Originally posted July 2, 2008

STRS Ohio Health Care Program News - Special Edition

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Retirement Board Approves Premiums for 2009 in Preparation for Health Care Open-Enrollment Period

At its June 2008 meeting, the State Teachers Retirement Board approved the premiums for calendar year 2009 for all of the health care plans offered through the STRS Ohio Health Care Program. The same factors that affect health care costs nationwide also affect STRS Ohio’s members. Medical and drug trend rates continue to outpace the CPI (Consumer Price Index). Contributing to these high trend rates is the continuing introduction of new medical technologies and high-cost services, as well as new prescription drugs. Biomedical and specialty drugs, such as oral cancer medications in particular, are exponentially adding to costs. Year-over-year cost increases are projected to be 20% to 30% for these types of medicines. For STRS Ohio, these drugs could increase to 25% from 10% of the total amount spent on prescription drugs in just the next two to three years.

Another factor considered in calculating STRS Ohio’s premiums is the claims experience for each of the health care plans’ risk pools (e.g., non-Medicare benefit recipients enrolled in Medical Mutual and non-Medicare spouses enrolled in Medical Mutual). The 2009 premiums also reflect the board’s continuation of its contribution strategy of providing a premium subsidy of 2.5% per year of service, up to a 75% maximum, for eligible benefit recipients, and requiring spouses and dependents to pay 100% of applicable rates.

A representative sampling of the premiums for 2009 are shown in the charts below.

Monthly Premiums for 2009 — Without Medicare

Monthly Premiums for 2009 — With Medicare Parts A & B

Click the appropriate link to view the 2009 monthly premiums for enrollees without Medicare, enrollees with Medicare Parts A & B and enrollees with Medicare Part B only; or call STRS Ohio’s Member Services Center toll-free at 1-888-227-7877. In late October, all current enrollees will also receive personalized information that outlines their 2009 plan options and monthly premiums. Open enrollment will run from Nov. 1 through Nov. 25, 2008.

Help With Open Enrollment Available to Members This Fall
To help guide STRS Ohio members through the annual health care open-enrollment process, STRS Ohio will offer the Health Care Program Highlights Meeting on multiple dates throughout Ohio in November. This meeting will be of special interest to members who are trying to gain a better understanding of the plans offered under the STRS Ohio Health Care Program, as they decide which health care plan best meets their current health care needs.

During each two-hour session, STRS Ohio representatives will review the 2009 health care premium information and cost-saving measures. All STRS Ohio health care plans available in the area are discussed at the meetings, and attendees are given the opportunity to ask questions at the meeting’s conclusion. Advance registration is required. You may register beginning Oct. 1. To register, call STRS Ohio toll-free at 1-888-227-7877, or register online (where directions are also available). After registering, you will receive a confirmation letter with further details. Space is limited; one guest per member, please.

Meetings will be offered at 1 p.m. and 6 p.m. on each date; dates and locations are as follows:

Registration begins Oct. 1, 2008.

Additional Health Care Program News

New Medicare Coordination of Benefits Program Offers $0 Copayments for Eligible Drugs and Supplies Beginning Aug. 1
Beginning Aug. 1, 2008, the STRS Ohio Health Care Program will offer a $0 copayment for designated Medicare Part B-covered drugs and supplies that are coordinated with Medicare. At its June 2008 meeting, the Retirement Board approved this program change for individuals who receive their prescription drugs through Express Scripts (enrollees in the Aetna and Medical Mutual health care plans). The $0 copayment will apply to Medicare Part B drugs and supplies that are dispensed by a participating Medicare retail pharmacy or through Express Scripts’ Medicare Part B mail-order pharmacy, NationsHealth.

Select medications in the following therapeutic classes are eligible for coordination under Medicare Part B: diabetic testing supplies; respiratory medications and nebulizers; and immunosuppressive, oral anticancer and oral antiemetic medications. When a pharmacy claim for one of these eligible drugs or supplies is coordinated with Medicare Part B, it means that the claim is submitted to Medicare first for primary payment and then to Express Scripts for secondary payment. This process is known as coordination of benefits.

Detailed information about this new program will be mailed to all eligible health care plan enrollees within the next few weeks.

Health Care Premium Assistance Expanded to Eligible Survivors, Beneficiaries
For several years, STRS Ohio has offered the Health Care Assistance Plan (HCAP) to create a safety net for low-income enrollees. Currently, benefit recipients with 25 or more years of service credit and all disability benefit recipients can participate in the HCAP if their annual family income does not exceed $23,800 and their household liquid assets are at or below $23,800. (A home is not considered a liquid asset.) The HCAP offers a $0 monthly premium. Individuals enrolled in the Aetna or Medical Mutual Plus Plans also have lower out-of-pocket costs.

During its June 2008 meeting, the Retirement Board voted to expand the HCAP to include all beneficiaries of retired teachers with 25 years or more of service, and all survivors of disabled teachers or active teachers — regardless of the deceased member’s years of service. This change goes into effect on Jan. 1, 2009.

To participate in the program, an application must be completed and returned to STRS Ohio. For more information or to receive an application, call STRS Ohio’s Member Services Center toll-free at 1-888-227-7877.

Enrollment in a Medicare Part D Plan Not Necessary
STRS Ohio members who are enrolled in Medicare and an STRS Ohio-sponsored health care plan do not need to enroll in a separate Medicare Part D prescription drug plan for 2009. STRS Ohio will continue to offer prescription drug coverage that is as good as or better than the standard Medicare Part D coverage.