• AlaskaCare Retiree Health Plan Settlement Agreement with RPEA
• Preventive Care—Cancer Screenings
• Don’t Forget to Submit Your 2021 Medicare Part D Surcharge Reimbursement Forms!
• Join the Conversation—Retiree Town Hall Events
• We Value Your Feedback!
• Health Benefit Contact Information

AlaskaCare Retiree Health Plan Settlement Agreement with RPEA

The Division of Retirement and Benefits (the Division) is pleased to announce a settlement agreement with the Retired Public Employees of Alaska, Inc. (RPEA) in two lawsuits involving the AlaskaCare Retiree Medical and Dental, Vision, and Audio (DVA) plans.

The agreement protects health care benefits from diminishment, as mandated by the Alaska Constitution, and it marks an end to years of costly litigation. Most importantly, it ushers in a new era of cooperation between RPEA and the State for the benefit of all retirees.

Both parties agree that the terms are more favorable to retirees than the likely outcome had either case continued to trial.

Certain settlement terms fall outside the scope of the claims brought by RPEA in its lawsuit, and could not have been achieved at trial. These include provisions to protect and enhance the process the Division follows when it considers changes to the health plans by providing retirees with additional, meaningful opportunities to engage with the Division.

Additional Information:

• Read the press release here.
• Learn more about the settlement here.

DVA-Specific Settlement Terms

• Continued Access to the Legacy DVA Plan: The Division has agreed to continue offering retirees the option of participating in the Legacy DVA plan (the plan in place prior to 2014) ) or the Standard plan (the plan in place after 2014) so long as the Legacy plan remains financially viable. Both plans are entirely funded by member premiums, and as with all health plans, the viability of the plans is a function of the costs of coverage and the number of beneficiaries paying premiums. The viability of the Legacy plan is dependent on how fast, or how much, dental, vision, and auditory costs rise and how many beneficiaries elect the Legacy plan.
  
  
• DVA Plan Premium Development: Premiums for each DVA plan offered by the Division will be determined based on the cost of each plan. The Division will continue to share publicly the process used to determine premiums for each plan and will provide members an opportunity to elect their plan of choice during an open enrollment period.

For more information regarding the differences between the Legacy Plan and the Standard Plan, please view the 2022 Dental Benefit Comparison.

Medical-Specific Settlement Terms

• Plan Amendment to Clarify Medical Necessity Terms: The Division will propose a Plan Amendment to clarify certain terms, detail the Plan’s procedures for determining whether services are medically necessary, and affirm the Plan Administrator’s (Commissioner of Administration) ultimate authority to make medical necessity determinations. The public will have at least 60 days to comment on this proposed amendment before it takes effect.
  
  
• Rehabilitative Care Coverage Clarification: The Division will issue a benefit clarification to specify that when treatment is being provided for musculoskeletal disorders, a medical necessity review will be performed after 25 visits in a year for a specific episode of care. If the review determines the course of treatment is necessary for maintenance care, 10 additional visits will be allowed in that year for that episode of care.

General Settlement Terms

• Expansion and Continuation of RHPAB: The Division will recommend the Retiree Health Plan Advisory Board (RHPAB, or the Board) be expanded to include an additional seat for an RPEA member, to be selected from a list of candidates proposed by RPEA. The Division will further recommend the continuation of the Board and the removal of the current sunset clause.
  
  
• Expansion of RHPAB Subcommittees: The Division will recommend that the Board expand the membership of the Retiree Health Plan Modernization Subcommittee to include a member of RPEA. This subcommittee is the working group where potential changes to the Retiree Health Plan are discussed and analyzed in detail. The Division will further recommend that the Board establish a Regulations Subcommittee to review proposed updates to regulations impacting the retiree health plan and that the Board include a member of RPEA on this newly created subcommittee.
  
  
• Regulations Related to Plan Changes: The Division will draft administrative regulations to formalize the process currently employed to review proposed changes to the retiree health plans. These regulations will be reviewed with the appropriate RHPAB subcommittee, and the public will have at least 60 days to comment on any resulting proposed regulations.

Background Information

You may have heard about two lawsuits related to the AlaskaCare Retiree Health plans. In 2014, after a competitive procurement process, the State of Alaska selected Aetna to serve as the AlaskaCare medical third-party administrator and selected Delta Dental of Alaska (Moda) to serve as the dental third-party administrator. Also in 2014, the Division adopted an amendment intended to eliminate areas of ambiguity in the plan, provide clarity to members, confirm prior practices, and align with best industry practices while maintaining affordable, valuable, and sustainable benefits for retirees. The 2014 plan amendment and changes applied to both the AlaskaCare Retiree Health Plan and the AlaskaCare Retiree Dental-Vision-Audio (DVA) Plan.

AlaskaCare Retiree DVA Plan Suit

In 2016, RPEA filed suit against the Division, alleging the optional retiree DVA plan was diminished through changes made to the plan in 2014. A trial was held in 2018 and the Alaska Superior Court ruled in RPEA’s favor. The Division appealed the decision to the Alaska Supreme Court. In January 2022, the Supreme Court ruled that the option to buy dental insurance is an accrued protected benefit for retiree members. However, the Supreme Court found that the trial court erred by failing to consider the reduction in premiums paid by retirees when evaluating the impact of the 2014 changes. Therefore, the Supreme Court vacated the judgment and sent the case back to the superior court for a new diminishment analysis using the correct legal standard.

AlaskaCare Retiree Medical Plan Suit

In 2018, RPEA filed a second lawsuit against the Division alleging the AlaskaCare retiree defined benefit medical plan was diminished as a result of the 2014 plan amendment. After multi-year litigation, the trial was set to begin at the end of January 2022. However, rather than incur the significant expense of a two-week trial, continued motion practice, and a likely appeal to the Supreme Court, the parties agreed to explore the possibility of settling the claims remaining in the case through mediation.

Mediation

The parties mediated the outstanding issues in both the DVA and medical plan cases on February 11, 2022, and a final agreement was signed on February 28, 2022.

Retiree FAQs: RPEA Settlement Agreement

• Where can I learn more?
  • Tune into the Division’s Retiree Town Hall on Wednesday, March 18 at 10 a.m. where we will be discussing the settlement agreement. You can register here. You can also listen online or through the Division’s Facebook page.
    
    
  • Join us at a special Retiree Health Plan Advisory Board meeting on Friday, March 25 at 9 a.m. Information about the meeting is available here. 
    
    
• Will my DVA benefit options change as a result of the settlement agreement?
  • No. The Division will continue to offer eligible retirees a choice between the Standard and Legacy DVA plans for as long as the Legacy DVA plan remains financially viable.
    
    
• Will my medical benefits change as a result of the settlement agreement?
  • Some retirees seeking care for musculoskeletal conditions may receive coverage for additional visits if their individual medical circumstances allow. Otherwise, your medical benefits will not change as a result of the settlement agreement.

Preventive Care—Cancer Screenings

The AlaskaCare plan expanded preventive care coverage to the Retiree Defined Benefit health plan effective January 1, 2022.

Join us during 2022 as we explore the preventive care benefits offered by your AlaskaCare Retiree Insurance Plan. Each month from January through June, we will take a closer look at some of the preventive services. If you missed the January or February newsletter, you can find a copy here.

This month we are featuring preventive cancer screenings.

Preventive Care – Cancer Screenings

Getting screening tests as recommended is the most important way to lower your cancer risk. It’s important to schedule any regular screenings you may have postponed during the pandemic. Screenings check your body for cancer before you have symptoms. Regular screenings may find breast, cervical, and colorectal (colon) cancers early when treatment is likely to work best.

Breast Cancer

Mammograms are a helpful tool to find breast cancer early when it is easier to treat. A mammogram is a low-dose X-ray that allows specialists to look for changes in the breast tissue. Mammograms may show changes in the breast before you or your doctor can feel them. When you get regular mammograms, doctors may find and treat these changes early before they become more serious.

AlaskaCare preventive services include coverage of mammograms for women 40 and older every 12 months. It also covers one baseline mammogram for women 35 -39 years of age.

Genetic Testing for BRCA-Related Cancer

The BRCA gene test is a blood test that's done to determine if you have changes (mutations) in your DNA that increase the risk of breast cancer.

AlaskaCare preventive services include coverage of genetic testing for BRCA related cancers once in your lifetime.

Cervical Cancer

The Pap test can find abnormal cells in the cervix which may turn into cancer. The HPV test looks for the virus (human papillomavirus) that can cause these cell changes. Pap tests also can find cervical cancer early, when the chance of being cured is very high.

AlaskaCare preventive services include coverage of pap smears for women 21-65 years of age every 3 years, and women 30 – 65 years of age every 5 years.

Colorectal (Colon) Cancer

Colorectal cancer almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early when treatment works best.

Getting screened for colorectal cancer may not sound pleasant, but on-time screening tests can find polyps before they turn into cancer. There are several screening test options; some you can even do from home. Talk to your doctor to decide which is best for you.

AlaskaCare preventive services include coverage for adults 45 years of age and older. Frequency depends on colorectal cancer screening type.

• Annual fecal occult blood testing; or
• Colonoscopy (every 10 years for persons at average risk); or
• CT Colonography (virtual colonoscopy) (every 5 years); or
• Double-contrast barium enema (DCBE) (every 5 years for persons at average risk); or
• Sigmoidoscopy (every 5 years for persons at average risk)
• Sigmoidoscopy (every five years) with annual fecal occult blood testing (FOBT); or
• Stool DNA (FIT-DNA, Cologuard) (every 3 years).

Lung Cancer

The USPSTF recommends yearly lung cancer screening with low-dose computed tomography (LDCT) for people who have a history of heavy smoking, smoke now, or have quit within the past 15 years and are between 50 and 80 years old.

AlaskaCare preventive services include coverage of lung cancer screening once a year, based on your risk factors.

Prostate Cancer

Prostate cancer may be found by testing the amount of PSA (prostate-specific antigen) in your blood. Your doctor can also find prostate cancer during a digital rectal exam.

AlaskaCare preventive services include coverage of PSA tests and digital rectal exams for men starting at age 50, once every 12 months.

Remember, some preventive care services are also covered for different age groups or at different frequencies than outlined above if your provider is using these services to diagnose or treat your condition. If you have questions about how any specific service would be covered, please call the Aetna Concierge at (855) 784-8646.

Don’t Forget to Submit Your 2021 Medicare Part D Surcharge Reimbursement Forms!

Are you enrolled in the AlaskaCare enhanced Employer Group Waiver Plan? Are you being charged a premium for your Medicare Part D coverage? If you answered yes to both of these questions you may be eligible for reimbursement from AlaskaCare for your Medicare Part D Income Related Monthly Adjustment Amount (IRMAA).

What is an IRMAA? Certain high-income retirees are required to pay an extra premium surcharge, known as an Income Related Monthly Adjustment Amount, or IRMAA. This is similar to the surcharge for high-income enrollees in the Medicare Part B plan. If you are an individual or a married couple earning more than the threshold, you will be required to pay an extra surcharge for being enrolled in the AlaskaCare Employer Group Waiver Program (EGWP) because it is a group Medicare Part D plan. Retirees whose household income is below this threshold will not be subject to the IRMAA premium surcharge.

If you are subject to the Medicare Part D IRMAA surcharge, you will be reimbursed.

For all Medicare plans, the IRMAA will be deducted directly from your monthly Social Security check (if you qualify for Social Security) or will otherwise be invoiced to you directly each month. If you are charged a Medicare Part D IRMAA for your prescription drug coverage, the Division of Retirement and Benefits will reimburse you for the full cost of the Medicare Part D premium surcharge each month, through a tax-advantaged Health Reimbursement Arrangement (HRA) account. If you receive a bill from Medicare, you should pay the bill timely, and contact the Division to learn about your reimbursement options.

The Division of Retirement and Benefits has partnered with OptumRx and Optum Bank to create an efficient way for members to receive reimbursement for their Part D IRMAA surcharge.

What do you need to know?

• You need to set up your HRA account every year since IRMAA surcharges are based on your annual income and your income may change from year to year.
• If you are not assessed a 2022 IRMAA surcharge this does not apply to you this year.
• The deadline for submitting your 2021 IRMAA for reimbursement is December 31, 2022.

Additional Resources

• IRMAA Brochure

Join the Conversation—Retiree 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. 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 for a Town Hall event on:

• Thursday, March 17, 2022, at 10 a.m. Alaska Time
• Thursday, April 21, 2022, at 10 a.m. Alaska Time

We Value Your Feedback!

As a State of Alaska retiree, your input is valued and important. Below, please see a list of ways to contact us with your feedback. Also, a full list of AlaskaCare health plan and partner contact information can be found on our website.

AlaskaCare – Plan Administrator

• Toll Free: (800) 821-2251
• In Juneau: (907) 465-4460
• TDD: (907) 465-2805
• Fax: (907) 465-3086
• Email: doa.drb.mscc@alaska.gov

Health Benefit Contact Information

Division of Retirement and Benefits
Member Service 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