1. Administered by Stirling Benefits, Inc. 2015 Connecticut State Teachers’ Retirement Board Health Plan

3.  Governed by the Connecticut Teachers’ Retirement Board (TRB)  Covering over 23,000 retired teachers  Administered by Stirling Benefits  Began service to TRB in 1996  Service company, not an insurance company  Based on the Blue Cross High Option

4. 1/3 Retiree 1/3 State of CT 1/3 Active Three Sources: State of CT = 1/3 Retiree = 1/3 Active teachers =1.25% of salary

5. TRB Subsidies Retirees receive either: Local Board subsidy  $110 per retiree or spouse per month  $220 per person per month if not eligible for Medicare Or TRB coverage subsidy  Two thirds (66%) of the cost of Medical & Rx  Once on the TRB plan, TRB no longer pays local board

6. TRB -- Who is eligible?

7. To obtain Medicare… Need 40 Quarters of Eligible Employment, or… Married 10 years to someone who has 40 quarters  Part A -- Paid by Medicare  Part B -- Cost Share with Retiree Pre 1987 hires may not have 40 quarters

8. MedicalPrescriptionDentalVision and Hearing 2015 enrollees receive all four parts

9. TRB Plan Process No Network Any provider that accepts Medicare Claims paid by Medicare first, then sent electronically to Stirling Benefits No paper claims to file

10. TRB Medical Covers what Medicare allows  Same as Blue Cross High Option No network, No Copayments, No Pre-Existing Condition Limitations No Individual Underwriting Picks up remainder after Medicare pays Coverage the same everywhere in the US and Puerto Rico

11. Lifetime Maximums Unlimited maximum on Hospitalizations Unlimited maximum on Basic Medical Unlimited maximum on Prescriptions $1 M max on a small portion of remaining claims (totaling about 3% of the total claims)  Applies to: Out of Country, extra 15% on unassigned Medicare claims, extra 20 days of skilled nursing care  No member has ever come close to hitting the limit.

12. Assignment of Claims Medicare claims are either Assigned or Unassigned Assigned Claims (95% of all claims):  Doctor agrees to accept what Medicare “allows” as full payment  Medicare and TRB plan pays the doctor  Doctor guaranteed to collect 100% of what Medicare allows. Un-Assigned Claims (5% of all claims)  Doctor may charge 15% more than “allowed”  Medicare and TRB Plan pays Member  Doctor must bill and collect from member

13. Examples of Claim Assignment Assigned claims (95% of claims) Un Assigned Claims (5% of claims) Doctor Charge $150 Medicare Allows $100 Medicare Pays $80 TRB Pays $20 15% Extra Billing -$15 TRB Pays -$12 Member Pays $0$3

14. Out of Country In-Patient Hospital – 30 days at 100% Physician’s charges paid at 80% Non-Emergency Only 20% for services usually covered by Medicare Cannot be used for experimental procedures.

15. Rx Benefits 2015 Calendar Year2015 Vendor:Express Scripts Deductible:$320 Coinsurance:$750 Out of Pocket$1,070 After Max OOP100%

16. 2015 - Plan Payments for Rx after Deductible Generic Drugs Preferred Drugs Non- Preferred Acute at Pharmacy 100%80%70% Maintenance Mail Order or pickup at many network Pharmacies 100%20%30%

17. Dental $45.00 / Month Administered by Aetna Dental  $50 annual deductible  100% cleanings  80% basic restorative  50% Major Restorative  $2,000 annual maximum Part of the 2015 package

18. Vision & Hearing $4.00 / Month Vision  Exams: $75 every 12 months  $100 toward frames and $60 - $200 allowance for lenses every 24 months, or $120 toward contacts every 12 months Hearing Aids: $750 every three years Administered by Stirling Benefits Part of the 2015 package

19. Monthly Cost Per Person 2009‘10‘11‘12‘13‘142015 Medical / Rx $99$112$125$124$117$97$91 Medical/Rx & Dental 144160174173160$141$136 Medical / Rx /Dental Vision & Hearing 149165179180165146$140

20. How Members Enroll Complete one form per person (Stirling or TRB website) Send form with proof of Medicare to TRB (not to Stirling) Must be received by the 25 th of the second month preceding coverage (25 th of November for January 1 st ) Cancel current Board of Education coverage

21. For More Information… Stirling Benefits, Inc.  20 Armory Lane, Milford, CT 06460  (203) 876-1660, ext. 0, www.StirlingBenefits.com Teachers’ Retirement Board  765 Asylum Avenue, Hartford, CT 06105-2822  (800) 504-1102, fax: (860) 622-2849, www.ct.gov/trb Express Scripts (844) 433-4883 Aetna Dental (855) 394-3874 Medicare (800) 772-1213 www.Medicare.gov Stirling Benefits, Inc.  20 Armory Lane, Milford, CT 06460  (203) 876-1660, ext. 0, www.StirlingBenefits.com Teachers’ Retirement Board  765 Asylum Avenue, Hartford, CT 06105-2822  (800) 504-1102, fax: (860) 622-2849, www.ct.gov/trb Express Scripts (844) 433-4883 Aetna Dental (855) 394-3874 Medicare (800) 772-1213 www.Medicare.gov