1. 2014 Benefit Updates and Communication

2. Vidant Health Total Compensation Philosophy Vidant Health strives to offer a Competitive Total Compensation Package including a Comprehensive Benefits Program –Vidant will invest almost $190 million in employee benefits during calendar year 2014 –This investment represents an additional approx. 32% of salary dollars –Benefits are designed to provide options that meet employee needs, while helping to manage employee and employer costs Vidant Health maintains a cost share philosophy for our self- funded medical benefit plan: –Of the total benefits investment, medical plan costs account for approx $82 million –Vidant Health pays 2/3 of Plan Costs –Employees pay 1/3 of Plan Costs 1

3. Vidant Health Medical Plan –Over the past decade, average health care costs for employers has increased more than $10,000 per employee per year –Like others nationwide, Vidant Health is challenged to prepare our plans for new federal regulations, while also dealing with continued increases in costs and utilization. –To ensure our plans are sustainable, Vidant Health is committed to: Partnering with employees to make choices and utilize services in a way that meets employee/family needs while managing costs for everyone Encouraging all members of the Vidant Health team to engage in health choices and wellness activities to improve overall health status, and reduce health problems that may be avoidable. 2

4. Vidant Health Employees…How are we doing? 3

5. Personal Accountability Did you know that 48% of VH female employees that are over 40 have not gotten their annual mammogram? Did you know that 44% of VH male employees that are over 50 have not gotten their PSA exam? Currently, 32% of VH females, ages 18-64, are not compliant in getting their annual physical. Currently, 80% of VH males, ages 50+ are not compliant in getting their annual physical. REMEMBER…Our Choices Drive Our Outcomes!! 4

6. Vidant Wellness Services Vidant Wellness provides an array of services for employees…. WellScreen Free: lipid panel, glucose, blood pressure, height, weight, body mass index and waist assessment provided through Vidant Employee Wellness and/or Vidant Occupational Health Clinics at each location yearly for all employees. 847- 5590 Disease Case Management Program Free: 1-on-1 disease management services with a Vidant Employee Wellness Nurse Case Manager or Health Coach available for Vidant Health employees and covered spouses who have high risk factors and/or complex medical conditions such as hypertension, diabetes, high cholesterol, obesity, asthma, congestive heart failure or coronary artery disease. 847-5590 Weight Management WeightWatchers at Work: Available on most Vidant Health campuses for a fee. 847-5590 Medical Weight Loss: The Vidant Health medical plan covers medical visits and prescriptive medication for weight loss as well as surgical weight loss for those that qualify. Healthy Weight, Healthy You Program enables you to learn behaviors that will help you achieve and maintain a healthy weight. Pregnancy Wellness Program Free: Pregnancy Wellness classes for employees, spouses, and covered dependants at most Vidant Wellness hospitals. 847-5590 Wellness Challenges Free: Vidant Employee Wellness provides wellness challenges to help motivate employees to practice a healthy behavior such as “Live Healthy 100 Day Challenge”, “Live Healthy Step 2 It Challenge”, “Couch to 5K”, “Maintain Don’t Gain” or others. 847-5590 5

7. Overview Health Care Reform Open Enrollment –Medical Plan –Pharmacy Benefits –Dental and Vision Plans –Flexible Spending Accounts –Special Enrollment Opportunity for Life & Disability plans New Leave Management Process Employee Self Service Employee Discounts 6

8. Health Care Reform

9. Health Care Reform Updates Affordable Care Act (ACA) is the law of the land and part of massive changes that our entire health system is currently experiencing. Starting Jan 1, 2014, health insurance will be a new ball game: –Insurance companies will accept everyone who applies for coverage, regardless of health status –Choose from four plan levels that fit your needs –Everyone must have insurance called the “individual mandate” –New requirements adopted that place additional cost burdens on employers - $1.2 million in fees for Vidant Health Public health care marketplace effective January 2014 –A marketplace where people can buy health insurance –Additional information at healthcare.gov –Government subsidies & eligibility – most employees ineligible due to employer sponsored medical plan coverage –VH employees need to do nothing beyond usual open enrollment 8

10. Health Care Reform Updates Marketplace (Exchange) enrollment began 10/01/13 for 01/01/14 coverage - Notice to inform employees of coverage options available were distributed in Sept. 2013. –NC/SC/VA – Federally Facilitated Exchanges – no state established marketplace –VH med plan meets “Minimum essential coverage ” Individual mandate to purchase medical insurance or pay penalty effective January 2014 – Penalty is 1% of income or $95 per person, whichever is higher; $47.50 per child – max penalty of $285 for a family. Employer penalty delayed to January 2015 9

11. Open Enrollment October 28-November 15

12. Benefits – Open Enrollment October 28-November 15 Opportunity to enroll in: Medical Dental Vision FSA (Flexible Spending Account) –Healthcare –Dependent Care SPECIAL Enrollment for: Life Insurances (Supplemental & Dependent) Short Term Disability Long Term Disability This year only! All elections made during Open Enrollment will be effective 1/1/2014 11

13. 2014 Plan Year Open Enrollment Each employee must go online to elect or waive coverage for each benefit listed below: Medical Dental Vision Health Care Flexible Spending Account Dependent Care Flexible Spending Account Short Term Disability Long Term Disability Supplemental Life Insurance Dependent Life Insurance 12

14. 2014 Medical Plan Medical Plan Options – Think through your health coverage needs –Employees can select either medical coverage plan Low plan utilization may consider 70/30 option Higher level of coverage (80/20) will cost more –Tobacco usage is no longer tied to plan selection – Employees can select either medical coverage plan –Created Employee + Child(ren) tier Those in family coverage without a spouse on the plan will see significant cost savings Those in Employee + Child tier will experience increased premium

15. 2014 Medical Plan Design Changes 2014 2 Plan Options - 70/30 or 80/20 (different deductible, out of pocket max and premium) - Employees can select either plan, tobacco usage no longer tied to plan selection. -Carefully evaluate your coverage needs. Add Employee + Child(ren) Tier (replaces Employee + Child) ER Co-pay -$150 plus Deductible and Coinsurance – Co-pay waived if admitted Precertification for MRI, CT, & Pet Scan SNP – RN IV level will have two tracks – One track at Level IV premium pay and one track at a lower rate of pay with a medical benefit – option becomes available during open enrollment – email will be sent to employees with enrollment instructions. 14

16. Bi-Weekly Medical Premiums Prior to Credits– Full Time Coverage Tier2013 Current Rate (80/20 & 70/30) Prior to Credits 2014 Medical 70/30 Prior to Credits 2014 Medical 80/20 Prior to Credits Employee Only$60.62 $70.62 Employee + Child(ren) $132.09$154.13$174.13 Employee + Spouse*$250.70$275.70$300.70 Employee + Family*$270.58$295.58$320.58 Employees may be eligible for bi-weekly medical premium credits from $2 to $77.00 per pay period starting January 2014 First premium change since Jan. 2011 * Spousal credit applies only to Employee + Spouse & Employee + Family tiers

17. Full-Time Medical Premiums 70/30 Plan TierPremium Cost Well Credit Adjusted Premium Non- tobacco credit Adjusted Premium Spousal Credit Net Total Premium Emp Only$60.62$2.00$58.62$25.00$33.62N/A$33.62 Emp + Child(ren) $154.13$2.00$152.13$25.00$127.13N/A$127.13 Emp + Spouse $275.70$2.00$273.70$25.00$248.70$50.00$198.70 Emp + Family $295.58$2.00$293.58$25.00$268.58$50.00$218.58 16

18. Full-Time Medical Premiums 80/20 Plan TierPremium Cost Well Credit Adjusted Premium Non- tobacco credit Adjusted Premium Spousal Credit Net Total Premium Emp Only$70.62$2.00$68.62$25.00$43.62N/A$43.62 Emp + Child(ren) $174.13$2.00$172.13$25.00$147.13N/A$147.13 Emp + Spouse $300.70$2.00$298.70$25.00$273.70$50.00$223.70 Emp + Family $320.58$2.00$318.58$25.00$293.58$50.00$243.58 17

19. Deductible & Out of Pocket Max In Network2014 70/30 Plan 2014 80/20 Plan Individual Deductible$800 (2013 - $600) $600 (2013 - $600) Individual Co-insurance plus co-pays + $3,050 (2013 - $3,000) + $2,500 (2013 - $2,500) Medical Out of Pocket Maximum = $3,850 (2013 – $3,600) = $3,100 (2013 - $3,100) Pharmacy Out of Pocket Maximum + $2,500 (2013 - $2,500) + $2,500 (2013 - $2,500) Out Of Pocket Total= $6,350= $5,600 Health Care Reform requires:  2014 - Medical Co-pays and Deductibles count toward Out of Pocket max 18

20. Medical Plan Premium Credits WellScreen Credit $2 biweekly Employees on the medical plan are eligible for a $2 biweekly credit in their paychecks for participating in the WellScreen Program during the fiscal year. This is voluntary, for employees only. Non-tobacco Use Credit $25 biweekly Employees on the medical plan will receive a $25 biweekly credit if they attest that they and their adult family members (including spouse and children over the age of 18 on the medical plan) do not use tobacco products. Includes smoking, chewing, dipping, etc. of any type of tobacco product During open enrollment each year, employees will attest that they (and their adult family members on the medical plan) do not use tobacco products or provide a certification form of exemption for active participation in an approved cessation program. 19

21. Medical Plan Premium Credits Spousal Credit of $50 biweekly (Employee + Spouse & Family Coverage Only) Will Receive Credit √Will Not Receive Credit x Spouse enrolled in Vidant Health medical plan and he/she is not eligible for insurance through his/her employer Spouse is eligible for coverage through his/her employer and chooses to remain on the Vidant Health medical plan Spouse has medical coverage through Medicare, TriCare, or is also an employee with Vidant Health Spouse is not employed IMPORTANT: To receive the credit, employees must attest during open enrollment each year. To offset premium increase, current credit of $25 transitioned to $50 for eligible employees. 20

22. Flex Credit A flex credit of $33.62 per pay period is given to full time employees who do not enroll in the Vidant Health Medical Plan. In order to receive this credit in 2014, an employee must waive coverage at Open Enrollment and answer questions attesting to medical insurance coverage (spouse, individual plan, no outside insurance, etc). Employees will not automatically receive the flex credit - you must complete Open Enrollment. 21

23. Credit Deadlines 9/30/13 – WellScreen completed between 10/1/2012 and 9/30/2013 to receive credit for 2014 10/28/13 – Tobacco users must be participating in an approved cessation program 11/15/13 – Last day for Tobacco Cessation Certification forms to be received by Vidant Employee Wellness. This will ensure non-tobacco use credit for 2014. **Tobacco Cessation Forms may be accessed through Employee Central (intranet) or vidanthealth.com (internet)** IMPORTANT 22

24. 2014 Prescription Drug Coverage Changes Prescription costs continue to increase year after year. Since the beginning of 2013, prescription costs alone have increased more than 15%. To help employees and the organization manage escalating costs, some changes are being made to the prescription benefit effective January 1, 2014. –Step Therapy –Prior Authorizations Letters mailed from CVS/Caremark to employees and providers impacted by prescription drug changes with instructions on the new process and any needed action 23

25. What is Step Therapy? Step Therapy is a program for people who take prescription drugs regularly for an ongoing condition. This program is a new approach to getting you the prescription drugs you need, with safety, cost and – most importantly – your good health in mind. It allows you and your family to receive the treatment you need while making prescription drugs more affordable for you. A generic front-line medication will cost, on average, between 30% and 80% less than the equivalent brand-name drug. The lowest-cost Step Therapy drugs also save money for your prescription-drug plan, and that helps ensure that your pharmacy benefit will be there for you and your family in the future. 24

26. What is Step Therapy? It is a process where prescriptions are filled with an effective, but more affordable medication (Step 1 – many times this will be a generic drug - you will pay lower copayment amounts for generic drugs than you do for brand-name drugs) When appropriate, a more costly (Step 2) medication can be authorized if the Step 1 prescription is not effective in treating the condition Remember, Step 2 prescription drugs will not be covered by the medical plan until Step 1 prescription drugs are tried first 25

27. What is Prior Authorization? A cost-savings feature of your prescription benefit plan that helps ensure the appropriate use of selected prescription drugs. It helps you get the most from your healthcare dollars with prescription drugs that work well for you and that are covered by your pharmacy benefit. It also helps control the rising cost of prescription drugs for everyone in your plan. Designed to prevent improper prescribing or use of certain drugs that may not be the best choice for a health condition Prior Authorizations may be obtained by working with your physician and pharmacy benefit manager (CVS Caremark) 26

28. 2014 Pharmacy Co-Pay & Co-Insurance Changes Vidant Employee Pharmacy20132014 Generic$10 (minimum $5) Preferred$25 Non-preferred$25$40 Co-insurance10% co-insurance for prescriptions ≥ $500 15% co-insurance for prescriptions ≥ $300 Retail Pharmacy20132014 Generic$25 Preferred$35$45 Non-preferred$45$65 Co-insurance10% co-insurance for prescriptions ≥ $500 25% co-insurance for prescriptions ≥ $300 27

29. Coverage Tiers2014 Dental (bi-weekly rate) 2013 Vision (bi-weekly rate) 2014 Vision (bi-weekly rate) Employee Only$11.654.38$4.16 Employee + Child(ren) $19.20N/A$6.85 Employee + Spouse $25.596.58$6.25 Employee + Family $34.4511.00$10.45 No changes to the dental or vision plan features for 2014 Vision premiums were reduced by 5% for 2014! 2014 Dental and Vision Plan 28

30. Flexible Spending Accounts Important Points to Remember… Health Care FSA Limit - $2,500 Budget for 2014 expenses (Jan 1-Dec 31) Plan carefully to cover as many eligible expenses as possible IRS rules – unclaimed funds are forfeited 2-1/2 month “grace period” extension (1/1-3/15) Hold on to ALL receipts and EOB’s 29

31. 2014 Life & Disability Insurances Updates Enhancements to Basic Life Insurance plan features –+10 yrs of service will receive an additional $25,000 – FREE! –Part time increase from $4,000 to $10,000 – FREE! Enhancements to Supplemental Life plan features –Special Enrollment Opportunity –Transition to age-banded premiums Enhancements to Dependent Life plan features –Special Enrollment Opportunity –Additional Spouse ($50,000) and Dependent ($10,000) Coverage Short term and Long term disability plans –Special Enrollment Opportunity 30

32. Special Enrollment Opportunity October 28 – November 15 Life Insurances –Supplemental Life –Dependent Life Short Term Disability –30/09 Plan –15/11 Plan Long Term Disability Guaranteed Issue! 31

33. Basic Life Insurance Basic life insurance is provided at no cost to you by Vidant Health Available only to full time and part time employees with benefits Full time employees with 10+ years of service will receive additional basic life insurance of $25,000 –New coverage effective 1/1 each year –All full time employees currently receive 1x annual salary up to $150,000 Part time basic life insurance increase to $10,000 (currently $4,000) 32

34. Supplemental Life Insurance Supplemental Life Supplemental life will transition to age banded premiums –New rates and coverage effective 1/1 each year –Employees will have the opportunity to increase their life insurance an additional 1x guaranteed issue! Ex #1: Jane currently has 1x her annual salary in supplemental life insurance. She can now increase her coverage amount to 1.5x or 2x her annual salary with no evidence of insurability. Ex #2: John did not enroll in supplemental life insurance when it was first offered. John can now enroll and elect.5x or 1x his annual salary with no evidence of insurability! –Coverage amounts offered by Vidant Health are.5x, 1x, 1.5x, 2x, 3x, and 4x annual salary. –Total amount of supplemental life insurance cannot exceed $500,000 33 Rate calculator on Employee Central!

35. Dependent Life Insurance Dependent Life –Spouse and child(ren) benefits are now separate (previously they were combined) –Spouse benefit increased to $50,000 (currently $5,000) Rate is based on employee’s age as of 1/1 each year –Dependent child(ren) benefit increases to $10,000 (currently $2,500) Unlimited number of dependent children under age 26 for flat premium.92/pay period. –If you have not previously elected dependent life this special enrollment will allow you to add spouse and/or child(ren) dependent life guaranteed issue. –If you have previously participated in dependent life you will have to re-elect since spouse and child(ren) dependent life are now separate. You may add dependents at this time. If your spouse or child also works at Vidant Health and are eligible for benefits, they are not eligible to be covered under Spouse and/or Child Dependent life. 34

36. Short Term Disability Available for full-time employees only Effective January 1, 2014 Pays 50% of your pre-disability salary to a maximum of $1,000 per week Weekly benefit is tax free Twelve month pre-existing condition clause Two Options –30/09 – 30 day elimination period, then 9 weeks of coverage –15/11 – 15 day elimination period, then 11 weeks of coverage Evidence of Insurability - required if you do not enroll during this special enrollment Reminder: The Leaves of Absence policy states that all accrued vacation, holiday, and sick time/PDO time must be used while on leave therefore disability payments, if approved, will not begin until after accrued paid benefit time has been exhausted. 35

37. Long Term Disability Available for full-time employees only Effective January 1, 2014 Pays 50% of base salary, up to $5,000 per month Monthly benefit is tax free 90 day elimination period Three month pre-existing condition clause Evidence of Insurability - required if you do not enroll during this special enrollment 36 Reminder: The Leaves of Absence policy states that all accrued vacation, holiday, and sick time/PDO time must be used while on leave therefore disability payments, if approved, will not begin until after accrued paid benefit time has been exhausted.

38. Re-evaluating your Benefits Open Enrollment is a great time to re-evaluate ALL of your benefits –401k/403b Contribution Can I contribute more toward my retirement? Don’t miss out on the employer match - FREE Money! –Beneficiary Information Life Insurances: Open Enrollment allows you to review and modify your beneficiaries for basic and supplemental life. For 401k beneficiaries call 1-800-343-0860 or online to www.fidelity.com/at workwww.fidelity.com/at work For 403b beneficiaries contact your HR/Benefits Department 37

39. What Happens If You Choose Not To Complete Open Enrollment? You will miss out on your annual opportunity to make changes to your medical, dental, vision and flexible spending accounts. You will have to wait until the next Open Enrollment to make changes unless you have a Family Status change. If you were enrolled in the Vidant Health Medical plan in 2013, you will default into the 70/30 medical plan with whatever coverage tier you previously selected and you will not be eligible for any premium credits. If you were receiving the flex credit ($33.62 per pay period), you will no longer receive this. You will miss out on the Special Enrollment Opportunity for guaranteed issue Supplemental Life Insurance, Dependent Life Insurance, and Disability Insurance. If you were a Flexible Spending Account participant you will not have a Flexible Spending Account in 2014. 38

40. Family Status Changes For Family Status Change, you have 30 days from the date of the event to contact your HR/Benefits Department to complete your benefit changes. Family Status Changes include the following: –Birth or adoption of a dependent –Marriage –Change in employment status –Change in work schedule –Divorce –Death of a dependent –Dependent child gain or loss of eligibility –Difference in spouse’s open enrollment period 39

41. When Can You Change Your Benefits Outside of Open Enrollment? If you have a Family Status Change you may make changes to your pre-tax benefits including medical, dental, vision, and flexible spending accounts with appropriate documentation. –For family status changes due to birth, marriage, or a situation where both spouse’s work at Vidant and one separates from service, dependent life may also be updated. You can add supplemental life, short term disability, and long term disability but it is not guaranteed issue, and you will need to complete an Evidence of Insurability Form - you may or may not be approved by the carrier for coverage. You can cancel post-tax benefits such as supplemental life, dependent life, short term disability, long term disability, critical illness, whole life or universal life at any time during the year by contacting your HR/Benefits Department. 40

42. New Leave Management Process

43. Effective October 1, 2013 any employee requesting FMLA, Medical LOA, Personal LOA, or Military LOA should be directed to Leave Management to begin the Leave Process. Managers will no longer provide the employee with initial leave request paperwork. Employees may contact Leave Management to request leave and begin the leave process via the following: –By Phone:252-816-8600 –By Email: leavemanagement@vidanthealth.comleavemanagement@vidanthealth.com –In Person:Doctors Park, Building #1AB –Via the Intranet:Employee Central  ”Time Away From Work” Employees will be notified of any leave approvals or denials via email along with their manager, unless US Postal mail is specified. 42

44. Leave Management Reminders Employees in a benefit status should speak with a Benefits Technician after initiating the leave process with Leave Management to receive information on their benefits while on leave. –Apply for Short term or Long term disability, if applicable Remember: You must exhaust all accrued vacation, sick, holiday, PDO, etc. per the Leaves of Absence policy. Disability benefits will not begin paying until an employee is on unpaid leave. –Set up benefits billing in order to continue benefits if accrued benefit time is exhausted. –Make changes to benefits prior to going on leave, if applicable. Leave Management must be notified of any changes to an employees leave of absence and must be contacted by the employee prior to returning to work. Also, employees should come by and speak with a Benefits Technician upon return from leave to reinstate benefits, as applicable. 43

45. Leave Management Reminders Employees will still communicate with their manager and follow department protocol for any call outs and/or schedule changes. However, employees must also contact Leave Management for each call out/absence related to: Family Medical Leave (including intermittent FMLA), Medical Leave of Absence, Personal Leave of Absence or Military Leave of Absence. Employees must contact Leave Management for all intermittent FMLA time – request will be approved based on the certification. 44

46. Employee Self Service

47. It is every employees responsibility to keep their personal information up to date through Employee Self Service. This includes: Your home address Your contact phone numbers Your personal email address This information is used for both Open Enrollment and Leave Management correspondence and must be correct to ensure you receive important communications from Vidant Health. Do not call the Benefit vendors – they can not accept your personal information changes – VH files are the master copy. 46

48. Employee Discounts

49. Great News! The Employee Discount page has been enhanced! New Partnership with Beneplace: –New website design for easy access www.beneplace.com/vidanthealth –More discounts & vendors –Local & Nationwide discounts available Soon, you can check it out through Employee Central! 48

50. QUESTIONS 49