Arkansas Public School Health Plan Comparing Plans Copyright © 2012 Five Points ICT, Inc. All rights reserved.

Disclaimer The content of this communication is for informational purposes only and is not intended as any form of professional advice. This communication is not intended to outline every benefit, limitation, or exclusion of the State-sponsored benefit plans. For questions or advice about your benefits, please contact your human resources representative or the Arkansas Department of Finance and Administration Employee Benefits Division. Five Points ICT, Inc. and its affiliate companies are not responsible for errors or omissions in this communication. Copyright © Five Points ICT, Inc. All rights reserved.

Important Information Copyright © 2012 Five Points ICT, Inc. All rights reserved. The information in this video may not apply to all employees in all situations Always refer to your Summary Plan Description (SPD) for more details about your plan options You can find more info at

Why Compare? Copyright © 2012 Five Points ICT, Inc. All rights reserved. There are some important differences between your plan options, including: –Type of plan –Premium cost –Deductibles/Co-insurance/Co-pays –Out-of-pocket limits –Networks

Total Cost of Healthcare Copyright © 2012 Five Points ICT, Inc. All rights reserved. Premium + Deductible + Co-payments + Co-insurance = Total Cost of Healthcare

Bronze Plan Copyright © 2012 Five Points ICT, Inc. All rights reserved. High-Deductible Health Plan (HDHP) – Health Advantage Network –Must meet calendar year deductible before plan pays for any service, other than preventive care, screenings or immunizations Health Savings Account (HSA) eligible –Use pre-tax dollars for qualified medical expenses, like deductibles, co-insurance, and more

Bronze Plan Premiums Copyright © 2012 Five Points ICT, Inc. All rights reserved. Level of Coverage Total Monthly Employee Cost Employee Only Current Renewal $ 0.00 Employee & Spouse$ $ Employee & Child(ren)$ 0.00 $50.94 Employee & Family$ $258.76

Bronze Plan Deductibles & Co-insurance Copyright © 2012 Five Points ICT, Inc. All rights reserved. Deductible amounts: –$2,000 in-network (IN)/$4,000 out-of- network (OON) for individuals –$3,000 IN/$8,000 OON for families Once deductible is met, plan pays 80% of maximum allowable charge (MAC) for covered in-network services No co-pays, except for vision/hearing screenings

Bronze Plan Out-of-pocket Limits Copyright © 2012 Five Points ICT, Inc. All rights reserved. Out-of-pocket limits –$4,350 IN/$8,700 OON for individuals –$6,525 IN/$13,000 OON for families –After deductible is met –Co-payments, premiums, balance-billed charges, and non-covered services not included

Silver Plan Copyright © 2012 Five Points ICT, Inc. All rights reserved. Point-of-service plan: –QualChoice Network –Deductible, then combination of co- payments and co-insurance –Premiums higher than Bronze Plan, but lower than Gold Plan –Preventive care, screenings, immunizations covered at no out-of-pocket cost

Silver Plan Premiums Copyright © 2012 Five Points ICT, Inc. All rights reserved. Level of Coverage Total Monthly Employee Cost Employee Only Current Renewal $23.78 $ Employee & Spouse$ $ Employee & Child(ren)$ $ Employee & Family$ $957.30

Silver Plan Deductibles/Co-pays/Co-ins. Copyright © 2012 Five Points ICT, Inc. All rights reserved. Deductible amounts: –$1,000 IN for individuals –$2,000 IN for families Once deductible is met, plan pays for covered in-network services according to the SPD You will have to pay co-pays and co- insurance for most services until your out-of-pocket limit is met

Silver Plan Co-Pays Copyright © 2012 Five Points ICT, Inc. All rights reserved. Coverage Total Monthly Employee Cost Physician Office Visit PCP Current Renewal $ 25 $ 35 Office Visit – Specialist$ 50 $ 70 Rx Tier 1 – Generic$ 10 $ 15 Rx Tier 2 – Preferred$ 35 $ 40 Rx Tier 3 – non-preferred$ 70 $ 80 Rx – Specialtyw/tier $ 100

Silver Plan Out-of-pocket Limits Copyright © 2012 Five Points ICT, Inc. All rights reserved. Out-of-pocket limits –$3,000 in-network (IN)/$6,000 out-of- network (OON) for individuals –$6,000 IN/$12,000 OON for families –After deductible is met –Co-payments, premiums, balance-billed charges, and non-covered services not included

Gold Plan Copyright © 2012 Five Points ICT, Inc. All rights reserved. Point-of-service plan –Blue Cross Network –Deductible, then combination of co- payments and co-insurance –“Richest” plan –Preventive care, screenings, immunizations covered at no out-of-pocket cost

Gold Plan Premiums Copyright © 2012 Five Points ICT, Inc. All rights reserved. Level of Coverage Total Monthly Employee Cost Employee Only Current Renewal $ $ Employee & Spouse$ $1, Employee & Child(ren)$ $ Employee & Family $ $1,423.48

Gold Plan Deductibles/Co-pays/Co-ins. Copyright © 2012 Five Points ICT, Inc. All rights reserved. No deductibles for individuals or families Plan pays for covered in-network services according to the SPD You will have to pay co-pays and co- insurance for most services until your out-of-pocket limit is met

Gold Plan Co-Pays Copyright © 2012 Five Points ICT, Inc. All rights reserved. Coverage Total Monthly Employee Cost Physician Office Visit PCP Current Renewal $ 25 $ 35 Office Visit – Specialist$ 35 $ 70 Rx Tier 1 – Generic$ 10 $ 15 Rx Tier 2 – Preferred$ 30 $ 40 Rx Tier 3 – non-preferred$ 60 $ 80 Rx – Specialtyw/tier $ 100

Gold Plan Copyright © 2012 Five Points ICT, Inc. All rights reserved. Out-of-pocket limits –$2,500 in-network (IN)/$5,000 out-of- network (OON) for individuals –$5,000 IN/$10,000 OON for families –Co-payments, premiums, balance-billed charges, and non-covered services not included

How to Decide Copyright © 2012 Five Points ICT, Inc. All rights reserved. All plans cover the same services To decide which plan may be best for you and your family, think about: –How many claims did you have the last year? How many do you expect this year? –How each type of plan works –Compare the cost of premiums

Proposed Premium Cost Copyright © 2012 Five Points ICT, Inc. All rights reserved. Level of Coverage Total Monthly Employee Cost GoldSilverBronze Employee Only$226.60$124.00$0.00 Employee & Spouse$1, $ Employee & Child(ren)$753.02$489.82$50.94 Employee & Family$1,423.48$957.30$258.76

Deductibles for 2014 Copyright © 2012 Five Points ICT, Inc. All rights reserved. Type of Deductible Annual Deductible GoldSilverBronze Individual In-Network$0$1000$2000 Family In-Network$0$2000$3,000

Out-of-Pocket Limits for 2014 Copyright © 2012 Five Points ICT, Inc. All rights reserved. Type of OOP Limit Annual OOP Limit GoldSilverBronze Individual In-Network$2,500$3,000$4,350 Family In-Network$5,000$6,000$6,525

Total Premium Cost, Deductibles & Out-of-Pocket Limits for 2014 Copyright © 2012 Five Points ICT, Inc. All rights reserved. Total Cost Total Monthly Employee Cost GoldSilverBronze Employee Only$5,219.20$5,488.00$6, Employee & Spouse$18,143.36$16,940.48$12, Employee & Child(ren)$14,036.24$13, , Employee & Family$22,081.76$19,487.60$12,630.12

Learn More Copyright © 2012 Five Points ICT, Inc. All rights reserved. Contact Employee Benefits Division – “Just Press One” Additional info online – –