! Action Required! Annual enrollment is Oct. 29 Nov. 9

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1 ! Action Required! Annual enrollment is Oct. 29 Nov. 9! Action Required! Current HRA participants and those who do not want short-term disability coverage must take action to avoid automatic selections. Learn more at BSWHbenefits.com.

2 At Baylor Scott & White, we re changing healthcare for the better and it all starts with you. You make it possible to deliver on our Ambition, and we re proud to offer benefit plan options that fit your lifestyle and your budget. This year, we ve refreshed our plans to better reflect our Strategy, industry best practices and employee feedback. The result is a benefits package that s not only competitive, but among the best in the industry. We re making it easier than ever to get safe, high-quality, convenient care from those you know and trust your colleagues. We re offering new programs that protect your finances should you encounter unexpected hardship. Mark your calendar for annual enrollment: Oct. 29 Nov. 9 Action required! Some plans require action to avoid automatic selections. Please review your options closely. Learn more at BSWHbenefits.com. As you prepare for annual enrollment, be sure to check out what s new on page 3 and keep your benefits checklist handy on page 4. Review your options closely as some require action to avoid automatic selection. You can always find more information at BSWHbenefits.com. Your Commitment is Core, and we re proud to invest in your health. Sincerely, John Lacy Chief Human Resources Officer 2 Annual Benefits Enrollment

3 You spoke we listened! Here s what s new this year: Medical Tier 1 Network now exclusively includes providers in the Baylor Scott & White Quality Alliance (BSWQA) Network. Tier 2 Cigna National Network is only available with the PPO and HSA plans and now includes: Airrosti, CTX Neurology, Hunt Regional, UT Southwestern physicians and Ophthalmology Surgery Center of Dallas. Select Exclusive Quality Alliance (SEQA)/Exclusive Quality Alliance (EQA) plan is our new single-network plan based on hourly wage. HRA plan is discontinued, but remaining HRA dollars can be used to pay for care if you enroll in the SEQA/EQA or PPO* plans (subject to 2018 rollover limits). Dental and Vision The maximum paid by the dental plan increased 25%! EyeMed is our new vision vendor and we ve increased the annual allowance for frames and contacts and lowered the cost of eye exams. Life, AD&D, Disability and EAP Cigna is our new life insurance carrier. Basic life and AD&D maximum is now $500,000 and voluntary life and AD&D maximum is now $2,000,000.***! Action required! If you are not currently enrolled in shortterm disability, you will be auto-enrolled for We ve lowered the premiums, so you may want to keep it! You only need to take action if you want to opt out.! Action required! Currently enrolled in the HRA plan? Take action or be automatically enrolled in the PPO plan for Basic long-term disability pays up to 50% of base pay, up to $15,000 a month.*** Those needing 60% income replacement have the option to buy up. HSA employer contribution is retired, but we ve lowered the Tier 1 deductible by the same amount we were contributing it s a wash!! Action required! Complete an annual preventive visit (health screening) by Nov. 9 or pay $30 per pay period beginning next year.** As part of this, the wellness credit will discontinue, effective the last paycheck of Voluntary Benefits Critical illness and accidental injury coverage are new plans offered through Cigna that protect your finances in cases of unexpected hardship. Cigna is our new employee assistance program (EAP) provider. Call or visit for 24/7 support. Spending/Savings Accounts Optum Bank is our new flexible spending and health savings account provider. Tuition Reimbursement New repayment provision added for classes starting on or after Jan. 1, Annual reimbursement now tied to degree path. Clinical $5,250 FT, $2,500 PT Non-clinical $4,250 FT, and $2,500 PT *To be eligible for HRA payment, care must be received from a Tier 1 BSWQA Network provider, except in cases of urgent care or emergency. **Impacts employees covered by Scott and White Health Plan in ***Other coverage levels for life, AD&D and disability are available for certain executive and physician roles and are visible in the PeoplePlace enrollment system. Did you know: We ve simplified short-term disability coverage We eliminated the Evidence of Insurability (EOI) requirement and added a pre-existing condition provision similar to what s in place for long-term disability coverage. This only applies to new enrollees on the plan. If you ve been diagnosed, treated or received medical advice for a condition within three months of your effective date on the plan (Oct. 1 Dec. 31), that condition will be excluded for a period of 12 months. For example, if you are pregnant at the time you enroll, your delivery and recovery will be excluded from the STD benefit for that coverage year. If you are currently enrolled in the plan, you do not need to satisfy the pre-existing condition provision. Annual Benefits Enrollment 3

4 2019 Benefits Checklist! Use this handy checklist to keep track of your benefits decisions. Remember, some require action!! Action required! Decision 1: Medical Coverage Pick a plan that best fits your needs and your income! Choose between the SEQA/EQA, PPO or HSA. Learn more on pages 6-9. If you were previously enrolled in the HRA plan and do not enroll in a new plan, you will be auto-enrolled in the PPO plan for Decision 2: Voluntary Critical Illness and Accidental Injury Insurance Protect your family and your finances. Enroll to receive a cash benefit during times of hardship. Learn more on page 10. Decision 3: Dental Coverage Keep your smile bright with one of two plans: MetLife Dental PPO or MetLife Dental PPO plus. Decision 4: Vision Coverage See the savings with our voluntary vision plan administered by EyeMed, which covers routine exams, lenses, frames and contacts. Decision 5: Savings/Spending Accounts Set aside pre-tax dollars to pay for eligible expenses with a general-purpose flexible spending account (FSA), limited purpose FSA, dependent day care FSA or health savings account.! Action required! Decision 6: Life Insurance Need more? We provide basic life insurance*, but you can elect additional voluntary coverage for you, your spouse or your children. Decision 7: AD&D Insurance Need more? We provide basic accidental death and dismemberment (AD&D) insurance*, but you can elect additional voluntary coverage for you, your spouse or your children. Decision 8: Short-Term Disability Insurance You only need to take action if you want to opt out, but you may want to keep it as we ve lowered the premiums! Short-term disability insurance pays a portion of your salary if you re sick, injured or add a child to your family by birth or adoption. Decision 9: Long-Term Disability Insurance Need more? We provide basic long-term disability insurance*, but you can elect additional coverage to increase your benefit to 60% of your base salary, up to $15,000 a month. Decision 10: Pre-Paid Legal Services Get help with a wide range of personal legal matters by enrolling in voluntary coverage offered through Hyatt Legal. Visit BSWHbenefits.com to learn more. *Other coverage levels for life, AD&D and disability are available for certain executive and physician roles and are visible in the PeoplePlace enrollment system. 4 Annual Benefits Enrollment

5 BSWQA: The Best Value Working together to keep you healthy Think of the Baylor Scott & White Quality Alliance (BSWQA) like family. It s a complete network of more than 6,500 primary care and specialty care physicians, 49 hospitals and more than 95 post-acute care facilities all working together to manage your health and wellbeing at an affordable price. How it works: You choose a BSWQA primary care doctor, and he or she focuses on your overall wellbeing and coordinates your care so you achieve your health goals. Your doctor keeps your health information in an electronic health record* to monitor your health history, test results and any gaps in your care. How it benefits you: It s personal. BSWQA doctors and facilities have secure access to your medical history* so they know you before you walk through the door. It s accountable. BSWQA doctors are accountable for achieving specific quality, patient satisfaction and cost measures. It s affordable. Staying in-network with BSWQA doctors and facilities can save you money on copays and out-of-pocket expenses. Find a Tier 1 BSWQA provider today! Visit bswh.swhp.org or call the HealthAccess Line at *Depending on your doctor s electronic health record system. Did you know: BSWQA is growing to serve you better Since 2016, the network has grown nearly 39% providing high-quality care where and when you need it. Pediatric access has increased 32.5% and primary care access has increased 31%. And there s more growth on the horizon. Nearly 88% of employees and dependents covered by our health plan currently use our Tier 1 BSWQA Network! Network Tiers Depending on the medical plan you choose, you ll have access to one or more of the following networks: Tier 1 BSWQA Network: A Texas-based network managed by BSWQA, in conjunction with Scott and White Health Plan (SWHP). It s the only network available for the SEQA/EQA plan, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided. Tier 2 Cigna National Network: A national network, managed by Cigna, in conjunction with SWHP. Only available with the PPO and HSA plans. Tier 2 now includes these providers, which were previously part of the Tier 1 Network: Airrosti, CTX Neurology, Hunt Regional, UT Southwestern physicians and Ophthalmology Surgery Center of Dallas. PPO and HSA plans: If you or a covered dependent live 40 or more miles from the nearest Tier 1 hospital, you will receive a higher out-of-area benefit (80% vs 50% after deductible) when you see a Tier 2 provider. Contact SWHP at to activate out-of-area coverage. Tier 3 Out of Network: Providers not included in the Tier 1 BSWQA or Tier 2 Cigna National networks. Only available with the PPO and HSA plans. Choosing providers in Tier 3 will always be the most expensive option. Annual Benefits Enrollment 5

6 Your Personal Benefits Counselor Choosing the right benefits can be tough but help is just a few clicks away. Ask Alex is our easyto-use virtual benefits counselor who can help you understand and select your benefits for Visit BSWHbenefits.com, click Ask Alex and answer a few simple questions. Alex will review your answers, explain your options and help you make the best choices for you and your family. Use his advice as a guide and be sure to use your other resources before making a final decision. Medical Benefits Benefits-eligible employees can select from three medical plans: SEQA/EQA, PPO or HSA. New! Select Exclusive Quality Alliance (SEQA) Plan The new SEQA plan is available to employees making $25.00 or less per hour. This plan has no deductible and exclusively includes providers in the Tier 1 BSWQA Network, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided. Live more than 40 miles from a Tier 1 BSWQA hospital or have out-of-state dependents? Consider the PPO or HSA plans as they offer an extended network of providers through Tier 2 and Tier 3 coverage. How You Pay for Care: You pay for care from your pocket or from any rollover HRA funds. You can also set aside pre-tax dollars through a flexible spending account (FSA) to help cover certain expenses. Deductible: This plan does not have a deductible. Copays: You pay copays from your pocket or from any rollover HRA funds. You can also set aside pre-tax dollars through an FSA to help cover certain expenses. Preventive visits are covered at 100%. This plan also offers very low copays for non-preventive office visits (for example, a primary care visit is $10). Urgent care visits, inpatient and outpatient services also have copays, making it easy to understand your out-of-pocket responsibility. Prescriptions: You pay copays for prescriptions (as low as $3-$5) from your pocket or from your FSA. There s no cost for diabetic medicine and supplies with this plan! Network: This plan only includes providers in our Tier 1 BSWQA Network. Be sure to check bswh.swhp.org to verify your provider is available with this plan. No out-of-network coverage is available, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided. 6 Annual Benefits Enrollment

7 Enrolling is easy! Simply log in to PeoplePlace and follow these steps: 1. Click Benefit Details 2. Click Benefits Enrollment 3. Click Select to choose your 2019 benefits and add or update your dependents and beneficiaries 4. Click Save and Continue to accept your final choices 5. Click Submit to finalize your choices You can change your elections until midnight on Nov. 9. Please note: Baylor Scott & White will be conducting a dependent verification in 2019 to ensure family members covered by our plans meet the eligibility criteria. Documentation such as marriage certificates, birth certificates, and tax forms may be requested. It is important to submit everything in a timely manner to ensure dependents remain covered. New! Exclusive Quality Alliance (EQA) Plan The new EQA plan is available to employees making $25.01 or more per hour. This plan has a lower deductible than the PPO or HSA plan and exclusively includes providers in the Tier 1 BSWQA Network, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided. Live more than 40 miles from a Tier 1 BSWQA hospital or have out-of-state dependents? Consider the PPO or HSA plans as they offer an extended network of providers through Tier 2 and Tier 3 coverage. How You Pay for Care: You pay for care from your pocket or from any rollover HRA funds. You can also set aside pre-tax dollars through a flexible spending account (FSA) to help cover certain expenses. Deductible: This plan offers a lower deductible than the PPO and the HSA plans. You meet your deductible with durable medical equipment expenses, private duty nursing, hearing aids, skilled nursing, home health and hospice care. After the deductible, you have a 10% coinsurance for these services. Did you know: HRA rollovers Unused HRA dollars can be used to cover medical expenses (except for pharmacy) incurred from a Tier 1 BSWQA Network provider if you enroll in the SEQA/EQA or PPO plan. Don t have HRA rollover dollars? Consider setting aside money in an FSA to pay for eligible expenses. Copays: You pay copays from your pocket or from any remaining HRA funds. You can also set aside pre-tax dollars through an FSA to help cover certain expenses. Preventive visits are covered at 100%. This plan also offers low copays for non-preventive office visits (for example, a primary care visit is $30). Urgent care visits, inpatient and outpatient services also have copays, making it easy to understand your out-of-pocket responsibility. Prescriptions: You pay copays for prescriptions (as low as $3-$5) from your pocket or from your FSA. Network: This plan only includes providers in our Tier 1 BSWQA Network. Be sure to check bswh.swhp.org to verify your provider is available with this plan. No out-of-network coverage is available, except in cases of urgent/emergency care or rare situations when an in-network provider is not available and authorization is provided. Annual Benefits Enrollment 7

8 Preferred Provider Organization (PPO) Plan This plan has a higher per-paycheck cost, multiple network options and a lower deductible than the HSA plan. How You Pay for Care: You pay for care from your pocket or from any remaining HRA funds (for care received from Tier 1 BSWQA providers or care that is urgent/emergent). You can also set aside pre-tax dollars through a flexible spending account (FSA) to help cover certain expenses. Deductible: You meet your deductible with lab work, imaging, outpatient procedures, etc. Do you know? If you were previously enrolled in the HRA plan and do not enroll in a new plan, you will be auto-enrolled in the PPO plan for Copays: You pay copays from your pocket, from rollover HRA funds, or from your FSA for office visits, urgent care visits and the emergency room for you and each of your covered dependents. Prescriptions: You pay copays for prescriptions (as low as $3-$5) from your pocket or from your FSA. Network: You have access to the Tier 1 BSWQA Network, Tier 2 Cigna National Network and Tier 3, which is out of network. For this plan, our Tier 1 BSWQA Network is always the best bet. Tier 3 includes providers who are not part of Tier 1 or Tier 2 and will always be the most expensive option. We re always looking for ways to keep our colleagues healthy. Thrive, our award-winning wellness program, is making a few changes. Employees covered by the Scott and White Health Plan in 2019 who do not complete an annual preventive visit (health screening) by Nov. 9 will pay $30 per pay period beginning with the first paycheck of As part of this change, the wellness credit will discontinue, effective the last paycheck of 2018, and medical premiums reflect an assumption that everyone is completing their Thrive requirements so completing your preventive visit will not only keep you healthy, it will also save you money like it does today! Remember, for employees enrolled in our medical plan, preventive visits with a Tier 1 or Tier 2 provider are free of charge. 8 Annual Benefits Enrollment

9 Health Savings Account (HSA) Plan This high-deductible plan works well for those who want to take a more active role in managing their healthcare. The plan is also HSA eligible, which gives you the opportunity to defer pre-tax dollars for future healthcare expenses (including in retirement) to an HSA with Optum Bank. When you invest your HSA funds, this plan has real value! Employees with high pharmacy costs or those who aren t used to managing a high-deductible plan should carefully research this plan before selecting. How You Pay for Care: You pay for care from your pocket or from tax-free contributions to your HSA through payroll deductions. You can change your HSA payroll contributions at any time during the year by calling PeoplePlace at Deductible: You meet your deductible by paying 100% of the contracted rate for office visits, prescriptions, urgent care visits, lab work, imaging, etc. Copays: Copays are not available with this plan. Prescriptions: You re responsible for 100% of the contracted rate of your prescription costs until your deductible has been met. Once your deductible is met, you pay 10% of costs up to the out-of-pocket maximum. Network: You have access to the Tier 1 BSWQA Network, Tier 2 Cigna National Network and Tier 3, which is out of network. For this plan, our Tier 1 BSWQA Network is always the best bet. Tier 3 includes providers who are not part of Tier 1 or Tier 2 and will always be the most expensive option. Annual Benefits Enrollment 9

10 Voluntary Benefits We care about your wellbeing and want to make sure you have a steady source of income during times of unexpected illness or injury. You can enroll in these optional plans in PeoplePlace. Coverage is guaranteed and no health questions or physician exams are required. Accidental Injury Insurance With Cigna accidental injury insurance, you get a benefit to help pay for costs associated with a covered accident or injury. It provides a lump sum payment to you, unless otherwise assigned, based on a schedule of covered injuries. The money can be used as you see fit there are no copays, deductibles, coinsurance, restrictions or network requirements to satisfy. Critical Illness Insurance With Cigna critical illness insurance, you get a benefit paid directly to the covered person, unless otherwise assigned, if they are diagnosed with a covered critical illness. You choose how to spend or save your benefit. It can be used for expenses, such as paying for child care or help around the house, travel costs to see a specialist, medical treatment and doctor visits, copays, deductibles and prescription drug costs. The plan also pays a $50 per insured person per covered year wellness benefit if a covered health screening is performed (annual checkup, colonoscopy, mammogram, etc.). If you elect coverage for your spouse or dependents, their benefit amount is 100% of your elected benefit amount. You do not need to be enrolled in other benefits to select this coverage. More information is available on BSWHbenefits.com. 10 Annual Benefits Enrollment

11 2019 Medical Plan Coverage and Costs Changed from 2018 benefits Medical Plan SEQA NEW! EQA PPO HSA Network Tier 1 BSWQA Tier 1 BSWQA Tier 1 BSWQA Tier 2 Cigna National Tier 3 Out-of- Network Tier 1 BSWQA Tier 2 Cigna National Tier 3 Out-of- Network Employer funded dollars (Use HRA Rollover Funds) (Use HRA Rollover Funds) (Use HRA Rollover Funds) (Use HRA Rollover Funds for Urgent Care and Emergency Only) Annual Deductible Employee only $0 $500 $1,000 $2,000 $5,000 $1,500 $3,000 $5,000 Employee + family $0 $1,000^ $2,000^ $4,000^ $10,000^ $3,000 $6,000 $10,000 Out-of-Pocket Maximum Employee only $3,000 $4,000 $4,000 $6,750 No Limit $3,950 $6,750 No Limit Employee + family $6,000^^ $8,000^^ $8,000^^ $13,500^^ No Limit $7,900^^ $13,500^^ No Limit Your Cost for Care and Services Preventive care* $0 $0 $0 $0 Not Covered $0 $0 Not Covered Primary care office visit $10 $30 $35 $70 70% AD 10% AD 50% AD 70% AD Specialist office visit $40 $50 $60 $100 70% AD 10% AD 50% AD 70% AD Urgent care office visit $50 $75 $75 $100 $100 10% AD 50% AD 50% AD Diagnostic labs and x-rays Labs: 20% X-rays: $75 Labs: 30% X-rays: $75 10% AD 50% AD 70% AD 10% AD 50% AD 70% AD Advanced imaging Ex. PET, CT, CAT Advanced imaging Ex. MRI, MRA $100 $100 10% AD 50% AD 70% AD 10% AD 50% AD 70% AD $150 $150 10% AD 50% AD 70% AD 10% AD 50% AD 70% AD Emergency room $250 $250 $250 $250 $250 10% AD 10% AD 10% AD Inpatient hospitalization $150/day (max of 5) $150/day (max of 5) 10% AD 50% AD 70% AD 10% AD 50% AD 70% AD Outpatient care $150/visit $150/visit 10% AD 50% AD 70% AD 10% AD 50% AD 70% AD * In order for preventive care to be covered at 100%, services must be coded as preventive. Please see bswh.swhp.org for a complete list of covered preventive care services AD means after you ve met your deductible. ^The plan provides after-deductible coverage once an individual with family coverage meets the individual deductible, even if the family deductible has not been met. ^^Once an individual with family coverage has met the out-of-pocket maximum, the plan provides 100% coverage for that individual, even if the family out-of-pocket maximum has not been met. Meet the Chionhs! Kristen is a director at the Baylor Scott & White Research Institute. Her daughter Megan is 11 and her son Cooper is 13. Together with their dad Andre, they love spending weekends at the park with Usher, their five-month-old goldendoodle. Annual Benefits Enrollment 11

12 Prescription Drug Costs Changed from 2018 benefits SEQA EQA and PPO HSA Type of Rx BSWH Pharmacy (30 day cost/ 90 day cost) Contracted Pharmacy *30 day supply only BSWH Pharmacy (30 day cost/ 90 day cost) Contracted Pharmacy *30 day supply only (BSWH or Contracted Pharmacy) *90 day supplies are only available through the BSWH Pharmacy Preferred generic $3/$6 $5 $3/$6 $5 10% AD Preferred brand $25/$50 $50 $35/$70 $50 10% AD Non-preferred brand and generic Lesser of $50/$100 or 50% Lesser of $75 or 50% Lesser of $50/$100 or 50% Lesser of $75 or 50% 10% AD Specialty $100 N/A 20% ($200 Max) N/A 10% AD** Chronic and preventive $10/$20 $0 Diabetic Treatment $20 $0 Diabetic Treatment $10/$20 $20 10% AD Employer Funded Dollars HRA rollover funds are not usable toward the pharmacy benefit HSA funds can be used toward both the medical and pharmacy benefit To help make some frequently prescribed preferred brand drugs for asthma, diabetes and some other chronic conditions more affordable, we ve placed a select group on a special chronic and preventive medication list. Find the complete list on bswh.swhp.org. * Only BSWH pharmacies can fill a 90 day supply of a medication. The max day supply through a contracted pharmacy is 30 days. Fertility drugs are covered at 20% with a maximum $400 copay and a $7,500 lifetime maximum pharmacy benefit. Drugs not listed on formulary require prior authorization. If authorized, you ll pay the applicable non-preferred or specialty copay. **Specialty drugs only available at BSWH pharmacy 12 Annual Benefits Enrollment

13 2019 Medical Premiums Per Pay Period Your Hourly Rate Coverage Tier SEQA NEW! EQA HSA PPO Employee only $9 $11 $33 Up to $13/hour Employee + spouse $63 $45 $91 Employee + child(ren) $62 $44 $88 Employee + family $106 The EQA Plan is $67 $138 unavailable for Employee only $18 this hourly rate $27 $49 $13.01 to $25/hour Employee + spouse $103 $87 $153 Employee + child(ren) $90 $71 $124 Employee + family $146 $117 $198 Employee only $59 $50 $72 $25.01 to $48/hour $48.01/per hour and above Employee + spouse $153 $130 $189 Employee + child(ren) $131 $108 $161 Employee + family The Select $202 $182 $258 EQA Plan is Employee only unavailable for $80 $71 $93 this hourly rate Employee + spouse $183 $164 $224 Employee + child(ren) $158 $135 $187 Employee + family $240 $230 $293 If you are a commissioned employee, your hourly rate is determined by your prior year W-2 earnings divided by annual hours worked. The hourly rate for new commissioned employees who haven t had a W-2 yet will be the base rate that is in PeopleSoft. Part-Time Employees Per Pay Period Coverage Tier SEQA ($25/hour and below) EQA ($25.01/hour and above) HSA PPO Employee only $92 $96 $225 Employee + spouse $274 $279 $402 Employee + child(ren) $194 $199 $393 Employee + family $327 $332 $601 This document summarizes programs and benefits available to employees and eligible dependents. Official plan documents, policies and certificates of insurance that contain the details, conditions, maximum benefit levels and restrictions on benefits govern our benefits program and will be available at BSWHbenefits.com. In case of a conflict between this document and the official documents, the official documents prevail. The information in this document isn t a guarantee of benefits. Baylor Scott & White reserves the right to modify or terminate its employee benefit plans and programs at any time for any reason. Annual Benefits Enrollment 13

14 Dental Premiums Per Pay Period Vision Premiums Per Pay Period Coverage Tier MetLife Dental PPO MetLife Dental PPO Plus Coverage Tier Employee only $8.50 $16.89 Employee only $3.08 Employee + spouse $17.03 $32.94 Employee + spouse $6.12 Employee + child(ren) $22.79 $42.39 Employee + child(ren) $6.00 Employee + family $28.91 $58.44 Employee + family $9.12 New! Accidental Injury Insurance Premiums Per Pay Period Coverage Tier Employee only $4.61 Employee + spouse $7.94 Employee + child(ren) $7.62 Employee + family $9.57 Plan is deducted on a post-tax basis. Rates for life insurance, short-term disability and long-term disability can be found at BSWHbenefits.com. 14 Annual Benefits Enrollment

15 New! Critical Illness Insurance Premiums Per Pay Period $15,000 Benefit Attained Age Employee Employee & Spouse Employee & Child(ren) Employee & Family 0-24 $2.10 $4.25 $4.84 $ $2.49 $4.88 $5.23 $ $3.43 $6.52 $6.18 $ $5.05 $9.61 $7.79 $ $6.51 $12.46 $9.25 $ $9.09 $17.86 $11.82 $ $12.09 $25.50 $14.83 $ $15.94 $35.32 $18.69 $ $19.81 $44.40 $22.55 $ $24.28 $53.20 $27.02 $ $33.84 $73.18 $36.57 $ $43.79 $95.48 $46.52 $ $60.91 $ $63.65 $ $77.41 $ $80.14 $ $30,000 Benefit Attained Age Employee Employee & Spouse Employee & Child(ren) Employee & Family 0-24 $4.20 $8.50 $9.67 $ $4.98 $9.76 $10.46 $ $6.87 $13.04 $12.35 $ $10.10 $19.21 $15.57 $ $13.02 $24.92 $18.49 $ $18.18 $35.72 $23.65 $ $24.18 $51.00 $29.66 $ $31.89 $70.65 $37.37 $ $39.61 $88.80 $45.09 $ $48.56 $ $54.04 $ $67.68 $ $73.15 $ $87.57 $ $93.05 $ $ $ $ $ $ $ $ $ Spouse and child rate are derived from employee age. Children are eligible up to age 26. Plan is deducted on a post-tax basis. Annual Benefits Enrollment 15

16 Presorted First Class Mail US Postage Paid Dallas, TX Permit #1832 We re here to help! Benefits on the go! The MyBSWHealth app is an easy and convenient way to manage your healthcare and access your health benefits on the go. Find providers, view claims, register for E-Visits and more! Get the latest MyBSWHealth app in the Apple App Store or Google Play today. Find a Tier 1 BSWQA Provider Baylor Scott & White Quality Alliance Health Access Line Click bswh.swhp.org and click Find a Provider Talk App MyBSWHealth App Questions about Pay, Benefits, Paid Time Off, Disability or Leave PeoplePlace Click mypeopleplace.com and select Request Help Talk Questions about Medical and Prescription Drug Coverage or Your Personal Claims and Account Information Scott and White Health Plan Click bswh.swhp.org Talk (dedicated employee line) App MyBSWHealth App? Questions about Retirement Empower Retirement Click BSWHretirement.com Talk App Empower Retirement While you re reviewing your benefits, it s a good idea to check on your retirement savings. Keep in mind you can sign up, make changes and adjust your retirement savings anytime during the year.