Open Enrollment Thurs Oct 25 Thurs Nov 15

Open Enrollment Thurs. Oct. 25 - Thurs. Nov. 15, 2018 System Office Colleague Briefing

Reflection And suddenly you know: It’s time to start something new & trust the magic of beginnings. Meister Eckhart © 2018 Trinity Health - Livonia, MI 2

Today’s discussion • Overview of Changes for 2019 • Enrollment Details and Resources • Benefit Eligibility • Choosing a Primary Care Physician • Summary of Benefit Programs • Additional Benefits • Questions © 2018 Trinity Health - Livonia, MI 3

Overview of Changes for 2019 © 2018 Trinity Health - Livonia, MI 4

What’s changing • Medical • Annual Maximum for Health Savings Account (HSA) increasing for 2019 to: $3, 500 Single (was $3, 450 in 2018) $7, 000 Family (was $6, 900 in 2018) • Weight Management Reimbursement Beginning Jan. 1, 2019 this benefit will be administered by Wage. Works Claims should be submitted to Wage. Works for review and approval. This will no longer be handled by the Blue Cross Blue Shield of Michigan (BCBSM). Eligibility – colleagues and dependents enrolled in all of Trinity Health’s medical plans: Traditional, Health Savings and Essential Plans Reimbursement will be paid through payroll with appropriate taxes withheld © 2018 Trinity Health - Livonia, MI 5

What’s changing • Medical Beginning Jan. 1, 2019 colleagues who are experiencing domestic violence may enroll in Trinity Health benefits anytime during the plan year if they are not already enrolled. For more information and documentation requirements contact the HR Service center at 877 -750 -4748 or HR 4 U@trinity-health. org. For additional help regarding domestic violence contact the Trinity Health Employee Assistance Provider (EAP) at: http: //mybenefits. trinityhealth. org/body. cfm? id=573&fr=true • Beginning Jan. 1, 2019 if you or your covered dependents have an emergency room visit that results in an inpatient hospital admission, the ER visit and the hospital admission will be covered at the Tier 1 benefit level, regardless of the hospital’s tier level. • Flexible Spending Accounts Maximum for Healthcare FSA increasing to $2, 650 (was $2, 600 in 2018) Dependent care FSA continues to be $5000 © 2018 Trinity Health - Livonia, MI 6

What’s changing • Vision Benefits • Effective 1/1/19, the vision plan is being enhanced to cover a second eye exam during a calendar year for children under age 13. The enhanced benefit also provides an additional pair of glasses if the child’s prescription changes by. 5 diopter or greater. The applicable copays for the exam and glasses still apply. © 2018 Trinity Health - Livonia, MI 7

Enrollment Details and Resources for 2019 © 2018 Trinity Health - Livonia, MI 8

Enrollment timing You will be able to enroll in health and well-being benefits for 2019 from: Thurs. Oct. 25 -Thurs. Nov. 15, 2018 © 2018 Trinity Health - Livonia, MI 9

Enrollment process and resources • My. Benefits: mybenefits. trinity health. org • Your single source for benefits information for all colleagues across the system, including benefit summaries, benefit provider contact info and more • Available from anywhere you have internet access — work, home or mobile Find health and welfare information, including Open Enrollment Guides, here Click My Self Service, then click the link for your Ministry to enroll in benefits © 2018 Trinity Health - Livonia, MI 10

Enrollment Process • On Thursday October 25 th you should have received an outlook communication that open enrollment has begun and you may now log into Workday to review and update your elections. To enroll: • Log into Workday by using your network user ID and password and click “sign in”. If you experience problems with logging in contact the Trinity Resolution Center at 888667 -3003 and select option 2. • Click on the “Inbox” worklet (icon) • Choose the “Open Enrollment” event from your “Actions” list. • Proceed to update your benefits by following the prompts to each page of the enrollment event. • Be sure to click the “I agree” checkbox at the bottom of the last page as your electronic signature. • Click “submit” at the end to save all changes/elections. • Be sure to print the enrollment page for your records by clicking on the “print” button located at the bottom left hand corner of the screen. Confirmation statement are no longer mailed to your homes. • Once your enrollment is finalized, you can continue to update your OE elections through 11/15/18 11: 59 pm EST. by logging into workday, opening the benefits worklet (icon), you will find a link to “Change Open Enrollment”. © 2018 Trinity Health - Livonia, MI 11

Why you must enroll • If you don’t make benefit elections during open enrollment, you will receive a default package of benefits which includes the same elections you had last year for: • Medical • Dental • Vision • life insurance and AD&D • Disability • The following contributions or elections will not carry forward and you must go online to make a new election. • Health Savings Accounts • Flexible Spending Accounts (medical and dependent care) • PTO Cash out • The benefits you elect will be in effect from Jan. 1 through Dec. 31, 2019 • You can only change benefits mid-year if you have a qualifying event (family status change or change in employment status) Keep in Mind… When you enroll, you will need to provide Social Security numbers for any dependent age one year and over. © 2018 Trinity Health - Livonia, MI 12

Benefit Eligibility © 2018 Trinity Health - Livonia, MI 13

Trinity Health benefits: Benefit eligibility Who is eligible? Dependents who are eligible for benefits include: • Eligible adult − Spouse, as defined by the IRS (pre-tax) − Civil union partner or other eligible adult who shares a permanent residence and is financially interdependent to the colleague • Your and/or eligible adult's natural children, legally adopted children or children for whom you/eligible adult are the court-appointed guardian − Eligible through the end of the plan year in which they turn 26 — or after if they meet certain disability criteria before their 26 th birthday − Eligible regardless of marital status, student status, residency or financial dependency • Eligible adult may not be covered as a colleague and as a dependent • Eligible children may only be covered under one colleague parent Note: Children of eligible adults may be covered only if their eligible adult is covered © 2018 Trinity Health - Livonia, MI 14

Choosing a Primary Care Physician © 2018 Trinity Health - Livonia, MI 15

Choosing a Primary Care Physician (PCP) • Maintaining a relationship with a primary care physician is an important factor in overall health • Recognize health problems • Identify and meet health goals • Help prevent serious, long-term health conditions • Following preventive recommendations help keep cost of health care low • Trinity Health encourages colleagues to develop a relationship with a PCP © 2018 Trinity Health - Livonia, MI 16

Choosing a Primary Care Physician (PCP) • Effective January 1, 2019 all members enrolled in an self-insured standard medical plan thru Blue Cross Blue Shield (BCBSM), (regardless of age) will be required to have a PCP on record • Member will select PCP via the BCBSM online portal © 2018 Trinity Health - Livonia, MI 17

Choosing a Primary Care Physician (PCP) • If a member does not select a PCP, the plan will auto assign based on the following hierarchy 1. Based on claim history 2. Tier 1 physician within 10 mile radius of member home 3. Tier 2 physician within 10 mile radius of member home • If a Tier 2 PCP was auto assigned, members have the option to self-elect a Tier 1 PCP for service BCBSM: One caution: at this time we do not have a safeguard that will prevent the auto designation of closed practices or PCP not accepting new patients © 2018 Trinity Health - Livonia, MI 18

Choosing a Primary Care Physician (PCP) • There will not be penalty for a member failing to choose their own PCP • Claims will not be impacted if a member seeks care from a different PCP than designated • Members may change their PCP every 30 days • Primary Care Physicians may also include certain specialty types: • Internal medicine, Family Medicine, General Practice, Pediatricians • BCBSM PCP names will not be printed on medical ID cards © 2018 Trinity Health - Livonia, MI 19

Summary of Trinity Health Benefit Programs © 2018 Trinity Health - Livonia, MI 20

Trinity Health benefits: Three medical plans give colleagues options to meet their diverse needs 1 2 3 Traditional Plan Health Savings Plan Essential Plan • Pay more each paycheck, but less at the time of service • Choose this plan if you are interested in lower costs at the time you use the insurance (HDHP with HSA) • Pay less each paycheck, but more at the time of service until you meet your deductible • Receive annual seed money in an HSA based on enrollment tier • Choose this plan to contribute to the HSA, and maximize your tax advantage as you save for current and future health care expenses (Assist plan with HRA if qualify) • Pay the least amount each paycheck, but more at the time of service • Choose this plan if you are interested in lower payroll contributions • Essential Assist plan, including HRA with annual seed money based on enrollment tier, available for colleagues who meet certain income requirements © 2018 Trinity Health - Livonia, MI 21

Health Savings Account (HSA) Health Savings Plan • Included with Health Savings Plan medical plan • Use it to pay for current or future health care costs • HSAs are a great way to save on taxes: • No taxes on the amount contributed through payroll deductions • No taxes on the amount withdrawn for qualified expenses • No taxes on the interest earned in the account (up to amounts set by federal law) • Trinity Health will make a full contribution to HSAs in January based on the coverage level elected • Any money not used during the year is carried over, without any limits • Change the amount contributed through payroll deductions at any time during the plan year • HSA money is yours to keep — and can be used for health care expenses even if you change jobs or retire HSA © 2018 Trinity Health - Livonia, MI 22

Essential Assist Plan with HRA Essential Assist • Essential Assist medical plan for colleagues who meet certain income requirements • You must apply to enroll in this plan. Applications and documentation due by November 19 th and should be sent the HR Service Center at: HR 4 U@trinityhealth. org • If you apply and qualify, you will be enrolled in the Essential Assist plan, and Trinity Health will make a full contribution to a Health Reimbursement Account — an HRA — in January based on your coverage level • Use it to pay for current or future medical costs that occur within the plan — funds are automatically withdrawn as you use your medical benefits; there is no need to make a payment and submit a claim for reimbursement • Any HRA money not used during the year is carried over as long as you meet the requirements and remain enrolled in this plan the next plan year • You cannot contribute to the HRA • Any remaining money in the HRA when you leave Trinity Health is forfeited HRA © 2018 Trinity Health - Livonia, MI 23

Three medical network tiers • Each plan offers three network tiers • Each Tier offers choice in where to receive care • You receive the highest level of benefits when you use the Tier 1 network and the lowest level benefits when you use the Tier 3 network TIER 1 TIER 2 TIER 3 Trinity Health network facilities and aligned providers — highest benefit Blue Cross Blue Shield in-network providers All other providers (out-of-network) — lowest benefit © 2018 Trinity Health - Livonia, MI 24

Trinity Health benefits: Medical and Rx Ded. = Deductible Coins. = Coinsurance Highlights Network Tier Traditional Plan Health Savings Plan Essential Pan Deductible 1 $250/$500 $1, 5002/$3, 000 $1, 0002/$2, 000 2 $750/$1, 500 $2, 5002/$5, 000 3 $1, 500/$3, 000 $3, 5002/$7, 000 $4, 0002/$8, 000 (single/family) HSA/HRA Contribution Coinsurance (patient pays) Out of Pocket Maximum, including deductible, copay and Rx (single/family) Preventive Care N/A HSA Single - $650 HRA Single - $8501 HSA Family - $1, 300 HRA Family - $1, 7001 1 10% 20% 20% 3 40% R&C 1 $2, 500/$5, 000 $2, 600/$5, 200 $3, 500/$7, 000 2 $4, 750/$9, 500 $5, 000/$10, 000 $5, 500/$11, 000 3 $9, 500/$19, 000 $7, 000/$14, 000 $9, 000/$18, 000 1, 2 0%, no Ded 1 HRA is only available to colleagues who participate in the Essential PPO Assist plan. 2 The individual deductible only applies to those enrolled in colleague-only coverage for the Health Savings PPO and Essential PPO Assist Plans. For all other coverage levels, the full family deductible must be met even if only one person in the family is receiving care. © 2018 Trinity Health - Livonia, MI 25

Trinity Health benefits: Medical and Rx Highlights Office Visits Inpatient Admission Retail Rx (34 -day supply) Mail Order Rx (90 -day supply) Ded. = Deductible Coins. = Coinsurance Network Tier Traditional Plan Health Savings Plan Essential Plan 1 PCP $20 copay; Specialist $30 copay 10% Coins. 2 PCP $30 copay; Specialist $40 copay 20% Coins. 3 40% Coins. 1 $0 copay; 10% after Ded. $0 copay; 20% after Ded. 2 $500 copay, then Ded. & 20% Coins. $750 copay, then Ded & 30% Coins. 3 $1, 000 copay, then Ded. & 40% Coins. $1, 000 copay, then Ded & 40% Coins. Generic $10 copay Brand Formulary 20% Coins. (min $30/max $80) 25% Coins. (min $30/max $80) Brand Non Formulary 40% Coins. (min $60/max $100) 50% Coins. (min $60/max $100) Generic $25 copay Brand Formulary 20% Coins. (min $75/max $200) Brand Non Formulary 40% Coins. (min $150/max $250) 20% after Ded. 25% Coins. (min $75/max $200) 50% Coins. (min $150/max $300) © 2018 Trinity Health - Livonia, MI 26

Plan Selection Tools • Caremark • Link for each plan to estimate cost of prescription drugs available on My. Benefits © 2013 CHE Trinity Health 27

Well-being initiative • Unified health, productivity and well-being initiative Activity Automatic Period 1 Period 2 N/A 100 Assessment Life. Points 100 Meaningful Choice Life. Points (complete the Health Assessment) (choose from various activities that add up to 100 points) Deadline N/A March 29 April 1 -June 28 Incentive Begin plan year with the Full Incentive rate for medical benefits from Jan. 1 – April 30 Maintain lower pay period cost for medical benefits from May 1 – July 31 Maintain lower pay period cost for medical benefits from Aug. 1 – Dec. 31 • Per-pay-period incentive value: • $15 for one person • $30 for two people (colleague + spouse/eligible adult) Learn More… • Online at mybenefits. trinity-health. org and click Live Your Whole Life • Or call 855 -491 -8781 © 2016 Trinity Health - Livonia, MI 28

Well-being initiative • Unified health, productivity and well-being initiative • Find tools, support and meaningful choice activities to support your journey Learn More… • Online at mybenefits. trinity-health. org and click Live Your Whole Life • Or call 855 -491 -8781 © 2016 Trinity Health - Livonia, MI 29

Live Your Whole Life Well-Being Incentive Summary • Who is eligible • Health plan enrolled colleagues • Health plan enrolled spouses/eligible adult dependents (children and adult children not required to participate in Health Assessment or meaningful choice activities) • All eligible members start with incentive • Separate incentive for health plan enrolled colleagues and spouses/eligible adult dependents • Two-period design gives a chance to regain the incentive if lost in Period 1 • Those who complete Period 1 activities maintain incentive May 1 -July 31, 2019 • Those who complete Period 2 activities maintain incentive Aug. 1 -Dec. 31, 2019 • Exceptions • Members who are benefits effective after 1/1/19 will be maintain the incentive rate through the remainder of the plan year • Submit all exception requests and appeals directly to LYWL well-being vendor • Must be submitted and received by the activity deadline for consideration • Leave of Absence does not equal exception from incentive activity design © 2016 Trinity Health - Livonia, Mich. 30

Live Your Whole Life Well-Being Tools • Assessment Activities – incentive activity • Health Assessment: a 15 -minute questionnaire about your health to find your strengths and see where you can improve. • Health Screening: complete tests to understand a few key health measures such as, blood pressure, cholesterol and glucose. There are several ways to submit your numbers: Get a health screening at scheduled on-site events Visit your healthcare provider and submit the completed Health Screening Form (you may use results from July 1, 2018 to March 31, 2019) Visit a community access lab • Meaningful Choice Activities - incentive activity • Red. Brick Track™: Log your daily well-being • Red. Brick Journeys®: Online programs your way, at your pace • Health coaching: Work one-on-one with a health expert • Challenges • These fun and social challenges give you the opportunity to fire up your competitive spirit. Participate to boost your motivation and stretch beyond your usual routine. © 2016 Trinity Health - Livonia, Mich. 31

2018 Cohort 1 Design Through the Live Your Whole Life well-being incentive design we do just that; offering meaningful choice activities and an incentive for working toward healthy living goals. Dates Incentive* Period 1 Oct. 1, 2018 Through Mar. 29, 2019 Maintain reduced per pay cost for medical coverage Period 2 April 1, 2019 through June 28, 2019 Maintain reduced per pay cost for medical coverage Activity** Points Goal Health Assessment Cohort 1 = 100 Earn 100 Assessment Activity Life. Points Coaching 50 points per call Journeys (digital coaching) 25 points per stage Track 5 points per day Earn 100 Meaningful Choice Activity Life. Points Assessment Activities Meaningful Choice Activities 32

Trinity Health benefits: Dental 1 2 Two Dental Plan Options: High Plan Standard Plan In-Network Highlights High Plan Standard Plan Network(s) Premier and PPO Deductible $25/$50 $50/$100 Annual maximum (non-ortho) $1, 750 $1, 500 Preventive care 100% covered Basic restorative services 80% after deductible 60% after deductible Major restorative services 60% after deductible 50% after deductible Orthodontics 50% Not covered Orthodontics lifetime max $1, 500 Not covered © 2018 Trinity Health - Livonia, MI 33

Trinity Health benefits: Vision 1 2 Two Vision Plan Options: High Plan Standard Plan In-Network Highlights Vision exam Lenses High Plan Frames Contact lenses (in lieu of eyeglasses) • Necessary • Elective (selection) • Elective (non-selection) 100% covered for: • Standard, Deluxe, Premium, Platinum Progressive, Photochromic and Polycarbonate lenses • Standard scratch-resistant, standard anti-reflective, ultraviolet and edge coating • Tints Standard Plan $10 copay 100% covered for: • Polycarbonate lenses • Standard scratch-resistant coating $150 retail allowance • 100% covered (up to 8 boxes) • $200 allowance • 100% covered (up to 6 boxes) • $175 allowance © 2018 Trinity Health - Livonia, MI 34

Flexible Spending Accounts (FSAs) Health Care FSA • Pay for eligible health care expenses, such as medical, prescription drugs, dental and vision • Contributions deducted before taxes from your biweekly paycheck • Full Health Care FSA election is available • Pay via debit card ― or submit claims through Wage. Works’ online portal (www. wageworks. com) or mobile app • May be used for expenses through March 15 immediately following the plan year (Dec. 31) • Any money not requested for reimbursement by March 31 following the plan year will be forfeited • Please note: Funds used January 1 -March 31 should be paid out of pocket and submitted for reimbursement if you wish to use last year’s funds. Use of the debit card during this time period will automatically use the current plan year funds. © 2018 Trinity Health - Livonia, MI 35

Flexible Spending Accounts (FSAs) Dependent Care FSA • Pay for eligible dependent care expenses for eligible dependents, such as day care and elder care services • Contributions deducted before taxes from your biweekly paycheck • Only your current FSA balance is available to use • May be used for expenses during the plan year (through Dec. 31) • Any money not requested for reimbursement by March 31 following the plan year will be forfeited • Submit claims through Wage. Works’ online portal (www. wageworks. com) or mobile app © 2018 Trinity Health - Livonia, MI 36

Trinity Health benefits: Life and AD&D Trinity Health paid Basic Life Insurance Basic AD&D 1 x annual base salary (max $1. 5 million) Colleague paid Supplemental Life and AD&D (these elections are separated) 1 x to 8 x annual base salary (max $1. 5 million) Child Life Spouse Life $10, 000, $20, 000, $50, 000, $80, 000 or $100, 000 $5, 000, $10, 000 or $20, 000 © 2018 Trinity Health - Livonia, MI 37

Trinity Health benefits: Additional benefits ü Group Legal Plan — Easy and low-cost access to attorneys for ü Adoption Assistance — You can receive financial help with ü Employee Assistance Program (EAP) — Free, confidential a selection of personal legal services – Enroll through annual open enrollment eligible expenses for each child you adopt, with a per adoption maximum – See System office policy for more information support to assist you with a wide variety of services, from finding solutions to personal and family issues to supporting you in completing daily life responsibilities – for phone numbers to your local EAP visit the my benefits website at: http: //mybenefits. trinity health. org/body. cfm? id=573&fr=true © 2018 Trinity Health - Livonia, MI 38

Questions and contact information • Questions? • For more information: • Visit: http: //mybenefits. trinity-health. org • Contact the HR Service Center at: HR 4 U@trinity-health. org or by phone at 877 -750 -4748 from 8: 00 a. m. to 5: 00 p. m. Monday Through Friday, select: Menu option #5 (enter your employee ID#) Menu option #9 (Open Enrollment) • Executives to contact Executive support at: Executive. HR 4 U@trinityhealth. org or by calling 734 -343 -1310 or 734 -343 -1427. © 2018 Trinity Health - Livonia, MI 39

The information provided in this summary is designed to assist you with understanding your options under Trinity Health’s welfare benefit plans and programs. It is only an overview and is not intended to be a comprehensive description of the benefit plans and programs available to you. It does not constitute a contract and is not meant to interpret, extend or change any plan or program provisions in any way. The summary plan descriptions and official plan and program documents describe the plans and programs in more detail, and you should refer to these documents for answers to your specific questions regarding the plans and programs, including what services are covered by a plan. If there is a discrepancy between printed materials, the official plan and program documents will prevail. Trinity Health retains the right to make changes to or terminate its benefit plans and programs at any time, including making changes to comply with and exercise its options under the Affordable Care Act and other applicable laws. To view the summary plan descriptions and certificates of coverage, visit the My. Benefits intranet site at http: //mybenefits. trinity-health. org. For any plan or program in which you participate, you also have the right to request from the colleague’s employer or Total Rewards Benefits & Well-Being, Trinity Health, 20555 Victor Parkway, Livonia, MI 48152, a full printed copy of the summary plan description or certificate of coverage and other official plan or program documents. There will be no charge for the printed copies. All Trinity Health group health plans provide care coordination, care management, utilization review and referral services to help manage the health care provided to covered members. By enrolling in a Trinity Health group health plan, you understand the plan will provide services to manage each covered member’s care. These services may be provided through independent third-party administrators, a clinically integrated network of hospital, physicians and other health care providers and professionals ("CIN") and other health care providers. Your participation in a Trinity Health group health plan means the persons contracted to provide these services will have access to your personal health information, including health information you disclose through wellness programs and well-being activities. Trinity Health facilities and health care providers and professionals affiliated with Trinity Health facilities participate in certain CINs. You may be contacted about your health care by a CIN, including by individuals at a Trinity Health facility or providers who are performing services for the CIN or directly for the group health plan. Information about your medical treatment at any facility and from any health care provider or professional may be accessed and used by individuals who work at a Trinity Health facility or provider (including your employer) participating in a CIN or the group health plan not only for treatment but also to manage and coordinate your health care. Any access to, use or disclosure of protected health information will comply with the privacy and security regulations under the Health Insurance Portability and Accountability Act and any applicable state privacy and security laws. © 2018 Trinity Health - Livonia, MI 40