Duke University & Health System Open Enrollment for 2016 Benefits Oct. 26 – Nov. 6, 2015

Pharmacy Usage Trends 86.0%

Duke’s medical insurance plans Duke offers 4 plans: Duke Basic (HMO with Triangle network primarily of Duke physicians) Duke Select (HMO with Triangle network primarily of Duke physicians) Blue Care (BCBS HMO with statewide network) Duke Options (PPO plan with international network)

Duke’s medical insurance plans Five tiers of coverage Employee Employee & Spouse Employee & Child Employee & Children Family

Medical insurance premiums Premium increases will again be less than the projected increases nationally $606 $583 $132 $127 Duke Options $613 $589 $137 Blue Care $445 $436 $75 $74 Duke Select $282 $276 $30 $29 Duke Basic 2016 2015   Family Individual

What if you had to be hospitalized But when looking at costs, you have to also consider the coverage and what you would pay if you had to use the benefit. For example, if you had to be hospitalized, your out-of-pocket costs would be significantly lower through Duke than at most of our peers.

Medical Plan Changes While primary care co-pay remains the same, specialist co-pay increases on Duke Select, Duke Options and Blue Care from $45 to $55; Duke Basic from $60 to $75. Annual deductible increase for Duke Basic individual from $500 to $600 and family from $1,500 to 1,800. Annual deductible increase for Duke Options individual from $100 to $130 and family from $300 to $390.

Benefit Eligibility A same-sex partner must be registered with Duke HR by December 31, 2015 in order to maintain eligibility for grandfathering status under the Same-Sex Spousal Equivalency policy. Beginning January 1, 2016, all faculty and staff, regardless of sexual orientation, must be legally married to cover a partner or a partner’s child for benefits unless the partner is grandfathered status under the Same-Sex Spousal Equivalency policy. Reminder: Employees must verify the eligibility of dependents covered by any of Duke’s medical plans by November 6, 2015 to continue coverage after December 31, 2015. Verification documentation is sent to Xerox HR Solutions.

Tobacco Surcharge In 2016, tobacco use surcharge will increase from $30 to $40 per month for health insurance. The surcharge does not apply to dependents. Surcharge will be removed if employee successfully completes a tobacco cessation program.

Open Enrollment for 2016 Pharmacy Plan

Pharmacy Plan No increases in co-payments for generic. Formulary drugs increase by $5 Non-formulary drugs increase by $10 Co-pay increase of $20 for formulary and $17 for non-formulary drugs for a 90-day supply of medication obtained through the mail order and on-site Duke Pharmacies.

Express Scripts Mail order or on-site Duke Pharmacy Retail pharmacy Express Scripts Mail order or on-site Duke Pharmacy Up to a 34-day supply Up to a 90-day supply First 3 purchases of any medication After 3rd purchase of long-term medication Anytime Generic (no deductible)* $10 (or cost of drug if less) 50%* Min. $10, Max. $25 $20 (or cost of drug if less) Brand ($100 per person annual deductible applies. No deductible for mail order or on-site Duke pharmacies.)* $45 Min. $55, Max. $125 $120 Non-formulary ($100 per person annual deductible applies. No deductible for mail order or on-site Duke pharmacies.)* $65 Min. $65, Max. 135 $155 *Participants in the Duke Basic plan have a $100 deductible for all prescription drugs, including generic, mail order and on-site Duke Pharmacies.

Open Enrollment for 2016 Vision Plan

Duke’s vision plan for 2016 No changes for 2016 to premium or benefit design: Individual Employee & Child Employee & Children Employee & Spouse Family $9.66 $18.49 $19.46 $18.50 $29.97

Open Enrollment for 2016 Dental Plan

Dental Premiums for 2016 PPO Plan: No premium increase Dental Plan A: Modest increase in premium Dental Plan B: No premium increase Individual Family 2015 2016 2015 2016 PPO $38.44 $38.44 $116.46 $116.46 Dental Plan A $41.28 $42.11 $125.05 $127.55 Dental Plan B $12.18 $12.18 $45.24 $45.24

Late Entrant Late entrant: if you or a dependent are planning to enroll for 2016 but are not currently enrolled for dental coverage at Duke Only covers two preventive care exams (not including X-rays), two cleanings, and one fluoride application (for children under age 19) for the first 12 months

Reimbursement Accounts Open Enrollment for 2016 Reimbursement Accounts

Save with reimbursement accounts Pre-tax savings is about 30 percent of every dollar you put in the accounts Health Care Reimbursement Account - $2,550 maximum Health Care Reimbursement Account allows for up to $500 to be carried over from one plan year to the next plan year Dependent Care Reimbursement Account - $5,000 combined household maximum

Many ways to save WageWorks Health Care Card App for iPhones, Androids and Blackberries Website Paper forms (fax/mail)

Summary for 2016 Modest premium increase for health plan, significantly less than national average No changes to primary care physician copay or generic drugs Modest increase in other copays including: Specialist, Formulary/non-formulary drugs, and deductibles No premium increases to vision No premium increases to Dental PPO and B, modest increase to Dental A

Open enrollment: Oct. 26 - Nov. 6 Enroll online through the Duke@Work Self-Service website Or By phone at 919-684-5600 hr.duke.edu/selfservice

Dependent Eligibility Verification Date mailed: October 1, 2015 Response: November 6, 2015 No response or ineligible: Dependent removed from plan Dec. 31, 2015 Help Line: 1-844-863-8561

What’s next? When What Sept. 29 HR Forum Oct. 1 Manager Memo/Presentation: Open enrollment changes for 2016 benefits Oct. 9 Guide: Print guide mailed home. Oct. 12 Article: Open enrollment for 2016 benefits Oct. 26 Open Enrollment Period Begins Email: Open enrollment period begins Nov. 3 Article: Reminder about deadline Nov. 4 Email: Reminder about deadline Nov. 6 Open Enrollment Period Ends More information about specific changes for benefits will be communicated next month as part of the annual open enrollment process. Articles and events are planned throughout the next few months to help provide context and set expectations about changes for 2011. Here are a few of the highlights of what you can expect to see.

Duke University & Health System Questions? Open Enrollment for 2016