July - August 2015 RPEA Newsletter

VOLUME 26 - ISSUE 3
JULY / AUGUST 2015
RETIRED PUBLIC EMPLOYEES’ ASSOCIATION
OF CALIFORNIA
Leading the way for California Actives and Retirees
Today & Tomorrow
RPEA AROUND THE STATES WORKING FOR OUR MEMBERS.
PRESIDENT’S
MESSAGE
Page 2
RPEA
HEALTH BENEFITS
UPDATE
Pages 4-5
CALPERS
HEALTH PLAN
RATE CHARTS
Pages 6-9
FRONT
COVER
CONTEST
Page 13
2016 MEDICARE PLAN
DRUG COVERAGE
COMPARISON CHART
Page 15
RPEA Membership
Update
President’s
Report
A Message from President George Linn
George Linn
RPEA President
RPEA
email
RPEAHQ@RPEA.com
website
www.RPEA.com
RPEA NEWSLETTER
Published 6 times a year by the
Retired Public Employees’ Association
of California,
300 T Street., Sacramento, CA 95811
1.800.443.7732
Opinions expressed in articles
are those of the writer and not
necessarily those of RPEA. Send
suggestions and comments to
RPEA Headquarters, attention
Bobbi Estrada, Editor.
Send changes of address to:
RPEA HEADQUARTERS
300 T Street
Sacramento, CA 95811
Attention: Changes of Address
Published in Partnership with
When I wrote my last President’s
Message in early May, the proposed Chuck
Reed/Carl DeMaio pension initiative was
merely a rumor. The facts were not clear
and had many different approaches. Then,
on a Thursday in June, the facts became
clear. This initiative is out to destroy
pensions for public employees.
What does this Reed/DeMaio initiative
mean to public employees? You will read
many versions of its implications. The fact
is that the “Voter Empowerment Act of
2016” is aimed directly at the defined
benefit pensions of public employees.
If passed, new public employees hired
after January 1, 2019 will not be allowed
to enroll in the defined benefit pension
plan in which current
public employees
already participate.
The only way for these
new employees to
receive any pension
program is to have the
plan approved by the
voters. This applies to
all employees entering
public service. In other
words, this initiative will
require costly elections in
order to make changes in
pension benefits.
This initiative has been called the bid
to disempower all California state and
local government public employees. It will
undermine the current processes by giving
voters control of all pensions and salaries.
How does this affect retirees? What
happens to CalPERS when there are no
new contributions by public employees
and their employers? This could cause a
serious drought at CalPERS. Our current
water crisis and drought have resulted in
rationing and restrictions. CalPERS could
be affected in the same way. There could
be a need to reduce pension payouts.
While this payout issue is not anticipated
at this time, the future could be difficult
2 RPEA NEWSLETTER • July / August 2015
for CalPERS members. The proposed
initiative is aimed at ALL public employees.
Librarians, clerical workers, safety
employees, managers, etc.—in fact all state,
county, city and small district employees.
Stated another way, this initiative may limit
the ability of pension plans to collect enough
employer contributions to fully pay existing
and future pensions.
What is the risk if this initiative qualifies
for the 2016 ballot? Historically, pension
bashing initiatives by Reed in San Jose and
by DeMaio in San Diego pass by the voters
62% and 69%, respectively. Those are
overwhelming margins in those metropolitan
areas and should strike fear in all of us.
This is not going to be an easy battle. It
is like going to war. We
must establish our plan of
attack.
This initiative is
working its way through
the government
administrative process
and is currently with the
California State Attorney
General for legal review.
The Attorney General
review will be completed
in mid-August. If it
passes the review, the
proponents will then be
able to put it out for signatures to qualify for
the ballot. It is important that this initiative
fails to qualify due to lack of signatures. Ask
your friends, colleagues and family not to
sign this petition. Don’t sign the petition!!!
The public needs to be informed and
educated. The average pension is less
than $2,800 or less than $34,000 per year.
This is a far stretch from the $100,000 that
the media seems to be stuck on as the
highlight of pensions. Thirteen billion dollars
are pumped into the California economy
every year by retirees receiving CalPERS
pensions. This does not include the “stand
alone” public pension systems or those of
President’s Report continues on page 3
Vice President’s Op/Ed
By Al Darby, Vice President
It appears that Chuck Reed and Carl DeMaio, the authors and municipalities are still cashof the new 2016 ballot initiative deigned to end the defined strapped. Only four cities/counties
benefit pensions that most public employees in California out of 400 went bankrupt after the
receive, have fully embraced the Wall Street propaganda terrible recession in 2008/9. The
that suggests public pension systems will devour all tax key word here is “well-managed.”
revenue and impoverish cities and counties while making For example, many cities/counties have consolidated their
retired public employees unduly rich. The average annual police/fire with other municipalities nearby to cut costs.
pension from CalPERS is $2,784 per month. No one in Technology has and will, in the future, make it possible
California is getting rich on that level of income. Many of to automate more city/county functions and enable cities/
these people do not receive
counties to thrive. Just
a Social Security pension.
a s i n p r i v a t e i n d u s t r y,
The average annual pension from CalPERS is
And, with the stronger
technology, in the form of
$2,784
per
month.
No
one
in
California
is
getting
e c o n o m y, m o s t p u b l i c
added computer capabilities
rich on that level of income.
agencies are financially
and more efficient heavy
healthy again.
equipment, will assist cities/
These pensions are not “crowding out,” as alleged, counties in fulfilling their obligations to the public and be
municipal services in the vast majority of municipalities in more cost efficient.
California. In fact, in a normal economy, which is almost the
The 2016 ballot initiative is simply another attempt to cut
case now, well-managed cities/counties find themselves in income to the middle-class to allow the top income earners
pretty good fiscal shape and capable of performing their to save on their taxes and gain more income from individuals
duties quite well. The improved economy has increased tax who, without CalPERS, would need to invest their earnings
revenue to cities/counties since 2010. Reed and DeMaio in 401K accounts that collect high fees, further reduce
want you to believe that tax revenue is still at 2009 levels middle-class income and make a secure retirement more
uncertain. We see numerous actions by corporations to cut
benefits (such as health care cuts) and keeping salaries low
in order for top executives to gain even more wealth while
lowering the standard of living for the rest of us. Additionally,
continued from page 2
top executives hate CalPERS and other large pension
the 37 Act Counties. Retiree pensions are a very important funds who meddle in their corporate affairs in shareholder
part of the California economy.
meetings. They also loathe other corporate governance
Each of us has an obligation to ourselves. That obligation
arenas such as federal and state regulatory agencies and
can be fulfilled by boosting the strength of RPEA with
new members to fight to help stop this initiative. There the SEC. They would love to have complete freedom from
are 575,000 retires receiving CalPERS pensions. Only a shareholder and regulatory oversight—a condition we know
small portion of these retirees belong to RPEA. It should, to be dangerous to our health and financial well-being.
We must unite to defeat this 2016 ballot initiative just as
therefore, be an easy task for each current RPEA member
to recruit at least one retiree for membership. Those we did in 2005 to defeat the Schwarzenegger anti-pension
CalPERS participants who are currently working can also initiatives. We need to fight to retain middle-class income
join RPEA prior to retirement for half the cost ($27/year) of a and improve it where possible, rather than continue to give
retiree membership. There are 1.7 million currently working up more of our income. The top 10% have gotten much
CalPERS participants. Each RPEA member should be able richer since 2009 – the middle-class should be richer too,
to recruit at least one person who is currently employed. but in reality we have lost ground. Let’s put an end to this
If you need membership information or membership “middle-class loss-of-income trend.” We can help a lot by
applications, please call our Headquarters Office at 800killing the Reed/DeMaio initiative. Recruit new members
443-7732, or download an application from our website,
and don’t sign petitions.
www.rpea.com.
PRESIDENT’S REPORT,
RPEA NEWSLETTER • July / August 2015 3
RPEAHealth
Membership
RPEA
BenefitsUpdate
Update
By Joanne Hollender, Director of Health Benefits
MEDICARE Basics
Many RPEA members have asked
for a review of the basics of Medicare.
Medicare is the federal health
insurance program for people 65 and older, certain younger
people with disabilities, and people with end-stage renal
disease. Different parts of Medicare cover different services,
commonly referred to as Part A, Part B, Part C, and Part D.
“Original” Medicare, administered directly by the federal
government, is the way most people obtain Medicare
coverage. It has two parts.
n Part A (Hospital Insurance) helps cover inpatient care
in hospitals and skilled nursing facilities, hospice and
home health care services. An individual is eligible for
free coverage if the individual has worked and paid
Social Security taxes for at least 40 calendar quarters
(10 years). Those who have worked and paid taxes for
less time pay a monthly premium.
n Part B (Medical Insurance) covers most medically
necessary doctors’ services, preventive care, durable
medical equipment, hospital outpatient services,
laboratory tests, x-rays, mental health care and some
home health and ambulance services. Beneficiaries pay
a monthly premium for this coverage.
n Part C (Combines Part A, Part B) allows private health
insurance companies to provide Medicare benefits.
These private Medicare health plans, such as Health
Maintenance Organizations (HMOs) and Preferred
Provider Organizations (PPOs), are known as Medicare
Advantage (MA) plans. Beneficiaries can choose their
Medicare coverage through an MA plan instead of
Original Medicare. The MA plans must offer at least the
same benefits as Original Medicare but can do so with
different rules, costs and coverage restrictions. Most
MA plans offer Part D (see below) as part of the benefits
package. Beneficiaries pay a monthly premium for Part C
coverage, in addition to the Part B premium. Note: If you
join a Medicare Advantage Plan, you cannot use or be
sold a Medicare Supplement Insurance (Medigap) policy.
n Part D (Prescription Drug Coverage) provides
outpatient prescription drug coverage. Part D is provided
only through private insurance companies that have
contracts with the government. It is never provided
directly by the government, like Original Medicare is.
Most MA plans provide prescription drug coverage.
4 RPEA NEWSLETTER • July / August 2015
CalPERS Health Plan
Open Enrollment for 2016
In June, the CalPERS Board of Administration adopted
health plan premiums and benefit changes for 2016. The
CalPERS annual Open Enrollment period runs from
September 14 through October 9, 2015 for coverage
effective January 1, 2016. The 2016 CalPERS health
plan premium charts are featured in this newsletter. Open
Enrollments packets are being mailed in late August.
Members are urged to read the CalPERS Health
Plan Open Enrollment materials about plan premiums,
benefit changes, and the new Medicare Advantage PPO
plan.
Minimum Employer Contributions
for CalPERS Health Plans for 2016
For State retirees and CSU employees, the State monthly
contributions for 2016 are: Single: $705, Two-party: $1,343,
and Family: $1,727.
The 2016 Contracting Agency Minimum Employer
Contribution is increasing to $125 from $122 per month.
Contracting Agencies may contribute more than the
minimum mandated Employer Contribution, up to 100%
of the premiums, for retirees. Most Contract Agency
retirees receive only the minimum contribution. Retirees
may contact their former employers to find out the monthly
contribution paid on their behalf in 2016.
2016 CalPERS HMO Plans Benefits & Rates
+ Medicare Advantage PPO Health Plan
In June 2015, the CalPERS Board of Administration
approved the 2016 HMO plan benefits and rates,
inclusive of the UnitedHealthcare (UHC) Group Medicare
Advantage PPO plan. This plan is a Medicare Part C or
Medicare Advantage (MA) plan, administered by the
federal government. It is not a Medicare Supplemental
plan. Medicare Advantage plans provide the same coverage
as both Medicare Part A (hospital care) and Medicare Part B
(doctor and outpatient care) but through private insurance. How the Out-of-Pocket Maximums Work
An out-of-pocket maximum places a limit on how much
money you have to pay out of pocket for your covered
Medicare Part A and Part B services during any calendar
year as long as your physician is a willing Medicare provider.
With the UnitedHealthcare Group Medicare Advantage PPO
RPEA Health Benefits Update
plan, the maximum you have to pay in any single calendar
year (1/1-12/31) is $1,500. In addition, the UnitedHealthcare Group Medicare
Advantage PPO plan includes Medicare Part D prescription
drug coverage. The UHC MA plan also includes HouseCalls
and SilverSneakers programs (as requested by RPEA),
which are not currently available to Medicare members.
As an optional benefit, the UHC plan provides retirees the
ability to purchase a vision and dental benefit.
The primary benefit of the UHC Medicare Advantage
PPO plan is that it allows plan members to receive care – at
the same benefit level – from any willing Medicare provider
in California and across the country. The plan covers all of
the care covered by Medicare Parts A, B and D and includes
a comprehensive national network of contracted health
care providers. If a non-contracting provider seeks money
up-front from a member, UHC guarantees reimbursement,
minus the co-pay, to the member within 30 days.
Under the new UHC plan, CalPERS savings are projected
to be $24 million assuming 40,000 Medicare members join
the plan.
In addition to the new UHC Medicare Advantage
plan, CalPERS will continue to offer the existing Kaiser
Medicare Health Maintenance Organization (HMO) and
the three CalPERS Preferred Provider Organization
(PPO) Medicare Supplemental plans (PERS Care, PERS
Choice, and PERS Select). However, the following
Medicare HMOs will no longer be offered in 2016:
Anthem Blue Cross, Blue Shield, Health Net, and Sharp.
If your CalPERS Medicare HMO health plan is no longer
being offered in 2016, you will need to select another plan.
CalPERS will be sending letters to members losing their
current health plan in 2016. If you do not take any action
during Open Enrollment, CalPERS will automatically enroll
you into the new United HealthCare (UHC) Medicare
Advantage (MA) Preferred Provider Organization (PPO)
plan. Members in “combo” plans (both Basic and Medicare
members) may require a change in provider. UHC has a
dedicated toll free phone number: (888) 867-5581. Members
can also check out information on the CalPERS website.
(Note: CalPERS is no longer referring to the UHC MA PPO
plan as a “single carrier plan,” as it confused people.)
The CalPERS Board-approved health plan rates include
benefit design changes, program and expansion efforts, as
well as additional costs attributed to the Affordable Care Act
(ACA). The 2016 health plan rates include the following:
Anthem Blue Cross
n Welvie, an online tool that helps educate members
and place more power in their hands when it comes to
minimizing unnecessary and inappropriate surgeries
(Basic plan)
n Select expansion into San Diego County (Basic plan)
Blue Shield of California
n Welvie (Basic plan)
n Enhancing the Prescription (Rx) benefit with a 90-day
supply option giving members the option to fill their
prescriptions at selected retail pharmacies when mail
service by PrimeMail is not feasible or desired (Basic
plan)
Health Net
n SmartCare expansion into Alameda, Contra Costa,
Fresno, Kern, Kings, Napa, Sacramento, San Francisco,
San Joaquin, San Mateo, Santa Clara, Santa Cruz,
Solano, Sonoma, Tulare and Yolo; totaling 21 counties
serviced (Basic plan)
Kaiser
n Standardization of acupuncture/chiropractic benefits,
$15.00 co-pay with a combined 20 visits per year
(Medicare plan)
UnitedHealthcare
n United Alliance HMO expansion into Kings, Marin, and
San Diego counties (Basic plan)
n UnitedHealthcare Medicare Advantage (MA) Preferred
Provider Organization (PPO) offered in all 58 counties
and out-of-state
n RX benefit of 90-day supply option at select participating
retail pharmacies at the mail order price (Note: RPEA
specifically requested this mail order feature.)
2016 CalPERS Preferred Provider
Organization (PPO) Plans Benefit & Rates
In June 2015, the CalPERS Board of Administration
approved the 2016 Preferred Provider Organization (PPO)
rates for Anthem Exclusive Provider Organization (EPO),
PERS Select, PersCare, and PERS Choice. The health
plans include the following:
n Welvie (Basic plan)
n Extension of Castlight Pilot through December 2016
RPEA Health Benefits Update continues on page 11
RPEA NEWSLETTER • July / August 2015 5
RPEAHealth
Membership
Update
CalPERS
Plan Rate
Charts
CalPERS 2016 State Health Premiums
Association Health Plans Only
CalPERS 2016 State Health Premiums - Association Health Plans Only
2015
Basic
Single
2016
2-Party
Family
Single
2-Party
Family
Percent
Change (+/-)
CAHP
620.79
1,205.17
1,576.26
620.79
1,205.17
1,576.26
0.00%
CCPOA North
681.33
1,365.26
1,843.13
681.33
1,365.26
1,843.13
0.00%
CCPOA South
561.88
1,126.30
1,521.82
561.88
1,126.30
1,521.82
0.00%
PORAC
675.00
1,292.00
1,642.00
699.00
1,399.00
1,789.00
8.03%
2.52%
Total ASN Basic Change
2015
Medicare
Single
2016
2-Party
Family
Single
2-Party
Family
Percent
Change (+/-)
CAHP
372.00
688.00
874.00
372.00
688.00
874.00
0.00%
CCPOA
447.79
897.61
1,342.41
435.34
872.56
1,304.91
-2.79%
PORAC
402.00
802.00
1,281.00
442.00
881.00
1,408.00
9.88%
2.49%
Total ASN Medicare Change
CalPERS2016
2016State
State Health
Health Premiums
Only
CalPERS
Premiums- -HMOs
HMOs
Only
2015
Basic
Single
Anthem HMO Select
Anthem HMO Traditional
2016
2-Party
Family
$639.45
$1,278.90
$1,662.57
727.34
1,454.68
1,891.08
Single
Percent
Change (+/-)
2-Party
Family
$695.77
$1,391.54
$1,809.00
8.81%
752.48
1,504.96
1,956.45
3.46%
BSC Access+
718.16
1,436.32
1,867.22
767.45
1,534.90
1,995.37
6.86%
BSC NetValue
670.36
1,340.72
1,742.94
761.20
1,522.40
1,979.12
13.55%
Health Net Salud y Más
535.97
1,071.94
1,393.52
552.39
1,104.78
1,436.21
3.06%
Health Net SmartCare
671.47
1,342.94
1,745.82
651.23
1,302.46
1,693.20
-3.01%
Kaiser
633.04
1,266.08
1,645.90
661.76
1,323.52
1,720.58
4.54%
Kaiser Out of State
922.78
1,845.56
2,399.23
930.29
1,860.58
2,418.75
0.81%
Sharp
586.38
1,172.76
1,524.59
574.73
1,149.46
1,494.30
-1.99%
UnitedHealthcare
642.40
1,284.80
1,670.24
625.78
1,251.56
1,627.03
-2.59%
7.21%
Total Basic Change
Medicare
Anthem Blue Cross
Blue Shield
a/
a/
a/
2015
Single
2-Party
2016
Family
$445.38
$890.76
$1,336.14
352.63
705.26
1,057.89
830.55
Single
2-Party
Family
Percent
Change (+/-)
276.85
553.70
Kaiser CA
295.51
591.02
886.53
297.23
594.46
891.69
0.58%
Kaiser Out of State
390.47
780.94
1,171.41
297.23
594.46
891.69
-23.88%
327.66
655.32
982.98
267.41
534.82
802.23
320.98
641.96
962.94
Health Net
Sharp
a/
UnitedHealthcare
Total HMO Medicare Change
-3.46%
a/ Medicare healthplan is not available in 2016 under the Single Carrier Proposal
Ratesfor
for
the
newly
adopted
CalPERS
Medicare
Advantage
plan
through UnitedHealthcare
can
Rates
the
newly
adopted
CalPERS
Medicare
Advantage
plan through
UnitedHealthcare
can be found here.
be found here.
6 RPEA NEWSLETTER • July / August 2015
CalPERS Health Plan Rate Charts
CalPERS2016
2016Health
Health Premiums
Premiums -- Regional
CalPERS
Regional
Contracting Agencies -- HMOs
Contracting
HMOs Only
Only
Basic
2015
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
Basic Premium Rates - Bay Area
Alameda, Amador, Contra Costa, Marin, Napa, Nevada, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano,
Sonoma, Sutter, and Yuba
Anthem HMO Select
$662.41
$1,324.82
$1,722.27
$721.79
$1,443.58
$1,876.65
8.96%
Anthem HMO Traditional
827.57
1,655.14
2,151.68
855.42
1,710.84
2,224.09
3.37%
Blue Shield Access+
928.87
1,857.74
2,415.06
1,016.18
2,032.36
2,642.07
9.40%
Blue Shield NetValue
870.60
1,741.20
2,263.56
1,033.86
2,067.72
2,688.04
18.75%
Health Net SmartCarea/
Kaiser CA
808.44
1,616.88
2,101.94
714.45
1,428.90
1,857.57
746.47
1,492.94
1,940.82
4.48%
850.67
1,701.34
2,211.74
955.44
1,910.88
2,484.14
12.32%
UnitedHealthcare
Basic Premium Rates - Sacramento Area
El Dorado, Placer, Sacramento, and Yolo
Anthem HMO Select
$811.14
$1,622.28
$2,108.96
$902.07
$1,804.14
$2,345.38
11.21%
Anthem HMO Traditional
940.16
1,880.32
2,444.42
1,112.54
2,225.08
2,892.60
18.34%
Blue Shield Access+
809.22
1,618.44
2,103.97
885.33
1,770.66
2,301.86
9.41%
Blue Shield NetValue
758.45
1,516.90
1,971.97
900.73
1,801.46
2,341.90
18.76%
Health Net SmartCarea/
Kaiser CA
747.55
1,495.10
1,943.63
660.96
1,321.92
1,718.50
695.11
1,390.22
1,807.29
5.17%
UnitedHealthcare
623.45
1,246.90
1,620.97
686.36
1,372.72
1,784.54
10.09%
Basic Premium Rates - Los Angeles Area
Los Angeles, San Bernardino, and Ventura
Anthem HMO Select
$493.40
$986.80
$1,282.84
$543.47
$1,086.94
$1,413.02
10.15%
Anthem HMO Traditional
631.62
1,263.24
1,642.21
610.64
1,221.28
1,587.66
-3.32%
Blue Shield Access+
517.87
1,035.74
1,346.46
566.53
1,133.06
1,472.98
9.40%
Blue Shield NetValue
485.41
970.82
1,262.07
576.46
1,152.92
1,498.80
18.76%
Health Net Salud y Más
430.71
861.42
1,119.85
466.11
932.22
1,211.89
8.22%
Health Net SmartCare
568.47
1,136.94
1,478.02
585.39
1,170.78
1,522.01
2.98%
Kaiser CA
521.18
1,042.36
1,355.07
543.83
1,087.66
1,413.96
4.35%
United Healthcare
458.74
917.48
1,192.72
492.24
984.48
1,279.82
7.30%
Basic Premium Rates - Other Southern California
Fresno, Imperial, Inyo, Kern, Kings, Madera, Riverside, Orange, San Diego, San Luis Obispo, Santa Barbara, and Tulare
Anthem HMO Select
$653.97
$1,307.94
$1,700.32
$634.75
$1,269.50
$1,650.35
-2.94%
Anthem HMO Traditional
743.12
1,486.24
1,932.11
710.79
1,421.58
1,848.05
-4.35%
Blue Shield Access+
598.66
1,197.32
1,556.52
654.87
1,309.74
1,702.66
9.39%
Blue Shield NetValue
561.09
1,122.18
1,458.83
666.35
1,332.70
1,732.51
18.76%
Health Net Salud y Más
520.59
1,041.18
1,353.53
535.98
1,071.96
1,393.55
2.96%
Health Net SmartCare
579.88
1,159.76
1,507.69
596.98
1,193.96
1,552.15
2.95%
Kaiser CA
579.80
1,159.60
1,507.48
605.05
1,210.10
1,573.13
4.35%
Sharp
UnitedHealthcare
564.57
1,129.14
1,467.88
561.34
1,122.68
1,459.48
-0.57%
449.10
898.20
1,167.66
493.99
987.98
1,284.37
10.00%
RPEA NEWSLETTER • July / August 2015 7
RPEAHealth
Membership
Update
CalPERS
Plan Rate
Charts
CalPERS2016
2016Health
Health Premiums
Premiums - Regional
CalPERS
Regional
Contracting Agencies
Agencies - HMOs
Contracting
HMOs Only
Only
Basic
2015
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
Basic Premium Rates - Other Northern California
Alpine, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Plumas, San
Benito, Shasta, Sierra, Siskiyou, Stanislaus, Tehama, Trinity, and Tuolumne
Anthem HMO Select
$728.65
$1,457.30
$1,894.49
$839.10
$1,678.20
$2,181.66
15.16%
Anthem HMO Traditional
838.48
1,676.96
2,180.05
964.91
1,929.82
2,508.77
15.08%
Blue Shield Access+
804.34
1,608.68
2,091.28
879.96
1,759.92
2,287.90
9.40%
Blue Shield NetValue
753.82
1,507.64
1,959.93
895.17
1,790.34
2,327.44
18.75%
Kaiser CA
716.98
1,433.96
1,864.15
755.27
1,510.54
1,963.70
5.34%
UnitedHealthcare
677.35
1,354.70
1,761.11
794.80
1,589.60
2,066.48
17.34%
$922.78
$1,845.56
$2,399.23
$930.29
$1,860.58
$2,418.75
0.81%
Basic Premium Rates - Out of State
Kaiser/Out of State
2015
Medicare
b/
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
Medicare Premium Rates - All Regions
$445.38
$890.76
$1,336.14
352.63
705.26
1,057.89
Health Netb/
Kaiser CA
276.85
553.70
830.55
295.51
591.02
886.53
297.23
594.46
891.69
0.58%
Kaiser Out of State
390.47
780.94
1,171.41
297.23
594.46
891.69
-23.88%
Sharpb/
UnitedHealthcare
327.66
655.32
982.98
267.41
534.82
802.23
320.98
641.96
962.94
Anthem Blue Cross
Blue Shieldb/
CalPERS
Health Premiums
Premiums- -PPOs
PPOs
Only
CalPERS2016
2016State
State Health
Only
Basic
2015
Single
2016
2-Party
Family
Single
2-Party
Family
Percent
Change (+/-)
Anthem EPO Del Norte
640.45
1,280.90
1,665.17
715.70
1,431.40
1,860.82
11.75%
Anthem EPO Monterey
640.45
1,280.90
1,665.17
715.70
1,431.40
1,860.82
11.75%
PERS Choice
640.45
1,280.90
1,665.17
715.70
1,431.40
1,860.82
11.75%
PERS Select
618.22
1,236.44
1,607.37
649.76
1,299.52
1,689.38
5.10%
PERSCare
718.93
1,437.86
1,869.22
801.58
1,603.16
2,084.11
11.50%
Total PPO Basic Change
Medicare
10.83%
2015
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
PERS Choice
339.47
678.94
1,018.41
366.38
732.76
1,099.14
7.93%
PERS Select
339.47
678.94
1,018.41
366.38
732.76
1,099.14
7.93%
PERSCare
368.76
737.52
1,106.28
408.04
816.08
1,224.12
10.65%
Total PPO Medicare Change
8 RPEA NEWSLETTER • July / August 2015
9.22%
CalPERS Health Plan Rate Charts
CalPERS
2016 Health
Health Premiums
Premiums -- Regional
Regional
CalPERS 2016
Contracting Agencies - PPOs Only
2015
Basic
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
Basic Premium Rates - Bay Area
Alameda, Amador, Contra Costa, Marin, Napa, Nevada, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz,
Solano, Sonoma, Sutter, and Yuba
700.84
1,401.68
1,822.18
798.36
1,596.72
2,075.74
13.91%
PERS Choice
PERS Select
PERSCare
1,380.86
1,795.12
730.07
1,460.14
1,898.18
5.74%
775.08
1,550.16
2,015.21
889.27
1,778.54
2,312.10
14.73%
Basic Premium Rates - Sacramento Area
El Dorado, Placer, Sacramento, and Yolo
PERS Choice
PERS Select
PERSCare
PERS Choice
PERS Select
PERSCare
690.43
679.26
1,358.52
1,766.08
727.58
1,455.16
1,891.71
7.11%
669.16
751.21
1,338.32
1,502.42
1,739.82
1,953.15
665.35
810.40
1,330.70
1,620.80
1,729.91
2,107.04
-0.57%
7.88%
Basic Premium Rates - Los Angeles Area
Los Angeles, San Bernardino, and Ventura
585.18
1,170.36
1,521.47
598.75
1,197.50
1,556.75
2.32%
576.49
1,152.98
1,498.87
547.55
1,095.10
1,423.63
-5.02%
647.11
1,294.22
1,682.49
666.91
1,333.82
1,733.97
3.06%
Basic Premium Rates - Other Southern California
Fresno, Imperial, Inyo, Kern, Kings, Madera, Riverside, Orange, San Diego, San Luis Obispo, Santa Barbara, and Tulare
PERS Choice
PERS Select
PERSCare
594.40
1,188.80
1,545.44
683.71
1,367.42
1,777.65
585.58
1,171.16
1,522.51
625.20
1,250.40
1,625.52
6.77%
657.32
1,314.64
1,709.03
761.50
1,523.00
1,979.90
15.85%
Basic Premium Rates - Other Northern California
15.03%
Alpine, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Modoc, Mono, Monterey, Plumas,
San Benito, Shasta, Sierra, Siskiyou, Stanislaus, Tehama, Trinity, and Tuolumne
Anthem EPO Del Norte
Anthem EPO Monterey
PERS Choice
PERS Select
PERSCare
656.08
1,312.16
1,705.81
795.57
1,591.14
2,068.48
21.26%
656.08
1,312.16
1,705.81
795.57
1,591.14
2,068.48
21.26%
656.08
1,312.16
1,705.81
795.57
1,591.14
2,068.48
21.26%
646.35
1,292.70
1,680.51
727.47
1,454.94
1,891.42
12.55%
725.54
1,451.08
1,886.40
886.15
1,772.30
2,303.99
22.14%
PERS Choice
PERSCare
653.58
1,307.16
1,699.31
625.31
1,250.62
1,625.81
-4.33%
722.74
1,445.48
1,879.12
696.49
1,392.98
1,810.87
-3.63%
Medicare
PERS Choice
PERS Select
PERSCare
Basic Premium Rates - Out of State
2015
Single
2-Party
2016
Family
Single
2-Party
Family
Percent
Change (+/-)
Medicare Premium Rates - All Regions
339.47
678.94
1,018.41
366.38
732.76
1,099.14
7.93%
339.47
678.94
1,018.41
366.38
732.76
1,099.14
7.93%
368.76
737.52
1,106.28
408.04
816.08
1,224.12
10.65%
RPEA NEWSLETTER • July / August 2015 9
RPEA
Membership
RPEA
LegislativeUpdate
Update
By James Anderson, Director of Legislation
The ability of the people of 30 days following receipt of the Title and Summary. The
the State of California to make proponent can make non-substantive changes in response
changes to laws has been around to the comments during this period. The legislature may
for over 100 years. The original hold hearings on the proposed initiative, but the legislature
plan for Initiative and Referendum cannot make changes. After this period, the proposal is
was to wrest the domination of the legislative process finally ready for the ballot and is placed on the Secretary of
by the railroads. It was successful, and the “progressive” State’s website.
movement provided many improvements to California.
The RPEA Board may recommend support or opposition
However, in recent years the initiative process has to an initiative that has been certified for the ballot.
become more and more impacted by special interests Before the Board makes that decision, an analysis and
trying to improve their legal
recommendation of the
situation. Some of these, like
proposal is made by the
Because of the low turnout in the last November
“Proposition 13” have been
Legislative Committee and
election the signatures required for a statute is
successful changing the way
submitted to the Board.
365,880, and for a constitutional amendment
property taxes are collected.
A proposal for a change
585,407 signatures are required. Because of these
(It was proposed by the
in benefits for public
“Apartment House Owner’s
employees called the “Voter
relatively low numbers, many issues are expected
Association” to improve their
Empowerment Act of 2016”
to be on the November 2016 ballot.
financial condition while
has been filed and is now
changing the assessment
in the Attorney General’s
and tax collections of all of us.) Recent attempts proposed Office but is not “officially” ready for action by RPEA’s
by the insurance industry have been less than successful.
Board. However, early review of this proposal shows that it
Getting an initiative on the ballot is a relatively simple will cause serious disruption in providing secured incomes
proposition. A draft of the proposal is filed with the Secretary and retirement benefits to all public workers. It is clear
of State with a modest fee of $200. The draft is then sent that significant expenditures by RPEA and others will be
to the Attorney General’s Office for preparation of a “Title required to help fight this proposal.
and Summary.” Before the “Title and Summary” are
RPEA has a political action committee called the
completed, the Legislative Analyst’s Office (LAO) must Independent Expenditure Committee (IEC). The Trustees
review the proposed initiative and determine the probable of the IEC can distribute funds to provide information that
cost which would result from passage. Once this process is would show the flawed thinking that has generated this
completed, the Attorney General’s office must send the Title initiative. However, the IEC cannot match the significant
and Summary back to the Secretary of State. This process resources that are expected to be placed in the hands of
takes up to 50 days.
the proponents. We will be asking the membership of RPEA
Upon completion of this process, the Secretary of State to make contributions to the IEC so that our collective voice
certifies that the initiative is approved for circulation of can be loud enough to get our message to the voters.
signatures. Signatures must then be gathered within 180 We will cooperate with others to counter the false and
days of this certification. The number of signatures is misleading claims that will harm all public employees.
dependent upon the percentage of voters in the last general
We are grateful to the Chapter 014–VENTURA/SANTA
election. For a change in statute the number is 5%, and for BARBARA for contributing $3,000 to the IEC last month.
a constitutional amendment the number is 8%. Because of As of June 30, 2015, funds available to the Trustees of the
the low turnout in the last November election the signatures Independent Expenditure Committee are $36,961.57. The
required for a statute is 365,880, and for a constitutional money comes from individual contributions or a continuing
amendment 585,407 signatures are required. Because of contribution from your retirement warrant. (There are only
these relatively low numbers, many issues are expected to 412 members making continuing contributions.) RPEA
be on the November 2016 ballot.
needs your contributions to increase the money that will be
Recent changes in the initiative process allow public needed in the coming fight to maintain a secured retirement
comments to be received by the Secretary of State for for all public workers.
10 RPEA NEWSLETTER • July / August 2015
Calendar of Events
HEALTH BENEFITS UPDATE,
continued from page 5
n Standardization of acupuncture/chiropractic benefits,
$15.00 co-pay with a combined 20 visits per year
(PERS Select and PERS Choice Basic, and all three
Medicare Supplemental plans (PERS Choice, PERS
Care, & PERS Select)
2016 CalPERS Association Plans Rates &
Benefit Modifications
In June 2015, the CalPERS Board of Administration
approved the 2016 rates for the California Association
of Highway Patrolmen (CAHP) Health Benefits Trust,
the California Correctional Peace Officers Association
(CCPOA) Benefit Trust Fund, and the Peace Officers
Research Association of California (PORAC) Insurance
and Benefits Trust. Benefit changes are detailed below.
CAHP Health Benefits Trust
n The CAHP health plan is a self-insured Preferred
Provider Organization (PPO) plan, administered by
Anthem Blue Cross of California. The following benefit
modifications will be made to the CAHP health plan for
2016:
n Basic plan: There are no benefit changes.
n Medicare plan: Implement employer group waiver
program for Medicare retiree pharmacy benefit.
CCPOA Benefit Trust Fund
n The CCPOA health plan is a fully-insured HMO plan,
administered by Blue Shield of California. There are no
benefit changes to the CCPOA health plan for 2016.
PORAC Insurance and Benefits Trust
n The PORAC health plan is a fully-insured PPO plan,
administered by Anthem Blue Cross of California.
n Basic plan: A separate out-of-pocket limit has been
added to the Medical and Prescription Drug benefit.
The out-of-pocket maximum is $4,500 for individual and
$9,000 for family on the medical benefits and $2,350 for
individual and $4,700 for family on the prescription drug
benefits.
As of this date, CalPERS and UHC have not finalized
the Evidence of Coverage (EOC) book nor the Formulary
for 2016. RPEA will be reporting more details about the
new UHC plan as it is rolled out.
Calendar of Events
n AUGUST 14 / 15— CalPERS Educational Event,
Garden Grove Hyatt Regency, 11999 Harbor Blvd,
Garden Grove, CA 92840. Both days 8:30AM 4:00PM
n AUGUST 18— CalPERS Full Board of
Administration Meeting, CalPERS Headquarters
Robert F. Carlson Auditorium, Lincoln Plaza
North, 400 P Street, Sacramento, CA 95811
n SEPTEMBER 7— Labor Day
n SEPTEMBER 14 / OCTOBER 9— CalPERS 2015
Health Plan Open Enrollment. For More Info:
www.calpers.ca.gov/docs/forms-publications/
open-enrollment-news.pdf
n SEPTEMBER 15— State Coalition of Retired
Employees (SCORE), CalPERS, 400 Q Street,
Rm. 1180
n SEPTEMBER 15—CalPERS Investment
Committee Meeting
n SEPTEMBER 17— CalPERS Pension &
Health Benefits Committee
n SEPTEMBER 18/19— CalPERS Educational Event,
Sacramento Convention Center. Both days
8:30AM - 4:00PM
n OCTOBER 12— Columbus Day
n OCTOBER 26-27— RPEA Board of Directors
Meeting, Crowne Plaza Hotel, Sacramento
RPEA NEWSLETTER • July / August 2015 11
RPEA
Membership
Update
Legislative
Update
By Aaron Read & Pat Moran, Legislative Advocates
PENSION INITIATIVE
As some of you may know, former
San Jose Mayor Chuck Reed and
former San Diego City Councilman Carl DeMaio have
teamed up to do a massive retirement, health benefits and
compensation reform initiative. That initiative is currently at
the Attorney General’s office for title and summary. It could
be cleared for circulation sometime in August.
The initiative, which has been titled the “Voter
Empowerment Act of 2016,” repeals the Defined Benefit
(DB) Retirement Plan for ALL new public employees hired
after January 1, 2019 throughout California, including state,
city, county, school, university and college employees.
Existing plans would be closed and only employees hired
prior to that date would remain. The cost for those plans
would then skyrocket, since new young members would
not be allowed to join. The initiative does not provide any
replacement benefits. It also says that the employer must
submit any attempt to place workers back into a DB Plan to
the voters for a vote.
To make things worse, the initiative defines “retirement
benefits” not only as a DB Plan, but also retiree healthcare
and any form of deferred compensation offered by
government employers. We must pay particular attention
to this matter because there are those who believe that
retirees receiving healthcare may not have a vested right,
in the same way they have a vested right to their pension.
We will provide more detailed information as additional
research is conducted.
LEGISLATION
As previously reported, May 15th was the policy
committee deadline, May 29th was the fiscal committee
deadline and June 5th was the house of origin deadline
to pass bills to the other house. Bills that failed these
legislative deadlines became “two-year bills”. Essentially, a
two-year bill is held for the rest of the year allowing time for
issues to be resolved; however, they can be revived again
next year, during the second half of the two-year session.
Below is a brief summary and status update on some of
RPEA’s major bills:
Sponsor
n AB 241 (Gordon, D-Menlo Park) Bankruptcy: Retired
Employees: Disclosure of Names and Addresses–
This measure would require, notwithstanding any other
law and under certain conditions, a local public entity to
12 RPEA NEWSLETTER • July / August 2015
provide the name and mailing address of each retired
employee or his or her beneficiary receiving the retired
employee’s retirement benefit to any organization that is
incorporated and qualified under specific state and federal
laws for the purpose of representing retired employees
or their beneficiaries as members of the organization in
a neutral evaluation process, the declaration of a fiscal
emergency and adoption of a resolution, or a bankruptcy
proceeding. RPEA is the sponsor.
Unfortunately, we ran into opposition from AFSCME, who
wanted AB 241 to be amended past its scope. Although
AFSCME has since removed their opposition, it was past
the deadline to hear the bill. We will take it up in January
and move the issue forward.
Support
n AB 332 (Calderon, D-Whittier) Long-Term Care
Insurance– This bill would require the Insurance
Commissioner to convene a task force composed
of specified stakeholders and representatives of
government agencies to examine the components
necessary to design a statewide long-term care
insurance program. The bill would require the task force
to recommend options for establishing this program and
to comment on their respective degrees of feasibility in
a report submitted to the commissioner, the Governor,
and the Legislature by July 1, 2017. AB 332 has passed
the Assembly and is currently waiting to be heard on the
Senate Floor. RPEA is in support.
n AB 374 (Nazarian, D-Sherman Oaks) Healthcare
Coverage: Prescription Drugs– This bill would prohibit
a healthcare service plan or health insurer that provides
medication pursuant to a step therapy or fail-first
requirement from applying that requirement to a patient
who has made a step therapy override determination
request if, in the professional judgment of the prescribing
physician, the step therapy or fail-first requirement would
be medically inappropriate for that patient for specified
reasons. AB 374 has passed the Assembly and is
awaiting a hearing in the Senate Health Committee.
RPEA is in support.
n SB 196 (Hancock, D-Berkeley) Elder Abuse:
Protective Orders– This bill would, commencing July
1, 2016, authorize a county adult protective services
agency and a public conservator to file a petition for a
protective order on behalf of an elder or dependent adult
if the elder or dependent adult has been identified as
Cover Contest
lacking capacity and a conservatorship is being sought.
Department of Community
The bill would require the adult protective services
Living– This bill would establish
agency or public conservator to provide a copy of the
the Department of Community
petition, a notice of the hearing, and any supportive
Living within the California Health
declarations to the elder or dependent adult at least
and Human Services Agency. The department would,
five days before the hearing, and to make reasonable
among other duties, serve as the single state-level
efforts to assist the elder or dependent adult to attend the
contact on issues of aging and long-term care, oversee
hearing and provide testimony to the court. SB 196 has
statewide long-term care service delivery, promote
passed the Senate and is currently waiting to be heard on
coordinated long-term care service delivery and access
the Assembly Floor. RPEA is in support.
to home and community-based services at the local
and regional level, and serve as the organizational unit
n SB 546 (Leno, D-San Francisco) Health Care
designated to oversee all long-term care programs in
Coverage: Rate Review– This bill would establish a rate
the state and to consolidate all long-term care programs
review process for increases to large group rates that
administered throughout all departments of the agency.
meet specified thresholds, and requires the Department
SB 547 was held at the request of the author and has
of Managed Health Care and Department of Insurance
been made a two-year bill. RPEA is in support.
to determine whether such large group rate increases
are reasonable. It also requires health care service n SJR 1 (Beall, D-San Jose) Social Security: Retirement
plans and health insurers to file specified information
Benefits: Public Employees– This measure would
regarding rate changes aggregated for the entire large
request the President and the Congress of the United
group market. SB 546 has passed the Assembly
States to pass legislation repealing the Government
and is currently awaiting a hearing in the Assembly
Pension Offset and the Windfall Elimination Provisions
Appropriations Committee. RPEA is in support.
from the Social Security Act. SJR 1 passed through
both houses of the Legislature and was signed by the
n SB 547 (Liu, D-La Canada Flintridge) Long Term Care:
Governor on July 6th. RPEA was in support.
Assistant Secretary of Aging and Long Term Care:
Join the fun!
Think you know what cities the cover photos represent?
If so, send your selections to me at editor@rpea.com. The first ten submissions
that correctly identify the locations of these cover photos will receive a See’s candy
certificate. The deadline for submissions is September 30, 2015. I look forward to
hearing from you!
Bobbi Estrada, Editor
RPEA NEWSLETTER • July / August 2015 13
Of Interest...Update
RPEA Membership
RECOGNIZING A STROKE
Thank God for the sense to remember the ‘3’ steps, STR. Read and Learn! Sometimes symptoms of
a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim
may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.
Now doctors say a bystander can recognize a stroke by asking three simple questions:
S * Ask the individual to SMILE.
T * Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently) (i.e. Chicken Soup)
R * Ask him or her to RAISE BOTH ARMS.
If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and
describe the symptoms to the dispatcher.
14 RPEA NEWSLETTER • July / August 2015
New Sign of a Stroke
Stick Out
Your Tongue!
NOTE: Another ‘sign’ of a
stroke is this: Ask the person
to ‘stick’ out his tongue. If the
tongue is ‘crooked’, if it goes
to one side or the other that is
also an indication of a stroke.
2016 CalPERS Medicare Plan & Drug Coverage Comparison
RPEA NEWSLETTER • July / August 2015 15
Retired Public Employees’ Association (RPEA)
300 T Street, Sacramento, CA. 95811-6912
Toll Free 1.800.443.7732
Phone (916) 441-7732 • Fax (916) 441-7413
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PERMIT NO. 40
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CHANGE SERVICE REQUESTED
Retired Public Employees’ Association of California (RPEA)
RPEA Board of Directors 2014/2016
300 T Street, Sacramento, CA 95811-6912
Toll Free: (800) 443-7732 Phone: (916) 441-7732 Fax: (916) 441-7413
Website: www.rpea.com
ROSTER OF 2014/2016 VOLUNTEER BOARD OF DIRECTORS
NAME
George Linn
ANY TIME
Al Darby
8AM – 9PM
TITLE
HOME ADDRESS
President
*****
E-MAIL ADDRESS
president@rpea.com
925 788 6068
NONE
aldarby9@hotmail.com
916 428 2090
NONE
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916 444 7019
NONE
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925 735 1150
NONE
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408 926 6664
NONE
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408 241-6075
408 241 6228
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(CELL)
951 686 7261
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707 573 1566
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Marie Reed
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Harvey Robinson
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Immediate Past
President
1277 Ridgeway Dr.
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Joanne Hollender
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Dir. Health Benefits
Rosemary Knox
ANYTIME
Dir. Membership
2215 Ladymuir Court
San Jose, CA 95131
Dir. Public Relations
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Santa Clara, CA 95051
Dir. Legislation
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Santa Cruz, CA 95062
Bobbi (Barbara)
Estrada
ANYTIME
Jim Anderson
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FAX
415 821 6539
8968 Panamint Court
Elk Grove, CA 95624
6796 Pocket Road
Sacramento, CA 95831
Vice President
PHONE
415 999 3538
*****
408 373 4220 (C)
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Dir. Member Svcs.
Paul Tamboury
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Area Director I
Ernest Sandoval
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Area Director II
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530 365 5678
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NONE
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Robert Van Etten
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Area Director III
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925 846-6563
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Teena Stone
Office Manager
Accts. Payable Clerk
IT Technician
Mem. Svcs. Secretary
300 T Street
Sacramento, CA 95811
8:00AM – 4:00PM
800 443 7732
916 441 7732
916 441 7413
tanya@rpea.com
radtana@rpea.com
corey@rpea.com
teena@rpea.com