When Am I Eligible? NH, VT, ME, full year. Benefits are effective on the first of the month following 60 days of employment.

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2 When Am I Eligible? NH, VT, ME, full year Benefits are effective on the first of the month following 60 days of employment. Employees must work 30+ hours a week to be eligible for benefits.

3 INCENTIVE PROGRAM Step 1. Tobacco Affidavit & PCP form Affidavit: Signed as a non-smoker, or enroll & complete an agency-approved tobacco cessation program within 120 days of the medical plan effective date PCP form: Includes Biometric screening information & provider signature Step 2. Online Health Risk Assessment The link will be sent to you from The Lawson Group (Mybiocheck@trale.com) after submission of step 1.

4 Key terms Copay A flat amount you pay for covered services like doctor visits or prescription drugs. Deductible The amount you pay each year before your plan starts to pay for care. Your percentage of the costs (coinsurance) After meeting your deductible, this is the percentage of the costs you pay for care. Out-of-pocket maximum The most you have to pay out of pocket each plan year for covered services. All copays, deductibles and coinsurance are part of your out-of-pocket maximum. 4

5 HMO Blue New England Choice Important plan features : PCP selection are required to be on file with Anthem for claims to process You MUST call member services at Anthem as soon as you received your ID cards PCP referrals are required if seeing a specialist Two Tiered benefit plan design Tier 1 lower deductibles and copayments Tier 2 higher deductibles and copayments Preventive Care covered at 100% (including 1 eye exam) All participating Blue Cross Blue Shield providers in CT, ME, NH, VT, MA, RI are your network No cost laboratories (Lab Corp, Quest, NorDx) Vitals Smart Shopper program is available to help you choose less costly facilities and rewards you for making good choices. Annual Out of Pocket Limit is now set at $7,150 per Member and $14,300 per family; this includes all copayments (including pharmacy), coinsurance and deductibles 5

6 Tier 1 Cost Share $20 PCP Copayment $50 SCP Copayment $125 ASC Copayment $3,000 Single Deductible $6,000 Family Deductible 0% Coinsurance $250 ER Copayment* $125 UC Copayment* Tier 2 Cost Share $30 PCP Copayment $50 SCP Copayment $125 ASC Copayment $5,000 Single Deductible $10,000 Family Deductible 20% Coinsurance $250 ER Copayment* $125 UC Copayment* * Tier 1 Deductible will apply for some services.

7 Medical Benefits Deductible: In patient hospitalization High tech imaging (CT scans, x-rays, MRI s etc.) Labs (if you don t go to a participating provider) Durable Medical Equipment (hearing aids, crutches etc.) ER & Urgent care visits - after the co-pay Co-Pay: PCP non-preventive care - $20 or $30 Specialist visits - $50 PT, OT or speech therapy Chiropractic visits Mental health or substance abuse outpatient - $20 Urgent care & ER visits (then deductible applies) - $125 / $250 Ambulatory Centers - for day surgery - $125 7

8 Ways to save If you can, go to an urgent care center instead of an emergency room. Unless you have an immediate emergency, you can save money by choosing an urgent care center. You pay a $125 urgent care copay or a $250 copay at the ER. Call Vitals Smart Shopper Program vitalsmartshopper.com / Call or shop online for cost effective choices of common medical services. Avoid paying higher costs and earn rewards. Use the mail order program and generic drugs whenever possible. Mail order home delivery service saves you money on copayments as do generic drugs. Speak with your doctor about what is right for you. See your PCP. Be sure to get your annual physical exam and annual dental cleanings. Tier 1 physicians / facilities will cost less Use Site of Service Independent Labs and Ambulatory Surgery Centers (ASC) whenever possible. Save here on your deductible with labs covered at 100% and a lower copayment for outpatient surgeries some labs are: Quest, LabCorp, NorDx LiveHealth Online a new way to receive low cost, convenient service. Save with low copayments and quick and convenient service in the comfort of your home or while traveling. 8

9 HMO Which Hospitals Blue New are in England Tier 1 Choice Tier 2 in NH? Tier 1 Hospitals Alice Peck Day Memorial Hospital Cheshire Medical Center Cottage Hospital Elliot Hospital Frisbie Memorial Hospital Monadnock Community Hospital Parkland Medical Center Portsmouth Regional Hospital Southern NH Medical Center Speare Memorial Hospital St. Joseph Hospital The Memorial Hospital Wentworth Douglass Hospital Memorial Hospital Tier 2 Hospitals Androscoggin Valley Hospital Catholic Medical Center Concord Hospital Dartmouth Hitchcock Exeter Hospital Franklin Regional Hospital Huggins Hospital Lakes Region General Hospital Littleton Hospital Mary Hitchcock Memorial Hospital New London Hospital Upper Connecticut Valley Hospital Valley Regional Hospital Weeks Medical Center 9

10 other New England States ME All providers are in Tier 1 benefit plan VT All providers are in Tier 1 benefit plan MA We follow MA BCBS Tier 1 and Tier 2 structure. Please see BCBSMA website for more details. 10

11 Prescription Drug Plan Tier 1a - $5 per fill Tier 1b - $20 per fill Tier 2 - $40 per fill Tier 3 - $70 per fill Tier 4 - $100 per fill Specialty Medication Only Save yourself some money Ask your doctor if there s a generic equivalent for the brand-name medications you ve been taking. Get a 90-day supply of maintenance drugs by mail for less than what you will pay at a pharmacy. Ask Accredo Specialty Pharmacy for copayment assistance. (specialty medication only) 11

12 Blue View Vision SM Yearly exams for a $20 co-pay Allowances ($100) for eye ware, contacts etc. every 2 years 12

13 Register at anthem.com When you register online, you have great personalized tools to help you: Search for doctors. Check your claims. Estimate your costs. Review your medical benefits. View your ID card. Refill a prescription. 13

14 Northeast Delta Dental Preventive covered in FULL Cleanings (4x year) Oral examinations (2 per year) Normal x-rays Fluoride treatment (up to age 19) Space Maintainers (up to age 16) Sealant (up to age 19) 14

15 Basic Service 6 month wait period Cost share 80% (NEDD) / 20% (Subscriber) Extraction / fillings / pulp capping / root canals Major Services 12 month wait period Cost share 50% / 50% Bridges / crowns / dentures Orthodontia 24 month wait period Cost share 50% / 50% to max of $1,000 Calendar Year maximum $2,000 /per person 15

16 Voluntary Vision / Blue View Vision $ 10 copays $130 allowance for glasses or contacts Every 12 months 16

17 Life Insurance Basic life insurance = 1x annual salary rounded up. Automatically enrolled Submit beneficiary form along with completed enrollment forms Supplemental life insurance 1x, 2x, or 3x annual salary See your enrollment forms for individual pricing Guaranteed Issue Amount if enrolling now & amount elected is less than $150,000 Otherwise must fill out Evidence of Insurability (medical questionnaire) for any amount elected or if electing during open enrollment 17

18 Life Insurance Spousal Life - $5,000 / $10,000 Guaranteed issue if sign up now Otherwise subject to the medical questionnaire Child Life - $2,000 / $4,000 Per family total If enrolling in spousal or child life, a Supplemental life policy must be elected also. 18

19 Disability Short Term Disability Income replacement if your are hurt off the job. 1 week elimination period /13 week max pay out Pre-Existing Condition Clause (12 months) Weekly available amounts are listed on your enrollment forms Ex. - Short term disability 100 = $100 week / up to 13 weeks Long Term Disability (Agency paid policy) 90 continuous days out of work 50% of monthly base earnings to a $5000 max / month 19

20 403(b) Retirement plan All employees are eligible to participate upon hire Matched dollar for dollar up to 2% (20+ hours) $200 minimum employee contribution per year to receive match Vested after 3 years based on date of hire Choose your own elections using offered choices Or Default to pre-arranged models see booklet Can enroll at any time 20

21 PTO & XIB Accrues effective date of hire can not use time for a three month period Accrual rate depends on your hire details hourly vs. salary / number of hours per week Your sick, vacation, personal & bereavement time Extended Illness Bank (XIB) after one year of service / 3-5 days each year till max of 60 days PTO at time of separation is paid at a percentage of the balance. 21

22 Holiday Some staff may be required to work on a holiday. Another day may be taken as a holiday. At the discretion of the supervisor, and extra day s pay may be given if a day off cannot be scheduled. Holiday must fall on your regularly scheduled work day. Must work normally scheduled work day prior to and after the holiday to be compensated for the holiday unless prior approval has been given. 22

23 Flexible Spending Accounts Flexible Spending Account (FSA) - Healthcare? Pre-tax dollars you designate to cover medically related expenses. Maximum contribution $2600 How does it work? Pre-Loaded Visa Card with the amount you choose. Your election is split over the remaining pay periods in the plan year and a deduction is made each pay period from your check. (i.e. $1,000 / 26 = $38.46) The elected amount is pretax. What can I use it for? Co-Pays, deductibles, eyeglasses/contacts, dental visits, prescriptions, etc. Flex Spend Account - Dependent Care Maximum contribution $5,000 Money not preloaded on card Call to discuss What can I use it for? Dependent care expenses, child care, summer camp for children under 12. What are the drawbacks? FSA is use or lose! You must use your total amount by 6/30 or forfeit the balance. 23

24 Open Enrollment - Making Changes to your benefits mid year Open Enrollment takes place each year, during the month of May, with an effective date of July 1st Changes to benefits OUTSIDE of open enrollment can be made if one of the following takes place: Marriage/Divorce Birth/Adoption Loss of insurance coverage Etc. There are only 30 days after a life changing event to make changes to your benefits 24

25 Accident Hospital Cancer Critical Care Short Term Disability Life Group rated / pre-tax or post tax deduction / portable Payroll deductions for FT staff David Healey (603) cell (888) fax david_healey@us.aflac.com 25

26 Questions? Leslie (603) Kathy - (603) Thank you! 26