2023 Retiree Benefit Plan Changes - Vbgov

2023Retiree BenefitPlan ChangesOpen Enrollment is your opportunity to review your coverage and makechanges and/or elections for the upcoming plan year to fit your needs and theneeds of your family. It is also the time to add eligible dependents or removedependents, and your changes will be effective January 1, 2023. Review thefollowing pages for important benefit changes effective January 1, 2023.ENROLLOpen Enrollment is October 3 - October 17, 2022VISIT vbgov.com/benefits/enrollDOWNLOAD the Benefitplace App

Changes for Retired EmployeesWhat’s changing in 2023Be sure to review benefit changes noted in the following pages and take a fresh look at yourbenefits. On Monday, October 3 – Monday, October 17, 2022, make desired changes to yourbenefits and covered dependents for the 2023 plan year (see back cover for information onHow To Enroll). This year’s Open Enrollment will be a passive enrollment, meaning the followingbenefit(s) will continue as currently elected (roll-over) for January 1, 2023:Health DentalYou are required to elect certain benefits on the BENEFITFOCUS platform to have coverage forthe upcoming plan year. The following benefit(s) must be elected to have coverage during 2023:Health Savings Account (HSA)Changes coming to the following benefit plans:Health Plan p2Health Savings Account (HSA) p6Health Plan UpdatesHealth: Optima HealthPharmacy ChangesPharmacy Benefit ManagerThe pharmacy benefit manager under Optima Health has changed to Express Scripts.This change is seamless to you – same plan design and there is no need to obtain newprescriptions!Preferred network pharmaciesAdditional pharmacies have been added to the preferred network list of pharmacies. Theseinclude Kroger, Rite-Aid, and more!Diabetic SuppliesThe following will be covered under the pharmacy benefit instead of your medical benefitservices:1. Continuous glucose monitors2. Diabetics testing supples (test strips, lancets, lancet supplies, control supplies)Vision Care ChangesOptima Health has changed their Vision provider to Vision Services Plan (VSP). The plan designis not changing.Mental Health and Substance Use Disorder ServicesDue to the Mental Health Parity Act, mental health benefits will be covered separately fromMedical/Surgery Benefits.2

Retiree RatesCity of Virginia Beach Health Plan PremiumsThere are no Health plan premium changes for retirees with a health plan employer contribution.However, retirees without an employer contribution toward health plan premiums may see anincrease to their premiums.CITY RETIREE PREMIUMS WITH1 EMPLOYER CONTRIBUTION (MONTHLY RATE)LEVEL OF COVERAGECDHPPOSSubscriber Only 121.59 256.24Subscriber 1 Child 178.53 373.76Subscriber Children 255.19 531.22Subscriber Spouse 543.27 857.00Family 630.18 1,035.46CITY RETIREE PREMIUMS WITHOUT1 EMPLOYER CONTRIBUTION (MONTHLY RATE)CDHPPOSSubscriber Only 854.01 986.75Subscriber 1 Child 1,238.16 1,430.62Subscriber Children 1,750.34 2,022.42Subscriber Spouse 1,974.59 2,281.52Family 2,555.06 2,952.21LEVEL OF COVERAGE1Eligibility information can be found in the Retiree Benefits Guide.Virginia Beach City Public Schools Health Plan PremiumsTo further their commitment to make substantial progress on health care costs, the schoolsinvested additional operating funds to lower health insurance premiums next year by as much as53% as compared to 2022. (Note, retirees without an employer contribution toward health planpremiums may see an increase to their premiums.)SCHOOL RETIREE PREMIUMS WITH1 EMPLOYER CONTRIBUTION (MONTHLY RATE)LEVEL OF COVERAGECDHPPOSSubscriber Only 69.31 146.06Subscriber 1 Child 101.76 213.04Subscriber Children 145.46 302.80Subscriber Spouse 309.66 488.49Family 359.20 590.21SCHOOL RETIREE PREMIUMS WITHOUT1 EMPLOYER CONTRIBUTION (MONTHLY RATE)CDHPPOSSubscriber Only 826.53 955.00Subscriber 1 Child 1,198.31 1,384.58Subscriber Children 1,694.02 1,957.33Subscriber Spouse 1,911.05 2,208.10 2,472.84 2,857.21LEVEL OF COVERAGEFamily1Eligibility information can be found in the Retiree Benefits Guide.3

2023 Optima Health Plan Comparison Summary of BenefitsPLAN FEATURESDeductibles3(per calendar year)HSA Employer Funding1Maximum Out-of-Pocket(MOOP)(per calendar year)Consumer Driven Health PlanCDHPPoint of ServicePOS*Non-embedded: Must meet the Family Deductible/Out-of-Pocket Max if enrolled in any tier other thanSubscriber Only.**Embedded: If one family member meets the individualdeductible, their benefits will begin. Once familydeductible is met, benefits are available to all members.Optima In-Network/PHCS NetworkOut-of-NetworkOptima In-Network/PHCS NetworkOut-of-Network 2,000 per individual* 4,000 per family* 4,000 per individual* 8,000 per family* 850 per individual** 1,700 per family** 1,700 per individual** 3,400 per family** 750 Subscriber Only / 1,250 All Other TiersN/A 4,500 per individual* 9,000 per family* 7,250 per individual* 14,500 per family* 3,000 per individual** 6,000 per family** 4,500 per individual** 9,000 per family**100% 2Covered at 50% A D100% 2Covered at 60% A DCovered at 100% ADNot CoveredCovered at 100% 2Not CoveredSQCN 3 , 5 PCP/Non-SQCN PCPCovered at 90% AD / 80% A DCovered at 50% A D 20 Co-pay 2 / 40 Co-pay 2Covered at 60% A DSQCN 3 , 5 Specialist/Non-SQCN SpecialistCovered at 90% AD / 80% A DCovered at 50% A D 40 Co-pay 2 / 60 Co-pay 2Covered at 60% A DSQCN 3 , 5 Maternity Care/Non-SQCN Maternity CareCovered at 90% AD / 80% A DCovered at 50% A D 350 Co-pay 2 / 500 Co-pay 2Covered at 60% A DInpatient & OutpatientHospital3Covered at 80% ADCovered at 50% A DCovered at 85%ADCovered at 60% A DDiagnostic (x-ray, lab work) 3& Imaging (CT/PET/MRI)Covered at 80% ADCovered at 50% A DCovered at 85%ADCovered at 60% A DEmergency Room 3Covered at 80% ADCovered at 80% A DCovered at 85%A DCovered at 85% A DUrgent Care 3Covered at 80% ADCovered at 50% A DCovered at 85%Covered at 60%Preventive CareMDLIVE 3 ,4 (virtual consult)For a complete list of covered services, please review the Summary of Benefits at vbgov.com/benefits.Preferred Pharmacy6 (Preferred Pharmacies include: Walgreens, Wal-Mart, Cardinal-Leadernet, Kroger, EPIC, Rite Aid, SHA in VA, Ahold, Sam’s Club, Publix,Costco, Wegmans, Albertsons, Safeway, Arete, Sentara Pharmacies, and more. Review the Summary of Benefits for details.)Tier 1 3 , 8 10 Co-pay A D 10 Co-pay 2Tier 2 3 , 8 25 Co-pay A D 25 Co-pay 2Tier 3 3 , 7, 8Covered at 75% A D (Max 50)Covered at 75% 2 (Max 50)Tier 1 3 , 8 25 Co-pay A D 25 Co-pay 2Tier 2 3 , 8 45 Co-pay A D 45 Co-pay 2Tier 3 3 , 7, 8Covered at 75% A D (Max 75)Covered at 75% 2 (Max 75)Covered at 75% A D, 3 (Max 200)Covered at 75% 2, 3 (Max 200)Non-Preferred Pharmacy6Specialty Pharmacy6NOTESADAfter Deductible (deductible must be paid first before the plan will providecoverage as indicated).5Sentara Quality Care Network (to see if your doctors are part of SQCN visitOptimaHealth.com. Look for doctors with a “SQCN” logo next to their name).1You do not have to be enrolled in health plan coverage to be eligible for the HealthCare FSA; You may not be enrolled in both an HSA and a Health Care FSA.62Deductible does not apply to this service (plan will provide coverage as indicatedand before the deductible has been met).Closed Formulary Prescription Drug Benefit (contains specific drugs in each drug class. Nonformulary medications must meet medical necessity criteria through an exception process to becovered).7Or the plan’s negotiated cost of the drug, if less.3Applies toward Maximum Out-Of-Pocket (MOOP) (separate in and out of networkMOOP).4MDLIVE virtual consult services available with health plan enrollment. For the CDHP,the cost is currently 39 before you meet your deductible (cost subject to changeduring 2023).48Please note: Prescription medications used to prevent any of the following medical conditionsare not subject to the deductible including medications for hypertension, high cholesterol,diabetes, asthma, osteoporosis, stroke, prenatal nutrient deficiency.

Dental: MetLifeDental PlanThere are no changes to premiums or plan design.DENTAL PLAN PREMIUMS(MON TH LY RATE )LEVEL OF COVERAGESILVERGOLDSubscriber Only 21.35 35.07Subscriber 1 Child 34.17 55.64Subscriber Children 45.20 73.69Subscriber Spouse 45.20 73.69Family 68.17 111.69Summary of Dental Plan CoverageThese deductibles and coverage levels reflect the Preferred Dentist Program (PDP) in-network care, and planfrequency limitations apply (for example, 2 cleanings per calendar year, etc.). Out-of-network care, deductibles, andcoverage levels are different. You can see those values in the full Dental Guide on the CBO website.METLIFE SILVERMETLIFE GOLDIn-NetworkIn-Network 75 Individual 225 Family 50 Individual 150 Family 1,000 1,300Type A - Prophylaxis/cleanings, oral examinations,topical fluoride applications, space maintainers, x-rays(bitewings), brush biopsies100% of Negotiated Fee1100% of Negotiated Fee1Type B - Fillings, simple extractions, repair of crown,denture and bridge, pulp caps/pulpotomy, periodontics(nonsurgical), sealants, x-rays (full mouth)60% of Negotiated Fee180% of Negotiated Fee1Type C - Bridges, dentures, endodontics (other thanpulp caps/pulpotomy), crowns, inlays/onlays, implants,oral surgery, periodontics (surgical)30% of Negotiated Fee150% of Negotiated Fee1Type D - Orthodontic Diagnostics, orthodontictreatmentNo Coverage50% of Negotiated Fee1Orthodontia Lifetime Maximum Per PersonNo Coverage 1,000Deductible (applies only to type B & C services)Annual Maximum Benefit per calendar year1Negotiated Fee refers to the fees that participating dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and benefits maximums.Negotiated fees are subject to change.5

HSA: HealthEquityHealth Savings Account (HSA)For a list of eligible expenses, easy to understand videos, and calculators, visit healthequity.com.CDHP (Consumer Driven Health Plan) Employer ContributionAnyone who elects the CDHP and, after confirming eligibility, elects a Health Savings Account(HSA) will receive an annual employer contribution into their HSA up to the following amounts:Subscriber OnlyAll Other Tiers 750 1,250Subscriber & child, subscriber & children, subscriber &spouse, subscriber & familyPlan LimitsThe IRS has increased the HSA contribution limits for 2023 to:Subscriber Only 3,850Family 7,750You may fund your HSA on a post-tax basis by transferring money into your account through the HealthEquitymember portal. For those who are age 55 or older, the age catch-up remains the same & you may contribute anadditional 1,000 in addition to the allowed contribution limits.6

How Does CBO Keep in Touch?How Does CBO Keep in Touch?The Consolidated Benefits Office communicates important benefit information and updatesdifferently for retirees!AS AN ACTIVE EMPLOYEE YOU RECEIVED:AS A RETIREE YOU WILL RECEIVE:Semi-Monthly e-BulletinsQuarterly Retiree NewslettersQuarterly BEWell BeatQuarterly BEWell BeatIntranet site(vbcps.sharepoint.com or Beachnet)vbgov.com/benefitsVisit this page frequently for benefit materials,newsletters, and announcements.IMPORTANTPlease Keep Your Contact Information CurrentBenefit vendors and the CBO will use your address on file to mail/emailyou important documents and other information. To update your contactinformation, please complete the Retiree Name and Contact ChangePacket available on the retiree page of vbgov.com/benefits.7