Trusted advisor for hundreds of thousands of retirees
Via Benefits (formerly known as Extend Health) is a leading provider of retiree health benefit administration services and will give you and your eligible Medicare dependents personalized assistance to help you navigate through your health care options.
Sandia has partnered with Via Benefits to offer retirees access to the Sandia-sponsored Humana Medicare Employer HMO Plan in New Mexico, United Healthcare Group Medicare Advantage (PPO) Plan, and the Sandia-sponsored Kaiser Senior Advantage Plan in Northern California. Via Benefits also offers a variety of individual Medicare supplemental medical and prescription drug coverage options.
To learn more about these options, please call Via Benefits at 1-888-598-7809 (TTY: 1-866-508-5123), Monday-Friday 7 a.m. – 7 p.m. MT.
Sandia Dental Care Program Summary
Sandia Vision Discount Program Summary
As a Sandia medicare-eligible retiree, you have several options for medical and prescription drug coverage available through Via Benefits. Some of your plan options include:
Via Benefits from Willis Towers Watson
Phone 1-888-598-7809 1-866-508-5123 (TTY) |
Website www.medicare.oneexchange.com/sandia |
Blue Cross Medicare Advantage (HMO)
Phone 1-877-299-1008 |
Presbyterian Senior Care HMO-POS
Phone 1-505-923-6060 or 1-800-797-5343 (outside Albuquerque) |
Website www.phs.org/PHS/healthplans/ Medicare2011/EmployerGroup/index.htm |
Kaiser Senior Advantage Plan (CA)
Phone 1-800-464-4000 |
Website www.kponline.org |
Sandia National Laboratories Health Benefits & Employee Services
Phone 1-505-844-HBES (4237) or 1-800-417-2634 ext. 844-4237 |
Website hbe.Sandia.gov |
This plan is fully insured through Humana for eligible Medicare-primary participants residing in the Humana Medicare Employer HMO within these New Mexico counties; Bernalillo, San Miguel, Sandoval, Santa Fe, Torrance and Valencia. Benefits are available only from providers who are in the Humana Medicare Employer HMO network.
You can obtain information on this plan (including a provider directory, drug formulary list, etc.) by contacting Humana Customer Care at 1-866-396-8810 (TTY: 711) Monday- Friday 6 a.m. - 7 p.m., Mountain Standard Time.
This plan is available to Medicare-primary retirees, surviving spouses, LTD terminees, and their eligible Medicare-primary Class I dependents who:
By enrolling in this plan, you will automatically be enrolled in the Medicare Part D prescription drug benefit and will receive all of your prescription drug benefits through this plan.
Sandia National Laboratories has chosen to offer a UnitedHealthcare Group Medicare Advantage (PPO) plan. Only eligible retirees of Sandia National Laboratories and their eligible dependents can enroll in this plan. You can't get it anywhere else.
"Medicare Advantage" is also known as Medicare Part C. These plans have all the benefits of Medicare Part A (hospital coverage) and Medicare Part B (doctor and outpatient care) plus extra programs that go beyond Original Medicare (Medicare Parts A and B).
This plan is available to Medicare-primary retirees, surviving spouses, LTD terminees, and their eligible Medicare-primary Class I dependents who:
By enrolling in this plan, you will automatically be enrolled in the Medicare Part D prescription drug benefit and will receive all of your prescription drug benefits through this plan.
You will not be required to enroll in an individual Medicare Part D or pay the additional Medicare Part D premium. You cannot be enrolled in the UnitedHealthcare Group Medicare Advantage (PPO) plan, which include prescription drug coverage and another Medicare Advantage plan or another Medicare Part D plan at the same time.
Note: Plans are pending Centers for Medicare & Medicaid Services (CMS) approval
The UnitedHealthcare Group Medicare Advantage (PPO) plan is a Preferred Provider Organization (PPO) plan. You have access to a national network of providers. You can see any provider (network or out-of-network) at the same cost share, as long as they accept the plan and have not opted out of or been excluded from Medicare.
Get access to benefits and programs like:
Referrals to specialists are not required.
Coverage is available worldwide for emergency and urgent care services
You can obtain information on this plan (including a provider directory, drug formulary list, etc.) by contacting UnitedHealthcare® at 1-844-496-0314, TTY 711, 8 a.m. - 8 p.m. local time, 7 days a week.
For additional information, refer to the UnitedHealthcare Medicare Advantage Plan benefits information at www.UHCRetiree.com/SandiaRetiree.
The Kaiser Senior Advantage plan is a Medicare Advantage plan with prescription drug benefits. This plan is fully-insured through Kaiser Permanente for eligible Medicare-primary participants who live in California, within Kaiser-designated service areas.
You can obtain information on this plan by contacting Kaiser Permanente Member Services Call Center at 1-800-464-4000, M-F 7 a.m. – 7 p.m., weekends 7 a.m. – 3 p.m., or by visiting www.kponline.org or, for additional information, refer to the Kaiser Senior Advantage Plan Evidence of Coverage and Kaiser Chiropractic Evidence of Coverage at hbe.Sandia.gov. If there are any discrepancies between this and the Evidence of Coverage, then the Evidence of Coverage supersedes.
This plan is available to the following who live within a Kaiser-designated service area (currently, Alameda, Contra Costa, Marin, Sacramento, San Francisco, San Joaquin, San Mateo, Solano, and Stanislaus counties are entirely inside a Kaiser service area; service areas for other Northern California counties are determined by specific ZIP codes within those counties).
This plan is available to Medicare-primary retirees, surviving spouses, Long-Term Disability (LTD) terminees, and their eligible Medicare-primary Class I dependents. Members must be enrolled in both Medicare Part A and Part B, and continue to pay Medicare Part A (if applicable) and Part B premiums.
I am not making any changes to my coverage during open enrollment. Will I receive a confirmation notice of this?
No. Confirmations are only sent to individuals who make changes to their benefits elections.
Do I have to call Via Benefits during Open Enrollment if I don't want to change any of my coverage?
No. If you do want to make any changes to your coverage (i.e., you want to keep the medical and dental plans you have and you do not need to change any dependent coverage), you do not need to call Via Benefits. Your coverage will remain in effect.
Can I elect the Your Spending Arrangement (YSA) option and use these funds to pay premiums for the Sandia-sponsored Presbyterian Senior Care HMO-POS, Blue Cross Medicare Advantage HMO, or Kaiser Senior Advantage Plan?
No. You can either elect the Presbyterian Senior Care HMO-POS, Blue Cross Medicare Advantage HOM, or Kaiser Senior Advantage Plan, OR the Your Spending Arrangement option, but not both.
If I elect the YSA option, how does this work?
You can use the annual credit amounts, as outlined on page 19 to buy an individual Medicare plan through Via Benefits, to pay for your Medicare Part A (if applicable) or Part B premiums, and/or to use toward copays and deductibles you pay under your individual Medicare coverage. Refer to the Your Spending Arrangement Program Summary at hbe.sandia.gov for more information.
Why was the decision made to not allow retirees enrolled in another qualified federal medical plan to enroll in the YSA?
YSA plan is an alternative to Sandia’s group and other group coverage. YSA is an option to allow retirees to purchase an individual Medicare plan through Via Benefits. There are very few exceptions to this (e.g., enrolled in TriCare, V.A., a Kaiser individual plan, or those who have YSA through Lawrence Livermore National Laboratories).
I am confused about the YSA option. Is Via Benefits the insurance company and I use the YSA to pay for my medical claims?
No, Via Benefits is not an insurance company. The Your Spending Arrangement option is being provided to primarily allow a Medicare individual to buy a Medicare plan through Via Benefits. This Exchange provides a multitude of Medicare plans that you can select from.
Once you enroll in a Medicare plan, you will receive an ID card from that plan. If you enroll in a Medicare Advantage plan, you will use this ID card, not your Medicare card, to access services. If you enroll in a Medigap plan, you will use both your Medicare card and the ID card you receive from the plan in which you enrolled to access services. You will pay your insurance plan directly and use the annual credit you receive through the YSA to pay for the premiums for the plan in which you enrolled. See below for more information.
Can I use the funds from the YSA option and buy my own medical coverage?
No. YSA funds may only be used to purchase an individual Medicare plan (Medicare Advantage, Medigap, and/or Part D Prescription Drug Plan) through Via Benefits. There are a few exceptions as noted in Question 3.
I enrolled in the YSA in a Medigap Plan F. I would like to change to a Medigap Plan N. Can I do this?
The ability to change Medigap plans after the first year is limited. Some carriers will allow a person to decrease coverage but will not allow them to increase coverage without medical underwriting. This is determined by the individual insurance carriers. Contact Via Benefits for assistance in changing plans.
I switched enrollment from the Presbyterian Senior care HMO-POS to a Medigap plan and a Medicare Part D plan. My Medicare Part D insurance provider is asking for a Certificate of Creditable Coverage? What is that and where can I get it?
The certificate of creditable coverage states that you had prior coverage with the insurance company. The certificate of creditable coverage will be mailed to you by the insurance company within 30 days of terminating the plan coverage. You may also call the insurance company through the telephone number provided on the back of the insurance ID card, and request a certificate of creditable coverage, or you may contact Via Benefits and we will assist you in obtaining the certificate of creditable coverage.
Do I need a special card to access the Vision Affinity Discount Program?
To receive services, 1) call the network provider and schedule an appointment 2) Identify self as a Davis Vision plan participant and a Sandia National Laboratories retiree or dependent. You may also reach Davis Vision at 1-888-575-0191 or the website at www.davisvision.com.
I was unable to attend any of the Medicare presentations. Are these available anywhere?
Yes. You can view and/or download them at hbe.sandia.gov.