Your 2020 Benefits Understanding Annual Enrollment 1 2020

Your 2020 Benefits Understanding Annual Enrollment 1

2020 Open Enrollment • Open Enrollment is February 24 th through March 6 th • Changes made during this Open Enrollment will become effective: March 1 st, 2020 2

Benefits Eligibility • Benefits eligible if you work at least 30 hours per week • Eligible dependents include: – – Your legal spouse Your domestic partner Your children up to age 26 Children to age 23 for dental 3

Coverage Information • 2020 elections remain in effect from March 1, 2020 through February 28, 2021 • Can only make changes if you experience a qualified “Life Event” • You must notify HR within 31 days of the change! 4

No Changes! Horizon BCBS of NJ • 2 Dental Plans • 5 Medical Plans – DA$15 – DA$20 – POS – OMNIA – EPO – PPO – DMO 5

Medical Plan Costs - $15 Base Plan • For Teachers, Principals, Supervisors, and Central Office Administration • The Direct Access $15 plan is the Base Plan. • The Direct Access $20 and POS plans are considered “BUYUP” options and you will be required to pay the full cost of the additional premium along with your Chapter 78 contribution. • The additional cost is the difference between the Base DA 15 plan and the DA 20 or POS plan -depending on your election. • There is a Contribution Calculator housed on the employee intranet to help you calculate your cost. 6

Medical Plan Costs Maintenance • New Hires eligible for EPO Only • All other plans are considered “BUYUP” options and you will be required to pay the full cost of the additional premium along with your Chapter 78 contribution. • The additional cost is the difference between the EPO plan and the other four plans -depending on your election. 7

Medical Plan Costs – Part-Time Transportation • New Hires eligible for EPO or Omnia Single Tier Only • All other plans and tiers (spouse, child(ren), family) are considered “BUYUP” options and you will be required to pay the full cost of the additional premium along with your Chapter 78 contribution. • The additional cost is the difference between the EPO plan and the other four plans -depending on your election both plan and tier. 8

Your Medical Benefits Plan Provisions Medical Cost Annual Deductible (Individual/Famil y) Out-of-Pocket Maximum (Includes Deductible) Lifetime * Additional Cost Maximum Direct Access $15 Copay In. Network Out-of. Network Base Plan Direct Access $20 Copay In. Network Out-of. Network Buy Up Plan* None $100/$25 0 None $100/ $250 $400/$800 $2, 000/ $5, 000 $400/ $800 $2, 000/ $5, 000 Unlimited POS $10 Copay In. Network Out-of. Network Buy Up Plan* N/A $500/ $1, 000 $4, 000/ $8, 000 Unlimited * There may be an additional cost to enroll in these plan depending on your CBA. 9

Your Medical Benefits Plan Provisions Direct Access $15 Copay Direct Access $20 Copay POS $10 Copay In. Network Out-of. Network Preventive Care 100% 30% 100% 20% 100% 40% Primary Care Physician Office Visits $15 Copay 30%* $20 copay 20%* $10 copay 40%* Specialist Office Visits $15 Copay 30%* $20 copay 20%* $10 copay 40%* X-Ray and Lab 100% 30%* 100% 20%* 100% 40%* Emergency Room Care $50 Copay Inpatient Hospital Services 100% 30% Outpatient Hospital Services 100% 30% *After deductible $25 copay $35 copay 100% $200 copay – then 20%* 100% 40%* 100% 20%* 100% 40%* 10

Your Prescription Drug Benefits Plan Provisions OOP Max (Individual/Famil y) Retail (30 -day supply) • Generic • Brand Preferred • Brand Non. Preferred Mail Order (90 -day supply) • Generic • Brand Preferred • Brand Non. Preferred Direct Access $15 Copay In. Network Out-of. Network N/A 10% Coinsurance $0 Copay Direct Access $20 Copay In. Network Out-of. Network POS $10 Copay In. Network Out-of. Network N/A $2, 600/$5, 200 10% Coinsurance $5 copay $10 copay $20 copay $0 Copay $5 copay $15 copay $25 copay 11

Your Medical Benefits Plan Provisions Medical Cost Annual Deductible (Individual/Famil y) Out-of-Pocket Maximum (Includes Deductible) Direct Access $15 Copay In. Network Out-of. Network Base Plan OMNIA Tier 1 Tier 2 Lower Cost Plan Option EPO In. Network Out-of. Network Lower Cost Plan Option None $100/$25 0 None $1, 500/ $3, 000 None $400/$800 $2, 000/ $5, 000 $2, 500/ $5, 000 $4, 500/ $9, 000 $2, 500/$5, 000 * Additional Cost Lifetime Maximum Unlimited * There may be an additional cost to enroll in these plan depending on your CBA. 12

Your Medical Benefits Plan Provisions Direct Access $15 Copay OMNIA EPO In. Network Out-of. Network Preventive Care 100% 30% 100% Primary Care Physician Office Visits $15 Copay 30%* $5 Copay $20 Copay Specialist Office Visits $15 Copay 30%* $15 copay $30 Copay $40 Copay X-Ray and Lab 100% 30%* 100% 20%* 100% Emergency Room Care Inpatient Hospital Services *After deductible Outpatient $50 Copay 100% 30% $100 Copay $250 Copay per day up to 5 days $100 Copay then deductible, then 20%* In. Network Out-of. Network $100 Copay $250 Copay per day up to 5 days 13

Your Prescription Drug Benefits Plan Provisions Direct Access $15 Copay In. Network Out-of. Network OMNIA In. Network Out-of. Network EPO In. Network Out-of. Network Deductible (Individual/Famil y) N/A N/A Retail (30 -day supply) • Generic • Brand Preferred • Brand Non. Preferred 10% Coinsurance Mail Order (90 -day supply) • Generic • Brand Preferred • Brand Non. Preferred $0 Copay 14

Horizon Doctor & Hospital Finder The PPO Network is the Horizon Dental Option The DMO Network is the Horizon Dental Choice 15

Dental Change! • Effective March 1 st the dental plans are moving from Delta Dental of NJ to Horizon BCBS of NJ. • The 2 plans offered are the – PPO – Dental Option Network (In-Network and Out-of-Network benefits) – DMO – Dental Choice Network (In-Network Only – Dental HMO) • Dental PPO highlights Two free exams and three cleanings per year • Covers basic and major services • Horizon Pilot Program - Services previously paid to Delta Dental dentist now considered out of network with Horizon will be reimbursed up to balance billed charges. • Carryover Maximum Benefit • You will receive credit for your 2019 Annual Deductible already satisfied • Dependent children covered up to the end of you year of age 23 16

Your Dental Benefits Plan Provision PPO DMO Annual deductible (Individual/family) $25/$75 None Annual maximum person $1, 2750 None Diagnostic and preventive care: Includes cleanings, fluoride treatments, sealants and x-rays 100%, no deductible See Copay Schedule** Basic services: Includes fillings, periodontics, scaling and root planning, and oral surgery 80%* See Copay Schedule** Major services: Includes crowns, bridges and full and partial dentures 50%* See Copay Schedule** 50% $1, 000 lifetime maximum See Copay Schedule** 24 months of active comprehensive treatment Orthodontia (Children up to age 19) *After deductible is met 17

Your Dental Premium Delta Dental Premium (Current) PPO DMO Employee Only $35. 51 $27. 56 Employee +1 $94. 34 $52. 74 Employee + 2 or more $94. 34 $88. 61 PPO DMO Employee Only $31. 87 $18. 54 Employee +1 $84. 91 $53. 35 Employee + 2 or more $84. 91 $53. 35 Horizon BCBS Premium (as of 3/1/2019) -10% off of current premium * Horizon - Two year rate guarantee 18

Dental Carryover Maximum • You can accumulate up to an additional $1, 250 of your annual maximum • Your total maximum can not exceed $2, 500 at any time • To qualify you cannot use more that 50% of the current year’s maximum – ($625) • To qualify a dental claim has to be submitted on your behalf during the year • The total carryover amount is $312. 50 per year 19

Horizon Member Portal 20

Horizon Doctor & Hospital Finder There is a video to assist you with finding your providers. 21

Horizonb. Fit Discount Program Fitness Incentive Program Ø Eligible to receive $20 reward for every month in which you make at least 12 visits at a participating facility Ø Up to $240 a year in rewards Ø 4, 000 participating facilities Active. Fit Makes Tracking Easy Ø Free mobile app Active. Fit can make reporting gym visits easy Ø App Store or Google Play 22

Horizon BCBS of NJ Website: horizonblue. com Toll Free Number: 1 -800 -355 -BLUE (2583) 23

Employee Health Advocacy Direct Path is a free, confidential service that can help employees navigate the healthcare system • Direct Path should be used when you: – Have a question about your any of your benefits – Medical, Dental, Life insurance – Receive a confusing bill – Would you like to know what your health care procedure costs are before you schedule it • Call 800 -640 -1898 or www. Direct. Path. Health. com 24

Items to Consider • All employees should review the medical and dental options and determine what is best for you and your dependents. • Please be on the lookout for the 2020 Open Enrollment Guide and updated Contribution Calculator. – 10 month and 12 month • You will only receive a new medical ID card if you change your medical plan election. 25

What’s Next? • Contact Donna Carlin in the Business Office if you want to change your benefit elections. 26