School District of Grafton

1. School District of Grafton Health Insurance Coverage Effective January 1, 2013 November 20th and November 27th

2. What will be covered in today’s meeting… • Introductions • Why is a change taking place? • 2013 Plan options and premiums • Fundamentals of a Health Savings Account • Humana insurance plan and member benefits • Banking arrangement – Port Washington State Bank • Life and Disability • Dental • Next Steps • Questions

3. Introductions • Willis is the independent consulting firm assisting the School District and it’s employees. • Ryan Barbieri – SeniorVice President • Humana will be the new health insurance company providing coverage effective January 1st. • Jon Klett- Large Group Sales Executive • Port Washington State Bank is the District sponsored bank for H S A contributions for those electing qualified plan starting January 1st. • Angie Regnitz – Personal Banker

4. Why the health insurance is changing • District budget for ‘12-’13 identified a structural deficit • Health insurance premiums were projected to rise more than 12% and this represents 13% of total District budget • There was a consensus within the Board of Education to explore some of the innovative and consumer driven health options • Many private sector employees enjoy having choices in what coverage is best for them • Change will offer an opportunity with reduced premium share for employees • Puts District in a better position to maximize future savings • Southeastern Wisconsin healthcare is trending at 12%

5. What has been done leading up to this point? • The Finance Committee, Board of Education, Administration and Willis completed a comprehensive review of insurance options • Broad market study took place for medical, life and disability: • WEA Trust Humana UHC WCA GHT Anthem • Madison National Epic Met Life Unum Principal • Mutual of Omaha Symetra • Insurance carriers were evaluated based upon: • Their ability to provide adequate coverage for employees • Various service components • Provider network access • Price • Ability to offer consumer driven options and multiple options

6. What has been done leading up to this point? • Based on this review, the Board decided to make the following insurance company selections: Health Insurance – Humana Life and Disability – Madison National Dental – Met Life (No Change) Flexible Spending Account – Diversified Benefits (No Change) • Employees will have the opportunity to participate in a Consumer Driven Health Plan that will qualify them for an additional benefit…H S A contributions made to a PWSB account for those electing the H S A plan • Disability benefits are changing to better align with current trends in public sector benefits • Those electing H S A plan will have an option for Limited Purpose FSA

8. WEA Trust $250/$500 Deductible Plan January 1st, 2012 CoverageAmount per Month Single $735.86 Family $1,666.24 Single Medicare $486.68 / $143.34* Family Medicare $973.36 / $286.68* Medicare Special $1,222.54 Humana Traditional Plan $500 / $1,000 Deductible Plan January 1st, 2013 CoverageAmount per Month Single $692.54 Family $1,568.16 Single Medicare $455.76 / $134.23* Family Medicare $911.50 / $268.46* Medicare Special $1,144.85 Health Insurance Full Premium Comparison *Premium for medical only coverage where Medicare D is in place for drug coverage

9. WEA Trust $250/$500 Deductible Plan January 1st, 2012 CoverageAmount per Month Single $735.86 Family $1,666.24 Single Medicare $486.68 / $143.34* Family Medicare $973.36 / $286.68* Medicare Special $1,222.54 Humana H.S.A. Plan $2,000 / $4,000 Deductible Plan January 1st, 2013 CoverageAmount per Month Single $551.62 Family $1,249.06 Single Medicare $364.82 / $122.52* Family Medicare $729.66 / $245.05* Medicare Special $916.45 Health Insurance Full Premium Comparison *Premium for medical only coverage where Medicare D is in place for drug coverage

10. Current Yearly Employee Contribution 12.6% Single Plan $1,113 Family Plan $2,519 Current Deductible Single Plan $250 Family Plan $500 Current CoInsurance Max Single Plan $0 Family Plan $0 Current Worst Case Scenario CoPays Excluded Single Plan $1,363 Family Plan $3,019 New Yearly Employee Contribution Trad. 12.6%H.S.A. 8% Single Plan $1,047 $530 Family Plan $2,371 $1,199 New Deductible Single Plan $500 $2,000 Family Plan $1,000 $4,000 CoInsurance Max Single Plan $1,000 $1,000 Family Plan $2,000 $2,000 Health Savings Account Contribution Single Plan $0 $1,500 Family Plan $0 $3,000 New Worst Case Scenario CoPays Excluded Single Plan $2,547 $2,030 Family Plan $5,371 $4,199

11. What Is A H S A Plan

12. What Is A HSA? • Combines a Qualifying High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) • Funded by the District and / or you • Pre-tax basis by salary deferral and direct deposit for participants • Pay for qualified expenses or save for the future • Annual limit that can be contributed to account • Catch-up contributions (Age 55 and up) up to $1,000 • Funds accumulate and earn non-taxable interest • The dollars in the HSA are yours! • It remains your money even if you leave the District or retire

13. Two Basic Parts: Intended to cover serious illness or injury after the deductible has been met. Part 1: Qualifying High Deductible Health Insurance Plan HSA Concept Part 2: Health Savings Account Pays expenses until the deductible is met. What is the HSA Concept?

14. Who is eligible for a HSA? An “eligible individual” is any individual who, for a given month… • is covered under a qualified high-deductible health plan (HDHP) • Is not also covered by any other health plan unless it is also an HDHP • may not be claimed as a dependent on another person’s tax return. • is not covered by Medicare and receiving benefits

15. Example of HSA Usage – TomEmployee Coverage $1,500 District Contribution $1,500 Employee Contribution

16. Example of HSA Usage – SarahEmployee + Family Coverage $3,000 District Contribution $0 Employee Contribution

17. What form can contributions be made? • Contributions to a HSA must be made in “cash”. For example, contributions may not be made in the form of stock or other property. • Contributions to the HSA can be made through payroll deduction on a pre-tax basis. • The District will contribute $1,500 for Employee coverage and $3,000 for Family coverage

18. How are distributions treated for tax purposes? • Tax Free • (Qualifying medical expense) • Ordinary Tax • (Non-medical distribution after age 65) • Ordinary Tax + 20% penalty • (Non-medical distribution prior to age 65)

19. When may I take distributions from my HSA? • Your HSA dollars can be taken at any time to pay for qualifying medical expenses. • Note: If reimbursing expenses from previous years, you must maintain sufficient records to prove the expense was not previously reimbursed.

20. Qualified HSA Expenses • Medical, dental, vision deductibles and coinsurance amounts • Certain Long Term Care insurance premiums • COBRA premiums • Hearing aids • Smoking cessation • Wheelchairs • Organ transplants • Medicare premiums

21. What are qualifying Medical Expenses? • A Qualifying Medical Expense (QME) is generally any expense incurred to maintain your health or your family’s health • A partial list of expenses that can be reimbursed is included with the HSA information • A complete listing provided in Section 213 of IRS Ruling.

22. New Medical Carrier Humana

23. MyHumana.com • Focus on personal health management • Members manage their health benefits and educate themselves • Secure MyHumana home page • Tailored employer campaigns to boost MyHumana registration • Review health plan benefits • View claim activity • Financial tools to see how much you are spending • Health resources to find information about medications, medical procedures, tests and treatments

24. National Point of Service (POS) How to Find a Provider

25. Healthcare Transparency – Humana’s Approach • Align tools with the consumer “shopping” thought process • What’s important to me? • What does it cost? • Who has the best quality? • What are others saying? • Make educated decisions and try to avoid surprises

26. Ease of Use • We put the pieces together for our members… • Easy to understand number and graphics • Focus on needs related to the entire treatment period instead of presenting information “a la carte” and point-in-time • Transparency content is fully integrated in the Humana MyChoicetools According to Forrester Research, 63% of consumers don’t know treatment costs for any procedure until the medical bill arrives – and 10% never know.

27. Provider Cost TransparencySimple and easy access on MyHumana.com For Grafton School District employees who are planning for a health procedure – or helping a family member, cost information allows them to make a decision they feel good about ... and perhaps save money in the process.

28. Provider Cost TransparencyPhysician Dr. John Doe Grafton School District members are provided with a total estimated cost for in and out-of-network and additional information highlighted above.

29. Provider Cost TransparencyOutpatient Procedures & Tests Lower costs with credentialed providers means more money stays in the pockets of Grafton School District employees

30. Vitals.com Humana furthers its industry leadership in the transparency space by being the only insurer to provide this level of physician transparency

31. Pharmacy Tools • Drug Pricing • RxCalculator • RightSourceSM prescription home delivery service • Pharmacy locator • Drug lists and forms

32. Drug Pricing • Find out if a drug is covered • View estimated prices, based on your pharmacy benefit and the pharmacy you select • Explore alternatives

33. Employee Assistance Program/Work-Life • Confidential, professional assistance to address personal issues that may impact job performance. • Services for Employees from substance abuse to personal finances and legal matters • Services for Managers from addressing chemical dependency issues to dealing with workplace conflict • Survey respondents reported seventy-three percent of employees who responded report having improved focus and production at work after using EAP/work-life services. Grafton School District employees can choose from an unlimited telephonic service or up to 3 visit in-person EAP program!

34. Supporting your employees • Depression • Legal • Childcare • Family Support • Stress • Eldercare • Education • Parenting • Grief • Substance Abuse • Adoption • Financial

35. Comprehensive Work-Life ServicesSupporting Your Employees • Unlimited access to internet based tools and resources • Life topic articles, practical help and information • Video/podcasts on all major life stages • Health care and legal libraries • Additional Information • Financial calculators for Retirement, Saving & Mortgage • Homework help • Concierge services • Alternative health information • Financial consulting services • Budgeting • Debt management • Home buying/refinancing • Retirement planning • Resource Locators • Child Care • Elder Care • Counselor • Legal services • Estate planning • Power of Attorney

36. Launching in the first quarter of 2013

37. A Simple Three-Step Approach 3. Earn rewards 1. Know your health 2. Improve your health • Set Goals and engage in activities focused on: • Education • Prevention • Fitness • Healthy Living • Health Assessment • Vitality Check • Engagement = Reward • Use points to redeem gifts Vitality Shopping Mall™ Concentra (Biometrics) Humana LifeSynch Health Coaching Concentra (Treatment) HumanaVitalitySM

38. Complete a health risk assessment (HRA)

39. Set goals to maintain health

40. HumanaVitality Standard Activities Member can take over 30 actions to improve their health status. Automatic feeds allow for accurate monitoring and direct link between action, health status and incentives.

41. Grafton School District benefits, too FORWARD THINKING: A proactive investment EASY: Seamless execution and minimal disruption EMPLOYEE PERFORMANCE: Healthier, more productive workforce CLAIMS EXPERIENCE:Could have a positive effect on your bottom line

42. Telephonic Health Coaching • Explore behaviors that impact one’s life • Coaching performed by certified health education specialists and registered nurses • Criteria-based coaching aligned with readiness to change and motivation • Tailored web program that delivers: • Written personalized action plan • Series of newsletter based on the individual assessment Members choose from one of seven telephonic health coaching programs Include inbound and outbound coaching with goal setting and progress tracking creating a personalize action plan

43. Real Results WeightManagement TobaccoCessation BackCare Nutrition Stress Management • On average, a 15% reduction in health-related absenteeism reported in the first 30 days • 72% said they had lost weight after 30 days of beginning the program • On average, over a 5% reduction in health-related absenteeism reported in the first 30 days • Over 58% remained smoke free after 90 days in the program • 73% made nutritional improvements within 30 days • On average, nearly a 25% decrease in absenteeism related to health reported in the first 90 days • Nearly 65% decreased personal symptoms of stress within 30 days

44. Guidance and Support - Personal Nurse • Registered nurse develops long-term, trusted relationship with member • Engages members to become more educated and more actively involved in health care decision-making • Supports consumers by • Building a relationship • Giving personalized education and guidance • Teaching how to most effectively use benefits • Identifying roadblocks to improved health The bottom line 84% of participants say they feel more prepared to manage their own health

45. Personalized Care & Support Guidance & Support – address chronic illness & long-term health

46. Humana Pharmacy Solutions – Cost Containment

47. The Humana Approach

48. RightSourceRx Preferred home delivery Also known as mandatory mail - Requires maintenance medications be filled at RSRx starting with the 3rd fill Two options Provides savings to the group through improved Brand and Non-MAC generics, and $0 dispensing fees We can provide an analysis of potential savings for groups that are interested - Savings of 4%-12% is common

49. Health Savings Account Port Washington State Bank

50. Health Savings Account A tax-advantaged account for individuals with High Deductible Health Plans to help pay for current or future qualified medical expenses for you, your spouse, and your dependents.