GROUP INSURANCE ORIENTATION VIDEO

Renown PPO, EPO & QHDHP/HSA MEDICAL COVERAGE Claims are paid by funds contributed by the District, its employees, and retirees. Renown PPO, EPO & QHDHP/HSA

PPO PLAN District covers employee’s premium Comprehensive Major Medical Plan Preferred Provider Organization (PPO) PPO PLAN

PPO PLAN Hometown Health (HTH) – Processes the Claims Hometown Health Network – Preferred Provider Panel website is located in the Question/Answers &Highlights Handout Preferred Provider Hospitals – Renown Medical Center, Renown South Meadows, Carson Tahoe Regional Medical Center & Northern Nevada Medical Center

PPO PLAN Deductibles Preferred Provider: - $500 per employee - $1,000 per family Non-Preferred Provider: $1,500 per employee $3,000 per family

Non-Preferred Provider: PPO PLAN Eligible Expenses Preferred Provider: After deductible has been met, eligible expenses covered at 80% Non-Preferred Provider: After deductible has been met, in most cases eligible expenses covered at 60% for usual and customary costs

Non-Preferred Provider: PPO PLAN Annual Out-of-Pocket Maximums Preferred Provider: $3,500 per employee $7,000 per family Non-Preferred Provider: $7,500 per employee $15,000 per family

PPO PLAN Co-payments for Preferred Provider Office Visits Primary Care Physician - $35 Specialists/Urgent Care - $50 No deductible & No Claim Forms

PPO PLAN Services That Require Pre-Certification All inpatient hospital admissions Outpatient services over $10,000 50% paid if not pre-certified

EPO PLAN Hometown Health (HTH) – Processes the Claims Hometown Health Network – Preferred Provider Panel website is located in the Question/Answers & Highlights Handout Preferred Provider Hospitals – Renown Medical Center, Renown South Meadows, Carson Tahoe Regional Medical Center & Northern Nevada Medical Center

EPO PLAN Employee pays a portion of the full premium* Must reside in the Northern Nevada or North Lake Tahoe service area Referral required for specialist or no coverage No referral required for annual Gynecologist exam or Chiropractic services * Check schedule of premiums in the Questions/Answers and Highlights

EPO PLAN No deductible No claim forms Make Co-payments

EPO PLAN Co- Payments for Service Listed $35 Physician Visits $50 Specialist Visits/Urgent Care $200 Emergency Services; $300 Non-Emergency $200 Outpatient Surgery Facility $1,250 Inpatient Hospital

QHDHP/HSA Qualified High Deductible Health Plan/Health Savings Account Healthcare Coverage for Medical Services and RX Used in conjunction with Health Savings Account (HSA) You pay 100% until High Deductible is met, and then you share only a portion of the cost You pay nothing once the Out-of-Pocket max is met (Preferred Providers)

QHDHP/HSA Hometown Health (HTH) – Processes the Claims Hometown Health Network – Preferred Provider Panel website is located in the Question/Answers &Highlights Handout Preferred Provider Hospitals – Renown Medical Center, Renown South Meadows, Carson Tahoe Regional Medical Center & Northern Nevada Medical Center

CALENDAR YEAR DEDUCTIBLE Individual Deductible: $2600 QHDHP/HSA CALENDAR YEAR DEDUCTIBLE Individual Deductible: $2600 Family Deductible: $5000

Preferred Provider: Non-Preferred Provider: QHDHP/HSA Eligible Expenses Preferred Provider: Non-Preferred Provider: After deductible has been met, After deductible has been met, in most eligible expenses covered at 80% cases eligible expenses covered at 60% for usual and customary costs

Annual Out-of-Pocket Maximums QHDHP/HSA Annual Out-of-Pocket Maximums Preferred Provider: Non-Preferred Provider: -$6550 per employee - $6,500 per employee - $13,100 per family - $ 13,100 per employee

QHDHP/HSA District will fund a portion of the Employee’s HSA The District will fund the employee’s HSA account two times a year; once in the beginning of the year and once in the middle of the year. The amount that the District funds will be determined by your insurance eligibility effective date. You own it – No “use it or lose it“ requirements Most out-of-pocket expenses can be paid with HSA. (Check IRS guidelines.)

QHDHP/HSA Not Eligibile If: Enrolled in a secondary health insurance that is non-HSA eligible, including a general purpose Health Flexible Spending Account (FSA) or a Health Reimbursement Account (HRA) Enrolled in Medicare or Tricare Claimed as a dependent on someone else's tax return Other exclusions may apply

How much can I contribute? QHDHP/HSA How much can I contribute? 2017 HSA Annual Contribution Limits (Set by the IRS) Single: $3400 Family: $6750 HSA Catch-Up Contribution $1000 per individual age 55 and over

American Fidelity’s GAP Plan Pay up to: $1,000 per Inpatient Stay $200 for Outpatient Services $25 per Doctor Visit to max of $125 per District covered family Dependents covered only if enrolled in District insurance QHDHP/HSA members are not eligible for GAP

PRESCRIPTION DRUG PLAN Welldyne $50 per covered insured calendar year deductible $10 co-payment for Generic Drugs $25 co-payment for Brand Drugs $50 co-payment for Non-Preferred Brand Your choice of Nationwide Network Pharmacies QHDHP Plan is subject to Plan deductible before copay applies

PRESCRIPTION DRUG PLAN Welldyne Mail Order $10 Co-payment for Generic Drugs $50 Co-payment for Brand Drugs $100 Co-payment for Non-Preferred Brand 90 Day Supply- Except for Specialty Drugs QHDHP Plan is subject to Plan deductible before copay applies.

DENTAL PLAN The Preferred Provider Dentist Network is Guardian Deductibles: -$50 per employee - $100 per family Calendar Year Benefit maximum - $2,000 Children under 19 have unlimited calendar year benefits No orthodontia coverage

DENTAL PLAN If using Preferred Provider Network Dentist: Preventive: 100% - No Deductible Restorative: 80% Major: 80%

Vision Service Plan (VSP) VISION PLAN Vision Service Plan (VSP) Premiums paid by District Dependents covered at no additional expense even if they are not enrolled on your medical coverage Eye exam once every 12 months $10 co-payment per eye exam Lenses/Frames or contacts once every 24 months

PREMIUMS Schedule of premiums is located in the Questions/Answer and Highlights packet Please review the rates in the PPO,EPO, and QHDHP plans as there could be a difference in cost to the employee Certified/Administrators – Monthly 12 Month Classified – 26 Pay Periods Other Classified – 18 Pay Periods Part-Time Certified – Premiums Prorated based on FTE

WELLNESS PROGRAM To promote and improve employee wellness and reduce health risks through education and wellness activities, goal setting and outreach events.

EMPLOYEE ASSISTANCE PROGRAM GuidanceResources® Confidential Counseling - 3 free in-person counseling sessions per person per issue per year Financial Information and Resources Legal Support and Resources Work-Life Solutions Tobacco Cessation GuidanceResources® Online

HEALTH MANAGEMENT Healthy Tracks Online Health Management Tools Health Insurance Premium Discount Opportunity Talk to a Trainer or Dietitian

LIFE INSURANCE District-Paid Term Life and AD&D Certified/Classified - $40,000 Classified Confidential - $50,000 Administrators/Psychologists/Pro-Techs - $250,000

Premium Conversion Plan SECTION 125 PROGRAM Premium Conversion Plan Allows dependent medical/health and cancer insurance premiums to be paid on a pretax basis If on the QHDHP, you cannot have a general purpose FSA (Flexible Spending Account) in the household, however, you may have a Limited Purpose Health FSA for dental and vision.

Flexible Spending Accounts SECTION 125 PROGRAM Flexible Spending Accounts Dependent Day Care $5,000 per year Children under 13 Non-Reimbursed Medical Expenses - $2,550 per year - Debit Card available

SECTION 125 PROGRAM Example: Salary: $2,000 Insurance Premiums: $200 Taxable Salary: $1,800 25% Tax Bracket: $450 instead of $500 $1,800 x 25% = 450 $2,000 x 25% =500 Extra $50 in Take-Home Pay

VOLUNTARY BENEFITS Group Legal Supplemental Life Insurance Disability Insurance Long-Term Care Cancer Insurance Accident Benefit Insurance

IMPORTANT! 90 days to complete forms and add dependents It is your responsibility to enroll within the required time frame Risk Management Office (775) 348-0343

RISK MANAGEMENT LOCATION 425 East Ninth Street Reno, NV 89512

THE END This is a brief overview of the coverage provided to you by the District. It is not meant as a full explanation of the benefits provided. Any conflict between this overview and related plan documents or contracts shall be governed by the provisions of the plan document or contract. To access the plan documents please visit the Washoe County School District website, under Risk Management. Thank you.