2015 Annual Enrollment Info for SHBP & FLEX

1. 2015 Annual Enrollment Info for SHBP & FLEX Presented by: Beth Findlay Beth.Findlay@dnr.state.ga.us

2. SHBP Annual Enrollment • AGENDA • Annual Enrollment Dates and Miscellaneous Info • 2015 Plan Options • HMO Plan and Rates • HRA Plan and Rates • HDHP Plan and Rates • Pharmacy Benefits for BCBSGa and UHC • Enhanced Benefits • 2015 Wellness • Tricare Supplement/PeachCare For Kids • Making your 2015 Election • Contact Information

3. SHBP Annual Enrollment Annual Enrollment dates are October 27, 2014 through November 14, 2014. The SHBP website (www.mySHBPga.adp.com) will open at 12:01 AM on 10/27/14 and close at 5:00 PM on 11/14/14. You will need to make your 2015 elections on-line. NOTE: You should not wait until the last minute to make your election as there may be heavy traffic.

4. SHBP Enrollment Portal Your password expires every 45 days. Login to the SHBP Enrollment Portal to set up your new password. • Login using your current password • If it’s been over 45 days since the last time you logged in, you’ll be prompted to create a new password (which will expire every 45 days) • If you do not know your current User Name or Password: • Click the Forgot User ID? or Forgot Password? from the login page • Links are located to the right of the User Name and Password blocks.

5. SHBP Annual Enrollment • 2015 Active Employee Decision Guide • Will not be printed, available on-line at www.dch.georgia.gov/shbp. • The Active Employee Decision Guide is also available on the DNR Intranet at http://dnrnet.dnr.state.ga.us/hr/benefits. • Please read the Decision Guide booklet so you will know what is changing and what effect the changes will have on your benefits, options, rates, etc. before making your election for the 2015 Plan Year.

6. SHBP Annual Enrollment • You should go online to make your HI selection. You will not be allowed to make a change in the coverage until the next Annual Enrollment period unless you have a qualifying event that allows a change. • You may go online as many times as you like – but the last election confirmed at the time AE closes will be your election for the 2015 Plan Year. • You should print and keep a copy of the confirmation page which will contain a confirmation number. Once AE is closed, you will be able to go online at www.mySHBPga.adp.com and view your 2015 election.

7. SHBP Annual Enrollment • When making your benefit election, you should: • Make sure you have selected the correct option. • Confirm you have added all eligible dependents for coverage. • Confirm you have answered the Surcharge question correctly. • Click “Confirm” and Print the Confirmation page. • NOTE: You must answer the Surcharge question EACH TIME YOU LOG ON TO THE WEBSITE. • NOTE: The last selection made when the website closes at 5:00 PM on 11/14/14 will be the Plan you are placed in for the 2015 Plan Year.

8. New Plan Vendors and Options BlueCrossBlueShield of GA • Health Maintenance Organization (HMO) • Health Reimbursement Arrangement (HRA) United Healthcare • Health Maintenance Organization (HMO) • High Deductible Health Plan (HDHP) Kaiser Permanente • Health Maintenance Organization (HMO) • Metro Atlanta Service Area/In-Network only plan

9. Statewide Health Maintenance Organization (HMO) An HMO allows you to receive covered medical services from in-network providers only (except for emergency care.) It is important to verify your current provider is in-network when selecting an HMO Plan Option. This option is available with Blue Cross Blue Shield of Ga (BCBSGa) and United Healthcare. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” • Certain services are subject to a deductible and co-insurance • You are not required to obtain referrals to see a Specialist (SPC), but are encouraged to select a Primary Care Physician (PCP) to help coordinate your care. • The medical and pharmacy out-of-pocket maximums are combined • Co-payments count toward your out-of-pocket maximum • Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease.

10. Statewide Health Maintenance Organization (HMO) HRA

11. Statewide Health Maintenance Organization (HMO) HRA Prescription costs do not apply to your deductible.

12. Kaiser Permanente HMO The Kaiser Permanente HMO Plan Option is available to SHBP eligible members who live or work in one of the 26 counties within the defined Metro Atlanta Service Area.* Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventative care.” • KP administers the benefits for medical, pharmacy and wellness • No deductibles • The medical and pharmacy out-of-pocket maximums are combined • Co-payment only option *Metro Atlanta Service Area includes the counties of: Barrow, Bartow, Butts, Carroll, Cherokee, Clayton, Cobb, Coweta, Dawson, DeKalb, Douglas, Fayette, Forsyth, Fulton, Gwinnett, Haralson, Henry, Lamar, Meriwether, Newton, Paulding, Pickens, Pike, Rockdale, Spalding, Walton

13. SHBP HMO Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.

14. Health Reimbursement Arrangement (HRA) The HRA provides first-dollar coverage for eligible medical and pharmacy expenses and is funded by SHBP. When going to the doctor, you will not pay a co-payment. Instead, you pay the applicable deductible and co-insurance. If you have remaining credits in your current HRA account, those credits will roll over to the next Plan Year as long as you remain enrolled in an HRA option. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums. • You are not required to select a Primary Care Physician (PCP) or obtain referrals to a Specialist (SPC) • The credits in your HRA Account are used to help meet your deductibles and out-of-pocket maximums • The medical and pharmacy out-of-pocket maximums are combined • Certain drug costs are waived if SHBP is primary and you actively participate in one of the Disease Management Programs for diabetes, asthma and/or coronary artery disease.

15. HRA Prescription costs do not apply to your deductible. Pharmacy Benefits are the same across the board regardless of plan option.

16. Benefits of an HRA • Your HRA is funded by SHBP. Any unused funds roll over for future health expenses. • HRA credits can assist you in paying health expenses that go towards your deductible. • Initial HRA credits vary depending on the option/tier chosen. • Any remaining HRA credits from previous years will rollover in March 2015, this allows a 2014 plan runout to pay late claims for 2014. • If you do not enroll in an HRA Plan Option in 2015, any remaining HRA credits from 2014 are forfeited. Also, if you experience a Qualifying Event during the Plan Year that results in a Plan Option change to HMO or HDHP then your HRA credits will be forfeited.

17. SHBP HRA Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.

18. High Deductible Health Plan (HDHP) The HDHP offers in-network and out-of-network benefits and has a low monthly premium. However, you must satisfy a high deductible that applies to all covered medical and pharmacy expenses. (except preventive care.) If you have any dependents, the entire family deductible must be met before benefits are payable for any family member. Also, you may qualify for a Health Savings Account (HSA) to set aside tax-free dollars to pay for eligible health care expenses. Plan Features • Plan pays 100% of covered services provided by in-network providers that are properly coded as “preventive care.” • Before you can use well-being incentive credits, members must meet a threshold ($1,300 – individual; $2,600 other tiers) • You must meet separate in-network and out-of-network deductibles and out-of-pocket maximums • You pay co-insurance after meeting the entire deductible for covered medical and pharmacy expenses • The medical and pharmacy out-of-pocket maximums are combined • The HSA cannot be combined with a Flexible Spending Account (FSA) • There are no co-payments

19. SHBP HDHP Rates NOTE: An additional $80.00 will be added to the monthly premium shown above, if you or your covered dependents use Tobacco products.

20. Blue Cross Blue Shield of GA and United Healthcare Elections Pharmacy Benefits • Express Scripts administers the prescription drug pharmacy benefits for members who choose BCBSGa and UnitedHealthcare. Express Scripts provides benefits for retail prescription drug products, mail order, home delivery and specialty pharmacy services. • Get up to a 90-day supply of your maintenance medication either through Express Scripts home delivery pharmacy services or at a participating 90-day retail pharmacy. • Express Scripts offers several programs for managing your prescriptions: • The My RX Choices Prescription Savings Program lowers out-of-pocket prescription costs • The Worry-Free Fills Program offers automatic refills for long-term medications and will be automatically shipped to you • The Extended Payment Program extends home delivery payments over three installments

21. Enhanced Benefits • Applied Behavior Analysis (ABA) for Autism • Effective January 1, 2015, SHBP will provide limited coverage for medically necessary ABA treatment of Autism Spectrum Disorder • Maximum benefit of $35,000 per year per approved member (through age 10) • Co-payments, deductibles and/or co-insurance may apply • Bariatric Pilot • The GA Legislature has established a pilot program to provide benefit coverage for certain bariatric surgical procedures for the treatment and management of obesity and related conditions. • Effective January 1, 2015, the pilot program is limited to 75 non-Medicare Advantage members for the 2015 Plan Year. • Qualified applicants will be randomly selected by the vendors for which you are enrolled. Please contact your vendors for more information. • Hearing Aids • Benefit allowance for hearing aids has increased for children up to age 19 from $1,500 to $3,000 every five years

22. Blue Cross Blue Shield of GA and United Healthcare Elections • 2015 Wellness • Healthways will remain the vendor for the wellness program • Health actions must be completed between January 15, 2015 and December 15, 2015 in order to earn the well-being incentive credits. • Members will have access to a variety of Healthways’ tools, activities and services such as the Well-Being Assessment, wellness incentives, Well-Being Coaching, Biometric Screenings, and on-site activities. • Healthways will also administer 2015 wellness incentives that will allow you to earn credits for offsetting certain health care costs. • Members can earn up to 480 well-being incentive credits toward medical expenses, plus an additional 480 for a covered spouse (total of 960 per household)

23. 2015 Wellness Incentives for BCBSGa and UHC

24. Kaiser Permanente (KP) Elections • 2015 Wellness • Members that elect KP will have access to a variety of tools, activities and services such as the Total Health Assessment, Biometric Screenings and Online and On-site Healthy Living Classes • As a part of the KP Wellness Program, if you sign up on kp.org and complete at least one of the identified health actions (e.g. getting your annual flu shot, completing one online health education class,) you will be entered into a monthly drawing for an iPad and a Fit Bit to help you manage your health. • For details on the KP Wellness Program, contact Kaiser Permanente at www.my.kp.org/shbp or call 1-855-512-5997.

25. Other Health Care Options Available to Qualified Employees • TRICARE Coverage • Voluntary, member-pay-all supplemental health benefit. • Available to SHBP eligible individuals who are also eligible for TRICARE, the military health benefit program. • Ends when you turn 65. • Everyone covered under the contract must be in Tricare. • PEACHCARE FOR KIDS • As state or public school employees, you could be eligible to enroll your children in PeachCare for Kids. • Visit www.peachcare.org or call 877-427-3224 for information. Children cannot be enrolled in both SHBP and PeachCare.

26. Patient Protection and Affordable Care Act (ACA) The Department of Community Health which administers the State Health Benefit Plan states that all entities involved in the State Health Benefit Plan may assume that “all options meet the affordability and minimum value requirements of the Patient Protection and Affordable Care Act.”  For this reason and others DNR is in compliance with the ACA. Employees of the DNR office of Human Resources (OHR) are not qualified to accurately answer any questions regarding this federal program. Therefore, employees are encouraged to direct their questions regarding the ACA to the federal government website www.Healthcare.gov or call 1-800-318-2596.  

27. Making Your 2014 Benefit Election • Online Election • Employees must make their health election on-line at www.mySHBPga.adp.com • Website Open & Close Dates • Website opens at 12:01 a.m. on October 27, 2014. • Website closes at 5:00 p.m. on November 14, 2014. • Active Employee Health Plan Decision Guide • Available on the website at www.dch.georgia.gov/shbp. • No printed hardcopies.

28. Employee Responsibilities • Read and make sure you understand the plan materials posted at www.dch.georgia.gov/shbp and other information provided by DNR and take the required actions. • Confirm that you answered the Tobacco Surcharge question appropriately • Check your payroll deduction to verify that the correct deduction amount has been made. If you are not being charged the correct amount, immediately contact HR. • Notify SHBP whenever you have a change in covered dependents (within 31 days of a Qualifying Event.)

29. What Happens If No Action Is Taken? • Members who do not make an election, either through the web portal or by calling the SHBP Member Services Center, will be defaulted to the Blue Cross Blue Shield HRA option previously selected for 2014, without co-payments. • If you do not make an election and are currently paying the Tobacco Surcharge, your coverage will default and the Tobacco Surcharge you were paying in 2014 will continue to apply. • If you do not make an election and are currently enrolled in TRICARE Supplement in 2014, you will be enrolled in TRICARE Supplement in 2015.

30. Contact Information Blue Cross Blue Shield of GA - www.bcbsga.com/shbp 855-641-4862 UnitedHealthcare– www.welcometouhc.com/shbp 888-364-6352 Kaiser Permanente– www.my.kp.org/shbp 855-512-5997 Healthways - www.BeWellSHBP.com 888-616-6411 Express Scripts – www.express-scripts.com/georgiaSHBP 877-841-5227 SHBP Call Center 800-610-1863 Tricare Supplement – www.asicorporation.com/ga_shbp 866-637-9911 PeachCare For Kids – www.peachcare.org 877-427-3224

31. Important Notice • The information provided in this presentation is a summary of changes for the 2015 Plan Year. It is intended only to highlight principal benefits. • Please refer to the Active Employee Decision Guide for more details.

32. FLEX Annual Enrollment • AGENDA • Annual Enrollment Dates and Miscellaneous Information • 2015 Flexible Benefit Changes • Specified Illness Plan Information • Spending Accounts Plan Information • Dental Plan Information • Life Insurance Plan Information • Reminders for AE 2015 • Contact Information

33. FLEX Annual Enrollment • Annual Enrollment • Dates for Annual Enrollment: • Starts: 1:00 AM on October 27th • Ends: Midnight on November 14th • Two Options to make benefit selections and/or update dependent information for Plan Year 2015: • Accessing the GaBreeze website: www.GaBreeze.ga.gov • Contacting the GaBreeze Benefits Call Center: • 1-877-342-7339 • Employees will be allowed to have multiple confirmations online during the Annual Enrollment period.

34. Flexible Benefit Changes Specified Critical Illness Plan – Aflac/CAIC Plan Changes Spending Accounts – SHPS/ADP Plan Changes Dental Plans – Cigna HMO Plan Changes Legal Plans – Hyatt Plan Changes

35. Specified Illness Plan Info • Specified Illness Plan – Aflac/CAIC • Rate decrease to the Select and Select Plus Options • Coverage levels added to the Spouse Specified Illness for the Select/Select Plus options ($20,000, $30,000,$40,000,$50,000) • Spouse Specified Illness guaranteed issue level will be $30,000 • EOI required for Spouse enrolling in $40,000 or $50,000 levels • If denied, coverage will default to the current level for PY 2014 • Reminder: Coverage for Spouse Specified Illness cannot exceed coverage level for Employee Specified Illness and cannot be of a different plan.

36. Specified Illness Plan Info • Specified Illness Plan – Aflac/CAIC • Additional enhancements effective January 1, 2015: • Benefits no longer reduce by 50% at age 70 • New Waiver of Premium Benefit included in 2015 • Additional and Re-Occurrence benefits, other than Cancer, will only require a 90 day interval between diagnosis (previously six months to a year between diagnois) • Waiting periods for the purchase of additional coverage have been waived from the plan • The current vendor will be changing its branding to Aflac/CAIC

37. Spending Accounts Plan Info • Spending Accounts – ADP • Relation to the Health Saving Account • Employees who enroll in the High Deductible Health Plan AND enroll in a Health Savings Account (HSA) will NOT be eligible to enroll in a Health Care Spending Account. • If an employee does enroll in a HCSA in error, it will be necessary for them to contact the GaBreeze Call Center and request an Appeal Form to submit to DOAS. • The form will be received and reviewed by DOAS • GaBreeze will be notified of the final determination regarding the Spending Account • NO REFUNDS WILL BE GIVEN

38. Spending Accounts Plan Info • Spending Accounts – ADP • If an employee has a current contribution for 2014, it will NOT automatically rollover into the new plan year. • Employees MUST make an election to continue contributions in the FSA Plans for 2015 (Dependent Care & Health Care). • Employees will be required to make an election amount in order to keep their Health Care and/or Dependent Care Spending Account active. • The last deduction for Spending Accounts will be November 30th unless a new election for 2015 is made. • There will still be a grace period to make claims.

39. Dental Plan Info • Dental Plans – Cigna (HMO Option) • New Features for PY 2015: • TMJ diagnosis and treatment, including custom mouthpiece or bite plate therapy • Athletic mouth guards • Cone beam CT X-rays, where applicable • Expanded coverage for periodontal maintenance • Lower teeth whitening co-pay • Additional applications of fluoride and fluoride varnish at a minimal co-pay • Coverage for same-day, in-office CAD/CAM services for crowns, inlays, onlays, post and cores • Veneers

40. Legal Plan Info • Legal Plans - Hyatt • Select Plus Plan – new services for PY 2015: • Security deposit assistance (for tenants) • Protection from domestic violence • Network of attorneys has increased nationwide to 13,000 with over 450 attorneys within the State of Georgia • New Hyatt mobile app for plan members available on Android phones and on Google Play

41. Life Insurance Plan Info • Life Insurance – MetLife • Current employees electing Life insurance for the first time OR wishing to increase their current level of coverage will be required to complete the online Statement of Health (SOH) No paper form will be issued by Metlife • Employees wishing to enroll in Spouse Life or increase the current level of spouse coverage will be required to complete the online Statement of Health (SOH) • Employees are required to pre-register their spouse on the GaBreeze website. • Spouse will receive an e-mail from Metlife with instructions for completing the SOH online; no paper form.

42. GaBreeze Confirmation • GaBreeze Confirmation Number • Employees will receive a Confirmation Number upon successful completion of their online Annual Enrollment on the Completed Successfully page on the GaBreeze website. • Additional changes will be permitted online during the remainder of the Annual Enrollment period. • - Employees will retain the same Confirmation Number • - Date/Time Stamp will update to reflect the most recent completion • Employees SHOULD PRINT A COPY of the Confirmation Number for their records.

43. Flex Annual Enrollment • 2015 Enrollment Materials from DOAS/HRA • You Decide! Booklet • Benefits At-a-Glance Brochure • What’s New for 2015? • Information available on-line at: • http://doas.ga.gov/StateLocal/HRA/Benefits/pages/home.aspx • Please read the information provided so you will know what is changing and what effect the changes will have on your benefits, options, rates, etc. before making your election for the 2015 plan year.

44. Reminders for AE 2014 • Log onto the GaBreeze website to verify and/or update User ID and Password. • Update email addresses on the “Personal Information” section of the “Your Profile” page to ensure quicker response time to receive password updates from GaBreeze. • Link to the DCH Annual Enrollment site will be on GaBreeze.

45. Contact Information GaBreeze Website: www.GaBreeze.ga.gov Toll Free: 1-877-3GBreez or 1-877-342-7339 GaBreeze Representatives available Monday – Friday, 8:00 am – 5:00 pm ET (excluding holidays)

46. Contact Information Office of Human Resources Beth Findlay (404) 656-2697 beth.findlay@dnr.state.ga.us