City of Marietta 2015 BENEFITS OPEN ENROLLMENT REVIEW

City of Marietta 2015 BENEFITS OPEN ENROLLMENT REVIEW 1

Shaw. Hankins §Service Center- can answer questions on all benefits §Available 8: 00 am – 5: 00 pm during open enrollment § Available until 7 pm until November 14 th § 800 -994 -7429 §Benefit Resource Center- shawhankinsbenefits. net/cityofmarietta 2

Changes for 2015 §BCBS POS Plan § Change in copays, deductible and out of pocket maximum § BCBS PPO Plan § Change in deductible and out of pocket maximum § New Medical Plan offering with Piedmont/Wellstar § Out of pocket maximum on all plans will now include prescription costs § New Pharmacy Benefit Manager-Pharm. Avail § Everyone will receive new ID cards from BCBS with Pharm. Avail information § Optional Vision Plan-Avesis 3

Open Enrollment § Open Enrollment is November 3 rd- November 21 st § Benefits Fair will be November 3 rd – November 7 th § HR and Shaw. Hankins will be available to answer questions and assist with online enrollment § Open Enrollment is your opportunity to make elections for 2015 § Only time you can make a change to those elections is if you experience a qualifying event: § § § § Marriage, divorce Birth or adoption Change in your or your spouse’s work status that affects benefits Spouse’s annual open enrollment period Change in dependent eligibility status Change in eligibility for Medicaid or Medicare Death of dependent Court order 4

Bswift Online Enrollment §Will make elections through Bswift enrollment portal §www. cityofmarietta. bswift. com § Username: first letter of first name, last name, and last 4 digits of SSN § Example: JSmith 0563 § Password: last 4 digits of your SSN § Example: 0563 § If you do not make elections through the enrollment portal, your coverage will roll over for the 2015 plan year. You will not be permitted to make changes after the open enrollment period ends, unless you experience a qualifying event. § FSA elections must be made with Colonial representative. Must make new election for 2015. 5

Benefits Fair Fire Department Conference Rooms B & C- 112 Haynes St Monday November 3 rd Tuesday November 4 th Wednesday November 5 th Thursday November 6 th Friday November 7 th 9: 00 am-12: 00 pm 1: 30 pm-4: 00 pm 6

Medical and Prescription Coverage 7

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PPO Plan-Grandfathered Employees Key Benefit Lifetime Maximum Deductible Coinsurance Maximum Annual Out-of-Pocket Limit Office Visits Primary Care Physician Specialty Care Physician Urgent Care Facilities Routine Preventive Care Inpatient Hospital Facility Services, Physician’s Visits/Consultations, Professional Services Outpatient Facility Services, Professional Services Hospital Emergency Room In-Network Out of Network Unlimited $800 person $2, 400 per family 80% plan / 20% member $1, 200 person $3, 600 per family 70% plan / 30% member $6, 600 person No maximum $13, 200 per family Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent Care, Emergency Room and Prescriptions Plan pays 80% after deductible Plan pays 70% after deductible No charge Plan pays 70% after deductible Plan pays 80% after deductible $300 per admit , then plan pays 70% after deductible Plan pays 80% after deductible Plan pays 70% after deductible Plan pays 80% after deductible 9

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Prescription Benefit Changes §Step Therapy-Require prior authorization and will be subject to step therapy § Brand name only cholesterol-lowering agents (statins) § Advicor, Altoprev, Crestor, Lescol XL, Livalo, Simcor, Vytorin § Brand name only COX-2 NSAID (Celebrex) § Brand name only Anti-Migraine Medication (Triptans) § Axert, Relpax, Frova, Sumavel, Treximet § Select brand name only Fibromyalgia Agents (Lyrica) § Brand name only ACE Inhibitors & ACE Inhibitor Anit-Hypertensive Agents § Diovan, Edarbi, Benicar, Tekturna 11

Prescription Benefit Changes §Coverage Change § OTC Proton Pump Inhibitor-Nexium 24 HR will be covered, Brand-name Rx Nexium will not be covered § Brand name only drugs with therapeutic generic equivalents § Will exclude coverage for brand name drugs with therapeutic generic equivalents § Adoxa, Doryx, Monodox, Oracea, Arestin, Dynacin, Solodyn, Moxatag, Duexis, Vimovo § Andogel, Testim, Fortesta, Axiron, Androderm, Striant 12

Prescription Benefit Changes §Additions to Non-Preferred Formulary Tiers- 3 rd tier copays apply § Azor, Coreg CR, Crestor, Janumet, Januvia, Lovanza, Modafinil, Pexeva, Pristiq, Provigil, Patanase, Pataday, Vilibryd § Specialty Medication Coverage- Prior authorization required and copayment change § Member share will be 10% of total prescription cost up to maximum of $200 per prescription § Examples: Simponi, Avonex, Stelara, Orencia, Humira, Enbrel, Cimzia 13

Key Benefit Lifetime Maximum Deductible Coinsurance Maximum Annual Out-of-Pocket Limit Office Visits Primary Care Physician Specialty Care Physician Urgent Care Facilities Routine Preventive Care Inpatient Hospital Facility Services, Physician’s Visits/Consultations, Professional Services Outpatient Facility Services, Professional Services Hospital Emergency Room Prescription Drugs Rx Deductible Tier 1 Tier 2 Tier 3 Tier 4 Mail Order- 90 day supply Piedmont/Wellstar HMO In-Network Unlimited $750 person $2, 250 per family 80% plan / 20% member $6, 600 person $13, 200 per family Out of Pocket Maximum includes deductible, coinsurance and all copays – Office Visit, Urgent Care, Emergency Room and Prescriptions $25 $40 $100 No Charge Plan pays 80% after deductible $200 None $10 $40 $65 10% to $200 max 2. 5 x copay 14

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City of Marietta Employee Medical Center: Location 268 Lawrence Street, Marietta, GA 30060 Hours of Operation Mondays: 8 am – 5 pm Tuesdays: 7 am- 1 pm Wednesdays: 8 am – 2 pm Thursdays: 8 am – 2 pm Fridays: 8 am – 1 pm Saturday: 8 am – 12 pm Available Services Primary, urgent and preventive care Laboratory testing Flu shots Treatment for chronic health conditions Medications What are the benefits to you? No more long stays in the waiting room No out of pocket expense Increased convenience and access More one-on-one time with the doctor 16

Dental Coverage §Will remain with BCBSGA §No change to plan design §PPO plan option allows you to see any dentist. However, you can see less out of pocket expense if you stay in the BCBSGA dental network. §Locate participating providers at bcbsga. com BCBS Dental In-network Annual maximum Deductible (Single/Family) Out-of-network $1, 000 person $25/$75 Diagnostic/preventive services* 100% Basic benefit services 80% Major benefit services 50% 17

Flexible Spending Accounts §Two separate accounts- Medical Spending Account and Dependent Care Spending Account §Allows you to set aside pre-tax dollars to spend on qualified expenses, saving on your taxable income §Must make new elections for 2015 -See Colonial rep 18

Flexible Spending Accounts §Medical Spending Account § Maximum contribution of $2, 500 § Some eligible expenses- Deductibles, copayments, dental expense, vision services and materials § Dependent Care Spending Account § $5, 000 for married couple filing joint income tax returns, $2, 500 if unmarried or married and filing separate income taxes § Some eligible expenses- any care of a dependent that allows you and your spouse to work: day care, after school program, in-home care, camps § Use funds by end of plan year or lose remaining amounts 19

Basic Life and AD&D §City of Marietta provides basic life and AD&D benefit at no cost to you §Provided through Met. Life §City Council Employees: $150, 000 §Closed Group of Public Safety Employees: $40, 000 §All Other Employees: 3 x your annual earnings, maximum $180, 000 20

Optional Life Insurance §Purchase coverage for yourself in increments of 1 x your annual earnings up to a max of 4 x earnings or $420, 000 §Elect coverage for your spouse in increments of $10, 000 up to $100, 000 §Coverage for your children of $5, 000 or $10, 000 §Includes Will Preparation Service and Legal services through Hyatt Legal §If you have declined this coverage in the past and wish to add coverage during this open enrollment, you must complete an evidence of insurability form and be approved for all amounts of coverage 21

Long Term Disability Coverage §Pays a benefit after you are disabled for 180 days §Covers 50% of your earnings up to a maximum of $5, 300 per month. §Continues to pay until you can return to work or reach SSNRA §Elect coverage with Colonial representative Nov 3 -7 §If you have declined this coverage in the past and wish to add at this time, you must complete an evidence of insurability form and be approved for coverage 22

Optional Vision Coverage §Coverage for 2015 provided through Avesis §You may receive an exam and new lenses every 12 months, new frames every 24 months Avesis Vision In-network Exam $10 copay Standard lens $25 copay Frames Contact lenses Medically necessary contact lenses Laser vision correction Out-ofnetwork reimburseme nt $35 $25 single, $40 bifocal, $50 trifocal $50 wholesale $45 allowance $130 Paid in full $150 one time $250 $150 one time 23

Colonial Benefit Options §Disability Insurance §Accident Insurance §Cancer Insurance §Critical Illness Insurance §Life Insurance 24

Met. Law §Telephone and Office Consultations §Legal Representation §Estate Planning-Wills, Powers of Attorney §Financial Matters-Bankruptcy, Foreclosure, Tax Collection §Real Estate Matters-Sale, Purchase, or Refinance, Eviction, Zoning §Elder Law Matters- Medicare, Deeds, Wills, Nursing Home Agreements §Family Law- Adoption, Guardianship, Prenuptial Agreement §Traffic Offenses- excludes DUI §Document Preparation- Deeds, Mortgages, Affidavits 25

Employee Assistance Program §Provided through Life. Works §Assistance with questions regarding handling stress, relationships, challenges at work, parenting, caring for an older relative, or health issues. §Available 365 days a year §Provided at no cost to you 26

Questions? 27