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If you are retiring or thinkng about retiring, you are at an exciting time in your life. This video, brought to you by the Office of Employee Benefits, will
provide an overview of UT Benefits available to eligible retired employees of The University of Texas System for this plan year: September 1st,
2013 through August 31st, 2014. If you have any questions about your eligibility to retire from a UT institution or your voluntary retirement plans
please contact your local institution Benefits office.
The Basic Coverage package for retired employees includes UT SELECT Medical, Prescription Drug coverage, and $6,000 Group
Term Life Insurance with no out-of-pocket premium cost to the retiree. The UT SELECT Medical plan is administered by Blue Cross Blue
Shield of Texas, Prescription Drug coverage is administered by Express Scripts and the Group Term Life Insurance is offered by
Dearborn National. The UT SELECT Medical and Prescription Drug coverage plans are self-funded.
Self-funded means that UT System determines the benefits and premium rates, contracts with
a third party administrator to provide the provider networks and to pay all claims. UT System assumes all risk in the event that total claims
expenses are greater than total premiums received. As a retired employee you may enrollyour eligible dependents in the UT SELECT
Medical plan at an additional out-of-pocket premium cost, which will be discussed in detail later.
We know good health is important to you and your family. That's why The University of Texas System offers UT SELECT members a great
resource: the Living Well Health and Wellness program. This program was established to encourage all employees, retirees, and
dependents to reach their potential and maintain the productivity necessary to meet the challenges of work and life.
By providing a variety of programs, tools, and resources, our goal is to enable employees,
retirees, and dependents to take charge of their health and develop their own personal wellness
program utilizing all University of Texas System institutions' programs and services.
At the Living Well: Make it a Priority program website you'll find information to better assess and manage your health. This simple to use
program offers ideas for getting active, eating right, tobacco cessation and more.
The UT System is committed to helping tobacco users quit by offering our UT SELECT covered members smoking and tobacco cessation
programs, pharmaceutical therapy, and nicotine replacement therapy at no cost to the member. Learn more about programs available at our
Living Well website. Wellness is so important that we have a comprehensive platform to help you take an active role in the quality of your life
offering you a reward for taking charge. The Office of Employee Benefits has teamed up
with Provant Health Solutions, an independent health and wellness company, to provide the new health platform to UT SELECT Medical plan
members age 18 and above. This 24/7 comprehensive online health platform offers wellness workshops, exercise routines, and meal
plans. From the platform e-mail a dietitian or ask a personal trainer a question. You will have help identifying any health risk factors you may, tools
for positive choices to improve your long term health and a reward for taking positive action.
Members will receive a $25 gift card after registering at the platform site, completing the
health assessment, and completing your annual preventive exam all during this plan year. More
information is available by reviewing the Welcome Brochure available in English and Spanish.
Part of UT SELECT Medical is the Tobacco Premium Program. The use of tobacco is one of the leading preventable health risks worldwide.
Because UT System is committed to promoting a culture of wellness and disease prevention while also recognizing the costs associated with
treating tobacco related health conditions, UT System implemented the Tobacco Premium
Program for tobacco users enrolled in the UT SELECT Medical plan.
A tobacco user is a person enrolled in the UT SELECT Medical plan, age 16 and above, who has used tobacco products within the past 60
days. If you did not previously declare your tobacco-user or non-user status for yourself and your eligible dependents while as an active
employee, you will need to do so during the retiree insurance enrollment process. If you declared your tobacco-user status while as an
active employee and there is no break between the end of employment and the beginning of retirement insurance coverage, your prior status
will automaticall carry forward as a retiree. An out-of-pocket premium of $30 per month for UT SELECT members who
use tobacco products will be applied to any tobacco user enrolled in the UT SELECT Medical plan. This premium also applies to your
spouse and dependent children. The premium for dependent children is $30 per month regardless of how many covered dependent children use
tobacco. Meaning, the maximum any family will pay is $90 per month if employee, spouse, and dependent children use tobacco.
All types of tobacco products are included as part of the Tobacco Premium Program, including, but not limited to, cigarettes, cigars, pipes, clove
cigarettes, all forms of smokeless tobacco, chewing tobacco, snuff, dip or any other product containing tobacco, any other smoking devices
that use tobacco, such as hookahs. E-cigarettes (which contain nicotine) are also included under the Tobacco Premium Program. The next portion
of this video will focus on the general details of each type of insurance coverage.
Following we'll review out-of-pocket cost to you and premium sharing. If you are not eligible for Medicare when you retire, you will have the
following UT SELECT Medical and Prescription benefits which are the same as for UT active employees.
Network benefits are available to UT SELECT participants living in Texas, New Mexico, and Washington D.C.
Office visits have a $30 copay when visiting a Family Care Physician and $35 when seeing a Specialist.
The copay for visits to an emergency room are $150 per visit.
The emergency room copay will be waived if the patient is admitted to the hospital. The annual deductible, a set amount of out-of-pocket
expense, for in-network services is $350 per person and $1,050 per family.
If you reach your plan's out-of-pocket maximum, the plan pays 100% of eligible expenses for the remainder of the year.
The out-of-pocket maximum is $2,500 per person and $7,500 per family in-network.
Out-of-network and out-of-area benefits are available to UT SELECT participants. Check the UT SELECT Medical plan guide for details.
The UT SELECT Medical plan includes a long list of preventive care services available to you with no copayment or coinsurance as long as you see
a network provider and meet certain screening eligibility requirements.
Some examples of services covered under this provision include: routine physical exams, well woman exams, immunizations for all ages,
osteoporosis screenings, prostate screenings, cancer screenings, routine mammograms, and routine colonoscopies.
It is important to note you may incur some cost if the preventive service is not the primary purpose of the visit or if your doctor bills for services that
are not preventive. To view a comprehensive list of preventive care benefits through the UT SELECT plan, visit our Living Well: Make it a
Priority website. As an additional network option, the UT System Office of Employee Benefits and the University of Texas Southwestern Medical
center are continuing the collaborative health care pilot program called the UT Southwestern Network during the upcoming plan year.
If you or a covered family member receives care from a UT Southwestern physician or at a UT
Southwestern facility, your out-of-pocket cost will be greatly reduced or eliminated. Benefits include a $10 primary care and $10 specialist
copayment, no out-of-pocket cost for inpatient or outpatient care, no deductible and no coinsurance for services offered by UT
Southwestern. You do not have to be associated with UT Southwestern to be eligible for this benefit.
The prescription drug benefit is administered by Express Scripts. Your annual per person deductible is $100. After the deductible is paid
then you pay copayments as follows. The Generic copay is $10 for a 30-day supply at a retail pharmacy and $20 for a 90-day supply
through the mail. Preferred brand name drugs will be $35 retail and $87.50 by mail. Non-preferred brands will be $50 and $125.
When you or any of your covered dependents become eligible for Medicare, you and your Medicare-eligible dependents should enroll in Part
A (typically inpatient coverage) and Part B (typically office visits and doctor fees).
Part C (Medicare Advantage) is not recommended for UT System retirees. And you should not enroll in Part D (prescription drug
coverage). The University of Texas System urges all retired employees and dependents to enroll in Medicare Parts A and B, sometimes referred to
as Traditional Medicare, when you become eligible at age 65, or earlier if you are eligible due to a disability such as end stage renal disease.
Retired employees, or soon to be retired employees, or their dependents who are eligible for Medicare must have Medicare Parts A and B
to receive the maximum benefit from the UT SELECT plan. Effective the date of your retirement, Medicare becomes your primary
insurance. UT SELECT Medical becomes your secondary insurance. You should contact the Social Security Administration to enroll in
Medicare at least 90 days before you retire. For more information about Medicare, go to www.medicare.gov or call 1-800-MEDICARE
Additional information is also available through the Social Security Administration. The website is www.ssa.gov or you can call 1-800-772-1213
You can also refer to the UT Benefits Handbook for Retirees at the OEB website.
In addition to the Basic Coverage package, retired employees can select optional coverages at an additional cost for themselves and their
eligible dependents. Optional coverage includes UT SELECT Medical and Prescription Drug coverage for eligible dependents, Dental, Vision,
Long Term Care, and Additional Voluntary Group Term Life Insurance.
Over the next few minutes we will briefly describe each of these coverage options.
Please note that Accidental Death and Dismemberment, Short-Term and Long-Term Disability, and participation in Flexible Spending
Accounts are coverages not available to retirees.
As with active employees, retirees have three dental insurance options depending on where you live.
Dental choices are UT SELECT Dental, UT SELECT Dental Plus or, in some areas, DeltaCare USA, a Dental HMO. All dental plans
are provided by Delta Dental. UT SELECT Dental provides the freedom to be treated by any licensed dentist.
However, to receive the lowest out-of-pocket cost you must be treated by a network dentist. The annual deductible is $25 per person.
The plan covers preventive and diagnostic services at 100%. Basic Services are covered at 80% and Major Services are covered at 50%.
The Annual Maximum is $1,250 and the Lifetime Orthodontics Benefit is also $1,250. UT SELECT Dental Plus is an enhancement to the standard
UT SELECT Dental plan. In addition to the freedom to be treated by any licensed dentist, the Annual Deductible is paid by the plan.
The plan covers Preventive and Diagnostic Services at 100%. An increased benefit includes Basic Services covered at 100%
and Major Services covered at 80%. The Annual Maximum increases to $3,000 and the Lifetime Orthodontics benefit also increases to $3,000.
DeltaCare is a Dental HMO provided by Delta Dental. This plan has lower out-of-pocket costs than the UT SELECT Dental and Dental Plus
plans. The DeltaCare plan has no deductible but you must select a network primary dentist to receive benefits. Referrals are required to
receive treatment from a specialty dentist. There is no annual dollar maximum. The plan uses a fixed copayment schedule that covers routine
cleanings in full with other costs varying by service.
Out-of-network benefits are limited to dental emergencies.
Superior Vision offers two vision plan options to UT retirees. The standard plan covers one comprehensive eye exam per plan year for a
$35 copay. There is a frame allowance of up to $140 and standard eyeglass lenses are fully covered. Or you have the option to choose
contact lenses instead of standard eyeglasses. There will be a $35 copay for a contact lens fitting exam and the plan will cover up to $125 of the
cost of contact lenses. While the standard vision plan is available with its robust and highly utilized plan design, for a small increase in premium, the
Vision Plus plan provides you with expanded, richer benefits including popular lens options covered in full and higher retail allowances.
The Superior Plus plan offers a $150 frame allowance, $150 contact lens allowance, and $120 progressive lens allowance.
Covered lens options are Scratch coat, Ultraviolet coat and (for dependents only) Polycarbonates.
Long Term Care Insurance is administered by CNA. Long Term Care Insurance provides funds for necessary services when an individual
becomes incapable of caring for him or herself. Long Term Care Insurance is not disability insurance. The Long Term Care plan
provides assistance in your home or care in a nursing facility. Choose one of five daily benefit levels.
Choose from either the Guaranteed Benefit Option or the Automatic Benefit Increase. You can find details about these benefit options at the
OEB website. This benefit is available to you and to your spouse.
Evidence of Insurability is always required for you and your spouse when applying to enroll in Long Term Care. If you enrolled in Long Term Care as
an active employee, your Long Term coverage will automatically continue at the same premium rates as long as you have no break in premium
payments. Enrolling for Long Term Care requires enrolling with CNA directly and being approved through their Evidence of Insurability process.
Premiums will be based on your age on the enrollment effective date.
Included with the UT SELECT Medical plan is $6,000 Basic Term Life Insurance for the retiree at no out-of-pocket cost.
You have the option to select Voluntary Group Term Life Insurance in increments of $7,000, $10,000, $25,000 or $50,000. You also have the
option to select an additional $3,000 of Life Insurance coverage for your spouse.
However, you must be enrolled in retired employee voluntary Group Term Life coverage to do so.
If you first move from active employment to a retired employee without a break in service, you are guaranteed coverage up to the amount of
voluntary Group Term Life coverage you had in force as an active employee (not to exceed a maximum of $50,000).
After your initial eligibility period to elect voluntary Group Term Life coverage as a retired employee, Evidence of Insurability is required for any
requested increase in voluntary Group Term Life Insurance benefits during annual enrollment or following a qualified change in status event.
Evidence of Insurability is required for all spouses of retired employees who elect to enroll for $3,000 of voluntary Group Term Life Insurance
coverage. However, this requirement will be waived if both you and your spouse were enrolled in voluntary Group Term Life Insurance on the
last day you were an active employee and there was no break between the end of employment and the beginning of retirement.
As a benefits-eligible retired employee, UT and the State of Texas will pay 100% of your premiums for the Basic Coverage package which
includes UT SELECT Medical and Prescription Drug Coverage for the retiree and $6,000 Basic Term Life insurance.
With dependents, up to 50% of the premiums for your dependents’ medical coverage.
You are responsible for all optional coverage premiums, which means, additional monthly out of pocket costs exist for the optional coverages
for both you, the retired employee, and any eligible dependents you add to your plan. A retired employee may waive the Basic Coverage plan if
satisfactory proof of other comparable health insurance coverage is provided. is Retired employees may received up to 50% of
state premium sharing to pay all or a portion of the premiums for Dental and Vision coverages for themselves and their covered dependents.
If you are eligible for program benefits as a retired employee, you have 31 days from your date of retirement to enroll in the Program.
A 90-day waiting period may apply if enrollment occurs after a break in employment and retirement. Contact your institution Benefits
Office to determine if the waiting period applies. If elections are not made within the 31-day period of eligibility, you will be required to wait until the
next Annual Enrollment period or a qualified change of status event during the plan year to make changes, including adding or dropping
coverage. Evidence of Insurability may apply to enroll in some coverages.
As a retired employee, Evidence of Insurability is required for voluntary Group Term Life Insurance for members requesting an increase in coverage
amount if there is a break between active employment and retirement. Spouses who were not previously enrolled in voluntary Group Term
Life will also be required to submit an Evidence of Insurability application. Anyone newly electing Long Term Care coverage will also be required to
submit an Evidence of Insurability application. For questions or to gather more information about eligibility, enrollment, or benefits please contact
a representative at your local institution Benefits Office. You can access contact information for your institution Benefits office at
www.utsystem.edu/benefits/contacts.
Thank you for taking the time to watch this video. Keep in mind, this is an overview. More detailed information outside this presentation is available
to you. Refer to the UT Benefits Handbook and Plan Guides for benefit details. Explore the Office of Employee Benefits website for benefits
materials, vendor presentations and contact information. Always feel free to contact a Benefits Representative at your local institution Benefits
Office if you have any questions or need assistance. The Office of Employee Benefits staff is here to help make it a priority for you and your
family to live well. We’re here to help you build a unique benefits package that cares for you today, tomorrow and beyond.
On behalf of The Office of Employee Benefits, we wish you a healthy and successful year with the University of Texas System. Thanks for watching!