2015 OPEN ENROLLMENT

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Arline Richard
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1 2015 OPEN ENROLLMENT

2 Online Open Enrollment April 13th, 2015 through May 1st, 2015 (No later than 4:30pm) Changes will take effect July 1, 2015 Allowed enrollment changes Change Network (BlueCross or Humana) Make FSA Election Elect/waive medical/dental coverage Add/remove dependents from medical/dental coverage If you are adding a new dependent to your existing coverage, you must complete the online enrollment process with all eligible dependents you want covered, not just the new dependent. In addition, you must provide all requested paperwork for new enrollees. Only the selected plan and coverage tiers and dependents listed on your Open Enrollment online form will be enrolled on July 1, 2015.

Online Open Enrollment Other than during Open Enrollment, you must have a qualifying event to make changes Marriage, divorce, legal separation, annulment, death of spouse, birth, adoption, permanent

3 Online Open Enrollment Other than during Open Enrollment, you must have a qualifying event to make changes Marriage, divorce, legal separation, annulment, death of spouse, birth, adoption, permanent legal guardianship, spouse open enrollment Information regarding Online Enrollment will be distributed via District . For IT/ support, contact the help desk at (815) Select Option 1 M-F 8AM to 5PM

4 We will be using Employee Navigator again for 2015 Open Enrollment this year. You will be able to make the following Changes: Add or drop dependent(s) Add or drop your Dental or Health plan(s) Change health plans Add or elect Voluntary Life and AD&D Please note that Employee Navigator should only be used if you are making the changes to the items listed above. Please refer to your Open Enrollment Guide for benefits and rates. All changes you make in Employee Navigator will be saved and applied to the 7/1/2015 effective date.

1. Go to https://www.employeenavi gator.com/benefits/login.a spx 2. Select Register as a new user I. First & Last Name II.

5 1. Go to gator.com/benefits/login.a spx 2. Select Register as a new user I. First & Last Name II. DOB (include 0s for single digit dates, ex. 05/02/1978) III. IV. Your company identifier is rps205 Last four digits of SSN

6 Plan Designs PPO 500 PPO 1000 HDHP In Out In Out In Out Office Visit $15 50% $15 50% Ded/Coins Ded/Coins Specialist $25 50% $25 50% Ded/Coins Ded/Coins Deductible Single $500 $1,000 $1,000 $2,000 $2,500 $5,000 Family $1,500 $3,000 $2,000 $4,000 $5,000 $10,000 Out of Pocket Max Single $3,500 $7,000 $4,000 $8,000 $3,500 $7,000 Family $7,500 $15,000 $8,000 $16,000 $7,000 $14,000 Coinsurance 80% 50% 80% 50% 80% 50% Rx Co-pays- Retail (30 Day Supply) 15/40/60 NA 15/40/60 NA NA NA Rx Co-pay Mail (90 Day Supply) 30/80/120 NA 30/80/120 Mandatory Mail Order Rx after 3 Fills The Out of Pocket Maximum Includes the Deductible

7 Medical Plan ER Visits PPO 500/PPO 1000 This is the amount you pay for emergency room visits In Network $75 co-pay Out-of-Network $75 co-pay Co-pay is waived if admitted Deductible and co-insurance apply to additional services A True Emergency Will Always Be considered In- Network. Also, Immediate Care is covered at $15 Copay

8 HDHP Medical Plan-ER Visits This is the amount you pay for emergency room visits In Network Deductible and Coinsurance Out-of-Network Deductible and Coinsurance Deductible and co-insurance apply to additional services A True Emergency Will Always Be considered In- Network

9 Network Choice (Non REA Only) Physicians Blue Cross Per Online Directory Network Hospitals OSF Swedish American RMH WILL BE CONISDERED OUT OF NETWORK AS OF 7/1/2014. Same Plan Designs and Options Regardless of which Network You Choose. Physicians Per Online Directory Network Hospitals RMH OSF Humana Swedish American WILL BE OUT OF NETWORK

10 RMH Claim Example- Outpatient Non-REA as of July 1 st 2014 RMH Discounts Humana Blue Cross Average Billed $5,662 Average Billed $5,662 Assume a 45% Discount $2,548 Assume a 32% Discount $1,812 Total Allowed $3,114 Total Allowed $3,850 Deductible $500 Deductible $1000 Amount Subject to OPX $2,614 Amount Subject to OPX $2,850 EE 20% Responsibility $523 EE 50% Responsibility $1,425 ER 80% Responsibility $2,091 ER 50% Responsibility $1,425 What You Owe $1023 What You Owe $2,425 Difference In EE Out of Pocket $1402

11 RMH Inpatient Example Non-REA as of July 1 st 2014 Humana Inpatient Stay Blue Cross Average Billed $17,865 Average Billed $17,865 Assume a 50% Discount $8,933 Assume a 32% Discount $5,717 Total Allowed $8,933 Total Allowed $12,148 Deductible $500 Deductible $1,000 Amount Subject to OPX $8,433 Amount Subject to OPX $11,148 EE 20% Responsibility $1,687 EE 50% Responsibility $5,574 ER 80% Responsibility $6,746 ER 50% Responsibility $5,574 What you Owe $2187 What you Owe $6574 Difference In EE Out of Pocket $4,387

12 Health Savings Accounts (H.S.A) Those who take the HDHP are eligible to open a Health Savings Account. H.S.A. Pre-Tax Rollover Use it or keep it health care $$$ which belong to you Debit Card, Checkbook and access same PPO providers Additional information on the H.S.A is available on Employee Navigator.

13 RPS Annual HSA Funding (Non REA) Pretax amounts below will made available to you day one Those enrolling in the HDHP need to complete an application for an HSA account with Associated Bank w/no fees. RPS will transfer the amounts below into your Associated HSA bank account based on medical enrollment status Pretax payroll deductions are allowed contact HR Interest earned grows tax free Mutual fund options are available at a nominal fee Single Employee Plus Spouse Employee Plus Child(ren) Family Standard $400 $700 $600 $800 Wellness $250 $500 $550 $700 Total (W) $650 $1200 $1150 $1500 Amounts in Purple are additional dollars provided to those who participate in the wellness program

14 RPS Annual HSA Funding (REA) Pretax amounts below are made available to you day one Those enrolling in the HDHP need to complete an application for an HSA account with Associated Bank w/no fees. RPS will transfer the amounts below into your Associated HSA bank account based on medical enrollment status Pretax payroll deductions are allowed contact HR Interest earned grows tax free Mutual fund options are available at a nominal fee Single Employee Plus Spouse Employee Plus Child(ren) Family $500 $1000 $1000 $1500

15 Preventive Care All In Network - 100% covered with no cost sharing (not subject to deductible) Out of network 50% covered (not subject to deductible) Preventative services include: Adults Cholesterol screening, immunizations, mammography, pap smear, colonoscopy, routine annual physical Children Immunizations, routine annual physical Preventive Care is Subject to Federal Guidelines as Laid Out by HHS Including Age and Frequency Limits.

16 Non REA Medical Plans Modifications Made In 2014 Chiropractic Visits 45 Annually PT/OT/ST Visits 45 Annually Prescriptions: Prior Authorization, Step Therapy and Quantity Limits in place. RMH Out of Network with Blue Cross Swedes Out of Network with Humana Coordination of benefits changes for dependents on the plan as secondary.

17 Wellness Program Premiums Non-REA Lower PPO 500 Premiums and Increased H.S.A. Contributions for Participating in the Wellness Program. Earn Incentives by Accumulating Points Biometric Screening (Free to Members) Participate in Wellness Activities Meet Healthy Goals (Health Evaluation had to be completed by )

18 My Rx Choices MANAGING HEALTH Comparison shopping for possible lower-cost maintenance medications Side-by-side drug comparisons showing plan pricing via retail and home delivery pharmacies for brand name and genericequivalent medications, if available Potential savings by drug and/or channel option Drug information Print a kit for doctor review

delivery Express Scripts can contact their doctor for new prescriptions on

19 MANAGING PRESCRIPTIONS My Rx Choices Members can easily switch to lower-cost options When members select a lower-cost generic equivalent and/or home delivery Express Scripts can contact their doctor for new prescriptions on their behalf, or Members can print information from My Rx Choices to discuss with their doctor.

possible lower-cost options could display Access to Consumer Reports Best Buy Drug information Information on plan paid

20 My Rx Choices Educates and provides personalized, actionable information Easy-to-understand definition of terms Explain my savings gives details about why the option could cost them less Clear identification of potential savings More than 25 possible lower-cost options could display Access to Consumer Reports Best Buy Drug information Information on plan paid amount DUR alerts as appropriate Confidential and Proprietary Information 2014 Express Scripts Holding Company. All Rights Reserved. 20

Getting a 90-day supply--in most cases--means fewer trips to the pharmacy and less time spent planning for refills.

21 Convenience and Cost Savings Mail Order PPO-500/PPO-1000 Medications are shipped right to your door at no charge. No more waiting in line at the retail pharmacy. Getting a 90-day supply--in most cases--means fewer trips to the pharmacy and less time spent planning for refills. Medications can be ordered by phone or internet at express-scripts.com any time of the day or night quickly and easily! Spread your prescription payments over three credit or debit card installments so you don t have to pay all at once.

22 New Prescriptions Using the ESI Pharmacy With the PPO-500 and PPO-1000 Ask your doctor to write a 90-day prescription, with refills up to one year as appropriate Option # 1 Ask your doctor to fax the prescription to Express-Scripts > Print and bring a mail order fax form to your doctor > Have your doctor fax the completed form and send to Express-Scripts* > Prescriptions are processed and delivered within 5-8 days (after receipt of your prescription assuming no additional information required) Option # 2 Mail in your prescription > Print a mail order form > Mail prescription to the ESI Pharmacy > Prescription will be delivered within 7-14 days (from the day you mail it to ESI assuming no additional information is required upon receipt) TIP Mail-order forms can be obtained through Express- Scripts.com

23 Prescription Drug Cost Saving Wal-Mart, Kmart & Target Prescriptions Up to 30 day supply $4 (Kmart $5) Up to 90 day supply $10 (Kmart $10 & $15) Express Scripts $10 Prescriptions (PPO 500 and 1000 only) Up to 90 day supply $10 Remember to present your ESI card!

24 Flexible Spending Account You must complete an FSA enrollment through Employee Navigator each period to participate in any of the FSA Plans: Medical/Dental Flexible Spending Account, $2,500 period maximum contribution. Limited Flexible Spending Account is for dental/vision expenses only. Used only for those who enroll in a HDHP with a HSA, $2,500 period maximum contribution. Day Care Flexible Spending Account, $5,000 period maximum contribution. Enrollment is required each plan period for eligibility. No elections roll over between plan periods.

Dental Plan 7-1-2015 Annual Deductible $50 Individual, $150 Family N/A to preventive /diagnostic Services paid at Preventive 100% Basic 80% Major 50% Orthodontia 50% Annual Benefit

25 Dental Plan Annual Deductible $50 Individual, $150 Family N/A to preventive /diagnostic Services paid at Preventive 100% Basic 80% Major 50% Orthodontia 50% Annual Benefit $1,500 Orthodontia Lifetime Limit (children up to age 19) $1,500 Out of network is paid based on usual and customary. Deductible and Annual Benefit Limit will reset as of July 1, 2015

Points to Remember Open Enrollment needs to be completed through Employee Navigator by May 1st, 2015 at 4:30pm Now is the only time to make changes for fiscal year July 1, 2015 through June 30, 2016

26 Points to Remember Open Enrollment needs to be completed through Employee Navigator by May 1st, 2015 at 4:30pm Now is the only time to make changes for fiscal year July 1, 2015 through June 30, 2016 without a qualifying event You have 30 days after a qualifying event to make allowed changes to your benefits Spousal Coverage Rule All medical and dental changes will be effective July 1, 2015 There is only one Open Enrollment period for Medical and Dental, this will be your only opportunity to make benefit elections for July 1, 2015 through June 30, 2016!

27 What Comes Next Making Changes to Medical, Dental, and Voluntary Life Insurance Including FSA: Complete Online Open Enrollment Through Employee Navigator by May 1st, :30pm No exceptions. Not Making Changes to Medical, Dental, Voluntary Life Insurance and Not Participating in the FSA No action is required.

28 Questions? Thank you for your time!

Mandatory Online Open Enrollment November 9-23, 2015

Mandatory Online Open Enrollment November 9-23, 2015 MVPOE16 All enrollees eligible for coverage must enroll. If you want to keep your current coverage, you must enroll online. If you waive your insurance