General Questions. UHC Account-Based Medical Options Questions

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1 Check this out! The following pages answer some of the questions you may have about your 2008 benefits through Unisys. For more detailed information, you can refer to the 2008 Annual Enrollment Guide (User ID: Unisys; Password: usbenefits). You can also reference the Summary Plan Descriptions (SPD) for the plans (from 1997) along with the Annual Enrollment Newsletters (Summaries of Material Modifications, or SMMs) from prior years (after 1997) on the U.S. Benefits Web site at (User ID: Unisys; Password: usbenefits). General Questions 1. What is changing for 2008? 2. Why are these benefits changes taking place? 3. For years, it seemed that Unisys directed employees to the Health Maintenance Organization (HMO) medical options. Does Unisys want employees to get out of the HMO options? New Account-based 4. Is my current medical option still available for 2008? 5. Why were some HMOs discontinued while others continue to be offered? 6. Are there negotiated rates with specialists and hospitals for network care? 7. Will the changes to the medical options affect which doctor I am able to see? 8. Do the medical options include dental and vision coverage? Health Savings Accounts ( 9. What does being a smart healthcare consumer mean? UHC Account-Based Medical Options Questions 10. How do the two UHC account-based medical options work? 11. How are the two UHC account-based medical options different from more traditional medical coverage such as HMOs and Point of Service (POS) medical options? 12. Who administers the two UHC account-based medical options? 13. What preventive care is covered at 100 percent from network providers? 14. How does the annual deductible apply under the two UHC account-based medical options? 1

2 Health Savings Account (HSA) Questions 15. What is a Health Savings Account (HSA)? 16. Who offers the HSA for Unisys participants? 17. What aspects of HSAs are governed by Federal rules? 18. What if I don t open my HSA during the 2008 Annual Enrollment? 19. Once I open an HSA, when will I begin receiving the Unisys contributions? 20. Who is responsible for ensuring that the money paid from my HSA is for an eligible expense under the Federal rules? 21. What if I have some eligible medical expenses and don t have enough money in my HSA yet to pay for them in full? 22. What happens to any balance in my HSA at the end of the year? 23. What happens to my HSA if I leave the company? 24. When can I diversify into investment options? 25. Are there any limits on the before-tax contributions and catch-up contributions to the HSA for 2008? 26. How does a lump-sum contribution to the HSA work? 27. If I retire part way through the year, can I continue to contribute to my HSA after my retirement? 28. If I opened my HSA last year, what do I need to do to get the Unisys contribution for 2008? Health Risk Assessment Discount Questions 29. Can I still get the monthly discount on my contributions for medical coverage through the company for completing the Health Risk Assessment? 30. How do I access the Health Risk Assessment? 31. If I complete the Health Risk Assessment, will my results be shared with the company? 32. My password doesn t work. Why not? 33. What happens to my information that I previously input? Non-Tobacco User Discount Questions 34. Do I receive a discount on my monthly contribution for medical coverage through the company if I choose to not use tobacco products? 35. Will I have any support through the company to stop using tobacco products? 36. How is the company going to enforce the non-tobacco user discount? Will there be penalties if someone receives the discount but actually is a tobacco user? 37. If I have not used tobacco products during 2007 or at the time of Annual Enrollment but start during 2008, what happens to the discount? Whom do I need to notify? 2

3 Flexible Spending Accounts (FSAs) Questions 38. What Flexible Spending Accounts (FSAs) will be offered for 2008? 39. Can I use a Health Care Flexible Spending Account (HC FSA) and be covered under one of the two UHC account-based medical options through the company? 40. What is a Limited Scope Health Care Flexible Spending Account (LSHC FSA)? 2008 Annual Enrollment Questions 41. When is the 2008 Annual Enrollment period? 42. Do I have to make elections? 43. Can I change my election(s) more than once before the October 31 deadline, or do I have only one shot to make elections? 44. How do I know which medical option to choose? 45. Can I just stay in the same medical option that I was in for 2007? Why do I have to do anything if I just want the same options? 46. What happens if I don t enroll? 47. How do I know if my 2008 benefits elections are confirmed? Prescription Drugs Questions 48. What are the prescription drug changes for 2008? 49. How can I determine whether my prescription drug requires prior authorization? 50. What do I need to do if a prescription drug I take requires prior authorization, step therapy or dose management in 2008? 51. Do the prescription coinsurance amounts apply to my annual out-of-pocket maximum and annual deductible under the two UHC account-based medical options? 52. What is the Dose-Optimization program? 53. Am I required to use the Medco Specialty Care Pharmacy if I take any of the drugs classified as Specialty Care Drugs? Spousal and Same-Gender Domestic Partner Surcharge Questions 54. What is the spousal surcharge? 55. What counts as subsidized medical coverage for the spousal surcharge? 56. Will the company require documentation of whether or not my spouse has medical coverage through a current or former employer? 57. Can I cover my spouse as a dependent on my coverage if my spouse is also a Unisys employee? 58. What if my covered spouse is eligible for subsidized medical coverage elsewhere but has an 3

4 enrollment period after the 2008 Unisys Annual Enrollment? Will I be assessed the surcharge? Decision Support Tools Questions 59. What tools will be available to help me make my 2008 benefits elections? 60. Are the decision support tools on the Your Benefits Resources (YBR) Web site available before Annual Enrollment opens? 61. What is the difference between preventive care and routine care in the Medical Expense Estimator? COBRA Questions 62. How does subsidized healthcare coverage under the Federal Consolidated Omnibus Budget Reconciliation Act (COBRA) differ from non-subsidized healthcare COBRA coverage? 63. Are contributions made to the Health Savings Account (HSA) during any period of company-subsidized COBRA healthcare coverage? 64. How will people who are eligible for benefits but no longer actively work at the company receive information about the 2008 Annual Enrollment period and make elections? 4

5 General Questions (Back to Table of Contents) 1. What is changing for 2008? Changes for 2008 include: Increasing the incentive for a tobacco-free lifestyle from $30 to $40 per month for 2008, and requiring that all household members be tobacco-free since January 1, 2007 and pledge to continue to be tobacco-free in the future in order to receive the benefit. Increasing the spousal and same-gender domestic partner surcharge from $75 to $100 per month for Doubling the Health Risk Assessment discount from $10 to $20 per month for Increasing monthly contributions for medical and dental coverage due to rising costs and maintenance of the company s share of the medical budget. Decreasing cost for Long-Term Disability coverage. Replacing selected insured medical options with expanded self-insured HMO offerings through Aetna, HealthPartners (under an alliance with CIGNA) and UnitedHealthcare. You were notified by mail if you re affected by this change. Changing the HealthPartners copayment for specialist office visits to parallel specialist copayments under the Aetna options and the UnitedHealthcare EPO. Expanding the classes of prescription drugs subject to Medco s clinical management programs. HMOs will no longer be offered to pre-medicare retirees or disabled former employees. See the 2008 Annual Enrollment Guide (User ID: Unisys; Password: usbenefits) for additional information. 2. Why are these benefits changes taking place? This year s benefits changes continue to align with the larger transformation underway at Unisys. While last year s Annual Enrollment included the unveiling of our new benefits strategy, this year we re focusing on updating and modifying only specific features of your current benefits options. Most of the changes focus on employee responsibility for making informed decisions, maintaining a healthy lifestyle, and being a smart healthcare consumer. 5

6 3. For years, it seemed that Unisys directed employees to the Health Maintenance Organization (HMO) medical options. Does Unisys want employees to get out of the HMO options? We offer a variety of medical options because we find value in different types of coverage because they each meet the needs of our employees differently. HMO options provide a high level of benefit value to our employees; however, the market trend is moving away from HMOs and toward account-based medical options, such as the two UnitedHealthcare (UHC) account-based medical options we will continue to offer in One reason for this transition is that HMOs do not always require thoughtful healthcare decision-making, which is important for managing both individual healthcare costs, as well as costs for companies throughout the U.S. Unisys evaluates the medical options each year to determine how the available types of coverage meet our business needs and the needs of our employees. 6

7 4. Is my current medical option still available for 2008? Most likely, your current medical option is available for The chart below outlines the medical options that won t be offered in 2008, along with replacement HMO options (if available). All other medical options will continue to be offered in Your Current Option: Keystone Health Plan Central (PA) Keystone Health Plan East (PA) Capital Health Plan (FL) MVP Health Care (VT) Optima Health Direct HMO (VA) Altius Peak HMO (UT) Blue Cross Blue Shield of North Dakota (Noridian) Coventry Healthcare of Iowa Lovelace Health Plan (NM) Anthem Blue Preferred HMO (IN) Care Choices HMO (MI) Health Alliance Plan (MI)* MVP Health Care (NY) Paramount Health Care, Inc. (OH) Physicians Health Plan Mid- Michigan Preferred Care Opportunity Plan (NY) Univera Healthcare HMO (NY) CIGNA HealthCare of North Carolina Healthkeepers by Priority (VA) Your HMO Options for 2008 May Include: Aetna HMO (Exclusive Provider Organization (EPO) in some geographic locations) UnitedHealthcare Choice EPO HealthPartners Open Access HMO (includes the national CIGNA network of providers) UnitedHealthcare Choice EPO Aetna HMO (EPO in some geographic locations) UnitedHealthcare Choice EPO Aetna HMO (EPO in some geographic locations) UnitedHealthcare Choice EPO HealthPartners Open Access HMO (includes the national CIGNA network of providers) Aetna HMO (EPO in some geographic locations) UnitedHealthcare Choice EPO Kaiser Permanente (Mid-Atlantic States) *Employees in UAW Local 1313 will continue to have this option. 7

8 5. Why were some HMOs discontinued while others continue to be offered? A number of factors were considered, including membership levels, quoted rate increases and available opportunities with one or more of our three main healthcare partners: Aetna, HealthPartners and UnitedHealthcare (UHC). The Kaiser options (including Group Health Cooperative) operate under a unique structure in most areas. Kaiser network providers typically are employed by Kaiser and are not free to participate in other networks. Kaiser facilities typically are owned by Kaiser and do not accept patients from other healthcare options. Employees participating in Kaiser options would have been gravely disadvantaged with respect to transitioning care to other providers. In addition, Kaiser typically has a very cost-efficient system for delivering medical care. PacifiCare is a UnitedHealth Group company, so retaining this HMO option takes advantage of excellent provider contracts under the PacifiCare name while utilizing our UHC partnership. Given our low number of employees in Hawaii, we decided not to expend limited resources to pursue state approval of our self-insured medical options. Therefore, we continue to offer two HMO alternatives in that state, despite the very low membership in these options. 6. Are there negotiated rates with specialists and hospitals for network care? 7. Will the changes to the medical options affect which doctor I am able to see? All of the medical options available through Unisys are network-based options. The network providers agree to negotiated rates for the covered services they provide to covered members. Network providers include primary care physicians (PCPs), specialists, hospitals, laboratories and other facilities. Which doctors you are able to see depends on which medical option you elect for Many doctors and hospitals participate in multiple networks. During 2008 Annual Enrollment, use the tools on the Your Benefits Resources TM (YBR) Web site at to determine which of your options include the providers you currently use. Network providers are subject to change, so it is always a good idea to verify continued network participation each time you access care. Note: Some of the medical options allow you to see the providers you choose, even if they are not network providers. You pay less, however, if you receive all of your covered services from network providers. 8

9 8. Do the medical options include dental and vision coverage? Dental and vision coverage is limited under the medical options. Some, but not all, HMOs cover routine vision exams from network providers at a predetermined frequency. Some may also offer discounted vision services. Few HMOs cover dental services. The Aetna Choice POS II option does not cover any routine vision services, but does offer discounted vision services and covers some oral surgeries that are typically considered to be of a medical nature rather than a dental nature. The two UHC account-based medical options cover routine vision exams from network providers at a predetermined frequency. Dental services are limited to a few oral surgeries that are typically considered to be of a medical nature rather than a dental nature. Coverage for many dental and vision expenses continues to be available through the separate Unisys Dental Plan and Unisys Vision Plan. 9. What does being a smart healthcare consumer mean? It means taking proactive steps to ensure the overall health of you and your family all year long. It s not only about choosing the right medical option during Annual Enrollment. And it s not only about saving money or cutting costs. It s about knowing how to get the most value from your medical option throughout the year. It s about taking steps to improve and maintain your health, including eating well, exercising regularly and keeping on top of any health risks you or your family may have. It s about playing an active role in managing your healthcare expenses. In short, being a smart healthcare consumer is about taking a holistic approach to healthcare all year long. 9

10 UHC Account-Based Medical Options Questions (Back to Table of Contents) 10. How do the two UHC account-based medical options work? The two UHC account-based medical options are designed to give you greater control over how you spend your healthcare dollars. You have the freedom to see any healthcare provider or visit any facility, including specialists. Covered preventive care from network providers is paid at 100 percent. All other covered services, including prescription drugs, are subject to a relatively high deductible before the option begins to pay a percentage for eligible services. Once your out-of-pocket expenses reach the annual out-of-pocket maximum, the option pays for covered services from network providers at 100 percent. These medical options can work alongside a Health Savings Account (HSA). An HSA works like a Federal income tax-favored bank account for your eligible out-of-pocket healthcare expenses. You can use the HSA to pay for your current healthcare needs or save for medical expenses later, perhaps at retirement. For additional details, refer to the 2007 Health & Wealth Guide (User ID: Unisys; Password: usbenefits) on the U.S. Benefits Web site. 11. How are the two UHC account-based medical options different from more traditional medical coverage such as HMOs and Point of Service (POS) medical options? 12. Who administers the two UHC account-based medical options? The main aspects of the two UHC account-based medical options include, but are not limited to, the following: Covered preventive care from network providers is payable at 100 percent. All other medical services, including prescription drugs, are subject to a higher annual deductible before the account-based medical options begin to pay a percentage for covered services. Individual annual deductibles and individual annual out-of-pocket maximums do not apply when you cover one or more eligible family members in this case, you and your covered dependents must meet the annual Family deductible before coinsurance applies. Covered expenses, including prescription drugs, are payable at 100 percent once the annual out-of-pocket maximum is met. You may participate in a Federal income tax-favored HSA and the company contributes during 2008 toward the HSA of active employees, provided you have opened an account with Exante Bank. The two account-based medical options are administered by UnitedHealthcare (UHC). They are called the UHC Choice Plus Account Based 70 and the UHC Choice Plus Account Based 90. The names for each of the options indicate the administrator (UHC), the appropriate network of providers within the UHC suite of networks (Choice Plus), the account-based type of coverage and the coinsurance rate (either 70 percent or 90 percent) once the annual deductible is met. 10

11 13. What preventive care is covered at 100 percent from network providers? 14. How does the annual deductible apply under the two UHC account-based medical options? Covered preventive care services are defined based on your age. For more details on the covered preventive care services, refer to the 2007Summary of Plan Changes, which is available on the U.S. Benefits Web site at (User ID: Unisys; Password: usbenefits). There is a significant difference in the way that the annual Family deductible works for the two UHC account-based medical options as compared to other medical options. Under the two UHC account-based medical options, Federal guidelines require that the entire annual Family deductible be met before anyone in the family receives reimbursement for covered services (other than for covered preventive care from network providers, which is always covered at 100 percent). In this context, Family means yourself and one or more covered eligible dependents, even if you choose only Employee + Spouse or Employee + Child(ren) coverage. Under the account-based medical options, you and/or your covered family members as a whole, need to incur $3,000 in covered services before the options begin to share the cost of covered medical expenses. If you have Employee Only coverage, you must incur $1,200 in covered medical expenses before the options begin to share the cost of your covered services. Contrast this with how the annual deductible works under the Aetna Choice POS II Option 80. Under this option, once any one family member reaches the individual annual deductible of $250, the covered expenses from network providers for that individual are shared at the 80 percent level. It doesn t matter if the annual Family deductible is ever reached for that individual. Once the combined covered expenses applied toward the annual deductible for two or more family members meet the $625 annual Family deductible, all covered family members receive network provider benefits of 80 percent. No one family member ever meets the annual Family deductible alone. 11

12 Health Savings Account (HSA) Questions (Back to Table of Contents) 15. What is a Health Savings Account (HSA)? An HSA is a Federal income tax-favored bank account that you control. In some states, HSAs also receive favorable state income tax treatment. You can use your HSA to pay for eligible medical expenses today and in the future, even during your retirement. You can contribute to the account in two ways: through before-tax payroll deductions or through your own Federal income tax-deductible contributions, but you may not exceed Internal Revenue Service (IRS) limits. The HSA is available outside the Unisys Flexible Benefits Program and it is not part of an employer-sponsored welfare benefit plan for purposes of the Employee Retirement Income Security Act of 1974, as amended (ERISA). The company makes no representations about the terms and conditions of your HSA. You are encouraged to consult your personal financial, legal or tax advisor before making any investment decisions. 16. Who offers the HSA for Unisys participants? The HSA is offered by and managed through Exante Bank, a UnitedHealth Group company. Exante Bank is not affiliated with Unisys. Other financial institutions are qualified to offer HSAs. You may choose to use one of these other financial institutions, however company contributions and any payroll deductions you authorize will be deposited to Exante Bank. 17. What aspects of HSAs are governed by Federal rules? Due to the tax advantages of participating in an HSA, Federal rules govern many aspects of HSA participation. These rules include, but are not limited to, the following: the minimum annual deductible and maximum annual out-of-pocket maximums required in the medical option in order to qualify for an HSA; how much can be contributed annually to an HSA; what expenses are considered to be eligible expenses and can be paid from an HSA without Federal income tax penalties; the implications of covering yourself and one or more eligible dependents; and catch-up contributions for participants age 55 and older. To read more about these Federal rules, visit the Internal Revenue Service Web site at 12

13 18. What if I don t open my HSA during the 2008 Annual Enrollment? If you enroll in your HSA during 2008 Annual Enrollment, you ll complete the process and forms necessary to establish your HSA through Exante Bank via the Your Benefits Resources (YBR) Web site. If you don t take advantage of the convenience of opening your HSA during Annual Enrollment and you participate in one of the two UHC account-based medical options, you can set up an HSA at any time. You ll need to take action with Exante Bank through the UHC Web site at (or the mymedica Web site at https// for participants who live in Minnesota and surrounding areas) to complete the enrollment process. Note: Any Unisys contributions to your HSA cannot begin until you have opened your account with Exante Bank. If you have an account open with Exante Bank and are enrolled in one of the two UHC account-based medical options for 2007, but fail to confirm elections for 2008, you ll have to contact the Unisys Benefits Service Center (UBSC) at , Monday through Friday (except holidays), 9:00 a.m. to 5:00 p.m., Eastern time, to begin receiving prospective contributions in 2008 as no company contributions is the default coverage. 19. Once I open an HSA, when will I begin receiving the Unisys contributions? It depends. If you elected participation in one of the two UHC account-based medical options, you are eligible to receive the company contribution to the HSA during If you open an HSA during the Annual Enrollment process, the company contributions will begin effective January 1, If your account is opened at a later date, you will begin receiving contributions on the first of the month following when you open your HSA with Exante Bank. If you default into the UHC Choice Plus Account Based 70 medical option, you must meet two conditions: you must contact the Unisys Benefits Service Center; and you must have an HSA account open with Exante Bank. 20. Who is responsible for ensuring that the money paid from my HSA is for an eligible expense under the Federal rules? 21. What if I have some eligible medical expenses and don t have enough money in my HSA yet to pay for them in full? It s your responsibility to ensure that expenses paid from the HSA are eligible expenses under the Federal rules. Neither UHC nor Unisys will monitor this. Contributions are made throughout the year; the full amount isn t available until the contributions have been deposited to your HSA. If you incur eligible expenses that exceed the current balance of your HSA, you are responsible for paying for the expenses out-of-pocket at that time. You can request additional reimbursement from your HSA when more money is deposited, provided the eligible services were received on or after the date your HSA was established. 13

14 22. What happens to any balance in my HSA at the end of the year? 23. What happens to my HSA if I leave the company? 24. When can I diversify into investment options? 25. Are there any limits on the before-tax contributions and catch-up contributions to the HSA for 2008? Unused HSA funds carry over from year to year, and accrue earnings Federal income tax-free. Used wisely, the money can be there when you need it now or in the future. Allowing your account to grow is a great way to plan to pay for eligible medical expenses after retirement. The balance of your HSA is portable. This means you keep the money in your account, even if you leave the company. All company contributions to your HSA end if you leave the company. In addition, the company stops paying the applicable monthly maintenance fees if you leave the company. Once your HSA balance reaches $2,000, you can invest the excess of $2,000 in increments of $100. Exante Bank offers several investment fund options. Yes, Federal law limits HSA contributions. In 2008, the maximum is $2,900 for employee only coverage and $5,800 for employee coverage plus one or more eligible dependents. The maximum includes company contributions. If you are age 55 or older (but not enrolled in Medicare), you may make catch-up contributions directly to Exante Bank. These catch-up contributions cannot be made through payroll deduction. For 2008, catch-up contributions are limited to $ How does a lump-sum contribution to the HSA work? 27. If I retire part way through the year, can I continue to contribute to my HSA after my retirement? 28. If I opened my HSA last year, what do I need to do to get the Unisys contribution for 2008? You (or someone on your behalf) can deposit a lump-sum amount into your HSA at any time by submitting the payment to Exante Bank. You must report any contributions you make on your Federal income tax return to claim any tax benefit that may be available. You can participate in the HSA only while you are participating in a high-deductible health plan as defined by Federal rules, but you don t need to be in active employment status. Once you retire and payroll deductions stop, you can make contributions directly to Exante Bank, provided you continue to be covered under a high-deductible health plan. You must actively elect one of the UHC account-based medical options during the Annual Enrollment period in order to get the contribution through the company for

15 Health Risk Assessment Discount Questions (Back to Table of Contents) 29. Can I still get the monthly discount on my contributions for medical coverage through the company for completing the Health Risk Assessment? Yes. As part of our commitment to promoting healthy lifestyles, we re increasing the 2008 discount to $20 per month on your contributions for medical coverage through the company for completing the Health Risk Assessment. If you have taken the Health Risk Assessment in the past, you now have a great way to measure the progress you ve made and build momentum for the coming year. To receive the discount for all of 2008, return to your profile before December 31, 2007 and update your profile and/or any responses that have changed from the last time you completed the Health Risk Assessment. To get the discount for all of 2008, be sure to complete or update your Health Risk Assessment no later than December 31, Please note: Plymouth UAW Local 1313 employees are invited to take the Health Risk Assessment. However, there is no financial incentive for doing so and there is not a $20 per month contribution discount on the cost of the Unisys medical plan coverage. Spouses and same-gender domestic partners of eligible employees are invited to take the Health Risk Assessment. However, there is no financial incentive if they do, and there is not an additional $20 per month contribution discount on the cost of the medical coverage through the company. 30. How do I access the Health Risk Assessment? You can access the Health Risk Assessment either: through the Your Benefits Resources (YBR) Web site at or directly at You ll need either your Aetna Navigator user name and password or your Company address to log on to the Health Risk Assessment Web site. If you don t have a Navigator user name and password or Company address, use employee access code P32KVPDUVZ If I complete the Health Risk Assessment, will my results be shared with the company? No, the information you provide through the Health Risk Assessment is confidential, and will not be shared with the company. Only aggregated data is shared with the company; no individual information is provided to Unisys. Your information may be shared with the claims administrator for your medical option to determine if you could benefit from any of their disease management programs. 15

16 32. My password doesn t work. Why not? 33. What happens to my information that I previously input? As of February 2007, the password requirements changed for the Health Risk Assessment. You ll now need an Aetna Navigator user name and password to access the site; your old user name and password won t work. But don t worry your past information is still saved in the system and will link to your new user name and password. Your past information is saved in the system and will link to your new user name and password. Non-Tobacco User Discount Questions (Back to Table of Contents) 34. Do I receive a discount on my monthly contribution for medical coverage through the company if I choose to not use tobacco products? 35. Will I have any support through the company to stop using tobacco products? 36. How is the company going to enforce the non-tobacco user discount? Will there be penalties if someone receives the discount but actually is a tobacco user? 37. If I have not used tobacco products during 2007 or at the time of Annual Enrollment, but start during 2008, what happens to the discount? Whom do I need to notify? If everyone in your household has been tobacco-free since January 1, 2007, and you all pledge to remain tobacco-free in the future, you re eligible to receive a $40 per month ($480 for the year!) discount on your contributions for medical coverage through the company in Note: This year, your entire household must meet these guidelines. The company is committed to helping you quit. If you need extra support, the Simple Steps Health Risk Assessment has an online program that helps users manage nicotine cravings and make healthy lifestyle changes. Most medical options, (except the Aetna Choice POS II Option 80, Aetna HMO (EPO in certain geographic areas) and UnitedHealthcare Choice EPO), have smoking cessation programs available to enrolled members. We expect our employees to be truthful in all dealings involving the company as required under our ethics policies and practices. As is the case with any affirmation made during a benefit enrollment, providing false information may result in the loss of coverage and possible disciplinary action, up to and including termination of employment. The company reserves the right to require proof of eligibility for the discount as part of periodic audits. If you or someone in your household begins using tobacco products after 2008 Annual Enrollment, you need to immediately notify the Unisys Benefits Service Center (UBSC) of your change in status by calling , Monday through Friday (except holidays), 9:00 a.m. to 5:00 p.m., Eastern time, Monday through Friday (except holidays). Your monthly contributions will be adjusted accordingly. 16

17 Flexible Spending Account (FSA) Questions (Back to Table of Contents) 38. What Flexible Spending Accounts (FSAs) will be offered for 2008? 39. Can I use a Health Care Flexible Spending Account (HC FSA) and be covered under one of the two UHC account-based medical options through the company? 40. What is a Limited Scope Health Care Flexible Spending Account (LSHC FSA)? For 2008 you can participate in: Unisys Health Care FSA (HC FSA), for eligible healthcare-related expenses for you and your dependents, if you don t participate in one of the two UHC account-based medical options. Unisys Limited Scope HC FSA (LSHC FSA), if you participate in one of the two UHC account-based medical options, you and your covered dependents cannot use a general purpose HC FSA to pay qualifying medical or prescription drug expenses before the annual deductible is met. The Limited Scope HC FSA covers only dental expenses, vision expenses and medical expenses that aren t covered under the medical option, as well as medical coinsurance after the annual deductible is met. In other words, expenses that are used to meet the annual medical deductible cannot be reimbursed by the LSHC FSA. Unisys Dependent Day Care FSA (DDC FSA), for qualifying (non-healthcare related) expenses related to the care of your dependents, such as care at a day care center. Healthcare expenses for your dependent(s) are not reimbursed under this account. Current Federal rules treat HC FSAs as if they are medical plans with first-dollar coverage available. Since this doesn t meet the requirement of a high deductible health plan, you (and your spouse) cannot be in a typical, general purpose HC FSA and also be eligible for the Federal income tax-favored status of a Health Savings Account. But you (and your spouse) can participate in a Limited Scope HC FSA that reimburses only dental expenses, vision expenses, medical expenses that aren t covered under the medical option or medical expenses after the annual deductible in a high-deductible health plan is met. To take advantage of this exception, if you are enrolled in one of the account-based medical options and choose to participate in the HC FSA, your enrollment automatically is assumed under a Limited Scope HC FSA. If you are enrolled in one of the two UHC account-based medical options and choose to participate in the HC FSA, your enrollment automatically is assumed under a Limited Scope HC FSA, because you cannot use a general purpose HC FSA to pay medical or prescription drug expenses before the annual deductible is met. The Limited Scope HC FSA covers only dental expenses, vision expenses and medical expenses that aren t covered under the medical option, as well as medical coinsurance after the annual deductible is met. In other words, expenses that are used to meet the annual medical deductible cannot be reimbursed by the LSHC FSA. 17

18 2008 Annual Enrollment Questions (Back to Table of Contents) 41. When is the 2008 Annual Enrollment period? 2008 Annual Enrollment runs from October 10 through October 31, You can make your elections online through the Your Benefits Resources (YBR) Web site at or over the phone by calling the Unisys Benefits Service Center at , Monday through Friday (except holidays), 9:00 a.m. to 5:00 p.m., Eastern time. You must complete all of your elections online before midnight, Eastern time, or by 5:00 p.m., Eastern time, if you register over the phone on October 31, 2007 or you will receive default coverages for 2008 that may not meet your needs. 42. Do I have to make elections? 43. Can I change my election(s) more than once before the October 31 deadline, or do I have only one shot to make elections? 44. How do I know which medical option to choose? Yes! For 2008, you must go online through YBR or call the Unisys Benefits Service Center (UBSC), to register and confirm your 2008 elections. All eligible employees need to make active elections even if you ve been hired recently, experienced a Qualifying Life Event, or are declining coverage for the first time. You can change your 2008 elections as many times as you like prior to October 31, Once you make your final elections, remember to confirm them and print your benefits elections, as well as your Completed Successfully! page as confirmation for your records. Once the enrollment deadline passes, you can only make further changes for 2008 if you experience a Qualifying Life Event (such as marriage, divorce, or the birth of a child) that allows for the requested change and you request the change within 30 days following the event. You need to understand how you currently use healthcare and consider how you might use it in the coming year before you can think about choosing the right option for you and your family. If you re not sure where to start, try the following resources made available to you by the company: 2008 Annual Enrollment Guide: mailed to your home and available online (User ID: Unisys; Password: usbenefits); online tools on the Your Benefits Resources (YBR) Web site: and Unisys Benefits Service Center (UBSC) at , available Monday through Friday (except holidays), 9:00 a.m. to 5:00 p.m., Eastern time. 18

19 45. Can I just stay in the same medical option that I was in for 2007? Why do I have to do anything if I just want the same options? You can choose the same medical option (assuming it is still offered in 2008), but you must actively elect and confirm it during the 2008 Annual Enrollment. Your 2007 coverage does not roll over to 2008 automatically. If you fail to actively elect your benefits for 2008, you ll receive default coverages. See below for details. Our hope is that you take the opportunity during Annual Enrollment every year to reevaluate your needs, examine all of your alternatives and choose the options that match how you expect to use healthcare services. If your current option fits your needs, that s fine. We just want you to take a long and hard look at your healthcare needs and assess how the available options meet them. 46. What happens if I don't enroll? If you don t make active elections during the 2008 Annual Enrollment and you are enrolled in medical coverage through the company for 2007, you will: default to the UHC Choice Plus Account Based 70 medical option; the family members you cover in 2007 will be included in your medical coverage for 2008 (provided they continue to be eligible); receive no company contribution to your Health Savings Account (HSA); be assessed a $100 per month ($1,200 per year!) spousal surcharge if you cover your spouse or same-gender domestic partner; miss out on the $40 per month ($480 per year!) discount for living a tobacco-free lifestyle; miss out on the $20 per month ($240 per year!) discount for completing the Health Risk Assessment; have no coverage through the dental or vision plans; and not be able to participate in any of the Flexible Spending Accounts (Health Care or Dependent Day Care). You will not be able to change these elections unless you experience a Qualifying Life Event during 2008 that allows for changes. You will be able to enjoy the discounts, avoid the surcharges and set up an HSA, if applicable, if you later contact the UBSC at , 9:00 a.m. to 5:00 p.m., Eastern time, Monday through Friday (except holidays) and update your responses to the discount and surcharge questions. If you were not enrolled in medical coverage through the company in 2007 and fail to make an active election during the 2008 Annual Enrollment period, you will default to no medical coverage for In addition, you will have no dental or vision coverage, and no participation in the HSA or Flexible Spending Accounts (Health Care or Dependent Day Care). 19

20 47. How do I know if my 2008 benefits elections are confirmed? Your 2008 benefits elections aren t confirmed unless you reach the Completed Successfully page on the Your Benefits Resources (YBR) Web site. Simply checking off your elections within YBR is not enough. You MUST take the final step of confirming your elections. Reaching the Completed Successfully page is the end of this process. Once you ve reached the Completed Successfully! page, make sure to print it out for your records. 20

21 Prescription Drugs Questions 48. What are the prescription drug changes for 2008? (Back to Table of Contents) Beginning in 2008, the clinical management programs will be expanded so that all employees are using prescription drugs cost-effectively and appropriately. These programs foster the appropriate use of select drugs based on widely accepted clinical guidelines. The expansions will be to the classes of drugs covered under one or more of the following clinical management programs beginning January 1, 2008: Prior authorization is a review process conducted by speciallytrained Medco pharmacists. A review is triggered when a brand-name drug is requested and a generic equivalent is available. The review determines if the brand-name drug is medically necessary (for example, you have tried the generic therapy and it failed or you are allergic to the dye in the generic product). If the brand-name drug is approved, it will be dispensed at the brand-name coinsurance rate. If it isn t approved as medically necessary, you can still request the brand-name drug; however, you ll pay the full difference in the discounted cost between the brand-name drug and the generic drug in addition to the coinsurance rate. Prior authorization also may be triggered if a prescription has the potential for misuse or mis-prescribing. Over time, clinicians identify drugs that aren t used appropriately. If the prescription is not approved for part or all of the duration prescribed, it will not be covered. If Medco has your 2007 prescription history due to your coverage through the company and you are currently taking a prescription drug that will require prior authorization in 2008 for the first time, you ll receive a letter from Medco by mid-december describing the prior authorization process. Important note: Prior authorization approvals expire one year from the date of the first time you fill the prescription or at the end of the initial prescription period, whichever is earlier. Step therapy review may be triggered if a drug is prescribed but widely accepted clinical guidelines indicate that alternate therapies or dosage levels should be tried first for your condition in attempts to achieve desired results. This process could occur if it cannot be determined through Medco claims history that the drug your doctor prescribed: is the next step in a dosing sequence when recommended clinical guidelines indicate a gradual increase in dosage level is appropriate until the desired results are achieved (for example, you try 5mg for a period of time and advance to 10mg only if the lower dosage is not optimizing results); and/or is the next step in a sequence of clinically-accepted alternate therapies, possibly including over-the-counter (OTC) drugs, generics or less costly alternatives. 21

22 If the appropriate clinical sequencing guideline hasn t been followed, coverage for the prescription will be denied and you ll need to go through the prior authorization process to obtain coverage for the prescription. Dose management may be triggered if a prescription is for a quantity or duration that exceeds widely accepted clinical guidelines or manufacturer s limits. This would occur due to one of two reasons: quantity limits: the quantity requested exceeds the clinically recommended supply, and/or duration limits: the period of time the prescription is to be taken exceeds clinically recommended durations. The clinically recommended amount/duration will be dispensed without prior authorization. Any amount in excess of the clinical guidelines requires prior authorization approval in order to be covered. 49. How can I determine whether my prescription drug requires prior authorization? If you are currently taking a prescription drug that will require prior authorization in 2008, you will receive a letter from Medco describing the prior authorization process by mid-december. You can also find a list of prescription drugs in the 2008 Annual Enrollment Guide (User ID: Unisys; Password: usbenefits). If you have questions during Annual Enrollment, you may contact Medco Member Services at When prompted, dial 1 for support during the Annual Enrollment period. You may also find a list of medications on Medco s Web site at Note: The list is updated by Medco periodically as widely accepted clinical guidelines evolve within the medical and prescription drug community. If you are currently using a prescription that is added to the list, you ll be contacted if prior authorization is required. 22

23 50. What do I need to do if a prescription drug I take requires prior authorization, step therapy or dose management in 2008? Here s what you need to do to fill a prescription for a drug that requires prior authorization, step therapy or dose management: Through Medco by Mail: You mail the prescription to Medco. If a review is necessary to obtain coverage for the medication, Medco contacts your doctor requesting any additional information. After receiving the necessary information, Medco notifies you and the doctor (usually within 1-2 business days) confirming whether or not coverage has been approved. If coverage is approved, you receive your medication and simply pay your normal coinsurance. If coverage isn t approved, the prescription is returned to you. You have the right to appeal the decision. Information about the appeal process will be included in the letter you receive with the returned prescription. At a retail pharmacy in Medco s network: You take the prescription to your local network pharmacist, who submits the information to Medco. If a review is necessary, Medco automatically notifies the pharmacist, who in turn tells you that the prescription needs to be reviewed. You, the pharmacist, or your doctor may start the review process by calling Medco toll-free at , 8:00 a.m. to 9:00 p.m., Eastern time, Monday through Friday (except holidays). Medco requests any additional information required for review from your doctor. After receiving the necessary information, Medco notifies you and your doctor whether coverage has been approved (usually within 1-2 business days). If coverage is approved, you simply pay your normal coinsurance. If coverage isn t approved, you ll be responsible for the full cost of the medication or, if appropriate, you can talk to your doctor about alternatives that may be covered. You have the right to appeal the decision. Information about the appeal process will be included in the letter you receive. 51. Do the prescription coinsurance amounts apply to my annual out-ofpocket maximum and annual deductible under the two UHC accountbased medical options? Until the annual deductible is met, you are responsible for the full cost of any covered prescription drugs. Once the annual deductible has been met, the prescription coinsurance amounts apply and the coinsurance you pay applies toward your annual out-of-pocket maximum. Once your portion of combined covered medical and prescription drug expenses reach the annual out-of-pocket maximums, the prescription coinsurance amounts no longer apply instead, covered prescription drugs are paid at 100 percent. 23

24 52. What is the Dose- Optimization program? The Dose-Optimization program involves coordination between Medco and your physician if your doctor prescribes a daily dosage regimen that could be clinically equivalent to alternate dosing. For example, if your doctor prescribes a medication with a dose of 5mg, two times per day, a daily dosage of 10mg, once per day, may be equally effective. If your doctor agrees to the change, Medco will automatically make the change and send you a letter explaining the change. This program is completely voluntary Medco provides coverage whether or not your doctor changes your dosage regimen. You don t need to do anything; Medco will contact your doctor directly if you re taking a prescription that could possibly be optimized by a change in the dosage regimen without adversely impacting your treatment as supported by widely accepted clinical guidelines. 53. Am I required to use the Medco Specialty Care Pharmacy if I take any of the drugs classified as Specialty Care Drugs? No, you are not required to use the Medco Specialty Care Pharmacy, but you could be missing out on a number of personalized, specialized supported services available specifically to individuals with your condition and treatments. For example, you would miss out on: 24/7 access to pharmacists for questions; personalized, condition-specific education from registered nurses; expedited, scheduled delivery via UPS or a similar service; free supplies to administer your medication (e.g., needles, syringes); and refill reminder calls. Spousal and Same-Gender Domestic Partner Surcharge Questions (Back to Table of Contents) 54. What is the spousal surcharge? You ll pay an additional $100 per month for medical coverage through the company if you choose to cover your spouse or same-gender domestic partner who has access to medical coverage through a current or former employer that pays some or all of the cost of coverage. Before you make your decision about coverage for 2008, discuss your options with your spouse or same-gender domestic partner. It may make more sense for your spouse or same-gender domestic partner to take advantage of his or her other medical coverage instead of medical coverage through Unisys. 24