2013 Benefit Open Enrollment

Benefit Overview Medical Anthem continues as our carrier for 7/1/13 Choice of Traditional PPO and HDHP No plan design changes or contribution increases Dental Delta Dental continues as our carrier for 7/1/13 No plan design changes Vision Anthem will replace Cigna as our vision carrier effective 7/1/13 Similar plan design and slight decrease in premiums

Medical Still two medical plan options from which to choose: o Traditional PPO – No plan design changes o High Deductible Health Plan – No plan design changes Find a network provider at - choose Blue Access PPO

Blue Access PPO Medical Plan In-NetworkOut-of-Network Anthem Network ( Deductible – Individual$ 1,000$ 2,000 Deductible – Family$ 3,000$ 4,000 Coinsurance80% / 20%60% / 40% Out-of-Pocket Maximum – Individual (includes deductible)$ 3000$ 6000 Out-of-Pocket Maximum – Family (includes deductible)$ 6000$ 12,000 Primary Care Visit Copay$ 2540% after deductible Specialty Care Visit Copay$ 5040% after deductible Urgent Care Center Copay$100 Copay40% after deductible Preventive Care100% coverage40% after deductible Emergency Room$200 Copay Hospital Services20% after deductible40% after deductible Out-Patient Services20% after deductible40% after deductible Maternity Services20% after deductible40% after deductible Mental & Nervous Care Inpatient20% after deductible40% after deductible Outpatient20% after deductible40% after deductible Lifetime MaximumUnlimited Prescription Drugs RETAIL Generic$1040% after deductible Preferred Brand (Tier 2)30%; $40 max40% after deductible Non-Preferred Brand (Tier 3)55%; $55 max40% after deductible MAIL ORDER Generic$20Not covered Preferred Brand (Tier 2)30%; $80 maxNot covered Non-Preferred (Tier 3)$55; $110 maxNot covered

Blue Access HDHP/HSA Medical Plan In-NetworkOut-of-Network Anthem Network ( Deductible – Individual$2,000$4,000 Deductible – Family (family coverage requires the full family deductible be met before coinsurance applies) $4,000$8000 Coinsurance80% / 20%60% / 40% Out-of-Pocket Maximum – Individual (includes deductible)$4,000$8,000 Out-of-Pocket Maximum – Family (includes deductible)$8,000$16,000 Primary Care Visit Copay20% after deductible40% after deductible Specialty Care Visit Copay20% after deductible40% after deductible Urgent Care Center Copay20% after deductible Preventive Care100% Coverage40% after deductible Emergency Room20% after deductible Hospital Services20% after deductible40% after deductible Out-Patient Services20% after deductible40% after deductible Maternity Services20% after deductible40% after deductible Mental & Nervous Care Inpatient20% after deductible40% after deductible Outpatient20% after deductible40% after deductible Lifetime MaximumUnlimited Prescription Drugs RETAIL Generic0% after deductible40% after deductible Preferred (Tier 2)40% after deductible Non-Preferred (Tier 3)50% after deductible40% after deductible MAIL ORDER Generic0% after deductibleNot covered Preferred (Tier 2)40% after deductibleNot covered Non-Preferred (Tier 3)50% after deductibleNot covered

Anthem Plan Highlights ALL mammograms paid at 100% Eligible smoking cessation medications (ex. Chantix or Wellbutrin ) covered under the Anthem Rx plan Access to a Worldwide network. Search for providers at

Anthem Website A demonstration of the Anthem website.

What is an HSA  Tax-advantaged checking account  Allows you to save for future medical expenses or pay current ones

HSA Eligibility An HSA can be established by an individual who: Is covered under a high deductible health plan (HDHP) Is not covered by any other health plan that is not an HDHP Is not enrolled for benefits under any part of Medicare Is not claimed as a dependent on another person’s tax return

HSA Features Tax Advantages  Tax free way to save for current and future medical expenses.  Contributions are pre-tax or tax-deductible up to annual HSA limits.  All earnings and interest are tax free.  Qualified withdrawals are tax free. Once reach age 65, non-medical withdrawals are taxed at your current tax rate, like an IRA. HSA is fully Portable. Ability to Accumulate funds – “Use it or Keep it!”. HSA funds can be used for items not covered by health plan such as; dental, vision etc. Same as an FSA plan.

HSA Contributions Options The HSA can be funded In one or more payments Payroll deduction will be available for all DePauw University employees  Elections can be stopped, started, changed on a monthly basis Contributions can be made by the employee, employer, or any other person on the employee’s behalf. Prior to the individual’s federal tax filing date (generally April 15)

HSA Contribution Maximums IRS Maximum 2013 contributions Self - $3,250 Family - $6,450 Catch up contribution - $1,000 for those 55 and older Note: Maximums include contributions made by DePauw

HSA University Contributions DePauw University’s Annual HSA Contribution Employee$1,000 Employee + Dependent(s)$2,000 Note: Employee’s will receive one-fourth of the University’s contribution each quarter.

HSA Distributions Pre-65 HSA owner: Qualified Distributions will be tax free. Non- Qualified Distributions will require individual to pay their personal tax rate on purchase and a 20% penalty. Post-65 HSA owner: Qualified Distributions will be tax free. Non- Qualified Distributions will require individual to pay their personal tax rate on purchase (No IRS Penalty)

Dental Carrier: Delta Dental Passive PPO plan: o Three levels of providers Find a network provider at

Dental Plan Design Dental BenefitsServicesDeductibleCoinsurance Benefit Maximum Class IExams, cleanings, x-rays, sealants, emergency treatment $50 individual/ $100 family, per calendar year 100% $1,250 maximum per plan year Class IIMinor Restorative – fillings, root canals, extractions, gum disease 80% Class IITMJ ($750 lifetime maximum per person) 80% Class IIIMajor Restorative – crowns, bridges, dentures, implants 50% Class IVOrthodontics – braces (To Age 19)50% $1,000 lifetime maximum

Delta Dental Premier negotiated fees no balance billing acceptance of processing policies 186,000 dentist locations Nonparticipating no discounts no discounts balance billing balance billing Delta Dental Network Delta Dental PPO significant discounts no balance billing acceptance of processing policies 108,000 dentist locations Delta Dental Network

PPO DentistPremier DentistNonparticipating Dentist Class II payment example for: Filling - Amalgam Restoration/One Surface (assuming any applicable deductible has been met) Submitted Fee:$ PPO Fee Schedule amount:$68.00 Delta Dental pays 80% of the PPO Fee Schedule amount:$54.40 Member pays:$13.60 The PPO dentist cannot charge the $52 difference between the PPO Fee Schedule amount and his/ her fee. Submitted Fee:$ Maximum Approved Fee:$ Delta Dental pays 80% of the Maximum Approved Fee:$88.80 Member pays: $22.20 The Premier dentist cannot charge the $9 difference between the Maximum Approved Fee and his/her fee. Submitted Fee:$ Nonparticipating Dentist Fee:$92.00 Delta Dental pays 80% of the Nonparticipating Dentist Fee:$73.60 Member pays:$46.40 Because the dentist does not participate, you are responsible for the difference between Delta Dental’s payment and his/her fee. Delta Dental Payment Example

Delta Dental Monthly Premium Contributions Enrollment Tier Employee Contribution Employee Only$10.92 Employee + Spouse/SSPD$21.63 Employee + Child(ren)$29.93 Family$42.86 Dental Rates

Vision NEW Carrier: Anthem Find a network provider at

Vision Plan Design ServiceFrequency In-Network Benefit Out-of-Network Benefit Eye Exam12 Months $10 CopayUp to $42 Allowance Lenses24 Months Covered in full after $10 Copay $42-$80 Allowance Frames24 Months $130 Allowance $45 Allowance Contact Lenses (in lieu of lenses and frames) 24 MonthsIf elective $130 Allowance If elective $105 Allowance If necessary Covered in Full If Necessary $210 Allowance To receive greater benefits, utilize a network provider:

Anthem Vision Monthly Premium Contributions Enrollment Tier Employee Contribution Employee Only$4.49 Employee + Spouse/SSPD$7.87 Employee + Child(ren)$8.54 Family$13.04 Vision Rates

With an FSA plan, you elect to have a certain dollar amount withheld from your paycheck so you can pay for health care and dependent care expenses with pre-tax money. Eligible expenses include your unreimbursed medical expenses, including deductibles, co-pays, co-insurance, and childcare expenses ! “Use it or Lose it Rule” – If you do not use all of your FSA funds they will be forfeited at the end of the plan year. If you elect the HDHP then you can enroll in FSA for Dependent Care Only. Reminder: Over-the-counter medications no longer eligible for reimbursement without a prescription FSA Annual Plan Limits: Health Care: $2,500 Dependent Care: $5,000 What is a Flexible Spending Account (FSA)

Your FSA debit card can be used at providers offices, hospitals, pharmacies, etc. If you receive a bill at home, you can write your debit card number on the bill to make payment like any other credit/debit card. If your childcare provider accepts Visa, you can use your debit card for childcare expenses as well You can also file claims online, using a smartphone app, or via mail Important Note: You still need to keep receipts and AdminPro will request them under certain circumstances FSA Debit Card

Remember: All benefit-eligible employees must elect or waive coverage and assign beneficiaries to life insurance plans no later than May 15, Enrollment will be completed in the ADP portal at Employee Action