IN THIS ISSUE:
- Health Plan Announces Changes Effective January 1, 2025 to Address Ongoing Headwinds and Ensure Long-Term Financial Stability. In an effort to address the ongoing headwinds of continuing healthcare inflation, including double-digit inflation projected for 2025, a low eligibility threshold and a growing retiree population, the Board of Trustees voted to implement the following plan changes effective January 1, 2025:
- Minimum Earnings Threshold for Health Plan Choice Coverage Increasing to $39,820 for Earning Periods Beginning in 2025. The minimum earnings threshold will increase to $129,150 under the Premier Choice Plan.
- Regular Carry-Over Earnings Threshold Increasing to $160,000. The carry-over maximum amount remains unchanged at $510,000. For more information regarding Carry-Over Coverage, refer to www.dgaplans.org/coverageextensions.
- Retiree Carry-Over Credit Eligibility Modified Effective January 1, 2025. The number of Earned Coverage years needed for a participant to use Retiree Carry-Over Credits will increase from 10 years to 20 years effective January 1, 2025. The Health Plan will grandfather current retirees who have started receiving Retiree Carry-Over Coverage until the later of January 1, 2026 or up to 12 months of this coverage.
- Non-Network Out-of-Pocket Limit Increases Effective January 1, 2025. The Non-Network Out-of-Pocket Limit will increase to $12,500 in the Premier Choice Plan, $20,000 in the Choice Plan and no limit in the Bronze Plan
- [INSERT] Notice of Change to Earnings Required for Credited Service Month Effective January 1, 2025. The earnings required to earn one Credited Service Month (CSM) will increase from $3,900 to $4,100 effective January 1, 2025. This means at least $49,200 in covered earnings will be required during the 2025 calendar year to earn the maximum 12 CSMs in 2025. This change is in line with the wage increases recently negotiated by the DGA in its Collective Bargaining Agreements. For participants who have not elected to receive reports electronically, this report will be mailed to you.
- All-Inclusive Out-of-Pocket Limit Decreases Effective January 1, 2025. The All-Inclusive Out-of-Pocket Limit sets a maximum on the amount you pay out of pocket per calendar year for network benefits, including deductibles, co-insurance and co-payments. The Health Plan evaluates this limit annually, in line with the amount established each year under the Affordable Care Act. Accordingly, beginning January 1, 2025, the Health Plan’s All-Inclusive Network Out-of-Pocket Limit will decrease from $9,450 individual/$18,900 family to $9,200 individual/$18,400 family.
- Delta Dental DMO Plan Eliminated Effective January 1, 2025. As only a handful of participants were enrolled, the Health Plan will no longer offer a dental HMO (DMO) plan, previously offered to California participants only. If you are currently enrolled in the DMO plan, you will be automatically enrolled in the Health Plan’s Delta Dental PPO plan on January 1, 2025. To find a network dentist and to learn more about the PPO plan, visit www.dgaplans.org/dental.
- CVS Updates Its List of Covered Medications, Effective January 1, 2025. CVS Caremark periodically reviews and updates its list of covered medications, called the formulary, to ensure access to safe, effective treatments in all drug classes. Effective January 1, 2025, CVS Caremark revised its list of covered medications in its formulary. Changes to the formulary affect which medications are covered by the Health Plan and how much you pay out-of-pocket for prescriptions. To view the complete formulary, visit www.dgaplans.org/formulary.
- FDA Warns GLP-1 Patients of Aspiration Risks While Under Anesthesia. GLP-1s slow the movement of food through the stomach, which the FDA warns puts GLP-1 patients at potential risk of pulmonary aspiration during surgical procedures. New warning labels for GLP-1s have been issued, along with pre-surgery recommendations for these patients, depending on their risk factors.
- Stop Leaving Money on the Pharmacy Counter. Try These Tools to See How Much You Can Save (…even compared with insurance). Insurance coverage can save you a lot of money on prescription medications, but in some cases, you can save even more with free drug discount tools available online. This article lists several prescription drug discount tools that you can use to decrease out-of-pocket costs for prescription medications, including expensive weight loss drugs like Wegovy and Zepbound. Tools include GoodRx, CVS’ RXCompare and manufacturer savings cards and programs.
- Be.Well. Get an In-Depth Look at Your Calorie Burn with the TDEE Calculator. The Total Daily Energy Expenditure (TDEE) calculator is different from other popular health calculators like the Body Mass Index (BMI) calculator, as it measures how many calories you burn per day. This tool can be used to learn more about your health and estimate the appropriate number of calories you should be consuming to meet your health goals
- [INSERT] The 2023 Summary Annual Report. The Summary Annual Report provides important information on the financial status of the Supplemental Pension Plan and the Health Plan, including asset values, expenses and total benefits paid from each plan. For participants who have not elected to receive reports electronically, this report will be mailed to you.
