1. Presented by: HUB International November 14, 2014
TOURO INFIRMARY
2015 OPEN ENROLLMENT
Presented by:
HUB International
November 14, 2014

2. Agenda
2015 Changes Wellness Benefits Medical Benefits Other Benefits Costs Websites

3. 2015 Changes
Merging the Base and Enhanced Plan into the Traditional plan.
Introducing a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA). Employer is contributing towards the Health Savings Account.
Covered with Services within LCMC Health or United Healthcare Network only with exception: Emergency Services.
Preventive Care will be covered at 100%
Generic Oral Contraceptives
Breast Pumps
Immunizations as recommended by CDC
All co-pays including prescription drug co-pays will accrue towards the annual out of pocket maximum.

4. 2015 Changes (cont’d)
Flexible Spending Account – $500 Roll over feature no longer allowed due to the Qualified High Deductible Plan and Health Savings Account Offering.
Increase in Flexible Spending Account for unreimbursed medical expenses to $2,550 annually.
Limited Purpose FSA available to employees who are participating in the HDHP/HSA plan for dental and vision expenses only.
LCMC Paid Short Term Disability with eligibility period of: 1st day of the month following 6 months of employment. Available to both full and part-time employees.
LCMC Paid Long Term Disability plan with benefits payable for 5 years for full-time. Employee Paid for Part-time.
Long Term Disability buy-up option with benefits extending benefits to your normal Social Security Retirement age. Available to full-time only.
LTD Eligibility period: 1st day of the month following 6 months of employment.

5. 2015 Changes (cont’d)
Hourly Employees - Increase in LCMC Paid Life Insurance and AD&D from 1 x annual earnings to a maximum of $50,000 to $75,000.
New Spousal Surcharge - If your spouse is eligible to participate in his/her employer’s medical plan but chooses to participate in the LCMC Health plan, a surcharge of $50 per month will be added to your premium. Spousal affidavit required.
Dependent certification form also needs to be completed if you wish to continue to cover your eligible dependents.
New Program for Specialty Drugs.
New ID cards will be issued for Medical and Vision.

6. LCMC System Facilities
Traditional Plan
Services
LCMC System Facilities
UHC Facility Providers and Professional Providers (Excluding Ochsner/Tulane)
Ochsner / Tulane
Deductible
- Individual
- Family
$500
$1,000
$3,000
$6,000
How Deductible Applies to Family Members
Deductibles are applied by individual and family unit. An individual may reach their deductible and begin coinsurance. A family deductible can be met by one or all family members. LCMC and UHC Network Combined; All cross apply.
Out-of-Pocket Limit Medical
$2,000 medical only
$4,000 medical only
$2,500 medical only
$5,000 medical only
$3,750
$7,500
Out-of-Pocket Limit Rx
-Individual
-Family
$2,500 Rx only
$5,000 Rx only
Out-of-Pocket Limit Combined Medical and Rx
$4,500
$9,000
$5,000
$10,000
$6,250
$12,500
Provider Office/Clinic Visit Co-pay
- Primary Care (not preventive)
- Specialist
- Preventive care/screening/immunization
$25
$40
Covered at 100%
Ded & Coinsurance may apply to facility charge
Testing
- Lab Services
- Imaging, X-Rays (CT/PET scans, MRIs)
Ded. & 10% coinsurance
Ded. & 20% coinsurance
Ded. & 40% coinsurance

7. Traditional Plan (cont’d)
Services
LCMC System Facilities
UHC Facility Providers and Professional Providers (Excluding Ochsner/Tulane)
Ochsner / Tulane
Therapies
- PT/OT/Speech
- Chemo/Radiation
Ded. & 10% coinsurance
Ded. & 20% coinsurance
Ded. & 40% coinsurance
Out-patient Surgery
- Facility Fee
- Physician/Surgeon Fees
Immediate Medical Attention
- Hospital Emergency Room Services
- Emergency Medical Transportation
- Urgent Care
$150 co-pay
$100 co-pay
$40 co-pay
Hospital Stay
Prescription Drugs - $100 deductible/individual
- Generic (ded. waived)
- Preferred
- Non-Preferred
- Specialty
Retail / Mail
$10/$22
$30/$65
$45/$100
$75/$165
Not covered outside of network

8. Specialty Drugs
Specialty medications treat complex chronic conditions and have a high cost. They often require special storage, handling and administration.
If you take a specialty drug, LCMC Health has contracted with special pharmacies to provide these drugs at a lower cost. Three pharmacies have been contracted with: Avita New Orleans Pharmacy; Walgreens Specialty Rx; and Accredo. If you obtain your specialty medication from one of these pharmacies, your co-pay will be $50 instead of $75 at other pharmacies.
Avita New Orleans
Phone: (504) or (877) ; 24 Hour Help Line
Walgreens Specialty Rx
Phone: Specialty Pharmacy & Care Team:
Accredo
Phone:

9. Traditional Premiums Monthly Rate EE Contribution LCMC Contribution
Employee
$404.65
$138.92
$265.73
Employee & Spouse
$809.29
$277.83
$531.46
Employee & Child(ren)
$728.37
$250.05
$478.32
Family
$1,157.29
$397.30
$759.99
2014 Plan
2015 Plan
EE Only
EE & Spouse
EE & Children
Family
Enhanced
Traditional
($51.41)
($135.47)
($115.40)
($193.73)
Basic
$15.48
$5.45
($1.93)
$44.30

10. What is a HDHP Plan?
A high-deductible health plan is a health insurance plan with lower premiums and higher deductibles than a traditional health plan. Being covered by an HDHP is also a requirement for having a Health Savings Account.
If family coverage is elected, the full family deductible must be met before the health plan reimburses.
Preventive Expenses are covered at 100%
Preventive generic prescriptions are covered at 100%
All Other medical services including office visits and prescriptions apply towards the deductible and out of pocket maximum at a discount rate.

11. What is an HSA Plan? Medical “IRA” Contributions are tax deductible
Earnings grow tax-free
Qualified distributions are tax-free
All IRS 213(d) expenses are eligible for reimbursement
IRS form 8889 filing with tax return
Both you and your employer can contribute to the HSA account
An account will be opened on your behalf and you will be provided with a debit card through HSA Bank
The maximum contribution (employee + employer) for 2015 is as follows:
Single $3,350
Family $6,650
Additional Catch up contributions of $1,000 annually if age

12. Who is eligible for HSA’s?
Any individual that:
Is covered by a HDHP
Is not covered by other health insurance
does not apply to specific injury insurance and accident, disability, dental care, vision care, long-term care
Is not eligible for Medicare
Cannot be claimed as a dependent on someone else’s tax return
Cannot run unreimbursed medical expenses through an FSA
You must open an HSA account with HSA Bank

13. HSA Distributions Distributions are tax-free if taken for:
person covered by the high deductible
spouse of the individual
any dependent of the individual
Spouse and dependents don’t need to be covered by the HDHP
If not used for qualified medical expenses, then amount is included in income
20% additional tax if taken for non-medical expenses, except when taken after:
Individual dies or becomes disabled
Individual is eligible for Medicare – age 65

14. LCMC Annual Contribution to your Health Saving Account
Coverage Tier
Dollar Amount
Employee
$500
Employee & Spouse
$750
Employee & Child(ren)
$1,000
Family
$1,500
50% of the contribution will be deposited into your HSA Bank Account January 2015 and the
Remainder will be deposited in July Can only access funds available.

15. High Deductible Health Plan with HSA
Services
LCMC System Facilities
UHC Facility Providers and Professional Providers (Excluding Ochsner/Tulane)
Ochsner / Tulane
Deductible
- Individual
- Family
$1,500
$3,000
$4,000
$8,000
How Deductible Applies Across Network Tiers
LCMC and UHC Network Combined; All cross apply.
How Deductible Applies to Family Members
Deductibles are applied by family unit. The deductible is not met for any individual until the entire family deductible is met.
Coinsurance
15%
25%
50%
Out-of-Pocket Max
$4,500
$9,000
$6,250
$12,500
Preventive Services
Covered at 100%
Provider Office/clinic visits and all other medical services
Ded. & 15% coinsurance
Ded. & 25% coinsurance
Ded. & 50% coinsurance
Prescription Drugs – AFTER DEDUCTIBLE
- Generic
- Preferred
- Non-Preferred
- Specialty
Retail / Mail
$10/$22
$30/$65
$45/$100
$75/$165
Not covered outside of network

16. HDHP Premiums Monthly Rate EE Contribution LCMC Contribution Employee
$393.41
$95.34
$298.07
Employee & Spouse
$786.83
$190.68
$596.15
Employee & Child
$708.14
$171.61
$536.53
Family
$1,125.16
$277.57
$847.59
2014 Plan
2015 Plan
EE Only
EE & Spouse
EE & Children
Family
Enhanced
HDHP/HSA
($94.99)
($222.62)
($193.84)
($313.46)
Basic
($28.10)
($81.70)
($80.37)
($75.43)

17. Dental Benefits through Assurant Low Option High Option
Calendar Year Maximum
$1,000 per Individual
$1,500 per Individual
Calendar Year Deductible $0
$25 per Individual
Preventive Care
85%
100% (deductible waived)
Basic Expenses
50%
80%
Major Expenses
30%
Orthodontia
(child only)
N/A
50% to $1,000 Lifetime Maximum
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18. Dental Premiums Coverage Level Low Option High Option Single
$17.47/Month
$8.74/PP
$29.97/Month
$14.99/PP
Employee & Spouse
$34.17/Month
$17.09/PP
$60.71/Month
$30.36/PP
Employee & Child(ren)
$39.65/Month
$19.83/PP
$67.11/Month
$33.56/PP
Family
$59.45/Month
$29.73/PP
$100.82/Month
$50.41/PP
To maximize your benefits use the Assurant network

19. Voluntary Vision Plan through Always Care Coverage Level Frequency
Co-Pays
In-Network
Out-of-Network
Exam
12 Months
$10 Co-pay
Up to $40 Allowance
Frames
24 Months
$25 Co-pay up to $130 Allowance
Up to $50 Retail Allowance
Lenses
$25 Co-pay
Allowances: $40 Single/$60 Bifocal/$80 Trifocal
Contacts
$25 Co-Pay up to $130 Allowance
Up to $105 Allowance
To maximize your benefits use the Always Care network
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20. Vision Premiums Coverage Level Employee Premium Full-Time $/Month
$/Pay Period
Single
$5.47/Month
$2.74/PP
Employee & Spouse
$10.48/Month
$5.24/PP
Employee & Child(ren)
$10.96/Month
$5.48/PP
Family
$16.80/Month
$8.40/PP

21. Flexible Spending Accounts - UMR
Pre-Tax Premium Contributions
Health Flexible Spending Account (FSA)
Un-reimbursed Medical Expenses ($2, max).
Common items for reimbursement:
Deductibles, co pays, out-of-pocket expenses, laser eye surgery, dental fees.
Dependent Care Flexible Spending Account (FSA)
Dependent Care/Child Care ($5, max);
Daycare expenses for PRE-KINDERGARTEN and UNDER.
Before and After School expenses for any child 12 yrs of age and under (No overnight camps - only day camps).
Elder Care expenses for a parent who lives with you and needs round the clock care.
Limited Purpose FSA (dental and vision only) $2,550 maximum for employees who are enrolled in the HDPD/HSA Plan.
Employee’s who have balances up to $500 will be rolled over into a limited FSA account if you are participating in the HDHP/HSA plan or a Standard FSA account if you are participating in the Traditional Plan.
You are putting it away in your own private account for the day when you need it to pay for some expense. When that day arrives — such as when you get the monthly bill from the daycare center — you pay the bill and then ask the bank to reimburse you for that expense.
The advantage to you is that every dollar which goes into that bank avoids taxation. It’s like a tax refund on every paycheck — and the government approves of it, even encourages it! In essence your personal account becomes a powerful budgeting tool to pay your medical and dependent care costs with tax free dollars.

22. How Does Flexible Spending Work?
Voluntary Participation
Annual Enrollment – Calendar Year
Careful Planning Required
Annual amount divided by 24 paychecks
Reimbursements are administered through a third party administrator - UMR
Medical & Dependent FSA Debit Cards – Your current debit cards will be replenished with your new allocation.
Debit Card transactions require substantiation of qualified expenses. You may receive notification from UMR requesting proof of qualified expenses.
Hopefully by now, I’ve piqued your interest so lets look at where we start.
First, you have some choices to make — which expense categories do you want to participate in?
Will it be medical expenses, dependent care, adoption?

23. FSA Qualifying Event Marriage Divorce or legal separation
You can change your expense election during the plan year if there is a major change in your family status due to:
Marriage
Divorce or legal separation
Birth/adoption of child
Part-time/full-time status
Termination/commencement of employment
Loss of a dependent
SCHIP eligibility

24. LCMC Paid Life Insurance through the Hartford Life Insurance & AD&D
Exempt Employees
Directors and Above
Hourly employees
Full-time employees only
1.5 x annual earnings to a maximum of $300,000
3 x annual earnings
1 x annual earnings to a maximum of $75,000
Accelerated Benefits
Up to 80% of life benefit
Subject to maximum

25. 60% of your base weekly earnings to a maximum of $1,500 per week
LCMC Paid
Short Term Disability
Benefit
60% of your base weekly earnings to a maximum of $1,500 per week
Payable
15th Day Accident
15th Day Sickness
Maximum
Up to 26 Weeks
Provided for full-time and part-time employees. Eligibility: 1st day of the month following
6 months of employment.

26. LCMC Paid LTD through the Hartford Monthly Benefit Maximum $10,000
Elimination Period
180 days
Benefit
60% of Monthly Earnings
Duration of Benefits
5 years
Mental & Nervous
Maximum 2 years
Alcohol & Drug Abuse
Pre-Existing Condition
3 months prior /12 months after
Survivor Benefit
3 months
Option to buy-up and extend the duration of benefits to your normal Social Security
Retirement age. Rates are based on age and income. Available to full-time employees only.
Part-time employees have the option of purchasing a 5 year benefit at their own cost.

27. Voluntary Life Insurance and AD&D the through the Hartford
Life Insurance & AD&D
Can be purchased in increments of $10,000 or 5 times your annual earnings to a maximum of $500,000
Guaranteed issue amount $250,000
Amounts in excess of $250,000 will require evidence of insurability.
Rates are age rated

28. Voluntary Dependent Life and AD&D through the Hartford
Life Insurance and AD&D
A spouse is eligible for an amount in increments of $5,000 or up to 50% of the employee’s voluntary amount . Guarantee issue amount $50,000. Amounts greater than $50,000 requires EOI.
Dependent Children
$10,000 for children age 6 months to 21 years or to 25 if full-time student. $250 for children age 14 days to 6 months, newborn children to age 14 days are not eligible for a benefit
Rates are age rated

29. Allstate Voluntary Cancer Protection
Covers you and your family for internal cancer.
Includes 29 other illnesses.
Pays you a benefit of $2,000 for first occurrence of internal cancer.
Daily benefit for hospitalization
Radiation, chemo and experimental treatments.
Wellness benefit of $50 per year/member
Rates - $15.70 single; $26.34 family per month.
New Hires are guaranteed issue – not required to complete evidence of insurability

30. REMINDER Benefit Choices That Require Action
Enrolling for the first time or enrolling in the High Deductible Health Plan
Adding or dropping dependent coverage
Enrolling in new Dental and Vision plans
Increasing life insurance coverage
Participation in the Flexible Spending Account (FSA)
Dependent certification form
Spousal Affidavit is needed if you are covering your spouse on the health plan. If form not received by 12/1/2014, a $50 monthly surcharge will be applied to your premium
Waiving coverage
All forms are due in Human Resources no later than 12/01/2014
IF NO CHANGE FORMS ARE RECEIVED BY THE END OF THE OPEN ENROLLMENT PERIOD FOR YOUR MEDICAL, YOU WILL BE DEFAULTED INTO THE TRADITIONAL HEALTH PLAN.

31. Websites Medical - UMR www.umr.com / 1-800-826-9781
Pharmacy Benefit Manager – CVS/Caremark /
Dental - Assurant /
Vision – AlwaysCare /
Life, Long and Short Term Disability - The Hartford /
Flexible Spending Account Plan - UMR
HSA Bank /

32. LCMC Health will continue to provide a high quality level of benefits to our employees at a cost that is competitive among the local healthcare market.

33. Questions 33