Episcopal Church Medical Trust Healthcare Benefits for The

Episcopal Church Medical Trust Healthcare Benefits for The Diocese of Southern Ohio Open Enrollment 2012 The Rev. Rusty Mc. Cown Regional Manager November 2 & 3, 2012 1

Agenda § Introduction § The Episcopal Church Medical Trust • Medical Plans – and HDHP/HSA plan • Additional Benefits • Dental Plans § Resources § Questions? 2

The Episcopal Church Medical Trust § Chartered by General Convention in 1978 § Reports to Church Pension Fund Trustees § Voluntary Employees’ Beneficiary Association (VEBA) § ERISA-exempt, free of most state benefit mandates § Tax-favored not-for-profit church plan 3

The Episcopal Church Medical Trust Our Mission … “Balancing compassionate Christian benefits with financial stewardship” 4

Episcopal Church Medical Trust Medical Plans– 2012 5

Your 2012 Medical Plan Choices In-Network and Out-of-Network Plans § Empire BCBS PPO 80/60 § Empire BCBS High Deductible Health Plan with Health Savings Account (HDHP/HSA) In-Network Only Plans § Aetna HMO/CIGNA Open Access § Aetna Select EPO § Empire BCBS EPO 90 § Empire BCBS EPO 80 6

ALL PLANS – Preventive Care Routine and Preventive Services § $0 Copay Network § Benefits include covered services received in a physician’s office such as: • • • Routine exams Well-Woman and Well-Man exams Routine exam X-rays and lab services Well-Child checkups Immunizations Other Routine Services 7

Empire BCBS High Deductible Health Plan & Health Savings Account (Preferred Provider Organization) www. empireblue. com (800) 352 -3152

HDHP/HSA: What is it? High Deductible PPO Health Plan consumer-directed health plan with preventive services covered at 100% + Health Savings Account allows employer and employees to make tax-free contributions and save for future healthcare expenses Employees can begin thinking like consumers when it comes to healthcare.

HDHP Benefits All Plans Subject to Plan Deductible and Coinsurance… § Medical Plan - Administered by BCBS § Pharmacy - Administered by Medco § Mental Health - Administered by BCBS Except the Eyemed Vision Benefits and CIGNA Employee Assistance Program (EAP).

Health Savings Account (HSA) § Tax-advantaged account regulated by the IRS § Employee sets up and owns the account § Balances accumulate and rollover year-to-year § Funds for qualified healthcare expenses only § Account must be held by qualified trustee • Mellon Bank for Empire BCBS • Funds may be invested § Only available to HDHP participants without other medical coverage

HSA - Contributions § Employers, employees or others may contribute to an employee’s HSA. § Limits on annual contributions set by IRS. • For 2012 - single $3, 100, family $6, 250 • Employee responsible for ensuring max not exceeded. § Additional contributions are possible for those age 55 (or older) by the end of the year ($1, 000 for 2012). § Deadline for 2012 HSA contributions - April 15, 2013.

HSA – Distributions § Distributions from an HSA for qualifying medical expenses are tax-free. • HDHP deductibles and coinsurance • Post-employment healthcare costs, Medicare Part B premiums • Long-term care premiums § May be used for employee or dependent expenses. § Other distributions subject to federal income tax plus a 20% penalty. (Penalty waived after age 65 or on account of death or disability. )

HSA - How are distributions made? Employees may: § Use the HSA debit card at doctor’s office or pharmacy § Write a check on the HSA account § Pay the provider or pharmacy out of personal funds and reimburse him/herself from the HSA Caution: § Employee must keep records to prove the funds were used for qualifying medical expenses. § Employee is responsible for any overdraft fees on the HSA.

Empire BCBS HDHP/HSA Plans Precertification is required for inpatient hospital admissions. Failure to precertify these services will lead to a reduction in benefits.

HDHP Cost Comparison per Employee Diocese of Southern Ohio Monthly Rates for 2012 Aetna HMO/CIGNA OAP Aetna Select EPO Empire BCBS PPO – 80/60 Empire EPO 80 Empire EPO 90 Single $675 $742 $875 $667 $705 E+1 $1, 214 $1, 335 $ 1, 576 $1, 200 $1, 269 Family $1, 889 $2, 078 $2, 447 $1, 866 $1, 972 Empire BCBS HDHP $504 $ 907 $1, 412

HDHP Cost Comparison per Employee Health Savings Account (HSA) Funding Monthly Cost to Employers for HDHP/HSA Empire BCBS HDHP Single $504 E+1 $907 Family $1, 412 HSA Funding ($2, 000/$4, 000) $167 $333 Total Cost to Employer $671 $1, 240 $1, 745

HDHP Cost Comparison per Employee Diocese of Southern Ohio Monthly Rates for 2012 Aetna HMO/CIGNA OAP Aetna Select EPO Empire BCBS PPO – 80/60 Empire EPO 80 Empire EPO 90 Single $675 $742 $875 $667 $705 Empire BCBS HDHP + HSA Funding $671 E+1 $1, 214 $1, 335 $ 1, 576 $1, 200 $1, 269 Family $1, 889 $2, 078 $2, 447 $1, 866 $1, 972 $1, 240 $1, 745

Medco Pharmacy Benefits www. medco. com (800) 841 -3361

Medco Pharmacy Tiers Generic: § Same active ingredients as the brand-name it replaces. Binder may differ. Formulary: § A list of brand-name drugs preferred by a plan based on clinical effectiveness and cost. (Also called “Preferred Brand Name”) Non-Formulary: § Brand-name drugs not on your plan’s formulary. (Also called “Non -Preferred Brand Name”) 20

Medco Pharmacy Plan Designs Standard Plan HDHP/HSA Retail Mail Order $50 person none Copays Tier 1: Generic Up to $10 Up to $25 You pay 15% after deductible Copays Tier 2: Formulary Up to $35 Up to $90 You pay 25% after deductible Copays Tier 3: Non-formulary Up to $60 Up to $150 You pay 50% after deductible Up to a 30 day supply Up to a 90 day supply Up to a 30 -day supply (retail) or 90 -day supply (mail order) Annual Prescription Deductible (Retail Only) Dispensing Limits per Copayment Retail & Mail Order $2, 700 person $5, 450 per family (combined with medical deductible) 21

CIGNA Behavioral Health Mental Health / Substance Abuse Benefits www. cignabehavioralhealth. com (866) 395 -7794

Mental Health / Substance Abuse Benefits § Plan Partner – CIGNA Behavioral Health* § Thirty years experience § Extensive mental health provider network § Out-of-network MH/SA benefits in all MT Plans* § Employee Assistance Program (EAP) *Empire BCBS HDHP has only EAP through CIGNA Behavioral Health. MH/SA benefits are embedded in the plan designs. 23

Mental Health / Substance Abuse Benefits § Plan Partner – CIGNA Behavioral Health* • Thirty years experience • Extensive mental health provider network § Out-of-network MH/SA benefits in all MT Plans* • Annual deductibles do not apply to MH/SA benefits • Shares out-of-pocket maximums with medical benefits • See Summary Plan Document for your specific plan details § Employee Assistance Program (EAP) • Administered by CIGNA *Empire BCBS HDHP has only EAP through CIGNA Behavioral Health. MH/SA benefits are embedded in the plan designs. 24

Value Added Benefits 25

Employee Assistance Program (EAP) § Administered by CIGNA Behavioral Health § 10 in-person sessions PER ISSUE at $0 COPAY § Multiple episodes of treatment per year § Unlimited telephonic sessions 26

Employee Assistance Program (EAP) Assistance with Family Care Services • • • Child care Parenting programs Adoption information Long-distance care-giving Researching nursing homes Personal Services • • 30 -minute free legal consultation Stress management Debt management Identity theft management Online Services • • • Emotional well-being and life events Family and care-giving resources Health & wellness resources Daily living resources Email assisted search 27

Health Advocate § Advocacy and assistance service § Facilitates member interactions with healthcare providers, insurance plans, and other community resources § Assists members with: • Finding doctors, hospitals and other healthcare providers • Resolving claims, billing and administrative problems with providers • Issues encountered while accessing the healthcare system § Protects privacy and confidentiality 28

Eye. Med Vision Care Benefits – At a Glance Plan Provision Annual Eye Exam Network Out-of-Network You pay $0 Plan pays up to $30 Choose Eyeglasses OR Contact Lenses Each Calendar Year: Lenses single vision bifocal trifocal You pay $10 Plan pays up to $32 $46 $57 Frames $130 allowance, 20% off balance over $130 Plan pays up to $47 Contact Lenses Conventional $130 allowance, 15% off balance over $130 Plan pays up to $100 Contact Lenses Disposable $130 allowance, then you pay balance over $130 Plan pays up to $100 For Assistance: (866) 723 -0513 www. eyemedvisioncare. com 29

Frontier. Medex and Hear. PO Frontier. Medex § § Access to Frontier. MEDEX Travel Assistance Provides 24/7 Emergency Medical Advocacy Note: Frontier. MEDEX is not responsible for medical costs while you are traveling. Hear. PO § Access to Hear. PO network discounts 30

CIGNA Dental Plans www. cigna. com (800) 244 -6224 (800 -CIGNA 24)

CIGNA Dental Plans – At a Glance Plan Provision Preventive Dental Basic Dental & Orthodontia What You Pay Preventive Services 0% 0% 0% Basic Services 20% 15% Major Services 99% 50% 15% Orthodontic Services 99% Not Covered 50% (includes 3 cleanings per year) ($1, 500 Lifetime Max) Deductible (single/family) Out-of-Network Benefits (based on Usual & Customary) Annual Benefit Maximum (in addition to preventive care) None $50 / $150 $25 / $75 Same as Network $1, 500 32

Dental Rates 2012 Diocese of Southern Ohio Monthly Rates for 2012 Preventive Dental Basic Dental and Orthodontia Single $121 $66 $53 E+1 $36 $116 $95 Family $56 $177 $148

Online Open Enrollment

Online Open Enrollment 35

Online Open Enrollment 36

Online Open Enrollment Please print this confirmation for your records. Thank you! 37

Resources 38

Getting Help: Contacts § Empire Blue. Cross Blue. Shield • • (800) 352 -3152 www. empireblue. com/medicaltrust § CIGNA Dental • • • (800) 224 -6224 (800) CIGNA 24 www. cigna. com 39

Getting Help: Contacts § Medco • • (800) 841 -3361 www. medco. com § CIGNA Behavioral Health (& EAP) • • (866) 395 -7794 www. cignabehavioral. com § Eye. Med Vision Care • • (866) 723 -0512 www. eyemedvisioncare. com 40

Getting Help: Contacts § Health Advocate • • (866) 695 -8622 www. healthadvocate. com § Frontier. MEDEX • • • (800) 527 -0218 (U. S. , Canada, Virgin Islands, Bermuda) (410) 453 -6330 (All other locations – call collect) www. frontiermedex. com § Hear. PO • • (888) 432 -7464 www. hearpo. com 41

Client Engagement We are here to serve our members Monday through Friday: 8: 30 am to 8: 00 pm Eastern Telephone Direct Toll Free 1 -800 -480 -9967 Email: mtcustserv@cpg. com Best sequence for problem resolution: 1 st: Call Vendor for most benefit-related issues 2 nd: Call Health Advocate 3 rd: Call Medical Trust 42

The Medical Trust Website www. cpg. org 43

HDHP/HSA Web Resources U. S. Treasury Department – Health Savings Accounts www. treas. gov/offices/public-affairs/hsa/ The HSA section of the US Treasury Department website contains links to informational brochures, up to date regulations, frequently asked questions, press releases, IRS forms and publications and technical guidance. IRS – Health Savings Accounts www. irs. gov The HSA section of the IRS website contains publications, bulletins and tax filing instructions. Publication 502 www. irs. gov/publications/p 502/index. html Publication 502 provides a list of qualified medical expenses.

HDHP/HSA Web Resources continued… U. S. Government Office of Personnel Management www. opm. gov/hsa/ Although primarily intended for government employees, this site is also a good resource for finding information about HDHPs and HSAs. HSA Insider (a division of Canopy Financial) – HSA Road Rules www. hsainsider. com/roadrules. aspx You will need to login to download the HSA Road Rules. This brochure includes a Table of Contents making it very user friendly. It also appears that this brochure is kept up to date with government regulations. In addition to the Road Rules, the HSA Insider site contains other valuable information.

Your ID Cards 46

Thank you! Any Questions? 47

Definitions § Benefits Period: A benefit period begins the day you are admitted to a hospital or skilled nursing facility (SNF), and ends when you have not received any inpatient hospital or SNF care for 60 days in a row. If you are admitted after a benefit period ends, a new one begins. You must pay any deductibles for each new benefit period. § Coinsurance: an amount, usually a percentage, you may be required to pay as your share of the cost of services after deductibles have been met. § Copayment or Copay: a fixed amount you may be required to pay as your share of the cost for services. § Deductible: the amount you must pay for healthcare or prescriptions before your benefits begin to be paid by the plan (where applicable. ) 48

Disclaimer This presentation is provided for your informational purposes only. In the event of a conflict between the information contained in this presentation and the official plan documents, the official plan documents will govern. The Church Pension Fund and its affiliates retain the right to amend, terminate, or modify the terms of any benefit plans described in this presentation, consistent with applicable law. 49