U.S. Retirees 2018 Health Care Guide for Annual Enrollment
Welcome to Annual Enrollment for your 2017 health care coverage. This is your opportunity to evaluate your current coverage and determine whether you need to make changes — particularly if your circumstances or health have changed over the last year.
Review the information in this guide to become familiar with the 2017 medical and prescription drug plan options, the plan changes that are being made for 2017, and how to make a coverage change for Jan. 1, 2018.
U.S. Retirees: HealthCare Brochure for Annual Enrollment
Pfizer remains committed to supporting your health by offering you and your eligible dependents coverage through the Pfizer Retiree Medical Plan. We also want to ensure that you have the information you need to make informed decisions, both during Annual Enrollment and as you use your benefits throughout the year. We are making some changes to our retiree health care benefits for 2018 that you may want to consider as you choose your coverage for the upcoming year. Following is a summary of changes, shown separately for non-Medicare-eligible retirees and retirees who are Medicare-eligible.
Changes for Non-Medicare-Eligible Retirees
For retirees and covered dependents who are not eligible for Medicare, the choice of plan options (the Retiree PPO or the High-Deductible PPO) as well as claims administrators (UnitedHealthcare (UHC) or Horizon Blue Cross Blue Shield (Horizon)) remains unchanged.
Effective 2018, there will be a few key changes to your benefits that you should be aware of. Information on additional changes is included in the enclosed benefits brochure.
What’s Changing January 1, 2018
Annual deductibles will increase under both Plan options.
Retiree PPO Plan
In-network deductible is increasing from $700 individual / $1,750 family to $800 individual / $2,000 family; and
Out-of-network deductible is increasing from $1,400 individual / $3,500 family to $1,600 individual / $4,000 family.
High-Deductible PPO Plan
In-network deductible is increasing from $3,000 individual / $7,500 family to $3,300 individual / $8,250 family; and
Out-of-network deductible is increasing from $6,000 individual / $15,000 family to $6,600 individual / $16,500 family.
Contributions are increasing for the Retiree PPO Plan and High-Deductible PPO Plan. Your 2018 contribution amounts will be shown on your Personal Fact Sheet (PFS), which is being mailed to you separately at the same time as this mailing.
Changes for Medicare-Eligible Retirees
For retirees and covered dependents who are eligible for Medicare, the choice of plan options and claims administrator remains the same, however, there are some changes and enhancements you should be aware of.
What’s Changing January 1, 2018
Diabetic supplies (e.g., test strips and glucose meters) that are covered under Medicare Part B, are currently being covered under both the UnitedHealthcare (UHC) Medicare Advantage Plans and SilverScript prescription drug coverage. Effective Jan. 1, 2018, diabetic supplies will only be covered under the UHC Medicare Advantage Plan and will no longer be covered under your SilverScript prescription drug coverage.
If you are currently enrolled in the Prescription Drug-Only option, you will no longer have coverage for Medicare Part B diabetic supplies through your Pfizer prescription drug coverage. Instead, diabetic supplies will only be covered under your Medicare Part B coverage.
Note: Diabetic medications, such as insulin, will continue to be covered under your Pfizer prescription drug coverage.
As previously communicated in June 2017, Pfizer made temporary coverage enhancements to the Pfizer Medicare Advantage Plans that will reduce costs and expand coverage for you and any covered Medicare-eligible dependents. These changes took effect on Jul. 1, 2017, and will continue through Dec. 31, 2018. As a reminder, they are described in the U.S. Retirees 2018 Health Care Brochure for Annual Enrollment, which is included in this package.
Effective Jan. 1, 2018, there will be one additional temporary coverage enhancement. The copay for Medicare Part B medications is being reduced from $35 to $25 under both Medicare Advantage options. This reduction will be in effect through Dec. 31, 2018. See page 12 of the U.S. Retirees 2018 Health Care Brochure for Annual Enrollment for details.
There will be contribution increases to all plan options. Your 2018 contribution amounts will be shown on your Personal Fact Sheet (PFS), which is being mailed to you separately at the same time as this mailing.
For All Pfizer Retirees
Validate Eligibility and Coverage for Your Dependents
You are required to validate that your dependents covered under Pfizer’s Retiree Medical Plan meet the Pfizer dependent eligibility requirements during Annual Enrollment. During first quarter 2018, Pfizer will be conducting a random audit of covered dependents to ensure they meet Pfizer’s eligibility requirements. During the audit, proof of eligibility will be required for continued coverage. If you do not provide proof of eligibility, your dependent will lose coverage and retirees found to be covering ineligible dependents may be subject to loss of retiree medical coverage.
Review the Pfizer Retiree Medical Summary Plan Description (SPD) for more details about dependent coverage and eligibility. The SPD can be found in the Reference Library on netbenefits.com. Click the Health & Insurance section on the home page, and then click Quick Links and Reference Library.
Evaluating Your Pfizer Coverage
Pfizer recognizes that you may find other coverage that is less costly than Pfizer’s coverage. If you choose to drop your Pfizer coverage, you may re-enroll within 31 days of an IRS qualifying life event or during a subsequent Annual Enrollment period, as long as you maintain continuous creditable medical and prescription drug coverage while not enrolled in the Pfizer Plan.
If you need help making enrollment elections or navigating your health care options, or if you are a caregiver arranging power of attorney for your patient, call the Pfizer Benefits Center at 1-877-208-0950. Representatives will be available to assist you Monday through Friday from 8:30 a.m. to Midnight, Eastern time.
Materials in This Package
Following is a list of materials included in this package:
U.S. Retirees 2018 Health Care Brochure for Annual Enrollment, which outlines your 2018 medical (including prescription drug) and vision coverage, enrollment information, resources and more;
The Pfizer Zero Cost Prescription Drug List showing the 2018 Pfizer medications (including Greenstone generics) dispensed through a pharmacy that are covered at no cost to you;
Legal Notices Booklet with information about your rights under your plans; and
Making Your 2018 Retiree Medical Coverage Election Online Tip Sheet with step-by-step instructions and screenshots of how to enroll online.
As a reminder, if you or your covered dependent(s) are eligible for Medicare, you will also receive information from UHC and SilverScript directly, concerning your Medicare Advantage and SilverScript coverage.
Annual Enrollment is from Oct. 10 – Oct. 27, 2017. Review the enclosed benefits information so you can select the right coverage for you and your family. During this time, you can enroll online at netbenefits.com or call the Pfizer Benefits Center at 1-877-208-0950, Monday through Friday from 8:30 a.m. to Midnight, Eastern time.