Health Care Update and Changes Gayln L Bowers

Agenda Health Care Plan Data Plan Changes Questions and Answers

PUC left Adventist Risk Management Health Care Plan and implemented the Pacific Union College Self Insured Group Health Care Plan. No employee contribution for the plan year. PUC Group Health Care Plan is a bundled plan inclusive of medical, prescription, dental and vision. Health Care Plan Review

Health and Wellness Program enhanced during the plan year to encompass a greater preventative strategy. Health Care Plan Review

Employee Contribution Implemented July 1, 2005 Employee Only - $30.00 per month Employee +One - $50.00 per month Employee + 2 or more - $75.00 per month Employee Contribution Changed July 1, 2009 Employee Only - $50.00 per month Employee +One - $80.00 per month Employee + 2 or more - $ per month Health Care Plan Review

Per Employee Per Month Medical$ Prescription$ Dental$ Vision$18.11 Admin/Re-insurance Fees$ Total$1, Group Health Plan Costs –

EE2-PartyFamily Medical & RX PPO$636.31$1,251.64$1, HDHP$538.61$1,059.46$1, HSA Fund$83.33$ Dental PPO$61.85$122.32$ Vision Vision Plan$13.92$27.39$39.71 Group Health Plan Costs – Premium Equivalencies per Month

ALL employees working hours per weeks are offered medical insurance. We have 91 full-time faculty and 153 full-time staff. TOTAL of 244 full-time employees 100% of our full-time employees have picked up the college’s health care plan Employees

100 % of full-time faculty members are on the College’s health care plan 100 % of full-time staff members are on the College’s health care plan 32 faculty members have the single plan 26 faculty members have the employee + one plan 33 faculty members have the employee + two or more plan 60 staff members have the single plan 44 staff members have the employee + one plan 49 staff members have the employee + two or more plan Health Care Coverage

Total of 48 part-time employees 9 Faculty Members 39 Staff Members Employees working 20+ hours are eligible for a buy-in to the health care plan. Part-time Employees

Unlimited Lifetime Maximum Benefit No Pre-existing Exclusions Dependent Coverage up to age 26 Affordable Care Act (ACA) Re-defines a full-time employee to at least 30 hours per week ACA establishes two fees Qualified Health Plans will be required to pay Patient-Centered Outcomes Research Institute (PCORI) Fee Transitional Reinsurance Program Fee Why Plan Changes?

Plan Changes

Health Plan Medical Prescription Dental Vision

Medical & Prescription Base Plan Traditional High Deductible DentalVision

Base PPO Health Care Plan In-NetworkOut-of-Network Annual Deductible$250 Individual $500 Family Coinsurance80%50% Office Visit Copay$25 per visit Primary Care, Deductible waived $40 per visit Specialist, Deductible waived Annual Maximum Out-of-Pocket$4,500 Individual $9,000 Family $8,000 Individual $12,000 Family Lifetime Maximum BenefitUnlimited

Base PPO Health Care Plan In-NetworkOut-of-Network Outpatient & Inpatient Services Preventive CareCovered 100%, Deductible waived50% Inpatient Hospital Services80%50% Emergency Room ($50 copay waived if admitted) $50 copay then covered 80% (see full list for Level ER service copays) Outpatient Services (Labs, X-rays)80%50% Additional Services Covered (refer to full plan summaries for benefits and limitations) Minimum Essential Benefits

Prescriptions/PharmacyRetail-30 Day Supply Home Delivery- 90 Day Supply Generic$10$15 Brand$40 Non-Formulary$55$50 Special Medications$85$50 Base PPO Health Care Plan

Employee Monthly Contribution Employee Only$25.00 Employee + One$40.00 Employee + Two or More$55.00

Traditional PPO Health Care Plan In-NetworkOut-of-Network Annual Deductible$350 Individual $700 Family Coinsurance80%50% Office Visit Copay$25 per visit Primary Care, Deductible waived $40 per visit Specialist, Deductible waived Annual Maximum Out-of-Pocket$3,000 Individual $6,000 Family $5,000 Individual $10,000 Family Lifetime Maximum BenefitUnlimited

Traditional PPO Health Care Plan In-NetworkOut-of-Network Outpatient & Inpatient Services Preventive CareCovered 100%, Deductible waived50% Inpatient Hospital Services80%50% Emergency Room ($50 copay waived if admitted) $50 copay then covered 80% (see full list for Level ER service copays) Outpatient Services (Labs, X-rays)80%50% Additional Services Covered (refer to full plan summaries for benefits and limitations) Physical, Occupational & Speech Therapy Vision Therapy and Care Durable Medical Equipment Organ & Tissue Transplant Refractive Eye Surgery

Traditional PPO Health Care Plan Prescriptions/PharmacyRetail-30 Day Supply Home Delivery- 90 Day Supply Generic$10$15 Brand$35$40 Non-Formulary$40$50 Special Medications$80$50

Traditional PPO Health Care Plan Employee Monthly Contribution Employee Only$50.00 Employee + One$80.00 Employee + Two or More$110.00

High Deductible Health Plan with Health Savings Account In-NetworkOut-of-Network Employer HSA Funding$1,000 Individual $2,000 Family Annual Deductible$2,000 Individual $4,000 Family Coinsurance90%50% Office Visit Copay$25 per visit Primary Care $40 per visit Specialist Annual Maximum Out-of-Pocket$3,000 Individual $6,000 Family $5,000 Individual $10,000 Family Lifetime Maximum BenefitUnlimited

High Deductible Health Plan with Health Savings Account In-NetworkOut-of-Network Outpatient & Inpatient Services Preventive CareCovered 100%, Deductible waived50% Inpatient Hospital Services90%50% Emergency Room ($50 copay waived if admitted) $50 copay then covered 90% (see full list for Level ER service copays) Outpatient Services (Labs, X-rays)90%50% Additional Services Covered (refer to full plan summaries for benefits and limitations) Physical, Occupational & Speech Therapy Vision Therapy and Care Durable Medical Equipment Organ & Tissue Transplant Refractive Eye Surgery

High Deductible Health Plan with Health Savings Account Prescriptions/PharmacyRetail Delivery – 30 Day Supply Home Delivery- 90 Day Supply Generic$10$15 Brand$35$40 Non-Formulary$40$50 Special Medications$80$50

Annual Deductible$75 Individual $150 Family Coinsurance80% Preventive CareCovered 100%, Deductible waived Annual Maximum$3000 Individual $6000 Employee + One $9000 Employee + Family Orthodontia50% Coinsurance $2400 Lifetime Maximum Covered up to age 26 Employee Monthly Contribution Employee Only$15.00 Employee + One$30.00 Employee + Two or More$60.00 Dental Plan

Annual DeductibleNone Coinsurance80% Preventive CareN/A Annual Maximum$560 Employee Monthly Contribution Employee Only$5.00 Employee + One$10.00 Employee + Two or More$15.00 Vision Plan

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