2012 Annual Benefits Enrollment

Web for Employees Available from 8:00am Saturday, October 1, until 6:00pm Monday, October 31, 2011 Review your benefit enrollments for 2012 and make changes 2012 Annual Benefits Enrollment

Review Your Benefit Enrollments Health Care Dental Vision Life

2012 Health Care Insurance Plans BlueOptions BlueChoice

2012 HealthCare Premium Chart Employee OnlyEmployee/ Spouse Employee/ Child(ren) Family OPSU Cost Employee Cost OPSU CostEmployee Cost OPSU CostEmployee Cost OPSU CostEmployee Cost BlueChoice $ $ 0.00 $ $ $ $ $ $ BlueOptions $ $ 0.00 $ $ $ $ $ $

Eligibility for BlueCross BlueShield Employee Eligibility: 6-Month Regular Appointment at least 75% FTE Health Benefits: Employee Only Coverage Employee/Spouse Coverage Employee/Child(ren) Coverage Family Coverage Dependent Coverage: Coverage to age 26

Prevention and Wellness Wellness Exams Immunizations Early Detection Exams & Testing Bone Density, Colorectal, Gynecological, Mammograms, PSA Blue Access & Personal Health Manager Health Risk Assessment, 24/7 Nurseline BluePoints, Health Tools & Management

BlueChoice PPO Preventive and Wellness at 100% Prescription drug coverage is the same benefit offered with BlueOptions, top 75 drug list $25 office visit copay $500 individual/$1500 family deductible 80% paid by BlueCross after deductible Out-of-pocket maximum

BlueOptions Preventive and Wellness at 100% Same prescription coverage benefit offered as BlueChoice, top 75 drug list $30 primary care office visit copay, $50 specialist office visit copay $750 individual/$2250 family deductible 80/20 co-insurance BluePreferred Network 70/30 co-insurance BlueChoice Network Out-of-pocket maximum

BlueOptions Deductible Credit Complete a Health Risk Assessment (HRA) on BlueAccess for Members – Receive a deductible credit of $250 – Reduce your calendar year deductible to $500 Enroll in Special Beginnings – Receive a deductible credit of $250 – Can be combined with the HRA deductible credit – First trimester enrollment is required

Condition Management Programs BlueOptions Only Diabetic Condition Management Program – Receive a reduction in pharmacy cost Generic and name brand copays reduced to $10.00 for one month supply – Enrollment required to receive pharmacy benefit Congestive Heart Failure Condition Management Program – 50% reduction on generic and name brand drugs – Enrollment required to receive pharmacy benefit

Healthy Interactions **NEW** Interactive sessions for OSU/A&M’s sponsored health and wellness programs Face to face small group sessions – Facilitated by trained, licensed professionals – Sessions in November

Prescription Drugs Negotiated Discounts $4.00 Top 75 Generics $25.00 Other Generics $50.00 Preferred $ Non Preferred $ Triessant Specialty $ Non Triessant Specialty LESSER of 34-day supply or 200 units

Dental and Vision Insurance 2012 OSEEGIB Employee Benefits Option Guide is available online at Add dependent children until age 26 If you cover one dependent, you must cover all dependents unless they have other group dental or vision coverage No changes to plans, minimal change in premiums For provider listings, sib.ok.gov

ING Supplemental Life Insurance No increase in premium rates No premium changes unless you go into the next 5- year age-rated bracket Add $5,000 if not at maximum At 65, 70, & 75 coverage decreases OPSU also provides 2 times annual earnings ($200,000 maximum) in life insurance NEW! ING Travel Assistance Service

OCTOBER IS ANNUAL BENEFITS ENROLLMENT MONTH Web for Employees