1. Open Employee Forum Medical Plans for 2012
September 14, 2011

2. 2012 Medical/Prescription Drug Benefits
SLU will continue to offer two programs:
Plus PPO Plan (with a modified Rx component)
Health Savings Account (HSA) Qualified Plan
Implement network only plans
Increase out-of-network costs that are properly placed in silos
Limit out-of-network coverage to a percent of Medicare
Covert from Coordination of Benefits to Maintenance of Benefits (COB to MOB)

3. 2012 Medical Plan Options Implement network only plans
Plus Plan
HSA Plan
SLUCare
In-Network
Out-of-Network
Deductible
Non-Embedded: (One member can satisfy entire family deductible)
Individual $0
$250
$750
$1,500
$3,000
Family
$500
$6,000
Coinsurance 0%
10%
40%
Out-of-Pocket Maximum (includes deductibles)
Non-Embedded: (One member can satisfy entire family OOP Max)
$1,250
$4,750
$2,500
$9,500
$12,000
Physician Office Visits
Primary Care
$10 copay
10% after ded.
40% after ded.
0% after ded.
Specialist Care
$20 copay
Preventive Care
100%
Inpatient Hospital
Emergency Room
$100 copay
Urgent Care Center
$50 copay
Implement network only plans
Increase out-of-network costs that are properly placed in silos
Limit out-of-network coverage to a percent of Medicare
Covert from Coordination of Benefits to Maintenance of Benefits (COB to MOB)

4. 2012 Pharmacy Plan Options
Plus Plan
HSA Plan
Express Scripts
Retail
(34-day supply)
Mail Order
(90-day supply)
Tier 1 $8
$16
Medical Deductible and Coinsurance
Tier 2
$30
$60
Tier 3
$50
$100
Tier 4
20% to $150
Preventive Medications
Priced according to the tier in which they fall
Covered at 100%, no copay or deductible
Implement network only plans
Increase out-of-network costs that are properly placed in silos
Limit out-of-network coverage to a percent of Medicare
Covert from Coordination of Benefits to Maintenance of Benefits (COB to MOB)
NEW! Under the proposed HSA plan, certain preventive, or “maintenance,” medications would be covered at 100%... NO copay or deductible would need to be satisfied by you or your family!
Information on which drugs qualify as preventive will be distributed during open enrollment.

5. What is an HSA?
Health Savings Accounts (HSAs) are designed to help you save and pay for your health care
So, what exactly is an HSA?
An HSA is a special type of bank account designed to help you save and pay for certain health care expenses. In simple terms, it’s like an IRA for your health. But with an HSA, you don't have to wait for retirement to spend the money. You can use it this year, next year or years from now.
An HSA works like this:
1. First you open an account and deposit money into it – tax free. The funds in the HSA belong to you, and that’s true whether you contributed money or your employer did.
2. You grow your account with tax-free interest earnings. You can, if you choose, invest some of your money in mutual funds. Be aware, though, that while deposits are insured by the FDIC up to $250,000, investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value.
3. You save on taxes. The money you put into an HSA is tax-deductible. You don’t pay federal income tax on HSA contributions, or state income taxes in most states. And, any money you take out for qualified medical expenses is income tax-free, too.
4. You use your HSA to pay for qualified medical expenses for you and your family, now or later.
The HSA is yours to keep. You own the account from the day you open it. If you’ve ever put money in a flexible spending account, you know that there’s a “use it or lose it” rule that requires you to use up your account funds within a plan year or you lose the money. There’s no “use it or lose it” rule with an HSA. The account is with you as long as you want it to be – even if you change jobs, lose your job, or choose a different health plan. (If your employer contributes to your HSA, the money is yours – even if you change jobs.)

6. OptumHealth BankSM, Member FDIC
Focuses solely on health care banking
We administer over 600,000 individual Health Savings Accounts
Is one of the nation’s leading custodians of health savings accounts
We offer three HSA options to meet individual goals
UnitedHealthcare HSA Bank of Choice
Established in 2003
OptumHealth Bank serves thousands of employers, families and individuals
We have more than $1 billion in assets
OptumHealth Bank, Member FDIC, is UnitedHealthcare’s HSA Bank of Choice. We differ from other banks in that we focus exclusively on health care banking.
OptumHealth Bank was formed in 2003, and holds over 600,000 individual HSAs and has more than $1 billion in assets. OptumHealth Bank is one of the nation’s leading custodians of health savings accounts and offers three types of HSAs to meet individual health savings goals and needs. 6

7. HSA Overview
Require a High Deductible Health Plan
Used to pay for qualified health care expenses immediately
Funded by you, your employer or others
Account funds belong to you
Grows over time and can be invested
First, you must be enrolled in a High Deductible Health Plan or HDHP before you can open, fund and use an HSA. Most HDHPs cover preventive visits at 100%, saving you even more. You can use your HSA contributions to help you pay for qualified medical expenses that the HDHP doesn’t cover. The balance in your HSA is yours to keep, however, and can be used to pay for health care expenses or saved for future use. If you change medical plans and are no longer covered by an HDHP, you can no longer contribute to your HSA.
Second, HSA funds can be used immediately but only to pay for qualified health care expenses. The IRS determines which expenses can be paid for with HSA funds. If you use the funds for non-qualified expenses, you will be required to pay taxes on the funds, as well as pay a penalty. We will discuss qualified and non-qualified expenses shortly.
Third, HSAs can be funded by many sources. You can contribute after-tax income or, if your employer allows, you can contribute through payroll deduction [remove if this employer does not support payroll deduction]. Plus, an employer and others, like family members, can make contributions.
Next, all funds in the account belong to you as soon as they are deposited, regardless of who contributed them. This means that the funds go with you if you leave your employer. You make all decisions about how and when you use your HSA funds.
Finally, your HSA funds can grow over time. HSAs are not covered by IRS “use it or lose it” rules. This means that unused funds remain in your account from year to year. Depending on the type of account you choose, your HSA balance can grow through new contributions, interest earnings or investment income. Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value.
There are a few other things that you need to keep in mind.
Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value. 7

8. You are eligible to open and contribute to an HSA if you:
HSA Eligibility
You are eligible to open and contribute to an HSA if you:
Are covered by an eligible high deductible health plan
Are not covered by any other health plan that is not a high deductible plan
Are not enrolled in Medicare, Medicaid, or TRICARE
Have not received VA benefits within the past 3 months
You are eligible to open an HSA if you meet these criteria:
First, you must be covered under a qualifying high deductible health plan (HDHP) on the first day of the month. . Your employer is making this plan available to you, so you should be set here.
Second, you cannot have other impermissible health coverage. For example, you cannot be covered by your spouse’s health care plan as well as this one, and you cannot be currently covered by a health care FSA. This is an important point. If you currently have a health care FSA and want to open an HSA, you’ll want to spend down your FSA before the start of the HSA-eligible plan year to ensure you make the most of your FSA and transition smoothly to your new HSA.
Third, you cannot be enrolled in Medicare.
Fourth, you cannot have received VA benefits within the past 3 months.
Fifth, you can not be claimed as a dependent on someone else’s tax return.
And, finally, you are not covered by a health care FSA.
Does anyone have any questions before we move on to discuss contribution limits in more depth?
Are not claimed as a dependent on someone else’s tax return
Are not covered by a healthcare FSA

9. Contribution Limits Amount of Funding
The IRS determines how much you can fund.
Rules
For 2012, individuals can contribute up to $3,100 and $6,250 for families.
Additional Funding
Those 55 years of age or higher, but not entitled to Medicare benefits, can fund an additional $1,000/year “catch-up” contribution!
As I mentioned earlier, the IRS determines the maximum amount you can contribute to an HSA every year.
In 2011, you can contribute up to $3,050 if you sign up for the health care plan as an individual. If you sign up as a family or individual +1, the contribution limit goes up to $6,150. For 2012, that changes to $3,100 for Individuals and $6,250 for families. These are the only two levels, with one exception. The IRS allows people nearing retirement age to make additional “catch-up” contributions to help build balances to be used to help pay for health care costs during retirement.
You can contribute an additional $1,000 a year if you are 55 years or older.
If both you and your spouse are 55 or older, you can both contribute an additional $1,000. Your spouse will need to open his/her own HSA to make his/her own HSA catch-up contribution.
You are not eligible to make “catch-up” contributions if you are receiving Medicare benefits.
You can learn more about contribution limits and making catch-up contributions by going to optumhealthbank.com or irs.gov.
[Answer questions as needed]
Now let’s learn how an individual might use an HSA to pay for health care costs and save on taxes. 9

10. How an HSA Helps You Save
Steve puts his money into his HSA pre-tax 1
Any money Steve withdraws from his HSA to pay for qualified medical expenses is withdrawn income tax-free. 2
Steve may earn interest on his account, and it is not taxable. 3
Let me introduce you to Steve. Steve is an illustrated example of an HSA Account holder.
Steve is married and has two children.
He has family coverage through a high deductible health plan and opened an OptumHealth Bank HSA through UnitedHealthcare in January 2011.
His federal income tax bracket is 25% and his state income tax bracket is 4%. (For this example, the state taxes do not apply to HSAs.)
Steve views his HSA as a “401(k) plan for health” because Steve or his employer can deposit money today that Steve can spend now or save for the future.
Let’s review the tax advantages Steve receives from his OptumHealth Bank HSA:
The money Steve puts into his HSA is tax-free. Any money Steve withdraws from his HSA to pay for qualified medical expenses is also tax-free. Steve earns interest on his account balance, and again, these interest earnings are not taxable. Finally, any amount that Steve does not spent during this year will carry over for use in future years.
So how much did Steve save by opening his HSA?
Steve
The amount not spent during this year carries over for use in future years. 4 10

11. How Much Did Steve Save? 1
In 2012, Steve will deposit $6,250 into his HSA, the maximum contribution for family coverage.
Steve’s federal and state income tax savings on his contributions for the year are $2,291. 2
Steve will withdraw $3,000 to pay for qualified health care expenses for him and his family.
Steve will not have to pay income taxes on the $3,000 as long as he uses it to pay for qualified expenses. 3
Steve earns interest on his account.
Steve does not have to pay income taxes on his interest.
You might be surprised to learn that Steve could save nearly $2,300 in taxes by contributing to an HSA! Here’s how Steve saved on income taxes and is building a long-term health care nest egg.
First, the money Steve put into his HSA is tax-free. Steve deposits $6,250 into his OptumHealth Bank HSA. This is the maximum contribution for family coverage allowed by the IRS. By making the maximum contribution, Steve saves $1,563 in federal income tax. He saves $250 in state income tax. And, because his employer offers payroll deduction, he can save an additional $478 on FICA taxes. As a result, Steve will save a total of $2,291 on his annual income taxes.
Steve continues to save on taxes when he withdraws funds from his HSA to pay for qualified expenses. For example, if Steve withdraws $3,000 to pay for health care expenses for him and his family, he will not have to pay income taxes on that money as long as the funds are used to pay for qualified medical expenses.
Even though Steve earns interest on his account, this interest is not taxable.
Finally, any amount that Steve doesn’t spend during this year will carry over for him to use in the future. Steve will carry over approximately $5,541 HSA dollars into the next year.
Steve can use his HSA funds in many ways. Let’s look at a few of them.
*Calculations based on 25% Federal tax rate, 4% state, and 2012 FICA rate of 7.65% 4
Steve will carry over $3,250 HSA dollars (contributions—expenses + account earnings) into the next year.
With a traditional plan, Steve wouldn’t have this carryover option, which helps him save for the future. 11 11

12. How You Can Make the Most of Your Coverage
Health Care Consumerism
Make informed choices
Look for ways to lower
health care costs
Own your health care decisions
Understand your medical coverage
To gain the benefits, your HSA funds should only be used for qualified medical expenses. You probably want to know how you can make the most of your HSA funds and your health care coverage.
You’ve probably heard the phrase, “health care consumerism”. Essentially, what we’re talking about is making informed choices about your health care. When you make good choices about your health, from simple things like choosing fruit over chips, or walking 20 minutes every day, you are rewarded for your health
It’s about being rewarded with potentially lower health care costs.
Consumerism in health care is based on the idea that you should take ownership of your health care decisions.
It’s important for you to understand your coverage and how it works.
Being a good consumer is about maintaining a healthy lifestyle. Take advantage of all of the wellness resources available to you.
Finally, use your preventive health care coverage to catch health issues early. Under most HSA-eligible health plans, preventive care is usually covered at 100% for network providers.
Maintain a healthy lifestyle
Use your preventive care coverage to catch health issues early 12

13. HSA Qualified Medical Expenses
Medical plan deductibles and coinsurance
Medical, dental and vision care and services
Use HSA dollars to pay for medical expenses for your spouse or dependents
 So, where can you use your HSA funds? You can use the money in your HSA to pay for “qualified medical expenses” identified by IRS.
 Qualified expenses include:
Coinsurance payments.
Medical, dental and vision care.
Medical, dental and vision services and products, such as glasses.
Prescription drugs and costs (that may apply to your medical plan deductibles).
You can use your HSA to pay for qualified expenses incurred by you, your spouse and your dependents even if they're not covered by your HSA eligible health plan. Remember, any money you take out of your HSA for qualified medical expenses is income-tax free.
You can find a detailed list of qualified and non-qualified expenses by going to irs.gov.
Generally, you cannot use HSA funds to pay for medical insurance premiums, but there are some exceptions. Let’s look at those.
Any money you take out of your HSA for qualified medical expenses is income-tax free 13

14. Other HSA-Qualified Medical Expenses1
Health coverage while receiving unemployment benefits 4 2
Medicare premiums and out-of-pocket expenses
COBRA continuation coverage
While you normally cannot use your HSA funds to pay for your health care premiums, there are a few exceptions. For example, you can use the funds in your HSA to pay for any health plan coverage you pay for while you receive federal or state unemployment benefits. In addition, you can use your HSA to pay COBRA health insurance continuation coverage if you lose your job or to pay for COBRA health insurance coverage for a spouse or dependent. You can also use your HSA to purchase qualified long-term care insurance. Finally, Medicare premiums and out-of-pocket expenses including deductibles, co-pays, and co-insurance for Medicare Parts A, B, C and D also can be paid for out of your HSA, as long as you are 65 or older.
One critical change is that as of January 2011, HSAs can no longer be used to purchase over-the-counter medicines besides insulin without a prescription.
It is possible to use your HSA to pay for non-qualified expenses. Let’s take a quick look at the impacts of paying for non-qualified expenses with your HSA. 3
Eligible
long-term care 14

15. Paying for Non-Qualified Expenses
The tax penalty increased from 10 to 20 percent in The penalty does not apply to account holders age 65 and older, those who become disabled or enroll in Medicare.
Any funds used for purposes other than to pay for qualified medical expenses are:
Taxable as income
Subject to a 20 percent tax penalty
There are a few things you need to remember if you use your HSA to pay for non-qualified expenses. Examples of non-qualified expenses include:
Medical expenses that are not considered “qualified” under federal law, like cosmetic surgery or health club dues.
Medicare supplement premiums and
Expenses that are not medical or health-related.
If you use your HSA to pay for a non-qualified expense, the amount of the purchase becomes taxable as income.
You also will have to pay a 20% tax penalty on that amount.
The 20% tax penalty does not apply if the account holder is age 65 and older, if the account holder becomes disabled or if the account holder enrolls in Medicare. However, the amount of the non-qualified expense that was paid for with HSA funds will be taxed as income.
As you can imagine, it’s very important to save your receipts for any expense that you pay for with HSA funds so that you can verify that a withdrawal was made for a qualified expense in the event that the IRS requests documentation. 15

16. Save Your Receipts!
Important Tips:
Save your receipts for all qualified health expenses.
OptumHealth Bank does not track or validate your expenses or verify eligibility.
Here are a few tips that can help save you a lot of time and headaches later on! Always save your receipts for all qualified medical expenses, note whether the expense was paid for out of your HSA, then retain the receipt for future reference. You can use a file folder, a shoebox, or scan in the documents – whatever method works for you.
Remember, OptumHealth Bank does not track or verify your spending. That is your responsibility. You do not need to provide receipts in order to reimburse yourself from the account, however you should always save your receipts for future reference in the case of an IRS audit.
Now that you’ve learned what your HSA funds can be used for, let’s check in with Molly to see how she accesses her HSA. 16 16

17. Molly goes to the doctor with her HSA
How Molly Uses Her HSA
Molly presents her UnitedHealthcare health plan ID card at the doctor’s office 1
Molly goes to the doctor with her HSA
The doctor submits a claim to the health care plan 2
Molly fills her prescription 3
Molly receives and pays her doctor’s bill 4
Meet Molly, another example of a typical HSA account owner. She’s been feeling ill and visits her primary care doctor. Molly presents her UnitedHealthcare plan ID card at the doctor’s office to make sure that she receives the network discount negotiated by UnitedHealthcare, Molly’s health insurance company. The doctor prescribes a lower cost generic medication to help Molly save money. Because Molly has no co-pay, so she pays nothing at the time of service. The doctor’s office submits a claim to Molly’s health insurance company.
Because Molly’s out of-pocket medical expenses haven’t reached her deductible yet, her health care plan notifies the doctor that Molly is responsible for paying for her visit. The doctor sends Molly a bill directly and charges the rate that he negotiated with her health care plan.
Molly goes to the pharmacy to fill her prescription. Molly shows the health plan ID card for her high deductible health plan to make sure the claim will count toward her deductible and that she can receive any available discounts on her medication. Molly then pays for the prescription in full, using her Health Savings Account Debit MasterCard® card.
When Molly receives her doctor’s bill, she checks her statement to make sure the amount billed matches what her health care provider says she owes. She pays the bill by writing the number of her HSA Debit MasterCard on the doctor’s invoice then mailing it.
Finally, Molly keeps her receipts for these HSA-qualified expenses so she can calculate her tax-free health spending on her tax return. She also keeps the receipts in the event of an IRS audit.
Molly can go online to check her balance and make sure that the payment was received. Let’s see how she can manage her account with UnitedHealthcare’s easy-to-use web site.
Molly keeps her receipts 5
Molly 17

18. Managing Your HSA with myuhc.com
Check monthly statements and interest rates
Pay bills to health care providers
Download forms needed to manage your account
Update personal information
Arrange deposits from another banking account
Manage investment activities for your HSA
Learn about HDHPs and HSAs
Use HSA calculators
Only OptumHealth Bank gives you the convenience of managing your HSA through your health plan website – myuhc.com.
When you log in to myuhc.com, you can do all of your banking: pay bills, make deposits, reimburse yourself, track spending, start investments and see your tax savings.
In addition, if your provider does not accept MasterCard, you can pay health care providers through our online bill pay feature. We also have a number of forms for managing the account, and you can update your personal information and arrange deposits from another banking account.
Another feature of the OptumHealth Bank HSA is the ability to invest a portion of your HSA dollars into mutual funds, which can be done online. Lastly, you’ll also find simple to understand resources to help you learn about HSAs, as well as access easy-to-use HSA calculators to help you determine your annual contribution.
Investments are not FDIC insured, are not guaranteed by OptumHealth Bank and may lose value. 18 18

19. Common Questions
Can I open a Health Savings Account at any time during the year? 1
Yes. You can open an HSA at any time, as long as you are covered by an HSA-eligible health care plan
Can I take the funds in my HSA with me if I leave the company? 2
Yes. Funds in your HSA belong to you, including any contributions that your employer or anyone else has made.
Am I required to contribute a specific amount each year? 3
No. You can contribute as much as you’d like up to the IRS maximums. Most people base contributions on the annual deductible required by their HDHP.
One of the most common questions that people ask when they consider opening an HSA is “Can I open a Health Savings Account at any time during the year?”
The answer is yes. You can open an HSA at any time, as long as you are covered by an HSA-eligible health care plan and fulfill the other eligibility requirements we discussed earlier.
Another common question is whether or not you can take the funds in your HSA with you if you leave the company? The answer is yes. Funds in your HSA belong to you, including any contributions that your employer or anyone else has made.
We also often field questions related to required contributions. There is no contribution requirement for HSAs. You can contribute as much or as little to your account as you’d like, up to the annual IRS maximum contributions for those with individual or family coverage. Account holders sometimes base their contributions on the annual deductible required by their HDHPs but others contribute the maximum amount allowable.
A final common question is whether or not you need to use all of the funds in your HSA before the end of the year. The answer is no. HSA plans are not subject to IRS “Use It or Lose It” regulations. This allows the funds in the account to continue to accumulate over time until they are used.
I hope you have found this presentation helpful. Are there any other questions that I can answer for you?
Do I need to use all of the funds in my HSA during the year? 4
No. HSA plans are not subject to IRS “Use It or Lose It” regulations. This means that funds in the account continue to accumulate over time. 19 19

20. To Learn More Online
A series of short, online training sessions on HSAs are available at any time
You can access all Health Accounts Self-Guided Tours at the site below.
We’ve covered a lot of ground in the last 45 minutes. I hope that you leave here with a better understanding of HSAs and how they can help you make the most of your health care dollars.
We have developed several short online training sessions that you can check out for more detailed information. You can access these short training sessions at your convenience, 24 hours a day, 7 days a week by going to the link listed above.
Access all Self-Guided Tours at: 20 20

21. With Wellness Incentive Without Wellness Incentive
2012 Cost Sharing
Plus Plan
Monthly Payroll Deductions
With Wellness Incentive
Without Wellness Incentive
Single
$94.34
$124.34
Employee and Spouse
$313.79
$343.79
Employee and Child(ren)
$283.90
$313.90
Family
$448.26
$478.26
HSA Qualified Plan
$29.81
$59.81
$178.28
$208.28
$161.30
$191.30
$254.68
$284.68
If you enroll in the HSA Qualified Plan for 2012, SLU will contribute funds to help you build your balance:
$250 for Single Enrollees
$500 for Enrollees with Family Members
Wellness Incentive increased from $20 to $30 for 2012
Implement network only plans
Increase out-of-network costs that are properly placed in silos
Limit out-of-network coverage to a percent of Medicare
Covert from Coordination of Benefits to Maintenance of Benefits (COB to MOB)

22. 2012 Cost Sharing Annual Contribution Difference vs. 2011 Plus Plan
Annual Difference in Payroll Deductions
With Wellness Incentive
Single
$304.44
Employee and Spouse
$181.92
Employee and Child(ren)
$164.52
Family
$259.80
HSA Qualified Plan
($469.92)
($1,444.20)
($1,306.68)
($2,063.16)
Implement network only plans
Increase out-of-network costs that are properly placed in silos
Limit out-of-network coverage to a percent of Medicare
Covert from Coordination of Benefits to Maintenance of Benefits (COB to MOB)
If you enroll in the HSA Qualified Plan for 2012, SLU will contribute funds to help you build your balance:
$250 for Single Enrollees
$500 for Enrollees with Family Members

23. Eligible Dependents
Definition of an Eligible Dependent Legal spouse or dependent child under 26 years of age of the employee or the employee's spouse. The term child includes any of the following:
A natural child
A stepchild
A legally adopted child
A child placed for adoption
A child for whom legal guardianship has been awarded to the employee or the employee's spouse
Handicapped children over the age of 26 with certification from a physician

24. Dependent Eligibility Audit
SLU has a responsibility to:
Administer the plan as stated in the plan document
Administer the plan consistently for all employees
Monitor the costs of the plan
SLU will complete a Dependent Eligibility Audit in early 2012
Employees will be asked to provide verification for enrolled dependents
Ineligible dependent will be removed from the plan
Claims paid for ineligible dependents may be recovered and the expenses would become the responsibility of the employee
Additional information will be provided

25. Vitality Program Activity Distribution Vitality Status Earned (YTD)
Members completing 2-5 activities
April: 60% of total population
May: 55% of total population
June: 52% of total population
Members completing over 10 activities
April: 5% of total population
May: 10% of total population
June: 12% of total population
Vitality Status Earned (YTD)
April/May/June
Blue: 1,874/1,897/1,868
Bronze: 740/722/757
Silver: 1,694/1,733/1,752
Gold: 16/20/28
Platinum: 1/4/6
Verified Workouts
April: 46
May: 334 Added Simon Rec Center
June: 427
Education Activities
April: 306
May: 342
June: 365
Healthy Living Activities
April: 40
May: 63
June: 70
Prevention Activities
April: 79
May: 118
June: 142

26. Contact Information
Please questions or comments to: or
Your feedback is important!!!