Ball State University Brandi McGlothin Payroll & Employee Benefits Open Enrollment 2011

 PPACA (Patient Protection and Affordable Care Act) Changes  Advisory Board Changes  Deductibles  Out-of-Pocket (OOP) Maximums  New Rates  Flexible Spending Accounts (FSA)  Health Savings Accounts (HSA)  Other Changes

◦ Elimination of the current lifetime maximum benefit of $2.0M ◦ Elimination of pre-existing condition limitations for enrollees younger than age 19 ◦ Elimination of the requirement that coverage for children of employees who are younger than age 26 is for IRS-qualified dependents only  As a grandfathered plan we will still require that, when available, these individuals obtain coverage from their employer or spouse’s employer ◦ Elimination of annual maximum benefit for pediatric dental (up to age 18) Our Plan is “Grandfathered”

Changes – Effective July 1, 2011:  Specialty Drug Sourcing - Accredo  Preauthorization for Non-Emergency MRI and CT Scans  Preauthorization Required Prior to Non- Emergency Orthopedic Surgery  Preferred Drug Step Therapy (PDST) Who is The Advisory Board Company? They are the leading provider of comprehensive performance improvement services to the health care and education sectors. *Just to clarify – these changes apply to non-emergency situations and there is an appeals process in place

Health Plan OptionsCoverage TiersDeductibles FromTo Low Deductible PPOEmployee only$300$350 Employee & Child(ren) or Family$750$875 High Deductible WellnessEmployee only$1000No Change Employee & Child(ren) or Family$2500No Change HSA Qualified Plan*Employee only$1500$1725 Employee & Child(ren) or Family$3750$4325

Health Plan Options Providers & FacilitiesOut of Pocket Maximums Per Person FromTo Low Deductible PPO Plan (does not include deductible) In Network/Endorsed Provider/Encircle Facility$1500$1725 Combination of In Network/Non-Endorsed Provider/Non-Encircle Facility $2250$2600 Out of Network$3000$3450 Prescription (mail-order only)$1500$1725 High Deductible Wellness (does not include deductible) In Network/Endorsed Provider/Encircle Facility Per Person $2500No change Combination of In Network/Non-Endorsed Provider/Non-Encircle Facility $3750No change Out of Network$6000No change Prescription (mail-order only)$1500$1725

High Deductible/ HSA Qualified Plan (includes deductible) Medical/Prescription Expenses Combined In Network/Endorsed Provider/Encircle Facility Individual Coverage $2500$2875 Combination of In Network/ Non- Endorsed Provider/Non-Encircle Facility Individual Coverage $3000$3450 Out of Network Individual Coverage $3500$4025 In Network/Endorsed Provider/Encircle Facility Employee & Child(ren) or Family Coverage $5000$5750 Combination of In Network/ Non- Endorsed Provider/Non-Encircle Facility Employee & Child(ren) or Family Coverage $6000$6900 Out of Network Employee & Child(ren) or Family Coverage $7000$8050

Low Deductible PPOHigh Deductible WellnessHigh Deductible/HSA Qualified Plan BiweeklyMonthlyBiweeklyMonthlyBiweeklyMonthly 18 pays24 pays 10 pays 12 pays 18 pays 24 pays 10 pays 12 pays 18 pays 24 pays 10 pays 12 pays Single$140.39$105.29$252.70$210.58$56.03$42.02$100.85$84.04$24.55$18.42$44.20$36.83 EE + Child (ren) $266.73$200.05$480.12$400.10$106.45$79.84$191.62$159.68$46.65$34.99$83.98$69.98 Family$364.42$273.32$655.96$546.63$145.44$109.08$261.79$218.16$63.74$47.81$114.73$95.61

◦ Plan Year is July 1, 2011 – June 30, 2012 ◦ Grace period extends time for incurring claims to September 15, 2012 ◦ Maximum annual election is $5,000 each for General Purpose and Dependent Care FSAs ◦ New Feature – direct deposit for FSA reimbursement ◦ Reminder: Over-the-Counter medications now require a prescription ◦ Eligible expenses may now be submitted for “adult children” up to age 26

 Effective January 1, 2012, Ball State will begin “seeding,” or contributing to employee HSAs  Seeding will done on a calendar year basis due to tax concerns  Employees must open an account with HSABank in order to begin receiving the seed  Ball State will pay the monthly maintenance fee for the HSABank accounts  Ball State is currently looking at an alternative contribution “vehicle” for employees in the HDHP who do not meet HSA eligibility requirements

HSA Qualified Plan Bi-Weekly Contribution 26-Pays Bi-Weekly Contribution 18-Pays Monthly Contribution 12-Pays Monthly Contribution 10-Pays Maximum 2012 CY University Contribution Individual Coverage Jan. 1 – June 30 $29.46 $38.30 (10 Pays) $63.83$76.60 $ Individual Coverage July 1 – Dec. 31 $14.73 $23.93 (8 Pays) $31.92$38.30 Employee & Child(ren)/Family Coverage Jan. 1 – June 30 $73.84 $96.00 (10 Pays) $160$192 $1440 Employee & Child(ren)/Family Coverage July 1 – Dec. 31 $36.92 $60.00 (8 Pays) $80$96

 Three-Year Commitment Rule lifted for this Open Enrollment period  Effective January 1, 2012, the Retail Refill Allowance (RRA) Penalty will be implemented for the High Deductible/HSA Qualified Plan ◦ 15% penalty after 3 rd fill of maintenance drug at retail (penalty does not apply to OOP maximum) ◦ OOP maximums could increase with continued retail pharmacy use to:  $5,950 for Single Coverage  $11,900 for EE+Child(ren) or Family Coverage

Plan Changes Effective July 1, 2011 Need Forms or Assistance? PEB Website: Call Deadline for Submitting Enrollment Forms Wednesday, May 18 th, 2011 Wednesday, May 18 th, 2011