Retiree Health Care Benefits

Retiree Medical Plan Election Period: October 17 – November 6, 2018

The annual election period for the retiree medical plan will be held from October 17 through November 6, 2018. The medical plans available to eligible retirees for 2019 are the 80-percent PPO and the Consumer-Directed Health Plan (CDHP).

The medical plans are described in the Medical Plan 2019 booklet. Premiums are shown on page 15 of the booklet.

Changes for 2019

The following changes will be in effect January 1, 2019

Changes in the 80% PPO Medical Plan

The 80% PPO in-network deductible will increase from $400 Individual / $800 Family to $450 Individual / $900 Family. Deductibles for out-of-network services will increase to $900 Individual / $1,800 Family. The out-of-pocket maximum (the most you will pay for covered charges) will increase from $2,500 Individual / $5,000 Family to $2,750 Individual / $5,500 Family (in-network) and from $5,000 Individual / $10,000 Family to $5,500 Individual / $11,000 Family (out-of-network).

Changes in Consumer-Directed Health Plan (CDHP) Medical Plan

The CDHP out-of-network deductible will increase from $2,600 Individual / $5,200 Family to $2,700 Individual / $5,400 Family. Deductibles for in-network services will not change.

More Flexible Frequency Limits for Vision Care

Currently, you need to wait 12 months (for eye exams and lenses) or 24 months (for frames) from the last date of service to have them covered under your vision plan. Beginning in 2019, eye exams and lenses are covered once per calendar year. Frames are covered once every other calendar year. If, for example, you have an exam and get new frames and lenses any time during 2019, you may get another exam and new lenses any time in 2020. You will have to wait until 2021 for new frames to be covered.

A New Option for Maintenance Medications

The Maintenance Medication Refill Program now provides you with two options to obtain refills of certain maintenance medications (those drugs you take regularly for ongoing conditions such as high blood pressure, diabetes, or high cholesterol). Under this program, the prescription plan will cover up to three retail pharmacy purchases of covered maintenance medications. After three retail purchases, you can fill those prescriptions through home delivery from the Express Scripts Pharmacy or, beginning January 1, 2019, at a participating retail SMART90 pharmacy. If you currently receive a maintenance medication through Express Scripts, you will be mailed more information about this option.

Prescription Drug Plan Formulary

The formulary of prescription drugs will change to Express Scripts’ National Preferred Formulary. There are no changes to the prescription drug plan design for copayments and coinsurance. Some prescription drugs may now be excluded and not covered. There will always be, however, a covered prescription drug alternative. If you are taking a drug being excluded from coverage, you will be contacted directly by Express Scripts by letter explaining your options.

Increase in Health Savings Account (HSA) Maximum Annual Contribution

The maximum annual HSA contribution from all sources (i.e., TVA contribution plus employee contributions) will increase to $3,500 Individual coverage / $7,000 Family coverage as mandated by the IRS. If you are age 55 or older, you can also make additional “catch-up” contributions. The maximum annual catch-up contribution is $1,000 beginning in the year you turn 55.

Reduction in Monthly Health Savings Account (HSA) Administrative Fee

If your HSA account balance is under $3,000, there is a monthly HSA administrative fee. The monthly administrative fee will be reduced from $1.75 to $0.25. There is no fee if you maintain a balance of $3,000 or more.

How to Make Changes

To change your medical coverage for 2019, the Retiree Medical Plan Election Form 2019 (see page 17 of the Medical Plan 2019 booklet) must be completed and returned to TVA Employee Benefits by November 6, 2018. If you have medical coverage in 2018 and your election form is not received by November 6, 2018, you will be enrolled in the same medical plan for 2019 at the same level of coverage – individual or family – you have in 2018.

If you want to keep the same medical plan you currently have, you do not have to return the election form.

You cannot change your election after January 1, 2019. Retirees who do not have medical coverage now may not elect coverage at this time.

Medical Insurance

Non-Medicare Retirees

If eligible for retiree medical coverage, retirees and their eligible dependents not yet eligible for Medicare may choose from medical plan options that include medical, prescription-drug coverage, and vision-care benefits. The benefit plans available to eligible retirees are described in Medical Plan 2019 (PDF, 285 kb). More detailed information can be found in Medical Plan Description.

Note: When retirees or their eligible dependents become eligible for Medicare, they cannot continue in these plans but are instead eligible to enroll in healthcare coverage through a private Medicare exchange provided by Via Benefits (formerly known as OneExchange) as described below in Medicare Retirees.

Summary of Benefits and Coverage

In accordance with the Patient Protection and Affordable Care Act, a Summary of Benefits and Coverage (SBC) for the TVA Medical Plan options is being made available to you. The SBC provides information to help you understand your medical plan options and make decisions about which medical plan to choose.

View and/or print the TVA Medical Plan’s SBCs below.

80-percent PPO
Consumer-Directed Health Plan

To have a copy sent to you free of charge, contact TVA Employee Benefits at TVAEmployeeBenefits@tva.gov, or call 1-888-275-8094 (toll-free), 1-423-751-8800 (Chattanooga), 1-865-632-8800 (Knoxville) or 1-800-848-0298 (TDD/TTY-TN Relay Service).

Medicare Retirees (Age 65 and Older)

If eligible for retiree medical coverage, retirees and their eligible dependents that are eligible for Medicare, and are at least age 65, are eligible to enroll in healthcare coverage through a private Medicare exchange provided by Via Benefits (formerly known as OneExchange). Other plans are available outside of Via Benefits.

Through Via Benefits, eligible retirees and dependents can enroll in medical, prescription drug, dental and vision coverage. They also have access to Benefit Advisors to help them shop for and select coverage that’s best for their situation.

When becoming eligible for Medicare upon reaching age 65, retirees and dependents have choice among competitively priced, guaranteed-issued individual health plans through the individual marketplace.

If enrolled in TVA’s retiree medical coverage, retirees and dependents will begin receiving information from Via Benefits as early as their 64th birthday. This information will provide details about their retiree healthcare benefits as well as information about how and when to enroll.

Retirees and their Medicare-eligible dependents can enroll through Via Benefits during the Initial Enrollment Period (IEP). The IEP is a seven-month period that starts three months before their Medicare-eligible date, includes the month of their Medicare-eligible date, and the three months after their Medicare-eligible date.

IMPORTANT: If the retiree, or the surviving dependent of a deceased retiree, does not enroll in a medical plan through Via Benefits during their Initial Enrollment Period, any dependents covered on a TVA group plan (i.e., 80% PPO or CDHP) will be removed from coverage. In addition, any TVA Contribution or TVA Healthcare Credit will no longer be provided.

Medicare Retirees (Under Age 65)

If eligible for retiree medical coverage, retirees and their eligible dependents that become eligible for Medicare before reaching age 65 due to disability, are given the option to stay in the plan they’re currently enrolled in, or enroll in a plan through Via Benefits.

Retirees or dependents becoming eligible for Medicare early must contact TVA Employee Benefits within three months of their Medicare effective date. Otherwise, they will remain in the plan they’re currently enrolled in.

For additional information on medical benefits available to TVA retirees, contact TVA Employee Benefits by calling TVA Connect at (888) 275-8094 or e-mail at TVAEmployeeBenefits@tva.gov.

Retiree medical forms

Retiree Medical Plan Bank Draft Authorization Form (TVA Form 17534)

To be used by retirees to authorize automatic bank drafts for collection of medical coverage premiums.

Retiree Status Change Form (TVA Form 17312A)

To be used by retirees to report life-event changes affecting medical coverage, including death, divorce or changes in dependent eligibility.

Health Savings Account

A Health Savings Account, or HSA, is available to retirees who are enrolled in TVA’s Consumer-Directed Health Plan (CDHP). The HSA gives you, the consumer, more control over how and when you spend your healthcare resources.

The HSA trustee is HSA Bank. The HSA trustee holds your balances for you, receives and records contributions and processes distributions. TVA contributions to the HSA are made to HSA Bank. TVA’s contributions for 2019 to the HSA are $600/individual and $1,200/family. The maximum annual HSA contribution from all sources is $3,500/individual and $7,000/family. The maximum is set by the IRS. If you are age 55 or older you can also make additional “catch-up” contributions. The maximum annual catch-up contribution is $1,000 beginning the year you turn 55.

There is a monthly HSA administrative fee of $0.25 if your account balance is under $3,000. There is no fee if you maintain a balance of $3,000 or more.

Important: If you currently have an HSA with HSA Bank you do not need to take any action. If you continue to be enrolled in the CDHP in 2019, TVA will deposit its HSA contribution into your account.

If you are a new retiree, please refer to the Benefits Summary for Terminating Employees for instructions regarding your HSA.

View information on the Health Savings Account.

Dental insurance

The retiree dental insurance plan is designed to help retirees with the cost of dental expenses. This plan is not tied to the retiree medical plan. Future retirees may choose not to enroll in dental but still maintain their medical coverage.

Delta Dental Plan of Tennessee is the carrier for this benefit. Delta allows participants to use any dentist, but offers incentives to those who choose a participating dentist. Visit Delta Dental’s Web site for a list of participating dentists.

The monthly premiums are $33.42 for individual coverage and $78.87 for family coverage.

Future retirees who wish to enroll must sign up within 30 days of their retirement. Coverage will be effective the first of the month following Delta Dental’s receipt of the enrollment form.

The following documents outline the dental plan and provide forms that can be printed out and mailed to Delta Dental.

Guidelines for Retiree Dental. Explains participants’ responsibilities under the plan, eligibility, payment of premiums, and more (58 kb).

Retiree Dental Information and Forms

Federal Long Term Care Insurance

The U.S. Office of Personnel Management offers this program to all federal employees and retirees, including those from TVA. Spouses and adult children of retirees are also eligible to enroll.

The program is designed to help with the costs of nursing-home care, assisted-living facilities, in-home care and other expenses not covered by medical plans. It is offered through Long Term Care Partners, a partnership of MetLife and John Hancock.

Those who wish to enroll in the program must request an enrollment application packet from Long Term Care Partners. TVA does not have application packets. Enrollment packets can only be requested from the Long Term Care Partners Web site or by calling (800) 582-3337.

The Web site has information on plan premiums and coverage options, as well as average nursing-home costs for major U.S. cities. The site also lists the health questions that all applicants are required to answer before being approved for coverage.

The premiums for this coverage are paid entirely by the retiree. Premiums can be paid through a deduction from the monthly pension benefit.

Prescription Safety Eyewear

The safety eyewear program is a courtesy offering as part of a contract with TVA’s safety eyewear vendor.

Retirees may purchase prescription safety eyewear at TVA’s discounted price, however, the retiree must be able to access the internet for instructions and to print out the form needed for their prescription eyewear provider.

Read about the program here.