This presentation is copyrighted © exclusively by Emeriti 2013 Benefits THE EMERITI PROGRAM for those planning for retirement 1 Medicare and Emeriti’s.

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Presentation transcript:

This presentation is copyrighted © exclusively by Emeriti 2013 Benefits THE EMERITI PROGRAM for those planning for retirement 1 Medicare and Emeriti’s Health Insurance and Reimbursement Benefit

Your Institution’s Commitment Giving you a tax-free way to pay your health care expenses in retirement Providing access to group health insurance when you retire Offering tax-free reimbursement for other health care expenses Keeping you informed about retiree health care issues along the way Your Institution is: 2

Comprehensive Retirement Security (b) Retirement Plan Accessible for general retirement expenses Retiree income distribution is taxable BeneficiariesAssets passed to the estate 501 (c) (9) – VEBA Retiree Health Plan Dedicated to health-related retirement expenses Retiree health benefit distributions are tax-free Dependents Assets passed on for mutual benefit of the plan

Emeriti’s Core Benefit Components 4 Tax-advantaged savings and investment vehicle, via VEBA Trusts, for payment of future medical expenses in retirement Emeriti Health Accounts Portable group retiree health insurance options building on the foundation of Medicare Emeriti Health Insurance Tax-free reimbursement of other qualified medical expenses not covered by Medicare or Emeriti insurance options Emeriti Reimbursement Benefits

Lifecycle funds Asset diversification among asset classes Automatic rebalancing TIAA-CREF Lifecycle Funds (Retirement Class) A money market mutual fund Seeks to assure the value of your investment at $1 per share TIAA-CREF Money Market Fund (Retirement Class) Some TIAA-CREF proprietary funds Some non-proprietary funds from other mutual fund families Additional Mutual Funds – based on institution’s election Investment Options 2013 – Emeriti Health Account 5 CORE FUNDS CORE PLUS FUNDS

Emeriti TIAA- CREF Accumulation Recordkeeping Trust Services Investment Management Proprietary Mutual Funds Non Proprietary Mutual Funds Savitz Disbursement Recordkeeping Insurance Premiums Qualifying Medical Expenses Debit CardManual Claims Aetna Retiree Health Plans HealthPartners Retiree Health Plans 6 Emeriti’s Service Providers

Source: EBRI estimates from the 2009 Medical Expenditure Panel Survey. 11 Out-of- Pocket 13% Private Insurance 14% Medicare 59% Other 14%* *VA, Tricare, other private, Medicaid, other. Medicare is Not Enough 7

What Are You Saving For? 8 Medicare Part B premium Part A deductible Part B deductible Part D deductible Part D Coverage Gap cost share Part D True Out-of- Pocket) TrOOP Supplemental Insurance Premiums Plan deductibles Plan co-pays and co-insurance Out-of-Pocket Expenses Vision Dental Hearing Medical equipment Long-term care Nursing home

*Higher-income beneficiaries will pay an additional amount for the Part B premium, based on their prior year AGI on the federal tax return, and also for the Part D premium. Beneficiaries who did not contribute to FICA for at least 40 quarters will also pay a Part A premium of $441 each month; higher-income participants may pay more. Understanding Medicare Cost Sharing Part A annual deductible will increase from $1156 to $1184 Part B annual deductible will increase from $140 to $147 Monthly Part B premium will increase from $99.90* to $ Part D annual deductible will increase from $320 to $325 Part D Coverage Gap threshold will increase from $2,930 to $2,970 Part D True Out-of-Pocket (TrOOP) will increase from $4,700 to $4,750 What’s New and What Stays the Same in

Medicare provides these coverages You have your choice of doctors & providers Part A (Hospital) and Part B (Medical) Original Medicare Private insurers approved by Medicare provide Parts A & B coverage You may get extra benefits Part C Medicare Advantage, PPO Plan Private insurers approved by Medicare provide coverage Different plans cover different drugs at different levels You can choose from a range of plan designs Part D Prescription Drug How Medicare Works 10

You pay first $325 as deductible You pay 25% of drug costs You pay 97.5% of brand drugs You pay 79% of generic drugs You pay 5% Deductible Initial Coverage Period Coverage Gap Catastrophic Coverage You reach Catastrophic Coverage at $4,750 in true out-of-pocket costs. You reach the Coverage Gap at $2,970 in total Part D covered drug expenditures (includes plan deductible, your costs and plan costs in the Initial Coverage Period). Four Components of Part D Benefit 11

Guaranteed issue group health insurance coverage Portable, nationwide access A flexible menu of insurance options Annual choice among plans Catastrophic protection Part D prescription drug coverage Foreign urgent or emergency care* Preventive care** Advantages of Emeriti Post-65 Insurance *Available in some plans. ** Varies by plan. 12 Emeriti’s group plans build on the foundation of Medicare.

Emeriti Insurance Choices for One Medicare coordination plan Two Medicare supplemental plans (availability based on state approval) One Medicare Advantage PPO (Extended Service Area (ESA) available for geographical areas outside Aetna’s network) Rx High Plan – continuing coverage in coverage gap Rx Mid Plan – generic coverage only in coverage gap Rx Low Plan – no coverage in coverage gap One dental plan Emeriti Group Medical Plans Emeriti Rx Plans* Emeriti Dental Plan PLEASE NOTE: Emeriti will offer Aetna Group Medicare Supplement Insurance (GMS) Plans A and L to retirees living in Florida.

$200 Deductible 20% coinsurance $1,250 out-of-pocket limit $0 Deductible 25% coinsurance $2,400 out-of-pocket limit $0 Deductible 50% coinsurance $4,800 out-of-pocket limit $0 Deductible in-network $0 Deductible out-of-network 15% coinsurance (in-network) 25% coinsurance (out-of-network) $2,750 out-of-pocket limit (in-network) $5,500 out-of-pocket (out-of-network) *For 2013, the SRM Plans are not available in VT, MN, and America Samoa. After plan deductible is satisfied, plan payment in full on Medicare eligible costs. Emeriti Group Medical Plan Options in 2013 Underwritten by Aetna Payment based on the balance after Medicare’s payment. Payment based on total Aetna allowable cost. Aetna Supplemental Retiree Medical Plan L* Aetna Supplemental Retiree Medical Plan K* Aetna Medicare Advantage - PPO/ESA-PPO Aetna Traditional Choice 100% preventive care covered by Medicare 100% preventive care covered by the Plan 14 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. Age banded Age banded Age banded Community rated

Standard Formulary $325 deductible Initial Cov Limit Retail: 15% - 30% Coverage Gap: no coverage* Catastrophic Cov: 95% coverage Step therapy required for some drugs Open Formulary $100 deductible Initial Cov Limit and Coverage Gap Retail 15% - 30% - 40% Coverage Gap: full coverage Catastrophic Cov: 100% coverage No Step therapy required Open Formulary $100 deductible Initial Cov Limit Retail 15% - 30% - 50% Coverage Gap: generic coverage only* Catastrophic Cov: 95% coverage Step therapy required for some drugs The Medicare Coverage Gap Discount Program provides a 50% manufacturer discount on brand drugs in the Coverage Gap for all Rx plans for participants not already receiving “Extra Help.” Rx Mid PlanRx Low Plan Rx Coverage Options in 2013 Underwritten by Aetna NOTE: 5% DISCOUNT ON MAIL ORDER through Aetna’s Rx Home Delivery. 15 *Participant has 79% cost sharing limit on generic drugs in Coverage Gap (Rx Low Plan), and 2.5% plan cost sharing on brand drugs in the Coverage Gap (Rx Mid Plan and Rx Low Plan). Rx High Plan Geographically rated Geographically rated Geographically rated

Preventive Service Coverage100% Annual Deductible (basic and major services)$100 Basic Services Coverage (e.g. fillings, standard crowns, extractions) 50% Major Services Coverage (e.g. root canal therapy, surgical removals, dentures) 50% Annual Benefit Maximum$1,500 Rate StructureCommunity rated NOTES: 1.Twelve month waiting period applies, but may be waived with evidence of continuing coverage. 2.One-time only opt-in opportunity. 3.Dental is only available when you enroll in a combination Medical/Rx coverage, or elect the stand-alone Rx Low Plan Dental Coverage in 2013 Underwritten by Aetna Dental Design 16

STEP 1 Create Your Own Plan STEP 2STEP 3 select a medical planselect an Rx planConsider the optional dental plan 17

Preserving Your Options at Initial Medicare Entry Choose Rx Low Plan as stand-alone option Select Rx Low Plan Add dental to the Rx Low Plan if you wish Consider Dental 18 NOTE: Be sure to determine Part D credible coverage if you stay in an active health plan beyond first Medicare eligibility

How Do You Access Medicare and Emeriti Health Insurance NOTE: Consult your Summary Plan Description for details. After age 65When you retire After enrollment in Medicare Parts A & B 19 Harvey Mudd College Retirement Eligibility for Insurance:  Age 55  5 Years of Service

Permanently disabled children** Dependent children (before majority, to age 26) Domestic partner (pre- or post-65) depending on your plan* Available for Participant & Dependents Participant’s dependents include: Who Can Use Emeriti Health Insurance Spouse (pre- or post-65) 20 NOTE: The employer’s plan establishes specific rules for vesting in the Emeriti account balance and retirement eligibility for the Emeriti insurance. *Domestic partners’ coverage is available only if elected by the institution. Independent domestic partners 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. Post-65 dependents must enroll in same coverage as participant

MEDICAL PLAN CHOICES2013 MONTHLY entry age 65 Group Medigap Plan K$ Group Medigap Plan L$ Medicare Advantage PPO$ – community rated Traditional Choice$ Estimating Future Supplemental Plan Rates Emeriti Rates in 2013 for Zip Code – RX PLAN CHOICES2013 MONTHLY any age Low Rx – no gap coverage$21.81 Mid Rx – generics - gap coverage$75.72 High Rx – generics and brands – through gap coverage $ DENTAL PLAN OPTION2013 MONTHLY any age PPO Plan$58.33 NOTE: For continuing participants in closed Mid-high Rx Plan, the rate is $116.71

Emeriti’s Other Program Components Emeriti Health Accounts A tax-advantaged way to save and invest for future medical expenses. Note: ACH savings option will be available in Emeriti Reimbursement Benefits A tax-free method for you to pay for other qualified out-of-pocket medical expenses not covered by Medicare or Emeriti insurance. 22

Reimbursement Benefits at Work 23 Manually submit claims to Savitz: Mail Fax Upload through Participant Benefits Dashboard (MyEmeritiBenefits.org) Debit card option in development for 2013 Reimbursement Benefits will be paid from participant’s balance in the Money Market Fund. Participants may transfer lump-sum amounts or set-up monthly systematic transfers in amounts of $100 or more. For expenses incurred after termination

NOTE: A wide range of health care expenses are eligible for tax-free reimbursement as long as they satisfy the requirements of Section 213 (d) of the IRS Code. How You Can Use Your Reimbursement Benefit Emeriti Reimbursement Form available on MyEmeritiBenefits.org 24 Partial List of Uses Medicare premiums and cost shares Supplemental insurance deductibles, co-insurance, co-pays Vision, dental, hearing care Over-the-counter and non-formulary drugs (with Rx prescription from doctor) Medical equipment Long-term care insurance Medical expenses associated with nursing or in-home health care services Other post-65 and pre-65 insurance premiums (if Emeriti coverage is not elected) Harvey Mudd College Vesting for Reimbursements:  5 years of service

Dependent relatives depending on your plan Permanently disabled children Dependent children (before majority, to age 26) Domestic partner (pre- or post-65) depending on your plan Available for You & Your Dependents Participant’s dependents include: Who Can Use Your Reimbursement Benefits Spouse (pre- or post-65) Consult your summary plan description for details 25

26 ESSENTIAL SERVICES Call toll-free: EMERITI ( ) Monday – Friday 9:00AM to 5:30PM (ET) Annual workshops on campus National teleconferences Investment statement Benefits statement When you are saving When you are nearing retirement When you are using retiree health benefits Initial age-in kit at Medicare eligibility Annual insurance enrollment kit, thereafter In print | In person | On phone

How to Use the Emeriti Service Center Emeriti Thank you for calling Emeriti Please listen carefully, as our menu has changed. YOU WILL HAVE 3 CHOICES For information about Insurance Enrollment, press 1 For information about the Reimbursement Benefit, press 2 For information about the Health Accounts, press 3

28 TIAA-CREF Quarterly Statement - InvestmentsSavitz Quarterly Statement – Benefits

29 DIGITAL SERVICES Online access via EmeritiHealth.org

30 DIGITAL SERVICES At-a-glance benefits website Register at MyEmeritiBenefits.org Check your Emeriti Health Account balance Log-in at tiaa-cref.org Comprehensive Program website Visit EmeritiHealth.org Online resource for insurance benefits and health information Check your insurance claims Order prescriptions online Access via EmeritiHealth.org Detailed investment information Prospectuses, fund fact sheets, performance reports Website in development Online access via EmeritiHealth.org Online resource for insurance benefits and health information Access via EmeritiHealth.org

31 Register today at MyEmeritiBenefits.org Health Account balances Health Insurance enrollments Reimbursement Benefit transactions

32 Log-in at TIAA-CREF.org Investment choices Account balances Contribution history Recent transactions

Status of 2012 Services Commitments 33 Improved Emeriti Service Center: 9am – 5:30pm ET EMERITI Dedicated Emeriti representatives Improved warm transfers Enhanced reimbursement benefit options: Manual claims can be submitted via direct mail, fax, or uploaded to participant benefits dashboard, starting in January New debit card option in development for 2013 Online participant dashboard: At-a-glance summary of Health Account activity, insurance plan information, and reimbursement benefit transactions. Enhanced menu of investment funds and institutional Microsites: Proprietary and non-proprietary fund choices Microsites in development for 2013 Quarterly statements: Investment statement from TIAA-CREF Health insurance and reimbursement benefit statement from Savitz Improved suite of life-stage communications for participants: Retired participants Participants nearing retirement Younger active participants – in development for 2013 Improved ACH savings opportunity from personal bank accounts: Recurring and periodic lump sum savings option – in development for 2013

34 Emeriti Program Fees FeesActivesRetirees* Emeriti$5.00 TIAA-CREF$.67 Savitz$1.00$6.00 Investment management fees are variable by selected mutual funds (see prospectuses) Monthly Participant Fees *Also applies to vested terminated employees Your employer may cover all or some portion of the service fees. Check with your institution’s benefit administrator if you are uncertain.

Emeriti Retirement Health Solutions is not an insurance company, insurance broker or insurance provider. Summary Plan Description (SPD) This presentation is intended to provide you with a brief summary of some of the details of your Employer’s Emeriti Plan and the Emeriti Program. For a full summary of the terms of your Employer’s Emeriti Plan you must consult the SPD, which will be provided to you upon enrollment or upon request. 35 Emeriti Retirement Health Solutions provided this information and is responsible for its content. Emeriti, TIAA-CREF, Savitz, Aetna Life Insurance Company, and HealthPartners are independent corporations and are not legally affiliated. The retirement healthcare program is offered by the employer. Teachers Insurance and Annuity Association (TIAA) will provide services to the plan and make available investment options. TIAA-CREF Trust Company, FSB provides investment management and trust services.

Investment Adviser Status Emeriti Retirement Health Solutions is a registered investment adviser for purposes of selecting the range of investment options for the Emeriti Program, selecting the investment manager for employer and voluntary employee contributions, and providing these and other impersonal educational materials to plan participants. Emeriti does not provide advice to participants about their individual investment selections. The participation interests in the voluntary employee contribution VEBA trusts associated with the Emeriti plans (the “Interests”) may be treated as securities under various state securities laws. The offering of these Interests is subject to compliance with any applicable state law. For residents of Georgia, the Interests are being offered in reliance on paragraph 13 of Code Section of the Georgia Securities Act of 1973, as amended (the “Georgia Act”). The Interests may not be sold or transferred except in a transaction which is exempt under the Georgia Act or pursuant to an effective registration under the Georgia Act. 36

Addendum 37

CMS 21% Mandate in the Coverage Gap 38 For generic drugs in the Gap (one month supply obtained at in-network retail pharmacy): Sample Generic - $30Rx Low PlanRx Mid PlanRx-High Plan Your Cost Share79%15% You Pay$23.70$4.50 All costs above are illustrative. Table reflects cost sharing between plan Initial Coverage Limit and TrOOP threshold for members not eligible for low income cost sharing subsidies.

CMS Negotiated Brand Discount in Coverage Gap CMS 2.5% Mandate in Coverage Gap 39 For eligible brand drugs in the Gap (one month supply obtained at in-network retail pharmacy): Sample Brand - $100 (Preferred Brand) Rx Low PlanRx Mid PlanRx High Plan Pharma Cost Share 50% Manufacturer Discount on total cost of drug Plan Cost Share 2.5% of $100 total drug cost Plan pays balance, after your 30% cost share Your Cost Share 47.5% 30% of total drug cost You Pay$47.50 $30 All costs above are illustrative. Table reflects cost sharing between plan Initial Coverage Limit and TrOOP threshold for members not eligible for low-income cost sharing subsidies. There is also a dispensing fee.

Retiree Cost Share for Typical Doctor’s Visit Bill of $100 Trad. ChoiceSRMP LSRMP KMA-PPO/ESA Charge Medicare Pays Aetna Pays You Pay $100 $80 $20 $0 $100 $80 $15 $5 $100 $80 $10 $100 $0 $85 $15 NOTE: Illustration assumes any annual plan deductibles have already been satisfied for the plan year. 40

YOU PAY FIRST $325 AS DEDUCTIBLE PLAN PAYS 75% OF DRUG COSTS ($ ) YOU PAY 25% OF DRUG COSTS ($661.25) YOU PAY 97.5% OF BRAND DRUGS AND 79% OF GENERIC DRUGS ($ ) PLAN PAYS 95% YOU PAY 5% * Greater of $2.65 or 5% for covered generic (including brand drugs treated as generic) drugs. Greater of $6.60 or 5% for all other drugs. Deductible Initial Coverage PeriodCoverage Gap Catastrophic Coverage You reach Catastrophic Coverage at $4,750 in true out-of-pocket costs. This threshold includes plan deductible, your 25% cost share during Initial Coverage Period, and your 97.5% cost share for brand drugs and 79% cost share for generic drugs in the Coverage Gap. You reach the Coverage Gap at $2,970 in total Part D covered drug expenditures (includes plan deductible, your costs and plan costs in the Initial Coverage Period). Standard Medicare Part D in