1. Duke University & Health System
Open Enrollment for Benefits
Oct. 26 – Nov. 6, 2015

2. Pharmacy Usage Trends
86.0%

3. Duke’s medical insurance plans
Duke offers 4 plans:
Duke Basic (HMO with Triangle network primarily of Duke physicians)
Duke Select (HMO with Triangle network primarily of Duke physicians)
Blue Care (BCBS HMO with statewide network)
Duke Options (PPO plan with international network)

4. Duke’s medical insurance plans
Five tiers of coverage
Employee
Employee & Spouse
Employee & Child
Employee & Children
Family

5. Medical insurance premiums
Premium increases will again be less than the projected increases nationally
$606
$583
$132
$127
Duke Options
$613
$589
$137
Blue Care
$445
$436
$75
$74
Duke Select
$282
$276
$30
$29
Duke Basic
2016
2015
Family
Individual

6. What if you had to be hospitalized
But when looking at costs, you have to also consider the coverage and what you would pay if you had to use the benefit.
For example, if you had to be hospitalized, your out-of-pocket costs would be significantly lower through Duke than at most of our peers.

7. Medical Plan Changes
While primary care co-pay remains the same, specialist co-pay increases on Duke Select, Duke Options and Blue Care from $45 to $55; Duke Basic from $60 to $75.
Annual deductible increase for Duke Basic individual from $500 to $600 and family from $1,500 to 1,800.
Annual deductible increase for Duke Options individual from $100 to $130 and family from $300 to $390.

8. Benefit Eligibility
A same-sex partner must be registered with Duke HR by December 31, 2015 in order to maintain eligibility for grandfathering status under the Same-Sex Spousal Equivalency policy.
Beginning January 1, 2016, all faculty and staff, regardless of sexual orientation, must be legally married to cover a partner or a partner’s child for benefits unless the partner is grandfathered status under the Same-Sex Spousal Equivalency policy.
Reminder: Employees must verify the eligibility of dependents covered by any of Duke’s medical plans by November 6, 2015 to continue coverage after December 31, Verification documentation is sent to Xerox HR Solutions.

9. Tobacco Surcharge
In 2016, tobacco use surcharge will increase from $30 to $40 per month for health insurance.
The surcharge does not apply to dependents.
Surcharge will be removed if employee successfully completes a tobacco cessation program.

10. Open Enrollment for 2016
Pharmacy Plan

11. Pharmacy Plan No increases in co-payments for generic.
Formulary drugs increase by $5
Non-formulary drugs increase by $10
Co-pay increase of $20 for formulary and $17 for non-formulary drugs for a 90-day supply of medication obtained through the mail order and on-site Duke Pharmacies.

12. Express Scripts Mail order or on-site Duke Pharmacy
Retail pharmacy
Express Scripts Mail order or on-site Duke Pharmacy
Up to a 34-day supply
Up to a 90-day supply
First 3 purchases of any medication
After 3rd purchase of long-term medication
Anytime
Generic (no deductible)*
$10 (or cost of drug if less)
50%*
Min. $10, Max. $25
$20 (or cost of drug if less)
Brand ($100 per person annual deductible applies. No deductible for mail order or on-site Duke pharmacies.)*
$45
Min. $55, Max. $125
$120
Non-formulary ($100 per person annual deductible applies. No deductible for mail order or on-site Duke pharmacies.)*
$65
Min. $65, Max. 135
$155
*Participants in the Duke Basic plan have a $100 deductible for all prescription drugs, including generic, mail order and on-site Duke Pharmacies.

13. Open Enrollment for 2016
Vision Plan

14. Duke’s vision plan for 2016
No changes for 2016 to premium or benefit design:
Individual
Employee & Child
Employee & Children
Employee & Spouse
Family
$9.66
$18.49
$19.46
$18.50
$29.97

15. Open Enrollment for 2016
Dental Plan

16. Dental Premiums for 2016 PPO Plan: No premium increase
Dental Plan A: Modest increase in premium
Dental Plan B: No premium increase
Individual
Family
2015
2016
2015
2016
PPO
$38.44
$38.44
$116.46
$116.46
Dental Plan A
$41.28
$42.11
$125.05
$127.55
Dental Plan B
$12.18
$12.18
$45.24
$45.24

17. Late Entrant
Late entrant: if you or a dependent are planning to enroll for 2016 but are not currently enrolled for dental coverage at Duke
Only covers two preventive care exams (not including X-rays), two cleanings, and one fluoride application (for children under age 19) for the first 12 months

18. Reimbursement Accounts
Open Enrollment for 2016
Reimbursement Accounts

19. Save with reimbursement accounts
Pre-tax savings is about 30 percent of every dollar you put in the accounts
Health Care Reimbursement Account - $2,550 maximum
Health Care Reimbursement Account allows for up to $500 to be carried over from one plan year to the next plan year
Dependent Care Reimbursement Account - $5,000 combined household maximum

20. Many ways to save WageWorks Health Care Card
App for iPhones, Androids and Blackberries
Website
Paper forms (fax/mail)

21. Summary for 2016
Modest premium increase for health plan, significantly less than national average
No changes to primary care physician copay or generic drugs
Modest increase in other copays including: Specialist, Formulary/non-formulary drugs, and deductibles
No premium increases to vision
No premium increases to Dental PPO and B, modest increase to Dental A

22. Open enrollment: Oct. 26 - Nov. 6
Enroll online through the Self-Service website Or
By phone at
hr.duke.edu/selfservice

23. Dependent Eligibility Verification
Date mailed: October 1, 2015
Response: November 6, 2015
No response or ineligible: Dependent removed from plan Dec. 31, 2015
Help Line:

24. What’s next? When What Sept. 29 HR Forum Oct. 1
Manager Memo/Presentation: Open enrollment changes for 2016 benefits
Oct. 9
Guide: Print guide mailed home.
Oct. 12
Article: Open enrollment for 2016 benefits
Oct. 26
Open Enrollment Period Begins
Open enrollment period begins
Nov. 3
Article: Reminder about deadline
Nov. 4
Reminder about deadline
Nov. 6
Open Enrollment Period Ends
More information about specific changes for benefits will be communicated next month as part of the annual open enrollment process.
Articles and events are planned throughout the next few months to help provide context and set expectations about changes for 2011.
Here are a few of the highlights of what you can expect to see.

25. Duke University & Health System
Questions?
Open Enrollment for 2016