Episcopal Church Medical Trust Healthcare Benefits for The

Episcopal Church Medical Trust Healthcare Benefits for The Diocese of East Tennessee Open Enrollment 2012 1

Agenda § Introduction § The Episcopal Church Medical Trust • Medical Plans • High Deductible Health Plan/Health Savings Account • Additional Benefits § Resources § Denominational Health Plan § 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 75/50 § Empire BCBS High Deductible Health Plan with Health Savings Account (HDHP/HSA) 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 PPO 80/60 – At a Glance Plan Provision Network Annual deductible (single/family) $500 / $1, 000 Annual OOP max (single/family) $2, 000 / $4, 000 Office visit copay Member coinsurance Inpatient hospital coinsurance Outpatient hospital coinsurance $0 Preventive $25 20% $100 per day, not to exceed $600 per admission 20% coinsurance $500 deductible 20% coinsurance

BCBS PPO 75/50 – At a Glance Plan Provision Network Annual deductible (single/family) $900/$1800 Annual OOP max (single/family) $3, 200/$6, 400 Office visit copay $0 Preventive $35/$45 Member coinsurance Inpatient hospital copay Outpatient hospital copay 25% $100 per day, not to exceed $600 per admission 25% coinsurance $900/1800 deductible 25% coinsurance

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.

Mental Health/Substance Abuse § In an HDHP, MH/SA benefits are embedded in the plan § § design and are administered by BCBS However, the Employee Assistance Program (EAP) is still available to members Benefits of the EAP include: • 10 in-person sessions with no copay • Unlimited telephone sessions • Multiple episodes of treatment per year • Includes Family Care, Personal, and Online services

Health Savings Accounts – Death § If the employee’s spouse is the beneficiary of the HSA, the HSA will be treated as an HSA of the spouse after the employee’s death. • No taxable event for Federal income tax purposes. § If there is a non-spouse beneficiary, the account ceases to be an HSA and the value of the account is taxed to the beneficiary. • If the employee’s estate is the beneficiary, the HSA balance is included in the employee’s final Federal income tax return.

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 BCBS 80/60 Plan Single Plus One Family Monthly $642 $1, 157 $1, 798 Annually $7, 704 $13, 884 $21, 576 Empire BCBS HDHP Single Plus One Family $440 $792 $1, 232 $5, 280 $9, 504 $14, 784 Savings Single Plus One Family $2, 424 $4, 380 $6, 792

HDHP Cost Comparison per Employee Health Savings Account (HSA) Funding Single Plus One Family $2, 200 $3, 325 * $4, 450 Net Savings To Employer Single Plus One Family $224 $1, 055 * $2, 342 *Note that the funding and net savings amounts for Single Plus One for the Diocese of East Tennessee differ from the amounts of $4, 450 [funding] and $(70) [net savings to employer] used for illustration purposes in the regional meetings held on Nov. 10, 2011.

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”) 23

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) 24

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. 26

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. 27

Value Added Benefits 28

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 29

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 30

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 31

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 32

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 33

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.

Denominational Health Plan Resolution A 177

Resolution A 177: What Was the Spirit in which the Resolution was Passed § § § Speaks to social justice issues around adequate benefits for the Church’s lay employees Cost concerns are real, but so is the need of lay employees to have adequate healthcare benefits The support and dedication of lay employees make many ministries possible…it’s the right thing to do General Convention actions will now assure lay employees the safety net of healthcare benefits Currently, some lay employees do not have access to healthcare benefits , and others have a higher cost-share than clergy

DHP- con’t § Required: • All domestic US dioceses, cathedrals, missions, and chapels by 2013 • All clergy and lay employees who work 30+ hours/week. Individuals may opt out through spousal coverage, Tri-care, etc. • Parity between clergy and lay coverage levels • Employees who work between 20 and 30 hours/week may participate---not required

DHP- con’t § Diocesan Choice and Control • Dioceses will determine whether diocesan institutions, schools, and agencies will be required to participate. • Diocese will establish cost sharing guidelines for congregations, i. e. parity. • Dioceses decide whether to offer healthcare coverage for domestic partners. • Diocese select plan designs.

Thank you! Any Questions? 50

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. 51