1. Benefits Overview Tier 2
The information contained in these slides is intended to be a summary only. Please refer to the Summary Plan Description and/or insurance certificates for detailed information.
January 14, 2013

2. Benefit Carriers
BC/BS of Michigan-Simply Blue PPO Medical/Prescription coverage BC/BS of Michigan Dental coverage BC/BS (VSP) of Michigan Vision coverage Lincoln Financial Group Life and AD&D, LTD, STD, and Accident Insurance HelpNet Employee Assistance Program

3. Deadlines
Benefit Elections must be made within 30 days of your date of hire.
Dependent certification is due within 30 days of your date of hire
Benefit Elections go into effect on your 31st day of employment.

4. Documentation
Proper documentation is needed for all eligible dependents that you would like to cover on the medical & prescription, dental or vision plan.
Copies are accepted and can be faxed or ed to human resources.
Child (Children can be covered until the day before their 26th birthday.)
Birth Certification or Adoption order or court document showing relationship.
Spouse (2 documents needed)
Marriage Certificate
Proof of current marriage (last year’s tax return or recent bill coming to your name and spouse’s name at same address.

5. Premium Costs for Medical and Prescription Insurance
Single coverage = No cost to the employee
2-Person coverage = $210.76/bi-weekly
Family coverage = $301.08/bi-weekly
*Premiums are based on 24 pays

6. Medical Deductible with BCBS
Single = $1, Family = $2,500
KRESA will be depositing a pro-rated amount of the single coverage deductible into your Health Savings Account (H.S.A.)
*This amount is pro-rated based on your start date after January 1, 2013

7. No Office Visit Co-pays!
Medical Plan Overview
Ability to choose
in-network or out-of-network care for medical services or supplies
Choose in-network whenever possible as cost will be cheaper
All medical and RX expenses go towards the deductible
Once deductible is met your medical expenses are covered at 100% (Rx subject to copay $10/$40/$80
In Network
Out-of-Network
Deductible
In & out of network does not cross accumulate
$1,250 per member $2,500 for family
$2,500/$5,000
Co-Insurance
100%
80%
Office Visit
80% after deductible
Urgent Care
ER Visit (waived if admitted)
% Co-Insurance
% Co-Insurance Maximum
Does not Include Deductible
$1,000 per member
$2,000/family
$2,000/4,000
Your Benefits-at-a-Glance enclosed in your Open Enrollment booklet go into more details regarding the benefits of each of the 3 plan offerings. The information on the slide is a high level overview of some of the highlights of these plans.
Review slide.
No Office Visit Co-pays!

8. Preventive Services Covered at 100%
Medical Plan Overview
Preventive Care Services (generally one per calendar year)
In Network
Out-of-Network
Health maintenance exam, includes chest x-ray, EKG, cholesterol screening and other lab procedures
Covered 100%
N/A
Gynecological exam
Pap smear—lab and pathology
Well-baby & child care (see multiple visit limits by age)
Mammography screening
Immunizations-pediatric & adult
Preventive Services Covered at 100%
Your Benefits-at-a-Glance enclosed in your Open Enrollment booklet go into more details regarding the benefits of each of the 3 plan offerings. The information on the slide is a high level overview of some of the highlights of these plans.
Review slide.

9. Medical Plan Overview Other covered services In Network Out-of-Network
Allergy testing and therapy
100% after deductible
80% after deductible
Chiropractic manipulation--12 visits per year
Outpatient physical, speech and
occupational therapy--
30 combined visits per year
Your Benefits-at-a-Glance enclosed in your Open Enrollment booklet go into more details regarding the benefits of each of the 3 plan offerings. The information on the slide is a high level overview of some of the highlights of these plans.
Review slide.
No Pre-existing Conditions
No Lifetime Maximums

10. Prescription Plan Overview
Cost of Prescription Applied to the Deductible
Once Deductible Met – Copay’s Apply
Once Copay’s Accumulate to the Out of Pocket Maximum $1,000 Single / $2,000 Family plan pays 100%
Step Therapy
Prescription Drug Coverage In-Network Benefits (up to a 30 day supply)
$10 (or less) co-pay: Generic
$40 co-pay: Formulary (Preferred) Brand Name drugs
$80 Non-Formulary (Non-Preferred) Brand Name drugs
Oral and Injectable contraceptives – covered with applicable copay
Applicable co-pay applies for elective drugs, i.e. infertility, weight loss & sexual impotency
Rx formulary can be found BCBSM web site on and has also been placed on the KRESA internal employee web site
Member uses the same card for med/surg and pharmacy both in and out of MI
Same Rx plan regardless of which medical plan you enroll in

11. Prescription Plan Overview Mail Order
Mail Order: Prescription Drug Coverage In-Network Benefits home delivery for a 31 to 90 day supply
Prescription Drugs will be subject to the following co-pay once the Single / Family deductible has been met
Generic drugs – $20 co-pay
Formulary drugs - $80 co-pay
Non formulary drugs $160 co-pay
Your plan also offers a retail 90 benefit. Members are able to obtain a 90 day supply of medication from a participating retail pharmacy. The Retail-90 program offers you the same financial incentive as the mail-order program (buy 2 get 1 free).
MOPD2x
Retail-90-2x
Go to website to find participating retail-90 pharmacies ( we will also have a list with us to reference).
Review slide

12. Dental Plan Overview Class I services - 25% of approved amount
Member’s responsibility (co-pays and dollar maximums)
Can use both provider networks (Dental Network of America or Traditonal Plus) found on BCBSM web site.
Dollar maximums
Annual maximum (for Class I, II and III services)
$1,000 per member
Lifetime maximum (for Class IV services)
$1,500 per member
Class 1: oral exams and xrays
Class 2: Fillings/crowns
Class 3 Bridges
Class 4: Orthodontics for children up to age 19
**Can use HSA dollars but does not go towards your medical deductible.
Class I services % of approved amount
Class II services % of approved amount
Class III services % of approved amount
Class IV services % of approved amount
**Review your Dental summary for specific services

13. Premium Costs for Dental Insurance
Single coverage = No cost to the employee
2-Person coverage = $18.41/bi-weekly
Family coverage = $26.30/bi-weekly
*Premiums are based on 24 pays

14. Blue Vision SM Choice with VSP
Annual Vision Exam - $10
Lenses & Frames - $25 copay
Lenses every 12 months
Frames every 12 months
Contact Lenses - $25 copay
Medically necessary
Elective $130 allowance
12 months
VSP (Vision Service Plan Network)
Discounts on additional pairs of prescription and nonprescription glasses, including sunglasses
Laser VisionCareSM program Discounts on LASIK and PRK 15% off or 5% off promotional offers .

15. Premium Costs for Vision Insurance
Single coverage = No cost to the employee
2-Person coverage = $3.82/bi-weekly
Family coverage = $5.45/bi-weekly
*Premiums are based on 24 pays

16. Flexible Spending Account Dependent Care
FSAs give you a convenient way to pay for eligible healthcare and/or day care (child and adult) expenses
Set aside pre-tax dollars through convenient payroll deductions
Use your debit card for eligible expenses
Save money on taxes
Contribute $100 - $5,000
If you do not use it you do lose it
HSAs are tax-advantaged savings accounts available to individuals who have a high-deductible health
plan and no other first-dollar medical insurance coverage. Money contributed by an employer or
employee (or both) to an HSA that is used to pay for qualified medical expenses is not taxable. The amount
of money contributed to the HSA, which is capped annually, may be contributed directly or deducted from
the accountholder’s individual or family federal tax return. Contributions to HSAs not spent on qualified medical expenses may be rolled over
from year to year.
Employer contributions are not subject to payroll taxes
- After-tax employee contributions are tax deductible from gross
income.
- Pre-tax contributions can be made through payroll deduction and are
not subject to Federal income tax, Social Security or (in most cases) state taxes.
May be combined with limited purpose HRA, limited purpose FSA and dependent care FSA
BCBSM does not automatically send claims for reimbursement for groups with a HSAs only
BCBSM will send eligibility files

17. Health Savings Accounts (HSAs) – Health Equity
Health Savings Accounts – What Is It?
Tax-advantaged savings accounts available to individuals who have a high deductible health plan and no other first dollar medical coverage
Contributions can be made by employer, employee, employer and employee and/or third party
You can stop or start contributing at any point in time.
KRESA will be depositing this amount into your Health Savings Account (H.S.A.)
This amount is pro-rated based on your start date after January 1, 2013
HSAs are tax-advantaged savings accounts available to individuals who have a high-deductible health
plan and no other first-dollar medical insurance coverage. Money contributed by an employer or
employee (or both) to an HSA that is used to pay for qualified medical expenses is not taxable. The amount
of money contributed to the HSA, which is capped annually, may be contributed directly or deducted from
the accountholder’s individual or family federal tax return. Contributions to HSAs not spent on qualified medical expenses may be rolled over
from year to year.
Employer contributions are not subject to payroll taxes
- After-tax employee contributions are tax deductible from gross
income.
- Pre-tax contributions can be made through payroll deduction and are
not subject to Federal income tax, Social Security or (in most cases) state taxes.
May be combined with limited purpose HRA, limited purpose FSA and dependent care FSA
BCBSM does not automatically send claims for reimbursement for groups with a HSAs only
BCBSM will send eligibility files
2013 Maximum Contributions:
Single $3250**
Family $6450**
** Includes KRESA employer contribution

18. What are the advantages of an HSA?
Flexibility
You can use the funds in your account to pay for current medical expenses, including expenses that your insurance may not cover, or save the money in your account for future needs, such as:
Health insurance or medical expenses if unemployed
Medical expenses after retirement (before Medicare)
Out-of-pocket expenses when covered by Medicare
Long-term care expenses and insurance
Savings
You can save the money in your account for future medical expenses and grow your account through investment earnings.
Portability
Accounts are completely portable, meaning you can keep your HSA even if you:
Change jobs
Change your medical coverage
Become unemployed
Move to another state
Change your marital status

19. What are the advantages of an HSA?
Ownership
Funds in your HSA belong to you and are always 100% vested.
Unlike other medical spending accounts HSA funds can remain in the account year to year. There are no “use it or lose it” rules for HSAs.
Tax Savings
Contributions to your HSA can be made on a pre-tax basis. HSA earnings grow tax-free and, as long as the funds are used for qualified medical expenses, withdrawals from your HSA are also tax-free.
If you spend any of your HSA money on non-qualified medical expenses prior to age 65, you will pay ordinary income tax on those funds and will have to pay a 20% IRS penalty.

20. Who is NOT eligible for an HSA?
Examples of “1st dollar” medical benefits that make someone ineligible for an H.S.A. per IRS guidelines
*Medicare
SSID (social security disability insurance)
Tricare Coverage
Full Medical Flexible Spending Arrangements (HRA)
Adult Children – that do not qualify as a your tax dependent (IRS Publication 502)
Covered by a spouses FSA or HRA plan (you cannot have an HSA if you are covered by your spouses plan that can pay for any of your medical expenses with an FSA or HRA before your HSA health plans deductible is met)
*If an eligible person isn’t enrolled in Medicare, even though that individual has reached age 65, the person can contribute to an HSA until the month they enroll in Medicare. Also can contribute “catch up” contributions until enrolled in Medicare. (you can continue to use your HSA care expenses, but you can no longer make contributions to your HSA savings account)

21. Member Portal Be sure to add a beneficiary to your account!
View balance
Review account activity
Transfer HSA funds
Pay bills online
View Insurance Information
Online account statements
Online tutorials
Online support links
Calculators
Forms
Member Portal
Be sure to add a beneficiary to your account!
**You will receive a welcome kit along with your debit card shortly after your benefits begin.

22. Accessing Funds
Funds from the spending accounts are disbursed in the following ways:
Debit card
Online bill payment
Online reimbursement
2 Debit Cards

23. Lincoln Financial Group

24. Lincoln Financial Group24
Lincoln Financial Group
Employer Paid Life Insurance
Employer Paid Long Term Disability
Voluntary Life Insurance
Voluntary AD&D Insurance
Voluntary Short Term Disability
Voluntary Accident Plan Benefit
Lincoln Accident Insurance pays a cash, lump sum directly to you for accidental injuries to help cover direct (deductibles; co-insurance; prescriptions; bandages; follow-up visits, including doctor’s visits and physical therapy) and indirect (lost wages, property damages (auto deductible), lodging and transportation) costs associated with accidental injuries.

25. Employer Paid Life and Long Term Disability25
Employer Paid Life and Long Term Disability
Life Insurance Benefit
$20,000 Employee Term Life Insurance
Long Term Disability Benefit
60% of your wages +
10% progressive Income benefit
70% total income benefit up to $6000/month
Benefit begins on 91st day
Lincoln Accident Insurance pays a cash, lump sum directly to you for accidental injuries to help cover direct (deductibles; co-insurance; prescriptions; bandages; follow-up visits, including doctor’s visits and physical therapy) and indirect (lost wages, property damages (auto deductible), lodging and transportation) costs associated with accidental injuries.
The 10% progressive is if you lose 2 or more of your daily life functions like eating and bathing.

26. Employee Voluntary Coverage Options26
Employee Voluntary Coverage Options
Voluntary Life Insurance
Employee - $10K increments up to 5x salary - $500k max
Spouse - $5K increments up to 2.5x emp salary - $250k max
Dependent Children – 4 options - $ $ $7, $10,000
Guaranteed issue amount is $140,000 for employees and $25,000 for a spouse
Voluntary AD&D Insurance
Employee - $10k increments but no more than 5x salary
Spouse - $5k increments up to 100% of employee election
Dep Children - $2k increments up to $10,000
Voluntary Short Term Disability Benefit
60% of your wages min $100/wk – max $1,200/wk
Begins 1st day accident / 8th day of Illness
Benefit duration is 13 weeks
Lincoln Accident Insurance pays a cash, lump sum directly to you for accidental injuries to help cover direct (deductibles; co-insurance; prescriptions; bandages; follow-up visits, including doctor’s visits and physical therapy) and indirect (lost wages, property damages (auto deductible), lodging and transportation) costs associated with accidental injuries.
Can only elect Accident insurance during open enrollment.

27. Employee Assistance Plan HelpNet
FREE to you and anyone living in the same household
Savings Center
Work/Life Balance
Trainings/Development
Financial Resources
Strictly confidential
Limited counseling services
Addictions
Emotional Problems
Legal and financial concerns
Careers
Relationships
Stress, Anxiety and depression
Aging Parents
Marital and family issues

28. Wellness Wellness at KRESA Wellness Committee Ways to get involved
The wellness committee exists to raise awareness of our wellness program as well as create opportunities for our colleagues to learn about and live a healthier lifestyle.
We feel that the health and well-being of our employees is a high priority. People who are healthy tend to lead happier lives and that includes being more engaged at work. As an added benefit it has also been shown that implementing a wellness program and encouraging healthier living will decrease healthcare costs over time

29. What needs to be COMPLETED?
Enrollment Form
Lincoln Beneficiary Form
Lincoln Evidence of Insurability
If electing over the guaranteed issuing amount

30. QUESTIONS AND ANSWERS