2023 Annual Enrollment Guide - Retirees
2023 ANNUALENROLLMENT GUIDEF O R P R E-65 R E T I R E E S
AnnualEnrollmentIs October17-30, 2022OCTOBER 2022Table of Contents1What’s Changing for 2023?4Annual Enrollment Checklist5 How to Make Your 2023 Benefit Elections62023 Benefit Highlights10Health Savings Account 10111Contacts12Important NoticesThis guide provides an overview of MPC’s benefits forpre-65 retirees in 2023 so you can make informeddecisions during this year’s Annual Enrollment.EnrollmentAnnual Enrollment is October 17-30, 2022.If you don’t want to make any changes, you donot have to participate in Annual Enrollment.Your current elections will roll over to 2023.However, it is important to review your elections andensure your covered dependents meet eligibilityrequirements.REMEMBER, THIS IS YOURONLY OPPORTUNITY TO MAKECHANGES TO YOUR 2023BENEFITS, UNLESS YOU HAVEA QUALIFYING LIFE EVENT.Participants have 31 days, including the dateof the event, to request a change and providesupporting documentation. Missing the 31days could have an effect on contributions,eligibility and COBRA offers.During Annual Enrollment You Can: Change your Health Plan option for 2023. Add or remove dependents from coverage for2023. Drop medical, dental, or vision for 2023 (You willnot be able to re-enroll at a later date if you dropcoverage).The Company’s policies, plans, practices and procedures maybe amended, terminated or changed at any time at the solediscretion of the Company. If that should occur, the material inthis document will be superseded and the provisions of theofficial plan documents will be followed. If there are discrepanciesbetween this document and the official plan documents, theofficial plan documents will always govern.
What’s Changing For 2023?The following changes will be effective January 1, 2023.Annual DeductiblesThe deductible for the Saver HSA Plan option will increase in 2023.Due to cost of living adjustment rules, the IRS has increased the High Deductible Health Plan minimum annualdeductible. The annual deductible for the Saver HSA plan will increase to 1,500 for those enrolled in employeeonly coverage and will increase to 3,000 for those who have dependents enrolled.The out-of-network deductible also will increase to 3,000 for those enrolled in Retiree Only coverage and willincrease to 6,000 for those who have dependents enrolled.Classic OptionIn-network benefitsDeductibleOut-of-pocket (OOP)MaximumCoinsuranceOffice VisitPreventive ServicesER ChargeSaver HSA OptionIn-network benefits 1,500 Retiree Only* 600 Individual1 3,000 Retiree Dependent(s)** 3,500 Individual 5,000 Individual 7,000 Retiree Dependent(s)1 10,000 Retiree Dependent(s)1You pay 20% after deductibleYou pay 20% after deductible 20 for primary care; 50 for specialist and urgent careYou pay 20% after deductiblePlan covers at 100% (no deductible)Plan covers at 100% (no deductible) 200 charge, then deductibleplus 20% coinsuranceDeductible, then 200 charge,then 20% coinsurance 1,200 Retiree Dependent(s)Employee Dependent(s) covers Employee Spouse/Domestic partner, Employee Child(ren) and Employee Family.Out-of-network deductible is 3,000**Out-of-network deductible is 6,0001*2023 ANNUAL ENROLLMENT GUIDE 1
Pre-65 Retiree HealthClassic and Saver HSA Monthly ContributionsRetiree contributions for both the Health Plan’s Saver HSA option and Classic option will increase for 2023.Retiree OnlyRetiree Spouse/Domestic Partner1Retiree Child(ren)Retiree FamilyClassic Option20232022 197.60 189.40 395.00 378.40Saver HSA Option20232022 108.00 103.00 210.00 201.00 395.00 378.40 210.00 201.00 592.60 567.80 342.00 328.00Kaiser Northern California and Southern California 2 Monthly ContributionsRetiree contributions will decrease for Retiree Only and increase for all other tiers in the Kaiser NorthernCalifornia Health Plan option. Retiree contributions for Retiree Family coverage will increase and all other tierswill decrease in the Kaiser Southern California option. For more plan information, please call Kaiser at 1-800278-3296.NorthernRetiree OnlyRetiree Spouse/Domestic Partner1Retiree Child(ren)Retiree Family2023 384.73 1,122.81 770.27 1,272.51Southern2022 458.41 1,100.82 736.02 1,255.232023 220.81 745.77 442.41 764.34Pre-65 Retiree DentalMonthly ContributionsRetiree contributions will remain the same for Retiree Only coverage and increase for all other tiers.Dental PlanRetiree OnlyRetiree Spouse/Domestic Partner1Retiree Child(ren)Retiree Family2023 26 50 58 822022 26 48 55 78 he IRS considers the value of Domestic Partner coverage (ifTnot a tax dependent) to be a taxable benefit, which is includedas imputed income for participants if elected.2 The Kaiser HMO option is only available to members with apermanent residence within the Kaiser California service area(N. CA or S. CA).12023 ANNUAL ENROLLMENT GUIDE 22022 322.73 819.92 528.23 613.29
Important RemindersAge 65New DependentsBenefits for members who are turning 65 will end onthe day before Medicare becomes effective (the 1stof the month in which you turn 65). If your birth dateis on the 1st of the month, Medicare will becomeeffective the previous month on the 1st. If the retireeis becoming Medicare eligible, the spouse/domesticpartner is eligible to remain in the Health Plan but theDental and Vision Plans will end. The BenefitsService Center will send instructions prior to thistransition, explaining any required actions.Dependents acquired after retirement (e.g., marriage,birth of child) will not be eligible to enroll in thepre-65 retiree benefit plans, even at the full cost ofthe plan.Members who are becoming eligible for Medicaredue to disability must enroll in Medicare Part A andPart B. Members may remain eligible for theMarathon Petroleum Health Plan, but Medicarecoverage is primary. For more information, pleasecontact a Benefit Service Center counselor at1-888-421-2199, option 1, then option 3.Waiving the Health, Dental and VisionPlansEligible retirees with a retirement date on or afterJanuary 1, 2021 have the option to waive coveragein the Retiree Health, Dental and Vision Plans atretirement and be allowed a one-time opportunity toenroll during a future Annual Enrollment period ordue to a qualifying life event, with proof of continuouscreditable coverage during the waived period. Onceenrolled into a Retiree Health, Dental or Vision Plan, ifcoverage is later dropped, there will not be a futureopportunity to enroll. A current member whoterminates participation in the Plan on or afterJanuary 1, 2021 will not be eligible to re-enroll.Printed GuidesMPC will no longer mail printed guides to pre-65retirees. All Annual Enrollment information will beposted on www.myMPCbenefits.com. Pleaseupdate your personal email address to receive futureupdates.2023 ANNUAL ENROLLMENT GUIDE 3
Annual EnrollmentChecklistRead this guide to find out what is changing in 2023.Review your current benefit elections and covered dependent(s) inBenefitSolver by visiting www.myMPCbenefits.com/mybenefits.Access detailed information about all of MPC’s benefit plans, including Summary PlanDescriptions (SPDs) and Summaries of Benefits and Coverage (SBCs) at www.myMPCbenefits.com under “Notices and Plan Documents.” If you prefer to receive aprinted copy of the SPDs or SBCs, we will provide one at no charge. Contact the Benefits ServiceCenter at 1-888-421-2199, option 1, then option 3 or email benefits@marathonpetroleum.com, torequest a copy.Change your benefit elections in BenefitSolver at www.myMPCbenefits.com/myBenefits betweenOctober 17-30, 2022. If you don’t want to make any benefit changes for 2023, you do not need to takeany action.Contact BenefitSolver by calling 1-844-408-2575 between 8am-8pm ET M-F with any questions.2023 ANNUAL ENROLLMENT GUIDE 4
Instructions ForCompleting EnrollmentFollow the instructions below tocomplete Annual Enrollment. If you donot want to make changes to yourbenefits, you do not need to take any action.1. Visit BenefitSolver at www.myMPCbenefits.com/myBenefits from any computer or smartdevice. New users must register. The MarathonPetroleum Company key is MPC.2. Once you log in, click Start Here on yourhomepage and use the Previous and Nextbuttons at the bottom of the page to movethrough each plan. Make sure your personalinformation, elections and dependentinformation is accurate and Approve yourenrollment. To finalize your enrollment, clickI Agree.3. Save or print a copy of your benefit summaryfor 2023.4. If you need to upload supportingdocumentation for a dependent (i.e., marriagelicense or birth certificate) you can upload yourdocumentation on the Action Required page,or under your To Do list on your home page.For questions, technical assistance or to enroll overthe phone, please contact BenefitSolver at 1-844408-2575.Enrollment also can be completed bydownloading BenefitSolver’s app, My ChoiceMobile. An access code is required and canbe obtained by registering or logging in toyour account.2023 ANNUAL ENROLLMENT GUIDE 5
2023 BenefitHighlightsMonthly contribution amounts for the Classic and Saver HSA Health Plan options shown beloware for retirees with 100% of the Company subsidy. Your specific rates, based on your earnedpercentage of the Company subsidy, can be found by logging in to BenefitSolver.You can find a complete list of the accrual rates on www.myMPCbenefits.com.Monthly ContributionsClassic OptionSaver HSA Option 197.60 395.00 395.00 592.60 108.00 210.00 210.00 342.00Retiree OnlyRetiree Spouse/Domestic Partner1Retiree ChildrenRetiree Family2023 Health Plan ComparisonsHealth Plan (includes Medical, Surgical, Mental Health and Substance Abuse)The deductibles in the Saver HSA Plan option will increase in 2023.Classic OptionIn-network benefitsDeductibleOut-of-pocket (OOP)Maximum2CoinsuranceOffice VisitPreventive ServicesER ChargeSaver HSA OptionIn-network benefits 600 Individual 1,500 Retiree Only 1,200 Retiree Dependent(s)3 3,500 Individual 7,000 Retiree Dependent(s) 3,000 Retiree Dependent(s)3 5,000 Individual3 10,000 Retiree Dependent(s)3You pay 20% after deductibleYou pay 20% after deductible 20 for primary care; 50 for specialist and urgent careYou pay 20% after deductiblePlan covers at 100% (no deductible)Plan covers at 100% (no deductible) 200 charge, then deductibleplus 20% coinsuranceDeductible, then 200 charge,then 20% coinsurance he IRS considers the value of Domestic Partner coverage (if not a tax dependent) to be a taxable benefit, which is included as imputedTincome for participants if elected.2Medical and prescription drug expenses will apply toward meeting the out-of-pocket maximum.3Retiree Dependent(s) covers Retiree Spouse/Domestic Partner, Retiree Child(ren) and Retiree Family.12023 ANNUAL ENROLLMENT GUIDE 6
Prescription Drugs (Rx)Marathon Petroleum’s Health Plan includes prescriptiondrug coverage, administered by Express Scripts. Thereare no changes to the prescription drug deductible, outof pocket maximums, copays or coinsurance for 2023. The prescription deductible still applies for 90-day fills made through the Express Scripts mail order option. All prescription and specialty drugs MUST be purchased through an Express Scripts participating networkpharmacy or through the Express Scripts mail-order pharmacy; otherwise, there will be no coverage from thePlan. Certain specialty drugs must be filled only through the Express Scripts specialty pharmacy, Accredo, afterthe first fill. Maintenance medications must be filled with 90-day supplies through a Walgreens pharmacy or the ExpressScripts mail-order pharmacy. Otherwise, you will pay the full cost of the medication after the second fill.SaveOnSPCovered members enrolled in the Classic option, who take certain specialty medications, can get fills for 0.See the list of included medications at www.myMPCbenefits.com.Classic Option30-Day Retail190-Day Mail Order 100 Individual/ 200 Family DeductibleRetail and mail order combinedGenericDeductible, 10Preferred BrandDeductible, 30Non-PreferredOut-of-pocket MaximumDeductible, 60Saver HSA Option30-Day Retail &90-Day Mail OrderDeductible, 25Deductible, 20%2Deductible, 75Deductible, 20%(Including Specialty)Deductible, 150Deductible, 20%Combined with medical1 o encourage the use of Mail Order or Smart90-Walgreens, there will be no coverage for the third and subsequent fills of aT“maintenance drug” purchased at other participating retail pharmacies. You will pay 100% of the cost of the medication.2 Certaingeneric preventive drugs under the Saver HSA option are covered at 100%. A list of these drugs can be found atwww.myMPCbenefits.com.2023 ANNUAL ENROLLMENT GUIDE 7
Pre-65 Retiree Dental PlanMarathon Petroleum’s Retiree Dental Plan isadministered by Delta Dental. To find a Delta DentalPPO or Premier provider in your area, call Delta Dentalat 1-800-524-0149 or go to www.deltadentaloh.com/findadentist. The largest discounts are availablethrough a PPO provider.If currently enrolled in the COBRA active employee Dental Plan, retirees also will have theopportunity to elect Pre-65 Retiree Dental at the time they voluntarily terminate COBRAdental, or at the time the COBRA period expires. Enrollment in the Retiree Dental Plan mustbe made within 31 days including the date the COBRA dental coverage ends. Once enrolledin Pre-65 Retiree Dental, if coverage is later dropped, there will not be a future opportunityto enroll.Pre-65 Retiree Dental Plan Monthly ContributionsMonthly contribution amounts will remain the same for Retiree Only coverage and increase for all other tiers.Monthly ContributionsRetiree OnlyRetiree Spouse/Domestic PartnerRetiree Child(ren)Retiree Family 26 50 58 82Pre-65 Retiree Dental Plan OverviewThere are no Plan changes in 2023.Annual Deductible: 50 per personCalendar Year Maximum: 1,000 per personType of ServiceService ExamplesCoverageExams (limited to two per year), x-rays100% (no deductible)Basic dental servicesFilling, extractions, root canals80%1 (after deductible)Major dental servicesInlays, crowns, dentures50%1 (after deductible)Orthodontia servicesNot coveredNot coveredPreventive and Diagnostic When you receive services from a nonparticipating dentist, or a Delta Dental Premierprovider, the percentages in this column indicate the portion of Delta Dental’s PPOprovider fee schedule that will be paid for those services. This amount may be lessthan what the dentist charges or Delta Dental approves and you are responsible forthat difference.12 50 individual deductible does not apply to preventive services.The Dental Plan details and the claim form can be found atwww.myMPCbenefits.com.2023 ANNUAL ENROLLMENT GUIDE 81,2
Pre-65 Retiree Vision PlanThe Marathon Petroleum Vision Plan is administered byAnthem Blue View Vision.For a list of in-network providers, call Anthem at 1-855698-5676, or visit www.Anthem.com.Blue View VisionSMIf currently enrolled in COBRA vision, retirees also will have the opportunity to elect Pre-65Retiree Vision at the time they voluntarily terminate COBRA vision, or at the time the COBRAperiod expires. Enrollment in the Retiree Vision Plan must be made within 31 days, includingthe date, the COBRA vision coverage ends. Once enrolled in Pre-65 Retiree Vision, if coverageis later dropped, there will not be a future opportunity to enroll.2023 Pre-65 Retiree Vision Plan Monthly ContributionsMonthly contribution amounts will remain the same for all coverage tiers in 2023.Monthly ContributionsRetiree OnlyRetiree Spouse/Domestic PartnerRetiree ChildrenRetiree Family 7 12 13 20Pre-65 Retiree Vision Plan OverviewThere are no plan changes in 2023.Plan FeaturesIn-NetworkOut-of-NetworkFrequency of Service Exams Lenses/Contacts FramesOnce every calendar yearOnce every calendar yearOnce every other calendar yearOnce every calendar yearOnce every calendar yearOnce every other calendar yearExamsNo copayUp to a maximum allowance of 35FramesNo copay (Up to 130 retail)Up to a maximum allowance of 45Lenses Single Vision Bifocal Trifocal 10 copay 10 copay 10 copayUp to a maximum allowance of 25Up to a maximum allowance of 40Up to a maximum allowance of 55Up to a maximum allowance of 130Up to a maximum allowance of 105This benefit applies to one order of contactlenses per calendar yearThis benefit applies to one order of contactlenses per calendar yearContact Lenses (in lieu ofprescription eyeglass lenses)A full schedule of vision benefits, includingout-of-network coverage, can be found onwww.myMPCbenefits.com.2023 ANNUAL ENROLLMENT GUIDE 9
Health SavingsAccount 101What is a Health Savings Account (HSA)?A type of savings account that lets you set asidemoney to pay for qualified health care expenses.What type of expenses does an HSA cover?Eligible items include, health plan deductibles andcoinsurance, most medical care, dental care, visioncare, prescription drugs and Medicare premiums (if65, or older). Refer to IRS Publications 969 and 502at www.irs.gov, or consult a tax professional formore information on eligible expenses.Key Features Administered by Fidelity. Triple tax advantaged account: the contributionsare tax-free, any investment earnings are tax-freeand payments for qualified health care expensesare tax-free. Contributions can be made anytime throughoutthe year.REMINDERThe Company does not make a contributionto the Health Savings Account for retirees inthe Saver HSA option. In lieu, the monthlyretiree contributions are reduced by theamount the company previously contributed.By reducing the monthly contribution,retirees realize a cost savings on their healthplan and also are able to take advantage ofthe tax savings of a full contribution to theirHSA. Please note that the IRS governs theHSA contribution limits. MPC may amendcontribution limits based on theseregulations, provided it is administrativelyfeasible. Your balance in the HSA rolls over from year to year. You can choose investments for your accountfrom a broad range of options, including a fullrange of Fidelity mutual funds, non-Fidelity fundsand individual funds.IMPORTANT HSA INFORMATION!It is the responsibility of each HSA owner toensure he or she satisfies applicable HSAeligibility rules and complies with applicablecontribution limitations. Contributions madeby ineligible owners and contributions inexcess of IRS prescribed limits are taxable tothe owner and subject to an excise taximposed on the HSA owner, unlessdistributed to the HSA owner within IRSprescribed time frames. It is the HSA owner’sresponsibility to request a distribution ofexcess contributions (including Companycontributions) within such time frames inorder to avoid the excise tax.HSA Eligibility Rules You must be enrolled in a high-deductible healthplan. You cannot be claimed as a dependent onsomeone else’s tax return. You cannot have any other medical coverage(such as through your spouse’s employer), unlessit is also an HSA-qualified, high-deductible healthplan under the IRS rules. If you or your dependents are 65 and/or Medicareeligible, special rules apply. Please consult a taxprofessional. If you are eligible for Veterans Benefits orTRICARE, special rules apply. Please consult a taxadvisor. You cannot use HSA dollars for domesticpartners, unless they are qualified taxdependents.2023 ANNUAL ENROLLMENT GUIDE 10
ContactsPlan or ServiceOnlinePhoneMobile 844-408-2575My Choice MobileCompany Key: MPC8:00 a.m. to8:00 p.m. on 1, then 3Service provider forbenefits enrollment, retireebilling and COBRA.MPC Benefits ServiceCenterAccess to Plan documents,forms and updates.www.myMPCbenefits.comReview your benefits and plan information onthe go.8:00 a.m. to5:00 p.m. ETHealth CareClassic and Saver HSAHealth Plan Optionswww.anthem.comGroup #: 212077Anthem BlueCrossBlueShield Find Providers Claims and ID Cards Pre-CertificationPrescriptionDrug ProgramExpress ripts.comGroup #: MARAPETBin #: -844-408-2575Pre-65 RetireeDental Planwww.deltadentaloh.comMy Choice MobileKaiser PermanenteFind doctors and locations, pay medical bills,schedule routine appointments and more.1-800-524-0149Delta Dental MobileAccess your ID card, find an in-networkdentist, estimate costs and check the statusof claims.Delta DentalPre-65 RetireeVision PlanExpress ScriptsReview your benefits and plan information onthe go.1-800-278-3296www.kp.orgAccess your member ID, estimate costs, finda doctor and check the status of claims.Access your member ID,find in-network pharmacies, refill and renewprescriptions and track the status of homedelivery prescriptions.Company Key: MPCKaiser PermanenteHealth PlanSydneywww.anthem.com1-866-723-0515SydneyAccess your member ID and view the statusof your claims.Anthem Blue View VisionHealth Savings Account 1-800-544-3716Change Your Current ElectionsBy October 30, 2022 You do not need to take any action if you don’t want tomake changes. New ID cards will only be provided for new enrollment.2023 ANNUAL ENROLLMENT GUIDE 11Fidelity NetBenefits
Important Notices Lose Medicaid or Children’s Health Insurance Program(S-CHIP) coverage because you are no longer eligible.You must request enrollment within60 days after the loss of such coverage.MPC is required by law to provide you with certain noticesthat inform you about your rights regarding eligibility,enrollment and coverage of health care plans.Women’s Health and Cancer Rights Act of1998 NoticeThe Women’s Health Act requires the publication ofthe following notice annually:The Plan provides mastectomy coverage and alsoprovides for reconstructive surgery in a mannerdetermined in a consultation with the attending physicianand the patient. Coverage includes reconstruction of thebreast on which the mastectomy was performed, surgeryand reconstruction of the other breast to produce asymmetrical appearance, and prostheses and treatmentof physical complications at all stages of the mastectomy,including lymphedemas.This notice is made solely to satisfy the Act’srequirements. The Health Plan has always coveredsuch procedures and in no way does this reflect a changein plan provisions.Special Enrollment NoticeSpecial enrollment events allow you and your eligibledependents to enroll for health coverage outsideof the Annual Enrollment period under certaincircumstances if you lose eligibility for other coverage,become eligible for state premium assistance underMedicaid or the State Children’s Health InsuranceProgram (S-CHIP), or acquire newly eligible dependents.This is required under the Health Insurance Portability andAccountability Act (HIPAA).If you decline enrollment in a medical plan for you or yourdependents (including your spouse/domestic partner)because of other health insurance coverage, you or yourdependents may be able to enroll in a medical planwithout waiting for the next BenefitsAnnual Enrollment period if you:To request special enrollment or obtain more information,contact the Benefits Service Centerat 1-888-421-2199.Premium Assistance Under Medicaid andthe Children’s Health Insurance Program(CHIP)If you or your children are eligible for Medicaid or CHIPand you’re eligible for health coverage from your employer,your state may have a premium assistance program thatcan help pay for coverage, using funds from theirMedicaid or CHIP programs. If you or your children aren’teligible for Medicaid or CHIP, you won’t be eligible forthese premium assistance programs but you may be ableto buy individual insurance coverage through the HealthInsurance Marketplace. For more information, visit www.healthcare.gov.If you or your dependents are already enrolled in Medicaidor CHIP and you live in a State listed below, contact yourState Medicaid or CHIP office to find out if premiumassistance is available.If you or your dependents are NOT currently enrolled inMedicaid or CHIP, and you think you or any of yourdependents might be eligible for either of these programs,contact your State Medicaid or CHIP office or dial1-877-KIDS NOW or www.insurekidsnow.gov to findout how to apply. If you qualify, ask your state if it has aprogram that might help you pay the premiums for anemployer-sponsored plan.If you or your dependents are eligible for premiumassistance under Medicaid or CHIP, as well as eligibleunder your employer plan, your employer must allow youto enroll in your employer plan if you aren’t alreadyenrolled. This is called a “special enrollment” opportunity,and you must request coverage within 60 days of beingdetermined eligible for premium assistance. If you havequestions about enrolling in your employer plan, contactthe Department of Labor at www.askebsa.dol.gov or call1-866-444-EBSA (3272). Lose other coverage. You must request enrollmentwithin 31 days, including the date of the loss of othercoverage.2023 ANNUAL ENROLLMENT GUIDE 12
If you live in one of the following states, you may beeligible for assistance paying your employer healthplan premiums. The following list of states iscurrent as of July 31, 2022. Contact your State formore information on eligibility:INDIANA — MedicaidHealthy Indiana Plan for low-income adults 19-64Website: http://www.in.gov/fssa/hip/Phone: 1-877-438-4479All other MedicaidALABAMA — MedicaidWebsite: https://www.in.gov/medicaid/Website: http://myalhipp.comPhone: 1-800-457-4584Phone: 1-855-692-5447IOWA — Medicaid and CHIP (Hawki)ALASKA — MedicaidMedicaid Website: https://dhs.iowa.gov/ime/membersThe AK Health Insurance Premium Payment ProgramMedicaid Phone: 1-800-338-8366Website: http://myakhipp.comHawki Website: http://dhs.iowa.gov/HawkiPhone: 1-866-251-4861Phone: 1-800-257-8563Email: CustomerService@MyAKHIPP.comHIPP Website: ipp HIPPMedicaid Eligibility: aspxPhone: 1-888-346-9562ARKANSAS — MedicaidKANSAS — MedicaidWebsite: http://myarhipp.comWebsite: https://www.kancare.ks.gov/Phone: 1-855-MyARHIPP (855-692-7447)Phone: 1-800-792-4884CALIFORNIA — MedicaidKENTUCKY — MedicaidWebsite: Health Insurance Premium Payment (HIPP) Programhttp://dhcs.ca.gov/hippKentucky Integrated Health Insurance Premium PaymentProgram (KI-HIPP) Website: pp.aspxPhone: 1-855-459-6328Email: KIHIPP.PROGRAM@ky.govPhone: 916-445-8322Email: hipp@dhcs.ca.govCOLORADO — Health First Colorado (Colorado’sMedicaid Program) & Child Health Plan Plus(CHP )Health First ColoradoKCHIP Website: https://kidshealth.ky.gov/Pages/index.aspxPhone: 1-877-524-4718Kentucky Medicaid Website: https://chfs.ky.govWebsite: https://www.healthfirstcolorado.com/LOUISIANA — MedicaidHealth First Colorado Member Contact Center:Website: www.medicaid.la.gov or www.ldh.la.gov/lahippPhone: 1-800-221-3943/ State Relay 711Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488(LaHIPP)CHP Website: -plan-plusCHP Customer Service: 1-800-359-1991/State Relay 711Health Insurance Buy-In Program (HIBI):Website: nce-buy-programHIBI Customer Service: 1-855-692-6442FLORIDA — MedicaidWebsite: lrecovery.com/hipp/index.htmlPhone: 1-877-357-3268Enrollment Website: hone: 1-800-442-6003TTY: Maine relay 711Private Health Insurance Premium s-formsPhone: 1-800-977-6740. TTY: Maine relay 711MASSACHUSETTS — Medicaid and CHIPWebsite: m-assistance-paPhone: 1-800-862-4840GEORGIA — MedicaidWebsite: um-payment-program-hipp– Click on Health Insurance Premium Payment (HIPP)Phone: 678-564-1162 ext 2131MAINE — MedicaidMINNESOTA — MedicaidWebsite: er-insurance.jspPhone: 1-800-657-3739MISSOURI — MedicaidWebsite: htmPhone: 573-751-20052023 ANNUAL ENROLLMENT GUIDE 13
MONTANA — MedicaidSOUTH CAROLINA — MedicaidWebsite: Website: http://www.scdhhs.govPhone: 1-800-694-3084SOUTH DAKOTA — MedicaidPhone: 1-888-549-0820NEBRASKA — MedicaidWebsite: http://dss.sd.govWebsite: http://www.ACCESSNebraska.ne.govPhone: 1-888-828-0059Phone: (855) 632-7633TEXAS — MedicaidLincoln: (402) 473-7000Website: http://gethipptexas.comOmaha: (402) 595-1178Phone: 1-800-440-0493NEVADA — MedicaidUTAH — Medicaid and CHIPMedicaid Website: http://dhcfp.nv.govMedicaid Website: https://medicaid.utah.gov/Medicaid Phone: 1-800-992-0900CHIP Website: http://health.utah.gov/chipNEW HAMPSHIRE — MedicaidPhone: 1-877-543-7669Website: https://www.dhhs.nh.gov/oii/hipp.htmPhone: 603-271-5218VERMONT— MedicaidWebsite: http://www.greenmountaincare.orgToll free number for the HIPP program:1-800-852-3345, ext 5218Phone: 1-800-250-8427VIRGINIA — Medicaid and CHIPNEW JERSEY — Medicaid and CHIPMedicaid Website: /medicaidWebsite: .coverva.org/en/hippMedicaid Phone: 609-631-2392Medicaid Phone: 1-800-432-5924CHIP Website: http://www.njfamilycare.org/index.htmlCHIP Phone: 1-800-432-5924CHIP Phone: 1-800-701-0710WASHINGTON — MedicaidNEW YORK — MedicaidWebsite: https://www.hca.wa.gov/Website: http://www.nyhealth.gov/health care/medicaidPhone: 1-800-562-3022Phone: 1-800-541-2831WEST VIRGINIA — MedicaidNORTH CAROLINA — MedicaidWebsite: http://mywvhipp.com/Website: https://medicaid.ncdhhs.gov/Toll-free phone: 1-855-MyWVHIPP
Retiree contributions will decrease for Retiree Only and increase for all other tiers in the Kaiser Northern California Health Plan option. Retiree contributions for Retiree Family coverage will increase and all other tiers will decrease in the Kaiser Southern California option. For more plan information, please call Kaiser at 1-800-278-3296.
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Aerospace Retirees’ Club (- Name of Board Member -) P.O. Box 2194 El Segundo, CA 90245 Call the ARC voicemail: 310-336-5454, Box 12582 NOTICE The expressions of opinion in the Aerospace Retirees’ Club Newsletter are the opinions of the writers and not necessarily those of the Aerospace Retirees’ Club or The Aerospace Corporation.
2, 2011 fornew retirees. Each copayment foractive employees and new retirees after September 2, 2011 is one foreach ninety (90) day supply. ii. Voluntaryfor current retirees age 65 orover. Once such individuals opt in at any open enrollment, continuing participation is mandatory. There shall be no copayments for current retirees (retired as .
Benefits, then Benefits for Retirees. Find More Retiree Benefits Information Online OHR Contact Center Telephone: 612-624-8647 Toll Free: 1-800-756-2363 hr.umn.edu/benefits. Benefits Enrollment for 2023 3 Table of Contents
Each year, Annual Enrollment is your chance to choose your ParTNers for Health plan benefits or make changes that will be effective the following Jan. 1 through Dec. 31. Your Annual Enrollment period for 2023 benefits is Oct. 1-28, 2022. This newsletter gives you important information about your 2023 benefits choices.
Each year, Annual Enrollment is your chance to choose your ParTNers for Health plan benefits or make changes that will be effective the following Jan. 1 through Dec. 31. Your annual enrollment period for 2023 benefits is Oct. 1-14, 2022. This newsletter gives you important information about your 2023 benefits choices.
2023 Retiree Premiums Fermilab continues to subsidize premiums for our retirees who are not yet eligible for Medicare. Effective . January 1, 2023, retiree contributions will go up overall 4.2%. Non-Grandfathered retirees will continue to pay 65% of the total cost of the coverage with no further increases planned.
Humira [AbbVie] Autoimmune Injection-SC Amjevita Amgen Jan. 2023 Cyltezo Boehringer Ingelheim July 2023 Hyrimoz Novartis/Sandoz Sept. 2023 Hadlima Merck/Samsung Bioepis June 2023 Abrilada Pfizer Nov. 2023 adalimumab Fresenius Kabi 3Q 2023 adalimumab Coherus BioSciences 2023 Avastin [Genen
