Non State Employee Health Plan Open Enrollment 2017

1. Non State Employee Health PlanOpen Enrollment 2017

2. State of the Plan • The A&M Efficiency Report recommends changes to the health plan • Plan reserves are slightly below the target level • Plan expenses must be covered by Plan revenues • Additional funding is needed for 2017

3. HCC Decisions • Rate & plan design changes approved to address funding needs of the plan • Employer & employee contributions will increase • Premiums for covering spouses will increase • 2nd year of a multi year plan to adjust rates • Dental rates will increase • Employee only will have an employee contribution

4. HCC Plan Changes • Plan A • Office visit Copays $40/$60 • Three (3) tiered Deductible $1,000/$2,000/$3,000 • Out Of Pocket (OOP) Max $5,750/$11,500 • Pharmacy Coinsurance: • Tiers are now 20%, 40% and 65% • Special Case Copay $100 per 30 day supply

5. HCC Plan Changes • Plan C • 20% Coinsurance for medical services • Pharmacy Coinsurance added • Coinsurance tiers: 20%, 40% and 65% • OOP Max is $5,000/$10,000 • HSA/HRA Employer Contribution • Reduced $500 for employee & employee/child tier • Reduced $1,000 for employee/spouse & family tiers

6. HCC Plan Changes • HealthQuest (HQ) Rewards: • New wellness vendor: Cerner Corporation • New weight management program: Naturally Slim by ACAP Health • 40 Credits required to earn premium incentive • Employees & covered spouses now eligible to earn HQ Reward for 2018 • Plan C: Covered employees & spouses can earn up to $500 each toward employee’s HSA/HRA in 2017

7. Selecting Your Health Plan • Pick a plan design (A or C) • Which plan design is right for you? • Premiums, Deductibles, Coinsurance • Review the provider networks • Review plan claim example online: • http://www.kdheks.gov/hcf/sehp/default.htm

8. PlanA Network Non Network * Non covered services & discount tier drugs do not count toward Deductible, Coinsurance or OOP Max.

9. Plan A - Three Tiered Deductible • How it works: • 1st Person has a $1,000 Deductible • 2nd Person has a $1,000 Deductible • All remaining covered members combine together toward a 3rd $1,000 Deductible • Maximum Deductible on a family with 4 or more members is $3,000

10. Pharmacy Changes • Plans A & C will offer 90 day supplies on most medications • Compound drugs will only be covered if purchased from a Network Pharmacy • Plan A Only: Asthma and Diabetes drugs: • Generics 10% to max of $20 per 30 day supply • Preferred brands 20% to a max of $40 per 30 day supply • Non Preferred brands – 65% Coinsurance

11. Anticipated Generic Releases • 4th Quarter 2016 • Seroquel • Zetia • 1st Quarter 2017 • Minastrin 24 FE • Vytorin • 2rd Quarter 2017 • Strattera • Relpax • 4th Quarter 2017 • Viagra • Viread

12. Plan C Network Non Network *Note: Discount tier and non covered items or services do not count toward Deductible or OOP Max.

13. Plan C - Health Savings Account • Its your bank account for health care! • Use your HSA to pay health care expenses of you & your tax qualified dependents • You can change your HSA contribution during the year

14. Eligibility for HSA • To qualify for an HSA: • You must enroll in Plan C • Your medical coverage must be limited to only High Deductible Health Plan(s) like Plan C. • You cannot be enrolled in Medicare or TRICARE • You cannot be claimed as a dependent on someone else’s tax return

15. Employer HSA & HRA Funding Employers’ HSA & HRA contributions will be made monthly * See Open Enrollment book for part time information

16. Employee HSA Funding • HSA Contributions are based on full time employees with 24 pay period deductions. See Open Enrollment book for part time information.

17. Health Reimbursement Account (HRA) • For employees not eligible for an HSA • The HRA is an employer funded account • Same employer contribution as HSA • Employee submits claims for reimbursement • HRA funds are use it or lose it

18. Preferred Lab: Stormont Vail • Plan A - 100% coverage for eligible outpatient lab services • Plan C - Discounts on eligible outpatient lab services until Deductible met, then paid at 100% • Labs drawn at other Cotton-O’Neil locations may be included if by network providers • Show your medical ID Card to access benefit BCBS Members: The local BCBS plan of the physician that ordered the lab test will process the lab claim. If your provider is outside of BCBS of Kansas area, Stormont-Vail may not be a network provider and the claim may be subject to non network benefits.

19. Preferred Lab: Quest Diagnostics • Plan A - 100% coverage of outpatient lab tests • Plan C - Discounts on eligible outpatient lab services until Deductible met, then paid at 100% • List of collection sites: www.labcard.com • Your doctor can draw the sample and send to Quest BCBS Members: The local BCBS plan of the physician that ordered the lab test will process your lab claim. If your provider is outside of BCBS of Kansas area, Quest may not be a network provider for that BCBS plan and the claim may be subject to non network benefits.

20. Dental Changes • Employee only dental will now have a contribution • You and your dependents must have medical coverage to buy dental • Changes to dental eligibility: • You may opt out of purchasing dental • You may elect a different coverage tier for dental than medical

21. Dental • Plan pays for 2 exams & cleanings per year Enhanced Basic

22. Vision Benefits

23. Voluntary Plans • New plans available from Colonial Life: • Accidental Insurance • Hospital Indemnity Insurance • Cancer Insurance • Critical Illness Insurance

24. HealthQuest (HQ) • New Naturally Slim program by ACAP Health • Interactive web based program that promotes healthy eating & weight management • New wellness vendor Cerner • New HQ website and programs • Aligning HQ year to calendar year • New programs start in January 2017

25. PY 2018 HealthQuest (HQ) Rewards • HQ Rewards Premium Incentive Discount for PY 2018 is available to employees & covered spouses that earn 40 credits. • Discount earned by coverage tier: • EE & EE/Children Tiers: • EE can earn the full $480 of the premium incentive • EE/Spouse & EE/Family Tiers: • EE & spouse can each earn $240 of premium incentive discount • The Premium Incentive Discount is earned in PY 2017 and received in PY 2018

26. HQ Rewards: Plan C only • Employees & covered spouse can each earn up to $500 HSA\HRA dollars by completing HQ activities • HSA/HRA funds earned will be paid during 2017 • More information coming soon! • The new HQ programs start January 1, 2017

27. Castlight Health Dental services information coming to Castlight in 2017! www.mycastlight.com/sehp

28. Rx Savings Solutions https://www.rxsavingssolutions.com

29. Identification Cards • BCBS, Caremark, Delta and Surency are sending new cards to all members • Aetna is sending all Plan A members new cards and members who make changes. • Quest is only sending cards to new members or members who make changes in coverage • Optum is only sending new debit card to new members enrolling in the HSA

30. Open Enrollment Oct. 1 – 31, 2016 • Enroll online: https://sehp.member.hrissuite.com

31. Questions Link to Open Enrollment book: www.kdheks.gov/hcf/sehp/default.htm HRA, HSA, Eligibility, & Enrollment Portal Questions: SEHPMembership@kdheks.gov Benefit & Plan Questions: Benefits@kdheks.gov

32. www.kdheks.gov