2013 Benefit Open Enrollment

Benefit Overview

Medical• Anthem continues as our carrier for 7/1/13• Choice of Traditional PPO and HDHP• No plan design changes or contribution increases

Dental• Delta Dental continues as our carrier for 7/1/13• No plan design changes

Vision• Anthem will replace Cigna as our vision carrier

effective 7/1/13• Similar plan design and slight decrease in premiums

Medical

• Still two medical plan options from which to choose:o Traditional PPO – No plan design changeso High Deductible Health Plan – No plan

design changes

• Find a network provider at www.anthem.com - choose Blue Access PPO

Blue Access PPOMedical Plan In-Network Out-of-NetworkAnthem Network (www.anthem.com)Deductible – Individual $ 1,000 $ 2,000Deductible – Family $ 3,000 $ 4,000Coinsurance 80% / 20% 60% / 40%

Out-of-Pocket Maximum – Individual (includes deductible) $ 3000 $ 6000

Out-of-Pocket Maximum – Family (includes deductible) $ 6000 $ 12,000

Primary Care Visit Copay $ 25 40% after deductibleSpecialty Care Visit Copay $ 50 40% after deductibleUrgent Care Center Copay $100 Copay 40% after deductiblePreventive Care 100% coverage 40% after deductibleEmergency Room $200 CopayHospital Services 20% after deductible 40% after deductibleOut-Patient Services 20% after deductible 40% after deductibleMaternity Services 20% after deductible 40% after deductibleMental & Nervous Care Inpatient 20% after deductible 40% after deductible Outpatient 20% after deductible 40% after deductibleLifetime Maximum UnlimitedPrescription Drugs RETAIL

Generic $10 40% after deductible Preferred Brand (Tier 2) 30%; $40 max 40% after deductible Non-Preferred Brand (Tier 3) 55%; $55 max 40% after deductible

MAIL ORDER Generic $20 Not covered

Preferred Brand (Tier 2) 30%; $80 max Not covered

Non-Preferred (Tier 3) $55; $110 max Not covered

Blue Access HDHP/HSA

Medical Plan In-Network Out-of-NetworkAnthem Network (www.anthem.com)Deductible – Individual $2,000 $4,000Deductible – Family (family coverage requires the full family deductible be met before coinsurance applies) $4,000 $8000

Coinsurance 80% / 20% 60% / 40%Out-of-Pocket Maximum – Individual (includes deductible) $4,000 $8,000Out-of-Pocket Maximum – Family (includes deductible) $8,000 $16,000Primary Care Visit Copay 20% after deductible 40% after deductibleSpecialty Care Visit Copay 20% after deductible 40% after deductibleUrgent Care Center Copay 20% after deductiblePreventive Care 100% Coverage 40% after deductibleEmergency Room 20% after deductibleHospital Services 20% after deductible 40% after deductibleOut-Patient Services 20% after deductible 40% after deductibleMaternity Services 20% after deductible 40% after deductibleMental & Nervous Care Inpatient 20% after deductible 40% after deductible Outpatient 20% after deductible 40% after deductibleLifetime Maximum UnlimitedPrescription Drugs RETAIL

Generic 0% after deductible 40% after deductible Preferred (Tier 2) 40% after deductible 40% after deductible Non-Preferred (Tier 3) 50% after deductible 40% after deductible

MAIL ORDER Generic 0% after deductible Not covered Preferred (Tier 2) 40% after deductible Not covered Non-Preferred (Tier 3) 50% after deductible Not covered

Anthem Plan Highlights

• ALL mammograms paid at 100%

• Eligible smoking cessation medications (ex. Chantix or Wellbutrin) covered under the Anthem Rx plan

• Access to a Worldwide network. Search for providers at www.bluecares.com

Anthem Website

A demonstration of the Anthem website.

www.anthem.com

What is an HSA

Tax-advantaged checking account

Allows you to save for future medical expenses or pay current ones

HSA Eligibility

An HSA can be established by an individual who:

• Is covered under a high deductible health plan (HDHP)

• Is not covered by any other health plan that is not an HDHP

• Is not enrolled for benefits under any part of Medicare

• Is not claimed as a dependent on another person’s tax return

HSA Features

• Tax Advantages Tax free way to save for current and future

medical expenses. Contributions are pre-tax or tax-deductible up to

annual HSA limits. All earnings and interest are tax free. Qualified withdrawals are tax free. Once reach

age 65, non-medical withdrawals are taxed at your current tax rate, like an IRA.

• HSA is fully Portable.Ability to Accumulate funds – “Use it or Keep it!”.

• HSA funds can be used for items not covered by health plan such as; dental, vision etc. Same as an FSA plan.

HSA Contributions Options

The HSA can be funded

• In one or more payments

• Payroll deduction will be available for all DePauw University employees

Elections can be stopped, started, changed on a monthly basis

• Contributions can be made by the employee, employer, or any other person on the employee’s behalf.

• Prior to the individual’s federal tax filing date (generally April 15)

HSA Contribution Maximums

IRS Maximum 2013 contributions

• Self - $3,250

• Family - $6,450

• Catch up contribution - $1,000 for those 55 and older

Note: Maximums include contributions made by DePauw

HSA University Contributions

DePauw University’s Annual HSA Contribution

Employee $1,000Employee + Dependent(s) $2,000

Note: Employee’s will receive one-fourth of the

University’s contribution each quarter.

HSA Distributions

Pre-65 HSA owner:• Qualified Distributions will be tax free. Non-

Qualified Distributions will require individual to pay their personal tax rate on purchase and a 20% penalty.

Post-65 HSA owner:• Qualified Distributions will be tax free. Non-

Qualified Distributions will require individual to pay their personal tax rate on purchase (No IRS Penalty)

Dental

• Carrier: Delta Dental

• Passive PPO plan:o Three levels of providers

• Find a network provider at www.deltadentalin.com

Dental Plan Design

Dental Benefits Services Deductible Coinsurance

Benefit Maximum

Class I Exams, cleanings, x-rays, sealants, emergency treatment

$50 individual/ $100 family, per calendar

year

100%

$1,250 maximum

per plan year

Class II Minor Restorative – fillings, root canals, extractions, gum disease

80%

Class II TMJ ($750 lifetime maximum per person) 80%

Class III Major Restorative – crowns, bridges, dentures, implants 50%

Class IV Orthodontics – braces (To Age 19) 50%

$1,000 lifetime

maximum

Delta Dental Premier• negotiated fees• no balance billing• acceptance of processing policies• 186,000 dentist locations

Nonparticipating• no discounts• balance billing

Delta Dental NetworkDelta Dental PPO• significant discounts• no balance billing• acceptance of processing policies• 108,000 dentist locations

Delta Dental Network

PPO Dentist Premier Dentist Nonparticipating Dentist

Class II payment example for: Filling - Amalgam Restoration/One Surface (assuming any applicable deductible has been met)

Submitted Fee: $120.00

PPO Fee Schedule amount: $68.00

Delta Dental pays 80% of thePPO Fee Schedule amount: $54.40Member pays: $13.60

The PPO dentist cannot charge the $52 difference between the PPO Fee Schedule amount and his/ her fee.

Submitted Fee: $120.00

Maximum Approved Fee: $111.00

Delta Dental pays 80% of the Maximum Approved Fee: $88.80Member pays: $22.20

The Premier dentist cannot charge the $9 difference between the Maximum Approved Fee and his/her fee.

Submitted Fee: $120.00

Nonparticipating Dentist Fee: $92.00

Delta Dental pays 80% of the Nonparticipating Dentist Fee: $73.60Member pays: $46.40

Because the dentist does not participate, you are responsible for the difference between Delta Dental’s payment and his/her fee.

Delta Dental Payment Example

Delta Dental Monthly Premium Contributions

Enrollment Tier  Employee Contribution

Employee Only $10.92

Employee + Spouse/SSPD $21.63

Employee + Child(ren) $29.93

Family $42.86

Dental Rates

Vision

• NEW Carrier: Anthem

• Find a network provider at www.anthem.com

Vision Plan Design

Service FrequencyIn-Network Benefit Out-of-Network

BenefitEye Exam 12 Months $10 Copay Up to $42 Allowance

Lenses 24 MonthsCovered in full after

$10 Copay $42-$80 Allowance

Frames 24 Months $130 Allowance $45 Allowance

Contact Lenses (in lieu of lenses and frames)

24 Months If elective$130 Allowance

If elective$105 Allowance

If necessaryCovered in Full

If Necessary$210 Allowance

To receive greater benefits, utilize a network provider: www.anthem.com.

Anthem Vision Monthly Premium Contributions

Enrollment Tier  Employee Contribution

Employee Only $4.49

Employee + Spouse/SSPD $7.87

Employee + Child(ren) $8.54

Family $13.04

Vision Rates

• With an FSA plan, you elect to have a certain dollar amount withheld from your paycheck so you can pay for health care and dependent care expenses with pre-tax money.

• Eligible expenses include your unreimbursed medical expenses, including deductibles, co-pays, co-insurance, and childcare expenses!

• “Use it or Lose it Rule” – If you do not use all of your FSA funds they will be forfeited at the end of the plan year.

• If you elect the HDHP then you can enroll in FSA for Dependent Care Only.

Reminder: Over-the-counter medications no longer eligible for reimbursement without a prescription.

2013-2014 FSA Annual Plan Limits:Health Care: $2,500

Dependent Care: $5,000

What is a Flexible Spending Account (FSA)

• Your FSA debit card can be used at providers offices, hospitals, pharmacies, etc.

• If you receive a bill at home, you can write your debit card number on the bill to make payment like any other credit/debit card.

• If your childcare provider accepts Visa, you can use your debit card for childcare expenses as well

• You can also file claims online, using a smartphone app, or via mail

Important Note: You still need to keep receipts and AdminPro will request them under certain circumstances

FSA Debit Card

Remember:

• All benefit-eligible employees must elect or waive coverage and assign beneficiaries to life insurance plans no later than May 15, 2013.

• Enrollment will be completed in the ADP portal at https://portal.adp.com.

Employee Action