TVA's Change in Medicare Supplement Plan – Welcome to OneExchange

Welcome to healthcare_medical2OneExchange

Effective January 1, 2017, TVA will no longer offer a Medicare Supplement Plan, but will instead offer medical, prescription drug, dental and vision coverage to Medicare-eligible retirees and Medicare-eligible spouses through a private Medicare exchange. Moving to a private Medicare exchange offers you more choice among competitively priced, guaranteed-issued individual health plans through the individual marketplace. It also allows TVA to continue providing you meaningful and affordable benefits, just in a different way.

TVA has partnered with OneExchange, a leading coordinator of individual coverage in the marketplace. Through OneExchange, you will have access to Benefit Advisors to help you make this transition smoothly, and to help you shop for and select coverage that’s best for your situation.

What you need to do to prepare for your selections:

1. Read all materials to learn about OneExchange and what’s changing. If you did not receive materials from OneExchange or have questions, please contact an OneExchange Benefit Advisor at 1-844-620-5725 (TTY: 711).
2. Call OneExchange to schedule your enrollment appointment at 1-844-620-5725 (TTY: 711).
3. Learn more about your new benefits with OneExchange at a retiree meeting, on the phone or via the web:

  • RSVP to attend an upcoming OneExchange retiree meeting to learn more about your options
  • Listen to a pre-recorded telephone information session 24 hours a day, seven days a week by calling 1-844-315-2767 (TTY:711)
  • Or, view a webcast of the presentation by vision the website at

The enrollment period is October 3 – December 31, 2016.

If you have ANY questions, please contact the OneExchange Benefit Advisor at 1-844-620-5725 (TTY: 711). These advisors have been thoroughly trained to assist you with all questions/issues regarding your move to OneExchange.

Additional resources to assist you:

OneExchange Getting Started Guide

Retiree Healthcare Cost Assistance Brochure

TVA Retiree Health Care Benefits

Projected Drug-Plan Costs Drive Changes for Medicare Supplement Plan in 2016

healthcare_pic1As part of the annual review of the Medicare Supplement Plan, the TVARA Health Committee worked with TVA to help determine how to recover the projected increase in plan costs for 2016.
The drug portion of the plan continues to be the driver for necessary plan design and premium changes.   As shown in the Key Plan Components table on page 5, a combination of changes in the premium, generic copays, and drug-plan deductible are being made to help cover plan costs in 2016.
In general, the plan redesign recovers costs in ways that are more directly related to your out-of-pocket drug costs, rather than additional premium increases that do not.
We believe these plan changes minimize the premium increase and will also help more members benefit from coverage-gap and catastrophic-coverage savings:

  • A $60 increase in the deductible  (to $160 from $100);
  • A generic-drug copay increase of $5 retail/$10 mail order (to $20/$40 from $15/$30);
  • Copays in the coverage-gap stage remain the same as in the initial stage;
  • A $14 premium increase (to $290 from $276).

What Fahealthcare_medical2ctors Are Considered in Deciding How To Recover Costs?

A major factor involves the plan’s coverage-gap and catastrophic-coverage sta
ges. The total costs of your covered drugs (what you pay and what the plan pays) accumulate as out-of-pocket costs toward reaching the coverage gap.  Once in the coverage-gap stage, only what you pay and the manufacturer’s discount on brand drugs accumulate as out-of-pocket costs toward reaching the catastrophic stage.  Your premium does not count as an out-of-pocket cost.  Your deductible and your copays do count, and can help you reach the coverage-gap stage where additional drug discounts apply.  If you reach the catastrophic-coverage stage, the plan pays most of the cost of your drugs.
In 2014 more than 4,000 members were in the coverage-gap stage by the end of the year, and more than 560 were in the catastrophic-coverage stage.  Monthly trends in 2015 were higher than in 2014, with more than 250 members in the gap by the end of January and some members already in the catastrophic-coverage stage.  For 2016, Medicare has increased the out-of-pocket cost threshold for the coverage gap to $3,310 from $2,960 and the catastrophic-coverage threshold to $4,850 from $4,700.  Hopefully, the decision to collect needed funds through the generic copay and deductible rather than through raising only the premium will help those with higher drug costs offset the higher thresholds.
Another consideration is trying to keep premiums lower for all those on the plan.  If no plan-design changes are made, all needed revenues would be collected through an even higher premium — a premium that would be paid regardless of plan usage and which would not count toward movement through plan stages.
Remember:  Some drugs cost less than your copay.   If so, you only pay the actual cost!  It’s easy to forget this and jump to the copay when you think about your drug cost.   For example, even though the generic copay is increasing in 2016, it doesn’t mean all of your prescriptions will cost more.  Many prescriptions cost less than the copay, so you will pay just the drug cost.  Generic blood pressure and cholesterol medications often fall into this category.
Remember your plan automatically accumulates your out-of-pocket costs (what you pay and what the plan pays) toward reaching the coverage-gap stage.  However, there may be times when these costs are not accumulated for you, such as when you purchase a covered drug without using your plan ID card or use a discount card.  To help Catamaran include all of your out-of-pocket costs, please read pages 43-44  (Chapter 4, Section 3) of your Evidence of Coverage booklet.  Each dollar is important to qualify for additional savings at the coverage gap level.


In Search of Lower Cost Health Insurance?
Here are a few things to consider… 


HSA (Health Savings Account) – administered by HSA Bank

HSA Letter

HSA Online Enrollment Instructions

HSA Application

HSA Beneficiary Form


Medicare Plan Only

2016 Premium Notice Letter 


healthcare_prescriptionPRESCRIPTION DRUG

(administered by OptumRx/Catamaran)

Medicare Plan Only

2016 Summary of Benefits
Evidence of Coverage 2016
Annual Notice of Changes for 2016
2016 Abridged Formulary (List of Covered Drugs)
Pharmacy Directory 2016




Retiree Dental Plan 

Questions about benefits, claims, and all other customer service matters must be directed to Delta Dental at 800-223-3104