• Stand-alone group contracts - Rates based on each policyholder’s own experience;
• Multiple Employer Trust (MET) - Rates based on the entire trust’s experience;
• Countrywide availability, no networks;
• Flexibility in plan design;
• Freedom to choose providers & hospitals at home and away;
• Guaranteed Issue;
• Electronic claims processing and payment cross-over with Medicare;
• Integrates with Medicare.

Medical Benefits

• Covers medical expenses not covered by Medicare;
• May potentially reduce an employer's FASB 106 or GASB 43/45 liability;
• Flexible plan designs, check our What’s New section or call one of our Sales Directors for current information on our new plan designs.

Administrative Services

Full and flexible administrative services performed by The Hartford’s approved third party administrators, including:

• Choice of billing options with the ability to manage all types of vesting schedules;
• Various enrollment methods to meet the employer’s needs;
• Ability to handle electronic claims processing and payment;
• Toll-free customer service number for retirees, employers and providers;
• Online capabilities for both benefit and claim inquiries;
• Customer Service Representatives trained in senior care relations;
• HIPAA compliant.

Prescription Drug Coverage

Plans can be designed from a variety of deductibles, co-payments, coinsurance and calendar year maximum options.

Two ways to meet your retirees' prescription drug needs:

• Fully insured plans that meet creditable coverage guidelines from CMS. Plans may qualify for the CMS Retiree Drug Subsidy for employer groups. Group Retiree Health, through its contract with CVSCaremark, provides the reporting to request reimbursement from CMS under the subsidy.
• Medicare Part D Prescription Drug Plans (PDP) through Employer Group Waiver Plans or other PDP options. Group Retiree Health contracts with a leading provider of Pharmacy Benefit Services that has extensive experience in managing all aspects of prescription drug coverage.

Pharmacy Benefit Manager Services

Visit the Web site for CVSCaremark, Group Retiree Health's Pharmacy Benefit Manager for fully insured coverage.

Fully insured coverage is provided through both retail and mail order with an open formulary, which includes a preferred drug list and generic drugs. CVSCaremark also provides a quarterly senior newsletter to member retirees.

Key Features