Why Save Now

The ability to pay for medical costs in retirement is one of society’s largest and most complex issues. Increases in health care costs have consistently outpaced the general inflation rate as measured by the Consumer Price Index (CPI). In addition, people are also living longer, which tends to increase individual medical costs. Because of these high costs, many employers are cutting back their health insurance subsidies for retirees.

This poses a problem to many retirement-eligible individuals who want to retire, but have drastically underestimated what health care will cost and how access to health care will be determined. The Emeriti Program provides a way for you to start saving now in preparation for such health care expenses in retirement.

Within the academy, retirement plans, tax-deferred savings and Social Security benefits were generally intended to replace 70%–80% of current income. Rising health care costs have pushed the savings requirement even higher.

Why Medicare Isn’t Enough

Medicare Part A and Part B cover just over 50% of the average retiree’s total health care expenses. Benefits are limited—particularly for catastrophic illnesses—and coverage restrictions may expose individuals to potentially devastating medical expenses¹. The Medicare Part D prescription drug benefit has been added to Medicare to cover prescription drugs, but individuals will still have to pay a substantial share of the total costs. When you take into account premiums, deductibles, coinsurance and copays, plus other out-of-pocket expenses, quite a lot may not be covered by Medicare.

As a result, you may need to pay for close to half of health care expenses for you and your dependents from your own personal resources. And if the pressures on Medicare require it to reduce benefits, your share may increase. It’s important to start saving as early as possible, because the longer you wait, the more you may need to save.

By 2010, retirees on average can be expected to spend close to 25% of their after-tax income on health care spending2.

A Fidelity Investments study estimates that a couple retiring in 2008 at age 65 without an employer-sponsored retiree health plan would require $225,000 in savings to cover their insurance premiums and other out-of-pocket retirement medical expenses.

¹ The Employee Benefit Research Institute (EBRI) estimates, Issue Brief No. 295, July 2006, Savings Needed to Fund Health Insurance and Health Care Expenses in Retirement, by Paul Fronstin, EBRI.

² Johnson & Penner, Will Health Care Costs Erode Retirement Security?, Boston College, 2004.

Contributing to Your Account

Employer
When your institution becomes a member of the Emeriti® Retirement Health Solutions consortium, it makes contributions to an Emeriti Health Account on your behalf (at a specified age). Such contributions are held in tax-advantaged trusts called VEBAs (Voluntary Employees Beneficiary Association) serviced by Fidelity Investments. Contributions are made tax free, and all contributions plus any earnings are disbursed tax free for retiree health benefits. After you retire, you can use your funds exclusively to pay for health insurance and many other qualified medical expenses.

Employee
If your institution’s plan allows, you can make voluntary contributions to your Health Account. There are no limits on contributions, and you can contribute even if you have contributed the maximum amount to your 403(b) or 401(k) plans. There is also no minimum distribution requirement. Employee voluntary contributions are made after-tax, and all assets including earnings accumulate tax free and are paid out tax free for retiree health benefits.

You can make voluntary contributions through transfers from your bank account in amounts of $100 or more.

The Triple Tax Advantage

* Call 1-866 EMERITI or check your Summary Plan Description to see if your employer offers this option. Under federal law, institutions with 50 or fewer employees cannot allow employee voluntary contributions.

Using Your Account

Accumulated Assets Can Be Used for Two Purposes:

Your Account in Retirement

If your institution’s plan does not permit voluntary employee contributions, or if there is an insufficient balance in your account to pay for insurance premiums, you will need to pay for Emeriti Health Insurance Plan premiums by setting up electronic fund transfers from your bank account to your Health Account.

During your retirement, you can make lump sum or periodic contributions as often as monthly; the minimum contribution is $100 per month. You may want to contribute this way if you can make contributions far enough in advance of withdrawals to take advantage of potential gains, which are tax free. Contributing and then withdrawing may not work to your advantage; remember that share price, yield and return will vary, and you may have investment earnings or loss when you sell your shares.

When you enroll in one of the Emeriti Health Insurance Plan Options, the same Emeriti Specialist will work with you to set up your payment method decisions. Even if you do not plan to enroll in any of the Emeriti Health Insurance Plan Options, you may want to contribute to your Health Account to pay for qualified medical expenses including any other insurance premiums, if your Institution's Plan allows employee contributions². You can call an Emeriti Specialist to:

¹ Depending on the organization, your employer's contributions may include amounts in lieu of compensation or other benefits. For example, your employer may have reduced employee salaries, limited salary increases, or reduced contributions to its retirement plan to help finance employer contributions. Such amounts are treated as employer contributions for tax purposes (i.e., they are exempt from tax).

² Subject to certain restrictions. Under federal law, institutions with 50 or fewer employees cannot allow employee voluntary contributions.

One of the benefits available to you now, while you are mid-way through your career and currently employed, is your Emeriti Health Account, a tax-advantaged way to invest today to help pay for your medical costs in retirement.

If you are age 40 or 50 or so, it’s not too late to potentially build up a significant amount of money in your Emeriti Health Account, but start as soon as you can. It really does not re­quire a lot of money to potentially benefit from compounding of earnings. If you have time on your side, and you can invest even a modest amount every year, you could do as well as or better than the person who waits until she/he can afford to contribute “enough” each month. And remember that you pay no taxes on any of that money as you withdraw it to pay for qualified health expenses in retirement.

How the Program Works While You are Employed

Your institution will begin making contributions to your Emeriti Health Account when you reach the age specified in your plan. (Talk with your benefits administrator for details.) These employer contributions and earnings accumulate tax free and are paid out tax free in retirement. You also have the opportunity to make voluntary contributions at any time, either through regular payroll deduction or with electronic transfers. Your voluntary contributions are made after tax, but as with employer benefits, they accrue tax free and the total accumulation is paid out tax free in retirement to cover the costs of health care for you and your dependents.

The Emeriti Program offers a choice of the Fidelity Freedom Funds® and the Fidelity Retirement Money Market Portfolio for investing the assets in your Emeriti Health Accounts.

Your Next Steps

You can request a more detailed information kit by calling 1–866–EMERITI (1–866–363–7484) Monday through Friday, 8AM–9PM ET; 5AM–6PM PT.

If you’re ready to start making voluntary contributions, call 1–866–EMERITI. Contributions to your Emeriti Health Account can be made via payroll deduction or through electronic transfers that you initiate from your bank account. An Emeriti Service Center Specialist will help guide you through the steps, including determining your investment choices and designating your eligible dependents.

Why Save Now

The ability to pay for medical costs in retirement is one of society’s largest and most complex issues. Increases in health care costs have consistently outpaced the general inflation rate as measured by the Consumer Price Index (CPI). In addition, people are also living longer, which tends to increase individual medical costs. Because of these high costs, many employers are cutting back their health insurance subsidies for retirees.

This poses a problem to many retirement-eligible individuals who want to retire, but have drastically underestimated what health care will cost and how access to health care will be determined. The Emeriti Program provides a way for you to start saving now in preparation for such health care expenses in retirement.

Within the academy, retirement plans, tax-deferred savings and Social Security benefits were generally intended to replace 70%–80% of current income. Rising health care costs have pushed the savings requirement even higher.

Why Medicare Isn’t Enough

Medicare Part A and Part B cover just over 50% of the average retiree’s total health care expenses. Benefits are limited—particularly for catastrophic illnesses—and coverage restrictions may expose individuals to potentially devastating medical expenses¹. The Medicare Part D prescription drug benefit has been added to Medicare to cover prescription drugs, but individuals will still have to pay a substantial share of the total costs. When you take into account premiums, deductibles, coinsurance and copays, plus other out-of-pocket expenses, quite a lot may not be covered by Medicare.

As a result, you may need to pay for close to half of health care expenses for you and your dependents from your own personal resources. And if the pressures on Medicare require it to reduce benefits, your share may increase. It’s important to start saving as early as possible, because the longer you wait, the more you may need to save.

By 2010, retirees on average can be expected to spend close to 25% of their after-tax income on health care spending2.

A Fidelity Investments study estimates that a couple retiring in 2008 at age 65 without an employer-sponsored retiree health plan would require $225,000 in savings to cover their insurance premiums and other out-of-pocket retirement medical expenses.

¹ The Employee Benefit Research Institute (EBRI) estimates, Issue Brief No. 295, July 2006, Savings Needed to Fund Health Insurance and Health Care Expenses in Retirement, by Paul Fronstin, EBRI.

² Johnson & Penner, Will Health Care Costs Erode Retirement Security?, Boston College, 2004.

Contributing to Your Account

Employer
When your institution becomes a member of the Emeriti® Retirement Health Solutions consortium, it makes contributions to an Emeriti Health Account on your behalf (at a specified age). Such contributions are held in tax-advantaged trusts called VEBAs (Voluntary Employees Beneficiary Association) serviced by Fidelity Investments. Contributions are made tax free, and all contributions plus any earnings are disbursed tax free for retiree health benefits. After you retire, you can use your funds exclusively to pay for health insurance and many other qualified medical expenses.

Employee
If your institution’s plan allows, you can make voluntary contributions to your Health Account. There are no limits on contributions, and you can contribute even if you have contributed the maximum amount to your 403(b) or 401(k) plans. There is also no minimum distribution requirement. Employee voluntary contributions are made after-tax, and all assets including earnings accumulate tax free and are paid out tax free for retiree health benefits.

You can make voluntary contributions through transfers from your bank account in amounts of $100 or more.

* Call 1-866 EMERITI or check your Summary Plan Description to see if your employer offers this option. Under federal law, institutions with 50 or fewer employees cannot allow employee voluntary contributions.

Using Your Account

Accumulated Assets Can Be Used for Two Purposes:
1. To pay for Emeriti Health Insurance Plan premiums when you retire
2. To pay for any other qualifying medical expenses for yourself, your spouse, and eligible dependents. These expenses include insurance deductibles and coinsurance; Medicare premiums; vision, dental, and hearing costs; over-the-counter drugs; long-term care insurance or at-home medical care and premiums for other pre- or post-65 retiree medical insurance.

Your Account in Retirement
If your institution’s plan does not permit voluntary employee contributions, or if there is an insufficient balance in your account to pay for insurance premiums, you will need to pay for Emeriti Health Insurance Plan premiums by setting up electronic fund transfers from your bank account to your Health Account.

During your retirement, you can make lump sum or periodic contributions as often as monthly; the minimum contribution is $100 per month. You may want to contribute this way if you can make contributions far enough in advance of withdrawals to take advantage of potential gains, which are tax free. Contributing and then withdrawing may not work to your advantage; remember that share price, yield and return will vary, and you may have investment earnings or loss when you sell your shares.

When you enroll in one of the Emeriti Health Insurance Plan Options, the same Emeriti Specialist will work with you to set up your payment method decisions. Even if you do not plan to enroll in any of the Emeriti Health Insurance Plan Options, you may want to contribute to your Health Account to pay for qualified medical expenses including any other insurance premiums, if your Institution's Plan allows employee contributions². You can call an Emeriti Specialist to:

¹ Depending on the organization, your employer's contributions may include amounts in lieu of compensation or other benefits. For example, your employer may have reduced employee salaries, limited salary increases, or reduced contributions to its retirement plan to help finance employer contributions. Such amounts are treated as employer contributions for tax purposes (i.e., they are exempt from tax).

² Subject to certain restrictions. Under federal law, institutions with 50 or fewer employees cannot allow employee voluntary contributions.

Now that you are nearing retirement, you will want to think about your retiree health care coverage needs.  The good news is that you will soon be eligible for Medicare, the primary medical benefit program for retirees over 65.  Medicare provides an excellent foundation for the health care coverage needs of retirees, and it is very important that you enroll as soon as you become eligible. 

Unfortunately, there are many health expenses that Medicare doesn’t cover completely, and others, such as vision, dental and hearing services, and long term care, where it provides no benefit.  Generally, Medicare is estimated to cover about 50-60% of your health care expenses in retirement, with the balance covered by private insurance and by your own out-of-pocket expenditures. 

Because medical expenses are a growing and significant expense for most retirees, it is essential that you understand what role Medicare plays, what it does not cover, what cost share responsibilities and financial exposure you will have for your health care, and how you can choose wisely among a bewildering array of options for additional insurance coverage. 

The Emeriti Program is designed to build on the foundation of Medicare, and to provide additional insurance coverage in those areas where retirees need it the most: major medical and prescription drug expenses that exceed what Medicare provides.  The Emeriti Program, offered through your institution’s Emeriti Plan, provides a carefully considered array of nationally available options at a range of costs.  It also provides a way for you to pay for insurance premiums, coinsurance, and other out-of-pocket health expenses through tax-advantaged savings.

If you are considering early retirement, and your institution has elected to offer Emeriti’s Pre-65 Retiree Group Health Insurance, you can learn more about this benefit by clicking here.

If you are age 55 or 60 or so, it’s not too late to build up money in your Emeriti Health Account, but start as soon as you can. It really does not re­quire a lot of money to potentially benefit from compounding of earnings.  And remember that these contributions are tax-favored. Employer contributions and earnings accrue tax free and are paid out tax free for reimbursement of qualified medical expenses. Employee voluntary contribu­tions are made after tax, but earnings accrue tax free and the total accumulation is paid out tax free for reimbursement of qualified medical expenses.

Your Emeriti Health Account will be used to fund your Emeriti insurance, and also to pay for other qualified medical expenses in retirement.  If you are participating in Emeriti as an active employee, your institution is making contributions on your behalf to the Health Accounts.  You may also be contributing to the Health Accounts. Your institution’s contributions and yours both have important tax advantages:

If your institution’s plan does not permit voluntary employee contributions, or once you retire, if there is an insufficient balance in your account to pay for insurance premiums, you will need to pay for Emeriti Health Insurance Plan premiums by setting up electronic fund transfers from your bank account to your Health Account.

During your retirement, you can make lump sum or periodic contributions as often as monthly; the minimum contribution is $100 per month. You may want to contribute this way if you can make contributions enough in advance of withdrawals to take advantage of potential gains, which are tax-free. Contributing and then withdrawing may not work to your advantage; remember that share price, yield, and return will vary, and you may have investment earnings or loss when you sell your shares.

Even if you can only invest a small amount, the earlier you start, generally the better. Time can be one of the most powerful investment tools around. And these contributions are tax-favored. Employer contributions and earnings accrue tax free and are paid out tax free for reimbursement of qualified medical expenses. Employee voluntary contributions are made after tax, but earnings accrue tax free and the total accumulation is paid out tax free for reimbursement of qualified medical expenses. Take a look at this chart:

The following is an illustration of the power of compounding-$100/month for 5, 10, 15, 20, 25, 30, 35, and 40 years.

The Emeriti Program investment choices

The Emeriti Program offers a choice of Fidelity Freedom Funds® and the Fidelity Retirement Money Market Portfolio to invest your employer contributions and, if your Emeriti Plan allows, your voluntary employee contributions.

Each of the Fidelity Freedom Funds invests in a diversified portfolio of well-established, actively managed Fidelity mutual funds designed to:

However, neither diversification nor asset allocation ensures a profit or guarantees against loss. Please note these funds are subject to the volatility of the financial markets in the U.S. and abroad and can be subject to the additional risks associated with investing in high yield, small cap, and foreign securities.

The Fidelity Retirement Money Market Portfolio is a money market mutual fund managed by Fidelity Investments and is designed to:

An investment in a money market fund is not insured or guaranteed by the FDIC or any other government agency. Although a money market fund seeks to preserve the value of your investment at $1 per share, it is possible to lose money by investing in these investment options.

For more detailed information on the Fidelity Freedom Funds, including performance, holdings, and prospectuses, visit fidelity.com.

View the most recent quarterly performance sheet for the investment options available through the Emeriti Program. For the most current performance data, please click here.

Strategic Advisers, Inc., a subsidiary of FMR Corp., manages the Fidelity Freedom Funds.

Choosing the Freedom Fund that's right for you

As you consider your investment choices, you should review the important differences between the investment options and determine which might align with your individual circumstances, retirement horizon, risk tolerance and investment goals.

For example, you may wish to allocate contributions in the Fidelity Freedom Fund closest to your target retirement date. Or you may want to allocate your contributions among several investment choices, such as a percentage in any Fidelity Freedom Fund of your choice and the remaining percentage in the Retirement Money Market Portfolio. No matter what you choose, you can change how future contributions to your Accounts are invested or rebalance your portfolio at any time. If you don't make a fund selection, then by default, your employer contributions will be invested in the Fidelity Freedom Fund closest to the year in which you will become Medicare eligible (currently age 65), at the direction of the Plan.

The underlying investment mix of each of the Fidelity Freedom Funds changes over time to help meet the changing needs of participants as they get closer to retirement, with the fund's allocation becoming more conservative as its target retirement date nears.

The funds with longer time frames are more aggressive, with higher concentrations of stock (equity) mutual funds, a greater potential for higher investment returns and higher potential volatility. These funds may be more appropriate for investors who are far enough away from retirement to tolerate the market's inevitable ups and downs.

The funds with shorter time frames are more conservative and may be more appropriate for investors who want to focus on preserving their current assets. These funds concentrate on investing in bond funds and money market funds, which historically have fluctuated less in value than stock funds although they also offer less potential for growth.

As each Freedom Fund nears its target retirement date, the fund will take on an asset mix comparable to the Fidelity Freedom Income Fund®. In fact, each of the Fidelity Freedom Funds will ultimately merge into the Fidelity Freedom Income Fund 10–15 years after the target retirement date is reached.

These funds are subject to the volatility of the financial markets in the U.S. and abroad and may be subject to the additional risks associated with investing in high yield, small cap and foreign securities.

Before investing in any mutual fund, please carefully consider the investment objectives, risks, charges and expenses. For this and other information, call or write Fidelity for a free prospectus. Read it carefully before you invest.

Emeriti Guaranteed Annuity Option to be Discontinued (for Now)

As a result of its continuing strategic product review, Fidelity will no longer issue guaranteed annuities, effective April 30, 2008. Emeriti continues to believe that a guaranteed income option is desirable for retirees who may wish to have a stable flow of income into their Emeriti Health Account, whether for a fixed term or for a lifetime, to pay for their health insurance premiums and other qualified medical expenses. Emeriti is looking for a replacement product.

If you’re thinking about early retirement, but are concerned about how you will find and fund insurance in the gap between COBRA and Medicare eligibility, Emeriti’s Pre-65 Group Retiree Health Insurance is the solution.  Emeriti offers three different pre-65 group retiree health insurance plans for individuals ages 60 to 64.  All of the plans are guaranteed issue (no pre-existing condition exclusions) and portable, so you can live anywhere in the U.S. 

 Learn more about Emeriti’s pre-65 group retiree health plans.

Please note:  If your institution is already a part of the Emeriti consortium, it does not automatically make this benefit available.  Your institution has to elect Emeriti’s pre-65 retiree health insurance in addition to electing Emeriti’s post-65 coverage.  Institutions cannot elect pre-65 retiree health insurance exclusively.  Check with your institution’s benefits administrator for more information. 

The Emeriti Reimbursement Benefit is a very flexible, tax-favored tool for managing your health care costs in retirement. It enables you to be reimbursed for a wide range of out-of-pocket health expenses that are not paid by insurance, and for premiums for other health insurance outside of the Emeriti Program, like long-term care insurance.

Funds that are in your Emeriti Health Account (contributions from you or from your institution* and any investment earnings) can be withdrawn tax free to reimburse yourself for the following types of qualified medical expenses:

You can utilize the Reimbursement Benefit not only for your own health expenses, but also for those of your spouse (or your dependent domestic partner, if allowed under your institution’s plan); your dependent children; and your dependent relatives, such as parents or siblings who meet the federal definition of dependent, if allowed under your institution’s plan. This benefit can be used throughout your lifetime and until the last of your dependents dies or is no longer in dependent status.

You may want to contribute to your Health Account to utilize the Reimbursement Benefit if you can make contributions sufficiently in advance of payments to take advantage of potential investment gains, which are tax free. You can contribute a minimum of $100 as often as monthly. Note that share price, yield and return will vary on the contributions you make into your Health Account, and you may have a gain or loss when you sell your shares.

* You may meet to meet age and service requirements set by your institution in order to have the right to use the institution’s contributions.

Emeriti offers pre-65 retiree group health insurance for participants seeking an affordable, sustainable health insurance solution in the gap between COBRA coverage and Medicare eligibility.

Pre-65 retiree coverage is  an optional additional benefit for Emeriti Consortium members.  It will not be available as a stand-alone product, and requires that your institution also participate in post-65 insurance options.  Coverage is underwritten by Aetna Life Insurance Company (Aetna) and is available to Emeriti member institutions in 48 states and the District of Columbia. Pre-65 options will not be available in 2009 for institutions located in Minnesota and New Mexico.

Pre-65 Eligibility

Dependents of a post-65 retiree enrolling or enrolled in the Emeriti post-65 insurance:

You may be eligible, if you are a pre-65 retiree at an Emeriti institution that has adopted pre-65 retiree coverage and you meet the definition of an eligible retiree. Also eligible:

Pre-65 Enrollment

You will have 90 days to enroll after you have terminated service at your institution.  If, after you terminate service, you are covered under COBRA or under a group insurance plan through your spouse or another employer, you can enroll in Emeriti Pre-65 plans within 30 days after your other coverage terminates. Insurance will be effective on the first of the month after enrollment.

Eligible dependents

If you are post-65 and enrolling in Emeriti, or if you are enrolling as a pre-65 retiree, you can enroll your pre-65 eligible dependents in one of Emeriti’s Pre-65 Group Retiree Health Plans.  Emeriti offers three different pre-65 group retiree health insurance options: high, medium, and low plans, all with in-network and out-of-network premium rates.  Alll of the plans are guaranteed issue (no pre-existing condition exclusions) and portable, so you can live anywhere in the U.S. 

Learn more about Emeriti’s pre-65 group retiree health plans.

While Medicare is a very strong foundation that provides substantial coverage for hospitalization (Part A), physicians' charges (Part B), and prescription drugs (Part D), there are many health expenses that Medicare doesn't cover completely. For other coverage, such as vision, dental and hearing services, and long term care, it provides no benefit.

The Emeriti Program's post-65 coverage is designed to build on the foundation of Medicare, and to provide additional insurance coverage in those areas where retirees need it the most: major medical and prescription drug expenses that exceed what Medicare provides. The Emeriti Program, offered through your institution's Emeriti Plan, provides a carefully considered array of nationally available options at a range of costs. It also provides a way for you to pay for insurance premiums, coinsurance, and other out-of-pocket health expenses through tax-advantaged savings (your Emeriti Health Account).

The Emeriti Program provides a menu of choices for your medical and prescription drug (Medicare Part D) insurance needs.  You can choose the type and level of coverage for your needs one year, and then choose a different combination the next year.  You will have national access to insurance, as well as urgent or emergency coverage for up to six months every year while traveling outside the U.S. And each of the medical and prescription drug plans offers some level of catastrophic coverage, which ultimately reduces your financial exposure and protects your other retirement assets.

Currently, retirees choose from four medical plan options and four Rx plan options.   Dental can be added to any of the combinations.  Please note that the current Rx Low Plan is the only plan that may be chosen as a stand-alone option; you can add dental to this plan, too. 

Four Post-65 Retiree Medical Plan Options:

Two are Medicare Supplementplans that build on Original Medicare Parts A and B.  The other two are Medicare Advantage (Part C) Private Fee-for-Service (PFFS) Plans.

The Emeriti Program enables you to create your insurance plan from a menu of options. Each plan has different levels of coinsurance and deductibles. You can view details for each plan by clicking here.

To calculate the monthly premiums for the different levels of coverage under the Emeriti Health Insurance Plan Options, underwritten by Aetna, click here.

The Emeriti Reimbursement Benefit is a very flexible, tax-favored tool for managing your health care costs in retirement. It enables you to be reimbursed for a wide range of out-of-pocket health expenses that are not paid by insurance, and for premiums for other health insurance outside of the Emeriti Program, like long-term care insurance.

Funds that are in your Emeriti Health Account (contributions from you or from your institution* and any investment earnings) can be withdrawn tax free to reimburse yourself for the following types of qualified medical expenses:

You can utilize the Reimbursement Benefit not only for your own health expenses, but also for those of your spouse (or your dependent domestic partner, if allowed under your institution’s plan); your dependent children; and your dependent relatives, such as parents or siblings who meet the federal definition of dependent, if allowed under your institution’s plan. This benefit can be used throughout your lifetime and until the last of your dependents dies or is no longer in dependent status.

You may want to contribute to your Health Account to utilize the Reimbursement Benefit if you can make contributions sufficiently in advance of payments to take advantage of potential investment gains, which are tax free. You can contribute a minimum of $100 as often as monthly. Note that share price, yield and return will vary on the contributions you make into your Health Account, and you may have a gain or loss when you sell your shares.

* You may meet to meet age and service requirements set by your institution in order to have the right to use the institution’s contributions.

Now that you are about to retire or are already retired, you will want to think about your health care coverage needs.  The good news is that you are eligible for Medicare, the primary medical benefit program for retirees over 65.  Medicare provides an excellent foundation for the health care coverage needs of retirees, and it is very important that you enroll as soon as you become eligible. 

Unfortunately, there are many health expenses that Medicare doesn’t cover completely, and others, such as vision, dental and hearing services, and long term care, where it provides no benefit.  The reality is that although Medicare is a comprehensive framework for health security in retirement, it doesn’t cover everything, nor was it ever intended to do so.  You should consider buying supplemental insurance that helps you with the costs that Medicare does not pay.  You should also think carefully about other out-of-pocket, health-related expenses beyond insurance coverage and factor them into your overall retirement budget.  On average, Medicare is likely to pay only about half of your medical costs in retirement*.

In order to make the best choices for your needs, it is important that you understand what choices you have and how Medicare operates.  Below is a brief description of how each part works:

To learn more, read or download Emeriti’s A, B, C, Ds of Medicare booklet, designed to help you to understand how Medicare works and what your share of your health care costs may be. 

*  The Employee benefit Research Institute (EBRI) 2006 estimates from the 2003 Medical Expenditure Survey. 

Your spouse* can be enrolled in Emeriti insurance at the same time you enroll.  If your spouse is over 65, he/she must be enrolled in Medicare Parts A and B, and must be enrolled in the same Emeriti Health Insurance Plan Options as you.  If you have a spouse* who is under age 65, or if you have children who qualify as dependents under federal law and are under age 19 (or under age 24** if full-time students), you can enroll them in a separate pre-65 Emeriti insurance plan, underwritten by Aetna.  When your spouse reaches age 65 and enrolls in Medicare Parts A and B, he/she can switch to the Emeriti Health Insurance Plan that you have chosen.  Special rules apply for permanently disabled family members.  Call 1-866-EMERITI (1-866-363-7484) for more information about who may qualify as eligible dependents.

Your spouse*, dependent children, and dependent relatives (if allowed under your institution’s plan) can be designated by you as eligible to use the assets in your Health Account for reimbursement of eligible out-of-pocket health expenses.

*  Domestic Partners’ coverage may be available if elected by your institution.  If you have a non-dependent domestic partner, you cannot use your Emeriti Health Account to pay for his/her health insurance or qualified medical expenses.  Insurance premiums must be paid each month via electronic transfer from other assets.

** Different state laws may apply.

The Pre-65 Dependents Plan Provisions

For detailed information about the Pre-65 plan provision choices, please review the Pre-65 comparison chart.

How the Pre-65 Dependents Plan Works

The Pre-65 Dependents Plans are Aetna Open Choice PPO/Indemnity Plans that work differently depending on where you live.

Emeriti offers pre-65 retiree group health insurance for participants wishing to retire between the ages of 60 and 64 who are seeking an affordable, sustainable health insurance solution in the gap between COBRA coverage and Medicare eligibility (age 65).

Pre-65 retiree coverage is an optional additional benefit for Emeriti Consortium members. It will not be available as a stand-alone product, and requires that your institution also participate in post-65 insurance options. Coverage is underwritten by Aetna Life Insurance Company (Aetna) and is available to Emeriti member institutions in 48 states and the District of Columbia. Pre-65 options will not be available in the near future for institutions located in Minnesota and New Mexico.

If your institution does not elect to carry Emeriti’s pre-65 retiree health insurance, or if you are a retiree residing in Minnesota, you can use your Reimbursement Benefit to pay for COBRA or other pre-65 insurance premiums out of your Health Account assets. When you turn 65, and enroll in Medicare, you can then buy Emeriti post-65 health insurance.

The Emeriti Program offers a choice of guaranteed issue insurance plans for pre-65 enrollees. The plan designs mirror the key elements of Emeriti’s post-65 program:

Dental coverage is available in addition to any of the medical/drug coverages. Keep in mind that you must enroll in coverage in order for your dependents to enroll, and if more than one member of the family is enrolling in pre-65 insurance through the Emeriti Program, all must choose the same coverage options.

Pre-65 Eligibility

Dependents of a post-65 retiree enrolling or enrolled in the Emeriti post-65 insurance:

You may be eligible, if you are a pre-65 retiree at an Emeriti institution that has adopted pre-65 retiree coverage and you meet the definition of an eligible retiree. Also eligible:

NOTE: In most areas you will be able to choose from three plans with different levels of coverage and cost. (In some areas where there are no networks of Aetna providers, you will be offered one plan, which is very similar to the Middle Plan with In-Network benefits.) For more information about the pre-65 insurance plans, please call the Emeriti Service Center.

Pre-65 Enrollment

You will have 90 days to enroll after you have terminated service at your institution. If, after you terminate service, you are covered under COBRA or under a group insurance plan through your spouse or another employer, you can enroll in Emeriti Pre-65 plans within 30 days after your other coverage terminates. Insurance will be effective on the first of the month after enrollment.

You can elect Aetna-underwritten dental coverage, in addition to whichever pre-65 health insurance plan that you choose.

NOTE: You cannot select the dental plan as a stand-alone option.

For detailed information about the provisions of the dental plan, click here.

How Dental Coverage Works:

Under the Aetna Dental® Preferred Provider Organization (PPO), you may choose at the time of service either a PPO participating dentist or any non-participating dentist. With the PPO plan, savings are possible because the PPO participating dentists have agreed to provide care at negotiated rates. Non-participating dentists will only be paid based on the standard negotiated rate provided to participating general dentists in the same geographic area. You will need to make up any difference between what Aetna pays and what the non-participating dentist charges.

Is your dentist in Aetna's network?

You can find out by using DocFind

Emergency Dental Care

When emergency services are provided by a participating PPO dentist, your copayment/coinsurance amount will be based on a negotiated fee schedule. When emergency services are provided by a non-participating dentist, you will be responsible for the difference between the plan payment and the dentist’s usual charge. Covered emergency services may vary, based on state law.

The information above is subject to change without notice. In case of a conflict between your plan documents and this information, the plan documents will govern.

Dental plans are provided or administered by Aetna Life Insurance Company, Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Health Inc.

In Texas, the Dental Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN), and Indemnity Dental plans are provided or administered by Aetna Life Insurance Company.

Aetna Navigator is a members-only website that offers health and personal benefits information, self-service features and interactive tools. When you register with Aetna Navigator, you'll have your own home page that shows personalized information such as recent claims and who is covered under your plan. There's also a direct link to DocFind, Aetna's online provider directory. Plus, you can take advantage of:

How to Register with Aetna Navigator

To register with Aetna Navigator:

Once you've completed this process, you can log in and start using Aetna Navigator. For security reasons, you won't be able to view personal data for ten days. You'll receive a confirmation letter in the mail and, after ten days, you'll have access to all your information.

After your first visit, you can enter your user name and password in the "log in" box on the Members page of www.aetna.com.

Take a Tour

Take a brief tour and learn about personalized resources to help you maintain your health and financial well-being.  

To calculate the monthly premiums for the different levels of coverage under the Emeriti Health Insurance Plan Options, underwritten by Aetna, click here. 

The Emeriti Reimbursement Benefit is a very flexible, tax-favored tool for managing your health care costs in retirement. It enables you to be reimbursed for a wide range of out-of-pocket health expenses that are not paid by insurance, and for premiums for other health insurance outside of the Emeriti Program, like long-term care insurance.

Funds that are in your Emeriti Health Account (contributions from you or your institution and any investment earnings) can be withdrawn tax free to reimburse yourself for the following types of Qualified Medical Expenses:

You can utilize the Reimbursement Benefit not only for your own health expenses, but also for those of your spouse (or your dependent domestic partner, if allowed under your institution’s plan); your dependent children; and your dependent relatives, such as parents or siblings who meet the federal definition of dependent, if allowed under your institution’s plan. This benefit can be used throughout your lifetime and until the last of your dependents dies or is no longer in dependent status.

You may want to contribute to your Health Account to utilize the Reimbursement Benefit if you can make contributions sufficiently in advance of payments to take advantage of potential investment gains, which are tax-free. You can contribute lump sum amounts by ACH transfers through your bank account for amounts of at least $100, and as often as monthly.

You become eligible when you meet one of the following criteria:

Please Note: QMEs do not include expenses incurred prior to the date you became a Participant in the Emeriti Program.

¹ Retirement Eligibility varies by plan. For more information, see your Plan's Emeriti Summary Plan Description, or call 1-866-EMERITI.

² Reimbursement for qualified medical expenses for dependent relatives and domestic partners is only available if elected by your institution. If you have a non-dependent domestic partner, you cannot use your Emeriti Health Account for reimbursement of qualified medical expenses, or for Emeriti Health Insurance. Insurance premiums must be paid each month via electronic transfer from other assets.

This is general information regarding eligibility; please refer to your institution's Emeriti Summary Plan Description for complete details under your Plan.

What Types of Expenses Qualify?

Qualified Medical Expenses (QMEs) are those expenses defined as “medical care” under Section 213(d) of the Internal Revenue Code that are not covered by insurance, Medicare or another reimbursement plan. This includes amounts paid for:

The Emeriti Health Accounts may be used to reimburse premiums paid for qualified long-term care insurance. The insurance contract is qualified if:

The IRS imposes a limitation (adjusted annually for inflation) on the amount of long-term care premiums that qualify as medical expenses. Therefore, there is an annual limitation on reimbursement of long-term care premiums that depends upon the age that the covered individual will be by the end of the calendar year.

Please Note: The descriptions provided above are not comprehensive and additional restrictions or limitations may apply.

How to Submit a Qualified Medical Expense for Reimbursement

After you have incurred an eligible expense that is not otherwise covered by a medical, dental, vision or other health plan, and which has not been previously reimbursed, you must fill out a QME Claim Form and return it along with the bill documenting the expense to Acclaris Inc. at the address given on the form. You will be reimbursed for eligible expenses out of your Health Account assets. You will need to make sure there are enough funds in your Health Accounts to cover these payments.

Please Note: The fee is waived for the first four submissions of bundled receipts in a calendar year. Thereafter, there is a fee of $6 for each subsequent submission of bundled receipts during the rest of the calendar year. So if you submit your expenses once per quarter, you will have no added cost for the Reimbursement Benefit.

Time Limit for Submission of Qualified Medical Expenses

Once you incur a Qualified Medical Expense, that expense must be submitted for reimbursement within 12 months following the end of the calendar year in which the expense was incurred.

Employer
Your employer makes contributions to an Emeriti Health Account on your behalf beginning at a specified age. Contributions to your Health Accounts are held in tax-advantaged trusts called a Voluntary Employees Beneficiary Association (VEBA), serviced by Fidelity Investments. These contributions are made tax-free, and all contributions plus earnings will be disbursed tax-free, in retirement, exclusively to pay for health insurance and many other Qualified Medical Expenses.

Employee

If your institution’s plan allows, you may make voluntary contributions to your Health Account. There is no minimum distribution requirement. Employee voluntary contributions are made after-tax, and all assets including earnings accumulate tax-free and will be paid out tax-free for your retiree health benefits.

Accumulated Assets Can Be Used for Two Purposes:

Using Your Account in Retirement

Your accumulated funds are available exclusively to pay for Emeriti pre-65 retiree health insurance and other Qualified Medical Expenses. If your are enrolled in Emeriti Health Insurance and there is an insufficient balance in your account to pay for insurance premiums, you will need to pay for Health Insurance Plan premiums by setting up electronic fund transfers to your Health Account.

During your retirement, you can make lump sum or periodic contributions as often as monthly; the minimum contribution is $100 per month. You may want to contribute this way if you can make contributions enough in advance of withdrawals to take advantage of potential gains, which are tax-free. Contributing and then withdrawing may not work to your advantage; remember that share price, yield and return will vary, and you may have investment earnings or loss when you sell your shares.

When you call to enroll in one of Emeriti’s Pre-65 Retiree Health Insurance Plan Options, the same Emeriti Specialist will work with you to set up your payment method decisions. Even if you do not plan to enroll in any of the Emeriti Health Insurance Plan Options, you may want to contribute to your Health Account to pay for Qualified Medical Expenses including any other insurance premiums, if your institution's Plan allows employee contributions*. You can call an Emeriti Specialist to:

*Subject to certain restrictions. Under federal law, institutions with 50 or fewer employees cannot allow employee voluntary contributions.

Even if you can only invest a small amount, the earlier you start, generally the better. Time can be one of the most powerful investment tools around. And these contributions are tax-favored. Employer contributions and earnings accrue tax free and are paid out tax free for reimbursement of qualified medical expenses. Employee voluntary contributions are made after tax, but earnings accrue tax free and the total accumulation is paid out tax free for reimbursement of qualified medical expenses. Take a look at this chart:

The following is an illustration of the power of compounding-$100/month for 5, 10, 15, 20, 25, 30, 35, and 40 years.

The Emeriti Program investment choices

The Emeriti Program offers a choice of Fidelity Freedom Funds^® and the Fidelity Retirement Money Market Portfolio to invest your employer contributions and, if your Emeriti Plan allows, your voluntary employee contributions.

Each of the Fidelity Freedom Funds invests in a diversified portfolio of well-established, actively managed Fidelity mutual funds designed to:

However, neither diversification nor asset allocation ensures a profit or guarantees against loss. Please note these funds are subject to the volatility of the financial markets in the U.S. and abroad and can be subject to the additional risks associated with investing in high yield, small cap, and foreign securities.

The Fidelity Retirement Money Market Portfolio is a money market mutual fund managed by Fidelity Investments and is designed to:

An investment in a money market fund is not insured or guaranteed by the FDIC or any other government agency. Although a money market fund seeks to preserve the value of your investment at $1 per share, it is possible to lose money by investing in these investment options.

For more detailed information on the Fidelity Freedom Funds, including performance, holdings, and prospectuses, visit fidelity.com.

View the most recent quarterly performance sheet for the investment options available through the Emeriti Program. For current performance data, and Money Market fund information, please visit the Fidelity website.

Strategic Advisers, Inc., a subsidiary of FMR Corp., manages the Fidelity Freedom Funds.

Choosing the Freedom Fund that's right for you

As you consider your investment choices, you should review the important differences between the investment options and determine which might align with your individual circumstances, retirement horizon, risk tolerance and investment goals.

For example, you may wish to allocate contributions in the Fidelity Freedom Fund closest to your target retirement date. Or you may want to allocate your contributions among several investment choices, such as a percentage in any Fidelity Freedom Fund of your choice and the remaining percentage in the Retirement Money Market Portfolio. No matter what you choose, you can change how future contributions to your Accounts are invested or rebalance your portfolio at any time. If you don't make a fund selection, then by default, your employer contributions will be invested in the Fidelity Freedom Fund closest to the year in which you will become Medicare eligible (currently age 65), at the direction of the Plan.

The underlying investment mix of each of the Fidelity Freedom Funds changes over time to help meet the changing needs of participants as they get closer to retirement, with the fund's allocation becoming more conservative as its target retirement date nears.

The funds with longer time frames are more aggressive, with higher concentrations of stock (equity) mutual funds, a greater potential for higher investment returns and higher potential volatility. These funds may be more appropriate for investors who are far enough away from retirement to tolerate the market's inevitable ups and downs.

The funds with shorter time frames are more conservative and may be more appropriate for investors who want to focus on preserving their current assets. These funds concentrate on investing in bond funds and money market funds, which historically have fluctuated less in value than stock funds although they also offer less potential for growth.

As each Freedom Fund nears its target retirement date, the fund will take on an asset mix comparable to the Fidelity Freedom Income Fund^®. In fact, each of the Fidelity Freedom Funds will ultimately merge into the Fidelity Freedom Income Fund 10–15 years after the target retirement date is reached.

These funds are subject to the volatility of the financial markets in the U.S. and abroad and may be subject to the additional risks associated with investing in high yield, small cap and foreign securities.

Before investing in any mutual fund, please carefully consider the investment objectives, risks, charges and expenses. For this and other information, call or write Fidelity for a free prospectus. Read it carefully before you invest.

Emeriti Guaranteed Annuity Option to be Discontinued (for Now)

As a result of its continuing strategic product review, Fidelity will no longer issue guaranteed annuities, effective April 30, 2008. Emeriti continues to believe that a guaranteed income option is desirable for retirees who may wish to have a stable flow of income into their Emeriti Health Account, whether for a fixed term or for a lifetime, to pay for their health insurance premiums and other qualified medical expenses. Emeriti is looking for a replacement product.

In preparation for your post-65 years, we recommend that you sign up for Medicare as soon as you are eligible. While Medicare provides an excellent foundation for the health care coverage needs of you, your spouse and eligible dependents, there are many health expenses it does not cover.

Read Emeriti’s A,B,C,Ds of Medicare booklet.

The Emeriti Program’s post-65 coverage is designed to build on the foundation of Medicare, and to provide additional insurance coverage in those areas where you need it the most: major medical and prescription drug expenses that exceed what Medicare provides. The Emeriti Program, offered through your institution’s Emeriti Plan, provides a carefully considered array of nationally available options at a range of costs. It also provides a way for you to pay for insurance premiums, coinsurance, and other out-of-pocket health expenses through tax-advantaged savings (your Emeriti Health Account).

The Emeriti Program provides a menu of choices for your medical and prescription drug (Medicare Part D) insurance needs.  You can choose the type and level of coverage for your needs one year, and then choose a different combination the next year.  You will have national access to insurance, as well as urgent or emergency coverage for up to six months every year while traveling outside the U.S. And each of the medical and prescription drug plans offers some level of catastrophic coverage, which ultimately reduces your financial exposure and protects your other retirement assets.

Currently, retirees choose from four medical plan options and four Rx plan options.   Dental can be added to any of the combinations.  Please note that the current Rx Low Plan is the only plan that may be chosen as a stand-alone option; you can add dental to this plan, too. 

Four Post-65 Retiree Medical Plan Options:

Two are Medicare Supplement plans that build on Original Medicare Parts A and B.  The other two are Medicare Advantage (Part C) Private Fee-for-Service (PFFS) Plans.

Four Medica Emeriti offers three types of medical plans. The Aetna Traditional Choice Medical Plan and the PFFS Medical Plan are available nationwide. For 2010, Emeriti’s new Supplemental Medical Plan K and Plan L are approved by 27 states plus the District of
Columbia for 2010. (See below for availability.) We expect to be able to make Plans K and L more widely available in 2011. Each type of plan deals with Medicare Parts A and B deductibles and Medicare allowable charges somewhat differently.

The Aetna Traditional Choice plancoordinates benefits with Medicare coverage. 

The Private Fee-for-Service (PFFS) Plan is a Medicare Part C Plan, where Aetna provides all of the benefits of Original Medicare Parts A and B; it also provides extensive preventive services for which you pay nothing.

Aetna Supplemental Retiree Medical Plans K and L build on what Medicare provides.

Aetna Supplemental Retiree Medical Plans K and L are available in the folliowing states: AL, AK, AZ, AR, CO, CT, DE, DC, GA, IN, IA, LA, MI, MO, MS, NE, NM, NY, NC, ND, OK, SC, SD, TN, TX, WV, WI, WY.

*In the state of New York the names of these group health plans are Retiree Medical Plans 5 and 6, and in all other states, Supplemental Retiree Medical Plans K and L.

Emeriti’s Medicare-approved Part D prescription drug plans:

Learn more about Emeriti’s Rx coverage.

Emeriti’s optional dental coverage can be added to any of the plan combinations.  Please note: you cannot elect dental coverage as a stand-alone.  You can choose to add dental to any combination of the medical and Rx plans.  Learn more.

*Aetna provides all coverage for institutions and their retirees in 48 states and the District of Columbia. For institutions and their retirees in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides prescription drug only plans. For institutions in Minnesota, and their retirees residing in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides a prescription drug-only plan. Click here to see the HealthPartners Freedom Plans available in Minnesota. If your institution has fewer than 50 employees, your Emeriti insurance option will be limited to a separate insurance offering mandated by your state insurance department as part of small group insurance reform. Please call an Emeriti Specialist from Aetna to find out what insurance coverage is available to you.

**For PFFS Plans, the provider must accept Private Fee-for-Service plan terms and conditions.  

Pre-approved Part D prescription drug plan options

Emeriti’s optional dental coverage can be added to any of the plan combinations.  Please note: you cannot elect dental coverage as a stand-alone. 

*If your institution has fewer than 50 employees, your Emeriti insurance option will be limited to a separate insurance offering mandated by your state insurance department as part of small group reform.

**In PFFS plans, the provider must accept PFFS. 

Now that you are about to retire or are already retired, you will want to think about your health care coverage needs. The good news is that you are eligible for Medicare, the primary medical benefit program for retirees over 65. Medicare provides an excellent foundation for the health care coverage needs of retirees, and it is very important that you enroll as soon as you become eligible.

Unfortunately, there are many health expenses that Medicare doesn’t cover completely, and others, such as vision, dental and hearing services, and long term care, where it provides no benefit. The reality is that although Medicare is a comprehensive framework for health security in retirement, it doesn’t cover everything, nor was it ever intended to do so. You should consider buying supplemental insurance that helps you with the costs that Medicare does not pay. You should also think carefully about other out-of-pocket, health-related expenses beyond insurance coverage and factor them into your overall retirement budget. On average, Medicare is likely to pay only about half of your medical costs in retirement ^*.

In order to make the best choices for your needs, it is important that you understand what choices you have and how Medicare operates. Below is a brief description of how each part works:

To learn more, read or download Emeriti’s A, B, C, Ds of Medicare booklet, designed to help you to understand how Medicare works and what your share of your health care costs may be.

* The Employee benefit Research Institute (EBRI) 2006 estimates from the 2003 Medical Expenditure Survey.

Your spouse* can be enrolled in Pre-65 Emeriti insurance at the same time you enroll.  Keep in mind that you and your pre-65 spouse* must enroll in the same insurance plan option. 

Review Emeriti’s Pre-65 Insurance Plan Options.

Post-65 Eligibility

When you reach age 65 and enroll in Medicare Parts A and B, you and your eligible dependents will be eligible to enroll in Emeriti’s post-65 coverage.  

If you have children who qualify as dependents under federal law and are under age 19 (or under age 24** if full-time students), you can enroll them also.  When your spouse* reaches age 65 and enrolls in Medicare Parts A and B, he/she can switch to the Emeriti Health Insurance Plan that you have chosen.  Special rules apply for permanently disabled family members.  Call 1-866-EMERITI (1-866-363-7484) for more information about who may qualify as eligible dependents.

You must be enrolled in Emeriti insurance in order for your eligible dependents to enroll when they turn age 65 and enroll in Medicare Parts A and B.  If you or any of your dependents are eligible for Medicare, please refer to the Emeriti post-65 insurance plan options.  You can obtain information about those plans by calling 1-866-EMERITI (1-866-363-7484) or by visiting the Emeriti web site at www.emeritihealth.org.

*  Domestic Partners’ coverage may be available if elected by your institution.  If you have a non-dependent domestic partner, you cannot use your   Emeriti Health Account to pay for his/her health insurance or qualified medical expenses.  Insurance premiums must be paid each month via electronic transfer from other assets.

** Different state laws may apply.

Now that you are about to retire or are already retired, you will want to think about your health care coverage needs. The good news is that you are eligible for Medicare, the primary medical benefit program for retirees over 65. Medicare provides an excellent foundation for the health care coverage needs of retirees, and it is very important that you enroll as soon as you become eligible.

Unfortunately, there are many health expenses that Medicare doesn’t cover completely. Others, such as vision, dental and hearing services, and long term care, it provides no benefit. Generally, Medicare is estimated to cover about 50-60% of your health care expenses in retirement, with the balance covered by private insurance and by your own out-of-pocket expenditures.

Because medical expenses are a growing and significant expense for most retirees, it is essential that you understand what role Medicare plays, what it does not cover, what cost share responsibilities and financial exposure you will have for your health care, and how you can choose wisely among all the the options for additional insurance coverage. (For more information on how Medicare works, read The A,B,C,Ds of Medicare.)

The Emeriti Program is designed to build on the foundation of Medicare, and to provide additional insurance coverage in those areas where retirees need it the most: major medical and prescription drug expenses that exceed what Medicare provides. The Emeriti Program, offered through your institution’s Emeriti Plan, provides a carefully considered array of nationally available options at a range of costs. It also provides a way for you to pay for insurance premiums, coinsurance and other out-of-pocket health expenses through tax-advantaged savings (your Emeriti Health Account).

The Emeriti program offers you a choice of four medical plans (depending on your state of residence, you may have two medical plan choices), three Medicare-approved Part D prescription drug (Rx) plans and a dental plan, all with a range of premium costs, deductibles and out-of-pocket limits.

You design your own plan from this menu by first choosing a medical plan from among the available options and then choosing an Rx plan from among three options.  You have the option to add dental to any of these combinations.  Please note that the Rx Low Plan is the only plan that may be chosen as a stand-alone option.

Emeriti’s Post-65 Retiree Medical, Rx and Dental Plans

Emeriti offers three types of medical plans. The Aetna Traditional Choice Medical Plan and the PFFS Medical Plan are available nationwide. For 2010, Emeriti’s new Supplemental Medical Plan K and Plan L are approved by 27 states plus the District of Columbia for 2010. (See below for availability.) We expect to be able to make Plans K and L more widely available in 2011. Each type of plan deals with Medicare Parts A and B deductibles and Medicare allowable charges somewhat differently.

The Aetna Traditional Choice plan coordinates benefits with Medicare coverage. 

The Private Fee-for-Service (PFFS) Plan is a Medicare Part C Plan, where Aetna provides all of the benefits of Original Medicare Parts A and B; it also provides extensive preventive services for which you pay nothing.

Aetna Supplemental Retiree Medical Plans K and L build on what Medicare provides.

Aetna Supplemental Retiree Medical Plans K and L are available in the folliowing states: AL, AK, AZ, AR, CO, CT, DE, DC, GA, IN, IA, LA, MI, MO, MS, NE, NM, NY, NC, ND, OK, SC, SD, TN, TX, WV, WI, WY.

*In the state of New York the names of these group health plans are Retiree Medical Plans 5 and 6, and in all other states, Supplemental Retiree Medical Plans K and L.

Emeriti’s Medicare-approved Part D prescription drug plans:

Learn more about Emeriti’s Rx coverage.

Emeriti’s optional dental coverage can be added to any of the plan combinations.  Please note: you cannot elect dental coverage as a stand-alone.  You can choose to add dental to any combination of the medical and Rx plans.  Learn more.

*Aetna provides all coverage for institutions and their retirees in 48 states and the District of Columbia. For institutions and their retirees in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides prescription drug only plans. For institutions in Minnesota, and their retirees residing in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides a prescription drug-only plan. Click here to see the HealthPartners Freedom Plans available in Minnesota. If your institution has fewer than 50 employees, your Emeriti insurance option will be limited to a separate insurance offering mandated by your state insurance department as part of small group insurance reform. Please call an Emeriti Specialist from Aetna to find out what insurance coverage is available to you.

**For PFFS Plans, the provider must accept Private Fee-for-Service plan terms and conditions.  

Each person has different health care needs and different tolerances for medical expense risk. So you will want to choose a plan at the premium level and coverage level appropriate for your expected usage next year. Remember that the Emeriti Program gives you an opportunity to choose a different combination of medical and Rx coverage each year.

As a starting point, take stock of your current medical and drug expenses, and those of your post-65 spouse or domestic partner, if you will both be insured through the Emeriti Program. Are you both in relatively good health? Or do you need regular medical care? Do you take a lot of prescription drugs, or maybe only one or two generic maintenance prescriptions? And is dental coverage important to you?

Once you have answered these questions for yourself, you’re ready to start building your Plan from among Emeriti’s health insurance options. As you review your medical and drug options, there are two important factors to consider: cost and coverage.

First, weigh your premium cost for each Plan. Higher premiums usually result in a richer level of insurance coverage and lower out-of-pocket limits, but you pay the premiums whether you use the coverage or not.

Second, estimate your Medicare cost shares and other likely health care expenses. Out-of-pocket costs are the expenses associated with each doctor visit, each lab test, each prescription, etc. If you choose a plan with higher cost shares and a higher out-of-pocket limit, your overall financial exposure is greater, but you will likely pay a lower premium.

Aetna Traditional Choice Medical Plan

Aetna Traditional Choice coordinates benefits with Medicare coverage. You are responsible for the $200 Traditional Choice plan deductible for the year.

The Medicare Part A and Part B deductibles count toward the plan deductible, and in most cases the $200 plan deductible is all that you will pay for Medicare allowable health care expenses throughout the year.

In addition, the Plan provides for some extra benefits that Medicare does not cover, such as emergency treatment while traveling outside the U.S. For these extra benefits, you will pay 20% until you reach a maximum out-of-pocket expenditure of $1250 for the calendar year.

Aetna Supplemental Retiree Medical Plans K and L*

Aetna Supplemental Retiree Medical Plans K and L build on what Medicare provides. These plans have no annual plan deductible, but they do have coinsurance. You will pay a portion of the Medicare Part A deductible, either 25% in Plan L or 50% in Plan K.

You will be responsible for 100% of the Medicare Part B deductible amount. Hospital stays are fully covered under Plan K and Plan L. For certain other Medicare covered expenses, you will have 25% coinsurance in Plan L, and 50% coinsurance in Plan K, on the balance after Medicare has paid its share.

Your out-of-pocket expenses are limited in 2010 to $2310 for Plan L and $4620 for Plan K. These plans are subject to state insurance laws and must be approved for use in each state.

For 2010, these plans have been approved in 27 states and DC (see below). If you live in one of these states, your 2010 choices include Supplemental Medical Plan K and Plan L. If you permanently reside in a state that has not approved these plans, Emeriti hopes to be able to offer them to you in 2011.

Aetna Supplemental Retiree Medical Plans K and L are available in the folliowing states: AL, AK, AZ, AR, CO, CT, DE, DC, GA, IN, IA, LA, MI, MO, MS, NE, NM, NY, NC, ND, OK, SC, SD, TN, TX, WV, WI, WY.

*In the state of New York the names of these group health plans are Retiree Medical Plans 5 and 6, and in all other states, Supplemental Retiree Medical Plans K and L.

Private Fee-for-Service (PFFS) Medical Plan

The PFFS Medical Plan is a Medicare Part C Plan, where Aetna provides all of the benefits of Original Medicare Parts A and B; it also provides extensive preventive services for which you pay nothing. (PFFS stands for Private Fee-for-Service.)

The PFFS Plan must cover all of the benefits of Original Medicare Parts A and B, and it provides some additional benefits beyond Medicare’s coverage limits. In PFFS, you will have no Medicare Part A and B deductibles to pay. As you begin health care services for the year, you will pay the $300 plan deductible, and then you will pay 15% coinsurance for your covered expenses, up to a maximum calendar year out-of-pocket expenditure of $2750, with your annual plan deductible counting toward that total. PFFS plans have extensive preventive services, for which you pay nothing.

Unlike traditional Medicare HMOs, the PFFS Plan has no networks or geographical restrictions. Be sure to check with your medical providers to see if they accept Private Fee-For-Service (PFFS) plan terms and conditions. Many providers do, but you need to be sure. The premium for the PFFS plan will vary considerably from one geographic area to another based on the level of subsidies that Medicare provides to health care providers.

PLEASE NOTE: Be sure to check with your medical provider to see if he/she accepts Private Fee-for-Service plan terms and conditions. Many providers nationwide accept PFFS plans, but you need to be sure. 

Emeriti offers three Medicare-approved Part D prescription drug plans1. The menu of Rx plan choices offers a range of coverages, at different premium levels:

Selecting The Right Plan

To choose the Rx plan that is right for you, you need to understand how Medicare Part D works.

The 2010 Standard plan design, as illustrated below, includes several phases of cost-sharing by you and the Plan. First, you pay a monthly premium. Then, as you begin to incur drug expenses, you pay the full cost, up to the annual Deductible amount ($310). Then, you pay 25% coinsurance (the Plan pays 75%) for each prescription, up to the Initial Coverage Limit ($2830 in total costs paid by you and the Plan).

If you have additional costs in the calendar year, you are in the Coverage Gap, and you pay 100% of the costs, until your True Out-of-Pocket (called TrOOP) expenditures reach $4550. If your Rx expenditures exceed $4550, you move to Catastrophic Coverage, where you pay the greater of 5% or $2.50 for covered generic drugs (including brand drugs treated as generic drugs), and the greater of 5% or $6.30 for all other drugs, for the remainder of the calendar year.

Emeriti’s basic Rx Low Plan is slightly richer than Medicare’s Standard Part D plan. It has a standard2 formulary and no coverage in the gap. The Rx High and Rx Mid plans are enhanced plans, meaning that they have open formularies, and they provide some continuing benefits in the coverage gap. The Rx Mid Plan provides only generic drug coverage in the gap. The Rx High Plan is significantly richer because it provides coverage of brand drugs in the gap; it also provides 100% coverage at the catastrophic coverage level. Most individual plans available in the open market provide no coverage at all or very limited coverage of prescription drugs in the gap (the so called donut hole), and very few provide coverage of brand drugs in the gap.

Understanding Formularies

A formulary is a catalogue of prescription medications, approved by Medicare for Part D plans. Each insurer constructs its own Medicare-approved formulary.

An open formulary covers all drugs on the Medicare formulary, with the plan paying a varying share of the costs for generic drugs, preferred brand drugs, and non-preferred brand drugs.

View Aetna's open formulary.

A standard formulary requires you to use only those medications that are designated as covered under the insurer’s preferred drug list. If your brand drug is not covered on the standard formulary, you can see if your doctor will prescribe a drug that is on the preferred drug list; or your doctor may obtain a medical exception from the insurer for the drug to be covered. If you decide to continue to take a drug not covered on the standard formulary without obtaining a medical exception, you will pay the full cost, and those expenses do not count toward the plan’s deductible or out-of-pocket limits.

View Aetna’s standard formulary.

If you have a number of prescriptions and are not sure which Rx plan would be best for you, Aetna can help.  Just make a list of all the drugs you are taking, the frequency, and the dosages (mg) and then call 1-866-EMERITI to speak with an Aetna representative.

You can elect Aetna-underwritten dental coverage, in addition to any of the medical/drug combinations you choose. Even if you did not select the dental plan last year, you have another opportunity to elect Emeriti dental insurance for each following year.

NOTE: You cannot select the dental plan as a stand-alone option.<

View dental features and provisions

How Dental Coverage Works:

Under the Aetna Dental^® Preferred Provider Organization (PPO), you may choose at the time of service either a PPO participating dentist or any non-participating dentist. With the PPO plan, savings are possible because the PPO participating dentists have agreed to provide care at negotiated rates. Non-participating dentists will only be paid based on the standard negotiated rate provided to participating general dentists in the same geographic area. You will need to make up any difference between what Aetna pays and what the non-participating dentist charges.

Emergency Dental Care

When emergency services are provided by a participating PPO dentist, your co-payment/coinsurance amount will be based on a negotiated fee schedule. When emergency services are provided by a non-participating dentist, you will be responsible for the difference between the plan payment and the dentist’s usual charge. Covered emergency services may vary, based on state law.

The information above is subject to change without notice. In case of a conflict between your plan documents and this information, the plan documents will govern.

Dental plans are provided or administered by Aetna Life Insurance Company, Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Health Inc.

In Texas, the Dental Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN), and Indemnity Dental plans are provided or administered by Aetna Life Insurance Company

Your spouse* can be enrolled in Emeriti insurance at the same time you enroll.  If your spouse is over 65, he/she must be enrolled in Medicare Parts A and B, and must be enrolled in the same Emeriti Health Insurance Plan Options as you.  If you have a spouse* who is under age 65, or if you have children who qualify as dependents under federal law and are under age 19 (or under age 24** if full-time students), you can enroll them in a separate pre-65 Emeriti insurance plan, underwritten by Aetna.  When your spouse reaches age 65 and enrolls in Medicare Parts A and B, he/she can switch to the Emeriti Health Insurance Plan that you have chosen.  Special rules apply for permanently disabled family members.  Call 1-866-EMERITI (1-866-363-7484) for more information about who may qualify as eligible dependents.

Your spouse*, dependent children, and dependent relatives (if allowed under your institution’s plan) can be designated by you as eligible to use the assets in your Health Account for reimbursement of eligible out-of-pocket health expenses.

*  Domestic Partners’ coverage may be available if elected by your institution.  If you have a non-dependent domestic partner, you cannot use your Emeriti Health Account to pay for his/her health insurance or qualified medical expenses.  Insurance premiums must be paid each month via electronic transfer from other assets.

** Different state laws may apply.

The Pre-65 Dependents Plan Provisions

For detailed information about the Pre-65 plan provision choices, please review the Pre-65 comparison chart.

How the Pre-65 Dependents Plan Works

The Pre-65 Dependents Plans are Aetna Open Choice PPO/Indemnity Plans that work differently depending on where you live.

For institutions in Minnesota, and their retirees residing in Minnesota, HealthPartners provides comprehensive coverage, and Aetna provides prescription-drug-only plans, as well as a dental-only plan. 

There are two HealthPartners medical/Rx plans available. These plans are Medicare Part C HMO-type Cost Plans. Unlike most other HMO options, insured retirees maintain their Medicare Part A and B benefits, which enables them to obtain Medicare services from non-contract providers within their service area, whereas other HMOs do not pay for services outside of the network, except for urgent or emergency situations. The HealthPartners Freedom Plan has an open access network; you do not have to select a primary care physician and can obtain services from any of the HealthPartners providers (including most doctors and hospitals throughout Minnesota) without a referral.

All HealthPartners plans are comprehensive plans, providing both medical and Medicare-approved Part D prescription drug coverage.  You can add dental coverage from HealthPartners to either of the comprehensive plans, or you can choose dental as a stand-alone option from HealthPartners.  Aetna also provides a dental plan that can only be elected with one of the HealthPartner comprehensive plans, as well as an Rx-only stand-alone benefit.

HealthPartners Insurance Plan Provisions

For a detailed comparison of the HealthPartners Insurance plan provisions, click here.

To review the HealthPartners Medicare Prescription Drug Program Formulary (Part D), and to find a network pharmacy in your area, click here.

HealthPartners Freedom Plan Provider Network

If you live inside the metro-Minnesota area, click here to review the Metro Area provider directory.

If you live outside of the metro-Minnesota area, click here to review the Greater Minnesota/Western Wisconsin provider directory.

Aetna Navigator™

Aetna Navigator is a members-only website that offers health and personal benefits information, self-service features and interactive tools. When you register with Aetna Navigator, you'll have your own home page that shows personalized information such as recent claims and who is covered under your plan. There's also a direct link to DocFind, Aetna's online provider directory. Plus, you can take advantage of:

How to Register with Aetna Navigator

To register with Aetna Navigator:

Once you've completed this process, you can log in and start using Aetna Navigator. For security reasons, you won't be able to view personal data for ten days. You'll receive a confirmation letter in the mail and, after ten days, you'll have access to all your information.

After your first visit, you can enter your user name and password in the "log in" box on the Members page of www.aetna.com.

Take a Tour

Take a brief tour and learn about personalized resources to help you maintain your health and financial well-being.  

How Medicare Works

Now that you are about to retire or are already retired, you will want to think about your health care coverage needs.  The good news is that you are eligible for Medicare, the primary medical benefit program for retirees over 65.  Medicare provides an excellent foundation for the health care coverage needs of retirees, and it is very important that you enroll as soon as you become eligible. 

Unfortunately, there are many health expenses that Medicare doesn’t cover completely, and others, such as vision, dental and hearing services, and long term care, where it provides no benefit.  The reality is that although Medicare is a comprehensive framework for health security in retirement, it doesn’t cover everything, nor was it ever intended to do so.  You should consider buying supplemental insurance that helps you with the costs that Medicare does not pay.  You should also think carefully about other out-of-pocket, health-related expenses beyond insurance coverage and factor them into your overall retirement budget.  On average, Medicare is likely to pay only about half of your medical costs in retirement*.

In order to make the best choices for your needs, it is important that you understand what choices you have and how Medicare operates.  Below is a brief description of how each part works:

To learn more, read or download Emeriti’s A, B, C, Ds of Medicare booklet, designed to help you to understand how Medicare works and what your share of your health care costs may be. 

*  The Employee benefit Research Institute (EBRI) 2006 estimates from the 2003 Medical Expenditure Survey. 

The Emeriti Reimbursement Benefit is a very flexible, tax-favored tool for managing your health care costs in retirement. It enables you to be reimbursed for a wide range of out-of-pocket health expenses that are not paid by insurance, and for premiums for other health insurance outside of the Emeriti Program, like long-term care insurance.

Funds that are in your Emeriti Health Account (contributions from you or from your institution* and any investment earnings) can be withdrawn tax free to reimburse yourself for the following types of qualified medical expenses:

You can utilize the Reimbursement Benefit not only for your own health expenses, but also for those of your spouse (or your dependent domestic partner, if allowed under your institution’s plan); your dependent children; and your dependent relatives, such as parents or siblings who meet the federal definition of dependent, if allowed under your institution’s plan. This benefit can be used throughout your lifetime and until the last of your dependents dies or is no longer in dependent status.

You may want to contribute to your Health Account to utilize the Reimbursement Benefit if you can make contributions sufficiently in advance of payments to take advantage of potential investment gains, which are tax free. You can contribute a minimum of $100 as often as monthly. Note that share price, yield and return will vary on the contributions you make into your Health Account, and you may have a gain or loss when you sell your shares.

* You may meet to meet age and service requirements set by your institution in order to have the right to use the institution’s contributions.

When Do I Become Eligible for the Reimbursement Benefit?

You become eligible when you meet one of the following criteria:

Please Note: QMEs do not include expenses incurred prior to the date you became a Participant in the Emeriti Program.

¹ Retirement Eligibility varies by plan. For more information, see your Plan's Emeriti Summary Plan Description, or call 1-866-EMERITI.

This is general information regarding eligibility; please refer to your institution's Emeriti Summary Plan Description for complete details under your Plan.

What Types of Expenses Qualify?

Qualified Medical Expenses (QMEs) are those expenses defined as “medical care” under Section 213(d) of the Internal Revenue Code that are not covered by insurance, Medicare or another reimbursement plan. This includes amounts paid for:

Qualified long-term care insurance premiums

The Emeriti Health Accounts may be used to reimburse premiums paid for qualified long-term care insurance. The insurance contract is qualified if:

Please Note: The descriptions provided above are not comprehensive and additional restrictions or limitations may apply.

How to Submit a Qualified Medical Expense for Reimbursement

After you have incurred an eligible expense that is not otherwise covered by a medical, dental, vision or other health plan, and which has not been previously reimbursed, you must fill out a QME Claim Form and return it along with the bill documenting the expense to Acclaris Inc. at the address given on the form. You will be reimbursed for eligible expenses out of your Health Account assets. You will need to make sure there are enough funds in your Health Accounts to cover these payments.

Please Note: The fee is waived for the first four submissions of bundled receipts in a calendar year. Thereafter, there is a fee of $6 for each subsequent submission of bundled receipts during the rest of the calendar year. So if you submit your expenses once per quarter, you will have no added cost for the Reimbursement Benefit.

Time Limit for Submission of Qualified Medical Expenses

Once you incur a Qualified Medical Expense, that expense must be submitted for reimbursement within 12 months following the end of the calendar year in which the expense was incurred.

Your Emeriti Health Account will be used to fund your Emeriti insurance, and also to pay for other qualified medical expenses in retirement.  If you are participating in Emeriti as an active employee, your institution is making contributions on your behalf to the Health Accounts.  You may also be contributing to the Health Accounts. Your institution’s contributions and yours both have important tax advantages:

If your institution’s plan does not permit voluntary employee contributions, or once you retire, if there is an insufficient balance in your account to pay for insurance premiums, you will need to pay for Emeriti Health Insurance Plan premiums by setting up electronic fund transfers from your bank account to your Health Account.

During your retirement, you can make lump sum or periodic contributions as often as monthly; the minimum contribution is $100 per month. You may want to contribute this way if you can make contributions enough in advance of withdrawals to take advantage of potential gains, which are tax-free. Contributing and then withdrawing may not work to your advantage; remember that share price, yield, and return will vary, and you may have investment earnings or loss when you sell your shares.

The Emeriti Program investment choices

The Emeriti Program offers a choice of Fidelity Freedom Funds® and the Fidelity Retirement Money Market Portfolio to invest your employer contributions and, if your Emeriti Plan allows, your voluntary employee contributions.

Each of the Fidelity Freedom Funds invests in a diversified portfolio of well-established, actively managed Fidelity mutual funds designed to:

However, neither diversification nor asset allocation ensures a profit or guarantees against loss. Please note these funds are subject to the volatility of the financial markets in the U.S. and abroad and can be subject to the additional risks associated with investing in high yield, small cap, and foreign securities.

The Fidelity Retirement Money Market Portfolio is a money market mutual fund managed by Fidelity Investments and is designed to:

An investment in a money market fund is not insured or guaranteed by the FDIC or any other government agency. Although a money market fund seeks to preserve the value of your investment at $1 per share, it is possible to lose money by investing in these investment options.

For more detailed information on the Fidelity Freedom Funds, including performance, holdings, and prospectuses, visit fidelity.com.

View the most recent quarterly performance sheet for the investment options available through the Emeriti Program. For the most current performance data, please click here.

Strategic Advisers, Inc., a subsidiary of FMR Corp., manages the Fidelity Freedom Funds.

Choosing the Freedom Fund that's right for you

As you consider your investment choices, you should review the important differences between the investment options and determine which might align with your individual circumstances, retirement horizon, risk tolerance and investment goals.

For example, you may wish to allocate contributions in the Fidelity Freedom Fund closest to your target retirement date. Or you may want to allocate your contributions among several investment choices, such as a percentage in any Fidelity Freedom Fund of your choice and the remaining percentage in the Retirement Money Market Portfolio. No matter what you choose, you can change how future contributions to your Accounts are invested or rebalance your portfolio at any time. If you don't make a fund selection, then by default, your employer contributions will be invested in the Fidelity Freedom Fund closest to the year in which you will become Medicare eligible (currently age 65), at the direction of the Plan.

The underlying investment mix of each of the Fidelity Freedom Funds changes over time to help meet the changing needs of participants as they get closer to retirement, with the fund's allocation becoming more conservative as its target retirement date nears.

The funds with longer time frames are more aggressive, with higher concentrations of stock (equity) mutual funds, a greater potential for higher investment returns and higher potential volatility. These funds may be more appropriate for investors who are far enough away from retirement to tolerate the market's inevitable ups and downs.

The funds with shorter time frames are more conservative and may be more appropriate for investors who want to focus on preserving their current assets. These funds concentrate on investing in bond funds and money market funds, which historically have fluctuated less in value than stock funds although they also offer less potential for growth.

As each Freedom Fund nears its target retirement date, the fund will take on an asset mix comparable to the Fidelity Freedom Income Fund®. In fact, each of the Fidelity Freedom Funds will ultimately merge into the Fidelity Freedom Income Fund 10–15 years after the target retirement date is reached.

These funds are subject to the volatility of the financial markets in the U.S. and abroad and may be subject to the additional risks associated with investing in high yield, small cap and foreign securities.

Before investing in any mutual fund, please carefully consider the investment objectives, risks, charges and expenses. For this and other information, call or write Fidelity for a free prospectus. Read it carefully before you invest.

Emeriti Guaranteed Annuity Option to be Discontinued (for Now)

As a result of its continuing strategic product review, Fidelity will no longer issue guaranteed annuities, effective April 30, 2008. Emeriti continues to believe that a guaranteed income option is desirable for retirees who may wish to have a stable flow of income into their Emeriti Health Account, whether for a fixed term or for a lifetime, to pay for their health insurance premiums and other qualified medical expenses. Emeriti is looking for a replacement product.

Your spouse* can be enrolled in Emeriti insurance at the same time you enroll.  If your spouse is over 65, he/she must be enrolled in Medicare Parts A and B, and must be enrolled in the same Emeriti Health Insurance Plan Options as you.  If you have a spouse* who is under age 65, or if you have children who qualify as dependents under federal law and are under age 19 (or under age 24** if full-time students), you can enroll them in a separate pre-65 Emeriti insurance plan, underwritten by Aetna.  When your spouse reaches age 65 and enrolls in Medicare Parts A and B, he/she can switch to the Emeriti Health Insurance Plan that you have chosen.  Special rules apply for permanently disabled family members.  Call 1-866-EMERITI (1-866-363-7484) for more information about who may qualify as eligible dependents.

Your spouse*, dependent children, and dependent relatives (if allowed under your institution’s plan) can be designated by you as eligible to use the assets in your Health Account for reimbursement of eligible out-of-pocket health expenses.

*  Domestic Partners’ coverage may be available if elected by your institution.  If you have a non-dependent domestic partner, you cannot use your Emeriti Health Account to pay for his/her health insurance or qualified medical expenses.  Insurance premiums must be paid each month via electronic transfer from other assets.

** Different state laws may apply.

The Pre-65 Dependents Plan Provisions

For detailed information about the Pre-65 plan provision choices, please review the Pre-65 comparison chart.

How the Pre-65 Dependents Plan Works

The Pre-65 Dependents Plans are Aetna Open Choice PPO/Indemnity Plans that work differently depending on where you live.

Your spouse* can be enrolled in Emeriti insurance at the same time you enroll. If your spouse is over 65, he/she must be enrolled in Medicare Parts A and B, and must be enrolled in the same Emeriti Health Insurance Plan Options as you. If you have a spouse* who is under age 65, or if you have children who qualify as dependents under federal law and are under age 19 (or under age 24** if full-time students), you can enroll them in a separate pre-65 Emeriti insurance plan, underwritten by Aetna. When your spouse reaches age 65 and enrolls in Medicare Parts A and B, he/she can switch to the Emeriti Health Insurance Plan that you have chosen. Special rules apply for permanently disabled family members. Call 1-866-EMERITI (1-866-363-7484) for more information about who may qualify as eligible dependents.

Your spouse*, dependent children, and dependent relatives (if allowed under your institution's plan) can be designated by you as eligible to use the assets in your Health Account for reimbursement of eligible out-of-pocket health expenses.

*  Domestic Partners’ coverage may be available if elected by your institution.  If you have a non-dependent domestic partner, you cannot use your  Emeriti Health Account to pay for his/her health insurance or qualified medical expenses.  Insurance premiums must be paid each month via ele tronic transfer from other assets.

** Different state laws may apply.

The Pre-65 Dependents Plan Provisions

For detailed information about the Pre-65 plan provision choices, please review the Pre-65 comparison chart.

How the Pre-65 Dependents Plan Works

The Pre-65 Dependents Plans are Aetna Open Choice PPO/Indemnity Plans that work differently depending on where you live.If you live in an Aetna PPO service area, the plan pays benefits according to a preferred provider arrangement. You may receive care from any licensed provider, but when you choose a provider who belongs to Aetna’s network (a preferred provider), the plan pays a higher level of benefits. In addition, the preferred provider files claims for you. If you choose a non-preferred provider, the plan pays a lower level of benefits and you must file your own claims. The Pre-65 Comparison Chart  [link to pre-65 comparison chart compares preferred and non-preferred provider benefits.