2013 Health & Welfare

Open Enrollment Overview

Open Enrollment October 22 – November 7, 2012

Please note: The introduction of this benefits package for represented caregivers will be subject to bargaining obligations.

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2013 Benefits Program Overview

• Open Enrollment Key Facts • Eligible Dependents • Medical • HSA and FSA • New Wellness Program • Dental • Vision • Life and AD&D • Short and Long Term Disability • Questions

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Key Facts

• Open Enrollment Dates: October 22 – November 7

• Positive Enrollment =

All caregivers must enroll or opt out of coverage

• What happens if I don’t enroll or opt-out?

You will be enrolled in the following default coverage: • ABHP Medical Plan - Caregiver Only (initially without HSA) • Core Life • Core AD&D • Core Short- and Long- Term Disability

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Eligible Dependents

• Your Legal Spouse

• Your Qualified Domestic Partner

• Your Legally Domiciled Adult (LDA); eligible for medical, dental and vision coverage only

• Your Dependent children up to age 26

Additional dependent benefit eligibility details can be found under the Life Events - Family and Relationships section of MyHR.

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Two Medical Plan Options:

Preferred Provider Organization (PPO) and

Account Based Health Plan (ABHP)

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Medical Plan Highlights

Preferred and In-Network Provider Tier Summary

PPO

ABHP

Preventive Care • www.healthcare.gov

Covered 100% Preferred and In-Network Tiers

Covered 100% Preferred and In-Network Tiers

Annual Deductible • Single • Family

$500 $1,000

$2,000 $4,000

Co-Insurance Office visit (PCP and Specialist)

20% (deductible waived)

10% (after deductible)

Co-Insurance • Hospital Inpatient • Laboratory Services

20% Preferred Tier 30% In-Network Tier (after deductible)

10% Preferred Tier 20% In-Network Tier (after deductible)

Annual Out-of-Pocket Maximum (excludes deductible) • Single • Family

$2,500 $5,000

$3,000 $6,000

Annual Health Savings Account Not Applicable 2013 PH contributes up to: $1,200 Single coverage $2,000 Family coverage

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Pharmacy Plan Highlights

Preferred and In-Network Provider Tier Summary

PPO Preferred In-Network

ABHP Preferred In-Network

Generic $10 copay $15 copay 20% after

deductible* 30% after deductible*

Brand Formulary 20% Min = $25; Max = $75

30% Min = $30; Max = $90

20% after deductible*

30% after deductible*

Brand Non-Formulary 30% Min = $40; Max = $120

40% Min = $50; Max = $150

30% after deductible*

40% after deductible*

Prescription expenses do not count toward the medical deductible or annual out-of-pocket. Minimum and Maximum amounts apply to each script.

Medical deductible must be met first before coinsurance applies *The ABHP deductible is waived for many preventive and chronic prescription drugs.

• Out-of-Network not covered • Mail Order – 90-Day scripts at 2.5X 30-day retail price (after deductible for ABHP)

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How The Two Medical Plans Work

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Health Savings Account (HSA) and

Flexible Spending Account (FSA)

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Set aside pre-tax money in an HSA or FSA to cover qualified medical expenses; generally defined as any expense incurred to maintain an individual’s health or the health of their family, including:

– Doctor and hospital visits – Medical equipment – Dental care, braces, dentures – Vision care, glasses & contacts – Prescription medications

*A definition of Qualified Medical Expense is provided in Section 213(d) of Internal Revenue Code. A list of eligible medical expenses can be found in IRS Publication 502

www.irs.gov/pub/irs-pdf/p502.pdf.

A pre-tax dependent care FSA is also available for qualified work-related cost of care for a qualifying dependent.

Tax Advantaged Accounts

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HSA vs FSA

Health FSA HSA

Medical Plan Pairing Not eligible if enrolled in the ABHP with HSA

ABHP

PeaceHealth 2013 contributions

$0 Up to $1,200 Single Up to $1,800 Family

2013 Annual Contribution Limits

$2,500 $3,250 Single $6,450 Family

$1,000 Catch Up age 55+

Account Ownership PeaceHealth You

Use It Or Lose It Yes No, funds rollover year to year

Substantiation Yes – submit receipts at time of reimbursement

No – keep receipts in the event of individual tax audit

Option to Change Contributions

Only with qualifying event Yes – can change payroll deductions during the year (not to exceed IRS contribution limit)

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• Covered by another insurance coverage plan that is not a High Deductible Health Plan, including spouse’s insurance and/or TriCare

• Claimed as a dependent on another person’s tax return (such as being claimed on parent’s taxes)

• Enrolled in Medicare (Part A or B)

Caregivers who are enrolled in a PeaceHealth Account Based Health Plan (ABHP) are qualified to enroll in the Health Savings Account (HSA) unless they are:

HSA Eligibility

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• Tax-deferred, interest-accumulating account • Automatic enrollment at HSA Bank with ABHP

medical plan election • Initial contribution made by PeaceHealth in January 2013 • You can contribute money to the account on a pre-tax basis • Funds roll over from year to year – No “use it or lose it” • Portability - Funds go with you if you leave PeaceHealth or

change health plans • You control your healthcare dollars and decide when to use

your funds. Pay medical bills direct from this account through online banking or the HSA bank debit card or checks.

• HSA Bank does not require you to submit receipts - keep receipts with tax filing paperwork for any IRS audit needs.

HSA Advantages

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2013 HSA Contribution Limits Medical Plan Enrollment Coverage Level

2013 IRS Limit

= PeaceHealth Contribution

+ Wellness Credit

+ What you can contribute

Individual $3,250 $1,000 $200 $2,050-$2,250

Family $6,450 $1,800 $200 $4,450-$4,650

Catch Up if age 55+ Additional $1,000

The IRS limits total contributions to an HSA each year; this includes dollars you contribute as well as those deposited by PeaceHealth. Remember, any unused dollars roll over from year to year.

HSA Contributions

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Using Your HSA

Pharmacy Applies network

discounts

Doctor Visit

Medical TPA

Applies network

discounts

Pharmacy Visit

Submit Claim

Fill Prescription

Sends EOB

Pay Doctor

Pay Pharmacy

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• They are not covered by another insurance coverage plan that is a High Deductible Health Plan paired with an HSA, including spouse’s insurance

• Spouse has not elected the annual maximum contribution under their own Health FSA (maximum of $2,500 is per household)

Caregivers are eligible if:

Dependent Care FSA is not linked to medical plan enrollments.

FSA Eligibility

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FSA Features - Health and Dependent Care

Annual Minimum Contribution Health Care FSA Annual Maximum Contribution Dependent Care FSA Annual Maximum Contribution

$100 $2,500 $5,000 or $2,500 (married filing separately)

• Use-It-Or-Lose-It; claim filing deadline April 30 of following year • Tax benefits on contributions • Health FSA can be used for qualifying medical expenses - see

IRS Publication 502: www.irs.gov/pub/irs-pdf/p502.pdf • Extended Grace Period: Unless enrolling in ABHP, Health FSA

reimbursement claims may be incurred between your benefit effective date and March 15 of the following year. ABHP enrollee deadline: end of plan year (12/31/12)

• Dependent Care FSA for daycare for children up to 12 years old, disabled dependents of any age, and elder care

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Pharmacy Applies network

discounts

Doctor Visit

Medical TPA

Applies network

discounts

Day Care Expense

Pharmacy Visit

Submit Claim

Fill Prescription

Sends EOB

Pay Day Care Provider submit receipts for

reimbursement

Pay Doctor with FSA debit

or submit receipts for

reimbursement

Using Your FSA

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Wellness at PeaceHealth

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Good health helps us live better lives at work and at home, and manage increasing health care costs for both you and our organization.

And we believe healthy caregivers deliver better and safer care to the communities we serve. Whether it’s getting your annual checkup, committing to regular exercise, or spending more time with family and friends — we can all take steps to improve our own health.

Why does Wellness matter?

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Our 2013 medical plans have been carefully designed to support continued good health for you and your family.

– Preventive services covered at 100%.

– ABHP deductible waived for a broader range of preventive and chronic condition prescription medications.

– Special support for caregivers or family members who have chronic conditions. In addition to coaching and support, PPO participants will be able to get their prescription drugs at a lower cost.

– Coordinated HealthCare. Our new health and wellness partner serves as your central point of contact and advocate when you need to navigate the health care system. They provide care coordination, disease management, care management, customer service and more.

– Biometric and health risk screenings

Wellness in Medical Plans

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1. Complete an online Wellness Assessment

2. Take part in the Biometrics Screening: Total Cholesterol; Height, Weight, BMI; Blood

Pressure ; HDL, TC/HDL Ratio; Waist

Circumference and A1C (blood sugar)

3. Enroll in one of the two medical plans

4. Complete all of the above? Receive additional $200 HSA

contribution (for ABHP participants) or a $200 premium

reduction (PPO participants)

5. You are then eligible to take part in the PeaceHealth / Virgin HealthMiles program. You will receive a pedometer/ accelerometer and be able to take part in fitness challenges, set individual goals, monitor your progress and compete for prizes

Wellness Participation and Incentives

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Additional Benefits:

Dental, Vision, Life and

AD&D, Disability

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Dental Plan Highlights

Washington Dental Service (WDS) Benefit

Maximum Benefit per person per calendar year $2,000

Annual Deductible per Individual/Family $50/$150

Preventive Services: Routine Exams, Cleaning, X-rays Covered in full

Basic Restorative: Fillings, Root Canals, Oral Surgery, Endodontics, Periodontics

20% after deductible

Major Restorative: Crowns, Dentures, Bridges, Implants 50% after deductible

Orthodontia 50% after deductible

$2,000 Lifetime Maximum Benefit per covered member

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Northwest Benefit Network (NBN)

In-Network Out-Of-Network Frequency

Routine Eye Exam 100% $50 allowance 12 months

Material Copay $25 $25

Basic Lenses 12 months

Single Vision Bifocal Trifocal

100% (after copay) 100% (after copay) 100% (after copay)

$50 allowance $75 allowance $100 allowance

Frames $150 allowance $70 allowance 24 months

Elective Contact Lens Allowance

$150 allowance $105 allowance 12 months

Vision Plan Highlights

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Core Life and AD&D 2x Base Annual Salary up to $200,000 maximum

Caregiver Supplemental Life and AD&D Additional 1x to 3x Base Annual Salary to $1,000,000 maximum

Spouse Supplemental Life and AD&D $10,000 - $100,000 in $10,000 increments

($50,000 Guarantee Issue)

Child Supplemental Life and AD&D – $10,000 or $15,000

Open Enrollment Evidence of Insurability Approval Requirements – Supplemental Life • New Supplemental Caregiver/Spouse coverage and Spouse amounts above Guarantee Issue • Increase in Caregiver Supplemental Life from 1X to 3X

Life and AD&D Highlights

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Core Short Term Disability (STD)

• 66 2/3% base salary continuation up to $1,500 weekly benefit

• 7 calendar day waiting period; available PTO/EIB to be used during this time

• After waiting period: must exhaust all EIB hours before STD benefits will apply; option to use 33 1/3% PTO in addition to STD benefit

• Continues for up to 6 months (integrates with long term disability)

• For those who have less than 12 months of continuous STD coverage prior to 1/1/2013, pre-existing condition limitations apply

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Long Term Disability (LTD)

• Core LTD - Provides 50% of base salary continuation up to $15,000 monthly

- Fully paid by PeaceHealth

• Supplemental LTD - Caregivers may purchase additional 16 2/3% of LTD for total coverage of 66 2/3% of base salary continuation up to $20,000 per month

• Benefit begins after continuous, approved disability of 180 days

Open Enrollment Evidence of Insurability Approval Requirements – Supplemental LTD No requirements during Open Enrollment this year. Evidence of Insurability required for supplemental coverage newly elected in future years.

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Caregivers may be eligible for the following benefits if they have worked for PeaceHealth for at least 6 months and meet the financial requirements for total household income: • Medical Premium Assistance Program Eligible caregivers may receive financial assistance to help

cover 100% of the cost of their health care premiums for them and their families (ABHP enrollment). Applications accepted during Open Enrollment.

• Emergency Loan Program Eligible caregivers may receive an interest-free loan (maximum

$500) to be repaid within 1 year. • Enhanced Tuition Assistance Eligible caregivers may have part or all of their school tuition

paid for by PeaceHealth. Additional details can be found under the My Other Benefits section of myHR.

Special Benefits Program

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Enrollment

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How to Enroll

1. Log onto myHR (from work or home) and select the “Open Enrollment” button to bring up the OE home page

2. Use check list on the OE home page to get ready

3. Click on “Enroll Now” to start your 2013 enrollment

4. If you are using a shared computer, be sure to log out for security.

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myHR/AskHR – https://myhr.peacehealth.org Caregiver Resource Center (CRC)

• AskHR email (CRC@peacehealth.org) via MyHR or

• Phone 855-333-6947

Resources/Questions

myHR Open Enrollment Home Page Links • eCascade Newsletters • E-Learning Modules • Plan Summaries • Calculator tools • Premium and Eligibility documents