University Human Resources WELCOME Merit Employees ISU Plan

University Human Resources WELCOME Merit Employees ISU Plan Benefits for January 1, 2018

UHR Service Center and Benefits Office Room 3810 Beardshear Hall Phone 515 -294 -4800 or 877 -477 -7485 Benefits Consultants: Jerilyn Rasmusson (A - C) Dawn Shedarowich (D - I) Kris Wyatt (J-L) Jane Walter (M - R) Colleen Schalinske (S - U) Sarah Ford (V – Z) University Human Resources

Points of Interest Iowa Legislature approved changes to the Iowa Code governing collective bargaining o Merit employees offered the ISU Plan • Effective January 1, 2018 • All Merit employees will need to make changes during open change to maintain benefits o All ISU employees offered the same benefit plan designs and employee premium contributions o No plan design changes and no premium increases for January 1, 2018 o University Human Resources

What Will Change? o o Medical / Pharmacy Insurance Dental Insurance Life Insurance Long-Term Disability Insurance University Human Resources

Medical and Dental Insurance Available for: • • • Tier One - Employee only Tier Two – Employee and a spouse or domestic partner Tier Three – Employee and your child or children Tier Four – Employee and your family (spouse or partner & children) Double spouse family plan (both employees work for ISU) University Human Resources

ISU Plan Medical Insurance Plans Administered by Wellmark Blue Cross/Blue Shield o Two Different Plan Designs • Preferred Provider Organization (PPO) Alliance Select • Health Maintenance Organization (HMO) Blue Advantage o Choice for the best coverage to meet your needs o University Human Resources

Monthly Medical/Prescription Insurance Premiums Comparison Tier of Coverage Alliance Select (PPO) & RX NEW (01/01/2018) Iowa Select & RX Program 3 Plus & RX Blue Access & RX (MCO) Blue Advantage & RX (HMO) NEW (01/01/2018) Employee Only $ 20. 00 $ 0 Employee + Spouse/Partner $263. 00 $ 78. 00 Employee + Children $173. 00 $ 46. 00 Employee + Family $339. 00 $328. 00 $335. 00 $20. 00 $112. 00 Family Double Spouse/Partner (Each Employee Pays ) $ 97. 00 $ 20. 00 $20. 00 $ 0 Note: This comparison shows current SOI rates but it is unknown at this time what plans and premiums will be offered to employees by the SOI after 12/31/17. University Human Resources

Medical Plan Comparison Plan Provisions Alliance Select (PPO) Iowa Select Program 3 Plus (NEW 01/01/2018) Deductible • Single Inpatient Services Only $300 $400 $0 in-network $300 out-of-network $600 out-of-network $250 $500 in-patient & out-patient Services 10% in-network 20% after deductible out-of-network 10% 20% $1, 500 in-network $3, 000 out-of-network $3, 000 in-network $6, 000 out-of-network $1, 000 $2, 000 Office Visit $20 copay in-network Does not apply toward out-ofpocket maximum 20% coinsurance out-of-network $15 copay Emergency Room $100 copay, then 10% in-network $100 copay, then 20% out-ofnetwork $50 0% No Deductible • Family Coinsurance Out-of-Pocket Maximum to end of calendar year • Single • Family University Human Resources

Medical Plan Comparison Plan Provisions Alliance Select (PPO) Iowa Select Program 3 Plus NEW (01/01/2018) Other Office Services Such as: Minor Surgery in an office setting $20 copay in-network, does not apply toward out-of-pocket maximum plus 10% 20% coinsurance out-of-network In-Network 10% Deductible waived Out-of-Network 20% After Deductible $20% after deductible Preventative Services Covered at 100% - in-network only No coverage – out-of-network Covered at 100% In-Network – Providers contracted with BC/BS as PPO Providers Nationwide Network – 90%/10% coinsurance No Network required but best to see BC/BS contracted providers 80%/20% coinsurance Out-of-Network – Providers NOT contracted as PPO but with BC/BS 80%/20% coinsurance Out-of-Network – Providers NOT contracted with BC/BS Risk of balance billing Referral May self-refer University Human Resources

Medical Plan Comparison Plan Provisions Alliance Select (PPO) Iowa Select Program 3 Plus (NEW 01/01/2018) Routine Eye Exam Covered – in-network only Covered Not Covered Routine Hearing Exam Covered – in-network only Covered Not Covered Chiropractic Services Covered Not Covered Impacted Wisdom Teeth Extraction Covered Not Covered Gastric By-Pass Surgery Covered Not Covered Infertility Treatment Fertility / Infertility Services – Transfer procedures subject to $15, 000 lifetime maximum. Prescriptions for this category are medical claims Fertility / Infertility Services – Transfer procedures and the collection of donor semen or oocytes $25, 000 per lifetime Guest Membership Nationwide Network, this does not apply University Human Resources

Medical Plan Comparison Plan Provisions Blue Advantage (HMO) Blue Access (MCO) NEW (01/01/2018) Deductible • Single • Family $0 $0 Coinsurance 0% 10% on inpatient & out-patient hospital services, ambulance & urgent care centers Out-of-Pocket Maximum end of calendar year • Single • Family $0 $0 $750 $1, 500 Office Visit $10 copay Emergency Room $100 copay $50 copay University Human Resources

Medical Plan Comparison Plan Provisions Blue Advantage (HMO) Blue Access (MCO) NEW (01/01/2018) Other Office Services Covered at 100% Preventative Services Covered at 100% In-Network – Providers contracted with BC/BS Iowa Network of Providers • Wellmark Health Plan of Iowa (WHPI) network Out-of-Network – Providers NOT contracted as Wellmark Health Plan of Iowa No coverage – Unless • Emergency room • Prior authorization from Wellmark for non-emergency services • Enrollment in Guest Membership Program (see next slide) Referral Self Referral to a provider, must be in WHPI network Not required for providers in the WHPI network University Human Resources

Medical Plan Comparison Plan Provisions Blue Advantage (HMO) Blue Access (MCO) (NEW 01/01/2018) Routine Eye Exam Covered – in Network Routine Hearing Exam Covered – in Network Chiropractic Services Limited Providers in Network Impacted Wisdom Teeth Extraction Covered – in-network Not Covered Gastric By-Pass Surgery Covered – in-network Not Covered Infertility Treatment Fertility / Infertility Services – Transfer procedures subject to $15, 000 lifetime maximum. Prescriptions for this category are medical claims Not Covered Guest Membership • • Allows for services for out-of-state college students, child residing with a out-of-state custodial parent or long-term travelers (90 -180 days) May not be retroactive, turn off guest membership when resuming in-network use Routine services allowed • • Allows for services for out-ofstate college students, child residing with a out-of-state custodial parent or long-term travelers (90 -180 days) May not be retroactive, turn off guest membership when resuming in-network use Routine services allowed University Human Resources

Prescription Plan Comparison Plan Provisions ISU Plan – Express Scripts Alliance Select (PPO) & Blue Advantage (HMO) NEW (01/01/2018) Wellmark Iowa Select & Program 3 Plus Wellmark Blue Access (MCO) Annual Out-of-Pocket Maximum $1, 500 single $3, 000 family $ 500 $1, 000 $ 5, 850 $11, 700 30 -day supply – Retail Pharmacy $10 copay for generic 30% coinsurance for preferred brand name ($100 maximum copay/prescription) 50% coinsurance for non-preferred brand name ($200 maximum copay/prescription) $5 $15 $30 or 25% whichever is greater $30 copay for generic 30% coinsurance for preferred brand name ($300 maximum copay/prescription) 50% coinsurance for non-preferred brand name ($600 maximum copay/prescription) $5 $15 $30 or 25% whichever is greater $0 copay for generic 25% coinsurance for preferred brand name ($250 maximum copay/prescription) 33% coinsurance for non-preferred brand name ($500 maximum copay/prescription) $10 $30 $60 90 -day supply – Retail Pharmacy 90 -day supply Home Delivery Pharmacy University Human Resources

ISU Plan - Prescription Coverage Making a transition to a new Prescription plan called Express Scripts o Prepare for transition: • Fill prescriptions prior to December 31, 2017, if possible • The Express Scripts formulary is specific to ISU Plan • Some drugs require: • Step-therapy • Prior authorization for coverage or quantity limits • Generic equivalent substitution may occur o Prior to enrollment - if you need information in advance about medications, discuss with an ISU Benefit Consultants o After enrollment - call Express Scripts if you have questions regarding your specific medication(s) o University Human Resources

Web Site Information Wellmark • http: //www. wellmark. com/ • 800 -494 -4478 • Register to receive electronic explanation of benefits • Register to access claims information • Locate participating providers Express Scripts • https: //www. express-scripts. com/ • 800 -987 -5248 • Create online account • View prescription purchases – mail order or retail purchases • Verify medication coverage University Human Resources

ISU Plan Dental Insurance Administered by Delta Dental of Iowa o Two Plan Choices: • Basic Plan • Comprehensive Plan o University Human Resources

Monthly Dental Insurance Premiums Comparison Tier of Coverage Basic Comprehensive NEW (01/01/2018) State of Iowa Employee Only $ 0 $16. 00 $0 Employee + Spouse/Partner $30. 00 $77. 00 Employee + Children $37. 00 $82. 00 Employee + Family $45. 00 $96. 00 $38. 53 Family Double Spouse/Partner (Each Employee Pays) $ 9. 50 $35. 00 $ 9. 85 Note: This comparison shows current SOI rates but it is unknown at this time what plans and premiums will be offered to employees by the SOI after 12/31/17. University Human Resources

Dental Insurance Comparison Delta Dental Premier (Dentist is Delta Dental Provider) Basic Comprehensive (3 -year lock in) NEW (01//01/2018) State of Iowa Plan NEW (01/01/2018) Maximum Person/ Year $750 (applied to restorative services only) $1, 500 Annual Deductible $0 $25. 00/contract – first restorative visit $0 Check Ups & Cleaning 100% Cavity Repair & Extractions 50% 80% Root Canals 50% 80% 50% Gum & Bone Disease 50% 80% 50% High Cost Restorations 50% 50% Bridges & Dentures Not Covered 50% Implants Not Covered 50% Not Covered Orthodontics Not Covered 50% after deductible of $50 to Life-time Maximum of $2, 000 (no age limit) $1, 500 Life-time maximum (up to age 19) BASIC RESTORATIVE MAJOR RESTORATIVE University Human Resources

Web Site Information o www. deltadentalia. com o 800 -544 -0718 o Register as subscriber to access coverage details o Register to receive electronic explanations of benefits o Locate participating providers University Human Resources

Double Spouse Options (Medical & Dental) Share A Family Contract on ISU Plan o Who can share: Faculty, P & S, Non-Supervisory/Confidential • Pre/Post Doctoral Associates • Merit • Two employees with children to insure can share a family contract. o One employee’s name is on the contract and the other employee is contributing spouse/partner. o ISU Plan double spouse only applies to a family plan, if children are coming off the plan, the double spouse option ends. o University Human Resources

Coordination of Benefits o o If your spouse/partner have coverage with another employer’s plan. There may be: • Coordination of medical and dental plans • ISU Plan does not allow prescription plan coordination with Express Scripts (choice of member) Coordination of benefit rules applied: • Employer’s plan coverage is primary for that employee. • Insured dependent children, the primary coverage is determined by earliest date of birth of both contract holders. University Human Resources

Tax Consequences of Insuring Domestic Partners / Child Over 26 ? Potential Implications • Individuals may not be “tax dependent” per the IRS • ISU will impute the income and you are taxed on added value of coverage Over-aged Dependent (that is not a tax dependent i. e. , disabled) • Over age 26 and an unmarried, full-time student Domestic Partner • State and Federal tax University Human Resources

Retiree Coverage Retirement after July 1, 2017 – offered ISU Plan medical/pharmacy and dental o ISU Plan Requires: o A minimum of 5 years of continuous participation in medical or dental plans up to the day retirement begins • Years of enrollment in the State of Iowa Plans will count • Must be 55 years of age or older o University contributions end o Coverage must become secondary to Medicare if you continue coverage when eligible for Medicare o Surviving spouse allowed to keep plan if o Enrolled at time of death and • No other group options are available for surviving spouse • University Human Resources

Group Term Life Insurance (Basic) NEW Premiums January 1, 2018: o Life Prior to January 1, 2018 – Cost is shared by you and ISU - your cost is $. 05 per month per $1, 000 of coverage o ISU Plan – 100% of cost paid by ISU University Human Resources

NEW Benefit Dependent Term Life Insurance Employee must be enrolled in both Group Term (Basic) and Voluntary Term Life to add Dependent Life for January 1, 2018. o If currently enrolled in both Group Term (Basic) and Voluntary Term Life, dependents will have guaranteed enrollment • But employee must take action to enroll the eligible dependents during open change period – November 17 Term Policy Eligibility: o Spouse/Partner/Children that are benefits eligible (not an ISU employee) o Children to age 26 o Employees should notify ISU Benefits office if dependents eligibility ends o May apply during open change period (underwriting will be required if not enrolled in basic and voluntary life) Benefits: o $2. 40 purchases term policy paying • $5, 000 for the eligible covered spouse or partner and • $2, 500 for each eligible child o $4. 80 purchases term policy paying • $10, 000 for the eligible covered spouse or partner and • $5, 000 for each eligible child University Human Resources

Long Term Disability Insurance Effective date of coverage: • Automatic enrollment after 12 months of employment • Optional enrollment for 1 st year of employment: Benefits If enrolled in plan at the time the disability incurred and following approval by Principal o Pays a replacement income (75% of first$1, 000/60% of remainder) o Pays into retirement fund for those enrolled in TIAA • Employee and Employer contribution continue • Not applicable to employees with IPERS o Pays all ISU life insurance policies (group term basic, voluntary and dependent) o Option to continue to participate in group medical & dental if enrolled at time of disability • ISU contribution towards medical and dental premiums ends • ISU Plan retiree premiums would apply (effective July 1, 2017 – December 31 2017) • Effective after January 1, 2018 – premiums are undetermined 90 work day waiting period Inquire at Benefits Office if you have questions University Human Resources

NEW - Annual Open Change Period o Every employee required to complete enrollment in Access. Plus • This year only, Merit employees do not have a passive enrollment • Which means employees need to make changes to maintain benefits • Computer labs may be available • Benefit Consultants available to assist o Limited open change period • November 1, 2017 – November 17, 2017 o Additional information in October University Human Resources

Benefits NOT Impacted o o o o Retirement Election Voluntary Term Life Flexible Spending • Review during open change for 2018 contribution Avesis Optional Eyewear Plan Sick Leave Converted Sick Leave Vacation University Human Resources

Benefit Web Page Review more information online: http: //www. hr. iastate. edu/tools-foremployees/meritempchgs o Scroll down to Benefit section o University Human Resources

CONTACTS o o o University Human Resources Service Center 515 -294 -4800 or 877 -477 -7485 Appointments are encouraged Benefits Office e-mail: benefits@iastate. edu Benefit website: http: //www. hr. iastate. edu/benefits University Human Resources

QUESTIONS UHR has a dedicated line to assist staff with questions. Phone: 515 -294 -7775 or email: hrshelp@iastate. edu University Human Resources