(This section is a Summary of Material Modifications [SMM] to the Summary Plan Description [SPD].)
The following changes to current
January 1, 2013.
Other Changes May Apply to HMO Coverage
Unless noted, the changes in this guide do not apply to Health Maintenance Organization (HMO) options. You will need to check the YBR website during the annual open enrollment period or contact the carriers of those options directly for their 2013 plan changes. Carrier contact information is located on the back of your HMO ID card and in the Benefits At-a-Glance and Resource Contact Information booklet.
New This Year:
Special Online-Only Enrollment Period
Already know what you want to elect for 2013? You will have an opportunity to make your elections — only on the YBR website — beginning Monday, October 8, 2012 through Sunday, November 4, 2012. The chart at right shows the timing for enrolling in and/or changing your coverage during the annual open enrollment period:
| From: | Monday, October 8, 2012 at 9:00 a.m., ET, through Sunday, November 4, 2012 |
Monday, November 5, 2012 at 9:00 a.m., ET, through Friday, November 16, 2012 at 5:00 p.m., ET |
|---|---|---|
| You may: | View your coverage and costs and make your elections on the YBR website. You will not be able to call the |
View your coverage and costs and make your elections on the YBR website. You may also call the |
| Be sure to take action before Friday, November 16, 2012 at 5:00 p.m., ET. Late enrollments will not be accepted. | ||
Medical Cost Increase for 2013
If you retired after March 1, 1990, your costs for medical coverage, which are calculated as a percentage of your pension, will increase for 2013. The amount of your increase for 2013 is based on whether or not you cover any dependents and whether or not you are eligible for Medicare. Review the YBR website during the annual open enrollment period for your 2013 premium costs.
Annual Out-of-Pocket Maximum Amounts for Medical Coverage
For 2013, there will be changes to the out-of-pocket maximum amounts for all of the medical coverage options. As a reminder, the annual out-of-pocket maximum for your medical coverage is the maximum amount you pay out of your pocket for medical services during the year, before the Plan begins to pay 100 percent of your costs for the remainder of the year.
The chart below shows the changes for each of the plans.
| 2012 Annual Out-of-Pocket Maximum | 2013 Annual Out-Of-Pocket Maximum | |||
|---|---|---|---|---|
| Point of Service (POS) | In-Network |
Out-of-Network |
In-Network |
Out-of-Network Individual: $4,000 Two-person: $8,000 Family: $12,000 (excludes deductible) |
| Traditional Indemnity | Individual: $1,500 Two-person: $3,000 Family: $4,500 (excludes deductible) |
Individual: $1,600 Two-person: $3,200 Family: $4,800 (excludes deductible) |
||
UnitedHealthcare Group Medicare Advantage (PPO) |
$1,500 per individual |
$1,600 per individual |
||
| For more information about how coverage works, see the Benefits At-a-Glance and Resource Contact Information booklet. | ||||
Medco and Express Scripts Are Now One Company
The combined company is in the process of changing the name on all communications to Express Scripts. Beginning on October 1, 2012, the new member website will be www.express-scripts.com. Until the renaming process is complete, you will sometimes see the Medco name in your prescription drug communications and online.
Please continue to refill your prescriptions as you normally would by using your current prescription drug ID card, refill order forms, the member website or the toll-free member services telephone number on your ID card.
Expanded Medco/Express Scripts Prescription Drug Coverage Management Programs
As part of
Prescription Drug Coverage
For 2013, there will be changes to the annual in-network out-of-pocket maximum, as well as retail and mail-order copayment amounts.
The chart below shows the changes for 2013:
| 2012 Prescription Drug Coverage | 2013 Prescription Drug Coverage | |
|---|---|---|
| Prescription Drug Annual Out-of-Pocket Maximum (in-network only; excludes deductible) |
$1,500 per individual | $1,600 per individual |
| Retail Copayments (up to 30-day supply using an in-network pharmacy) |
Generic: $10 Formulary: $33 Non-Formulary: $55 |
Generic: $10 Formulary: $35 Non-Formulary: $60 |
| Mail-Order Copayments (up to 90-day supply) |
Generic: $25 Formulary: $82.50 Non-Formulary: $137.50 |
Generic: $25 Formulary: $87 Non-Formulary: $150 |
| For more information about how coverage works, see page 6 of the Benefits At-a-Glance and Resource Contact Information booklet. | ||
Long-Term Care Insurance (LTCI): Enrollment Deadline Extended to December 31, 2012
Good news! The deadline for enrollment in the LTCI program has been extended to December 31, 2012. This means that eligible retirees and family members will continue to have the opportunity to enroll in the MetLife LTCI program until December 31, 2012. After December 31, 2012, the LTCI program will be closed to new entrants.
If you are not currently enrolled in LTCI, you must request your enrollment kit from MetLife no later than November 30, 2012. Your completed application must be received by MetLife no later than December 31, 2012.
If you are interested in learning more about LTCI, or requesting an enrollment kit, please contact MetLife at
New-Look YBR Website
The YBR website was updated in May 2012. If you have not been to YBR since the update, you will notice some enhancements.
You will be prompted to indicate whether you would prefer to receive communications from the
Please note: Your election for receipt of communications on the YBR website will not impact the method of delivery for your annual open enrollment communication materials.
Premium Costs
Review the YBR website during the annual open enrollment period for your 2013 premium costs.
New for Participants Who Receive a Form W-2
The Affordable Care Act (healthcare reform law) requires that employers disclose the value of the employer-provided benefit for health insurance coverage on each participant's Form W-2. This means that plan participants who receive a 2012 Form W-2 from
Annual Open Enrollment Is Going Green
As part of our corporate environmental commitment, more of your benefit information is available to you online instead of in print.
1 Including COBRA participants and survivors in the Family Security Program (FSP).