1. Employee Benefits Open Enrollment

2. OVERVIEW Trutina Financial – Resource for employees Open Enrollment
Medical – Kaiser – Access PPO VisitsPlus Silver $2,500
Dental – Willamette Dental
Vision – Vision Service Plan (VSP)
Life & AD/D – Unum
Short Term Disability (STD) – Unum
Health Reimbursement Account (HRA) – Sound Benefits Administration

3. TRUTINA FINANCIAL Trutina Financial is a resource for you:
General benefits questions
Claim issues / resolutions
Contacts:
Morgan Patterson, Account Manager
Client Services Team

4. OPEN ENROLLMENT
Opportunity to add or delete coverage for self and dependent for an effective date of December 1, 2018
Coverage will remain in place until November 30, 2019 unless you have a qualifying event
ALL EMPLOYEES MUST COMPLETE ENROLLMENT ON EE NAVIGATOR BY NOVEMBER 12TH

5. ENROLL THROUGH EE NAVIGATOR

6. MEDICAL PLAN OVERVIEW kp.org/wa/provider-directory
Plan Name
Kaiser Permanente
Access PPO VisitsPlus Silver
Benefits
Preferred Provider Network
Out-of-Network
Deductible
In Network: $2,500 Individual and $5,000 Family
Out-of-Network: $5,000 Individual and $10,000 Family
Annual Out-of-Pocket
In Network: $7,350 Individual and $14,700 Family
Out-of-Network: $22,050 Individual and $44,100 Family
Cost Share
In-Network: Copay or Deductible, then 30% Coinsurance
Out-of-Network: Deductible, then 50% Coinsurance
Office Visits
Primary Care
Specialist
$35 Copay ($25 Copay – Enhanced Benefit)
$55 Copay ($45 Copay – Enhanced Benefit)
Deductible, then 50% Coinsurance
Preventative Care
Covered 100%
Emergency Services
Deductible, then 30% Coinsurance
Urgent Care
$35 Copay ($25 Copay – Enhanced Benefit)-Primary
$55 Copay ($45 Copay – Enhanced Benefit)-Specialty
Pharmacy
Up to 30 day supplies at Preferred & Up to 90 day supplies at Group Health Pharmacy
Generic: $25 Copay
Preferred Brand : $55 Copay ($50 Copay Enhanced Benefit)
Specialty Drugs: 50% Coinsurance
Not Covered
kp.org/wa/provider-directory

7. Utilize Enhanced Benefit Care Clinics
care-clinic.org

8. Health Reimbursement account
New Horizons Medical Plan: $2,500 Deductible $7,350 Out-Of-Pocket Max
1: Member receives a medical
bill $4,000.
2: Member has to pay
$2,500 Deductible first.
3: HRA FUNDING = Member pays first $1,250, New Horizons pays next $1,250 through HRA (Health Reimbursement Account)
HRA
Health Reimbursement account
4: After the deductible has been paid;
Insurance pays 70%, the member pays 30%.
$2,500 (deductible)+(30% of $1,000 =$300)=$2,800
*Remember - $1,250 of the $2,500 Deductible was paid by New Horizons through the HRA so member pays
$1,250 (deductible) + $300 (coinsurance) = $1,550.
5: The member pays 30% of medical expenses until they reach their Out-Of-Pocket Maximum (OOPM).
6: The Out-Of-Pocket
Maximum ($7,350) is the
most you pay out of pocket
in a calendar year. Once the
Out-Of-Pocket is met,
medical expenses are
covered 100% with
in-network providers.

9. DENTAL PLAN OVERVIEW Willamette Dental Plan Name Provider Network
Provider Network
Willamette Dental Group
Benefit Period
January 1, 2019 – December 31, 2019
Deductible
Copay
Per Person: $0 / Per Family: $0
$25 Per Visit
Benefit Period Maximum
No annual Maximum
Diagnostic & Preventive
Exams, Cleanings, X-rays, Fluoride & Sealants
Covered with Office Copay $25
Restorative
Fillings & Crowns
Fillings Covered with Office Copay $25
Crowns Covered with $400 Copay
Endodontics & Periodontics
Refer to schedule
Oral Surgery
Routine Extraction (Single Tooth)
Surgical Extraction
$190 Copay
Orthodontia
Pre-Ortho Services
Comprehensive Ortho
$150 Copay
$2,850 Copay

10. Vision Service Pan (VSP)
VISION PLAN OVERVIEW
Plan Name
Vision Service Pan (VSP)
Provider Network
VSP Signature
Well Vision Exam
$10 Copay
Every 12 months
Prescription Glasses
$25 Copay
Lenses - every 12 months
Frame – every 24 months
$150 allowance + 20% discount on any amount over allowance.
Contact Lenses
(If chosen instead of glasses)
Up to $60 copay for contact lens exam
$150 allowance for contacts

11. Life & AD/D OVERVIEW Unum Plan Name Additional Benefits:
Employee Life Insurance
$10,000
Employee AD&D Insurance
Additional Benefits:
Will Preparation
Preparing a will doesn’t have to be complicated — or expensive. Your employee assistance program includes simple tools that can help you create a basic will in no time.
Work Life Balance (EAP)
Balance can be a call
or click away:
, English
, Spanish
, TTY/TDD
When you have questions, concerns or emotional issues surrounding your personal or work life, you can count on us to offer help. Unum’s EAP offers unlimited access to master’s level consultants by telephone, resources and tools online, and up to three face-to-face visits with a
consultant for help with a short-term problem.

12. Short Term Disability (STD)
Plan Name
Unum
Employee Weekly Benefit Amount
60% of weekly earnings up to a maximum of $1,500 per week.
Elimination Period
14 days for both covered injury & covered sickness
Benefit Duration
Benefits extend for 11 weeks as long as you meet the definition of disability
Definition of Disability
You are disabled when Unum determines that, due to sickness or injury:
• You are limited from performing the material and substantial duties of your regular occupation;* and
• You have a 20% or more loss in weekly earnings due to the same sickness or injury.

13. REMINDERS Do preventive checkups/cleanings
No cost for preventive medical procedures provided you go in network and the procedure is coded as preventive
ALL EMPLOYEES MUST COMPLETE BENEFIT ELECTION THROUGH EE NAVIGATOR BY NOVEMBER 12TH
Be sure you have the right beneficiary
Reach out to us or the carrier with individual medical questions

14. New Horizons Ministries Benefits Plan Contacts: 12/1/18 - 11/30/19
Medical: Kaiser Permanente
Group #
Health Reimbursement Account (HRA): Sound Benefit Administration
Dental: Willamette Dental
Group # WA477
Life/AD&D & STD: Unum
Vision: VSP
Group #
Employee Assistance Program (EAP):
Unum
If you have any questions that your health insurance companies cannot answer, please feel free to contact us at