Benefits for 2014

2. Benefits for 2014 Health Protection • Medical and Prescription Drug Coverage • Health Reimbursement Arrangement (HRA) with SmartHealth Plan • Socially Just Medical Benefits • Dental Care Coverage • Vision Care Coverage Tax-Advantaged Spending Accounts • Healthcare Flexible Spending Account (FSA) • Dependent Day Care Flexible Spending Account (FSA) Income and Survivor Protection • Short Term Disability (STD) • Long Term Disability (LTD) • Basic Life and AD&D Insurance • Supplemental Term Life Insurance • Supplemental AD&D • Business Travel Accident Insurance • Legal Services Plan Securing Your Retirement • Voluntary Employee Retirement Savings Plan Contributions • Employer-Paid Retirement Benefits (Eligible Employees) Enriching Self and Spirit • Employee Assistance Program (EAP) • SmartHealth Wellness Program • Tuition Reimbursement • Paid Time Off (PTO)

3. Let’s Discuss Be sure to enroll by October 15, 2013 • What’s changing and why? • Who is eligible for benefits? • How do my benefits work? • What do I need to do?

4. What’s changing and why Why benefits are changing What’s changing • We are adjusting to a changing healthcare environment and must work together to slow down the rising cost of benefits • Lourdes Health Network is aligning with the Ascension Health benefit platform, along with other Health Ministries – gaining access to competitive programs while saving administrative costs • We are continuing to offer a competitive package to meet the needs of a diverse group of associates – but a package that is more in line with benefits offered by other employers • New Eligibility Classifications • New SmartHealth medical plans offering access to new Ascension Health network as well as the BCBS network • New Medical Plan Administrator • Prescription Drug Program through Lourdes Rx and MedImpact • Health Reimbursement Arrangement (HRA) to pay for medical, pharmacy, dental or vision expenses • Employer paid Long Term Disability and Short Term Disability, EIB no longer accruing • Basic, Supplemental and Spouse Life Coverage

5. Who Is Eligible for Benefits?

6. MedicalBenefits SmartHealth Medical Benefits including Prescription Drug Program through MedImpact

7. SmartHealth Medical Benefits SmartHealth is… • Ascension’s system-wide medical plan for associates.  • On the forefront of adopting all healthcare reform initiatives • Offers both comprehensive and cost-effective health care through benefit designs and networks • Creation of our own Ascension network of providers • Access to a National Network of Blue Cross providers for services that are not provided by Health Ministry facilities and contracted physicians. • While being good stewards of our healthcare spending, promotes prevention and wellness in mind, body and spirit, to further our mission of treating the whole person

8. SmartHealth Medical Benefits Our partners • National Network (Tier 2) • Ascension Health network (Tier 1) • Contact ABS when you have questions. • Claims administered by ABS • Coverage includes Rx through MedImpact

9. SmartHealth Medical Benefits Ascension Health Network (Tier 1) • You get the best value and highest level of benefits when you receive care from Ascension Health Ministries and their contracted providers • Since we are providing the care within our own system, the cost is less • You share in the cost savings when our own facilities and physicians provide services National Network (Tier 2) • You get preferred pricing and a competitive level of benefits when you receive care from Blue Cross providers Out-of Network (Tier 3) • If you use providers who are not members of either the Ascension Health Network or the National Network… • you will get a lower benefit level and will be responsible for higher out-of-pocket costs. • Each option offers the same network access

10. How my plan works Take time to understand your medical coverage before you need to use it

11. 2014SmartHealth Medical BenefitPlans My Plan Details

12. Prescription Drug Benefits MedVantx program discontinued, mail order through Lourdes Rx only.

13. The true cost of your medical plan includes not just your out of pocket expenses, but also your payroll contributions BiweeklyPayroll Contributions

14. Prior Authorization – New Process • All services received from the following providers must receive Prior Authorization: • Kadlec Health System, Richland, WA • Kennewick General Hospital, Kennewick, WA • Tri-City Orthopedic, Richland, WA • Benton Franklin Orthopaedic Associates, Kennewick, WA • Tri-City Radiology, Kennewick, WA • Northwest Cancer Clinic, Kennewick, WA • Services will be approved for Tier 2 coverage include: • Brain • Heart • Obstetrics/Labor and Delivery • Newborn Care • No benefits will be payable by the Plan if Prior Authorization is not obtained for services received at the providers shown above. • Authorization to receive care at the facilities listed above will ONLY be granted if the service is not available at Lourdes Health Network. • No benefits will be payable by the Plan if Prior Authorization is not obtained.

15. SmartHealth Medical Benefits Terms to know Deductible: You pay this amount each year before Coinsurance starts • Satisfied by all services, excluding Co-Pays and non-covered services • With Family Coverage, each individual satisfies their own Deductible but once the family deductible is satisfied, benefits can start for all covered family members Coinsurance: After satisfying the deductible, you and the Plan pay a % up to the Out-of-Pocket Maximum (OOP Max) OOP Max: After your Coinsurance reaches the OOP Max, the Plan pays 100% for the rest of the calendar year Co-Pay: A fixed dollar amount that you pay for non-hospital services – Co-Pays do not apply to OOP Max

16. New Wellness Program – Simple & Effective • Earn Health Reimbursement Arrangement (HRA) dollars for wellness participation.

17. HRA and FSA—what’s the difference?

18. The difference a network makes: An example • FT Associate with Associate + 1 coverage

19. Tips to Avoid Unnecessary Costs Be a wise healthcare consumer • Choose Ascension Health Network (Tier 1) for all care if you can and verify network affiliation by using the Provider Directory available on our intranet or at MySmartHealth.org (during open enrollment) • Have all ancillary testing done at our hospitals/facilities. Remind your physician’s office to refer your lab/pathology specimens to our facilities – don’t assume they will • Understand your benefits Verify prior authorizations • The ordering physician is responsible for obtaining the prior authorization according to the guidelines set by the Third Party Administrator who handles your claims • Always ask whether or not a prior authorization is needed for services • Note: Bariatric Surgery is only covered in Tier 1 if it’s available from a Health Ministry within 100 miles

20. Women’s Preventive Services • The U.S. Department of Health and Human Services, the Department of Labor and the Internal Revenue Service have jointly released final regulations regarding women’s preventive services under the Affordable Care Act (“ACA”). The ACA requires group health plans to provide coverage for "contraceptive services" as part of an array of women’s preventive services that must be included in health plans without cost sharing to covered participants. • The regulations contain an accommodation for eligible non-profit religious organizations that oppose providing contraceptive coverage. As a healing ministry of the Catholic Church, Ascension Health does not promote or condone contraceptive practices and objects to providing such coverage. Therefore, as the plan sponsor of both our self-insured Ascension Health SmartHealth Medical Plan (“SmartHealth Plan”) and our self-insured Ascension Health Prescription Drug Program (“Rx Plan”), Ascension Health qualifies as an eligible organization that is entitled to the accommodation. As a result, neither the SmartHealth Plan nor the Rx Plan will provide coverage for contraceptive benefits that are in conflict with our Catholic Identity and the Ethical and Religious Directives for Catholic Health Care Services. • As part of the accommodation, third party administrators of our SmartHealth and Rx plans are required to provide this coverage to covered members at no cost, independently of Ascension Health and consistent with the authority given them by the final regulation. You will receive information directly from those Administrators about the coverage that may be available to you for those “preventative services.”

21. Socially Just Health Benefits Subsidy • Ensuring access to care for all • Offered to FT associates • Income must be less than 200% of the Federal Poverty Level based on family size • If eligible, associates must enroll in the PPO $200 deductible/ 0% cost-share plan • Associates may be eligible for 100% waiver or a discount of 25%, 50% or 75% on associate premiums, inpatient and outpatient service co-pay/cost-share at our facilities only

22. Non-Medical Benefits Flexible Spending Accounts (FSAs) Delta Dental Coverage Vision Service Plan (VSP) Life, Disability, and More

23. Flexible Spending Accounts Administered by ADP Be sure to elect your contribution amount before deadline Remember: if you don’t use it, you lose it

24. Dental Plan • Your Delta Dental plan provides comprehensive coverage • Watch for a new Delta Dental card coming in the mail before 1/1

25. Vision Services Plan • You may elect Full Coverage with VSP

26. Disability Coverage STD and LTD benefits are offset by any other income you may receive EIB plans will stop accruing at the first of the year – balances may be used through June 2015

27. Other protection Legal Services Plan • Low-cost legal assistance is available to you through Hyatt Legal, including assistance with adoption services, wills, trusts, living wills, and identity theft, etc. • You may enroll during any open enrollment period if you think you’ll need a lawyer in the year ahead.

28. Enriching Self and Spirit • Lourdes Health Network provides additional benefits to support associates in meeting goals for personal development and well-being, including: • Employee Assistance Program – support is available to you and covered dependents through LifeWorks for assistance with managing stress, relationships, and financial issues. You can talk to someone 24/7 by phone or in person by appointment. • Educational Assistance – please see newly revised policy on Ellucid.

29. Open Enrollment Resources Available on our Intranet – click on • 2014 Benefits Handbook • Benefit FAQs

30. Next Steps Take time to consider your options • Open enrollment begins October 1, 2013 • Remember: This is an “active enrollment” – all benefits eligible associates must re-enroll in all benefits for 2014 • Enroll before October 15, 2013

31. Thanks for listening!