:14.880
you must meet all of your employers
eligibility guidelines.

9cad8991-bf21-49f7-aab4-2a5f12dd32a6-0
00:52:14.880 --> 00:52:17.960
You're here today because you're eligible
for this plan.

18fd2c98-e79c-4388-9817-ad748593bd95-0
00:52:17.960 --> 00:52:22.320
That's why you're listening in so that
one you can consider checked off the list.

3992c17e-7c09-4e93-ae36-223514790713-0
00:52:22.960 --> 00:52:26.438
You do have to be enrolled in Medicare,
both Parts A&B,

3992c17e-7c09-4e93-ae36-223514790713-1
00:52:26.438 --> 00:52:30.903
and we do really recommend if you're
someone that is turning 65 maybe in the

3992c17e-7c09-4e93-ae36-223514790713-2
00:52:30.903 --> 00:52:35.541
first few months of next year or you know
that you're retiring early next year,

3992c17e-7c09-4e93-ae36-223514790713-3
00:52:35.541 --> 00:52:39.368
when it comes time for you to sign up for
Medicare Parts A&B,

3992c17e-7c09-4e93-ae36-223514790713-4
00:52:39.368 --> 00:52:40.760
do not delay doing that.

79e81da7-d383-40b9-a8b0-dd5a15fbb32d-0
00:52:41.440 --> 00:52:44.037
You do have to be enrolled in Medicare
A&

79e81da7-d383-40b9-a8b0-dd5a15fbb32d-1
00:52:44.037 --> 00:52:46.240
B in order to be enrolled in this plan.

00dee51e-7fb6-4179-b6a7-875b320d9f06-0
00:52:46.560 --> 00:52:50.840
You also must continue to pay your Part V
premium just like you're doing today.

a07f1f05-46df-4e46-ac29-e4f5fe8757ab-0
00:52:51.920 --> 00:52:57.058
You have to live in Care First group of
Medicare Advantage service area which

a07f1f05-46df-4e46-ac29-e4f5fe8757ab-1
00:52:57.058 --> 00:53:00.880
includes all 50 United States,
DC and all US territories.

2ae1990f-bb9b-4009-94ab-09e641ae6854-0
00:53:01.200 --> 00:53:04.200
So you do have to live in the the US.

433771e7-cc44-4d28-b3f1-bb21cc718a11-0
00:53:04.200 --> 00:53:07.147
If you were to move permanently into
another country,

433771e7-cc44-4d28-b3f1-bb21cc718a11-1
00:53:07.147 --> 00:53:10.040
then you would no longer be able to be on
this plan.

27777d11-8be9-4f82-90b7-5da7e36c07fe-0
00:53:10.880 --> 00:53:13.987
Lastly,
we do have to have a physical address for

27777d11-8be9-4f82-90b7-5da7e36c07fe-1
00:53:13.987 --> 00:53:18.960
you within the service area listed above
to establish your permanent residence.

4dfc1bd0-b828-4622-88dc-73d007708be9-0
00:53:18.960 --> 00:53:20.600
This cannot be APO box.

9909a28a-3864-4bd7-8fec-50788bdc5660-0
00:53:20.680 --> 00:53:23.400
We can use APO box for your mailing
address.

5975ef14-0abf-4f62-906c-08c611271217-0
00:53:23.640 --> 00:53:24.640
That's no problem.

49a070e7-80fc-44fd-80d7-9db0c5f35936-0
00:53:24.640 --> 00:53:28.960
But Medicare does require a physical
address to enroll you in this plan.

00f31447-c792-4dc3-af2a-863ac6fadf7e-0
00:53:29.720 --> 00:53:33.870
And then probably the most important
thing on this whole slide is what's in

00f31447-c792-4dc3-af2a-863ac6fadf7e-1
00:53:33.870 --> 00:53:37.583
yellow at the bottom here,
which is you can only be enrolled in one

00f31447-c792-4dc3-af2a-863ac6fadf7e-2
00:53:37.583 --> 00:53:39.440
Medicare Advantage plan at a time.

c044ebba-320d-47a2-be0c-479514f506b2-0
00:53:39.960 --> 00:53:44.871
Medicare will automatically terminate you
from your group plan if you happen to

c044ebba-320d-47a2-be0c-479514f506b2-1
00:53:44.871 --> 00:53:48.800
enroll in another Medicare Advantage or
prescription drug plan.

cbb6b5c3-86b0-4c45-9a77-7759df5c15f7-0
00:53:48.800 --> 00:53:51.160
Whether you do that on purpose or on
accident.

3cd5bba6-127a-4b74-aa86-c782cfe8f153-0
00:53:51.840 --> 00:53:54.520
This time of year especially it's,
it can be tricky.

19c47729-f6f1-4c2a-a342-6c22b1a4d6f7-0
00:53:54.960 --> 00:53:57.240
It's Medicare's annual election.

007f0e52-a2c6-491c-bef5-4e797c8c73fc-0
00:53:57.240 --> 00:54:01.515
And you're probably receiving a lot in
the mail about these individual Medicare

007f0e52-a2c6-491c-bef5-4e797c8c73fc-1
00:54:01.515 --> 00:54:04.080
Advantage plans and,
and asking you to sign up.

ed9085e6-c344-4352-b3c9-ebc3d398bed6-0
00:54:04.560 --> 00:54:06.962
Be very,
very cautious of of those types of

ed9085e6-c344-4352-b3c9-ebc3d398bed6-1
00:54:06.962 --> 00:54:11.384
communications because it's very easy to
think that you need to do something and

ed9085e6-c344-4352-b3c9-ebc3d398bed6-2
00:54:11.384 --> 00:54:12.040
take action.

73062752-4c92-495e-89c2-ef1990eb3ed9-0
00:54:12.040 --> 00:54:14.663
And in this case, it could actually,
you know,

73062752-4c92-495e-89c2-ef1990eb3ed9-1
00:54:14.663 --> 00:54:16.840
kick you off this group advantage plan.

556e8a62-2ab4-4bdd-9859-cf1427c5da68-0
00:54:16.840 --> 00:54:19.737
So again,
just be very mindful of what's being sent

556e8a62-2ab4-4bdd-9859-cf1427c5da68-1
00:54:19.737 --> 00:54:24.139
to you and and really be cautious of
enrolling in anything else without either

556e8a62-2ab4-4bdd-9859-cf1427c5da68-2
00:54:24.139 --> 00:54:28.541
contacting the HR team at Calvert County
or retiree first just to kind of talk

556e8a62-2ab4-4bdd-9859-cf1427c5da68-3
00:54:28.541 --> 00:54:29.600
through what it is.

041f0124-83a0-4c66-b9e1-b58342ffd07f-0
00:54:31.400 --> 00:54:32.720
All right, next steps.

94180394-0849-40a4-bba1-4827a9faa511-0
00:54:32.720 --> 00:54:34.960
And we're almost to the finish line here.

f8ef04c3-af0b-47cc-97c6-c9929bdec9ff-0
00:54:36.240 --> 00:54:39.821
I think the the 2026 healthcare benefit
guide that was mailed to you from

f8ef04c3-af0b-47cc-97c6-c9929bdec9ff-1
00:54:39.821 --> 00:54:42.579
Carefirst is a,
is a really good resource just to become

f8ef04c3-af0b-47cc-97c6-c9929bdec9ff-2
00:54:42.579 --> 00:54:44.080
familiar with, to read through.

125d9297-f9e3-4cbe-bc89-e5b887feaf92-0
00:54:44.080 --> 00:54:46.786
And really again,
it captures a lot of the benefits we've

125d9297-f9e3-4cbe-bc89-e5b887feaf92-1
00:54:46.786 --> 00:54:48.280
already talked about here today.

bce0fcf9-f08f-4fea-b30e-b240671c12ea-0
00:54:48.600 --> 00:54:52.006
That mailing also included your summary
of benefits document,

bce0fcf9-f08f-4fea-b30e-b240671c12ea-1
00:54:52.006 --> 00:54:56.511
which went into more detail about all of
the various co-pays for your medical and

bce0fcf9-f08f-4fea-b30e-b240671c12ea-2
00:54:56.511 --> 00:54:57.720
prescription benefits.

22cd50bb-4293-494a-a508-91a5dde936cd-0
00:54:57.720 --> 00:55:01.640
So just keep that on hand and just know
that's a really good reference for you.

0b955429-ed57-4c42-a043-2c323a27b12c-0
00:55:02.720 --> 00:55:03.920
Call retiree first.

4c85580c-e3cc-42f1-b49e-5c70dca9b481-0
00:55:04.360 --> 00:55:08.459
So we've said it a few times,
we'll probably say it a few more times,

4c85580c-e3cc-42f1-b49e-5c70dca9b481-1
00:55:08.459 --> 00:55:13.320
but this team is here for you to help you
with really any questions that you have.

e3cfd4d2-aba4-405f-999e-03534141b90f-0
00:55:13.640 --> 00:55:16.788
A really good next step,
if you haven't already done so,

e3cfd4d2-aba4-405f-999e-03534141b90f-1
00:55:16.788 --> 00:55:21.262
is to get a list together of all of the
doctors that you're currently seeing and

e3cfd4d2-aba4-405f-999e-03534141b90f-2
00:55:21.262 --> 00:55:25.516
all the medications that you're taking
and call Retiree First to share those

e3cfd4d2-aba4-405f-999e-03534141b90f-3
00:55:25.516 --> 00:55:26.399
lists with them.

b20bdf52-8ad8-468e-9107-a7fbcc36f88f-0
00:55:26.680 --> 00:55:27.640
They can look them up.

1caf1ac8-d648-40a5-a31c-86f2711249bb-0
00:55:27.840 --> 00:55:29.480
They can make sure that they're in our
network.

727bedec-cb8c-4a52-b759-6eea3a2c4106-0
00:55:29.480 --> 00:55:32.480
They can tell you what drug tier they're
on and what your copay will be.

e77e7cc0-8f1f-4387-bff7-fb26f24ce869-0
00:55:32.680 --> 00:55:34.320
They can do all of that homework for you.

07208f5f-deca-4661-849e-ede593a7801d-0
00:55:34.320 --> 00:55:34.680
Now.

a210fb53-a54f-4398-8f20-1892ac621229-0
00:55:34.680 --> 00:55:38.240
You do not need to wait to be enrolled in
the plan to call Retiree First.

a0cea344-4bd0-4dd4-b30b-be6bebae7144-0
00:55:38.240 --> 00:55:41.447
So by all means,
if you do nothing else when you leave

a0cea344-4bd0-4dd4-b30b-be6bebae7144-1
00:55:41.447 --> 00:55:44.595
here today,
consider calling them and and having them

a0cea344-4bd0-4dd4-b30b-be6bebae7144-2
00:55:44.595 --> 00:55:46.520
run those those searches for you.

9077ae04-e3d3-41e1-8f4a-06a467db6a40-0
00:55:46.960 --> 00:55:51.911
You do of course have the ability to do
this research on your own and our website,

9077ae04-e3d3-41e1-8f4a-06a467db6a40-1
00:55:51.911 --> 00:55:54.953
carefirst.
com/learn Group MA is available for you

9077ae04-e3d3-41e1-8f4a-06a467db6a40-2
00:55:54.953 --> 00:55:57.280
to do so, so it is listed here as well.

ce20bd3c-1620-4415-89af-b4cdc9d29144-0
00:55:58.800 --> 00:56:03.017
We touched on this at the very top of the
presentation, but just to reiterate,

ce20bd3c-1620-4415-89af-b4cdc9d29144-1
00:56:03.017 --> 00:56:07.394
if you are currently enrolled in a group
retiree medical plan from Calvert County

ce20bd3c-1620-4415-89af-b4cdc9d29144-2
00:56:07.394 --> 00:56:10.384
Public Schools,
there is nothing that you have to do to

ce20bd3c-1620-4415-89af-b4cdc9d29144-3
00:56:10.384 --> 00:56:13.160
enroll in this new Care First Group
Advantage plan.

38d08213-efd8-424b-a045-4eab9494557d-0
00:56:13.160 --> 00:56:15.320
You are automatically going to be
enrolled.

50c8371c-c28b-4f7e-bb82-5b541ba44704-0
00:56:15.600 --> 00:56:17.360
There is no paperwork for you to fill out.

d6110b93-63f4-4497-975f-fb24000a68ee-0
00:56:17.360 --> 00:56:22.363
You will be moved into this new plan if
you are only enrolled in the group dental

d6110b93-63f4-4497-975f-fb24000a68ee-1
00:56:22.363 --> 00:56:27.000
or vision plan and would like to now
enroll in the Medicare Advantage plan.

dccb8b0f-3879-4d2c-9d36-c9c30187e801-0
00:56:27.000 --> 00:56:31.196
Assuming that you are medical Medicare
eligible and you're enrolled in Medicare

dccb8b0f-3879-4d2c-9d36-c9c30187e801-1
00:56:31.196 --> 00:56:34.080
Parts A and Part B,
then you would need to complete an

dccb8b0f-3879-4d2c-9d36-c9c30187e801-2
00:56:34.080 --> 00:56:34.920
enrollment form.

c084454b-9077-443e-80af-4c2053e43e41-0
00:56:34.920 --> 00:56:37.600
And those were mailed out to those folks.

d7f66a4c-409a-4743-bfb4-85aba3dbef18-0
00:56:37.800 --> 00:56:40.862
But if if you're interested and you don't
have that form,

d7f66a4c-409a-4743-bfb4-85aba3dbef18-1
00:56:40.862 --> 00:56:45.087
certainly that's a good thing to drop in
the chat or to address on the Q and AI

d7f66a4c-409a-4743-bfb4-85aba3dbef18-2
00:56:45.087 --> 00:56:48.519
should say, and we can,
we can probably take those case by case.

530fea5e-fd24-453b-83d2-0c9a426e17d3-0
00:56:48.720 --> 00:56:51.800
The HR department at Calvert County can
certainly help there as well.

3e1a3d46-5e34-49a6-b502-43bb0cd67deb-0
00:56:52.600 --> 00:56:55.221
And then just to recap,
you're going to be getting those

3e1a3d46-5e34-49a6-b502-43bb0cd67deb-1
00:56:55.221 --> 00:56:57.566
additional communications over really in
December,

3e1a3d46-5e34-49a6-b502-43bb0cd67deb-2
00:56:57.566 --> 00:56:59.360
your confirmation of enrollment letter.

a6add8af-244d-4563-b6b8-501adbb8cfe5-0
00:56:59.360 --> 00:57:02.595
You're going to get that welcome package
with your welcome brochure and then

a6add8af-244d-4563-b6b8-501adbb8cfe5-1
00:57:02.595 --> 00:57:04.360
you'll get the member ID card in the mail.

90855ab4-14c9-4107-bdf5-8e654128d926-0
00:57:04.360 --> 00:57:06.080
So that's all too common.

64d0e677-b5a0-4394-9d9f-b449c863b510-0
00:57:06.080 --> 00:57:08.040
Just something to keep your eyes out for.

b651aeae-f7d2-4372-9e8f-63a48fe919a8-0
00:57:09.640 --> 00:57:11.720
So one more slide before we wrap.

d95d2748-abb5-48ea-a655-771091a80406-0
00:57:11.880 --> 00:57:15.360
And this is a really useful one,
really key contacts.

3517ef00-550f-4431-b270-5d0bc494754d-0
00:57:15.360 --> 00:57:18.426
So if you have questions,
which we anticipate that you will,

3517ef00-550f-4431-b270-5d0bc494754d-1
00:57:18.426 --> 00:57:22.347
I think it's very normal and we would
expect you to have more questions after

3517ef00-550f-4431-b270-5d0bc494754d-2
00:57:22.347 --> 00:57:24.760
you have a chance to sit with this
information.

38ec8434-9848-451d-b52e-c7287c291dde-0
00:57:25.160 --> 00:57:27.964
But we wanted to leave you with who
should you call for which types of

38ec8434-9848-451d-b52e-c7287c291dde-1
00:57:27.964 --> 00:57:28.360
questions.

0c5c5491-4032-46e9-9ed3-b636c1c42fdc-0
00:57:28.360 --> 00:57:32.230
So if you have questions pertaining to
your eligibility in the plan,

0c5c5491-4032-46e9-9ed3-b636c1c42fdc-1
00:57:32.230 --> 00:57:35.877
your current dental or vision benefits,
or your monthly premium,

0c5c5491-4032-46e9-9ed3-b636c1c42fdc-2
00:57:35.877 --> 00:57:40.308
those are all questions that should be
directed to the wonderful HR department

0c5c5491-4032-46e9-9ed3-b636c1c42fdc-3
00:57:40.308 --> 00:57:42.160
at Calvert County Public Schools.

9f55fcec-41e7-40d3-8c30-af1b5d2d8104-0
00:57:42.720 --> 00:57:46.360
You'll see their e-mail address is listed
here as well as their phone number.

dbdda296-e57f-4bfa-816e-63fd895d0b11-0
00:57:47.120 --> 00:57:51.311
Anything though pertaining to the new
care first group Advantage plan,

dbdda296-e57f-4bfa-816e-63fd895d0b11-1
00:57:51.311 --> 00:57:54.440
it's benefits, your co-pays,
your enrollment status.

6b832edf-24d8-4e28-b83f-8d6348bea6ea-0
00:57:54.480 --> 00:57:57.760
If you have questions about Medicare or
Social Security,

6b832edf-24d8-4e28-b83f-8d6348bea6ea-1
00:57:57.760 --> 00:58:01.040
your claims once you're in the plan prior
authorization.

a4706192-314d-4392-9d35-ca8b0d47d810-0
00:58:01.040 --> 00:58:05.677
Those are all questions that retiree
first can field for you and retiree first

a4706192-314d-4392-9d35-ca8b0d47d810-1
00:58:05.677 --> 00:58:10.491
really should be considered your primary
member services contact your go to point

a4706192-314d-4392-9d35-ca8b0d47d810-2
00:58:10.491 --> 00:58:12.839
of contact for these types of questions.

f59e9c31-9982-4ba4-9d07-77fc3b6eb659-0
00:58:13.080 --> 00:58:15.450
So we've already provided the phone
number a few times,

f59e9c31-9982-4ba4-9d07-77fc3b6eb659-1
00:58:15.450 --> 00:58:16.720
but we listed it here as well.

7023f012-2b40-4d6a-a5cd-e8aa81b6fd5b-0
00:58:17.400 --> 00:58:21.760
And the website is listed here too,
which is where the webinar recording will

7023f012-2b40-4d6a-a5cd-e8aa81b6fd5b-1
00:58:21.760 --> 00:58:22.320
be posted.

024fd51a-d71a-4310-b9a4-f8f561742aa5-0
00:58:23.480 --> 00:58:27.876
You can certainly call Care First with
those same types of questions,

024fd51a-d71a-4310-b9a4-f8f561742aa5-1
00:58:27.876 --> 00:58:31.958
but Retiree First just adds an extra
level of of convenience and

024fd51a-d71a-4310-b9a4-f8f561742aa5-2
00:58:31.958 --> 00:58:36.920
responsiveness that I think you're really
going to enjoy as part of this plan.

10fda16d-e3d2-4db4-9c89-631f5fe875d3-0
00:58:36.920 --> 00:58:38.800
So please call Retiree first.

809ae7e2-8293-4254-9897-e566563bfb2a-0
00:58:40.360 --> 00:58:44.174
All right, well,
I do very much appreciate everyone's time

809ae7e2-8293-4254-9897-e566563bfb2a-1
00:58:44.174 --> 00:58:46.760
and attention on a, a Tuesday afternoon.

6ad4ccf9-613c-4b6e-9e81-830a9456e7c3-0
00:58:46.760 --> 00:58:50.014
I understand this is not always the most
fun material to cover,

6ad4ccf9-613c-4b6e-9e81-830a9456e7c3-1
00:58:50.014 --> 00:58:53.320
but really appreciate us being able to
walk through it with you.

c9e05568-29fd-4731-9487-0b0f397b8c83-0
00:58:54.040 --> 00:58:58.955
I did want to mention that we do have a
survey that we will promote here just to

c9e05568-29fd-4731-9487-0b0f397b8c83-1
00:58:58.955 --> 00:59:02.840
to really ask for feedback as it pertains
to this presentation.

9692d7cc-8a6d-4a71-8d92-c2eaadbd70c7-0
00:59:03.080 --> 00:59:06.800
We are always looking for ways to do
better and improve for our members.

56093ea1-0eed-49e6-8efe-3a433cf40459-0
00:59:06.800 --> 00:59:11.009
If they're if there's anything you'd like
to tell us about today's session,

56093ea1-0eed-49e6-8efe-3a433cf40459-1
00:59:11.009 --> 00:59:13.280
you can do so using this 5 minute survey.

0abec601-ec1c-450e-9e67-c8719c05d4f9-0
00:59:13.640 --> 00:59:18.739
There's AQR code here on the screen that
you can open up your phone and access the

0abec601-ec1c-450e-9e67-c8719c05d4f9-1
00:59:18.739 --> 00:59:19.600
link that way.

0bc13b6f-4939-49cb-87dc-e38b5072a636-0
00:59:19.960 --> 00:59:23.960
I think potentially we can drop the link
in chat or the Q&A.

f5b0e80d-1504-4dd6-b2e2-b6007bb083dd-0
00:59:23.960 --> 00:59:26.300
I'll,
I'll come off here in a minute and ask my

f5b0e80d-1504-4dd6-b2e2-b6007bb083dd-1
00:59:26.300 --> 00:59:27.080
team to do that.

d297679b-f307-4e57-8888-bf995c986bf6-0
00:59:27.080 --> 00:59:28.480
But again, just thank you in advance.

48e4253d-3782-4a76-a47a-ce9619a31d79-0
00:59:28.480 --> 00:59:30.560
If you have any feedback for us,
we would love to hear it.

7f717cb7-8c7e-4f80-bc4f-ebf8c2ac565a-0
00:59:31.680 --> 00:59:33.720
Last but not least, I think that is it.

5a9d4d7f-965e-47ca-b8e2-1e3a65e9da83-0
00:59:33.720 --> 00:59:37.598
I am going to see if anybody from the
Carefirst or Calvert team wants to add

5a9d4d7f-965e-47ca-b8e2-1e3a65e9da83-1
00:59:37.598 --> 00:59:41.628
anything or if there are any questions we
want to bring forward that were maybe

5a9d4d7f-965e-47ca-b8e2-1e3a65e9da83-2
00:59:41.628 --> 00:59:44.751
answered in the Q&
A that would be beneficial kind of for

5a9d4d7f-965e-47ca-b8e2-1e3a65e9da83-3
00:59:44.751 --> 00:59:45.960
the whole group to hear.

afe1eaef-7f75-4a88-ad20-12fc45958b73-0
00:59:45.960 --> 00:59:47.920
I'm happy to open up the floor.

a6950ca6-a7d9-4147-b587-a24ed7fe4c30-0
00:59:50.520 --> 00:59:53.597
Thank you,
Diana and Lindsay for your your

a6950ca6-a7d9-4147-b587-a24ed7fe4c30-1
00:59:53.597 --> 00:59:54.600
presentations.

6a474f18-4d18-4af6-8003-b6ab34e7e35d-0
00:59:54.600 --> 00:59:57.600
They're very thorough and I think answer
a lot of questions.

d4303a9b-491e-4747-8a3b-0afdcc03444d-0
00:59:57.800 --> 01:00:02.282
There were two questions that I did want
to bring to the forefront for the whole

d4303a9b-491e-4747-8a3b-0afdcc03444d-1
01:00:02.282 --> 01:00:05.160
group of the first question is about
Johns Hopkins.

1ced8888-db03-4bdb-b3cd-65a62d91aa0d-0
01:00:05.160 --> 01:00:10.720
Would you just explain why Johns Hopkins
is considered out of network?

87bf3e79-4fdb-4a21-93de-80b2b844e774-0
01:00:11.200 --> 01:00:11.320
Sure.

590bc07e-95a0-41bb-9ba0-b036e232f8fb-0
01:00:12.120 --> 01:00:14.520
So Johns Hopkins is out of network.

7b364d63-b37c-406e-8f4d-b0c0c3334ee4-0
01:00:14.520 --> 01:00:19.840
They do not participate in many, if any,
Medicare Advantage plans network.

8798a5a4-0f81-40a9-bd80-9c4d0b785b08-0
01:00:19.840 --> 01:00:24.166
The main reason for that is they have
their own individual Medicare Advantage

8798a5a4-0f81-40a9-bd80-9c4d0b785b08-1
01:00:24.166 --> 01:00:27.438
plan that they offer,
so they don't really play with other

8798a5a4-0f81-40a9-bd80-9c4d0b785b08-2
01:00:27.438 --> 01:00:28.160
health plans.

44b750fb-ddbf-4442-b747-9c6b97a5db81-0
01:00:28.680 --> 01:00:31.896
However,
we have a host of members who routinely

44b750fb-ddbf-4442-b747-9c6b97a5db81-1
01:00:31.896 --> 01:00:36.689
utilize John Hopkins services and
facilities and we have no problem with

44b750fb-ddbf-4442-b747-9c6b97a5db81-2
01:00:36.689 --> 01:00:40.760
them billing us and you being able to
utilize their services.

9b6cc342-1117-4781-a334-a06b6b02020a-0
01:00:40.760 --> 01:00:43.800
So that is, you know, available to you.

70830571-b38b-49ad-9ff2-c2e4d1739d2a-0
01:00:44.000 --> 01:00:48.053
Just don't be alarmed if you search our
provider directory and you don't see them

70830571-b38b-49ad-9ff2-c2e4d1739d2a-1
01:00:48.053 --> 01:00:48.400
listed.

82cf6c9c-bbdb-47ec-9bac-0ab93fb24c39-0
01:00:48.600 --> 01:00:51.249
Again,
you will be able to see out of network

82cf6c9c-bbdb-47ec-9bac-0ab93fb24c39-1
01:00:51.249 --> 01:00:55.915
providers that are part of Medicare and
they are and that are willing to bill us

82cf6c9c-bbdb-47ec-9bac-0ab93fb24c39-2
01:00:55.915 --> 01:01:00.120
And Hopkins routinely literally every day
bills us for our members care.

aef108e9-5260-4830-b0a2-4a4cf33baaa5-0
01:01:00.120 --> 01:01:01.840
So great question.

0c8112a5-63e4-45c0-be20-c43ddf553e6e-0
01:01:01.840 --> 01:01:03.480
Thank you Susan for for that.

9ffa9647-a6dd-41cc-806b-2c90e6e36ee9-0
01:01:04.520 --> 01:01:09.002
And the second question goes back to
prescriptions and it is just the

9ffa9647-a6dd-41cc-806b-2c90e6e36ee9-1
01:01:09.002 --> 01:01:14.190
difference in the 90 day prescriptions as
to the benefit that if it's mail order

9ffa9647-a6dd-41cc-806b-2c90e6e36ee9-2
01:01:14.190 --> 01:01:16.560
versus picking it up at CVS directly.

ba1131e8-d982-4808-8aad-8480eec44b36-0
01:01:17.080 --> 01:01:17.320
Yeah.

98a989e0-6130-498f-8d9d-a405790d86db-0
01:01:17.640 --> 01:01:19.560
So let me just go back to that one real
quick.

91079ccd-2be7-42ec-a50b-cd66249690de-0
01:01:19.880 --> 01:01:25.080
So I believe the difference is the 90
days you're going to pay the same co-pay.

a21c1bc3-01bc-4101-80fb-160f118c8da4-0
01:01:25.560 --> 01:01:26.480
Give me one second here.

f32ad01c-425f-4300-b4ba-6d7522f272ec-0
01:01:26.480 --> 01:01:27.760
So many slides, so little time.

d85de20a-562a-4a37-bb61-3bffa21d0feb-0
01:01:29.400 --> 01:01:31.616
Yes,
if you pick up a 90 day supply at a

d85de20a-562a-4a37-bb61-3bffa21d0feb-1
01:01:31.616 --> 01:01:34.374
retail pharmacy,
if you're going in person to your

d85de20a-562a-4a37-bb61-3bffa21d0feb-2
01:01:34.374 --> 01:01:37.240
pharmacy,
you're going to pay double the copay here.

39d16801-6e10-4082-beae-1d5c25b47353-0
01:01:37.240 --> 01:01:41.265
So if it's a generic drug and you're
going to the retail pharmacy to get that

39d16801-6e10-4082-beae-1d5c25b47353-1
01:01:41.265 --> 01:01:44.000
90 day supply in person,
you're going to pay $16.00.

cd189145-4794-479f-a6ae-622695178cb2-0
01:01:44.680 --> 01:01:48.808
If you get it through the mail order,
you're only going to pay one time the

cd189145-4794-479f-a6ae-622695178cb2-1
01:01:48.808 --> 01:01:49.840
copay, which is $8.

3f73c9d2-7c57-4cc9-8547-0cb349ff622b-0
01:01:49.840 --> 01:01:52.200
So it is still a savings either way.

d7dbe390-9225-4c1f-b12e-ef2c381762f0-0
01:01:52.200 --> 01:01:56.938
You're not paying three times,
right for which is what 90 day supply is,

d7dbe390-9225-4c1f-b12e-ef2c381762f0-1
01:01:56.938 --> 01:02:01.547
is, is 3030 day supply times 3,
but the mail order just gives you that

d7dbe390-9225-4c1f-b12e-ef2c381762f0-2
01:02:01.547 --> 01:02:03.560
additional, additional savings.

7617c8bd-96b0-4a71-bfa9-35fad1398fb4-0
01:02:04.680 --> 01:02:07.280
Does that answer the question or were
there, was there something more specific?

24848646-1b6d-43b8-a9ae-78deb59a701c-0
01:02:07.360 --> 01:02:12.105
OK, I also want to know and I didn't this,
there's a lot on the slide and there's a

24848646-1b6d-43b8-a9ae-78deb59a701c-1
01:02:12.105 --> 01:02:13.800
lot of information in general.

57639bf4-95d0-4af2-864a-fa07f79102f2-0
01:02:13.800 --> 01:02:18.608
But we also do make available 100 day
supplies and those will be if your drug

57639bf4-95d0-4af2-864a-fa07f79102f2-1
01:02:18.608 --> 01:02:22.431
qualifies, if it's on tier one,
which is those generic drugs,

57639bf4-95d0-4af2-864a-fa07f79102f2-2
01:02:22.431 --> 01:02:27.239
you will be able to get a 100 day supply
at the same cost as a 90 day supply.

846d448f-f325-4172-a9b8-641e06dcf35a-0
01:02:27.240 --> 01:02:30.956
So that's something that we did to help
our members with adherence and really

846d448f-f325-4172-a9b8-641e06dcf35a-1
01:02:30.956 --> 01:02:34.530
just make sure that they have their
medications that they need on hand and

846d448f-f325-4172-a9b8-641e06dcf35a-2
01:02:34.530 --> 01:02:35.960
without any limitations there.

885b5f82-21db-48ce-8365-32c4809d0790-0
01:02:37.440 --> 01:02:41.291
And then actually there's a third
question I'd like to bring up and it's

885b5f82-21db-48ce-8365-32c4809d0790-1
01:02:41.291 --> 01:02:42.400
really for either Mr.

3050aa1a-f358-4d27-8c65-9bb61273074b-0
01:02:42.400 --> 01:02:45.760
Sewell or Missus Stalker or someone in
the HR team.

0e5d4192-30ee-4bdb-a5b5-9a3cf250655a-0
01:02:46.000 --> 01:02:50.627
So if you could come off mute,
the question has come up over time is can

0e5d4192-30ee-4bdb-a5b5-9a3cf250655a-1
01:02:50.627 --> 01:02:52.720
my spouse be a part of this plan?

164f50d3-f8f1-49f0-b453-c6d2d2a319c9-0
01:02:53.000 --> 01:03:00.240
So if you could speak to that very
particular question and when it is.

2de21723-39a9-4533-a1ca-badfb01557cd-0
01:03:00.560 --> 01:03:02.960
And then I have one more question for our
team as well.

8a1b1b33-e262-4d46-8c56-af94664dfa96-0
01:03:07.720 --> 01:03:08.640
Hi, this is Zach.

c0ffd110-a725-4b55-a0c3-f85bdf0a2b9e-0
01:03:08.640 --> 01:03:10.160
Can you guys hear me OK?

5e19ecda-0ad6-4319-8918-48a26bd4cb51-0
01:03:10.280 --> 01:03:11.160
I think I'm off mute.

75f5ffb0-aede-4365-aa1c-b45cb28a1330-0
01:03:12.720 --> 01:03:15.080
So the question doc, I can hear you.

57b82d03-8053-498f-bf7b-0d36a7084c55-0
01:03:15.080 --> 01:03:19.920
So the question is about when can a
spouse come on to the plan?

adf75a95-9440-431b-9d35-007c7c41bb79-0
01:03:19.920 --> 01:03:25.850
So if if your spouse is Medicare eligible
now and receives some sort of benefit

adf75a95-9440-431b-9d35-007c7c41bb79-1
01:03:25.850 --> 01:03:31.557
through CCPs, not a retiree of CCPs,
but receives a benefit through you as a

adf75a95-9440-431b-9d35-007c7c41bb79-2
01:03:31.557 --> 01:03:36.079
the spouse of a retiree,
if they receive a benefit currently

adf75a95-9440-431b-9d35-007c7c41bb79-3
01:03:36.079 --> 01:03:41.119
either medical, dental or vision,
then they can opt into this plan.

7abe7abf-fa8f-493b-a6ba-8b282a829d7d-0
01:03:41.560 --> 01:03:46.196
There is a requirement to have some sort
of coverage with us currently to be able

7abe7abf-fa8f-493b-a6ba-8b282a829d7d-1
01:03:46.196 --> 01:03:47.440
to come into the plan.

a4c3b824-0f12-43ff-9fe1-884624b8f9cd-0
01:03:47.440 --> 01:03:52.329
You have to maintain either medical,
dental or vision or all three or at least

a4c3b824-0f12-43ff-9fe1-884624b8f9cd-1
01:03:52.329 --> 01:03:57.280
one of the three in order to have an
option for a spouse to come into the plan.

ee90414e-0030-42d0-b1e2-5227b57d2cd7-0
01:04:00.480 --> 01:04:00.840
Thank you.

0aaae113-6428-42e0-9985-bb1606f8f086-0
01:04:02.120 --> 01:04:03.520
And here's the second question.

e003f109-881c-46aa-9c91-e310005f2d17-0
01:04:04.080 --> 01:04:07.360
So this plan is different because the
plan year is different.

8bc3c7d0-6992-4f27-9dbd-39422198a028-0
01:04:07.360 --> 01:04:12.966
Could you as CCPs just talk with the
retirees that are 65 years and older,

8bc3c7d0-6992-4f27-9dbd-39422198a028-1
01:04:12.966 --> 01:04:18.796
the difference between this plan year and
then open enrollment for dental and

8bc3c7d0-6992-4f27-9dbd-39422198a028-2
01:04:18.796 --> 01:04:19.320
vision?

9e19a1f7-849f-451e-a85d-fc18690b3256-0
01:04:26.240 --> 01:04:29.360
I'm sorry, Doctor Johnson,
is that a question for for us in HR?

fd1ed74f-b1ed-4ec4-bb19-d3947d69cf80-0
01:04:29.800 --> 01:04:30.640
Yes, OK.

b50ecdd9-ee79-49ac-85de-baf8a82734b0-0
01:04:30.640 --> 01:04:34.845
Yes,
So Medicare open enrollment nationwide

b50ecdd9-ee79-49ac-85de-baf8a82734b0-1
01:04:34.845 --> 01:04:38.000
happens January through December.

192c523e-b673-422a-afd5-546f02816afc-0
01:04:38.240 --> 01:04:43.355
So that's why this effects our Medicare
eligible retirees now because the open

192c523e-b673-422a-afd5-546f02816afc-1
01:04:43.355 --> 01:04:47.952
enrollment for Medicare is actually
taking place as we speak for to be

192c523e-b673-422a-afd5-546f02816afc-2
01:04:47.952 --> 01:04:51.513
effective January 1,
the school system and for current

192c523e-b673-422a-afd5-546f02816afc-3
01:04:51.513 --> 01:04:54.880
employees,
we go through a fiscal year calendar for

192c523e-b673-422a-afd5-546f02816afc-4
01:04:54.880 --> 01:04:56.240
our health insurance.

576b4c00-b0ee-4b24-ade1-034dccc1bb9f-0
01:04:56.400 --> 01:05:02.149
So our open enrollment is or I'm sorry,
our benefits is effective July 1 through

576b4c00-b0ee-4b24-ade1-034dccc1bb9f-1
01:05:02.149 --> 01:05:03.640
June 30th every year.

3c4b5b2d-bb42-40fb-9897-4b5869e63392-0
01:05:03.640 --> 01:05:07.240
So our open enrollment takes place prior
to the end of June.

76461d3e-6ed2-4df0-b8b1-5f0f4465d1a7-0
01:05:07.320 --> 01:05:10.680
We usually plan that for the month of
April or May.

64faa5bf-dd2a-4690-a80c-ae912c77de14-0
01:05:11.320 --> 01:05:14.480
Sometimes it rolls over a little bit into
May to be effective July 1.

ec650590-b864-42e0-8a6a-f39814a181ec-0
01:05:17.640 --> 01:05:22.422
And will these retirees,
65 and older retirees need to do anything

ec650590-b864-42e0-8a6a-f39814a181ec-1
01:05:22.422 --> 01:05:25.920
particular for vision and dental moving
forward?

1ed50b0c-bcaf-401a-95d9-4890fe55ee68-0
01:05:26.440 --> 01:05:26.600
Yeah.

11a2c47d-4737-476e-823c-c838071caab7-0
01:05:26.600 --> 01:05:31.783
So because the vision and dental is still
under coverage through the CCPs,

11a2c47d-4737-476e-823c-c838071caab7-1
01:05:31.783 --> 01:05:36.897
that open enrollment that takes place
during the fiscal year of of July 1

11a2c47d-4737-476e-823c-c838071caab7-2
01:05:36.897 --> 01:05:40.560
through June 30th will still take place
every April.

1df00873-4cb4-454b-98d3-71ce21f31647-0
01:05:40.560 --> 01:05:46.360
And our retirees outside of this plan
will still have to make any elections for,

1df00873-4cb4-454b-98d3-71ce21f31647-1
01:05:46.360 --> 01:05:52.161
for benefits coverage during that open
enrollment that CCPs holds in April every

1df00873-4cb4-454b-98d3-71ce21f31647-2
01:05:52.161 --> 01:05:52.520
year.

1bd930a0-b4c0-43d8-bd97-f76394f99e41-0
01:05:52.720 --> 01:05:56.824
So, so for, if,
if you're receiving vision or dental

1bd930a0-b4c0-43d8-bd97-f76394f99e41-1
01:05:56.824 --> 01:06:01.625
benefits from CCPs,
you will still need to participate in the

1bd930a0-b4c0-43d8-bd97-f76394f99e41-2
01:06:01.625 --> 01:06:07.820
open enrollment come April for the July 1
implementation if if you want to make

1bd930a0-b4c0-43d8-bd97-f76394f99e41-3
01:06:07.820 --> 01:06:08.440
changes.

3b444f2a-74bb-4e08-b6a4-e8591f564610-0
01:06:08.440 --> 01:06:14.030
So we have over the past year changed our
open enrollment to a passive open

3b444f2a-74bb-4e08-b6a4-e8591f564610-1
01:06:14.030 --> 01:06:14.840
enrollment.

0825ac45-03b1-4361-bf38-2e2e15e988de-0
01:06:15.000 --> 01:06:19.381
So we only require you to let us know
during that open enrollment if you're

0825ac45-03b1-4361-bf38-2e2e15e988de-1
01:06:19.381 --> 01:06:21.400
going to make changes to your plan.

7ee4fe6c-aaeb-4b3b-8b3f-7face93457c3-0
01:06:21.400 --> 01:06:25.964
If you don't contact us or respond to us
when we we send that information out,

7ee4fe6c-aaeb-4b3b-8b3f-7face93457c3-1
01:06:25.964 --> 01:06:30.702
your coverage will continue the same as
what it was because we now implement that

7ee4fe6c-aaeb-4b3b-8b3f-7face93457c3-2
01:06:30.702 --> 01:06:31.800
passive enrollment.

431f7bdc-df73-4579-b3c9-cfdd3dfd5c97-0
01:06:38.220 --> 01:06:38.580
Thank you.

753d9ddf-d480-4c54-ba27-d8e6edba7dc9-0
01:06:38.580 --> 01:06:40.100
Those are the questions that I saw.

c7941b3b-f1db-4af9-8097-b55ef461025c-0
01:06:40.100 --> 01:06:43.806
But if anybody else on the team feels
there are other questions that need to

c7941b3b-f1db-4af9-8097-b55ef461025c-1
01:06:43.806 --> 01:06:45.780
move forward, please, please let us know.

1310d73b-1973-411d-b515-9deeabe571bf-0
01:07:00.560 --> 01:07:02.846
Lindsay,
could we move the screen back to the

1310d73b-1973-411d-b515-9deeabe571bf-1
01:07:02.846 --> 01:07:04.040
important phone numbers?

02258a49-a6d9-49fe-a18b-38656e3b9695-0
01:07:12.090 --> 01:07:12.450
Thank you.

eb5f3ede-e998-41fd-b104-5ae1a3ab4c1b-0
01:07:12.450 --> 01:07:12.810
Absolutely.

80ef56cf-b60b-4902-8af0-57199b2dffa0-0
01:07:14.960 --> 01:07:20.313
So I thank everyone for being here today
and I appreciate the questions that have

80ef56cf-b60b-4902-8af0-57199b2dffa0-1
01:07:20.313 --> 01:07:21.880
been placed in the chat.

45bbd23a-c1db-4efc-9529-450fef56cb9c-0
01:07:22.320 --> 01:07:25.680
I do want to end with this key contacts
page.

dc569704-6d29-4425-91d0-d2919a6155d5-0
01:07:25.680 --> 01:07:27.040
We're going to leave this up.

b207144c-3c1c-4812-8ead-b8cfbfe59feb-0
01:07:27.960 --> 01:07:32.960
We will also post this on our website as
well so that you'll have access to it.

70192198-4630-47f7-b504-08a3a75c4de5-0
01:07:33.200 --> 01:07:38.960
But these are the important numbers and
why you would call each of those numbers.

42fac10e-7608-4186-aef5-3dc8b1f9eb96-0
01:07:38.960 --> 01:07:42.383
So again,
if you have questions about eligibility

42fac10e-7608-4186-aef5-3dc8b1f9eb96-1
01:07:42.383 --> 01:07:46.012
for the plan,
anything with dental or or the monthly

42fac10e-7608-4186-aef5-3dc8b1f9eb96-2
01:07:46.012 --> 01:07:49.093
premium,
please contact us at Calvary County

42fac10e-7608-4186-aef5-3dc8b1f9eb96-3
01:07:49.093 --> 01:07:50.120
Public Schools.

ec913cf8-f006-47f7-9462-f91af851d55d-0
01:07:50.560 --> 01:07:54.713
If you want to find out more about your
enrollment status,

ec913cf8-f006-47f7-9462-f91af851d55d-1
01:07:54.713 --> 01:07:59.712
Medicare or Social Security plan,
benefits, claims, pre authorization,

ec913cf8-f006-47f7-9462-f91af851d55d-2
01:07:59.712 --> 01:08:03.513
provider bills,
anything with regard to managing your

ec913cf8-f006-47f7-9462-f91af851d55d-3
01:08:03.513 --> 01:08:06.400
healthcare, please contact retiree first.

247d18aa-7f65-4143-bd72-38bcfd189bba-0
01:08:06.560 --> 01:08:11.165
And then if you have very specific
questions about your plan,

247d18aa-7f65-4143-bd72-38bcfd189bba-1
01:08:11.165 --> 01:08:16.662
benefit claims or prior authorization,
you can also contact Care 1st as a

247d18aa-7f65-4143-bd72-38bcfd189bba-2
01:08:16.662 --> 01:08:18.520
secondary support to you.

e89532d4-33b8-45a9-affd-f162fef427cb-0
01:08:18.920 --> 01:08:24.066
So we thank you again,
thank you Lindsay and Kelly and thanks to

e89532d4-33b8-45a9-affd-f162fef427cb-1
01:08:24.066 --> 01:08:26.680
our HR team for being here today.

ccd417b7-91cc-48e8-a304-b2b260ab4080-0
01:08:26.680 --> 01:08:30.000
And again,
if you have any questions at all,

ccd417b7-91cc-48e8-a304-b2b260ab4080-1
01:08:30.000 --> 01:08:33.320
if you when should they get their new
cards?

21815c49-9470-46ec-b943-6f45e4dab43c-0
01:08:34.280 --> 01:08:36.451
Yeah,
so that should be coming in the first or

21815c49-9470-46ec-b943-6f45e4dab43c-1
01:08:36.451 --> 01:08:37.560
second week of December.

161841b4-1ed9-4beb-a971-0075d6a59391-0
01:08:37.880 --> 01:08:41.200
And once they have that card,
still hang on to it.

f19542d4-3ed7-46d6-b565-c344f21ae16b-0
01:08:41.200 --> 01:08:44.698
Don't start using it until January 1st or
whenever your first appointment is

f19542d4-3ed7-46d6-b565-c344f21ae16b-1
01:08:44.698 --> 01:08:45.880
scheduled in the new year.

e9f3851e-e650-41c2-ab95-8a00c0a8134b-0
01:08:46.680 --> 01:08:49.257
But yes,
they should be coming shortly after you

e9f3851e-e650-41c2-ab95-8a00c0a8134b-1
01:08:49.257 --> 01:08:50.520
get that welcome packet.

ab84de88-e147-4e03-9ddf-677d6db968d0-0
01:08:50.520 --> 01:08:52.120
So be on the lookout.

835a896f-bebb-4839-a5f3-3714e879c216-0
01:08:52.200 --> 01:08:56.295
And if you know you haven't received it
or if you have any questions about it,

835a896f-bebb-4839-a5f3-3714e879c216-1
01:08:56.295 --> 01:08:57.280
call retiree first.

623b43c7-ec81-4f48-8f08-ec98941500b4-0
01:08:58.120 --> 01:09:02.085
And if you don't receive the welcome
package or by the second week of December

623b43c7-ec81-4f48-8f08-ec98941500b4-1
01:09:02.085 --> 01:09:05.800
you haven't received the card,
please call Calvert County Public Schools.

d3a00d8f-3b62-4536-bb38-45271173f1dd-0
01:09:05.800 --> 01:09:11.080
We want to make sure that you have what
you need and that you are taken care of.

20c678e2-2933-4c4c-bfa9-01927e2a5bdc-0
01:09:11.080 --> 01:09:14.870
So please don't hesitate to call us if
you feel like you haven't gotten what

20c678e2-2933-4c4c-bfa9-01927e2a5bdc-1
01:09:14.870 --> 01:09:15.560
you've needed.

4abc7735-9149-41f3-a989-500fcb0b8d19-0
01:09:16.480 --> 01:09:18.920
So again,
thank you very much for attending today.

b2f4dc29-506c-46c4-97a8-e89259097da5-0
01:09:19.040 --> 01:09:20.120
Have a great afternoon.

8b745b4f-1050-4e2d-82bb-88b460d0c3e3-0
01:09:20.680 --> 01:09:21.160
Thank you.

28a906c9-3e3d-4525-8795-09bb435eb022-0
01:09:22.680 --> 01:09:24.640
Thanks everyone, have a great afternoon.

35b76e09-eab1-424a-be42-8ac596a30f5d-0
01:09:26.040 --> 01:09:26.640
Bye, bye now.