Open Enrollment Plan year: July 1, 2019 – June 30, 2020 May 19, 2019

Dependent Eligibility Columbus State recognizes the importance of providing our employees and their families (spouse, eligible dependent children) with quality benefits. Please review the dependent verification form provided in your packet. *Please be sure to provide appropriate dependent verification information!

Working Spouse Premium Working Spouse Premium - there will be a surcharge for spouses who are eligible for medical coverage through their employer but elect the Columbus State plan as primary coverage: 24 pay-period fee is $50.00/pay and 18 pay-period fee is $66.66/pay. $1200.00 annually – in addition to premium If you have a spouse enrolled on the Columbus State plan, complete the Affidavit and return it with your enrollment form within 31 days of your date of hire. If NO form is returned, the surcharge will apply.

Per Pay Employee Contributions-24 pays/Annual CORE/PPO Teamster Single $72.76/$1746.20 $76.41/$1833.77 Family $191.31/$4591.42 $200.87/$4820.96 80%/20% Per Pay HDHP/HSA College Contributes Single $61.10/$1466.39 $1000 Family $160.67/$3856.15 $2000 80%/20% Per Pay Tiered PPO EE $66.52/$1596.45 EE + Spouse $159.61/$3830.76 EE + 1 or 2 Child(ren) $119.72/$2873.20 EE+ Family $174.92/$4198.13

Per Pay Employee Contributions-18 pays CORE/PPO Single $97.01 Family $255.08 80%/20% Per Pay HDHP/HSA College Contributes Single $81.47 $1000 Family $214.23 $2000 80%/20% Per Pay Tiered PPO EE $88.69 EE + Spouse $212.82 EE + 1 or 2 Child(ren) $159.62 EE+ Family $233.23

Benefit Plan Overview 3 Plans to choose from High Deductible Health Plan with the Health Savings Account Core Plan Tiered Core Plan

Definitions to know Annual Deductible – the amount of eligible expenses that you pay each calendar year for covered health services before you are eligible to begin receiving Benefits. The amount is different in each plan and based on network or non-network providers. Coinsurance – the % of eligible expenses that you are responsible for paying. It usually applies after the deductible has be satisfied. Copay – the amount you pay for certain covered health services. Annual Maximum Out of Pocket – the most you will pay each calendar year for covered health services. The amount may be different in each plan and is based on network or non-network providers. The copays, deductible, and coinsurance apply to the applicable out of pockets maximum. The HDHP has the lowest OOP of all the plans.

Definitions to know Payroll deductions – the portion you are responsible to pay from each pay to participate in the healthcare plans that you elect. MIPA – the added payroll deduction for non-participation in Well-being. Spousal surcharge – the additional contribution that you are responsible to pay when your spouse or partner enrolled in the college’s medical benefit, they are employed and offered employer sponsored benefits that they waive, making Columbus State primary for the employer portion of their covered healthcare expenses. Cost to you each year is $1200.00.

Questions to ask yourself when making a plan choice: Do you want to pay more in case you need it? Or do you want to pay when you need it? What type of services do you use? Are they preventive or medical? Do you have a medical condition that requires medications and appointments? What medications do you take? What type of appointments do you utilize? Think about the total spend per year (OOP maximum) and the cost of the plan. Do you want the ability to save through tax free contributions?

Applies to All Three Plans Preventive Care Routine Physical Well Child The deductible and out of pocket for all medical plans run on a calendar year - January through December. The FSA plan runs on the fiscal year - July through June. The same network of Physicians and Pharmacies. Types of coverages. All three have restricted generic fill.

Main Differences HDHP Single HSA /HDHP ONLY Employer Contributions HDHP Family CORE PPO CORE PPO Teamster Tiered PPO Annual cost EE Family EE and SP EE plus 1-2 children 1466.39 1000 3856.15 2000 1746.20 4591.42 1833.77 4820.96 1596.45 4198.13 3830.76 2873.20 Annual cost no Rewards 2199.59 5784.22 2619.30 6887.13 2750.67 7231.44 2394.68 6297.21 5746.14 4309.80 Deductible 2500 3000/6000 500/1000 750/1500 Maximum Out of Pocket 3000 4000/8000 4500/9000

High Deductible Health Plan with a Health Savings Account (HSA) Option

Health Savings Account What is an HSA? An Account established to pay for qualified medical expenses for the member covered by a high deductible health plan (HDHP) Columbus State HSA Contributions Columbus State may contribute up to $1,000 for single and $2,000 for family. These amounts are deposited equally via payroll deductions over the 18/24 pay period. HSA Contribution Combined Annual Limits (IRS) Employee’s age 55 and older are eligible for a “catch-up” contribution of $1,000. 2019 EE $3500 Family $7000

High Deductible Health Plan (HDHP) with HSA Network Benefits Deductible-Single Deductible-Family $2,500 $3,000/6,000 (embedded) **Each member of the family plan will be embedded at $3,000. Coinsurance 90%/10% Out of Pocket-Single Out of Pocket-Family $3,000 $4,000/$8,000 **Each member of the family plan will be embedded at $4,000. Office Visit-PCP Office Visit-Specialist Deductible then 10% Urgent Care Emergency Room Preventive Services Covered at 100% Prescriptions Retail (preventive RX not subject to deductible) $10 Tier 1/ $30 Tier 2/$80 Tier 3 $20 Tier 1/ $60 Tier 2/$160 Tier 3 *Restricted generic plan Mail (90- day supply)

Core Plan

Core Plan Network Benefits Deductible-Single Deductible-Family $500 $1,000 Coinsurance 80%/20% Out of Pocket-Single Out of Pocket-Family $4,500 $9,000 Preventive Services Office Visit-PCP Office Visit-Specialist Covered at 100% $20 copay $30 copay Inpatient Hospital 20% after deductible Outpatient Hospital Emergency Room Urgent Care $35 Prescriptions Retail $10 Tier 1/ $30 Tier 2/$80 Tier 3 $20 Tier 1/ $60 Tier 2/$160 Tier 3 *Restricted generic plan Mail (90- day supply)

Tiered Core Plan

Tiered Core Network Benefits In Network Deductible-Single/EE+ 1 or 2 Child(ren)/Family $750/$1,500 Coinsurance 70%/30% Out of Pocket- EE EE+ 1/ EE plus 2 or more/family $4,500 $9,000 Office Visit-PCP Office Visit-Specialist Urgent Care Emergency Room $25 Copay $40 Copay $35 Copay Deductible & Coinsurance Preventive Services Covered at 100% Prescriptions Retail $10 Tier 1/ $40 Tier 2/ $100 Tier 3 *Restricted generic plan Mail (90 day supply) $20 Tier 1/ $80 Tier 2/ $200 Tier 3

Dental and Vision Plans

Delta Dental Plan Design Network Benefits when services are rendered by a PPO provider Deductible - None $1,500 Annual Maximum Preventive- Covered at 100% - 2 cleanings per year Basic - Covered at 90% Major - Covered at 60% Orthodontia - $1,000 Individual Lifetime Maximum (Dependents under 19 only) Delta Dental PPO Per Pay Single $3.42 Family $10.17

Delta Dental Enhanced Plan Design Network Benefits when services are rendered by a PPO provider Deductible - None $2,500 Annual Maximum Preventive- Covered at 100% - 2 cleanings per year Basic - Covered at 90% Major - Covered at 60% Orthodontia - $1,500 Individual Lifetime Maximum (EE and Dependent children up to 26) Delta Dental PPO Per Pay Single $4.62 EE plus SP $10.17 EE plus 1-2 (Children) $11.86 Family $18.44

VSP Voluntary Vision Vision Service Plan (VSP) In Network Benefits Eye Exam- $10 copay once every 12 months Frames- Up to $130 retail allowance- once every 24 months Single Lenses- 100% after $25 copay Bifocal Lenses- 100% after $25 copay Lenticular Lenses- 100% after $25 copay Lenses are once every 12 months Contact lenses instead of frames- Necessary 100% after $25 copay; Elective up to $135 allowance VSP Plan Per pay – 24 pays Single $1.63 Family $4.50

Life/AD&D and Supplemental Life Insurance

Employer Paid Basic Life Insurance Columbus State Community College currently provides and pays for 2 times your base annual earnings in Life Insurance benefits Coverage includes Waiver of Premium and Conversion privileges Coverage includes Accidental Death & Dismemberment which is 100% of your Basic Life benefit.

Supplemental Coverage: Employee Coverage available – 1 or 2 times base annual earnings

Supplemental Coverage: Dependent Spouse Coverage available- $10,000 or $20,000 Dependent Child(ren) Coverage is a flat $5,000 per child(ren) 6 months and older; $500 benefit applies to child(ren) 15 days to 6 months old Cost is a unit cost, so regardless of how many child(ren) you may have, the same cost applies.

Cost record for supplemental life. The cost changes each 5 years by the Employee’s age.   It can also change when the employee’s salary changes. The cost increment is per $1000. If an employee is 55 and makes $100,000 The cost is $50.00 per month.

MetLife Benefits Cont’d. Will Preparation Grief Counseling

New Voluntary Benefit Options

Voluntary Benefit Options Critical Illness Hospital Indemnity Accident Identity Protection

Rate Confirmation Critical Illness “Here you will see the rates for each product. Please take a moment now or after the call to confirm what you have matches what is indicated here. We will be using these rates to build our internal systems, so it is important to make sure they match your enrollment system as soon as soon as possible.”

Rate Confirmation Hospital Indemnity “Here you will see the rates for each product. Please take a moment now or after the call to confirm what you have matches what is indicated here. We will be using these rates to build our internal systems, so it is important to make sure they match your enrollment system as soon as soon as possible.”

Rate Confirmation Group Accident “Here you will see the rates for each product. Please take a moment now or after the call to confirm what you have matches what is indicated here. We will be using these rates to build our internal systems, so it is important to make sure they match your enrollment system as soon as soon as possible.”

Identity Theft Protection

Flexible Spending Account FSA Plan year 7/1/19-6/30/20

Healthcare FSA Elect before-tax dollars to use toward eligible healthcare expenses: Medical, Dental/Ortho, Vision $2,700 Annual Maximum Contribution as required by Healthcare Reform Annual contribution is 100% available for reimbursement from the first day of the Plan Year Use it or lose it

Dependent Care FSA Elect before-tax dollars to pay for eligible dependent day care services while you (and your partner) are working or attending school full-time. Daycare centers, Nannies, Nursing Homes Dependent Care FSA funds are only available for reimbursement as they are deducted from your paychecks and contributed to the Plan (money-in, money-out). They are not immediate as with the healthcare FSA.

Transportation Reimbursement $3180.00 Transportation Maximum Must be work-related Mass transit (bus, subway, ferry)

FSA Forfeiture FSA balance does NOT rollover at the end of the Plan Year! If you do not spend the money in your account by the end of the Plan Year, your remaining balance is forfeited. TIPS: Be conservative. Set aside only dollars you will actually use. Access your account to check balance frequently.

CancerBridge provides information specific to your cancer inquiry, expert cancer navigation, and insights into treatment options. For assistance call toll-free 855-366-7700

Healthy Rewards Program

Rewards Overview CSCC has chosen the UnitedHealthcare Health Rewards SM program to engage our employees and their spouse/partner in their wellness incentive. By completing the simple steps toward wellness, and obtaining 8 points each, it will allow you to retain the current 80/20 contribution. If you choose not to complete the steps by the deadline, your payroll contribution will be move to 70/30:

Employee Assistance Program (EAP) MATRIX

Employee Assistance Program/ Matrix Who is eligible? All full time employees, their spouses and/or dependent children What is the cost? FREE-up to six visits per issue

Employee Assistance Program/ Matrix How to access services: Human Resources-Wellness Program Nichole Bowman-Glover, Wellness Coordinator SX132 614-287-3989 nbowmang@cscc.edu MATRIX 2 Easton Oval, Ste. 450 Columbus, OH 43219 614-475-9500/1-800-886-1171 www.matrixpsych.com

Questions ???