Benefits Benefit Changes Conference Call for ESC Represented Employees November 19, 2013

Benefits Agenda New Medical Plan for 2014 –New Resources - where to get more information –What’s changing? –New Plan Design for 2014 Question and Answer Period

Benefits New Resources Provant – Your One-Stop Shop for Health and Wellness Questions Talk to a health advocate for: Billing Questions New Health Account Plan questions Dental or Vision Plan Questions Questions about health screenings, health accounts PROVANT Phone support: , M-F, 5am-5pm. Pacific Time support:

Benefits New Resources New Website: Details on the new Anthem and Kaiser HAP for 2014 Accessed from any computer with internet access What to expect at the doctor and pharmacy on your first visit in 2014 How to use your different cards Where to get more information as you use the plans

Benefits What Isn’t Changing?What Is? Dental Delta DentalNew coverage for dental implants Vision VSPDiscounts on non-covered services are different Medical Monthly PremiumNew Health Account Plan in effect for both Kaiser and Anthem: two provider networks-same plan design Hearing Aids covered for all employees and retirees What’s Changing?

Benefits What’s Changing? Rules for Covering Children Children can be covered under your PG&E medical, dental and vision plan until their 26 th Birthday They no longer have to be students unmarried your tax dependent They can be employed and be offered benefits (New)

Benefits New Medical Plan for 2014 The Health Account All active employees enrolled in Anthem or Kaiser will have a Health Account Both the Anthem and Kaiser PG&E plans for active employees will be called the Health Account Plan, or HAP

Benefits New Medical Plan for 2014 The Health Account Health Account Deposits Single Coverage Family Coverage Remember: If you don’t use all your credits in one year, they roll over

Benefits New Medical Plan for 2014 Earning Health Account Credits Health Screening consists of four tests: Weight/Height to get BMI Blood Pressure Glucose Level (non-fasting) Cholesterol Level Tobacco use test is optional and done with an oral swab Tobacco users can skip the tobacco use test and complete a tobacco cessation course with Provant to earn credits Employees with family coverage will earn credits for their entire family – their dependents do not need to do a screening to earn credits

Benefits New Medical Plan for 2014 Health Screenings and Tobacco Use Test Three ways to get a Health Screening/Tobacco Test On-site event: enroll online at or call Provant Concierge: call Provant at to schedule at your home or office Take a form to your doctor: doctor’s offices don’t do tobacco screenings; you’ll need to walk into any on-site screening – no appointment needed. Download the screening form from Check for your results at Have until Sept. 30, 2014 to earn credits for 2014 plan year

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Using Health Account Credits Pay for plan deductibles and other out-of-pocket expenses Credits can be used for: –medical, dental and/or vision expenses –for you or your family members –unused credits roll over year after year and can be used for PG&E Retiree Medical Plan expenses You can still contribute to a Health Care Flexible Spending Account (FSA)

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Using Health Care Flexible Spending Account NEW! Can roll over $500 from one year to next, amounts above $500 left in account at end of year are still a “use-it-or-lose-it” Will work with the Health Account Administrators: –Your Spending Account (for Anthem Blue Cross members) –Kaiser (for Kaiser members) Will automatically use the Health Care Flexible Spending Account first

Benefits Use card to pay expenses for: Medical Mental health Pharmacy Dental Vision Use card to pay expenses for: Kaiser pharmacy Kaiser medical expenses and mental health expenses automatically taken out of your account after your visit to Kaiser Submit claims to pay for Dental Vision How the Plan Works – Health Account Debit Cards YSA (Anthem HAP) Kaiser HAP

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works 4 free primary care visits per year for every covered family member First choice for everything from chronic disease management, physicals, everyday ailments Choose a family doctor who knows you and cares about your “whole person” health Primary Care Doctors General or family practitioners (including nurses) Internal Medicine doctors Pediatricians OB/GYNs Urgent care

Benefits New Medical Plan for 2014 Other Free Services Some free preventive screening services (e.g., mammograms, pap smears, colonoscopies, immunizations) Some free prescription drugs for preventive care and chronic conditions (e.g., insulin for diabetes) Free maternity and well-baby office visits to age two Go to for lists of which preventive services and prescription drugs are freewww.mypgebenefits.com Tip: free doctor visits may include additional tests or services performed during your visit – these are covered, but may not be free

Benefits New Medical Plan for 2014 A few terms to understand … Annual Deductible For services that aren’t free, amount you’re responsible to pay for first before the plan will start to pay Co-insurance You pay a percent of the cost of a medical service Out-of-Pocket Maximum The limit on the amount you have to pay every year for covered services

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Annual Deductible If you have single coverage, annual deductible is $1,000 If you have family coverage, annual deductible is $1,000 per person but no more than $2,000 for your entire family Remember: if you earn all your Health Account credits, you’ll have enough to pay your whole deductible from your Health Account

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Coinsurance You’ll be responsible for either 10% or 20% of the covered cost and the HAP will pay the other 90% or 80% respectively. There are no copayments under the HAP, so instead of paying a flat $10 or $20 copayment at the time of service, you’ll pay 10% or 20% for services that are not free But, your expense is limited by the Out of Pocket Maximum….

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Out-of-Pocket Maximum Limits how much you are responsible for paying every year Once out-of-pocket maximum is reached, all covered services are free for the rest of the year Includes all money you spend on covered medical services, prescription drugs and mental health services Includes credits you used from your Health Account for medical expenses Includes deductible and co-insurance

Benefits New Medical Plan for 2014 How the Health Account Plan (HAP) Works Out-of-Pocket Maximum If you have single coverage, the annual out-of-pocket maximum is $2,400 If you have family coverage, the annual out-of-pocket maximum is $2,400 per person but no more than $4,800 for your entire family All covered expenses paid at 100% for the rest of the calendar year

Benefits How the Plan Works – Coinsurance MEDICAL SERVICES Primary care office visits after first four free visits Outpatient mental health visits 10% with no deductible Therapies – 1 st five visits (i.e., acupuncture, chiropractic, outpatient physical therapy, occupational therapy) 10% after deductible Specialists Laboratory/X-ray Therapies – additional visits after five (i.e., acupuncture, chiropractic, outpatient physical therapy, occupational therapy) Hospital care Emergency room 20% after deductible PRESCRIPTION DRUGS Retail Pharmacy – must first meet deductible15% generic 25% brand Mail-Order – must first meet deductible10% generic 20% brand

Benefits New Medical Plan for 2014 Things to note about pharmacy Express Scripts will continue to be the pharmacy provider for Anthem Blue Cross; Kaiser provides pharmacy benefits for its members Free medications for Anthem HAP must be obtained from Express Scripts mail order Free medication from Kaiser can be from any Kaiser pharmacy or mail order Anthem HAP members will have mandatory mail order for many maintenance drugs – drugs you take on a long-term basis –In 2014, can get three fills at a retail pharmacy, then must get the drugs through Express Scripts mail order, or pay 100% of the cost –Can sign up now with Express Scripts mail order if currently enrolled in Anthem –Most narcotics, ADHD drugs and compound drugs are not included – you will continue to have coverage for these at a retail pharmacy

Benefits What do you need to do now? Schedule a Health Screening to maximize your Health Account credits for 2014 If you want a flexible spending account, enroll by November 21, 2013 Review Health Account Plan User Guide that will be sent to you in late December Visit for more information on the new Health Account Planwww.mypgebenefits.com Contact Provant with detailed questions , M-F, 5am-5pm, Pacific Time

Benefits Question & Answer

Benefits Thank You Questions? Log onto for more informationwww.mypgebenefits.com Or call Provant at for medical plan questions