1. HUMAN RESOURCES HR Forum: Connecting HR… Serving the Duke Community September 9, 2009 9-11 a.m. Medical Center Boardroom, Duke South

2. Today’s Meeting Topics 2010 Health Plan and Open Enrollment Financial Certification Training H1N1 Update E-Verify and I-9s

3. 3 2010 Health Plan and Open Enrollment

4. My Health. My Life. Open Enrollment: October 19 – October 27

5. Agenda  Timeline  Process  Communications  Highlight of changes for 2010 Why is your health important to you?

6. Open Enrollment: October 19 – October 27 [hr.duke.edu/selfservice] 1.Enroll online through the Duke@Work Self-Service website Or 2.By phone at 919-684-5600 Enrollment for 2010.”

7. Communications WhenWhat Aug. 1 -Article: Rising cost of health claims Sept. 1 -Article: Value of reimbursement accounts Sept. 9-30Manager Presentations: Open enrollment for 2010 benefits Sept. 21Memo: Open enrollment for 2010 benefits Oct. 1 -Article: Open enrollment for 2010 benefits Oct. 2Information sessions: Open enrollment for 2010 benefits Oct. 3Webcast: Open enrollment for 2010 benefits Oct. 6Guide: Print guide mailed home. Oct. 19Open Enrollment Period Begins Oct. 19Email: Open enrollment period begins Oct. 26Article: Reminder about deadline Oct. 26Email: Reminder about deadline Oct. 27Open Enrollment Period Ends

8. Current Environment for Health Care

9. Health costs on the rise  Drivers: increased utilization and higher costs for prescription drugs.

10. Premium comparison for 2009

11. Comparing the cost of health care Did You Know ? As of June 30, 2009, the average annualized health cost per employee was $6192, most of which was covered by Duke. (based on 2009 figures)

12. What you can do to help?  Exercise and eat healthy, balanced meals  Take the health risk assessment to better understand your risks  Establish a relationship with a primary care physician  Request generic drugs and use Medco mail order for maintenance prescriptions  Utilize appropriate health care facilities Did You Know? Nearly 80% of disease in this country is preventable.

13. Where should you go?

14. Duke Urgent Care

15. Medical Insurance Plans for 2010

16. Highlights for 2010  Despite increasing cost, coverage remains intact for 2010  No co-pay increases for primary care, urgent care, mental health visits or generic drugs.  Still offering four plans to provide individual choice based on cost and needs  Adjustments to premiums and some co-pays to keep plans financially viable

17. Duke’s medical insurance plans  Duke offers 4 plans: Duke Basic Duke Select Blue Care Duke Options  Consider: Cost Coverage Physician network Dependents, etc.

18. $438.00$412.36$95.00$89.24Duke Options $444.00$418.74$99.00$92.57Blue Care $355.00$334.87$60.00$56.19Duke Select $225.00$212.20$23.00$20.97Duke Basic 2010200920102009 FamilyIndividual Medical insurance premiums for 2010  Duke’s premium increases are about half of the projected increases nationally  Increases will range from $2.03 for individual coverage to $25.64 for family coverage. $2.03 – $6.43/month$12.80 – $25.64/month

19. Expanded coverage  As part of the Mental Health Parity Act, Duke has removed the limits for inpatient and outpatient care from network providers.  Applies to all health plans. Did You Know? Personal Assistance Service (PAS) has expanded the number of visits from 6 to 8.

20. Expanded coverage, cont.  Bariatric surgery Covered if meet minimum qualifications: –Must meet physician’s medical/psychological criteria –BMI of 40 or more, unless significant co-morbid condition with a BMI of 35-39 –Employed at Duke in benefit eligible category for 5 years –Participated in supervised weight loss program for 6 mos. –Available through Duke Select, Blue Care, Duke Options If eligible, surgery will only be available at a Duke facility. There will be a co-pay of $4,000.

21. Co-payment changes  No changes in co-pays for primary care, urgent care, mental health visits, or generic drugs.  Increases in co-pays for specialist visits, outpatient surgery and most emergency and inpatient services

22. Pharmacy Plan for 2010

23. Pharmacy benefits  No changes in co-pay for generic drugs.  New $100 annual deductible* for brand and non-formulary drugs purchased at local pharmacies  Deductible waived if ordered through Medco home delivery program Did You Know? Typically, generic drugs cost 30 percent to 60 percent less than the brand-name drug. *Duke Basic deductible for all pharmacy remains in effect.

24. Retail Pharmacy (34-day supply)  Co-pay for generic drugs remains same at $10  Co-pay increases for retail purchases of brand and non-formulary medications Type20092010 Generic$10 (or cost of drug if less) $10 (or cost of drug if less) (no deductible) Brand$35 $40 (after $100 deductible) Non-Formulary (Brand) $50 $55 (after $100 deductible) Pharmacy benefits, cont.

25. Save with generics  If you use generics, the $100 deductible is waived.  If you choose a brand drug when the generic equivalent is available, you'll pay a $10 co-pay plus the cost difference between the brand and the generic drug.

26. Incentive for mail order Mail Order for Maintenance Medications  Cost savings for mail order  Increased cost for retail purchases Type Retail (initial 3-months) Retail (after initial 3-months) Medco Home Delivery Generic (no deductible) Co-pay of $10 per month = $30 (or cost of drug if less) Co-pay of 50% of cost of drug (min: $10, max $25) = $30-$75 $20 (no deductible) Brand ($100 deductible before co-pay takes effect) Co-pay of $40 per month after $100 deductible = $120 Co-pay of 50% of cost of drug (min: $55, max $125) per month = $165-$375 $100 (deductible waived) Non-Formulary ($100 deductible before co-pay takes effect) Co-pay of $55 per month after $100 deductible = $165 Co-pay of 50% of cost of drug (min: $65, max $135) per month = $195 - $405 $138 (deductible waived)  3-month supply 

27. Switching to mail order… New Maintenance Prescription:  Ask your physician to write 2 prescriptions: 1) 34-day prescription for retail pharmacy 2) 90-day prescription for Medco home delivery, plus refills Existing Maintenance Prescription:  Complete Medco Mail Order form  Contact your physician and request a 90-day prescription for Medco home delivery, plus refills

28. Step Therapy  For seven therapies, participants are required to try the generic or target formulary drug before the plan will “step up” to pay for more expensive alternatives. These therapies are: Proton Pump Inhibitors (reflux) Sleep Agents Depression (exception for current Rx for anti-depressants) Osteoporosis Intranasal Steroids (asthma, allergies) Migraine Therapy Angiotensin Receptor Blockers (hypertension)

29. Duke’s Vision Plan for 2010

30. Duke’s vision plan for 2010  No increase in co-pays or premiums in 2010.  Duke SuperOptics (Medical Center) now in-network Vision Plan: provides coverage for prescription lenses and frames or contact lenses (in lieu of eyeglasses), as well as a complete annual eye exam. Individual Employee & Child Employee & Children Employee & Spouse/ Partner Family $8.85$16.95$17.84$16.96$27.47

31. Duke’s Dental Plan for 2010

32. Duke’s dental plans for 2010  No increase in premiums for Dental Plan B.  Premiums for Dental Plan A will increase $1.90/month for individual coverage and $5.75/month for family coverage. $40.40 $10.88 Dental Plan B $104.95$99.20$34.65$32.75 Dental Plan A 2010200920102009 FamilyIndividual

33. Reimbursement Accounts for 2010

34. Save with reimbursement accounts  Pre-tax savings is about $30-$40 for every $100 of eligible expenses  Health Care Reimbursement Account  Dependent Care Reimbursement Account

35. Another way to explain it … Play

36. Reimbursement account examples

37. Health care reimbursement made easy  Pay at point of sale  Purchase home delivery Rx without credit card or check  Works like a debit card … deducts pre-tax dollars from your reimbursement account  Helps cover co-pays and deductibles.  Helps reduces paperwork, waiting for reimbursement Did You Know? Despite being one of the best ways to save money on health care expenses, only 6,800 faculty and staff took advantage of the Health Care Reimbursement Account last year.

38. Duke’s Investment in You through Benefits

39. Investing in you …  Duke contributes about 25 cents in additional benefits for every dollar an employee earns.  Average cost of health care per employee last year was $5,868, most of which was covered by Duke. Did You Know? Collectively, benefits represent an additional 20 - 25 percent of your compensation. 25% Benefits 75% Salary

40. Investing in you …  In 2008 alone, Duke contributed more than $89.7 million to the retirement plans of faculty and staff.  In 2009, Duke increased reimbursement for tuition assistance to $5,250 per year.

41. Questions?

42. 42 Financial Certification Training

43. HR Forum Financial Certification Program Overview September 9, 2009

44. The Financial Certification Program Immediate objectives –Clarify expectations for employees with financial responsibilities –Provide clearer career path opportunities for employees –Differentiate internal applicants for vacant positions

45. The Financial Certification Program Immediate objectives –Clarify expectations for employees with financial responsibilities –Provide clearer career path opportunities for employees –Differentiate internal applicants for vacant positions Anticipated outcomes… –Enhanced retention of highly-skilled and motivated employees –More effective internal hires/ promotions –Creation of a community of internal peers for formal/ informal networking –Strengthening of Duke’s internal control environment (fewer errors!)

46. The Financial Certification Program Phase 1: –Certified Financial Systems Specialists (SAP, Excel, etc…) –Certified Payroll Representatives –Went live in April 2009 –To date, have certified over 66 Financial Systems Specialist and 51 Payroll Representatives. Phase 2: –Certified Procure-to-Pay Specialists –Certified Financial Managers –Expected go-live in Spring of 2010.

47. The Financial Certification Program Certification for Financial Managers –Designed for business manager level employees –Two tracts – basic sciences and research/clinical –Cohort approach for a core group of classes will provide interaction and lay foundation for networking among business managers –Maintaining certification will require attending an annual “CPE”-type class to stay current on relevant and important topics.

48. The Financial Certification Program Partnering with Human Resources –The FCP will promote “core competencies” (knowledge, skills, abilities) required for success in job positions targeted by the certifications. –In the long-term, the FCP (and training for other non-financial positions of the University) will be part of a comprehensive HR system that will be competency based and utilized in performing functions such as recruiting, interviewing, professional and career development for Duke employees, and identification of departments/areas where core competencies gaps/deficiencies exist. –An LMS module integrated with SAP will probably be a required foundation to get to this level of full functionality.

49. The Financial Certification Program Next Steps for Certified Financial Manager Program –Currently meeting with administrators within the management centers for the Provost, School of Medicine, and Central Administration to identify key competencies. What makes a great business manager? –Will meet with small focus groups of business managers to get their input once a preliminary list of core competencies is formulated. –Good managerial skills require HR-based soft skills as well as financial- based skills. –Stakeholders Group, including James McPherson, is meeting every other week to finalize on curriculum and develop content that will be appropriate for business managers. –Anticipated go-live for program will be in the Spring of 2010.

50. The Financial Certification Program Website: http://www.finsvc.duke.edu/fcp/ http://www.finsvc.duke.edu/fcp/ Contact information –Joe Schwartz, Financial Services: joseph.schwartz@duke.edujoseph.schwartz@duke.edu –Tom Clark, Financial Services: tom.clark@duke.edutom.clark@duke.edu –Gwen Hall-DiFabio (Curriculum Leader for Payroll Representatives): gwen.halldifabio@duke.edu gwen.halldifabio@duke.edu –Christeen Butler (Curriculum Leader for Financial Systems Specialists): christeen.butler@duke.edu christeen.butler@duke.edu

51. 51 H1N1 Update

52. 52 Thermometers/Surgical Masks *Primary Message: Employees need to be aware of flu and should stay at home if sick. Use of Thermometers: Will be made available- but only should be used for employees who become sick at work and are making the determination about going home. Supervisors should not take employee’s temperature. Instruction sheet for managers will be provided. Operating instruction sheet for thermometers will be provided.

53. 53 Thermometers/Surgical Masks Use of Surgical Masks: Not advised for work outside of direct patient care. Emphasize existing measures to minimize flu: hand washing, cough etiquette, safe distance, etc.

54. 54 Seasonal Flu Vaccination Clinics Duke North (adjacent to Conf Room 2002) –September 28 (8:00a - 2:00p) –September 29 (7:30a - 1:30p) –September 30 (7:30a - 1:30p) –October 1 (8:00a - 2:00p) –October 2 (7:30a - 1:30p) –October 5 (7:30a - 1:30p) –October 6 (8:00a - 2:00p) –October 7 (8:00a - 2:00p) –October 8 (8:00a - 2:00p) –October 9 (7:30a - 1:30p)

55. 55 Seasonal Flu Vaccination Clinics Durham Regional (Private Dining Room D) –September 28 (7:30a - 4:00p) –September 29 (7:30a - 4:00p) –September 30 (7:30a - 9:00a) (11:30a - 1:30p) (2:45p - 4:00p) –October 1 (7:30a - 9:00a) (11:30a - 1:30p) (2:45p - 4:00p) –October 29 (10:00a - 3:00p) **DRH Health Fair Smith Warehouse (Rm A2-57) October 13 (9:00a - Noon) Human Resources (705 Broad Street) October 13 (1:30p - 4:00p) Lilly Library (East Campus) October 14 (9:00a - Noon) Fuqua (Fox Center- Jenkins A&B) October 15 (9:00a - 1:00p)

56. 56 Seasonal Flu Vaccination Clinics Health Fair (Searle Center) October 20 (10:00a - 3p) University Development (615 West Main) October 21 (9:00a - 1:30p) Hock Plaza (Hock Auditorium) October 23 (9:00a - 2:00p) Perkins Library (Rm- 218) October 27 (8:30a - Noon) PRMO (5313 South Alston Avenue) October 28 (9:00a - 1:00p) North Pavilion (Lower Lecture Rm) October 29 (9:00a - Noon) American Tobacco (Strickland Bldg- Trinity Rm) November 3 (9:00a – Noon) Need more info? www.duke.edu/flu

57. 57 Return to Work Staff with patient contact who have flu-like symptoms must remain home for at least 7 days from symptom onset. All other staff must be free of fever for at least 24 hours before returning to work. Staff must receive clearance from (EOHW) prior to returning to work. Departments will receive confirmation when staff members have been cleared by (EOHW) to return to work.

58. 58 Contact Information Questions about temporary time-off policy: –Staff & Labor Relations: 684-2808 (University) –684-5557 (DUHS) Questions about pay, timecards, etc.: –Corporate Payroll Services: 684-2642 Questions about employee health: –Employee Occupational Health & Wellness: 684-3136, Option 2 684-8115 (after hours)

59. 59 E-Verify and I-9s

60. 60 E-Verify Federal employment authorization system –Confirms work authorization with DHS and SSA For Federal Contracts signed after September 8 –Over $100,000 Timeline to comply –Duke has 120 days after the first contract is signed –Earliest possible date - January

61. 61 E-Verify Currently working to identify employees on federal contracts May be necessary/beneficial to verify all new hires –Do we have the ability to accurately identify? –Pending NC legislation

62. Process Department must verify in the first 3 days of employment (as with I-9) All employees are either “confirmed” or “tentative non-confirmed” –Employer can not resolve for employee Technology will be in place –Additional workload should be minimal –Tied to I-9s 62

63. Electronic I-9s Improve accuracy and efficiency Decrease audit risk and physical storage Through Duke@Work –Same security access as iForms and Candidate Selection –Training materials and instruction 63

64. Electronic I-9s Timeframe –January I-9 functionality (regardless of e-verify status) Pending negotiations with vendor –Long term Workflow with e-verify and with background checks 64