2016 Faculty & Exempt Open Enrollment Monday, November 2, 2015 - Wednesday, November 25, 2015

What’s New in 2016 Four Medical Plans to chose from 4 Tiered Premium Rates for Medical, Dental and Vision New Vision Vendor New Flexible Spending Account Vendor

CHEIBA Tiered Premium Structure Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

Anthem Blue Cross Blue Shield Medical Plans Blue Advantage HMO/Point of Service Prime Blue Priority PPO Blue Priority HMO Lumenos HDHP

Anthem Blue Cross Blue Shield Medical Plans Blue Advantage HMO/POS This is an existing plan with no changes other than the addition of the annual eye exam.

Blue Advantage Point of Service POS/HMO PCP Required Yes Individual /Family Deductible $0/$0 Out-of-Pocket Max Individual/ Family $2,000/$4,000 Preventative Care Visits 100% Covered Primary Care Office Visits $20 Copayment Specialist Office Visits Emergency Room $100 Copayment Inpatient Hospital $400 Copayment per admission Outpatient Ambulatory surgery $60 Copayment

Anthem Blue Cross Blue Shield Medical Plan Prime Blue Priority PPO Formerly known as the Prime Plan. Plan option has been modified to include an additional tier of coverage. If you or a family member utilize a Designated Primary Care Physician (PCP) or Specialist, your out-of-pocket cost will be lower. Designated Provider are located in the following counties: Adams , Arapahoe, Boulder (including Longmont), Broomfield, Denver, Douglas, Elbert, El Paso, Fremont, Jefferson, La Plata, Montezuma, Pueblo, Summit and Teller. If you do not reside in these counties, you can access these providers while traveling.

Prime Blue Priority PPO Tier 1 (limited Network) Tier 2 Out of Network PCP Required Yes Individual /Family Deductible $400/$800 $960/$1,920 Out-of-Pocket Max Individual/ Family $750/$1,500 $2,000/$6,000 Preventative Care Visits 100% covered Primary Care Office Visits $10 Copay 15% After Ded 35% After Ded Specialist Office Visits Emergency Room Inpatient Hospital Outpatient Ambulatory surgery 10% After Ded

CHEIBA Tiered Premium Structure Blue Advantage Point of Service Plan (HMO/POS) & Blue Prime PPO Plan & Custom Plus Health Plan Total Cost Your monthly Cost Employee Only $637.52 $147.00 Employee + Spouse $1,528.84 $352.00 Employee + Child(ren) $1,401.84 $323.00 Employee and Family $1,759.13 $405.00

Anthem Blue Cross Blue Shield Medical Plans Lumenos HDHP HDHP = High Deductible Health Plan Features a plan year deductible that applies to medical or prescription drug benefits Health Savings Account eligible plan. Health Savings Account (HSA)is an account that allows you to pay for qualified out-of-pocket medical expenses. HSA is a personal, portable account and remains in your control regardless of your employment. Contact your financial institution for more information about setting up a HSA.

Lumenos HDHP PCP Required No Individual /Family Deductible $2,500/$5,000 Out-of-Pocket Max Individual/ Family $2,5000/$5,000 Preventative Care Visits 100% covered Primary Care Office Visits $0 After Ded Specialist Office Visits Emergency Room Inpatient Hospital Outpatient Ambulatory surgery

CHEIBA Tiered Premium Structure Lumenos 2500 HDHP Total Cost Your Monthly Cost Employee Only $573.52 $132.00 Employee + Spouse $1,376.84 $317.00 Employee + Child(ren) $1,261.84 $291.00 Employee and Family $1,584.13 $365.00

Anthem Blue Cross Blue Shield Medical Plans Blue Priority HMO (Limited Network) NEW Plan for 2016. In-Network Only Plan. Network is limited to providers in Denver metro area, which includes Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, and Jefferson, counties as well as Elbert, El Paso, Teller, Fremont, La Plata, Montezuma, Pueblo, and Summit counties. Most ASU employees are not eligible unless you live in the counties listed. Your PCP will coordinate your care within the Blue Priority HMO Network. Referrals are required.

CHEIBA Tiered Premium Structure Blue Priority HMO Plan (Limited Network) Total Cost Your Monthly Cost Employee Only $586.52 $137.00 Employee + Spouse $1,406.84 $325.00 Employee + Child(ren) $1,289.84 $298.00 Employee and Family $1,619.13 $374.00

Finding / Selecting Providers (Primary Care Providers = PCP) Go to anthem.com Select Find a Doctor Select type of care – Search as a member Select State – Colorado Select Plan/Network (i.e. Prime Blue Priority PPO) Select type of physician Select specialty Select location Click Search Visit HR website for more information and instructions on selecting a PCP.

New for 2016 LiveHealth Online See a doctor 24 / 7 on your computer or mobile device. No waiting for a callback. Wait time – 2-3 minutes. Available anywhere you have a computer or mobile device with Internet access. Access to in-network board-certified Physicians. Allows doctors to ePrescribe medications. Members may pay via Visa, MasterCard, American Express and Discover. Cost is lower than or equal to a doctor’s visit. More Information or to sign up https://www.livehealthonline.com/

Anthem Blue Cross Blue Shield Dental Plans Two Dental plans offered 1. Anthem Blue Dental PPO Plus 2. Anthem Blue Dental PPO No changes to the plans

Anthem Blue Cross Blue Shield Dental Plans Anthem Blue Dental PPO Plus Anthem Blue Dental PPO In Network Out of Network Annual Maximum $1,500 Annual Deductible $25/$75 $50/$150 Diagnostic & Preventive Services* (No Deductible) 100% Restorative/General Services (Fillings, Composites, Anesthesia, Emergency, Oral Surgery) 80% 60% Endodontic Services (root canal therapy, etc.) Periodontal Services* (gingivectomy, osseous surgery, periodontal scaling & root planing and maintenance) Major Services (Crowns, Bridges, Dentures, Approved Implants) 50% 40% Orthodontia Lifetime Maximum for Eligible Dependent children to age 19 50% up to $1,000 40% up to $1,000

Anthem Blue Cross Blue Shield Dental Plans – Premium Tier Anthem Blue Dental PPO Plus or Anthem Blue Dental PPO Total Cost Your monthly Cost Employee Only $39.00 $13.00 Employee + Spouse $90.00 $31.50 Employee + Child(ren) $86.00 $30.00 Employee and Family $102.00 $36.00

Anthem Blue Cross Blue Shield Vision Plans Anthem Blue View Vision Plan replaces VSP Enrollment in any of the Anthem medical plans will automatically include an annual eye exam. Access to vast network of both private doctors as well as retail locations such as: Sears Optical, Pearle Vision, JCPenney Optical, Target optical and LensCrafters. Also local providers Rocky Mountain Eye Center and Abba Eye Center.

Anthem Blue View Vision Employees enrolled in an Anthem Medical plan & would like to cover material and hardware can elect the Blue View Vision Materials Only Benefit Employee Only $6.36 Employee + Spouse $11.92 Employee + Child(ren) Employee and Family $17.31

Blue View Vision Materials Only Description Level of Coverage from an Anthem Provider Non-Anthem Provider Eyeglass Frames (once every 12 months) $130 allowance, the 20% off any remaining balance Reimbursed up to 70% Standard plastic single vision lenses $15 Copay, then covered in full Reimbursed up to $50 Standard plastic lined bifocal lenses Reimbursed up to $75 Standard plastic lined trifocal lenses Reimbursed up to $100 Contact Lenses (once every 12 months $130 allowance, then 15% off any remaining balance

Anthem Blue View Vision Employees who are not enrolled in the Anthem medical plans but would like vision coverage can elect Voluntary Exam & Materials (Full-Service) Plan Employee Only $8.80 Employee + Spouse $16.49 Employee + Child(ren) Employee and Family $23.95

Supplemental Programs 24 Hour Nurse Line – Reach a RN 24 hours a day, 7 Days a week. Audio Health Library – More than 300 prerecorded health topics. Future Moms – Manage a healthy pregnancy. MyHealth Advantage – Home mailings from Anthem. Condition Care – Support for Chronic conditions. Colorado Quitline – Support for helping to quit smoking or tobacco use. PAL Program – Independent consultant who can help you navigate the Anthem system or claims issues Health Fairs – Yearly blood draws, flu shots and biometric screenings.

Flexible Spending Account – 24 Hour Flex 24 Hour Flex is replacing PayFlex as new vendor. Claims for expenses incurred 2015 to PayFlex. (Deadline is April 15, 2016). I will be in touch with anyone who currently has a Flex that might be impacted by the roll-over Maximum amount for Health Account is $2,550.00 Maximum amount for Dependent Account is $5,000.00 Pre-tax deductions & pre-retirement. Use it or lose it. 24 Hour Flex Debit Card is available. Sign up for direct deposit. Must enroll yearly

ASU CHEIBA Health Fair Wednesday, November 11, 2015 Free blood draws, flu shots and biometric screens. SUB 309 7:00am until 11:00 am. Vendors from Anthem, 24 Hour Flex, TIAA- CREF, Valic and Fidelity.

2016 Faculty & Exempt Open Enrollment For more information or to print forms http://www.hr.adams.edu/administration/hr/benefits.php Questions….