2018 Dallas County

Employee Benefits Meeting

Employees making a difference. Everyday.

Presentation Goals:

• What’s New for 2018

• Review PPO Plan

• Review High Deductible Health Plan w/ HSA (Lower Premium Cost)

• Review 2018 Rates (Medical, Dental, Vision)

• Side-by-Side Comparison PPO vs HDP w/ HSA

• Wellness Program Rewards

What’s New for 2018: Choice of Medical Plans

90 Day Retail fills at select EAN pharmacies (Maintenance meds only, copays match home delivery copays)

Cholesterol Care Program (PCSK9 inhibitor available only through Accredo), prior authorization with clinical documentation

Specialty Pharmacy removed retail courtesy fills except for a “stat” specialty drug, Specialty drugs must be filled through the specialty pharmacy

Confirm non-EAN pharmacy $10 upcharge (penalty) does not count toward deductible or out-of-pocket cost

Implemented Out-of-Pocket Protection Program applies to specialty dugs (Accredo) lower cost applies to members deductible and OOP

Virtual Visits $0 copay (Currently $25) PPO members only

Health Savings Account Limits increased maximum annual contributions single $3,450 (from $3,400), family $6,900 (from $6,750)

Cover Fecal DNA testing for colon cancer (CPT81528) as preventive(no cost share)

Cover 3-D Mammography (CPT 77063) as preventive (no cost share)

Adopted ACA recommendation for low/moderate dose statin drugs to be available at zero cost share for members who meet certain criteria and do not have a history of cardiovascular disease.

• The plan will still be administered through United HealthCare (UHC)

• If your hire date is January 1, 2015, or later, you can NOW enroll in PPO Plan

• ADDING A NEWLY DEPENDENT FOR 2018 BE SURE TO TURN IN YOUR VALID DOCUMENTATION BY NOVEMBER 17, 2017 OR THE DEPENDENT(S) WILL BE REMOVED

NOTE: Coverage obtained through the Health Care Marketplace (Exchange) is not eligible for employer opt-out contributions.

2018 Freedom of Choice......

Terms You Need to Know

Co-payment — Fee you are responsible for paying for health care services, such as office visits, emergency room care, and prescriptions. This is sometimes referred to as “copay.” PPO Plan Only

Deductible — Amount you must pay out of pocket before your health insurance plan begins to pay for health care costs.

Co-insurance — The percentage of the total cost you pay for services — such as office visits, emergency room care and lab work — after you’ve paid your deductible.

Out-of-Pocket (OOP) Maximum -— This amount is the most you have to pay each year for covered services. The plan will then pay 100% of all remaining covered expenses for the rest of the plan year. Your deductible, coinsurance, and ALL co-payments apply to your Out-Of-Pocket maximum for In-Network services.

Processing Order = Co-payment, deductible, coinsurance,=OOP.

What Medical Plans Will Dallas County Offer?

Preferred Provider Organization (PPO) –

Plan Features:

Can select any physician within the network.

Must pay a copay until max OOP is met.

Must pay a deductible (upfront cost) for medical treatment until deductible is met.

Can Use OON physicians can increase cost.

No primary care physician (PCP) or Referral Required.

Preventive Care Paid at 100%.

Higher Monthly Premium than HDP w/ HSA.

2018

PPO -- Plan Year 2018

2018 PPO In Network (No Changes from 2017) Copay – Rx Drugs (generic/preferred/non-preferred) $15/$30/$60

Copay -PCP -Tier 1 Specialist/Specialist and Urgent Care $25/$35

Additional charge for Non EAN Pharmacy $10

Copay – Medical and Rx Counts towards Max OOP

Deductible $500/$1000

Coinsurance 80%/20%

Out-of-Pocket (OOP) Max $3,000/$6,000

Hospital/Surgery 80%/20%

Emergency Room Cost $300 + coinsurance waived if admitted

Flexible Savings Account (FSA) Employee Max: $2,550

FSA – rollover up to $500

Preventive Care Paid At 100%

Express Advantage Network (EAN)

Express Scripts includes 32,000+ Pharmacies in Dallas and surrounding areas, including many major chains such as:

*If you purchase prescriptions from a Non-EAN, an additional $10 will be included with your copay. For a full list please visit: www.pebcinfo.com (password: 123dallas)

Non-EAN* are major chains such as:

Preventive Care

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Regardless of the plan you choose, both plans offer preventive care services at no cost to you.

Free preventive care services include the following: • Immunizations, well-woman check, well-child check • Mammogram, blood pressure tests, cholesterol tests • Annual physical exams and more

Your plan also covers other routine services, but those services may require you to pay out of your pocket. For more information, visit uhcpreventivecare.com

What Medical Plans Will Dallas County Offer

High Deductible Plan with Health Savings Account(HSA)

Plan Features: 1) Can select any physician within the network for a lesser cost

2) No co-pay required subject to deductible/coinsurance

3) Must pay a higher deductible (upfront cost) for medical treatment until deductible is met, then 20%

4) Can Use OON physicians at an increase cost

5) No primary care physician (PCP) or Referral Required

6) Preventive Care Paid at 100%

7) Lower Monthly Premium than PPO

8) Known as a High Deductible Health Plan

9) Must open a tax-favored Health Savings Account(HSA)

2018

High Deductible Health Plan w/ HSA

2018 High Deductible Health Plan w/HSA

Copays do not apply for Rx Drugs/PCP/Specialist and Urgent Care

Pay full discounted cost, part of deductible and coinsurance

Deductible Single/Family $1,500/$3,000 Coinsurance 80%/20% Out-of-Pocket (OOP) Max $3,000/$6,000

Hospital/Surgery 80%/20%

Preventive Care Paid At 100%

Emergency Room Cost Pay full discounted cost, part of deductible and coinsurance

High Deductible Health Plan w/ HSA

2018 High Deductible Health Plan with HSA Limited Purpose Flexible Savings Account (LP-FSA) Max is $2,550

LP-FSA Dallas County’s Contribution is $240

LP-FSA can rollover Up to $500

HSA Max is: $3,450/$6,900

HSA Seed Money from Dallas County is $750/$750

Employee Max HSA contribution with Dallas County Seed is $2,700/$6,150

HSA Catch Up Age and amount 55+ extra $1,000

HSA Catch Up Max $4,450/$7,900

EE Max HSA contribution w/ ER Seed–Catch Up $3,700/$7,150

HSA funds are yours to keep even if you leave Keep it year after year

Employee Only -- HDP + Allowable Copay Deductible Coinsurance Running

Max OOP Total $17,525.00 $0.00 $1,500.00 $1,500.00 $3,000.00

Dallas County Seed Money for Employee Only ($750.00) Out of Pocket minus Dallas County Seed $2,250.00

*based on 20% tax rate

Premium Difference PPO vs High Deductible Health Plan for Employee Only ($678.00)

Out of Pocket minus Premium Difference PPO vs High Deductible Health Plan $1,632.00

Dallas County Limited Purpose FSA (LPFSA) contribution ($240.00) Out of Pocket minus DC LPFSA Savings $1,332.00 Pre-Tax Savings Resulting from HSA Contribution of Premium savings of

$678* ($136.00) Out of Pocket minus Pre-Tax Savings $1,196.00

IF YOU CAN COMMIT TO THE MAXIMUM HSA CONTRIBUTION OF $3,450

Pre-Tax Savings Resulting from MAXIMUM HSA Contribution* ($690.00) Out of Pocket minus Pre-Tax Savings Max

Contributions $506.00

HOW THE HIGH DEDUCTIBLE PLAN WITH HSA WORKS

HOW THE HIGH DEDUCTIBLE PLAN WITH HSA WORKS

Employee + Family Allowable TTL Co Pay Deductible Coinsurance Running Max OOP

Total $17,525.00 $0.00 $3,000.00 $3,000.00 $6,000.00 Dallas County Seed Money for Employee + Dependents: ($750)

Out of Pocket minus Dallas County Seed: $5,250.00

*based on 20% tax rate

Premium Difference PPO vs High Deductible Health Plan Employee + Family ($2,730.00) Out of Pocket minus Premium Difference PPO vs High Deductible Health Plan $2,520.00

Dallas County Limited Purpose FSA (LPFSA) contribution ($240.00) Out of Pocket minus DC LPFSA Savings: $2,280.00

Pre-Tax Savings Resulting from HSA Contribution of Premium savings of $2,730 ($546.00) Out of Pocket minus Pre-Tax Savings*: $1,734.00

IF YOU CAN COMMIT TO THE MAXIMUM HSA CONTRIBUTION OF $6,900

Pre-Tax Savings Resulting from MAXIMUM HSA Contribution * ($1,380.00) Out of Pocket minus Pre-Tax Savings Max Contributions: $354.00

Premium Differences

Group Single - Employee Only Premium Difference PPO vs High Deductible Health Plan $678.00

Single - Employee + Spouse Premium Difference PPO vs High Deductible Health Plan $2,111.72

Single - Employee + Child(ren) Premium Difference PPO vs High Deductible Health Plan $1,295.84

Employee + Family Premium Difference PPO vs High Deductible Health Plan $2,729.74

2018 Medical Rates

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MONTHLY RATES -- CALENDAR YEAR 2018 BI-WEEKLY RATES

PPO

EE share % of Ttl CO share % of Ttl Total EE Rate 2017 EE Rate 2018

EE only $88.35 10% $795.16 90% $883.51 $37.76 $40.78

EE+spouse $662.64 38.0% $1,104.39 63% $1,767.03 $283.18 $305.83

EE+children $346.78 23% $1,111.02 77% $1,457.81 $148.20 $160.05

EE+family $921.07 39% $1,420.25 61% $2,341.32 $393.62 $425.11

High Deductible Health Plan Plan with HSA

EE share % of Ttl CO share % of Ttl Total EE Rate 2017 EE Rate 2018

EE only $31.84 5% $877.81 95% $909.65 $13.99 $14.69

EE+spouse $486.66 27% $1,332.63 73% $1,819.29 $213.92 $224.61

EE+children $238.78 15% $1,262.13 85% $1,500.91 $104.96 $110.21

EE+family $693.60 29% $1,716.95 71% $2,410.56 $304.88 $320.12

2018 Dental/Vision Rates

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100% Employee or Retiree Paid

ASSURANT DENTAL Assurant Assurant Assurant Per Pay

2017 2017 2018 Period 2018 EE Only or Retiree $12.88 $12.88 $12.88 $5.94 EE + Sp or Retiree $21.94 $21.94 $21.94 $10.13 EE + Ch or Retiree $28.95 $28.95 $28.95 $13.36 EE + Fa or Retiree $36.99 $36.99 $36.99 $17.07

100% Employee or Retiree Paid

PEBC DENTAL PEBC Per Pay PEBC Per Pay 2017 Period 2017 2018 Period 2018

EE Only or Retiree $31.19 $14.40 $31.19 $14.40 EE + Sp or Retiree $57.68 $26.62 $57.68 $26.62 EE + Ch or Retiree $71.72 $33.10 $71.72 $33.10 EE + Fa or Retiree $99.79 $46.06 $99.79 $46.06

VSP-HEALTHSMART VISION PLAN RATES 2018 – 100% Employee or Retiree Paid

VSP 2017 VSP 2017 VSP 2018 VSP 2018 EE/Ret Per Pay Period EE/Ret. Per Pay Period

Retiree or EE Only $6.46 $2.98 $6.46 $2.98 Retiree or EE + Sp $12.09 $5.58 $12.09 $5.58 Retiree or EE + Ch $12.87 $5.94 $12.87 $5.94 Retiree or EE + Fa $20.06 $9.26 $20.06 $9.26

In Network 2018 PPO 2018 HDP w/HSA

Prescription Drugs Additional $10 charge for Non-EAN

Copay is $15/$30/$60

No Copay -- Pay full discounted cost, part of

deductible/coinsurance

PCP-Tier 1 Specialist /Specialist and Urgent Care Copay is $25/$35 No Copay – Same as Above

Medical and Rx Copays Counts towards Max OOP No Copay –Same as Above

Deductible Single/Family $500/$1000 $1,500/$3,000

Co-insurance ER/EE 80%/20% 80%/20%

Out-of-Pocket (OOP) Max $3,000/$6,000 $3,000/$6,000

Hospital/Surgery 80%/20% 80%/20%

Preventive Care Paid At 100% 100%

Emergency Room Cost $300 +coinsurance – waived if admitted

Pay full discounted cost, part of deductible and coinsurance

PPO vs HDP – Comparison 2018

PPO vs HDP – Comparison 2018 2018 PPO 2018 High Deductible Health Plan

w/HSA HSA Seed Money from ER N/A $750 single/family

FSA Max/LPFSA Max $2,550 $2,550

FSA ER Contribution LPFSA ER Contribution

FSA -- $0 LPFSA -- $240

FSA/LPFSA – rollover next year Both are “Use it or Lose it” funds exceeding over $500

HSA Max N/A $3,450/$6,900

HSA – belongs to the employee N/A Yes, year to year

EE Max HSA contribution with ER Seed

N/A

$2,700/$6,150

HSA Catch Up Age N/A 55+

HSA Catch Up Max N/A $4,450/$7,150

EE Max HSA contribution with ER Seed – Catch Up

N/A $3,700/$6,400

IRS rules require that you qualify in order to have an HSA (see below). If you do not qualify, you can still enroll in the HDP, but you cannot receive employer seed money contributions to an HSA and you cannot contribute to an HSA.

You: • have to be enrolled in a high deductible plan • cannot have other health coverage (such as your spouse’s medical Plan, another state plan, a retiree health plan, etc.) See note below. • cannot be enrolled in Medicare • cannot be claimed as a dependent on someone else’s tax return • cannot be covered by a general purpose health care flexible spending account (such as the PEBC FXM) or by your spouse’s FSA plan. (Limited purpose flexible spending account is ok – see next slide)

Note: Other health coverage includes TRICARE and services received at a VA facility within 3 months of an HSA contribution (including filling a prescription).

Are you eligible for HSA contributions?

• Employer seed-money contributions will be available to you through a Limited Purpose Flexible Spending Account.

• You can also elect up to $2,550 employee contribution each year if you like.

• Up to $500 of unused funds can be rolled over to the next plan year and you will forfeit any unused funds above that amount.

• This account is different than a regular flexible spending account, and can be used for the eligible expenses listed below, provided you are not reimbursed form any other source including insurance:

1. Out-of-pocket eligible vision expenses

2. Out-of-pocket eligible dental expenses

3. Medical expenses exceeding your deductible until your out-of-pocket maximum is met. (EOB required)

If you do not qualify for HSA contributions

Important Information - PayFlex Card

Click YES to continue using your card or to have a card mailed to your home address on file.

HSA Eligibility – It’s all about YOU

Reminder for those enrolled in Medicare: If you are enrolled in Medicare, you can no longer contribute to an HSA. Funds saved while an active employee can be used after retirement to reimburse the retiree for Medicare Part B premium AND can also be used to pay Medicare Advantage premium. HSA funds cannot be used to pay for a Senior Supplement or Medi-gap plan.

IMPORTANT!! HSA SHOULD ONLY BE USED FOR QUALIFIED MEDICAL EXPENSES, OTHERWISE A 20% PENALTY TAX AND TAXES ON FUNDS USED WILL OCCUR. The 20% tax penalty does not apply to account holders age 65 and older, those who become disabled or enroll in Medicare.

Please refer to www.pebcinfo.com for additional information on HSA eligibility or contact HR Benefits at 214-653-6161.

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Very Important Tip

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Additional Information for Employees

Spouse Surcharge

• Spouse surcharge (applies to medical plans only) Will default to the surcharge if a spouse is on your medical.

• If a spouse waives their spouse’s own employer coverage and

enrolls in PEBC medical plan, $200 surcharge (per month) applies. In this case, PEBC plan is primary payer for spouse’s expenses.

• If a spouse enrolls in their spouse’s own employer coverage

and enrolls in PEBC plan, a monthly surcharge will not apply. In this case, PEBC plan is secondary payer for spouse’s expenses.

SPOUSE AFFIDAVIT WILL BE ELECTRONIC THIS YEAR

NO PAPER TO TURN IN!!

ELECTRONIC SPOUSE SURCHARGE AFFIDAVIT

SPOUSE MEDICAL

SURCHARGE ELECTRONIC

VERSION

Basic employee term life and AD&D (GLF) Employer paid If you are a benefits-eligible employee, your employer provides this coverage at no cost to you.

Optional term life (TLF) Employee TLF is voluntary and is based on your annual salary times your selected coverage level. Spouse optional term life (SLF)

SLF coverage amount cannot exceed 50% of and employee’s TLF coverage amount.

Dependent optional term life (DGL) Dependents up to age 26

LIFE INSURANCE and AD&D

BENEFICIARY FORM

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PORTABILITY OF LIFE INSURANCE

When coverage ends due to termination of employment or Retirement, portability allows active employees to continue Optional Term Life, Spouse Term Life and Dependent Term Life coverage by remitting premium directly to Dearborn National.

Contact the HR Benefits Section for additional information at 214-653-6161.

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Tools and Resources

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Helpful Websites

www.pebcinfo.com for a wide range of information on Dallas County Benefits programs, enrollments guides, tools, and other important info. Password: 123dallas

myuhc.com your personalized gateway to information that may lead to better decisions

myHealthcare Cost Estimator -- is available on myuhc.com...YOUR personalized online tool to make MORE informed health care decisions.

UnitedHealthcare Customer Care --- Health Advisors, First Call Resolution --- 1-877-370-2849

myNurseline -- 24/7, where to go for care - ER/Urgent Care, questions, symptoms, confidential --- 1-877-370-2849

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PPO/HDP

Wellness Program “To Create a Culture of Better Health”

Wellness Rewards • 300 points= $300 maximum annual reward (all or nothing) • Paid once each year • Option to take CASH (minus taxes) unless the employee selects FLEX or health savings accounts (after PEBC notifies reward has been earned) • No awards can be earned in November or December • Earn points and rewards for you and your covered spouse

Dallas County has paid out over $222,000 so far this year; last year payout total was $225,000

October 31st is the deadline to complete for 2017 payout.

RALLY WELLNESS REWARDS PROGRAM

YOU HAVE TO REGISTER WITH MYUHC.COM BEFORE YOU CAN REGISTER WITH WE RALLY OR IT WILL ASK YOU FOR A CODE TO CONTINUE.

https://accounts.werally.com/

FREEDOM OF CHOICE

Employee Benefits Meetings

CONTACTS ANDREA NAVARRETTE – HR BENEFITS TECHNICIAN

214-653-6161

TESS MCCALL – HR BENEFITS SPECIALIST 214-653-6579

RUTHIE HUDDLEN- HR BENEFITS MANAGER

214-653-7605

2018 Dallas County

Employee Benefits Meeting

Employees making a difference. Everyday.