together walking 2016 Employer Guide to the Concordia Health Plan What to consider before choosing your option(s) Focused on what matters.

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1 2016 Employer Guide to the Concordia Health Plan What to consider before choosing your option(s) NON-EXEMPT EDITION walking together Focused on what matters. CO N C O RD I A PLA N SER VI C ES 2016 E M P L O YE R G U I D E (N O N -E XE M P T ) 1

2 Inside This Guide 2 What s New? 3 Getting Started: What You Need to Know 6 Compare Health Plan Options pg 3 pg Discover the Advantages of Personal Spending Accounts 14 Determine Your Funding Strategy 15 Important Dates 16 Enrollment Checklist 17 Important Notes About the CHP and Health Care Reform 2 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

3 Dear Concordia Health Plan Partner: We recognize the huge commitment of time that goes into understanding your health benefit information, as well as the dedicated planning, budgeting, and decision making for which you are responsible as the benefits administrator(s) at your organization. We respect the commitment you have made to serve your workers, and we strive to support you by providing total health solutions and excellent customer service. As you read through this guide, you ll notice symbols to call your attention to important information and point you to online resources. Look online for more information Important date or detail Questions? Call or Our Employer Resources Consultants and Employer Relations Specialists can provide you with information about which option(s) may be the right fit for your organization and workers, and talk with you about ways to maximize your healthcare dollars. CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 1

4 What s New? Throughout this summer and into the fall, Concordia Plan Services (CPS) is excited to be rolling out multiple healthcare consumer tools that will add even more value to all the Concordia Health Plan (CHP) options. These tools will help workers: locate quality healthcare providers learn of ways to save on healthcare costs Important Your election period will begin in July, and you will have until September 8 to make your elections. For more information, go to ConcordiaPlans.org. manage their own health using technology connect with a team of healthcare specialists to get healthy and maintain good health CPS encourages employers to promote health and wellness among their workers. So know that when you are making your 2016 CHP elections, you are giving your workers the tools that will help them become better healthcare consumers, which leads to savings and good health all around! In our effort to continue to support your changing needs, CPS is also dedicated to keeping these four factors in mind as we work to deliver the best health care coverage for your workers. 1. Flexibility 2. Simplicity 3. Affordability 4. Segmentation Our Strategy Continues for 2016 We are incorporating the feedback we have received from you. The CHP for 2016 and beyond will meet the broad needs of all workers, while being cost effective for employers. Legislative provisions of the Affordable Care Act (ACA) caused us to consider the different types of organizations that are served by CPS. We want to offer flexibility in plan design options to meet the needs of ministries while upholding The Lutheran Church Missouri Synod (LCMS) Doctrinal beliefs. We need to be flexible in planning and preparing for the changes ahead that will impact the CHP as a result of the ACA. One change in particular is a 40% excise tax, or Cadillac Tax, that will be imposed by the ACA on employers beginning in 2018 on high-end employer-sponsored health care coverage. 2 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

5 Getting Started: What You Need to Know Which Group Am I In? The contraceptive mandate under the ACA positions CHP employers into two categories exempt and non-exempt. See below to learn about the categories and what they mean in terms of the ACA and your 2016 health plan options. Coverage for certain women s preventive care services that are not aligned with our Lutheran beliefs Group 1 (Exempt) Churches, conventions or associations of churches, and integrated auxiliaries Conscience protection applies to Group 1 Group 2 (Non-Exempt) Universities, some schools, Recognized Service Organizations (RSOs), and all others not meeting the ACA definition of religious employer Conscience protection does not apply to Group 2, unless they remain in a grandfathered health plan If you have questions about the group to which you belong, please see The ACA Contraceptive Mandate: Is Your Organization Exempt? flow chart located under Health > Health Care Reform > Resources at ConcordiaPlans.org. As an employer, it is your responsibility, not Concordia Plan Services, to determine if your organization is exempt or non-exempt. Health plan options in 2016 Four options + an HMO exemption under the ACA allows flexibility Six options + 3 HMOs grandfathered options still available for this group CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 3

6 Health Care Reform requires that you provide: Summary of Benefits and Coverage (SBC) applicable to the employer s CHP option(s) to any newly hired workers who are eligible to enroll in the CHP. A Marketplace Notification is required to be provided within 14 days of the worker s start date. This notification informs workers about the Health Insurance Marketplace in their state. If you re an Applicable Large Employer under the Affordable Care Act, certain tax-reporting to demonstrate compliance with affordability, minimum value, and minimum essential coverage requirements For detailed information about distributing these documents, visit ConcordiaPlans.org and click on Health > Health Care Reform > Concordia Health Care Reform. Minimum Participation Requirements Employers must meet the following minimum participation requirements to offer the CHP: Another health plan cannot be offered alongside the CHP. At least 75% of those eligible to enroll in the CHP must be either enrolled in the CHP or be an eligible opt-out (as defined below). If you have three workers, you can have one ineligible opt-out, as long as two workers are enrolled in the CHP. Eligible Opt-Outs Eligible opt-outs are workers who are not enrolled in the CHP because they already have health coverage under: A spouse s or parent s group health plan (coverage by virtue of employment, including military service) A former employer s group health plan A current non-lcms employer s group health plan The military as a retiree A Medicare supplement plan A government medical assistance program for low-income persons (e.g., Medicaid) A foreign country health plan A group health plan of an employer located in the state of Hawaii A worker also is considered an eligible opt-out if he/she does not meet the minimum hours worked requirement (more than 20, more than 25, more than 30, or 30 or more hours per week, as selected by the employer) to be eligible for the CHP. 4 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

7 How Many Options Can I Offer? OR 3. NOTES: All employers, regardless of size, may participate in Employer Choice. That means you, as an employer, choose only one coverage option for your workers from all of the options available for your specific group (see pages 7-10). Eligible employers may participate in Worker Choice. With this option, you choose to offer workers two or three options from the combinations available for your specific group (see page 11). Each worker then chooses which option is best suited to cover his/ her healthcare needs for the calendar year. Keep in mind that Worker Choice employers will be responsible for extra administrative duties, which include designating a contact person and facilitating worker elections to ensure worker election information is submitted to CPS by the October 16 deadline. The elections you and/or your workers select will apply for a calendar year. Each fall, during the annual election period, you have the opportunity to select a different coverage option from all the options available for your specific group for the upcoming plan year. To qualify for Worker Choice, employers must have: A minimum of 15 workers enrolled in the Concordia Retirement Plan At least 75% of eligible workers enrolled in the CHP (no less than 10 workers) No dual health plan coverage with another carrier offered to workers If you qualify for Worker Choice, a Worker Choice Election Form is included with this mailing. All other employers receive an Employer Choice Election Form. If you did not receive a form and you qualify for Worker Choice, call CPS at Understanding How Worker Choice Works How many options should we offer? Which options should we select? Here are the options we will offer in 2016 Step 1 Employer chooses to offer: 1 Option 2 Options 3 Options Step 2 Employer selects options: Option C Option D Option HDHP Step 3 Employer shares with workers CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 5

8 Compare Health Plan Options All options include medical, preventive care, mental health and substance abuse, prescription drug coverage, dental, vision, hearing care, and employee assistance program. See the boxes to the right for a quick comparison of the PPO and HDHP options, and then review the charts on the next pages for more information. Group 2 organizations have six health plan options to choose from. Keeping these options available for employers in this group will provide the necessary conscience protection for them since they are not considered exempt under the law from covering certain women s preventive services. Preferred provider organization (PPO) options Options A-D Members pay copayments and coinsurance for eligible medical and prescription drug expenses up to a coinsurance maximum. Consumer-directed health plan (CDHP) options Option E and Option HDHP Members generally pay the full cost of coverage up to a deductible. Option E has copayments for prescription drugs; whereas Option HDHP treats prescription drugs the same as medical expenses (i.e., you must meet the deductible before the plan pays). Preventive care is covered at 100% and not subject to the deductible. These options are typically paired with personal spending accounts. Option E can be paired with a health reimbursement arrangement (HRA); Option HDHP can be paired with a health savings account (HSA) or an HRA. Monthly premiums Monthly premiums Deductibles Deductibles + Health Maintenance Organization (HMO) Health maintenance organization (HMO) options (HMO, HMO-C, and HMO-C2), administered by Cigna HealthCare, are available to employers in locations across the country where Cigna HMO network access and cost of the coverage make it possible to offer. Option HMO is typically available in Phoenix, Tucson, Las Vegas, New York City, and parts of New Jersey. HMO-C and HMO-C2 options are available only in California.* With an HMO option, all services and supplies must be provided or authorized by a primary care physician (PCP). Members will need to designate a PCP to coordinate their care. There are no benefits available for services received outside of the network or not authorized by the PCP. 6 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) *HMO Options are predominant in the greater metropolitan areas of Los Angeles, San Diego, and San Francisco. Refer to your rate notice to see if an HMO option is available in your area.

9 A Closer Look at Options for Group 2 CDHP Options PPO Options Option HDHP* Option E Option D Option C Option B Option A Medical benefits administered by Blue Cross Blue Shield of Minnesota Individual Deductible Maximum $2,850 $1,800 $1,200 $600 $350 $0 Family Deductible Maximum $5,700 $3,600 $2,400 $1,200 $700 $0 Coinsurance 0% 20% 20% 20% 15% 10% Individual Coinsurance Maximum $0* $3,600 $3,000 $2,400 $1,750 $600 Family Coinsurance Maximum $0* $7,200 $6,000 $4,800 $3,500 $1,200 Preventive Care $0 $0 $0 $0 $0 $0 Office Visit (other than preventive care) $0 after deductible $0 after deductible $35 copay $30 copay $25 copay $25 copay Well-baby and Well-child Care (under age 6) $0 $0 $0 $0 $0 $0 Inpatient and Outpatient Hospitalization, Other Medical Expenses $0 after deductible 20% after deductible 20% after deductible 20% after deductible 15% after deductible 10% no deductible Emergency Room Visit $0 after deductible $120 copay (waived if admitted) $120 copay (waived if admitted) $120 copay (waived if admitted) $120 copay (waived if admitted) $120 copay (waived if admitted) Lifetime Maximum (includes all CHP-eligible benefits) Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited *Once the deductible is satisfied, the out-of-pocket maximum is also satisfied. There is no coinsurance for Option HDHP. NOTE: This chart displays the CHP member s deductible, coinsurance, and copay responsibility for services received by network providers only. Services received out of network have higher deductibles and coinsurance, or may not be covered at all. For information about non-network benefits, visit ConcordiaPlans.org. CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 7

10 A Closer Look at Options for Group 2 (continued) CDHP Options PPO Options Option HDHP* Option E Option D Option C Option B Option A Mental health/substance abuse benefits Administered by Blue Cross Administered by Cigna Behavioral Health Includes counseling, psychological and laboratory testing, and inpatient care Combined with medical care (applies to deductible). $0 after medical deductible. $0 deductible. Outpatient testing, therapy, and inpatient care covered at 100%. $0 deductible. Outpatient testing and inpatient care covered at 100%. Outpatient therapy: $35 copay Outpatient therapy: $30 copay Outpatient therapy: $25 copay Outpatient therapy: $25 copay Prescription drug benefits administered by Express Scripts Generic Brand-name Formulary Non-formulary Combined with medical care (applies to deductible). $0 after deductible (cost of medication is actual discounted retail price). Retail $15; mail order $25 Retail $30; mail order $60 Retail $15; mail order $25 Retail $30; mail order $60 Retail $60; mail order $120 Retail $60; mail order $120 Dental benefits administered by Cigna Dental Preventive Care $0 (no deductible) $0 (no deductible) Basic Dental Care Orthodontic Care Other CHP benefits and discounts 20% after $100 individual or $300 family deductible ($1,500 annual maximum benefit) 50% after deductible ($1,500 lifetime maximum benefit) 20% after $100 individual or $300 family deductible ($1,500 annual maximum benefit) 50% after deductible ($1,500 lifetime maximum benefit) Vision Care Vision Service Plan Vision Service Plan Hearing Care Discounts HearUSA HearUSA Employee Assistance Program Cigna Behavioral Health Cigna Behavioral Health *Once the deductible is satisfied, the out-of-pocket maximum is also satisfied. There is no coinsurance for Option HDHP. NOTE: This chart displays the CHP member s deductible, coinsurance, and copay responsibility for services received by network providers only. Services received out of network have higher deductibles and coinsurance, or may not be covered at all. For information about non-network benefits, visit ConcordiaPlans.org. 8 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

11 Discounted retail prices through Express Scripts Because copays do not apply to medications in Option HDHP, the following is an example of what common medications may cost. Retail Home Delivery Drug 30-Day Supply 90-Day Supply Simvastatin (20 mg) $3.79 $3.71 Omeprazole (20 mg) $7.11 $8.56 Plavix (75 mg) $ $ Boniva (150 mg) $ $ Prices shown are estimated as of June 2015 and include Express Scripts negotiated discounts. This fall, members will be able to log on to the Express Scripts preview website at express-scripts.com/concordia2016 to see the discounted retail price of their prescriptions. Workers and their spouses both eligible for enrollment in the CHP as workers Workers are able to enroll together in family coverage and only be subject to one family deductible. Please contact Concordia Plan Services for additional details on how to handle enrollment for this special situation. CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 9

12 HMO Options for Group 2 Option HMO Option HMO-C Option HMO-C2 (Non-California) (Phoenix, Tucson, Las Vegas, New York City, & New Jersey) Medical benefits administered by Cigna HealthCare. Only network benefits are available. Deductible $0 (except for prosthetic & orthopedic devices) (California) (California) $0 $0 Coinsurance 0% 0% 0% Individual Out-of-Pocket Maximum $1,850 $1,850 $2,450 Family Out-of-Pocket Maximum $5,550 $5,550 $7,350 Primary Care Physician Office Visit $20 copay $20 copay $30 copay Specialist Office Visit $30 copay $20 copay $40 copay Inpatient and Outpatient Hospitalization $430 copay per admission $430 copay per admission $430 copay per admission Emergency Room Visit $120 copay (waived if admitted) $90 copay (waived if admitted) $90 copay (waived if admitted) Urgent Care Facility $60 copay $90 copay $90 copay Lifetime Maximum Unlimited Unlimited Unlimited Prescription drug benefits administered by Cigna HealthCare Generic Retail pharmacy $15; mail order $25 Retail pharmacy $15; mail order $25 Retail pharmacy $15; mail order $35 Brand-name Formulary Retail pharmacy $25; mail order $50 Retail pharmacy $25; mail order $50 Retail pharmacy $35; mail order $70 Non-preferred Retail pharmacy $50; mail order $100 Retail pharmacy $40; mail order $80 Retail pharmacy $55; mail order $110 Dental benefits administered by Cigna Dental Preventive Care Basic Dental Care Major Restorative Care Orthodontic Care Mental health/substance abuse benefits administered by Cigna Behavioral Health $0 (no deductible) 20% after $50 deductible per person ($1,500 annual combined maximum benefit) 50% after $50 deductible per person ($1,500 annual combined maximum benefit) 50% ($1,250 lifetime maximum) Deductible $0 Coinsurance 0% Outpatient Therapy and Testing Therapy $20 copay; testing $0 Inpatient Care Other CHP benefits and discounts Vision Care Hearing Care Discounts Employee Assistance Program $430 copay Vision Service Plan HearUSA Cigna Behavioral Health NOTE: This chart displays the CHP member s coinsurance and copay responsibility for services received by network providers. Medical services received out of network are the full responsibility of the member. 10 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

13 Worker Choice Combinations for Group 2 If you qualify for and decide to offer Worker Choice, you may choose from the following valid option combinations: Two-Option Combinations Options C, D Options C, HMO (or HMO-C) Options C, HMO-C2 Options D, HMO (or HMO-C) Options D, HMO-C2 Options HDHP, C Options HDHP, D Options HMO-C, HMO-C2 Three-Option Combinations Options B, C, HMO (or HMO-C) Options B, C, HMO-C2 Options C, D, E Options C, HDHP, HMO-C2 Options C, HMO-C, HMO-C2 Options HDHP, B, C Options HDHP, C, D Options HDHP, D, E If you are interested in offering options that are not displayed here, contact Concordia Plan Services for more information at or info@concordiaplans.org. Discover the Advantages of Personal Spending Accounts Personal spending accounts (health savings accounts, health reimbursement arrangements, and flexible spending accounts) give you the opportunity to help workers pay their out-of-pocket health care expenses with a tax-advantaged account. The scenarios on the following page show how employers might combine personal spending accounts with their CHP option to help workers with out-of-pocket medical expenses. All dollar amounts refer to individual (self-only) coverage and assume the use of network providers. For cost information on other classes of coverage and non-network services, refer to the enclosed rate notice and visit the Health section of ConcordiaPlans.org. To learn more about personal spending accounts, refer to the 2016 Employer Guide to Personal Spending Accounts (this guide can be found on ConcordiaPlans.org under Ministry Resources > Forms & Publications) or call SelectAccount at if you have any questions. CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 11

14 Example 1 Employer 1 currently offers workers Option A, which includes a $0 deductible. For 2016, the employer decides to switch to Option HDHP, a high deductible health plan with a $2,850 deductible, and funds the workers HSAs $210 per month ($2,520 per year) so that the workers out-of-pocket cost for eligible medical expenses will only be $330. Workers can also use HSA dollars for dental and vision expenses or save for future medical expenses. Win-Win Scenario When switching health plan options, offering a personal spending account and making a contribution is the best way to maximize your savings on the cost of health coverage while minimizing the impact of out-ofpocket costs for your workers. This way, everyone can benefit from the savings. Contribution rate savings of $407* per worker per month minus monthly HSA contributions could save the employer $2,364* per worker during the course of a year, while providing an extra benefit to help workers save for and cover their medical expenses. *These cost savings are estimates and are based on a worker in St. Louis in Cost Area C. Refer to the enclosed rate notice for the contribution rates in your area. Example 2 Employer 2 currently offers Option A with a $0 deductible. Members are responsible for office visit and prescription drug copays. The employer switches to Option C, with a $600 deductible. The employer sets up a flexible spending account (FSA) and makes a contribution. Workers also can fund with pre-tax dollars to be used toward eligible medical expenses, such as deductible, copays, and coinsurance. The worker has access to the full FSA annual election at the beginning of the year. The worker has discretion on how to use FSA funds. If he/she does not incur costs toward the deductible, FSA money can be used toward any FSA-eligible expenses, including copays, dental and vision expenses, and some over-the-counter items. At the end of the plan year, any unused FSA dollars can revert back to the employer (after any grace period, as directed by the employer), unless the employer elects to allow up to a $500 rollover for the workers accounts. NOTE: Option C carries higher office visit copays, coinsurance percentage, and coinsurance maximum when compared with Option A. See pages 7-10 for more detailed benefit information. 12 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

15 Example 3 Employer 3 currently offers workers Option C. In 2016, Option C will have a $600 deductible. For 2016, the employer switches to Option D with a $1,200 deductible and opts to provide an HRA. Due to added flexibility and funding options, the employer sets parameters around the HRA so that it will only reimburse a worker s deductible expenses after he/she has paid $600 toward the deductible. Now, the worker has the same out-of-pocket deductible responsibility as Option C, with the contribution rates of Option D. This could save the employer approximately $768* per worker per year, with a maximum HRA liability of $600 per worker. In addition, for any worker who does not hit the $1,200 deductible, the remaining funds allocated to the HRA will revert back to the employer (if the employer opts not to allow rollover). NOTE: Option D carries higher copays and coinsurance maximum when compared with Option C. See pages 7-10 for more detailed benefit information. *These cost savings are estimates and are based on a worker in St. Louis in Cost Area C. Refer to the enclosed rate notice for the contribution rates in your area. CO N C O RD I A PLA N SER VI C ES 2016 E M P L O YE R G U I D E (N O N -E XE M P T ) 13

16 Determine Your Funding Strategy You, as the employer, have a great deal of flexibility and many options to consider as far as who pays what and when for healthcare expenses. Keep the following funding strategies in mind when considering your healthcare elections for the coming year. Looking for Ways to Save on Your Healthcare Costs? Concordia Plan Services Employer Resources Consultants can help. Call Visit ConcordiaPlans.org, and click on Ministry Resources > Consulting. Choice of health plan option If you qualify to offer Worker Choice (see page 5), consider making two or three options available to your workers. If you provide an incentive for workers to enroll in Option HDHP, such as a monthly contribution to their health savings accounts, your workers may be more inclined to take advantage of an option with a lower contribution rate. Choice of employer/worker funding You are required to pay at least 50% of the individual worker cost of the health plan but can determine the additional amount paid toward the cost of worker and dependent coverage. If you are paying 100% of the cost for dependents in the CHP, there is no incentive for a worker s spouse to use alternative health coverage that may be available. You may want to offer a monthly stipend for a worker s dependent to use the other available health plan. If you have the worker share in the cost of CHP coverage, use workers pre-tax dollars. If you adopt a Premium Only Cafeteria Plan (document available on our website), you can permit workers to deduct their portion of healthcare contributions pre-tax from their paychecks. 14 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

17 Choice of hours and probationary period For the Concordia Health Plan, you can designate more than 20, more than 25, more than 30, or 30 or more hours per week and more than 5 consecutive months as the definition of full time.* For all the Concordia Plans, you also may adopt a probationary period to delay enrollment of a newly employed lay worker for up to 60 days. (Probationary periods do not apply to rostered workers.)* *You must apply definitions of hours and probationary period equally for all workers in the specified class of employees. Universities and other Non-Qualified Church-Controlled Organizations that are enrolled in the Concordia Retirement Savings Plan cannot use a probationary period to delay enrollment in the Plans. Personal spending accounts See pages for examples of how these accounts can help workers save on eligible expenses, such as copays and deductibles. See your 2016 Employer Guide to Personal Spending Accounts for more information, including pricing scenarios and account administration. This guide can be found at ConcordiaPlans.org under Ministry Resources > Forms & Publications. Contact SelectAccount s Employer Spending Account Help Line at to learn more. Important Dates For details regarding all CHP enrollment opportunities, visit ConcordiaPlans.org under Health > Concordia Health Plan > Concordia Health Plan Enrollment. Employer Elections Worker Open Enrollment Elections Become Effective SEPT 8 Deadline to submit your 2015 Option Election Form is September 8. SEPT 14 Annual Open Enrollment for workers and dependents begins September 14 and will end on October 16. JAN 1 Elections become effective January 1, 2016, and apply for the calendar year. Workers can only make changes to their coverage if they experience life events, such as marriage, the birth or adoption of a child, or the loss of health coverage under another plan. CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 15

18 Enrollment Checklist What You Need to Do to Make Your 2016 Elections Have a question or need help completing your Election Form? Call Concordia Plan Services at Compare the available CHP options for your specific group. Consider cost and coverage to find the best fit for your organization and your workers. Not sure which group you are in? See page 3. Decide if you want to offer personal spending accounts through SelectAccount. See pages for examples of how these accounts can help workers save on eligible expenses. Indicate your CHP and personal spending account elections on the enclosed Election Form. CPS will send you a Plan Design Guide for the personal spending account, which must be completed and returned to SelectAccount by September 25. If you already offer a personal spending account and you will continue to offer it, refer to the 2016 Employer Guide to Personal Spending Accounts for renewal information. This guide can be found on ConcordiaPlans.org under Ministry Resources > Forms & Publications. Make sure your Election Form is completed accurately and signed by an authorized representative. Send your Election Form to CPS by September 8 via: Fax to , Scan and to info@concordiaplans.org, or Mail in the envelope provided IMPORTANT! Whether you are offering only one CHP option or more than one CHP option, we strongly encourage all employers to make an active election decision for This means even if you are staying with the same plan option that you had in 2015, you should still complete the Election Form and submit it to Concordia Plan Services by September 8. Help facilitate Open Enrollment with your workers to ensure any requested changes to their coverage are received by the October 16 deadline. 16 CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT)

19 Important Notes About the CHP and Health Care Reform The CHP will continue to be available to LCMS ministries and their full-time employees in 2016 providing a variety of health plan options which offer a wide array of coverage levels. The CHP is a grandfathered health plan under health care reform. As such, we have been able to maintain benefit options that are aligned with our Lutheran faith and beliefs for employers and workers who would otherwise not have these protections. The CHP intends to comply with all health care reform requirements applicable to grandfathered health plans. Coverage for essential health benefits will be included, as will additional benefits, keeping the CHP a comprehensive benefits package designed to care for workers and their families. All options under the CHP meet the minimum value requirement regarding the percentage of costs associated with care that must be reimbursed by the plan. Our team of Employer Resources Consultants also can work with employers to review their funding strategies. CPS or its benefits administrators will provide proof of Minimum Essential Coverage (Form B) as outlined under the Individual Mandate of the Affordable Care Act to all workers enrolled in the CHP and to the IRS. Grandfathered Status The CHP believes it is a grandfathered health plan under the Patient Protection and Affordable Care Act (the Affordable Care Act, or ACA). As permitted by the ACA, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that the CHP may not include certain consumer protections of the ACA that apply to other plans for example, the requirement to provide an internal and external appeal review process. However, grandfathered health plans must comply with certain other consumer protections in the ACA (for example, the elimination of lifetime limits on benefits). Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to CPS at You also may contact the U.S. Department of Health and Human Services at healthcare.gov. CPS is a resource. For information related to health care reform, visit ConcordiaPlans.org and click on Health > Health Care Reform. You also can contact us at CONCORDIA PLAN SERVICES 2016 EMPLOYER GUIDE (NON-EXEMPT) 17

20 Concordia Plan Services The Lutheran Church Missouri Synod 1333 South Kirkwood Road St. Louis MO ConcordiaPlans.org 12090n-0715 (NON-EXEMPT EDITION)