Page 3 - Cover Letter and Evaluation for Judy Thomas

The premium comparisons for Plans G and N are shown in Appendices B1 and B2. These
comparisons are from CSG Actuarial, and they can be helpful in a couple of ways. First, they can
serve as a starting point to identify the companies that have lower premiums; second, these
quotes also show the insurance companies’ financial ratings by A.M Best and (for the larger
companies) Standard & Poor. They do not show the companies’ phone numbers, which I’ll send
in a separate attachment from the Colorado’s Dept. of Regulatory Agencies. This attachment
also shows each company’s Medigap premiums as of July, 2018.

Discounts

Insurance companies that sell Medigap policies offer discounts of various kinds. As an example,
some companies have discounts for automatic debit payments of monthly premiums or for
paying a year’s premiums in advance. The largest discounts are typically available when both
spouses buy their policies from the same company. While not all companies offer these
“household discounts,” the ones that do often have substantially reduced premiums. In both
your and your husband’s evaluations, the premiums from CSG Actuarial include household
discounts (for those insurers who offer them).

In addition to discounts, some insurers provide extra benefits such as membership in Silver
Sneakers, which give you access to more than 12,000 gyms and health clubs nationally (the
PERA plans also provide Silver Sneakers memberships).

The two PERA Advantage plans

As you are aware, Advantage plans are managed-care plans – primarily HMO’s and PPO’s. But
the two PERA Advantage plans do not appear to have any network restrictions -- you can go to
any doctor who accepts Medicare without having to pay more to see out-of-network providers.

The absence of network restrictions may be PERA’s way to smooth the transition from a
traditional Medicare plan to a managed care plan. There’s a good possibility, of course, that at
some future point there will be additional costs for seeing out-of-network doctors and, as in
most Advantage PPO plans, a higher out-of-pocket maximum if you see doctors who are not in
the network. Currently all five of your doctors are listed in various Anthem PPO networks, as
shown in Appendix A2.

Here’s are brief summaries of the two PERA plans:

1) Anthem Medicare Advantage Plan #1. This is the stronger of the two PERA plans
and in addition to having no health plan deductible, it has a low $2,000 annual out-
of-pocket maximum, which does not include the plan’s premiums or prescription
drug costs. Net monthly premiums are $145 ($260 minus the $115 monthly subsidy),
or $1,740 a year. Thus the worst case for medical costs is $3,740 a year – $1,740 in
premiums plus the $2,000 out-of-pocket maximum.

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