Benefits Bulletin Keeping you informed about your benefits

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1 Benefits Bulletin Keeping you informed about your benefits October 2017 Open Enrollment for 2018 Benefits Enrollment Period is November 1 15, 2017 You Must Re-enroll by November 15 This year during annual Open Enrollment you have the opportunity to enroll in, or change your current benefits and add or remove dependents between November 1 and 15, You must enroll before the deadline to continue your elective benefits after December 31, All changes take effect on January 1, This Benefits Bulletin summarizes what s new, what s changing and what to do during the Open Enrollment period. This notice describes your options and changes affecting your benefits beginning January 1, What to Know and What s Changing Healthy Results Incentives Enrollment Requirement Beginning next year, the incentive for completing Healthy Results wellness program activities will change. If you complete the required activities, you will earn cash rewards added to your Health Savings Account. See page 7 for details. All employees need to enroll this year for 2018 benefits. Even if you are keeping your current elections, you still need to access the enrollment system and re-enroll. It s recommended that you use this opportunity to review your benefit options and see if you need to realign your benefit elections to your current needs. Take Advantage of These Resources Rx Help Center: Helps you afford qualifying high-cost brand-name and specialty drugs. See page 5. My IU Health: If you enroll in a medical plan and register with this service, you will be able to manage your personal health information online. HMO Ends December 31, 2017 You must enroll in either of the remaining medical plans for coverage beginning January 1, Medical Plan Deductible for HDHP Low Beginning January 1, 2018, the annual deductible in the HDHP Low will increase to comply with the IRS minimum deductible regulation for HDHP-type medical plans. See page 4. Use BenefitSolver Enrollment System Log on to benefitsolver.com to enroll and: Check your current benefit elections before you enroll Add dependents and benefits After Open Enrollment, use the system to make benefit changes, change beneficiaries, and more. Delta Dental Replaces Guardian Delta Dental offers a larger network of dentists and lower contribution rates. See page 2 for enrollment instructions. Using Your IU Health ID Card If you have an IU Health ID card, IU Health is your network provider. If you have an Encore logo on the back of that card, you would use that network for out-of-state coverage, if you are traveling, or if you are a retiree or student living out of state, for example. Encore network expenses are paid based on the medical plan s out-of-network coverage. 1

2 How to Enroll Follow these steps. Log on and Register at Begin here Review your benefit choices before you re-enroll Make your elections Review your dependents to add or remove Review your elections and click Approve to continue 2

3 How the HDHPs Work The HDHPs have two parts. A high-deductible health plan that covers your medical care and an optional Health Savings Account that helps you pay for your medical care. The High Deductible Health Plan You pay the full cost of your health care and prescription drugs until the annual deductible is met. For example, if you visit the doctor for something other than for preventive care, which is covered at 10 when using network providers, you pay the cost of the visit not a copay. If you have a prescription filled you pay the cost of the prescription drug not a copay. High Deductible Health Plan + = Health Savings Account HDHPs Once the annual deductible is met, the plan pays 10 of eligible in-network expenses for the rest of the year. This does not preclude an out-of-network provider from billing you in excess of the out-of-pocket maximum. What Is an Embedded Deductible? If you enroll in family coverage, each family member has his or her own deductible. This means that when the family member s out-of-pocket expenses reach the deductible, the plan pays 10 of his or her eligible expenses for the rest of the year. For example, Marie enrolled her family in HDHP 1. Her son Noah s eligible medical expenses met the individual deductible of $2,700 and the plan began paying 10 of her subsequent eligible in-network expenses for the rest of the year. Chloe did not have to wait for the family s $5,400 deductible to be met. This design makes the HDHPs more affordable. Advantages of a Health Savings Account Health Savings Accounts are designed for you to contribute to, invest your funds (in BMO Bank investment funds) and save for the future, much like a 403(b) savings plan. Your contributions are deducted before payroll taxes and added to your HSA (bank account) each pay period (up to $3,450 for single coverage and $6,900 for family coverage for 2018). You may change your contribution at any time during the year. If you re between the ages of 55 and 65, you can add up to an additional $1,000 in catch-up contributions. HSA contributions are tax-free, you can deduct any investment gains added to your HSA, and any payments made for qualifying expenses are tax-free. You can pay qualified medical expenses from your HSA both before and after the deductible is met. If you pay non-qualifying expenses, you will be subject to income tax and an additional 2 tax penalty (if you are under age 65). To Set up an HSA Contact Shandy Brickler at shandy.brickler@wayne.k12.in.us to set up an HSA for pre-tax payroll deductions with BMO Harris Bank. At the end of the calendar year, any balance in your HSA carries over to the next year, enabling you to build up a sizable account to pay future medical expenses. The money in your HSA is yours to keep if you change medical plan options or your employment ends. Your HSA remains tax-free as long as you use it to pay qualifying medical expenses. 3

4 Features Annual Deductible Individual Family Medical Plan Options All medical plan options include Prescription Drug Benefits Go to iuhealthplans.org for more information and to see if your doctor is in-network. What You Pay HDHP Low HDHP High In-network Out-of-network In-network Out-of-network $2,700 $5,400 $5,000 $10,000 $5,000 $10,000 $10,000 $20,000 Coinsurance 3 3 Annual Out-of-Pocket Maximum Individual Family Preventive Care* Doctor s Office Visit Primary Care Physician Specialist Urgent Care Emergency Room Inpatient Facility Outpatient Facility $2,700 $5,400 covered in full $7,500 $15, $5,000 $10,000 covered in full $15,000 $30, Wellness Center Yes Yes Yes Yes In-network only Generic Formulary Brand Non-Formulary Brand Specialty Retail (30-day supply) Prescription Drugs Mail Order (90-day supply) Not available Not available Retail (30-day supply) *For a list of preventive services, go to k12.in.us/hr/staff_benefits.asp Mail Order (90-day supply) Not available Not available Cancer Insurance Included with Medical Plans If you enroll in an HDHP, you automatically receive a $5,000 cancer benefit plan at no additional cost to you. Your coverage is the same as the coverage you enroll in for the medical plan (Employee Only, Employee plus Spouse, Employee plus Children or Family). It pays cash if you or a covered family member are diagnosed with a qualifying cancer. You can use the cash to pay any expenses, including those that count toward your HDHP s deductible. Upgrade for More Coverage You can upgrade to a complete package of supplemental insurance for more protection, as noted in the table on the next page. With this upgrade, you would have additional cancer coverage if you enroll in an HDHP. 4

5 Humana Supplemental Policies Features and Benefits Hospital Indemnity Accident $500 first admission per year $100/day standard room up to 15 days $200/day if confined to an intensive care, cardiac care, or burn unit for up to 15 days $400 per accident for emergency treatment in an emergency room or urgent care facility following a covered accident $5,000 lump sum benefit is included with the HDHP. Additional coverage pays benefits if you are diagnosed with any of the following critical illnesses: Critical Illness Well-being benefit Well-Being Benefits pay cash to use in making a positive lifestyle change Heart attack Stroke End-stage renal failure Coma Permanent paralysis Severe burns (third degree) You and your covered spouse each receive $100/year (after completing a physical exam). Loss of speech, hearing or eyesight Occupational HIV Amyotrophic lateral sclerosis (ALS/Lou Gehrig s disease) Multiple sclerosis Major organ transplants $100 for completing one of 21 wellness screenings (see the separate Humana summary on page 6) $50 if you are diagnosed with one of the following health conditions: obesity, high blood pressure, high cholesterol level, diabetes, cancer, heart disease $100 for finishing one of the following Lifestyle Rewards Program or stick with it for 90 days: weight loss, nutrition, smoking cessation, health coaching Frequently Asked Questions Will I need to complete a medical questionnaire for evidence of insurability? No. Do any pre-existing conditions restrict enrollment? Only applies to new enrollees for the Cancer Policy. Only new cancer diagnoses are eligible. Is there a waiting period for pregnancy? Yes, 180 days for new enrollees. Bi-weekly Rates for the Humana Supplemental Policy Coverage Level If You Enroll in an HDHP If You Do Not Enroll in an HDHP Employee Only $9.10 $11.82 Employee + Spouse $20.01 $24.63 Employee + Children $14.81 $17.89 Family $24.75 $

6 Well-Being Benefits Pay Cash for Positive Lifestyle Changes A wellness benefit is automatically included and will pay you up to $250 for completing the listed activities with your doctor. See below for a list of wellness activities. Earn $100 for completing Pap smear Mammography (including ultrasound) PSA (prostate cancer) Colonoscopy Chest x-ray Stress test (bike or treadmill Bone marrow testing Biopsy for skin cancer Serum Protein Electrophoresis Oral cancer screening using VisiLite, Ora Test or dental code D blood pressure readings in 14 days with healthcare practitioner attestation Flexible Sigmoidoscopy Fasting Lipoprotein Diabetes blood glucose test CA 15-3 (breast cancer) CEA (colon cancer) CA-125 (ovarian cancer) Water displacement test Skin Caliper Blood test for Triglycerides Electrocardiogram (EKG) Earn $50 if you are, or have been, one of the 45% of Americans diagnosed with one of the following conditions: Obesity High blood pressure High cholesterol Diabetes Cancer Heart disease And you sign up for one of four lifestyle reward programs: Weight loss Smoking cessation Nutrition Health coaching Earn $100 When you finish the lifestyle reward program or stick with it for 90 days. Note: This document summarizes changes to the Metropolitan School District of Wayne Township (MSD Wayne Township) benefit plans effective January 1, 2018 for eligible employees and dependents. It highlights some, but not all, of the MSD Wayne Township) benefit plan features. More details can be found in the plan documents, certificates of insurance and summary plan descriptions available from Human Resources. In the event of a conflict between the descriptions in this document and any other descriptions of the benefit plans, the formal plan documents and insurance contracts will control. MSD Wayne Township reserves the right to amend, modify, revoke or terminate these plans in whole or in part at any time. Receipt of this document does not guarantee benefits eligibility or employment with MSD Wayne Township. This document also functions as a summary of material modifications to supplement the summary plan descriptions for the MSD Wayne Township benefit plans, effective January 1,

7 Wellness Program Healthy Results MSD Wayne Township s employee wellness program Your well-being is important to you, your family and to MSD Wayne Township. The goal of Healthy Results is to help you stay healthy by providing you with resources, tools and the incentives that will encourage you to use them. The Healthy Results program is available to you if you are enrolled in a MSD Wayne Township medical plan and to your spouse if covered in the medical plan. How Healthy Results Works An annual health exam is at the core of Healthy Results. At the exam, a clinician will conduct a biometric screening to collect your health data and that you can monitor every year for changes in your risks for a serious health issue. In fact, tracking your biometric data every year may help you detect if you have a health condition early enough to give you a chance for successful preventive measures or treatment. If you have a chronic health condition, annual biometric screenings can help you in managing it. For 2017, biometric screenings will be offered to collect health data. For 2018, an annual physical exam with your doctor will be required to collect health data. Your health plan covers an annual physical at 10. Biometric Standards Biometric screening goals are determined by guidelines set forth by medical governing bodies such as the CDC, American Heart Association and NIDDK. How to Earn Incentives All employees and their covered spouses on the medical plan are eligible to earn incentives. By simply participating in our annual biometric screenings, you and your covered spouse earn contributions that will be added to your Health Savings Account (HSA). This year, up to $500 each for you and your spouse can be added to your HSA. This is money you can use to help cover qualifying medical expenses or to save and accumulate for future expenses. By meeting additional healthy metrics and standards, you and your covered spouse can earn more HSA dollars. You will earn additional contributions to your HSA if your biometric screening results meet these Healthy Standards. If your: Body Mass Index (BMI) is less than 25 or your waist circumference is less than 40 for men or less than 35 for women Blood Pressure less than or equal to 120/80 Hgb A1c less than or equal to 5.7 (test for diabetes) Triglycerides less than or equal to 150 $150 $50 each (total $200) Meeting all four biometrics Employee and spouse each complete Health Assessment questionnaires $50 Employee and spouse each complete one health webinar (nutrition or stress management via Safe Schools Programs) Total HSA Dollars Available $50 $50 $500 each employee and spouse Rewards for participating in a wellness program are available to all employees and spouses on the medical plan. If you believe that you and your spouse will be unable to meet a standard for earning an incentive, you can qualify to earn the same rewards by performing a reasonable alternative standard. 7

8 Rx Help Center Concierge Prescription Drug Advocacy Service This service is at no cost to you for you and your covered family members as long as you are participating in a Wayne Township medical plan. You have the option to use the service for your extended family as well, including your in-laws, for $50 a month. If you or your family members medications qualify, you can save significantly on your cost. If you are enrolled in a medical plan and are prescribed expensive medications and/or those drugs classified as specialty, the RX Help Center (RXHC), a prescription drug advocacy service, may be a solution for helping them be affordable. In some cases, the Rx Help Center can even help those whose prescription drugs are not overly expensive. Cost savings may be available if you are spending more than $75 for a single prescription or $100 or more per month for all of your prescriptions. You are not required to use this service. RXHC does not guarantee it can reduce your prescription costs. An initial study will find out. If savings are available, RXHC can significantly lower your prescription drug costs. The concierge service is not an overnight solution as it may take from 14 to 30 days Want to know more about the Rx Help Center? to implement. It s a resource that can help you save money on prescription drugs, especially helpful as you pay out-of-pocket for your To see if you qualify and to register, visit the MSD medications before the deductible is met in our health plans. Wayne IU Wellness Center for personal assistance. You can visit the website at: rxc msdwts.rxhelpcenters.com/ 8

9 My IU Health My IU Health is available to patients who have been treated at an Indiana University Health facility in Indianapolis, and these Indiana regions: West Central East Central South Central This free service allows you to manage your health care through the IU health facilities faster and conveniently from your computer, tablet or mobile device. Go to MyIUHealth.org and click on Create Account (see screenshot). Then, you can schedule appointments, securely message with your doctor, view your lab results and much more. Watch the intro video for more information. Have a question about My IU Health? Get an instant answer with our Help Guide. Wayne Wellness Center Note that the Wayne Wellness Center is not an urgent care facility. You can generally make same -day appointments. However, you should schedule an appointment as early as possible. For Information and Hours Visit wayne.k12.in.us/district/wellness/default.asp. 9

10 Dental Benefits For 2018, the Dental Plan will have a new network and administrator. Delta Dental will replace Guardian with a larger network and lower contribution rates. You can choose one of the two Delta Dental plans or waive coverage. If you enroll, you can choose to use any qualifying dentist and the plan shares your expenses with you, as shown in the following table. Stay In-Network to Maximize Savings Both plans give you a choice in dentists. The PPO Network or the Premier Network. Whether or not the charges are from in-network dentists, the plan covers your expenses at virtually the same percentage. So, what s the difference? The PPO Network has fewer dentists, but they charge the least The Premier Network has more dentists, but they may charge more for some services Dentists who do not belong to either network typically charge the most For example, let s say you enroll in the Enhanced Plan and you go to a dentist for a crown and both the PPO and Premier network dentists charge Plan Features Annual Deductible Applies to Basic and Major Services, not to Preventive Care and Orthodontic Services Maximum Payment Maximum the plan pays per plan year Diagnostic / Preventive Services Two routine exams every 12 months, includes x-rays, sealants and cleanings Basic Services Fillings and crown, bridge and implant repairs, root canals, periodontics to treat gum disease, extractions and surgery Major Services Crowns, bridges, implants and dentures Orthodontic Services What s the difference between the plans? Dental Benefits and Network Coverage 10 $1,018. Although Delta Dental covers 5 of the charges from either dentist, they limit the dollar amount based on separate contracts for the network dentists. This means they would cover different dollar amounts: $725 of the PPO dentist s charges and $979 of the Premier dentist s charges. So, you would pay $ of the PPO dentist s charges and $ of the Premier dentist s charges. Using the PPO dentist, in this example, would save you $127 in out-of-pocket charges. If you were to use an out-of-network dentist in this example, you would pay $ out-of-pocket. The same would apply if you enrolled in the Basic Plan, except that the difference in your out-of-pocket costs between the two networks would produce a savings of $254 by using PPO network dentists or $293 savings compared to out-of-network dentists. Know What It Costs First If you or a covered dependent needs extensive dental treatment, ask your doctor to obtain a predetermination of benefits so you will know in advance what the treatment will cost. See the Delta Dental summary for coverage details Enhanced Plan Basic Plan PPO Network, Premier Network or Out-of-Network $50 per person $150 per family $1,000 per person (excludes orthodontic services) You pay no deductible You pay 2 You pay 5 You pay 5 and Plan pays 5 up to $1,000 Lifetime Maximum per adult or child Basic Services covered at 8 PPO Dentists $50 per person $150 per family $1,000 per person (excludes orthodontic services) You pay no deductible You pay 2 You pay 5 You pays 5 and Plan pays 5 up to $1,000 Lifetime Maximum per adult or child Premier or Out-of- Network Dentists $50 per person $150 per family $1,000 per person (excludes orthodontic services) You pay no deductible You pay 5 You pay 5 You pay 5 and Plan pays 5 up to $1,000 Lifetime Maximum per adult or child Basic Services covered at 5 for out-of-network expenses

11 Avoid Balance Billing If you use a dentist who does not participate in either network, you pay 10 of the charge that exceeds Delta Dental s approved amount. This additional charge is referred to as balance billing. Carry over Unused Claims Dollars Delta Dental will carryover a portion of your unused $1,000 maximum payment to the next year if your claims are $500 or less during the year. Up to $250 of the remaining balance will carryover to your next year s Maximum Payment and can accumulate from one year to the next. This gives you access to additional coverage for your dental work. What if you have a carryover balance from the Guardian plan? Your carryover balance will be added to your Maximum Payment under the Delta Dental Plan in accordance with the terms of the Guardian Plan. Additional Dental Benefits for Special Circumstances The Delta Dental Plan will cover 10 of prophylaxis services and 8 of periodontal maintenance cleaning for: Diabetics with periodontal disease Pregnant women with periodontal disease Participants with renal failure or undergoing dialysis, with suppressed immune systems, undergoing head and neck radiation or individuals at risk for infective endocarditis Vision Benefits You have two choices for vision benefits: Option 1: Full Feature through VSP Choice Network Option 2: Full Feature-Designer through Davis Vision Your eye care benefits are available through the vision care professionals of your choice. However, using Vision Benefits What You Pay Option 1: Full Feature VSP 11 Option 2: Full Feature-Designer Davis Covered Services In-network Out-of-network In-network Out-of-network Network VSP Choice Network Davis Vision Exams $0 after $10 copay Amount over $39 $0 after $10 copay Amount over $50 Lenses $0 after copay for single, lined bifocal, lined trifocal Lenticular $25 copay covers frames and lenses Frames 8 of amount over $130 $25 copay covers frames and lenses Amount over: $23 single $37 lined bifocal $49 lined trifocal $64 lenticular Contact Lenses: $25 copay (waived for non-formulary elective contact lenses) $0 after copay for single, lined bifocal, lined trifocal Lenticular $25 copay covers frames and lenses Amount over $100 8 of amount over $120 $25 copay covers frames and lenses Amount over: $48 single $67lined bifocal $86 lined trifocal $126 lenticular Amount over $48 Elective Amount over $130 Amount over $100 Not available Not available Elective and conventional Not available Not available 85% of amount over $120 Amount over $105 Planned replacement and conventional Not available Not available 85% of amount over $120 Amount over $105 Medically necessary $0 Amount over $210 $0 Amount over $210 What s the difference between the plans? Network has over 50,000 locations and is the nation s largest. network providers will cost you less, as shown in the Vision Benefits table below. The plans have separate networks, so be sure to use the network in the table to find network vision care providers when you go to Click on Find a Provider. Use Group number Network has retail centers such as Walmart, JC Penney, Sears, Target, Sam s Club, Pearle and Visionworks

12 Flexible Spending Accounts You can open a tax-free Health Care Flexible Spending Account (FSA), a Dependent Care FSA or both and save money on certain health care and dependent daycare expenses. You never pay taxes on tax-free money added to an FSA if you use it to pay eligible expenses. Healthcare FSAs Limited Purpose Health Care FSA: If you enroll in either HDHP, you cannot have a full Health Care FSA if you also have a Health Savings Account. However, you may enroll in a Limited Purpose Health Care FSA and pay eligible dental and vision care expenses not covered by another health plan. You cannot use it to pay medical or prescription drug expenses since your Health Savings Account can pay these expenses. This makes this FSA an ideal financial supplement to an HDHP. General Purpose Healthcare FSA: If you do not enroll in an HDHP or you enroll and do not elect a Health Savings Account, you can enroll in a General Purpose Health Care FSA. You can use this FSA to pay eligible expenses not covered or reimbursed by the medical, dental, and vision plans (such as expenses to pay the deductible or coinsurance) as well as prescribed drugs. To open either Health Care FSA, choose how much you want to contribute and the amount will be deducted before payroll taxes are withheld. You can contribute up to $2,600 for the year. What s the Difference between an HSA and an FSA? A Health Care Flexible Spending Account (FSA) is a spending account. You must spend the money in an FSA before a specific deadline and any balance left after the deadline is forfeited. A Health Savings Account (HSA) is a savings account. You have the option to spend or save the money and any balance in the account at the end of the year carries over to the next year for new funding. Dependent Care FSA To be eligible for a Dependent Care FSA, you and your spouse must both work, be actively looking for work, or be a full-time student. You can pay eligible childcare or elder care expenses with tax-free dollars from your FSA. For childcare expenses, your dependent must live with you and be under age 13 (or older if you prove your dependent is physically or mentally disabled). To open a Dependent Care FSA, choose how much you want to contribute and the amount will be deducted before payroll taxes are withheld. You can contribute up to $5,000 if you are married and you file a joint tax returns or $2,500 if you are married and file separate returns. Carry over Your Health Care FSA Balance to Next Year If you have money in your Healthcare FSA at the end of the year, you can carry over up to $500 to the next year and use it to pay eligible expenses. Eligible Expenses For a List of Eligible Expenses you can pay from a flexible spending account: Health care: irs.gov/pub/irs-pdf/p502.pdf Dependent care: irs.gov/publications/p503/ar02.html IRS Rules that Apply to FSAs You must enroll every year if you want to continue participating from one year to the next. You can begin using the full annual amount you contribute to a Health Care FSA beginning January 1, even though the full amount is not in your account. For the Dependent Care FSA, you can only be reimbursed up to the balance in the account. You cannot use a Dependent Care FSA and take a tax credit on your 1040 federal return for the same expenses. You cannot use a Health Care FSA to pay for dependent care expenses and vice versa. You will pay taxes and a penalty if you use your FSA to pay ineligible expenses. 12