Baylor Scott & White benefits enrollment is coming. Which medical plan will be the right fit? Look inside to get a head start.

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1 Baylor Scott & White benefits enrollment is coming. Which medical plan will be the right fit? Look inside to get a head start.

2 Benefits enrollment starts October 24 Find 2017 premiums, interactive tools and informative videos on bswhbenefits.com. Which medical plan will be the right fit for you? Presorted First-Class Mail U.S. Postage PAID Appleton, WI Permit No. 39

3 Baylor Scott & White Health offers three medical plans. Health Reimbursement Account PPO HRA What will I choose? HSA Preferred Provider Organization Health Savings Account The plans are similar, with some important differences. Plan Similarities Plan Differences Preventive care Your Tier 1 and Tier 2 in-network preventive care is 100% covered in every plan. Providers Our plans use the same provider networks. Each plan covers the same list of services, procedures, prescription drugs, diagnostic tests, etc. Meeting your deductible Labs, diagnostic tests, imaging and other services count toward your deductible in each plan. After-deductible coverage After you meet your deductible, you and the plan share costs. You pay: p 10% for Tier 1 care p 50% for Tier 2 care p 70% for Tier 3 care Out-of-area coverage All plans give you out-of-area coverage when you or your covered dependent live more than 40 miles away from the closest Tier 1 facility. For 2017, the plans pay 80%, you pay 20% after you meet the deductible. Call the Scott & White Health Plan to activate this out-of-area coverage. Premiums HRA and HSA offer lower premiums than the PPO. Help meeting your deductible The HRA and HSA offer contributions to help you meet your deductible. The PPO doesn t. Deductibles The amount you pay before the plan begins to share your costs is lowest in the PPO, highest in the HSA. Pharmacy The HRA and PPO cover prescription drugs from day one. You ll pay copays based on the type of drug, the supply (30- or 90-day), and where it is filled (Baylor Scott & White pharmacy or contracted pharmacies). With the HSA, you meet your deductible before the plan pays for any care including prescription drugs. Find your prescription drug coverage on the Prescriptions page in the Medical section of bswhbenefits.com. Doctor s office visits The PPO offers copays for doctor s office visits. With the HRA, your health reimbursement account pays first, then you pay. After you meet your deductible, you ll pay a percentage from your pocket. With the HSA, you ll first pay with HSA dollars or from your pocket. After you meet your deductible, you ll pay a percentage with your health savings account, or you can save your HSA dollars and pay from your pocket.

4 inside your benefits Inside is a side-by-side comparison of the main plan features. When you re ready to look closer, visit bswhbenefits.com. You ll find: 2017 premiums, what's new for 2017, pharmacy coverage, and Baylor Scott & White s full benefits menu. All the nitty-gritty details in the Summary Plan Description (SPD) on the Resources tab. More detail than a highlights chart, less intense than the SPD, the Summary of Benefit and Coverage is a federally mandated overview of each medical plan. Informative, quick videos that explain how the plans work. Ask ALEX, the interactive benefits helper who can walk you through all your options. An on-demand video enrollment meeting. Terms to know Deductible: Before the plan begins to share your costs, you must pay a certain amount from your pocket. For example: With the PPO, your lab work, diagnostic tests, and imaging costs apply to the deductible. If your doctor wants to run tests or send you for an X-ray, you are responsible for paying the full cost,* up to your deductible amount. With the HRA, your health reimbursement account pays first, then you pay the full cost up to your deductible. With the HSA, your medical and pharmacy costs apply to the deductible. You use your health savings funds or pay from your pocket up to your deductible. Out-of-pocket maximum: The plans protect you from the financial burden of serious care through the After you meet your deductible, you share costs with the plan until you reach this spending limit for the year. Your deductible counts toward your Learn more benefits vocabulary in the Summary Plan Description. It s posted on bswhbenefits.com under the Resources tab. *The only exception is if your provider performs these tests in his or her office and bills those costs as part of your office visit.

5 Lower premiums Higher deductible Upfront coverage thanks to your health reimbursement account It starts with your health reimbursement account. Baylor Scott & White contributes to this account every year. Health reimbursement account dollars you don t use carry forward to the next year if you stick with the HRA plan. How it works Your HRA pays first. It pays the full cost for most medical care. It will reimburse you automatically for urgent care and emergency department copays. You pay next. You pay the full cost and copays until you meet your deductible. You and the plan share costs. You pay a percentage until you meet your Tier 1: You pay 10%. Tier 2: You pay 50%. Tier 3: You pay 70%. The plan pays 100%. Your in-network (Tier 1 or Tier 2) care is fully covered for the rest of the year. Out-of-network (Tier 3) care does not have an For prescription drugs, you share costs with the plan from the beginning. For most prescriptions, you ll pay a copay. Paying for care Deductibles Your health reimbursement account pays for the first part of your deductible. When it s spent, you pay the full network cost for most care until you meet your deductible. For prescription drugs, urgent care and emergency department visits, you ll pay copays. Who s covered Tier 1 deductibles HRA pays first: You pay: Employee only $2,000 $1,000 $1,000 Employee + spouse $3,750 $1,750 $2,000 Employee + child(ren) $3,250 $1,750 $1,500 Employee + Family $4,000 $2,000 $2,000 When you cover family members, the plan will provide after-deductible coverage once an individual has met the individual deductible, even if together you haven't met the family deductible. Out-of-pocket maximums Your HRA and deductible count toward your Who s covered Tier 1 out-ofpocket maximums Subtract your HRA contribution You pay: Employee only $3,425 -$1,000 $2,425 Employee + spouse $6,850 -$1,750 $5,100 Employee + child(ren) $5,137 -$1,750 $3,387 Employee + Family $6,850 -$2,000 $4,850 When you cover family members, the plan will provide full coverage once an individual has met the individual out-of-pocket maximum, even if together you haven t met the family maximum.

6 Higher premiums Lower deductible Fixed copays for common services No Baylor Scott & White contribution The PPO Plan has fixed copays for common services. You pay copays for common care: Tier 1 doctor s office visits (primary care $25, specialists $40) Urgent care visits ($50 in Tier 1, $100 in Tier 2) How it works You pay first. You pay copays for common care. For other care, you pay the full cost until you meet your deductible. You and the plan share costs. You pay a percentage until you meet your outof-pocket maximum. Tier 1: You pay 10%. Tier 2: You pay 50%. Tier 3: You pay 70%. The plan pays 100%. Your in-network (Tier 1 or Tier 2) care is fully covered for the rest of the year. Out-of-network (Tier 3) care does not have an! Baylor Scott & White benefits offer three levels of coverage based on where you receive care. To make things a little simpler, we are only including benefits for our Tier 1 network. You can find how Tier 2 and Tier 3 care is covered on our benefits website, bswhbenefits.com. Emergency department visits ($200 for all tiers) Most prescription drugs (primarily copays) For all other care including lab work,* diagnostic screenings,* X-rays, imaging, outpatient procedures, and hospital stays, your costs work through the plan. Paying for care Deductibles You pay the full cost until you meet your deductible. Who s covered Tier 1 deductibles You pay: Employee only $800 $800 Employee + spouse $1,600 $1,600 Employee + child(ren) $1,200 $1,200 Employee + Family $1,600 $1,600 When you cover family members, the plan will provide after-deductible coverage once an individual has met the individual deductible, even if together you haven t met the family deductible. Out-of-pocket maximums Your deductible and copays count toward your Who s covered Tier 1 out-ofpocket maximums *Unless billed by your doctor as part of your office visit. You pay: Employee only $3,300 $3,300 Employee + spouse $6,600 $6,600 Employee + child(ren) $4,950 $4,950 Employee + Family $6,600 $6,600 When you cover family members, the plan will provide full coverage once an individual has met the individual out-of-pocket maximum, even if together you haven t met the family maximum.

7 Lower premiums Higher deductible A tax-advantaged health savings account Your health savings account grows with each paycheck. Baylor Scott & White contributes to your health savings account (HSA) to help you meet your deductible. The contribution is based on who you cover. You can save tax-free dollars* through payroll deductions. How it works You pay first. You pay the full cost until you meet your deductible. You can use the Baylor Scott & White contribution to meet your deductible. You and the plan share costs. You pay a percentage until you meet your Tier 1: You pay 10%. Tier 2: You pay 50%. Tier 3: You pay 70%. The plan pays 100%. Your in-network (Tier 1 or Tier 2) care is fully covered for the rest of the year. Out-of-network (Tier 3) care does not have an Your HSA belongs to you. If you don t spend all your HSA dollars, they build up your savings. The HSA is not for everyone. If you have a chronic condition or your household budget cannot afford to pay upfront costs, consider the HRA or PPO instead. Paying for care Deductibles Who s covered Tier 1 deductibles Your HSA contribution You pay: Employee only $2,000 $500 $1,500 Employee + spouse $4,000 $1,000 $3,000 Employee + child(ren) $4,000 $1,000 $3,000 Employee + Family $4,000 $1,000 $3,000 When you cover family members, the entire group deductible must be met before the plan pays. Out-of-pocket maximums Who s covered Tier 1 out-ofpocket maximums Subtract your HSA contribution You pay: Employee only $3,275 -$500 $2,775 Employee + spouse $6,550 -$1,000 $5,550 Employee + child(ren) $6,550 -$1,000 $5,550 Employee + Family $6,550 -$1,000 $5,550 When you cover family members, the plan will provide full coverage once an individual has met the individual out-of-pocket maximum, even if together you haven't met the family maximum. *IRS limits apply. $3,350 employee only, $6,750 all others. The Baylor Scott & White contribution counts toward these IRS limits. Make a $1,000 catch-up contribution if you are age 55 or older during the year.

8 get more info, stat. bswhbenefits.com Explore your Baylor Scott & White benefits, links and phone numbers for each benefit and much more. bswh.swhp.org Find providers, a prescription drug list, forms, and link to your personal medical claims and account info. Scott & White Health Plan Medical claims and network Prescription drug coverage Baylor Scott & White Quality Alliance HealthAccess for help finding Tier 1 providers They can even schedule appointments for you! PeoplePlace Benefit eligibility inquiries, paid time off information and human resources questions of all kinds for Central Texas employees HR Service Center Benefit eligibility inquiries, paid time off information and human resources questions of all kinds for North Texas employees until December 28, 2016