Up and Atom. It s Open Enrollment! October 11 - November 5, 2018

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Darrell Green
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1 Up and Atom. It s Open Enrollment! October 11 - November 5, 2018 It s time to make benefit choices to keep you and your family physically and financially well in 2019.

2 This presentation is available at: 1

3 What We ll Cover What s new in 2019 Monthly Rates for Medical Plans Other Benefits How to Enroll and Update Beneficiaries New Grand Rounds Health Advocacy Program Anthem Virtual Office Visit Program Live Health Online Choosing the Right Medical Plan A Closer Look at the High Deductible Plans (HDHP) Health Savings Accounts Flexible Spending Accounts Life, Accident and Disability Coverage Open Enrollment Checklist Questions 2

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5 Benefits Open Enrollment for Faculty, Postdoctoral Scholars and Staff October 11 - November 5 4

details on page 14) Lower deductibles New medical advocacy program No cost to employees; 100% paid by Caltech Available to all

6 What s New in 2019 New Anthem High Deductible Health Plan (HDHP) PPO It s called the HDHP 1350 Similar to the current Anthem HDHP 2700 PPO Same in-network doctors and hospitals Same coinsurance and out of pocket maximums as current HDHP 2700 plan (more details on page 14) Lower deductibles New medical advocacy program No cost to employees; 100% paid by Caltech Available to all benefit based employees and their family members who are covered by our heath plans Administered by Grand Rounds (more details on page?) 5

7 Benefit Changes for Anthem and Kaiser HMOs: Anthem HMO and Kaiser copay for outpatient surgery increasing to $150 Anthem HMO out-of-pocket maximum is increasing to $1,500 single/$3,000 family What s New in 2019 New Medical Evacuation and Repatriation Coverage (MER) All benefit-based employees and their family members get MER at no cost; 100% paid by Caltech Built into Business Travel Accident policy; no election needed Coverage complies with J-1 Visa requirements Applies to business or personal travel No Changes in benefits or costs for: Dental Vision Life Disability Personal Accident Insurance Your monthly benefit rates: Anthem HDHP 2700 costs less Anthem HMO costs increasing Kaiser HMO costs increasing 6

Your Monthly Contributions Medical Anthem Anthem Kaiser Anthem Coverage Level Employee only: Employee + Child(ren): Employee + Spouse: Employee + Family: NEW!

8 Your Monthly Contributions Medical Anthem Anthem Kaiser Anthem Coverage Level Employee only: Employee + Child(ren): Employee + Spouse: Employee + Family: NEW! HDHP 1350 HDHP 2700 HMO HMO $120 $95 $50 $100 $125 $136 $150 $251 $199 $105 $216 $270 $284 $313 $285 $226 $119 $244 $305 $323 $356 $450 $356 $187 $390 $488 $504 $556 7

9 Value-Based Philosophy Pay more when you get services Lower comparative value HDHPs Pay less when you get services Higher comparative value HMOs Lower monthly premiums Higher monthly premiums HDHP 2700 HDHP 1350 Kaiser HMO Anthem HMO 8

10 Other Benefits No Changes for 2019 Dental Life Insurance Disability Voluntary Long Term Care Personal Accident Insurance Voluntary Auto, Home, Pet Insurance 9

11 How to Enroll and Update Beneficiaries 10

12 How to Enroll and Update Beneficiaries 11

13 How To Get The Mobile App Access MyBenefits from your mobile device to view your benefits, make your annual elections, or make changes during the year Download the Benefitfocus App from the Play store on your device Company ID = caltech Select Campus Login Or JPL Login Enter your Caltech/JPL credentials The App works with Android and iphones 12

14 New Grand Rounds Health Advocacy Service Starting January 1, 2019 Caltech will provide Grand Rounds services free of charge to all employees and family members enrolled in at Caltech medical plan Need help finding an in-network doctor or hospital? Grand Rounds will help you find the provider and schedule an appointment Can t get a diagnosis? Grand Rounds will gather your medical records and obtain a diagnosis from one the worlds leading experts Activate your account online at grandrounds.com/caltech or by calling (800)

15 LiveHealth Online Get Healthy, Save a Copay, and See a Doctor Now! Virtual office visit with a board-certified doctor anytime, day or night, from your computer, tablet or smartphone: $0 copay for Anthem HMO members $49 copay for HDHP members before you meet deductible Mental Health Services by appointment: $0 copay for Anthem HMO members $85 for HDHP members before you meet deductible Register today at LiveHealthOnline.com 14

16 The High Deductible PPO Plans Taking a Closer Look PPO Health Savings Account (HSA) High Deductible PPO Plan 15

17 HDHPs: Key Features Low monthly premiums (but you pay more than HMO plans for non-preventive care) Choice of doctors and hospitals (you pay less if you use innetwork providers) Preventive care is covered at 100% (as long as you use in-network doctors and facilities) You pay 100% of the cost of your non-preventive care until you meet the annual deductible Then you pay 20% of cost (innetwork) and 40% (out of network) Prescriptions (RX) Preventive RX is covered for a copay Non Preventive RX, you pay 100% until you reach the Annual Deductible; then you pay 20% of the cost for RX Plan pays 100% after you reach the annual out of pocket maximum (as long as you use in-network doctors and facilities) 16

18 Comparison of HDHP Plan Options Coverage HDHP 2700 HDHP 1350 Rates $50/Month EE Only $119/Month EE + SP $105/Month EE +CH $187/Month Family $120/Month EE Only $285/Month EE + SP $251/Month EE+ CH $450/Month Family Deductible Out of Pocket Maximum In-network Preventive Care Coinsurance In-network $2,700 per person $5,400 per family $4,000 per person $8,000 per family $1,350 per person $2,700 per family You pay 0% if care is provided by in-network provider and/or facility You pay 20% of negotiated rate after deductible (plan pays 80%)

19 Coverage HDHP 2700 HDHP 1350 Prescription Drug Retail PreventiveRx drugs No Deducible for Preventive RX; copays apply: $15 generic $45 brand-name formulary $75 brand-name non-formulary After deductible is satisfied, you pay 20% of cost as follows: Prescription Drug Retail Non-Preventive Rx drugs 20% coinsurance up to $100 per prescription for Generic 20% coinsurance up to $250 per prescription for brand-name formulary, and brand-name non-formulary

20 Need Help Deciding What Medical Get help with: Plan to Choose? Set Up an Appointment with Our On-Site Anthem Concierge Understanding what your plan covers Finding an Anthem doctor, hospital, lab, or other provider and even make appointments for you Finding lower-cost medications and set up mail order prescriptions Using Anthem's Estimate Your Cost tool to find the right care at the right price Reading your explanation of benefits (EOB), resolve provider billing errors, and understand the claim appeals process Getting answers to your HSA banking questions Caltech - Keita Heckard Phone: (626) kheckard@caltech.edu JPL - Vida Techachaiponpoj Phone: vidat@jpl.nasa.gov Getting answers to just about any question you might have about your Anthem plan options 19

21 Choosing the Right Medical Plan for You Example 1: Jillian has Single Coverage Gets regular preventive care, no prescriptions HDHP 2700 HDHP 1350 Kaiser Anthem HMO EE Only Coverage Annual Premium $600 $1,440 $1,500 $1,800 Annual Preventive Exam and Testing (in-network) $0 $0 $0 $0 Annual Cost of Ownership $600 $1,440 $1,500 $1,800 Example 2: Jillian has Family Coverage Gets regular preventive care, no prescriptions HDHP 2700 HDHP 1350 Kaiser Anthem HMO EE + Family Coverage Annual Premium $2,244 $5,400 $5,856 $6,672 Annual Preventive Exam and Testing (in-network) $0 $0 $0 $0 Annual Cost of Ownership $2,244 $5,400 $5,856 $6,672 20

22 Choosing the Right Medical Plan for You Example 3: Simon, single coverage - $2,110 in annual claims costs Claim Costs What Simon Pays Annually HDHP 2700 HDHP 1350 Kaiser Anthem HMO EE only: Annual Premium $600 $1,440 $1,500 $1,800 2 Generic Prescriptions $15 copay for 12 months) Ann'l Preventive Exam (In-network) $ 360 $ 360 $ 360 $ 360 $ 360 $ - $ - $ - $ - $ - 1 Brand Prescription on Formulary cost of $50/mo for 6 months) $ 300 $ 300 $ 300 $ 210 $ Emergency Room Visit $ 1,200 $ 1,200 $ 1,200 $ 250 $ Specialist Visit (non-preventive; innetwork) $ 250 $ 250 $ 250 $ 30 $ 40 Total Claims Cost $ 2,110 $ 2,110 $ 2,110 $ 850 $ 920 Paid Toward Deductible $ 1,750 $ 1,350 N/A N/A Coinsurance Paid $ - $ 80 N/A N/A Total Out of pocket (Ded + Coins + Copays) $ 2,110 $ 1,790 $ 850 $ 920 Annual Cost of Ownership $ 2,710 $ 3,230 $ 2,350 $ 2,720 21

23 Choosing the Right Medical Plan for You Example 4: Bob has single coverage - $8,910 in annual claim costs What Bob Pays Annually EE only: Claim Costs HDHP 2700 HDHP 1350 Kaiser Anthem HMO Annual Premium $600 $1,440 $1,500 $1,800 2 Generic Prescriptions $15 copay for 12 months) Ann'l Preventive Exam (In-network) $ 360 $ 360 $ 360 $ 360 $ 360 $ - $ - $ - $ - $ - 1 Brand Prescription on Formulary cost of $50/mo for 6 months) $ 300 $ 300 $ 300 $ 210 $ 270 Outpatient Surgery $ 8,000 $ 8,000 $ 8,000 $ 150 $ Specialist Visit (non-preventive; innetwork) $ 250 $ 250 $ 250 $ 30 $ 20 Total Claims Cost $ 8,910 $ 8,910 $ 8,910 $ 750 $ 800 Paid Toward Deductible $ 2,700 $ 1,350 N/A N/A Coinsurance Paid $ 988 $ 1,258 N/A N/A Total Out of pocket (Ded + Coins + Copays) $ 4,000 $ 2,968 $ 750 $ 800 Annual Cost of Ownership $ 4,600 $ 4,408 $ 2,250 $ 2,600 22

24 Choosing the Right Medical Plan for You Example 5: Beth has Family Coverage Has $10,000 in Annual claims costs for 1 family member What Beth Pays Annually EE only: Claim Costs HDHP 2700 HDHP 1350 Kaiser Anthem HMO Annual Premium $2,244 $5,400 $5,856 $6,672 2 Generic Prescriptions, $15 copay for 12 months) $ 360 $ 360 $ 360 $ 360 $ 360 Ann'l Preventive Exam (Innetwork) $ - $ - $ - $ - $ - 1 Emergency Room Visit $ 1,300 $ 1,300 $ 1,300 $ 250 $ 250 Outpatient Surgery $ 8,000 $ 8,000 $ 8,000 $ 150 $ Specialist Visit (non-preventive; in-network) $ 340 $ 340 $ 340 $ 30 $ 20 Total Claims Cost $ 10,000 $ 9,640 $ 9,640 $ 790 $ 780 Paid Toward Deductible $ 2,700 $ 2,700 N/A N/A Coinsurance Paid $ 1,388 $ 1,388 N/A N/A Total Out of pocket (Ded + Coins + Copays) $ 4,000 $ 4,000 $ 790 $ 780 Annual Cost of Ownership $ 6,244 $ 9,400 $ 6,646 $ 7,452 23

25 Choosing the Right Medical Plan for You Example 6: Jonah has EE+Spouse Coverage He has $2000 and Spouse has $1300 in medical costs annually. 24

26 Choosing the Right Medical Plan for You Example 7: Daisy has EE+Spouse Coverage Both meet the deductible 25

27 HDHPs: How to Use The Plan tech Retiree Benefits caltech.edu/retirees See the Doctor Anthem Issues the EOB Doctor sends you a bill Get Services Allow Anthem to process the claim Match bill to Explanation of Benefits and pay your share of costs

28 HDHPs: Points to Keep in Mind Choose your provider carefully! Use an in-network provider to ensure you receive the lowest possible negotiated rates for services. If you receive services from an out-of-network provider and/or medical facility, you are responsible for paying the difference between the covered or allowable charges and the billed charges Ways to find in-network providers Anthem Concierge on Lab and on Campus Grand Rounds can help you find an doctor in-network Anthem.com/ca/Caltech - Find a Doctor 27

29 HDHPs: Blue Distinction Centers Using a Blue Distinction Center can save you money The plan pays more if you utilize an in-network Blue Distinction Center if you need any of the following procedures: Spinal surgery Hip/knee replacement Bariatric Transplants Cardiac Care Blue Distinction Centers are known for their expertise and quality outcomes Coinsurance (The % of cost the plan pays) Blue Distinction Centers 85% In-Network Providers 75% Out-of-Network Providers 60% 28

30 HDHPs: Health Savings Account Health Savings Account (HSA) Available if you are in HDHP Save for the current year s expenses Save for the future tax deferred Unused funds accumulate year over year HSA Max 2019 Under Age 55 Age 55+ Single $3,500 $4,500 Consider putting the money you are saving in premiums in your HSA Family $7,000 $8,000 Note: To be eligible to contribute to an HSA, you cannot be enrolled in a non-hdhp plan or in any part of Medicare 29

31 HDHPs: Learn more Visit MyBenefits to view the High Deductible PPO Guide 30

32 A few things to remember. 31

33 Flexible Spending Accounts Choose your contributions carefully whatever you don t use by year end will be forfeited (except for $500 rollover in the Health Care FSA) Health Care FSA Dependent Day Care FSA Who Can Participate Anyone who is not enrolled in the HDHP plans Anyone who has an eligible dependent Types of Expenses Allowed Eligible medical, prescription drug, dental and vision expenses Eligible child and elder care expenses (so you and your spouse/domestic partner can work or go to school) How Much You Can Contribute Annually Up to $2,650 Up to $5,000 *You are not eligible for a 2018 FSA rollover if you have elected a Health Savings Account (HSA) for

34 Life, Personal Accident Insurance, Disability Caltech offers a variety of options These benefits provide replacement income for you or your beneficiaries in the event of disability, accident or death Helps your family members maintain their standard of living if something happens to you How much your family needs depends on your personal situation other income sources, monthly expenses and short- and long-term debt such as credit card or mortgage expenses, etc. If you already have Supplemental Life, you can increase coverage by 1x during Benefits Open Enrollment, without evidence of insurability (EOI) Any other Supplemental Life or Supplement LTD elections require EOI 33

What You Need to Do Give Your Benefits an Annual Checkup Will your current elections still work for you next year?

Choose your Flexible Spending Account (FSA) or Health Savings Account (HSA) contributions for 2019 Are you saving enough for a

Review your current voluntary Caltech Retirement Plan contributions and update them, if you d like Do you cover any dependents?

35 What You Need to Do Give Your Benefits an Annual Checkup Will your current elections still work for you next year? We ve made changes for Review your options and update your elections if needed Want to save on taxes? Choose your Flexible Spending Account (FSA) or Health Savings Account (HSA) contributions for 2019 Are you saving enough for a healthy financial future? Review your current voluntary Caltech Retirement Plan contributions and update them, if you d like Do you cover any dependents? You must certify their eligibility on an annual basis. Also confirm we have their Social Security numbers Are your beneficiaries still current? From MyBenefits, you can review and update your beneficiary designations for Caltech Life benefits and Retirement Plans with TIAA 34

36 Questions? 35

This presentation provides only highlights of your benefits. It is not a contract. It does not change the terms of your benefit plans or the official documents that control them.

37 This presentation provides only highlights of your benefits. It is not a contract. It does not change the terms of your benefit plans or the official documents that control them. Consult the individual plan booklets for specific details of benefit coverage. To permit a brief summary of benefits and services, use of actual contract language has been minimized. This summary comparison does not replace the legal documents that establish the plans. Final interpretation of any provision of the plans will be governed by the master policies and service agreements, which are on file in the office of the plan administrator. Caltech reserves the right to change, suspend or terminate its benefits programs, in whole or in part, at any time and for any reason. October October/November 2016

2018 SUMMARY OF CALTECH BENEFITS CAMPUS STAFF IN SOUTHERN CALIFORNIA

2018 SUMMARY OF CALTECH BENEFITS CAMPUS STAFF IN SOUTHERN CALIFORNIA You are eligible for the Caltech benefits described in this summary if you are regularly scheduled to work 20 or more hours per week