2018. WHAT S NEW 2018! GOOD NEWS! HDHP

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1 Your Open Enrollment period is: October 16, 2017 through vember 13, Your Period of Coverage is: January 1, 2018, through December 31, Welcome to Broward County s Open Enrollment for WHAT S NEW for 2018! HDHP Base plan has a higher deductible due to IRS requirements: $1,350 Single Coverage, $2,700 Emp+Dep(s). HSA/HRA funding (HDHP Base and In/Out of Network Plans only) = $1,350 Single/$2,700 Emp+ Dep(s) for both plans. HDHP Base and In/Out of Network Plans have a reduction in co-insurance from 30% to 20%. OptumRx - some formulary changes. Members affected will be notified by OptumRx. CDH Low Plan eliminated and replaced with a Narrow Network Plan which has a higher benefit level but is restricted to the following hospital groups: Memorial rth Broward Holy Cross Cleveland Clinic Weston Health and pharmacy will be administered by Community Care Plan, not UHC or OptumRx. Dental DHMO Plan - no rate increase. Dental PPO Plan 8% rate increase. Vision Plan no rate increase. For more information, go to Broward.org/benefits GOOD NEWS! At the Board meeting on September 14 th, 2017, the Broward County Board of Commissioners approved staff recommendations concerning the County s group health plans for 2018, which included no premium increase to the HDHP Base plan, HDHP In/Out of Network Plan and the CDH High Plan and continued funding of the HSA/HRA for the two HDHP plans at the HDHP Base plan amount. Also approved was the elimination of the CDH Low plan and the addition of a new Narrow Network Plan. NO HEALTH PREMIUM INCREASES FOR 2018! REMEMBER ALEX? ALEX is back to help you with selecting and understanding benefit plans available so that you can determine the best-fit for you and your dependents for Alex asks questions about your coverage needs and explains how the different plans work, then provides recommendations including financial implications. NOTE: ALEX does not enroll you in any coverage, it just provides recommendations based on your information. You must complete your enrollment or waiver of benefits through the County s on-line system. ENGAGEMENT INCENTIVE complete by 12/31/17 Improved process no paper forms to complete. Funding of the HSA (or HRA as applicable) for the two HDHP plans will be based on electronic files received from UnitedHealthcare (UHC). UHC will provide a file with a Yes flag indicating you have completed one of the options in As claims can take up to 45 days to be processed, it is recommended that you complete your incentive as early as possible to avoid a delay in receiving your 2018 funding. Newly benefit-eligible employees with benefits effective January 1, 2018, or later, will automatically receive funding for 2018; however, will have to complete one of the options in 2018 to receive funding for WAIVING HEALTH COVERAGE? You must go online and waive coverage through the open enrollment system to receive the Waiver Credit. Broward.org/benefits, click on Open Enrollment for plan information. It is your responsibility to verify your 2018 coverage and dependents are correct. 1

2 HEALTH PLAN OPTIONS FOR 2018 As our new CCP Narrow Network plan is not administered through UnitedHealthcare (UHC), the health plan options for 2018 will be broken into two sections UHC plans and the new Community Care Plan (CCP). PLANS UNDER UNITEDHEALTHCARE: High Deductible Health Plan Base Plan (HDHP Base) High Deductible Health Plan In/Out of Network (HDHP OON) CDH High Plan High Deductible Health Plans High Deductible Base Plan (HDHP) annual deductible increased by $50 Single/$100 Dependents due to IRS requirements. HDHP Base Plan HDHP In/Out of Network Plan In-Network Only In-Network Out-of-Network Deductible $1,350 Single/$2,700 Deps $1,500 Single/$3,000 Deps $3,000 Single/$6,000 Deps Co-insurance $2,075 Single/$4,150 Deps $1,500 Single/$3,000 Deps $3,000 Single/$6,000 Deps Maximum Out of Pocket $3,425 Single/$6,850 Deps $3,000 Single/$6,000 Deps $6,000 Single/$12,000 Deps HSA/HRA Funding* $1,350 Single/$2,700 Deps $1,350 Single/$2,700 Deps * Requires completion of Engagement Incentive Highlights of HDHP Plans All health and prescription services are subject to the annual deductible and coinsurance based on tier of coverage except for mandated preventive services or designated preventive prescriptions (see Preventive Rx list at broward.org/benefits, click on Open Enrollment, then Pharmacy). Medical and prescription expenses will be applied toward meeting the annual deductible and coinsurance amount based on tier of coverage (Member Only coverage or Member + Dependents coverage). Once the annual deductible is met, the health and pharmacy plan pays 80% and you pay 20% coinsurance of the eligible discounted costs (in-network). When you reach the out-of-pocket maximum, the Plan pays 100% of eligible in-network health and prescription expenses for the remainder of the calendar year. Preventive services and designated preventive prescriptions are covered at 100%. If you have students attending college outside of UnitedHealthcare s National Choice Network you will need to enroll in the HDHP Out of Network Plan. Annual eye exam at no cost at a participating optometrist. Discount dental plan included at participating dental providers. CDH High Plan changes to CDH High Plan premium, plan design, deductibles, coinsurance, copays, and out-of-pocket. Highlights of CDH High Plan Preventive services, when billed by Provider as Preventive, covered 100% in-network. Some services received for a copay (Primary, Specialist, Urgent Care, Emergency Room). Some services subject to the annual deductible/co-insurance (Outpatient or inpatient services/ procedures). Behavioral health/substance Abuse out-patient services first 20 visits covered at no cost, then $25 copay. Diagnostic tests at a participating freestanding facility capped at $100 per test. Annual basic eye exam at no cost at a participating optometrist. Discount dental plan included at participating dental providers. NO OUT OF NETWORK COVERAGE (you are always covered when travelling for a medical emergency). 2

3 Networks HDHP Base Plan, and CDH High - UnitedHealthcare s National Choice Network-Open Access* HDHP Out of Network UnitedHealthcare s National ChoicePlus Network-Open Access* * Open Access means a referral to see most network specialists is not required. However, certain services require Prior Authorization. CDH LOW PLAN ELIMINATED, REPLACED WITH NEW NARROW NETWORK PLAN Need assistance with UnitedHealthcare s Medical or Vision plans? Contact one of the UHC on-site Representatives: Danila Montgomery Marc Dormeus Look up providers, cost comparisons, facility comparisons, claims history and more at myuhc.com PHARMACY PLAN (HDHP Base Plan, HDHP In/Out of Network Plan and CDH High Plan) Pharmacy benefits are provided under the County s self-insured plan through OptumRx (HDHP Base Plan, HDHP Out of Network Plan, CDH High Plan). The only changes to the plan for 2018 are annual Formulary changes. Review the 2018 Formulary at broward.org/benefits. Maintenance medications can only be filled for 30 days 3 times, then must be filled as 90 days. 90-day mandatory maintenance medication program at retail or mail order Large network of participating pharmacies (Walgreens, Target, CVS, Publix super markets, etc.) Restricted generic policy (generics will be dispensed if available unless the doctor indicates Dispense As Written (DAW1) due to medical necessity on the prescription. (Member will pay a higher copay on CDH High Plan.) 30-day Specialty pharmacy home delivery. Contact Briova Rx at or briovarx.com for more information regarding specialty pharmacy. Some prescriptions require Prior Authorization. Physician should contact OptumRx to provide medical history and medical necessity. New CCP Narrow Network Plan through Community Care Plan (CCP) Plan is administered by Community Care Plan, not UnitedHealthcare All services must be obtained by providers, facilities and hospitals within the following four hospital groups: Memorial Healthcare System rth Broward Hospital Group Holy Cross Cleveland Clinic Florida-Weston About CCP The Community Care Plan is a community-based health plan owned by Broward Health Group and Memorial Healthcare System. The CCP Narrow Network plan is built around a total care philosophy. Members will receive one-on-one member support through CCP s personalized Concierge Care Coordination (C3) program which helps members receive quality care at the right time and in the right place. Members enrolling in the new CCP Narrow Network plan will receive a one-on-one onboarding experience with a CCP Care Coordinator who will get to know you, learn about your health care needs and provide you with information on all of the services they offer to their members. For more information go to ccpcares.org/bcg 3

4 The CCP Narrow Network Plan provides a plan design similar to the CDH High Plan, at a lower cost than the CDH High Plan. The chart below is summary of coverage, for more details go to ccpcares.org/bcg: BENEFIT CCP NARROW NETWORK Annual Deductible* $1,300 Single, $2,600 Dependents (Does not include Rx) Annual 20%* $1,500 Single, $3,000 Dependents Annual Max Out of Pocket* $2,800 Single, $5,600 Dependents Preventive Care Cost when billed as Preventive Care by Provider Primary Care Doctor $25 copay Specialist $50 copay Lab Work cost at Lab Corp or Quest Virtual Visits (Telehealth) $40 copay Urgent Care (CCP Network) $50 copay Emergency Room $250 copay MRI/Nuclear Medicine 20% up to a $100 max, at Freestanding Facility Behavioral Health/Substance Abuse Out Patient visits cost for first 20 visits, $25 copay per visit thereafter. Requires a referral prior to 1 st visit All other medical services Subject to Annual Deductible and 20% Coinsurance Rx copays (EnvisionRx) Generic: $ day $ day Preferred: $ day $ day n-preferred: $ day $ day Specialty: $ day Only Plan includes the following benefits: Basic annual eye exam Discount Dental Plan *Does not include pharmacy copays CCP WELLNESS PROGRAM- MyHealth, My Life MyHealth, MyLife is a wellness program focused on achieving and maintaining good health. The program is designed to educate, engage, involve and empower members to take control of their daily activities to maintain optimal health. PHARMACY PLAN (CCP NARROW NETWORK PLAN) Pharmacy benefits are provided through the CCP Narrow Network Plan s pharmacy vendor, EnvisionRx, not OptumRx. IMPORTANT: there will be some differences between the CCP formulary and the OptumRx formulary. Check with CCP to see if your prescription is covered under their plan. Maintenance medications can only be filled for 30 days 3 times, then must be filled as 90 days. 90-day mandatory maintenance medication program at retail or mail order Large network of participating pharmacies (Walgreens, Target, CVS, Publix super markets, etc.) Restricted generic policy (generics will be dispensed if available unless the doctor indicates Dispense As Written (DAW1) due to medical necessity on the prescription. Member will pay a higher copay. 30-day Specialty pharmacy home delivery. Clinical Prior Authorization Program. 4

5 HDHP, CDH HIGH AND CCP NARROW NETWORK PLAN COMPARISONS (For more details go to broward.org/benefits, click on Open Enrollment) UNITEDHEALTHCARE PLANS COVERAGE HDHP BASE PLAN HDHP IN/OUT-OF- NETWORK PLAN Preventive Care at no Yes - in-network Yes cost out-of-network Preventive Prescriptions Yes in-network at no cost* Yes t covered outof-network CDH HIGH PLAN Yes COMMUNITY CARE PLAN CCP NARROW NETWORK PLAN Labs Lab Corp & Quest Lab Corp & Quest Lab Corp & Quest Lab Corp & Quest Out of Network Coverage Yes Network UHC Choice UHC Choice Plus UHC Choice CCP-BCG Network Copays PCP $25 PCP $25 Spec $50 Spec $50 Urgent Care $50 Urgent Care $50 Emerg Room $250 Emerg Room $250 Rx-Generic $7/$14 Rx-Generic $7/$14 Rx-Preferred $30/$60 Rx-n-Pref $45/$90 Rx-Preferred $30/$60 Rx-n-Pref $45/$90 Specialty $75/NA Specialty $75/NA Annual Deductible $1,350/$2,700 In- $1,500/$3,000 Out- $1,500/$3,000 $1,300/$2,600 $1,300/$2,600 Coinsurance $2,075/$4,150 In- $1,500/$3,000 Out- $3,000/$6,000 $1,500/$3,000 $1,500/$3,000 Max out of Pocket** $3,425/$6,850 In- $3,000/$6,000 Out- $6,000/$12,000 $2,800/$5,600 $2,800/$5,600 **Prescriptions Apply to Annual Deductible & Coinsurance Yes Yes in-network t covered outof-network $3,000/$6,000 Out of Pocket Max Yes $3,000/$6,000 Out of Pocket Max HSA/HRA Funding $1,350/$2,700 $1,350/$2,700 N/A N/A *Preventive medications are defined as those prescribed to prevent the occurrence or recurrence of a chronic disease or condition, such as high blood pressure, high cholesterol, diabetes, asthma, osteoporosis, and heart disease. See applicable category on OptumRx s Formulary list for covered generic and formulary medications. Dependents: If you are enrolling new dependents for 2018, please include each new dependent s Social Security number. This is now required due to the Affordable Care Act (ACA) reporting that started in Attend a Vendor Fair and Presentation to learn all about your benefit choices for Schedules for dates and times, including on-site flu shots and finger stick screenings, available at broward.org/benefits. Click on Open Enrollment, Vendor Fairs or Presentations. Don t forget to visit ALEX, your online benefits counselor 5

6 DENTAL PLANS DHMO DENTAL Plan Humana/CompBenefits See Humana s Dental brochure at broward.org/benefits for more information. NO PLAN DESIGN OR PREMIUM CHANGES Highlights: In-network coverage only referral for specialty services Must select a Primary Care Dentist or Facility Covered services based on Fee Schedule, all other services received at a discount Orthodontia coverage for children and adults claim forms to file PPO HIGH DENTAL PLAN Humana See Humana s Dental brochure at broward.org/benefits for more information. NO PLAN DESIGN CHANGES, 8% PREMIUM INCREASE Highlights: In- or out-of network coverage Extensive national network Maximum annual benefit of $1,500 per person in-network, $1,000 per person out-of-network Orthodontia coverage for children (must be banded by 17 th birthday) Some exclusions and limitations (missing tooth) VISION PLAN UnitedHealthcare NO PLAN DESIGN OR PREMIUM CHANGES See UHC s material at broward.org/benefits for more information Highlights: In- and out-of-network coverage Exams, Eyeglass Frames Lenses and Contact Lens coverage Large network of providers TOBACCO CESSATION PHARMACY WAIVER The County will continue to waive the copay or cost for prescription or generic Over-the-Counter smoking cessation products up to two annual cycles per person per year. Over-the-Counter generic products (gum, patches, etc.) require a prescription to be eligible for coverage through the pharmacy plan. FLU SHOTS The Health Department recommends getting an annual flu shot. Flu shots are covered at no cost through our health plans as a Preventive benefit and may be obtained through your physician or at a retail health clinic such as Walgreens Take Care Clinic or CVS Minute Clinic. If service is for anything other than the flu shot, you will be responsible for the applicable copay or cost. NEW Flu shots are now available through the pharmacist with your OptumRx/Catamaran ID card. See Open Enrollment Vendor Fair schedule for dates and times of on-site flu shots 2018 OPEN ENROLLMENT PRESENTATIONS, VENDOR FAIRS, & FLU SHOT SCHEDULES AVAILABLE ON broward.org/benefits 6

7 2018 HEALTH, DENTAL AND VISION MONTHLY RATES HEALTH INSURANCE FULL TIME EMPLOYEES (Employees waving medical receive $ Waiver Credit biweekly) FULLTIME UHC High Deductible Health (HDHP) UHC High Deductible Health (HDHP) Base Plan Out-of-Network Plan Deduction HSA/HRA Deduction HSA/HRA Employee $ $ $5.00 $1, $ $ $15.38 $1, Emp+Spouse $ $ $15.00 $2, $ $ $35.20 $2, Emp+Child $ $ $10.00 $2, $ $ $28.68 $2, Emp+Family $ $ $60.00 $2, $ $ $70.49 $2, NEW CCP Narrow Network Plan UHC Consumer Driven Health (CDH) High Plan FULLTIME Deduction HRA Deduction HRA Employee $ $ $49.43 $ $ $69.89 Emp+Spouse $ $ $ $ $ $ Emp+Child $ $ $91.38 $ $ $ Emp+Family $ $ $ $1, $ $ HEALTH INSURANCE PT20 EMPLOYEES (Employees waving medical receive $59.61 Waiver Credit biweekly) UHC High Deductible Health Plan (Base Plan) UHC High Deductible Health Plan (Out-of-Network) PT20 Payroll Deduction HSA/HRA Deduction HSA/HRA Employee $ $ $64.62 $1, $ $ $75.00 $1, Emp+Spouse $ $ $74.62 $2, $ $ $94.82 $2, Emp+Child $ $ $69.62 $2, $ $ $88.30 $2, Emp+Family $ $ $ $2, $ $ $ $2, NEW CCP Narrow Network Plan UHC Consumer Driven Health (CDH) Plan - High PT20 Deduction HRA Deduction HRA Employee $ $ $ $ $ $ Emp+Spouse $ $ $ $ $ $ Emp+Child $ $ $ $ $ $ Emp+Family $ $ $ $1, $ $ DENTAL INSURANCE VISION INSURANCE TIER DHMO CS15PB DPPO TIER UNITEDHEALTHCARE Employee $5.59 $15.61 Employee $3.16 Emp+Spouse/DP $10.05 $30.98 Emp+Spouse/DP $6.32 Emp+Child $11.18 $36.34 Emp+Child $5.99 Emp+Family $13.41 $51.71 Emp+Family $9.42 IMPORTANT: During Open Enrollment, you are required to re-enroll in, or waive coverage, through the on-line system benefit plan deductions/waiver Credit (1) will be effective in the January 5, 2018 paycheck. (1) Waiver Credit will not start until proof of other group health coverage for 2018 is received and approved. 7

8 EMPLOYEES WITH DOMESTIC PARTNER COVERAGE AND/OR OVER AGE DEPENDENT (CHILD AGE on 01/01/18) COVERAGE Per IRS rules, deduction is broken into pre- and after-tax; a portion of the County s subsidy is subject to Imputed Income FULLTIME Emp+CH over 26 (Child+$20) Emp+Family w/ child over 26 (Family+$20) tax. See We ve Got You Covered benefits ebook for details. UHC High Deductible Health(HDHP) UHC High Deductible Health (HDHP) Base Plan In/Out-of-Network Plan Deduction Imputed Annual Deduction Imputed Pre-Tax After-Tax Income HSA/HRA Pre-Tax After-Tax Income Annual HSA/HRA $5.00 $25.00 $ $2,700 $15.38 $33.30 $ $2,700 $15.00 $65.00 $ $2,700 $35.20 $55.29 $ $2,700 Emp+DP $5.00 $10.00 $ $2,700 $15.38 $19.82 $ $2,700 Emp+CH of DP $5.00 $5.00 $ $2,700 $15.38 $13.30 $ $2,700 Emp+CH of DP over 26 (CH+$20) Emp+DP+CH w/ no child of DP $5.00 $25.00 $ $2,700 $15.38 $33.30 $ $2,700 $10.00 $50.00 $ $2,700 $28.68 $41.81 $ $2,700 Emp+DP+CH of DP $5.00 $55.00 $ $2,700 $15.38 $55.11 $ $2,700 Emp+DP+CH over 26 w/ no child of DP (Fam+$20) Emp+DP+CH of DP over 26 (Fam+$20) FULLTIME Emp+CH over 26 (Child+$20) Emp+Family w/ child over 26 (Family+$20) $5.00 $75.00 $ $2,700 $15.38 $75.11 $ $2,700 $5.00 $75.00 $ $2,700 $15.38 $75.11 $ $2,700 NEW CCP Narrow Network Plan UHC Consumer Driven Health (CDH) High Plan Deduction Imputed Annual Deduction Imputed Annual Pre-Tax After-Tax Income HRA Pre-Tax After-Tax Income HRA $49.43 $61.95 $ $69.89 $79.12 $ $ $92.49 $ Emp+DP $49.43 $59.37 $ Emp+CH of DP $49.43 $41.95 $ Emp+CH of DP over 26 (CH+$20) Emp+DP+CH w/no child of DP $49.43 $61.95 $ $91.38 $89.91 $ Emp+DP+CH of DP $49.43 $ $ Emp+DP+CH over 26 w/ no child of DP (Fam+$20) Emp+DP+CH of DP over 26 (Fam+$20) $49.43 $ $ $49.43 $ $ $ $ $ $69.89 $82.90 $ $69.89 $59.12 $ $69.90 $79.12 $ $ $ $ $69.89 $ $ $69.89 $ $ $69.89 $ $ IMPORTANT DATES Event Due Date Submit enrollment/waiver of coverage online by 5:00pm. 11/13/17 Provide proof of relationship documentation for newly added dependents. 11/13/17 Provide proof of Over Age Dependent (age 26-30) financial dependence. 11/13/17 Deadline to complete 2017 Engagement Incentive to receive HSA or HRA funding. 12/31/17 Review new deductions on 1 st pay voucher in January. 1/05/18 Provide proof of other group health coverage. 1/12/18 Provide proof of Over Age Dependent (age 26-30) student status. 1/12/18 8