UNA MEJOR OPtion PARA SU SALUD TOTAL [Employer group name] City and County of Denver High Deductible Health Plan (HDHP)

| © Kaiser Permanente. All rights reserved.2  Welcome and Introduction(s)  Video: How does a HDHP work?How does a HDHP work?  Terminology and Definitions  Plan Benefits / Services Covered  What is a Health Savings Account (HSA)  Jump starting your HSA City and County of Denver – HDHP Agenda

| © Kaiser Permanente. All rights reserved.3 Integrated Care in Denver/Boulder 22 fully-staffed Medical Offices from Boulder and Longmont to Castle Rock Over 1,000 Primary and Specialty care physicians to choose from No referral needed for most specialists including Orthopedic and OB/Gyn Primary Care, Laboratory, Radiology, and Pharmacy available in most offices Additional approved providers available in Southern and Northern Colorado

2016 City and County of Denver High Deductible Health Plan

| © Kaiser Permanente. All rights reserved.5 City and County of Denver - HDHP Terminology and Definitions Deductible The amount you or your family must pay (“satisfy”) before the health plan shares in the expense of services received Coinsurance The percentage of the cost of services received for which you are responsible. You are charged coinsurance for services after satisfying your deductible Out-of-pocket maximum (OPM) The maximum limit you pay each year in coinsurance and deductible for covered services received Explanation of Benefit (EOB) A tracking document for each date of service outlining deductible status and out-of- pocket tracking Patient Billing Statement Statement outlining member’s financial responsibility after claim has processed through claims system

| © Kaiser Permanente. All rights reserved.6 City and County of Denver – HDHP – 2016 Annual deductible – per plan year$1,350 subscriber only / $2,700 family Annual out-of-pocket maximum (OPM) - per plan year $2,700 subscriber only / $5,400 family You must meet the family Deductible before plan moves to coinsurance. Deductible is included in the OPM. Covered serviceYou pay Preventive careNo cost for most services Doctor’s office visit20% coinsurance* Diagnostic lab tests20% coinsurance* Imaging (x-ray, MRI, CT/PET scan)20% coinsurance* Outpatient surgery20% coinsurance* Hospitalization20% coinsurance* Emergency care20% coinsurance* Prescription drugs (in pharmacy)20% coinsurance* * Coinsurance applies after the Deductible is met. This is only a summary of some benefits and their copays and coinsurance. This chart does not describe the benefits. Refer to your Evidence of Coverage for information about coverage, limitations and exclusions of all benefits, including those not listed in this summary.

| © Kaiser Permanente. All rights reserved.7 City and County of Denver Health Savings Account (HSA) You are responsible in opening your Health Savings Account (HSA). An HSA is a savings account that works with an HSA-Qualified Deductible HMO (HDHP) plan. You contribute money to your HSA each year and use those funds to pay for qualified medical expenses, now or in the future. You own the money in this account, which you can grow and take with you, even if you change jobs or retire. To meet the requirements for an HSA, you must be enrolled in an HSA-qualified deductible health plan and meet other HSA eligibility rules. For further information, refer to IRS Publication 969, Health Savings Accounts and Other Tax-Favored Health Plans, at irs.gov/publications. HSAs may also experience investment losses.

| © Kaiser Permanente. All rights reserved.8 The IRS has provided tax benefits for your HSA funds. The funds in your HSA are not considered part of your wages, so they’re not subject to federal income taxes HSA funds used to pay for qualified medical expenses are not subject to taxes. Any interest earnings in an HSA is tax-free as long as they’re used for qualified medical expenses Maximum annual amount for Individual is $3,350 and Family is $6,750 Tax references in this document are related only to federal income tax. Consult your financial or tax advisor about state income tax law. Refer to the list of medical costs that meet the requirements, as defined under Internal Revenue Code Article 213(d); refer to IRS Publication 502, Medical and Dental Expenses, at irs.gov/publications. City and County of Denver – HSA and Tax Benefit

| © Kaiser Permanente. All rights reserved.9 Contributing to your Health Savings Account City and County of Denver providing tax-free seed money Individual - $600 Family - $1200 Annual maximum contribution for Individual - $3,350 $3,350 - $600 = $2,750 Annual maximum contribution for Family - $6,750 $6,750 - $1,200 = $5,550 Amount rolls over from year to year without penalty

| © Kaiser Permanente. All rights reserved.10 Examples of Qualified Medical Expenses You can use the funds in your HSA to pay for qualified medical expenses, which will include deductible and coinsurance amounts for: Non-preventive office visits with your PCP or Specialist Prescription drugs X-rays, MRIs, CT scans, PET scans and lab tests Emergency visits Hospital visits Refer to the list of medical costs that meet the requirements, as defined under Internal Revenue Code Article 213(d); refer to IRS Publication 502, Medical and Dental Expenses, at irs.gov/publications. City and County of Denver – Qualified Medical Expenses

Dave, with Department of Natural Resources, only covers himself on the plan. He is generally healthy, but has developed knee problems. He visits a specialist – orthopedic surgeon ($215). The specialist orders and MRI ($1,467), and based on the results, recommends outpatient surgery ($5,000). Dave also needs pain medication after the surgery (1 generic prescription). Scenario 1: Employee Only Coverage Note: These are estimated costs only. Figures based on 2015 Sample Fee List. Specialty Office Visit $ 215 MRI Procedure $1,467 Out Patient Surgery $5,000 Generic Prescription $ 12 IND Deductible $1,350 Total Cost of Services $6,694 Total Cost – Individual Deductible = $5,344 $5,344*20% = $1, $1,350 + $1068 = $2,418 IND Deductible $1,350 20% of $5,344 $1,068 IND OPM $2,700 Difference $2,700-$2,418 = $282

Scenario 2: Family Coverage Note: These are estimated costs only. Figures based on 2015 Sample Fee List. Ded=deductibleCoin=coinsurance Copay=Copayment OPM=Out of Pocket Maximum Allison, Department of Public Safety, currently covers her husband and a daughter on the plan. She will deliver their second child, a son, in 4 months. The family has 4 preventive visits (including well baby visit), an inpatient stay for delivery ($9,000), 4 generic prescriptions after the baby is born and 1 specialist visit to the pulmonologist for their daughter’s allergies ($154 + $58 for a breathing test). Prescriptions Breathing Test $ 58 Specialty Office Visit $ Generic Prescription $ 48 Inpatient Stay $9,000 Total Cost – Family Deductible = $6,260 $6,260*20% = $1,252 Family Deductible $3,000 Total Cost of Services $9,260 Family OPM $5,400 $1,252 + $3,000 = $4,252 Family Deductible $3,000 20% of $6,260 $1,252 Difference $5,400-$4,252 = $1,148

| © Kaiser Permanente. All rights reserved.13 Important Points to Remember City and County of Denver – Wrapping it Up Evaluate Your Health Needs to determine best plan Select your Kaiser Permanente plan, DHMO or HDHP If you don’t select you will fall into the default plan Open your Health Savings Account when electing the HDHP If you don’t open your Health Savings Account the City and County of Denver cannot release your seed money into a non existent account

| © Kaiser Permanente. All rights reserved.14 Financial Counselors or TTY for the hearing/speech impaired. Clinical Pharmacy Call Center – or TTY for the hearing/speech impaired Both departments can be reached Monday through Friday between 8am and 6pm Additional Resources

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