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The Division of Retirement and Benefits sends monthly
e-newsletters to provide you with accurate, timely information about your
AlaskaCare retiree health benefits. You can expect to receive an e-newsletter
each month, and the Division may also send out timely information and updates
through this
e-mail list. If you prefer not to receive these e-mail updates,
you can unsubscribe at any time. Either way, you will continue to receive the
Health Matters newsletter in the mail, as well as your important health plan
information.
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The Division has begun hosting monthly Tele Town Halls for
all interested AlaskaCare retirees and families to ask questions about the
retiree health plan. The Division hosted its
first two Tele Town Hall on August 23 and September 20th.
Feedback about this event
has been overwhelmingly positive: the format gives retirees a chance to connect
directly with Division staff, ask questions and learn more about the health
plan. We want to continue the conversation with you at future events! Watch for
announcements about upcoming Tele Town Halls in the retiree e-newsletter and on
the Tele Town Hall webpage.
If you haven’t participated in a Tele Town Hall before: Many
AlaskaCare retirees will be called into a shared line automatically when the
event starts. If you would like to participate, just answer that call and stay
on the phone! Be sure you receive a
call by pre-registering at the link below.
The town hall meetings are
also live streamed. A link becomes available on the Tele Town Hall page the day of the event.
Division staff will share a short overview of the topic, and
the rest of the event is dedicated to answering your questions. We will answer
as many questions as we can during the call. This event will also be recorded.
The audio recording and a written summary will be available online following the
event.
Register online here: AlaskaCare.gov. Registering for this
event means that we will have your correct phone number to call when the event
begins!
Still have questions?
You can read more about EGWP on the AlaskaCare website. You can also contact the
Division at (907) 465-4460 or by e-mail at doa.drb.benefits@alaska.gov.
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 It’s official!
Beginning January 1, 2019, OptumRx will become the Pharmacy Benefits Manager. Aetna, with their subcontractor CVS/Caremark, is currently the Pharmacy Benefit Manager (PBM) for the AlaskaCare plans. Periodically the Division competitively solicits bids for third party administrator health plan contracts through a Request for Proposal (RFP). This gives the Division an opportunity to seek better service at lower cost for members and the plan. After concluding the procurement process this summer, the Division has selected OptumRx as the new PBM for all AlaskaCare plans, including AlaskaCare Employees and Retirees. Aetna, with their subcontractor CVS/Caremark, will remain the PBM for the AlaskaCare plans in the interim period. OptumRx offers flexibility to select the most convenient way to receive medication—via home delivery or through your local retail pharmacy. There are over 67,000 retail pharmacies in the OptumRx network, including most of the Alaska pharmacies that are in network today.
The Division and OptumRx will send out a welcome kit in November 2018 with information, including:
- new ID cards;
- a toll-free number to reach an OptumRx health care advisor 24 hours a day, 7 days a week (phones lines will open on October 31, 2018);
- how to register online after January 1st to actively manage and get the most from your prescription benefits, including how to sign up for text messages reminders to refill or take your medications;
- how to easily manage prescriptions from your mobile device using the OptumRx app; and
- how to get started with OptumRx’s home delivery or BriovaRx specialty pharmacy.
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The Retiree Health Plan Advisory Board (RHPAB) is tasked with facilitating engagement and communication among the Commissioner of Administration, the Division of Retirement and Benefits, and the community of AlaskaCare retirees. The seven-member board meets four times per year.
Highlights from the August 29 Quarterly Board Meeting
RHPAB held its in-person quarterly board meeting in Juneau
on Wednesday, August 29. Some highlights:
- The Board
passed Resolution 2018-01, supporting implementation of an enhanced Employer
Group Waiver Plan (EGWP) for Medicare-eligible retirees for pharmacy benefits;
- Representatives from OptumRx, the new Pharmacy
Benefit Manager (PBM) for AlaskaCare, were available to answer questions about
the transition and what to expect this fall;
- The Board heard testimony from members of the
public; and
- Member Mark Foster, whose seat represents PERS,
TRS or JRS retirees and whose term expires on October 2, 2018, will not renew
his term on the board. The Office of Boards of Commissions, part of the Office
of the Governor, has solicited applications for qualified members to fill this
seat. The new RHPAB member will be seated before the November 28 meeting.
A recording of the meeting and a copy of Resolution 2018-01
are available on the board’s web page.
Modernization Committee
The board has formed a subcommittee for more in-depth review
and discussion about the modernization project. A collection of initiatives and
proposed changes to the health plan is under consideration by the Division to
provide updated benefits while preserving the overall value of the plan for
retirees. The modernization committee will meet regularly this fall to continue
its review of the changes under consideration, including the Division’s
research and analysis about each initiative.
Upcoming committee meetings:
- Friday, September 28, 9:30 a.m. to 12:30 p.m.
- Tuesday, October 23, 9:30 a.m. to 12:30 p.m.
Agenda packets for all meetings are posted at the board's web page.
Next Quarterly Board Meeting: November 28
The next board meeting is scheduled for Wednesday, November
28, from 9 a.m. to 4 p.m., with locations in Juneau and Anchorage and
teleconference provided. Members of the public are always welcome to attend and
observe the meeting or listen in via phone. Each RHPAB board meeting includes
time on the agenda for public comment, and written comments may be submitted to
the board at AlaskaRHPAB@alaska.gov. If you want to be sure that your comments are included in the agenda
packet for the next quarterly board meeting, please submit them at least thirty
days in advance of the next scheduled meeting. Please see the RHPAB public
comment guidelines for more information and what to expect in a board meeting. For more about
RHPAB and upcoming meetings, including teleconference information and meeting
materials, please visit the Retiree Health Plan Advisory Board web page.
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 We
are pleased to have available online, the updated September 2018 AlaskaCare Retiree Health Plan booklet! Thank you to everyone who submitted comments during the
public comment period, June 15 to August 15.
The
Division updated the booklet based on feedback from retirees about how the
booklet should be easy to use and have clear information about plan benefits.
The revisions in the booklet are not changes to the benefits themselves, but a
reorganization of the document to make it easier to read, moving previous
amendments to the booklet into the relevant sections instead of a list at the
front, and adding in formal benefit clarifications and the existing eligibility
regulations.
Read the new booklet here.
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You worked hard during
your service to Alaska, and you’ve earned these benefits! We want you to
understand your AlaskaCare health plan, so you can make the best use of your
health plan for yourself and your family. As a small service to you, we will
feature information about health plan benefits in each issue. This month’s
featured benefit is Pharmacy by Mail. For questions about your pharmacy benefits,
you can always reach out to the Aetna concierge with questions at (855) 784-8646.
This month’s featured benefit: Understanding your medical plan cost share
Cost sharing is the portion of covered medical benefits (excluding pharmacy benefits) you pay out of your own pocket. This includes your deductible, coinsurance and annual out-of-pocket limit.
Deductible is the amount you pay each benefit year before a portion of your covered medical expenses are paid by your AlaskaCare medical plan benefits. You pay the full cost of your eligible health expenses until you meet your deductible. The AlaskaCare retiree medical deductible is $150 for an individual, with a maximum of three deductibles ($450) applying to a family.
Coinsurance is the percentage of covered expenses paid by AlaskaCare once you meet your deductible. This can vary, but for most services the plan pays 80% until the out-of-pocket limit is reached.
Out-of-pocket limit is a cap which AlaskaCare has set to protect you from large expenses. If you reach the out-of-pocket limit, AlaskaCare will then pay 100% of your eligible expenses for the rest of the calendar year.
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The world of health
care is complex and uses a lot of jargon. You don’t need to be a health care
specialist to get the most out of your benefits but knowing some of the technical
terms makes it a little less mysterious. This month’s keyword is Formulary.
A Formulary is a list of medications that
a health plan will pay for, and often includes multiple tiers of coverage
depending on whether the drug is a brand name or generic. In its original
meaning, a formulary would include formulas for pharmacists to prepare
medications by mixing individual drugs together or with other ingredients,
known as compounding. A modern-day formulary has evolved to be a list of
medications, primarily produced by manufacturers rather than prepared by a
pharmacist onsite, that provides guidance to the health plan when processing
pharmacy claims.
The AlaskaCare retiree health plan offers what is known as
an open formulary: this means that the plan does not limit drugs to specific
physicians, disease states, or limit the medications covered in the plan as
long as they are medically necessary and meet the definition of “prescription
drug.” The State can choose to provide coverage for new or not previously
covered medications, such as FDA-approved medications that have not been added
to the formulary.
Check out a glossary of more health care terms at HealthCare.gov/glossary.
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Ben Franklin wrote,
“An ounce of prevention is worth a pound of cure.” We cannot prevent all of the
health issues we will experience in a lifetime, but taking care of ourselves
and our family’s physical, mental and emotional well-being helps us avoid or
address problems early and maintain a good quality of life. This month’s
prevention tip about keeping your brain healthy and active as you age.
 Healthy aging includes taking care of your brain throughout your lifetime. Cognitive health, the ability to clearly think, learn, and remember, is an important component of aging well and staying healthy. Did you know that while the brain is only 2 percent of the body’s weight, it receives 20 percent of the body’s blood supply? Managing chronic conditions such as diabetes, high blood pressure, depression, and high cholesterol, are important for your brain as well as your overall health.
Here are some other ways to protect your cognitive health:
- Ask your doctor or pharmacist about the medications you take and possible side effects for memory, sleep, and overall brain function. Remember: some medicines can be dangerous when mixed with alcohol!
- Reduce your risk for brain injuries due to falls and other accidents. Safety tips:
- Remove trip hazards in your home, such as loose area rugs or slippery floors
- Be careful on ladders and when working on home improvement projects
- Practice safe driving, including not driving while sleepy or distracted
- Join group activities that involve physical activity and exercise, which not only keeps you moving but also provides valuable social time and connections with others in your community. Consider trying a new hobby, from hiking to photography to golfing, or learning a new skill!
- Healthy eating supports a healthy brain. If you are stuck in a rut with your usual diet, consider trying at least one new -healthy recipe, or a new fruit or vegetable, per week. If you can meet that goal every week, you will have tried at least 52 new foods in a year!
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