AlaskaCare Retiree Health News | Monthly e-newsletter | October 2019

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AlaskaCare Retiree Health News

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Volume 19| October 2019

Retiree DVA Open Enrollment Has Begun!

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Eligible retirees can make Dental, Vision, and Audio (DVA) plan elections any time from October 16, through November 27, 2019 at 5 p.m. Alaska Time using the retiree DVA plan open enrollment online form.

Eligible retirees should have received a 2020 Benefit Comparison Guide and a 2020 Enrollment Guide containing monthly premium information and coverage comparisons in the mail. Review the standard plan (your current plan) and the legacy plan (the plan in place prior to 2014) provisions to help decide which plan is best for you and your family in the coming year. You can also view the information online:

We encourage all eligible retirees to review the dental benefits in both plans before making a plan selection. If you are currently enrolled in the DVA plan and take no action, meaning you do not make any plan selection by the end of the open enrollment period, you will remain in the plan you currently have today, the AlaskaCare retiree standard DVA plan. Vision and audio benefits remain the same in both plans.

Intent to Award Contract Medical Third-Party Administrator—Aetna

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The Department of Administration intends to award Aetna the Medical Third-Party Administrator, Benefit Manager services contract for the State of Alaska employee and retiree medical plans.

Medical, vision, and audio services are currently provided by Aetna. The bidding process is competitive, and the selected bidder will process an estimated 2 million claims annually for nearly 90,000 policies. The contract is for an initial 5 year term with 5 years of optional renewal periods and will take effect January 1, 2020. 

Resources Copies of the Request for Proposals and the official notice of intent to award are available at here.

Maximize Your Dental Benefits with In-Network Providers

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When you need dental care, selecting a provider that is in-network can save you money and help you get the most value out of your dental benefits. To find an in-network dental provider, call Delta Dental Member Services at 855.718.1768 or use the Find a Dentist search tool.  

The AlaskaCare plans limit payment of covered services to the recognized charge (the maximum amount the AlaskaCare plans will pay for a covered service). Delta Dental and their respective network providers, or “participating providers,” agree to a set of discounted negotiated rates for services provided.

The recognized charge for network providers is the negotiated rate, while out-of-network providers is based on a percentile of billed charges in the area where the service is provided. The standard plan and the legacy plan use different percentiles and percentages to determine the recognized charge for out-of-network providers. The recognized charge for out-of-network dental providers in the standard dental plan is 75% of the 80th percentile of the prevailing charge rate for the geographic area where the service is furnished. The recognized charge for out-of-network dental providers in the legacy dental plan is 100% of the 90th percentile of the prevailing charge rate for the geographic area where the service is furnished.  

Please see the AlaskaCare Retiree Insurance Information Booklet for more information.

An out-of-network provider can charge you the difference between the recognized charge and the billed charge, leaving you responsible for the difference. This is often referred to as "balance billing". Network providers agree to accept, as payment in full, the negotiated charge. Meaning you are protected from balance billing when you use a network provider.

Keep Up-to-Date with News from the AlaskaCare Health Plan

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Join us for Town Hall Events

Town Hall Events are group calls hosted by the Alaska Department of Administration, Division of Retirement and Benefits for all interested AlaskaCare retirees and families to ask questions about the AlaskaCare health plans. We are also hosting Special Town Hall Events during October and November to review the new Retire Dental Vision and Audio Plans. You can join the call to learn more about your health plan and ask Division staff any questions you have about your benefits. This format gives retirees a chance to connect directly with Division staff to hear the latest news on all things AlaskaCare, raise questions, share comments, and learn more about the health plans. Pre-register now online.

Please Join Us! Upcoming Town Hall Event Schedule

DVA Event

Nov 1, 2019

9 to 10 a.m. AKDT

Click here to register

DVA Event

Nov 7, 2019

10 to 11 a.m. AKDT

Click here to register

Regular Event

Nov 22, 2019

10 to 11 a.m. AKDT

Click here to register

Subscribe to the Monthly Retiree Health Plan Newsletter

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Retiree newsletters are sent electronically to Health Plan members that have subscribed to receive updates. Each month we feature an article that helps you Get to Know your Benefits, provides you with updates about the Health Plan, and information about health events and resources. You can subscribe or unsubscribe at any time by managing your preferences here.

Retiree Health Plan Advisory Board

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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 helps represent you, the members of the AlaskaCare Retiree Health Plan.  The board consists of representatives from the Teachers' Retirement System (TRS), Public Employees' Retirement System (PERS), political subdivisions participating in the State’s retirement systems, the Alaska Retirement Management Board (ARMB), and the public.

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 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.

The next Quarterly Retiree Health Plan Advisory Board Meeting: November 14, 2019

The agenda will include updates and in-depth discussion about the AlaskaCare retiree health plans. Meeting materials will be posted to the Retiree Health Plan Advisory Board website.

Frequently Asked Questions

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We update the FAQs regularly on our website, please keep checking back for new information! Here are some recently asked questions:

How do I avoid receiving a balance bill?
You may prevent balance billing by verifying all medical providers are in the Aetna network and making sure your AlaskaCare Plan covers the services you need. For example, if you're receiving x-rays, MRIs, CT scans, or PET scans, make sure both the imaging facility and the radiologist who will read your scan are in-network. If you're planning surgery, ask whether the anesthesiologists are in-network. If available, the facility should accommodate your request to use a network provider for your services.

Similarly, for AlaskaCare covered dental services, you may prevent balance billing by verifying the provider is in the Moda/Delta Dental network.

How is the recognized charge amount determined?
The recognized charge for out-of-network medical providers is the 90th percentile of the prevailing charge rate for the geographic area where the service is furnished. The AlaskaCare plans establish the percentile (i.e., 90th percentile) to be applied to the prevailing charge rate; however, the prevailing charge rate is reported by FAIR Health, an independent not-for-profit corporation. FAIR Health collects charge data from claims received by insurance plans and health plan administrators across the country for charges billed by physicians, hospitals and other healthcare providers. Charges reported are the full fees that healthcare professionals report to insurers as part of the claims process—not the negotiated rates that apply when visiting a network provider. Charges reported are maintained by FAIR Health in its database, which is comprised of billions of claims for billed medical procedures from across the United States. New charge data is continually added to the FAIR Health database.

The recognized charge for out-of-network dental providers in the standard dental plan is 75% of the 80th percentile of the prevailing charge rate for the geographic area where the service is furnished. The recognized charge for out-of-network dental providers in the legacy dental plan is 100% of the 90th percentile of the prevailing charge rate for the geographic area where the service is furnished.

How does the plan know that FAIR Health's information is reliable?
FAIR Health has audit and validation programs in place to ensure the integrity of its data. Part of the validation process entails testing the data with statistical algorithms and examination by FAIR Health's in-house statistical and technology experts. A team of healthcare researchers from leading academic institutions advise FAIR Health on the best methods for analyzing its national claims data. FAIR Health is also advised by an independent Scientific Advisory Board of prominent researchers who review Fair Health's statistical methods and data. FAIR Health also seeks input from other stakeholders such as consumer and patient advocacy groups, healthcare providers, actuaries and federal officials.

How are the geographical areas determined?
FAIR Health organizes its data by geozip—a geographical area usually defined by the first three digits of the U.S. zip codes. Geozips may include areas defined by one three-digit zip code or a group of three-digit zip codes. Geozips generally do not include zip codes in different states.

The State of Alaska is currently defined into three geozips:

  • 995 and 997: Including Anchorage, Bethel, Fairbanks, Kotzebue, etc.
  • 996 and 998: Including Homer, Kodiak, Juneau, Sitka, etc.
  • 999: Including Ketchikan, Prince of Wales, Wrangell, etc.

Where can I get more information about the two DVA plans?
You can find information about the two DVA plans online:

You can also call the AlaskaCare Member Services Contact Center toll free at (855) 821-2251, in Juneau at (907) 465-4460, or Delta Dental of Alaska at (855) 718-1768.

Can one person with two retirements choose both Dental plans?
If one person has two retirement accounts and would like to enroll in dental coverage, they cannot choose different plans for each retirement account. If a member and their spouse each have their own retirement plan and claim one another as dependents, one can choose the Standard Plan and the other can choose the Legacy plan. Each member would need to pay the appropriate plan premium.

Can I switch between the DVA plans?
Yes, for as long as the State offers two DVA plans, you will have an opportunity to change your dental plan selection during the open enrollment period. Outside of the open enrollment period, you will not be able to make changes to your selections unless you have a qualifying life event.

If you miss the open enrollment window and have questions about your next opportunity to make a DVA plan selection, please contact the Division of Retirement and Benefits.

EGWP Enrollees: IRMAA Submission Reminder

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Certain high-income retirees who are Medicare-eligible and enrolled in the AlaskaCare enhanced Employer Group Waiver Program (EGWP) pharmacy plan are required to pay a premium surcharge associated with Medicare Part D plans, known as an Income Related Monthly Adjustment Amount, or IRMAA. This is required by Medicare and is the same type of surcharge that high-income enrollees already pay for a Medicare Part B plan. If you are an individual earning more than $85,000 per year or a married couple who earns more than $170,000 per year, you will be required to pay the IRMAA; retirees enrolled in EGWP and whose household income is below this threshold will not be subject to the IRMAA premium surcharge.

If you are required to pay the IRMAA premium surcharge, the Division will reimburse you for the amount you are charged each month through a tax-advantaged health reimbursement arrangement (HRA) account, so the EGWP plan has no additional cost to you!

Each November, Medicare-eligible individuals receive a letter from Social Security that outlines the Medicare premiums. Please submit the most recent letter you’ve received from Social Security that states you are subject to IRMAA surcharge for 2019, and at what amount, to the Division.

You can provide a copy of your letter to the division by:

  • Emailing a copy or a photo of the letter to:
  • Faxing a copy to: (907) 465-3086
  • Mailing a copy to:
    Alaska Department of Administration

    Division of Retirement and Benefits
    P.O. Box 11023
    Juneau, AK 99811-0203

Once the Division receives a copy of your annual letter sent from Social Security, we will establish an HRA for you through PayFlex, Aetna’s subsidiary that administers the HRA on behalf of AlaskaCare. PayFlex will send you a letter that outlines how to access your HRA account information and how to set up claims for reimbursement. We encourage you to set up reimbursement on an automatic reoccurring basis, but you may elect to request reimbursement manually. Reimbursement can be made by check or through electronic funds transfer.

New enrollments are processed weekly after they are received by PayFlex, with follow up to the member within 10 business days. If you have submitted your information more than two weeks ago, but have not yet received a welcome kit, please contact PayFlex at (888) 678-8242. You can also email the Division at to check on your paperwork.

Health Benefit Contact Information

Division of Retirement and Benefits
DRB Call Center: (907) 465-4460 |Toll Free: (800) 821-2251

Medical Benefits: Aetna
Member Services: (855) 784-8646

Long Term Care Benefits: CHCS Services, Inc.
Member Services: (888) 287-7116

Dental Benefits: Moda/Delta Dental
Member Services: (855) 718-1768

Pharmacy Benefits: OptumRx
Member Services: (855) 409-6999

Specialty Pharmacy: BriovaRx
Enrollment Services: (855) 427-4682

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