whirlpool corporation: 2011 u.s. benefits · whirlpool corportation confidential whirlpool...

22
WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November 17, 2010

Upload: others

Post on 15-Apr-2020

22 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL CORPORATION

2011 US Benefits

Susan PavlopoulosSenior ManagerGlobal Benefits

November 17 2010

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE amp RETIREE MEDICAL PLANS

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE REWARDS AND SAVINGS PLANS

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE AMANA HOURLY PLANS

Presentation title 4

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE FT SMITH HOURLY PLANS

Presentation title 5

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 2: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE amp RETIREE MEDICAL PLANS

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE REWARDS AND SAVINGS PLANS

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE AMANA HOURLY PLANS

Presentation title 4

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE FT SMITH HOURLY PLANS

Presentation title 5

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 3: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE REWARDS AND SAVINGS PLANS

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE AMANA HOURLY PLANS

Presentation title 4

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE FT SMITH HOURLY PLANS

Presentation title 5

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 4: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE AMANA HOURLY PLANS

Presentation title 4

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE FT SMITH HOURLY PLANS

Presentation title 5

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 5: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 ACTIVE FT SMITH HOURLY PLANS

Presentation title 5

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 6: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

ACTIVE FLEXFORCE LIMITED PLAN

Limited Plan

in-network out-of-network

EMP

LOY

EE

PA

YS

Deductible

Per Person3 $1800 $3600

Out-of-Pocket Limit

Per Person none none

Benefit DescriptionW

HIR

LPO

OL

PAY

SPrimary Care Physician (PCP) Office Visits

70 50

Specialist Office Visits 70 50

Hospital (Inpatient amp Outpatient)2 70 50

Surgery (Inpatient amp Outpatient) 2 70 50

Adult Routine Wellness 100 Not covered

Well Child Care 100 Not covered

Emergency Room70 70

50 if non-emergency

Mental and Nervous (inpatient amp outpatient)

70 50

Chiropractic Care

70 50

limited to 20 visits per calendar year (combined limit)

Home Health Care

70 50

limited to 120 visits per calendar year (combined limit)

Annual Maximum na

Lifetime Maximum na

Prescription Benefit Highlights

Retail or Mail Order 70 coinsurance

Indicates no deductible applies

Corporate StandardSample PowerPoint 6

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 7: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care Adults Actives amp Pre Medicare Retirees

bull 100 no deductible in network

bullBill with routinepreventive V-code

Well-adult care includes one routine office visit and examination each Plan Year after age 18 years and one OBGYN office visit and examination after age 18 years of age each Plan Year

Included immunizations and screenings associated with the above routine office visits are as follows bull Immunizations

1Tetanus Diphtheria (Td) Booster once every 10 years 2Influenza Vaccination (flu shot) one shot each Plan Year

3Pneumococcal Vaccination (Pneumovaz) one dose for persons 65 years and over

4Meningococcal conjugated vaccine (MCV4) one dose for college freshmen living in dormitories 5bull Screenings

6Cholesterol screening including triglycerides LDL HDL or lipid panel once every 5 years beginning at age 20 years

7Baseline Mammogram one between 30 and 40 years of age and one Mammogram each Plan Year starting at age 40 years of age

8Pap Smear and Routine Pelvic Exam one each Plan Year beginning at age 18 years

9Bone density test for osteoporosis every two years for women age 50 years and over

Colorectal Cancer Screenings 1048707 Fecal occult blood test (FOBT) or Colonoscopy or Double contrast barium enema 1048707 Digital rectal examination (DRE) and prostate specific antigen (PSA) test

bull Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive care visit due to age andor family history and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 8: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL WELLNESS PREVENTIVE CARE BENEFITS

Preventive Care

Children

bull 100 no

deductible in

network

bullBill with

routinepreventive

V-code

Well-child care includes routine office visits and examination as follows 1 Six visits 0 ndash 12 months 2 Three visits 12 ndash 24 months 3 Annual visits from 24 months through age 18 years of age4 GYN exam for children at age 18

When associated with routine office visits the following immunizations and screenings are covered

bull Immunizations o Two doses of Hepatitis A Three doses of Hepatitis B

o Six doses of Diphtheria Tetanus Pertussis (DtaP) Four doses of Haemophilus

Influenza type b Four doses of Polio Four doses of Pnuemococcal Conjugate

Two doses of Varicella wo doses of Measles Mumps Rubella

o One dose of Influenza vaccine (flu shot) one dose each Plan Year for children over

the age of 8 years two doses (administered separately by at least 4 weeks)

each Plan Year for children up through 8 years of age

o Human papilloma virus (HPV) vaccine for girls ages 9 through 18 years of age at the

following intervals

1048707 One complete dosage per lifetime consisting of 3 shots given within a 6 month

timeframe

1048707 Women over the age of 18 years but under the age of 26 years who have not yet

received the HPV may also receive the vaccine

bull Meningococcal conjugated vaccine (MCV4) at the following intervals

One dose between the ages of 11 and 12 years or

One dose before high school entry or at age 15 years whichever

occurs first for children who have not previously received the

MCV4 vaccine

bull Screenings and Exams Lead level testing one between ages 9 to 12 months and one at 24 months or after Vision screening conducted as part of Well-child care visit at ages 3 4 5 6 8 10

12 15 and 18 years Hearing screening conducted as part of Well-Child care Visit at ages 4 5 6 8 10 12

15 and 18 years Pap smear and routine pelvic exam one each Plan Year beginning at age 18 years or

the onset of sexual activity whichever comes first

Pathologies labs chest x-rays and EKGs that are ordered as part of your preventive

care visit and are considered preventive care by your Physician

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 9: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGING

Active Medical

Dependents up to age 26 may be added to plans student and marital status no longer apply

Lifetime maximums on active plans have been removed

Over the counter medications will no longer be reimbursable through an FSA (or HSA) without a prescription

Retiree Medical

Most Pre-65 retirees moving to Rewards and Savings plans

No I-account for pre-65 Rewards and Savings plans

Most Post-65 retirees moving to stipend as of 1111

Pre and post-65 plans offered thru Whirlpool have LTM

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 10: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 11: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

2011 PHARMACY BENEFIT FOR ACTIVES amp PRE-65 RETIREES

Tier 0 $0 or 0 Coinsurance

Tier 1 10 Coinsurance30-day supply

Min $5 Max $1290-day supply

Min $1250 Max $30

Tier 2 20 Coinsurance

30-day supplyMin $20 Max $100

90-day supplyMin $50 Max $250

Tier 3 50 Coinsurance

30-day supplyMin $50 Max $250

90-day supplyMin $125 Max $625

Tier 4 100 Coinsurance

INCREASED VALUE TO MEMBERS amp PLAN

Encourage the

utilization of clinically

and cost effective

therapies

Primarily Generics

Encourage the

utilization of cost

effective therapies that

donrsquot qualify for $0 tier

Primarily Generics

Encourage the

utilization of cost

effective therapies

relative to other agents

therapies

Primarily Preferred

Brands

Products that are not as

clinically or cost

effective relative to

other available agents

therapies

Primarily Non-Preferred

Brands

Products

considered to have

minimal or no

clinical or cost

effectiveness

relative to other

available agents

therapies

Primarily Non-

Preferred Brands

90-day supply available thru

Walgreens network

pharmacies or mail order only

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 12: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHATrsquoS CHANGINGActive amp Pre-65 Pharmacy

Walgreens Health Initiatives (WHI) selected to replace Medco as pharmacy benefit manager (PBM)

30-day fills use the WHI network for discounted pricing

90-day fills maintenance medications may be filled at Walgreens retail or thru Walgreens mail order

WHI network includes independent pharmacies as well as chains such as CVS Rite Aid Wal-Mart amp Target

Post-65 Retirees

Moving to stipend

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 13: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will prescriptions automatically be transferred to Walgreens

A 30-day prescriptions will not be transferred to Walgreens

90-day mail maintenance medications will be automatically transferred to

Walgreens Mail Service as of January

NOTE 90-day prescriptions not filled using mail service any 30-day

prescription as well as narcotics and compound medications will not be

transferred and will require a new prescription from your physician

Q Will the tier of drugs change

A No the tiers in the benefit plan design are not changing

However the price that members pay for medication may change due to the

special discount pricing being offered by WHI

WHI QampA

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 14: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

Q Will there be two ID cards for next year

A No active and pre-65 members will continue to have one card for

medical and pharmacy

14

ID CARDS

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 15: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

PHONE 1-877-WHIRL50 (877-944-1550)

FAX 1-800-736-8270

WEB wwwwalgreenshealthcom

Click on Healthcare Professionals tab

15

WHI Contact Information

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 16: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

HEALTHSCOPE BENEFITS

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 17: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

17

HealthSCOPE Benefits

Pre-certificationPre-authorization

Claim Status

Eligibility

Benefit Information

Provider Network verification

IVR- Available 247

1st Level Appeals

1-800-660-6212CUSTOMER CARE

REPRESENTATIVES

Whirlpool Service Line

1-800-660-6212

M-F 800 am ndash 600 pm EST

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 18: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

18

HSB Whirlpool Customer Care Web Tools

Click on Providero Check on

o Claim Status

o Eligibility

o Benefit Information

o Precert Information

o Copies of EOBs

wwwhealthscopebenefitscom

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 19: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

19

HealthSCOPE Benefits

Copy of provider EOB

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 20: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

20

PRE-CERTIFICATION PROCEDURES

All members along with their providers will be required to pre-certify all Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI amp CT Scans Outpatient mental health facility admits or visits

Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212

Member ID card has reminder statement regarding pre-certification

20

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 21: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

WHIRLPOOL PROVIDER UPDATES

COMMUNICATIONS THROUGHOUT THE YEAR

Quarterly Newsletters

Quarterly Teleconferences

Join the mailing list Send an email to susan_a_pavlopouloswhirlpoolcom

HealthSCOPE Benefits websitewwwhealthscopebenefitscom

Walgreens website

wwwwalgreenshealthcom

21

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS

Page 22: WHIRLPOOL CORPORATION: 2011 U.S. Benefits · WHIRLPOOL CORPORTATION CONFIDENTIAL WHIRLPOOL CORPORATION: 2011 U.S. Benefits Susan Pavlopoulos Senior Manager// Global Benefits November

WHIRLPOOL CORPORTATION CONFIDENTIAL

QUESTIONS