OPEN ENROLLMENT FOR HEALTH INSURANCE

OVERVIEW AND SUMMARY

Open Enrollment Open Enrollment Open Enrollment Open Enrollment ffffoooorrrr HHHHeeeeaaaalllltttthhhh IIIInnnnssssuuuurrrraaaannnncccceeee Window: June 14, 2018 to June 21, 2018Window: June 14, 2018 to June 21, 2018Window: June 14, 2018 to June 21, 2018Window: June 14, 2018 to June 21, 2018

INTRODUCTIONINTRODUCTIONINTRODUCTIONINTRODUCTION The Ute Indian Tribe is happy to continue to offer a full suite of benefits for you and your families. There are some

changes this year with our carriers, but the benefits will remain the same. Please note that you will be receiving new

medical ID cards and it will be important to use those starting July 1, 2018. There is no increase to the monthly premiums There is no increase to the monthly premiums There is no increase to the monthly premiums There is no increase to the monthly premiums

you will pay for your benefits this year!you will pay for your benefits this year!you will pay for your benefits this year!you will pay for your benefits this year!

If you don’t want to make any changes to your current benefit elections, you don’t need to take any action. This includes

dental enrollment. If you are currently enrolled in medical and as a result, enrolled in dental, your election will carry

forward unless you want to make changes. All of your current benefit elections will automatically carry over and remain

effective for the next 12 months. If you want to change any of your current benefit elections, you will need to log into

BenefitSolver and make your enrollment changes by June 21, 2018.June 21, 2018.June 21, 2018.June 21, 2018.

OPEN ENROLLMENT MEETINGSOPEN ENROLLMENT MEETINGSOPEN ENROLLMENT MEETINGSOPEN ENROLLMENT MEETINGS If you have questions, please attend one of the following meetings.

• Wednesday, June 20th: 1:30 – 2:30 pm or 3:00 – 4:00 pm or 5:30 – 6:30 pm

• Thursday, June 21st: 9:00 – 10:00 am or 11:00 am – 12:00 pm

SUMMARY OF EMPLOYEE BENEFITS CHANGESSUMMARY OF EMPLOYEE BENEFITS CHANGESSUMMARY OF EMPLOYEE BENEFITS CHANGESSUMMARY OF EMPLOYEE BENEFITS CHANGES

Medical Plan ChangesMedical Plan ChangesMedical Plan ChangesMedical Plan Changes

• Moving from MBA to HealthSmart for the third-party administrator. FirstHealth network of providers and

facilities to use for in-network benefits. Please make sure to refer to their website to access a list of in-network

providers. www.firsthealth.com .

• New ID cards will be issued for you and your enrolled family members. These cards are to be used starting July 1,

2018. Please make sure toPlease make sure toPlease make sure toPlease make sure to show your new ID cards to both your doctors and at your pharmacy.show your new ID cards to both your doctors and at your pharmacy.show your new ID cards to both your doctors and at your pharmacy.show your new ID cards to both your doctors and at your pharmacy.

• Vision will continue to be included with the medical plan. HealthSmart will be the new administrator.

MONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONS Employee Employee Employee Employee OnlyOnlyOnlyOnly

Medical CoverageMedical CoverageMedical CoverageMedical Coverage

Employee +1Employee +1Employee +1Employee +1

Medical CoverageMedical CoverageMedical CoverageMedical Coverage

FamiFamiFamiFamilylylyly

Medical CoverageMedical CoverageMedical CoverageMedical Coverage

Age 0-30 $83.41 $164.38 $193.21

Age 31-35 $96.17 $191.46 $218.04

Age 36-40 $104.44 $210.74 $257.34

Age 41-61+ $119.49 $235.11 $284.26

2

VisionVisionVisionVision Plan ChangesPlan ChangesPlan ChangesPlan Changes

• Moving from MBA to HealthSmart for the third-party administrator. You can continue to go to any provider;

there is no provider network.

MONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONS Vision with Medical CoverageVision with Medical CoverageVision with Medical CoverageVision with Medical Coverage VisionVisionVisionVision without Medical Coveragewithout Medical Coveragewithout Medical Coveragewithout Medical Coverage

Employee Only $0 $2.62

Employee + 1 $0 $5.03

Employee + Family $0 $9.21

DentalDentalDentalDental Plan ChangesPlan ChangesPlan ChangesPlan Changes

• Moving from MBA with no provider network to Ameritas with a network of providers. You can continue to go to

any provider, but you will pay less out of pocket if you go to an Ameritas provider.

• Starting July 1, 2018, you will need to make a separate enrollment for dental. You will no longer automatically be

enrolled in dental if you elect medical.

• New ID cards will be issued for you and your enrolled family members. These cards are to be used starting July 1,

2018.

MONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONSMONTHLY CONTRIBUTIONS Dental Dental Dental Dental

(No Orthodontia Coverage)

Dental Dental Dental Dental

(with Orthodontia Coverage)

Employee Only $5.82 $5.82

Employee + 1 $10.66 $19.50

Employee + Family $21.14 $29.98

CompanyCompanyCompanyCompany----paid and Voluntary Life Insurance, paid and Voluntary Life Insurance, paid and Voluntary Life Insurance, paid and Voluntary Life Insurance, Voluntary Voluntary Voluntary Voluntary ShortShortShortShort----term Disability Coverageterm Disability Coverageterm Disability Coverageterm Disability Coverage, Voluntary Critical Illness , Voluntary Critical Illness , Voluntary Critical Illness , Voluntary Critical Illness

InsuranceInsuranceInsuranceInsurance

• No Changes. Coverage will remain with Principal.

NOTENOTENOTENOTE: After open enrollment, you cannotcannotcannotcannot make changes to your coverage during the year unless you experience a change

in family status, such as:

• Loss or gain of coverage through your spouse

• Loss of eligibility of a covered dependent

• Death of your covered spouse or child

• Birth or adoption of a child

• Marriage, divorce or legal separation

• Switch from part-time employment to full-time employment

**You have 30 days from a change in family status to make changes to your current coverage.*