Your Emeriti Retirement Health Plan 2017 Benefits Your Emeriti Retirement Health Plan

What’s New In 2017? Premiums for Rx plans increase 4.3% Insurance plan options stay the same Premiums for Rx plans increase 4.3% Premiums for Medicare Advantage Plans increase 6.5% Dental plan premium will NOT increase Premiums for SRM Plans K & L increase 3.5% Premiums for Pre-65 plans will increase 10%

Your Emeriti Retirement Health Benefit Tax-advantaged Retiree Health Account Tax-free Reimbursement Benefit For Qualified Out-of-Pocket Medical Expenses Flexible Group Health Insurance Underwritten By Aetna (HealthPartners in Minnesota) For you and your dependents

2017 Retiree Health Plans 3 Medicare Advantage Plans 2 Medicare Supplement Plans 3 Medicare-approved Part D prescription drug plans Annual choice Guaranteed issue Optional dental plan Underwritten by Aetna Benefits available to employee (retiree) and, if the plan permits, spouse and eligible dependents

How Supplement Retiree Medical Plans (SRM) L & K Work Medicare is primary insurance Aetna plans coordinate with Original Medicare Parts A & B Use Medicare card & Aetna card You pay Part B premium No extra benefits. No plan deductibles. You pay percentage of Medicare Parts A & B deductibles.

How Medicare Advantage Plans Work Aetna is primary insurance Aetna provides Medicare Parts A & B benefits Use one Aetna card You still get your Medicare card You still pay Part B premium Extra Benefits Annual eye & hearing exams Silver & Fit Exercise & Healthy Aging Program Aetna Nurse Case Manager Wellness Coach No plan deductibles. No Medicare Parts A & B deductibles.

2017 Aetna POST-65 Medical Plans – CHOOSE ONE PLAN Aetna Medicare Advantage Premium ESA Aetna Medicare Advantage Plus PPO/ESA-PPO Standard Aetna SRM Plan L Plan K Plan Deductible $0 in- and out-of-network $0 Medicare Deductible 25% of Part A 100% of Part B 50% of Part A Primary Care $15 copay * 15% coinsurance (in-network) 25% (out-of-network) $15 copay (in-network) 30% coinsurance (out-of-network) 25% coinsurance 50% coinsurance Specialist $40 copay Hospital 100% by the Plan $500 per admission (in-network) 25% per admission $200 per day (1-7) (in-network) 30% per admission. Preventive Care Covered 100% $0 after Medicare 50% after Medicare Out-of-Pocket Limit $2,000 * $2,750 (in-network) $5,500 (out-of-network) $6,700 (in-network) $10,000 (out-of-network) $2,480 $4,960 2017 Aetna POST-65 Medical Plans – CHOOSE ONE PLAN 1 2 3 4 5 Medicare Advantage Premium Medicare Advantage Plus Standard Aetna SRM Plan L Plan K Plan Deductible $0* $0 Medicare Deductible 25% of Part A 100% of Part B 50% of Part A Primary Care $15 copay * 15% coinsurance in-network $15 copay in-network 25% coinsurance 50% coinsurance Specialist $40 copay in-network Hospital Covered 100% $500 per admission in-network $200 per day (1-7) in-network 25% of the Medicare Part A deductible 50% of the Medicare Part A deductible Preventive Care Some paid by Medicare Out-of-Pocket Limit $2,000 * $2,750 (in-network) $5,500 (out-of-network) $6,700 (in-network) $10,000 (out-of-network) $2,480 $4,960 Medicare Advantage replaces Medicare Parts A and B. SRM Plans coordinate with Original Medicare – and Medicare is the primary insurer. *In- and out-of-network For 2016, the SRM Plans are not available in VT, MD, MN, and U.S. Territories. For 2016, Part A Deductible - $1,288; Part B Deductible - $166 NOTES: The ESA-PPO Plan has the same benefits as the In-Network PPO Plan. Aetna’s GMS Plans A and L will be offered in Florida in place of SRM Plans K and L.

2017 Aetna Part D Drug Plans – CHOOSE ONE PLAN Rx Premium Plan Rx Plus Plan Rx Standard Plan Open 2 Formulary GRP B2 Formulary $100 deductible $310 deductible Initial Coverage Limit: Coinsurance: 15% generic, 25% preferred brand, 40% non-preferred brand 50% non-preferred brand 25% preferred brand Coverage Gap: Same coverage at same coinsurance level 15% copay for Tier 1 generic drugs, 45% brand 58% generic, 45% brand Catastrophic Coverage: 100% coverage 95% coverage 2017 Aetna Part D Drug Plans – CHOOSE ONE PLAN 1 2 3 Rx Premium Rx Plus Rx Standard Open Formulary GRP B2 Formulary Deductible: $100 Deductible: $310 Initial Coverage Limit: 15% generic, 25% preferred brand, 40% non-preferred brand 50% non-preferred brand 15% generic, 25% preferred brand Coverage Gap: Same coverage, same coinsurance level 15% copay for Tier 1 generic drugs, 40% brand 51% generic 40% brand Catastrophic Coverage: 100% coverage, you pay nothing 95% coverage, you pay 5% The Medicare Coverage Gap Discount Program will continue to provide manufacturer discounts on brand name drugs to Part D beneficiaries who reach the Coverage Gap and are not already receiving “Extra Help.” A 50% discount on the negotiated price of preferred and non-preferred brand drugs (excluding the dispensing fee) will be available from manufacturers that have agreed to provide the discount. 2017 Standard drug plan deductible on the individual market: $400, Initial Coverage limit: $3,700, True-Out-Of-Pocket Threshold: $4,950

2017 Aetna Dental Plan – Optional Preventive Service 100% coverage Annual Deductible (basic and major services) $100 Basic Services Coverage (fillings, standard crowns, extractions) 50% Major Services Coverage (root canal therapy, surgical removals, dentures) Annual Benefit Maximum $1,500 NOTES: Twelve month waiting period applies for major services, but may be waived with evidence of continuing coverage. One-time only opt-in opportunity. Dental is only available when you enroll in a combination Medical/Rx coverage, or elect the stand-alone Rx Standard Plan Please note: in the states of CA, OR, WA, the stand-alone Dental plan may be elected if the participant is enrolled in a Kaiser Permanente MAPD Plan, and with evidence of existing coverage. Dental not available in MD.

Choosing Your Coverage Jim has a chronic medical condition. He takes 3 brand drugs, sees a specialist twice a year, and is sometimes in the hospital. Consider: Medicare Premium Plan or SRM L Plan Rx High Plan Mary is generally pretty healthy. She takes 2 generic drugs, gets her annual check-ups, and sees a specialist once a year for allergies. Consider: Medicare Standard Plan or SRM K Plan Rx Standard Plan For illustration purposes only. Emeriti does not provide advice about health insurance plans.

Emeriti’s Open Enrollment Insurance enrollment kits mailed in October Open Enrollment dates: Monday, November 14 – Friday, December 9 Call the Emeriti Service Center 1-866-363-7484 press option #1 Enroll in health insurance after age 65, upon retirement and after enrolling in Medicare Parts A & B. Post-65 retiree and their dependents can enroll in different plans NOTE: The employer’s plan establishes rules for vesting in the Emeriti Health Accounts and retirement eligibility for Emeriti insurance. *Independent domestic partners generally pay for insurance outside of the Health Account. **Determination of permanent disability also confers access to post-65 insurance for these individuals. Disability must occur before majority. Visit EmeritiHealth.org for more information

1 2 3 Next Steps Review insurance enrollment kit, mailed to your residence Change coverage. - Or - Do nothing, & be defaulted into the plans you had in 2016 Enroll on the phone or online. 12

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Addendum

How Primary Care Charge Works Medicare Advantage Premium Medicare Advantage Plus Medicare Advantage Standard Aetna SRM Plan L Plan K Primary Care Charge $200 Medicare Pays $0 $160 Aetna Pays $185 $170 $30 $20 You Pay $15 copay (in- and out-of-network) $30 coinsurance (in-network) $10 coinsurance $20 coinsurance Medicare covers 80% of the charge for Plans L and K.

Important information Emeriti Retirement Health Solutions provided this information and is responsible for its content. Emeriti, TIAA, CBIZ Savitz, Aetna Life Insurance Company, and HealthPartners are independent corporations and are not legally affiliated. Emeriti Retirement Health Solutions is not an insurance company, insurance broker or insurance provider. For institutional investor use only. Not for use with or distribution to the public.

Interests in any retiree healthcare plan discussed herein are offered solely by the employer. Teachers Insurance and Annuity Association of America (TIAA) will provide services to the plan and may issue plan communications on behalf of the plan sponsor, in its capacity as a plan recordkeeper. Investment, insurance and annuity products are not FDIC insured, are not bank guaranteed, are not deposits, are not insured by any federal government agency, are not a condition to any banking service or activity, and may lose value. The TIAA group of companies does not provide legal or tax advice. Please consult with your legal or tax advisor. C33829