State of Tennessee Group Insurance Program New Employee

State of Tennessee Group Insurance Program New Employee Benefits Orientation State and Higher Education Employees

Who is Eligible for Coverage? • Full-time employees and their dependents, who may include: • Legally married spouses • Children up to age 26, (natural, adopted, step-children or children for whom the employee is the legal guardian) • Special circumstances for disabled dependents that may allow for coverage after age 26. Refer to Eligibility and Enrollment Guide or consult your ABC for more information. • Employees cannot be enrolled in Tenn. Care and a State Group Health Insurance Plan • Contact your caseworker at Tenn. Care within 10 days of your date of employment to report your new job, salary and that you have access to medical insurance with your new employer www. partnersforhealthtn. gov 1 -800 -253 -9981 1

Adding Coverage Three times you may add health coverage: 1. As new employee 2. Annual Enrollment in the fall 3. If you experience a special qualifying event Ø Specific life change, (marriage, birth of a baby or something that results in loss of other coverage) Ø Submit within 60 days of the event or loss of other coverage Ø A complete list is provided on page three of the enrollment application www. partnersforhealthtn. gov 1 -800 -253 -9981 2

Choosing Your Health Insurance Options Plan Options Premier PPO Standard PPO Promise Health. Savings CDHP/HSA* Insurance Three Carriers Premium Four Levels (tiers) • Blue. Cross Blue. Shield of Tennessee (Baptist) • Employee • Cigna Local Plus Network( Methodist) • Employee + spouse • Cigna Open Access (Methodist – broader network) • Employee + child(ren) • Employee + spouse + child(ren) After new hire period, changes can only be made if you experience a special qualifying event or during Annual Enrollment in the fall. *COBRA participants and retirees are not eligible for the Wellness Health. Savings CDHP. www. partnersforhealthtn. gov 1 -800 -253 -9981 3

Plan Options (PPOs) • There are three PPO Health Insurance Plan options available to you: • Premier PPO • Standard PPO • Both of these plan options are Preferred Provider Organizations (PPOs) • How a PPO Works: • Visit any doctor or hospital you want • However, the PPO has a list of in-network doctors, hospitals and other providers that you are encouraged to use • These in-network providers have agreed to take lower fees so you pay less for services • You will pay more for non-emergency services from out-ofnetwork providers www. partnersforhealthtn. gov 1 -800 -253 -9981 4

Health Benefits Preferred Provider Organizations (PPOs) • Premier PPO and Standard PPO • Offer same services and treatments • Pay less in copays and coinsurance with the Premier PPO versus the Standard PPO • Pay deductible first before coinsurance applies • Separate out-of-pocket maximums for medical and pharmacy • Pay for prescriptions with copays • When out-of-pocket maximum reached the plan pays 100% for in-network services www. partnersforhealthtn. gov 1 -800 -253 -9981 5

Health Benefits Health. Savings CDHPs 1. Wellness Health. Savings CDHP –the state will put $250 for employee coverage or $500 for family coverage into your HSA* *New enrollees with hire dates August 2 through Dec 1, 2020, will not receive a state contribution in 2020. www. partnersforhealthtn. gov 1 -800 -253 -9981 6

Health Benefits With the Health. Savings CDHP options you have: • Provide comprehensive health insurance coverage • Lower monthly premiums but a higher deductible. A tax-free HSA – which you own. To meet your deductible before the plan starts paying for covered expenses. No separate deductible or out-of-pocket maximum for pharmacy. Coinsurance after you meet your deductible. Lower total out-of-pocket maximum compared to PPOs. www. partnersforhealthtn. gov 1 -800 -253 -9981 7

Health Insurance CDHP restrictions: You cannot enroll in a CDHP if you are enrolled in another plan, including a PPO, your spouse’s plan or any government plan (e. g. , Medicare A and/or B, Medicaid, TRICARE), or if you have received care from any Veterans Affairs (VA) facility or the Indian Health Services (IHS) within the past three months. • Generally, members eligible to receive free care at any VA facility cannot enroll in the CDHP because a HSA is automatically opened for them. Individuals are not eligible to make HSA contributions for any month if they receive medical benefits from the VA at any time during the previous three months. However, members may be eligible if the following applies: • Member did not receive any care from a VA facility for three months, or • The member only receives care from a VA facility for a service-connected disability (and it must be a disability). • Go to https: //www. irs. gov/irb/2004 -33_IRB/ar 08. html for HSA eligibility information. You cannot have a HSA if you or your spouse are enrolled in a medical flexible spending account (FSA) or HRA. You can have a HSA and enroll in a limited purpose FSA for dental and vision costs. www. partnersforhealthtn. gov 8

Health Benefits What are the benefits of an HSA? • The money in your HSA (yours and employer contributions) rolls over each year • Use money in your account to pay deductible and qualified expenses including some not covered by the CDHP (i. e. vision and dental, hearing aids, acupuncture etc. ) • The money is yours! Take it with you if you leave, retire or change plans • The HSA offers tax advantages on money in your account: • 1. Both employer and employee contributions are tax free. • 2. Withdrawals for qualified medical expenses are tax free. • 3. Interest earned is tax free • HSA is a retirement savings account option. www. partnersforhealthtn. gov 1 -800 -253 -9981 9

Health Insurance How does the CDHP/HSA work? You get a HSA to save! The state will put money into your account, and you can contribute too. For example, you can put the difference in premiums between the CDHP and PPO (premium savings) into your account each month. You can use your HSA money to pay for your out-of-pocket costs like your deductible, coinsurance for doctor’s visits and prescription drugs. Your HSA money rolls over each year — you keep it if you leave or retire. • When you turn 65, you can use money in your HSA for non-medical expenses (before age 65 non-medical expenses are both taxed and subject to a 20% penalty. After age 65, non-medical expenses are taxed, but the 20% penalty does not apply). • 2020 maximum HSA contribution amounts (includes employer contributions): • $3, 550 for employee only (includes $250 state HSA contribution) • $7, 100 for all other tiers (includes $500 state HSA contribution) • Members 55 or older can save an extra $1, 000 in a catch up contribution during the plan year www. partnersforhealthtn. gov 10

Health Benefits Pay. Flex – Health Savings Account • If you choose to enroll in a Health. Savings CDHP, a health savings account is automatically opened for you. • Pay. Flex will send you a letter asking for additional information • Then, you will receive a debit card from Pay. Flex. • Register and access your Pay. Flex HSA online at www. stateoftn. payflexdirect. com www. partnersforhealthtn. gov 1 -800 -253 -9981 11

Health Benefits Pay. Flex – Health Savings Account • Pay. Flex free mobile app • Manage and access your account 24/7 • Available for most mobile digital devices • Upload photos of receipts for tax purposes • Earn interest and invest your money • Earn tax free interest on HSA • When account reaches $1, 000 – may invest the funds over this amount online • Account fees: The state pays monthly HSA maintenance fee while you’re enrolled in Health. Savings CDHP. You are responsible for standard banking fees. If you leave your job, retire or choose a PPO option in the future, you will be responsible for paying any applicable HSA fees. www. partnersforhealthtn. gov 1 -800 -253 -9981 12

Voluntary Wellness Program A voluntary wellness program will be available for active state and higher education employees and spouses. The wellness vendor, Active Health, will email information about programs. Regardless of the health plan you choose, you can participate in the program You and your spouse can each earn up to $250* a year by completing certain wellness activities –up to $500* per employee and spouse annually! More information about programs and activities will be available at tn. gov/partnersforhealth on the Wellness page. The Diabetes Prevention Program (DPP) is also offered in 2020. Go to tn. gov/partnersforhealth for details under Other Benefits, Wellness on the DPPwebpage. The cash incentive for both the employee and eligible spouse will be deposited directly into the member’s paycheck. The incentive is taxable and subject to withholding, garnishment and reporting which will impact the actual amount in the member’s paycheck. 13

Telehealth 24/7 Care — When You Need It All health plan members have access to Telehealth medical services. It is available as a part of your health insurance. You can talk to a doctor by phone or computer from anywhere, at any time. When to use Telehealth For non-emergency medical issues (allergies, asthma, bronchitis, cold & flu, infections, fever, ear aches, nausea, pink eye, sore throat) • 24 hours a day, seven days a week — including nights, weekends and holidays • Your doctor or pediatrician is unavailable • It’s not convenient to leave your home or work • You are traveling and need medical care www. partnersforhealthtn. gov 14

Telehealth Cost: • PPO Members: Copay is $15 • Local CDHP Members: You pay the negotiated rate per visit until you reach your deductible, then the primary care office visit coinsurance applies. More Information: You must pre-register with your network vendor to use Telehealth. Network vendor information is below. Blue. Cross Blue. Shield of Tennessee Members • Log into Blue. Access at bcbst. com • Look for Physician. Now • Or, call 888. 283. 6691 Cigna Members • Log into My. Cigna. com • Look for MDLive or Amwell and select the vendor of your choice • Or, call 888. 726. 3171 for MDLive or 855. 667. 9722 for Amwell www. partnersforhealthtn. gov 15

Premiums for 2020: State and Higher Education Employee Share of Monthly Premiums Premium Level Premier PPO Standard PPO CDHP/HSA Employee Only $136 $92 $60 Employee + Child(ren) $204 $139 $89 Employee + Spouse $284 $195 $125 Employee + Spouse + Child(ren) $352 $241 $154 • • Premiums shown are for the employee share for active employees. A complete chart is available in the enrollment newsletter and on the Par. TNers for Health website Premiums are for the BCBS Network S or Cigna Local. Plus network Premiums do NOT include the cost for the larger Cigna Open Access Plus network – which would add $40 to $80 more EACH MONTH depending on your tier www. partnersforhealthtn. gov 16

2020 Deductibles and Out-of-Pocket Co-insurance Maximums Premier PPO Standard PPO Health. Savings CDHP In-Network Employee only $500 $1, 000 $1, 500 Employee + Child(ren) $750 $1, 500 $3, 000 Employee + Spouse $1, 000 $2, 000 $3, 000 Employee + Spouse + Child(ren) $1, 250 $2, 500 $3, 000 Deductibles * Out of Pocket Max (medical and pharmacy combined) Employee only $3, 600 $4, 000 $2, 500 Employee + Child(ren) $5, 400 $6, 000 $5, 000 Employee + Spouse $7, 200 $8, 000 $5, 000 Employee + Spouse + Child(ren) $9, 000 $10, 000 $5, 000 *Out-of-network providers haven’t agreed to the terms and rates of your plan. When you use an out-of-network provider, you pay the difference in the provider’s billed charges and our maximum allowable charge. The amount can be substantial. 17

Pharmacy Benefits CVS/Caremark is the pharmacy benefits manager for all plan members Ø Covered drug list is the same for both the PPOs and CDHPs Ø More than 67, 000 independent and chain pharmacies throughout the U. S. Ø 90 day supply of approved maintenance drugs is available at discounted rates » Copay Installment Program for Maintenance Medications • You can spread the cost of your 90 -day mail order prescriptions over a three-month period – at no additional cost to you. Enroll online or by calling CVS/Caremark customer care: • • For each plan, how much you pay depends on the prescription tier: • Lowest cost: Tier one/generic drug • Higher cost: Tier two/preferred brand drug • Highest cost: Tier three/non-preferred brand • New specialty pharmacy tier - 10% coinsurance will apply with a member minimum ($50, ($150) out-of-pocket. Members enrolled in a CDHP will pay coinsurance for specialty drugs. About 916 Tennessee pharmacies fill 90 -day prescriptions in the Retail 90 Network and a maximum Tobacco Cessation: The state’s prescription drug coverage provides free tobacco quit aids to members who want to stop using tobacco products. www. partnersforhealthtn. gov 1 -800 -253 -9981 18

Pharmacy benefits are included when you and your dependents enroll in a health plan. The plan you choose determines the out-of-pocket prescription costs. How much you pay for your drug depends on whether it is a generic, brand or non-preferred brand the day-supply. CDHP STANDARD PPO PHARMACY (IN-NETWORK)* PREMIER PPO *These are the innetwork pharmacy benefits. If out of network pharmacy benefits are available, they are different and will cost you more. ** Specialty Network Pharmacy: Specialty drugs must be filled through a Specialty Network Pharmacy and can only be filled every 30 days. 30 -DAY SUPPLY 20% coinsurance after Generic $7 $14 deductible is met Brand $40 $50 Non-preferred brand $90 $100 90 -DAY SUPPLY (Retail-90 network pharmacy or mail order) 20% coinsurance after Generic $14 $28 deductible is met Brand $80 $100 Non-preferred brand $180 $200 90 -DAY SUPPLY (certain maintenance medications from a Retail-90 network pharmacy or mail order) 10% coinsurance Generic $7 $14 without having to meet Brand $40 $50 deductible Non-preferred brand $160 $180 SPECIALITY PHARMACY** 10% (min $50; max 20% after deductible Coinsurance $150) www. partnersforhealthtn. gov 19

Optional Dental Benefits Eligible employees can choose between two dental options: Cigna Prepaid Plan Met. Life Dental Preferred Plan • Fixed Copays • Coinsurance and deductibles • Participating dentists only • Any dentist • Pay less with network providers • Eligible employees can enroll in one of two options • Dental insurance premium is paid 100 percent by the employee www. partnersforhealthtn. gov 1 -800 -253 -9981 20

Prepaid Plan Administered by Cigna Services provided at set copay amounts from limited network • Must select a dentist from the Prepaid Plan list and notify Cigna • Some areas in state where network dentists are not available • Must use selected dentist to receive benefits • No deductible, no claims and no waiting period • Referrals are not required www. partnersforhealthtn. gov 1 -800 -253 -9981 21

Dental Preferred Provider Organization (DPPO) Plan administered by Met. Life The DPPO plan provides services with member coinsurance rates • Choose any dentist (maximum benefits when visiting an in-network Met. Life DPPO provider) • Pay co-insurance for covered services • Deductible applies for out-of-network dental care only • You or dentist file claims for covered services • Referrals not required • Some services require waiting 12 -month waiting period • Some limitation and exclusions apply www. partnersforhealthtn. gov 1 -800 -253 -9981 22

Dental benefits Monthly Premiums for Active Members Premiums Cigna Prepaid (DHMO Plan DPPO - Met. Life Employee Only $13. 44 $23. 64 Employee + Child(ren) $27. 91 $54. 36 Employee + Spouse $23. 83 $44. 72 Employee + Spouse + Child(ren) $32. 76 $87. 50 Dental services for both the Prepaid (DHMO)Plan and the DPPO Plan include: • Periodic oral evaluations • Routine Cleanings • Amalgam fillings • Endodontics-Root Canal • X-rays • Extractions • Major restorations • Orthodontics • Dentures www. partnersforhealthtn. gov 23

Vision benefits The state will offer voluntary vision benefits through ― Davis Vision Basic Plan • Discounted rates • Allowances Expanded Plan • Provides services with a combination of copays • Greater allowances • Discounted rates Both options offer the same services including: • Routine eye exam once every calendar year • Frames once every two calendar years • Choice of eyeglass lenses or contact lenses once every calendar year • Discount on LASIK/refractive surgery The basic and expanded plans are both managed by Davis Vision. In-network and out-of-network benefits are available. You will receive the maximum benefit when visiting a provider in Davis Vision’s network. www. partnersforhealthtn. gov 24

Vision benefits Premium rates in 2020: Basic Expanded Employee Only $3. 07 $5. 56 Employee + Child(ren) $6. 13 $11. 12 Employee + Spouse $5. 82 $10. 57 Employee + Spouse + Child(ren) $9. 01 $16. 35 www. partnersforhealthtn. gov 25

Pay. Flex – Flexible Benefits • Allows employee to set aside $2700 - $5, 000/yr. pretaxed dollars for medical and dependent care expenses • Medical Expense Reimbursements include: • Insurance Deductibles, Co-pays, Vision Care, Dental Expenses • Some over the counter drugs – with prescriptions • Other approved out of pocket Medical Expenses • Must re-enroll every calendar year • Dependent Care Reimbursement • Care of children and disabled dependents ( must be tax dependent) • Before care & After school care • **Transportation (120 Per month) & Parking Reimbursement ($230 month) **May enroll anytime 26

Limited Purpose Flexible Spending Account (LPFSA) • Employees that are enrolled in the Health. Savings CDHP Plan, can use the limited purpose FSA to pay for certain dental and vision cost not covered by insurance. • Contribute pretax dollars from your paycheck, up to the Internal Revenue Service (IRS) limit of $2, 700. • Your full contribution is available at the start of the plan year. • Eligible expenses may include: Dental and orthodontia care, like fillings, X-rays and braces, vision care, including eyeglasses, contact lenses and LASIK laser eye surgery. 27

Basic Term Life and Accidental Death and Dismemberment • The State provides free to all full-time employees: • $20, 000 of basic term life insurance • $40, 000 of basic accidental death and dismemberment (AD&D) • If you are enrolled in health insurance as the head of contract, your coverage automatically increases with your salary up to: • $50, 000 for term life insurance • $100, 000 for AD&D insurance • If you enroll in family health insurance, your enrolled dependents are covered for $3, 000 of basic term life coverage and basic AD&D based on your salary and family composition. Coverage effective date is the same as health insurance. • *ULPS employee – Basic Life Insurance is based upon UT salary only $20, 00 and $40, 000 AD&D www. partnersforhealthtn. gov 1 -800 -253 -9981 28

Optional Accidental Death & Dismemberment Insurance • • • Accidental death protection for yourself and your dependents Coverage is available at low group rates – no questions asked Premiums vary by salary You may enroll as a new employee or during Annual Enrollment The maximum benefit available to employees is $60, 000 Enroll through ESS • * ULPS – Voluntary AD&D insurance is based upon UT salary. Basic Term Life, Basic AD&D and Optional AD&D are administered by Minnesota Life. www. partnersforhealthtn. gov 1 -800 -253 -9981 29

Optional Term Life Insurance • Premiums are based on age and the amount of coverage requested • Coverage is also available for spouses and dependent children Ø Spouses: Maximum level of coverage is $30, 000 Ø Children: $5, 000 or $10, 000 term rider • Must enroll in first 31 days of employment for guaranteed issue coverage. Effective after three full months of employment. • You can apply later during Annual Enrollment by answering health questions • Select up to five times your annual base salary when first eligible Ø Ø Minimum coverage level: $5, 000 Maximum coverage level: $500, 000 • Enroll through Minnesota Life website at lifebenefits. com/stateoftn * ULPS employees – Term Life Insurance is based upon UT salary. Optional Term Life Insurance is administered by Minnesota Life. www. partnersforhealthtn. gov 1 -800 -253 -9981 30

Disability insurance (voluntary) The state will offer voluntary disability benefits to full-time state and higher education employees. Important information if you are thinking about enrolling in coverage: • For this annual enrollment period only, there will be no questions asked about your health. • Full-time higher education employees may enroll in short term disability insurance. • Higher education employees should contact their ABCs for more information on long term disability insurance available to them. • * ULPS – Benefit is based upon UT salary only! www. partnersforhealthtn. gov 31

Short term disability insurance (state and higher ed employees) Short term disability insurance (state and higher education employees) Short term disability insurance replaces a portion of your income during a disability, which could last up to 26 weeks. It may be good for those who: • Have little annual or sick leave • Take part in high-risk activities • Don’t have six-month emergency funds Two Options: Option A – 14 day elimination or Option B – 30 day elimination. Both plans will pay 60%of your salary. • To calculate your monthly premium, go to metlife. com/Stateof. TN, click on state employees or higher education employees, and then click on Rates at the top. The short term disability insurance plan is managed by Met. Life. Call the Met. Life State of Tennessee Dedicated Customer Service Line with questions: 855. 700. 8001, Mon. - Fri. , 7 a. m. -10 p. m. , Central time. www. partnersforhealthtn. gov 32

Short-Term Disability Insurance Rates STD Cost: per $100 of member’s covered Monthly Salary Option A: 60%, 14 day elimination period Option B, 60%, 30 day elimination period $1. 34 $1. 08 Determine your covered monthly salary ex. $45, 000 /12 = $3, 750 Divide covered monthly salary by $100 to get Your per$100 of covered monthly salary $3, 750 /100 = $37. 50 Calculate your approximate monthly premium $37. 50 x 1. 34 = $50. 25 33

Lincoln Financial Group – Long Term Disability • Supplemental income paid if you become disabled and can no longer work. • 4 Month Waiting Period • Pays a 67% of Income Replacement • Premiums differ depending on the Level of Coverage • Cost of Living Allowance –Optional • Enrollment is Optional – Must enroll within the first 31 days for guaranteed coverage • After 31 days must answer health questionnaire. 34

Employee Assistance Program (EAP) The Employee Assistance Program (EAP) provides you and your family with both workplace and personal resources. Benefits are administered by Optum Health. • Services are confidential and available at no cost to eligible employees and their • • eligible dependents – even if they don’t have medical coverage. COBRA participants are also eligible. Services are available 24 hours a day, 365 days a year New -Tele. Behavioral Health – talk to a provider over the phone You may use up to five counseling sessions per episode • EAP has resources that can help you and your family with: Family or relationship issues Child and elder care Feeling anxious or depressed Difficulties and conflicts at work Dealing with addiction Grief and loss Legal or financial issues Work/life balance • Call Toll Free 24/7 at 1. 855. HERE 4 TN (855. 437. 3486) www. partnersforhealthtn. gov 35

Behavioral Health and Substance Abuse Treatment All members of state health plans have behavioral health and substance abuse treatment benefits through Optum • Call 1. 855. HERE. 4. TN (1. 855. 437. 3486) or www. here 4 tn. com • Services include: • Outpatient assessment and treatment • Inpatient assessment and treatment • Alternative care (partial hospitalization, residential or intensive outpatient treatment • Treatment follow-up and aftercare • Prior authorization is required for some services • Tele. Behavioral Health – counseling services with a provider over the phone. www. partnersforhealthtn. gov 1 -800 -253 -9981 36

When Will Coverage Begin? • Coverage starts on the first day of the month after you complete one full calendar month of employment. • Positive pay status within 26 weeks, and you gain full-time status, your coverage will start the first day of the month after gaining full-time status. • Health, dental, vision and basic term life/AD&D coverage begin on the first day of the month after one full calendar month of employment from your hire date • Optional Term Life coverage begins after three full calendar months from employment/eligibility • You have 31 days from your hire date to turn in your enrollment paperwork. www. partnersforhealthtn. gov 1 -800 -253 -9981 37

When Are Premiums Paid? • Your ABC will tell you when your premiums will be deducted from your paycheck • If you do not enter your benefit selections early, in some instances you could end up with a double deduction from your paycheck the first month of enrollment. www. partnersforhealthtn. gov 1 -800 -253 -9981 38

When Will My ID Cards Arrive? • Within three weeks of the date your application is processed Blue. Cross Blue. Shield Cigna • Sends up to two ID cards automatically, both with member’s name • Sends separate ID cards for each insured family member with each participant’s name • These may be used by any covered dependent • There may be up to four ID cards in each envelope • CVS/Caremark will send separate ID cards for pharmacy benefits (Note: • If you enroll in dental or vision benefits, you will receive your ID cards within three weeks www. partnersforhealthtn. gov 1 -800 -253 -9981 39

Booklets and Enrollment Forms - Directories - Handbooks - Wellness information - FSA and HSA - LTD Forms 40

Thank you for your attention during this presentation. More information is available at tn. gov/finance/section/fa-benefits If you have questions, please ask your Agency Benefits Coordinator at this time. • 4 1