medicare-eligible welcome kit - welcome to mercer...

*Services provided by Mercer Health & Benefits Administration LLC.

This booklet contains important information on how health care plan changes will affect you.

Medicare-Eligible Welcome Kit

Mercer Marketplace 365SM*

P.O. Box 14401, Des Moines, IA 50306-3401844.618.6289 (toll-free)800.695.1317 (TTY) 857.362.2999 (fax)[email protected]://retiree.mercermarketplace.com/TransCanada

Medicare-Eligible Welcome KitPAGE 2

INCLUDED IN THIS KIT

WHO’S WHO .............................3There are many people supporting youthrough this change. This list will help youunderstand the roles and responsibilitiesof each group.

WHAT YOU NEED TO KNOW ........4Knowing what to do and what to expect will help you prepare for a smooth transition.

APPOINTMENT PREPARATION ............................5

Following these steps will help you get the most out of your appointment with your Benefits Counselor.

QUESTIONS TO THINK ABOUT ............................6

Considering these issues will help you make an informed decision.

HEALTH CARE PROVIDER TRACKER ...................................7

List your important health careproviders to help determine whatkind of plan will best meet your needs.

PRESCRIPTION DRUG TRACKER ...................................8

Gather your prescriptions in one place to give you a head start toward making a sound selection.

MEDICARE OPTIONS ...................9

This tutorial will help you decide which plan options best fit your needs and budget.

HEALTH REIMBURSEMENT ACCOUNT (HRA) .......................10

Important facts about the HRA.

NOTES .....................................11

Use this page to keep track of any items you wish to discuss when you talk to your Benefits Counselor.

Welcome to Mercer Marketplace 365. Having the right health care coverage to meet your needs and budget during retirement is important.That’s why TransCanada is partnering with Mercer Marketplace 365 to provide resources that will help you choose a plan from a variety of health care coverage options.

You will shop for and enroll in your new coverage through Mercer Marketplace 365. You now have several options to choose from to meet your medical and prescription drug needs. Mercer Marketplace 365 and its Benefits Counselors are ready to support you before, during, and long after your medical plan changes. They will help you understand the different individual plans offered to you, determine the best plan for you, and help you enroll.

When you sign up for your new coverage through Mercer Marketplace 365, TransCanada will provide you with a subsidy to offset the cost of your health insurance. The subsidy will be placed in a Health Reimbursement Account (“HRA”) set up in your name. This is a special, tax-free account that you may use to reimburse yourself for insurance premiums and eligible health care expenses as defined by the IRS. Page 10 provides more information about your Health Reimbursement Account. To be eligible for the subsidy, you must enroll for medical coverage through Mercer Marketplace 365.

You will have a dedicated Benefits Counselor from Mercer Marketplace 365. Your Benefits Counselor will help you compare your medical, prescription drug, dental, and vision coverage options. You can also visit our website to compare your options and learn more about Medicare. Refer to page 5 for more information about connecting with your Benefits Counselor.

In the meantime, review this Welcome Kit. It contains tools and exercises to help you start learning about your new health plan options. Completing the information in this kit will make it easy for you and your Benefits Counselor to evaluate your options and get you enrolled.

Our team is excited to serve you in this new program. Benefits Counselors are available to support you during your enrollment period. You may reach Mercer Marketplace 365 Monday through Friday, from 8:00 a.m. to 5:30 p.m.EST at 1-844-618-6289 toll-free (TTY 1-800-695-1317) to set up a consultation. Or, visit us online at http://retiree.mercermarketplace.com/TransCanada at your convenience, 24 hours a day, seven days a week.

For additional information about Mercer Marketplace 365, including our compensation and privacy practices, please see the enclosed documents.

We look forward to working with you.

Mercer Marketplace 365

Who’s Who?You are not alone in this change. TransCanada carefully evaluated the retiree health insurance market and selected a team of companies and individuals to support you throughout the enrollment period and in the future.

TransCanada values their retiree relationships and continues to work to provide access to comprehensive programs that support the needs of retirees and their families. TransCanada research determined that the robust individual health insurance market offers retirees choice and flexibility in coverage options to maximize the value of your HRA dollars. To best support retirees with the service and support necessary for this transition, TransCanada evaluated several potential partners and has assembled the following team:

MERCER MARKETPLACE 365 Our Benefits Counselors are licensed insurance professionals who are available to assist you with this transition. They will help you learn how to evaluate and compare plans to select a strategy that best fits your needs.

When you have selected your plan(s), your Benefits Counselor will help you through the enrollment process to ensure that all information is submitted accurately and timely to the insurance carrier(s). Once you have enrolled, your Benefits Counselor continues to support you throughout the year with your reimbursement requests, HRA inquiries, and insurance advocacy.

INSURANCE COMPANIES You will be able to enroll in individual health plan policies offered by leading health insurance companies. You may choose from any of several Medicare Supplement, Medicare Advantage, Part D, Dental and Vision plans. Once you enroll in your selected plan, a new health insurance card will be issued to you by your new insurance carrier.

Our Benefits Counselors will help you through the change in health insurance and get the most out of your Health Reimbursement Account (HRA).

PAGE 3


WHAT YOU NEED TO KNOW

Before your call with Mercer Marketplace 365 KEEP TRACK OF YOUR HEALTH AND PRESCRIPTION DRUG COSTS AND LIST YOUR PROVIDERS

Start by keeping track of your individual health care needs. This step will prepare you for your call with your Benefits Counselor. Use the Health Care Provider Tracker to list your important providers. Use the Prescription Drug Tracker to record your monthly prescriptions. Providing correct information in the trackers will help your Benefits Counselor at Mercer Marketplace 365 analyze your health care insurance needs. As soon as possible SCHEDULE A TELEPHONE CONSULTATION WITH YOUR BENEFITS COUNSELOR

Call Mercer Marketplace 365 at 1-844-618-6289 to schedule a one-on-one consultation with your dedicated Benefits Counselor. In addition to support from your Benefits Counselor, you will also have access to Medicare Supplement, Medicare Advantage and Prescription Drug plan information.

To avoid a gap in your health care coverage ENROLL IN YOUR HEALTH PLAN When you are ready to enroll in your new plan(s), call your Benefits Counselor at 1-844-618-6289 or TTY 1-800-695-1317.

Post enrollment EXPECT YOUR ENROLLMENT PACKAGE

After submitting your enrollment, please watch for an enrollment package from your Benefits Counselor. This package will provide details on when to expect your insurance card(s), how to access your HRA, how to submit claims and when you will receive reimbursements.

Ongoing UTILIZE YOUR BENEFITS COUNSELORYour Benefits Counselor is your year-round advocate. Call your Mercer Marketplace 365 Benefits Counselor whenever you have questions about any health insurance related matters.


NEXT STEPS

Appointment PreparationFollow these steps to ensure that you are prepared for your phone consultation with a Mercer Marketplace 365 Benefits Counselor.

Please see page 9 for information on the differences among Medicare, Medicare Supplement, and Medicare Advantage Plans.

QUESTIONS FOR MY BENEFITS COUNSELOR

ACT QUICKLY for your new

health care plan to be effective as

applicable.1 Call Mercer Marketplace 365 Monday through Friday

between 8:00 a.m. and 5:30 p.m. EST at 1-844-618-6289 to schedule your one-on-one consultation with a Benefits Counselor.

Appointment Date____________________________

Time ______________________________________

Benefits Counselor ____________________________

Phone_____________________________________

2 Prepare for your appointment. To help guide your decision, please see the “Questions To Think About” on page 6.

3 Complete the Health Care Provider Tracker and Prescription Drug Tracker forms included in this kit. Please mail, fax, or email this information at least 10 days before your appointment.

Email: [email protected]

Secure fax: 857-362-2999

Address: Mercer Marketplace 365 P.O. Box 14401 Des Moines, IA 50306-3401

Write down your questions or concerns in the space on the left side of this page. Your Benefits Counselor will take the time to explain your health care insurance options and answer any questions you have. Our goal is to help you select the health plan that best fits your needs.

Have your Medicare (red, white, and blue) ID card available. You will need to provide both your Part A and Part B effective dates. Please do not email or fax this card or Medicare number.

4

5


PREPARING FOR YOUR CONSULTATION

Questions to Think About1 Do you have end stage renal disease (ESRD)?

2 Do you currently reside in a Nursing Home or Assisted Living

Facility?

3 Do you anticipate spending considerable time away from

your primary residence during which you would seek non-

emergency medical care?

4 Do you use the same group of health care providers? Are they

relatively consistent and close to home?

5 Are you comfortable with an HMO/PPO network which may

include some, but not all, of your providers and may not

provide care outside your area without additional higher fees?

6 Would you be willing to switch providers if the most

economical health plan did not include your current

providers?

7 Do you use health care providers that do not accept

Medicare? (You can call your providers and ask the billing

department.)

8 Are you entitled to TRICARE For Life, other prescription drug/

health benefits through the VA, or any other health

or prescription drug benefits not listed here?

9 Has Medicare or the Social Security Administration notified

you that you are eligible for assistance with paying for

Medicare prescription drug plan costs?

10 Are you currently receiving Medicaid benefits?

With so many health care plans to consider, it helps to narrow down options based on certain criteria that are important to you. Your answers to these questions will help the Benefits Counselor discuss health care insurance plans that best fit your needs.


Health Care Provider TrackerList your current health care providers on this sheet. Most health care plans like HMOs and PPOs use networks. Gathering your health care providers’ information here will help you and a Benefits Counselor compare access to your current providers. You also can contact your providers and ask them which Medicare plans they accept.

1. PRIMARY CARE PHYSICIAN

NAME___________________PHONE___________________

ADDRESS_________________________________________

2. SPECIALIST

NAME___________________PHONE___________________

ADDRESS_________________________________________

3. SPECIALIST

NAME___________________PHONE___________________

ADDRESS_________________________________________

4. OTHER

NAME___________________PHONE___________________

ADDRESS_________________________________________

5. OTHER

NAME___________________PHONE___________________

ADDRESS_________________________________________

Please submit this worksheet 10-14 days prior to your scheduled appointment.

Mail, fax, or email to:

Mercer Marketplace 365

P.O. Box 14401, Des Moines, IA 50306-3401

Fax: 857-362-2999

Email: [email protected]

NAME________________________ PHONE______________ (PLEASE PRINT)

Gathering your health care providers’ information will help determine if your providers accept the new health insurance you are considering.

TIPSome providers do not participate in certain HMO and

PPO plans.


NAME________________________ PHONE______________ (PLEASE PRINT)

Prescription Drug Tracker(Please Print Clearly)

In order to construct an accurate cost analysis, we will need your complete and accurate prescription drug information. For example, it is important to indicate the name of the prescription drug that you are taking, and whether you are taking a BRAND or GENERIC version. Please note, over-the-counter medications, vitamins, and supplements are not covered by prescription drug plans (e.g., Medicare Part D) and therefore are not required on this form.

All Medicare Part D prescription drug plans cover generic drugs at considerable savings over brand-name prescriptions. You may want to have a discussion with your provider regarding the possibility of switching current brand prescriptions to generics before you enroll in a new Prescription Drug plan.

IF THE SUPPLY OF A MEDICATION LASTS LONGER THAN ONE MONTH OR IS ONLY USED AS NEEDED (PRN), PLEASE TELL US HOW OFTEN IT IS ORDERED.

NAME OF MEDICINE(Excluding vitamins and over the

counter)

BRAND OR GENERIC

FORM AND DOSAGE

PACKAGE SIZE /

QUANTITY

MONTHLY(Quantities,

number of packages)

COST

Simvastatin 20 mg tablet 30 30

Timolol Maleate Opthalmic Sol 0.5% OP Sol 10 ml bottle 1 bottle per month

Nasocort AQ AER 55 mcg/AC 16.5 gm inhaler 1 inhaler per month

Ciclopirox Gel 0.77% gel 30 gm tube 1 tube per month

Lantus Solostar INJ 1 ml 3 ml pen (pack of 5)

10 pens (2 packs of 5 pens per month)

EXAMPLES:

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

B G

++

+B G+

+Please complete one Prescription Drug Tracker per person. Please mail, fax, or email this worksheet 10-14 days before your scheduled appointment to:

Mercer Marketplace 365 P.O. Box 14401, Des Moines, IA 50306-3401 Fax: 857-362-2999 Email: [email protected]

IF THE SUPPLY OF A PRESCRIPTION DRUG LASTS LONGER THAN ONE MONTH OR IS ONLY USED AS NEEDED (PRN), PLEASE TELL US HOW OFTEN IT IS ORDERED.


ORIGINAL MEDICARE WITH MEDICARE SUPPLEMENT

MEDICARE ADVANTAGE PLAN LIKE AN HMO OR PPO NETWORK

PART A (HOSPITAL INSURANCE) PART B (MEDICAL INSURANCE)

• Medicare provides this coverage.

• You have your choice of doctors, hospitals, and other providers that accept Medicare.

• Most people pay a monthly premium for Part B. In addition, you will pay deductibles for services covered under Parts A and B and pay co-insurance for all Medicare-covered services.

IN ADDITION, YOU MAY ADD A MEDICARE SUPPLEMENT POLICY TO YOUR PART A AND B MEDICARE COVERAGE.

• These plans are offered by private insurance companies that pay all or part of the deductibles and co-insurance with predictable out-of-pocket expenses.

• If you have a Medicare Supplement policy you cannot join a Medicare Advantage Plan.

• No network restrictions, as long as the provider accepts Medicare.

PART C: INCLUDES BOTH PART A (HOSPITAL INSURANCE) & PART B (MEDICAL INSURANCE)

• Private insurance companies approved by Medicare provide this coverage.

• In most plans, you need to use approved network doctors, hospitals, and other providers or you will pay more.

• You pay a monthly premium (depending upon the plan), your Part B premium, and co-payments for covered services.

• Costs, rules, and coverage beyond what’s covered in Medicare Parts A and B will vary by plan.

• Note: If you join a Medicare Advantage Plan, you do not need to have a Medicare Supplement policy.

• Normally you will see lower monthly premium costs, but higher out-of-pocket expenses when services are rendered.

• If you want this coverage, you must choose a Medicare Prescription Drug Plan.

• These plans are run by private insurance companies approved by Medicare.

• You must pay the monthly plan premium and drug co-payments.

• Most Medicare Advantage Plans include prescription drug coverage (Part D).

• Generally, the drug premium is included in your monthly Medicare Advantage premium. You will be responsible for co-payments and any other out-of-pocket plan costs.

STEP 1: DECIDE IF YOU WANT

Original Medicare with Medicare Supplement (Medigap) vs. Medicare AdvantageUse this chart to help you decide which plan is right for you.

FACTBoth Part D and

Medicare Advantage

plans are subject to the

coverage gap

(i.e., “donut hole”)

STEP 2: DECIDE IF YOU WANT PRESCRIPTION DRUG COVERAGE (PART D)

What is a donut hole?

A “donut hole” refers to a coverage gap that you may enter after you and the prescription drug plan you have selected have spent a certain amount for covered prescription drugs.

No plans currently eliminate the “donut hole.”

Your Benefits Counselor will be able to explain how the donut hole could impact you and your eligible dependents based on the specific prescription drugs taken.


HRA (if applicable to you)

TransCanada is providing an HRA for their retirees. This HRA may be used for Individual Health, Prescription Drug, Dental and Vision plan(s). This means that once you select your new plan(s), you will first pay your premiums directly to your insurance carrier, then be reimbursed by Mercer Marketplace 365 from your HRA account. Because Mercer Marketplace 365 is administering these HRA reimbursements, you will have one place to call for all your insurance and reimbursement needs. Any change will be provided via direct communication from TransCanada.

> Who’s covered? Medicare-eligible retirees, if they elect individual health care insurance coverage through Mercer Marketplace 365.

> How can I use the HRA? You can be reimbursed for certain eligible health care expenses (for example, your monthly premiums, and other eligible out-of-pocket expenses, including co-payments, coinsurance, deductibles, Medicare Part B and D premiums).

To be eligible for subsidy from TransCanada, you must enroll through Mercer Marketplace 365 for your medical coverage.

ONLINE ACCESS OF YOUR HRA

You will be able to access your HRA information 24/7 by taking the following steps:

1) Visit http://retiree.mercermarketplace.com/TransCanada In the far right box, outlined in red below, click ‘LOGIN.’ Use the primary account holder’s information to log in to access your HRA .

2) Next, in the red box outlined below, enter your Social Security Number (omit any dashes) as your User Name, and your Date of Birth (MMDDYYYY) as your password. You will be prompted to change your password after you complete this initial log in. (This is a secure site.)

3) From your dashboard, shown below, you can:

• View your account balance

• Submit claims and check their status

• Set up or edit direct deposit

• Access many other convenient features

WHEN TO EXPECT REIMBURSEMENTS FROM YOUR HRA

Approved claims received Monday through noon EST on Friday will be reimbursed Friday of the following week, excluding bank holidays. Direct deposits are made that Friday. Hard checks will be issued Friday and take approximately 3-5 business days to be delivered.


NOTES AND QUESTIONS FOR A BENEFITS COUNSELOR

medicare-eligible welcome kit - welcome to mercer...

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