1. State of Maine Department of Administrative and Financial Services Bureau of Human Resources Division of Employee Health and Benefits Phone: (207) 624-7380 or 1-800-422-4503 TTY: Dial Maine Relay 711 FAX: (207) 287-6796 www.maine.gov/deh RSS Feed - Subscribe to latest news! Office Hours: Monday – Friday 8am to 5pm Effective 07/01/20151

2. Your State of Maine Benefits Health Insurance Wellness Programs Dental Insurance Vision Insurance Voluntary Retirement Savings Plan Flexible Spending Accounts Living Resources Program (*Life Insurance is administered by the Maine Public Employees Retirement System) www.maine.gov/dehwww.maine.gov/deh is your resource for all governing statutes, benefit overviews, premium rates, provider listings and much more! 2

3. Who can participate in the health, dental & vision insurance programs? Active State of Maine & ancillary employees who are eligible to participate (contribute) with the Maine Public Employees Retirement System o Retired teachers please note this requirement 3

4. When does my insurance start? New employees are eligible the 1 st of the month following one month of employment o Example: May 4 th - First day of work June 4 th - One month of employment July 1 st - Insurance becomes “effective” No waiting periods on any of the plans The above example applies if enrollment paperwork is received by Employee Health & Benefits within 60 days of date of hire. 4

5. Health Insurance Self-Insured plan o Governed by the State Employee Health Commission o Administered by: Point of Service Policy In-network coverage AND Out-of-network coverage In-Network Coverage Provides o Preventive Care o Medical and Sick Care (e.g. hospital services) o Prescriptions o Mental Health Services 5

6. Health Insurance: Provider Network Aetna Network Doctors Primary Care Physicians Preferred PCP’s Participating PCP’s SpecialistsHospitals Preferred Hospitals Participating Hospitals Pharmacies 6 Provider Lists and Ratings www.AetnaStateOfMaine.comwww.AetnaStateOfMaine.com (“DocFind”) www.GetBetterMaine.org Provider Lists and Ratings www.AetnaStateOfMaine.comwww.AetnaStateOfMaine.com (“DocFind”) www.GetBetterMaine.org

7. Health Insurance: Tools & Resources Customized website for the State of Maine “Express Lane” www.AetnaStateOfMaine.comwww.AetnaStateOfMaine.com o Find a Provider o Benefit Overview Secure member website – Aetna Navigator o Look up a claim o Order/print an ID card o Keep track of health care costs Aetna Mobile o Mobile web o App for Android & iPhone Aetna 24/7 Nurse Line o 1-800-270-2386 7

8. Health Insurance: Out-of-Pocket Expenses Doctor office visits Prescriptions 1. Copays Tests (e.g. diagnostic labwork, x-ray) Procedures (e.g. surgery) 2. Deductible Tests (e.g. diagnostic labwork, x-ray) Procedures (e.g. surgery) 3. Coinsurance How much the insurance will cost 4. Premiums 8

9. Health Insurance: In-Network Copays 9 Planned Office Visit Copays Preferred PCP $0 Participating PCP $20* Specialist $25* *Waived for preventive visits Urgent or Emergency Care Walk-In Clinic or Urgent Care $25 Emergency Room $300 (waived if admitted) www.AetnaStateOfMaine.com

10. Deductibles & Coinsurance *Any portion of your annual deductible met during October, November or December will roll over to the new year as a credit Effective 07/01/1510 BenefitIn-NetworkOut-of-Network Annual Deductible* Calendar Year $500 individual $1,000 family $2,500 individual $5,000 family Coinsurance 20% or 10% preferred 40% Coinsurance Limit Calendar Year $1,500 individual $3,000 family $2,500 individual $5,000 family

11. Out-of-Pocket Limit: Medical (In-Network) Out-of- Pocket Limit Medical Copays DeductibleCoinsurance 11 In-Network $2,000 Individual $4,000 Family Effective 07/01/2014

12. Out-of-Pocket Limit: Pharmacy (In-Network) 12 Out-of- Pocket Limit Prescription Copays Effective 07/01/2015 In-Network $4,600 Individual $9,200 Family

13. Frequently Asked Question What is the cost for lab work? Preventive lab work: $0 cost to member (covered by the plan at 100%) Diagnostic lab work: Deductible and coinsurance applies 13

14. Pharmacy Copays Medication Category Copay for a 30-Day Supply Copay for a 90-Day Supply Generic*$10$15 Preferred Name Brand$30$45 Non-preferred Name Brand$45$70 Lifestyle (e.g. infertility, impotency) $50$75 14 *Maine is a generic substitution State (some exceptions apply) Prescriptions can be filled at your local retail pharmacy or through Aetna mail order You can view the Aetna Preferred Drug Guide at www.AetnaStateOfMaine.com (“Pharmacy” tab) www.AetnaStateOfMaine.com

15. Health Insurance Premiums How much will your health insurance cost? There are four factors to consider when calculating your health insurance premium: 1.Your base annual rate of pay 2.Employment status (full-time, part-time, intermittent, etc.) 3.Family members covered on policy 4.Participation in annual Health Credit Premium Program 15

16. Health Insurance Premiums (continued) Base Annual Rate of Pay Employee’s % of Own (individual) Policy Bi-weekly Premium Deduction Bi-weekly STATE Portion of Premium Amount Less than or equal to $30,000 5%$19.88$377.73 Greater than $30,000 but less than $80,000 10%$39.76$357.85 Equal to or greater than $80,000 15%$59.64$337.97 MRS Title 5, 285 (7-C)16 Example above is for a full-time employee on a single policy Deductions are withheld pre-tax (domestic partner premiums are post-tax) Part-time employees pay an additional pro-rated share of the individual premium (Contact Employee Health & Benefits for premium amount.) The State pays 60% of the dependent premium; the employee pays 40% Health Credit Premium Program – Up to 5% savings on your premium The entire premium rate sheet can be found at www.maine.gov/dehwww.maine.gov/deh

17. Health Insurance Family Contract Available to: Two married State of Maine employees with children. Domestic Partners who are both State of Maine employees with children. Partners must qualify by filing a domestic partner affidavit.* Portion of the family premium for child(ren) is waived! Contact Employee Health & Benefits (207)624-7380 17

18. Healthcare Reform Health Insurance Marketplace notice is given to all employees o Copy of the notice is available at www.maine.gov/deh www.maine.gov/deh More information about healthcare options in the Marketplace can be found at www.healthcare.govwww.healthcare.gov 18

19. COBRA As a new employee of the State of Maine you will receive a required notice: “Continuation Coverage Rights Under COBRA” The purpose of the notice is to explain what COBRA coverage is, when it may be available to you and your family and how to protect the right to receive it The State of Maine contracts with Combined Services to administer the COBRA notification and billing process For more information about COBRA: www.dol.gov/ebsa 19

20. Expert Medical Opinion Program Program Highlights Access to the world’s medical experts* Free 100% Confidential Open to any and all conditions and treatments Advance Medical 1-888-218-0992 www.advance-medical.com/maine (*EMO physicians are not a substitute for your current provider)

21. Wellness Programs Aetna Extras – www.AetnaStateOfMaine.comwww.AetnaStateOfMaine.com o Discount programs Aetna Fitness (health club memberships, home exercise equipment and videos through GlobalFit™) Aetna Weight Management (CalorieKing®, Jenny Craig®, Nutrisystem®) Wellness Works – www.wellnessworksme.orgwww.wellnessworksme.org o Healthy Directions (education and training programs) o On-site gyms (Augusta East Side and Bangor) o ME FIRST Statewide Fitness Program – www.maine.gov/dehwww.maine.gov/deh o Network of many YMCA and University of Maine facilities o Minimum of 8 visits/month required to maintain State-paid membership o Fair market value of membership is taxable (per IRS) 21

22. Dental Insurance Member Services 1-800-832-5700 www.NEDelta.com 22

23. Dental Insurance: Coverage 23 Coverage Category State Of Maine PPO Network Delta Dental Premier Network Out-of- Network Preventive & Diagnostic100% 90% Basic Restorative90%80%70% Major Restorative60%50%40% Orthodontics60%50%40% Level of coverage based on reasonable & customary charges Please refer to your Summary of Benefits for calendar year and lifetime maximums Provider lists can be found at www.nedelta.comwww.nedelta.com Secure member login available View balance of your calendar year maximums, claims, recent treatment summary, etc.

24. Dental Bi-weekly Premiums Part time employees pay a pro-rated premium There is no State contribution for dependent premium on the dental insurance Premiums Effective 7/1/1524 Coverage Bi-Weekly Premium Full Time Employee $0 (no cost to you) Employee + 1 Family Member$10.34 Employee + 2 or more$31.78

25. Vision Insurance “Blue View Vision” – Supplemental vision insurance coverage Find a provider at www.anthem.comwww.anthem.com 25 Aetna Health PlanBlue View Vision Plan Routine eye exam Eye infectionGlasses Eye injuryContact lenses Non-routine services Refer to your benefit overview for more information Check with your Human Resources department regarding the Video Display Terminal benefit (“VDT”)

26. Blue View Vision Biweekly Pretax Premiums Employee Only: $2.19 Employee + 1 family member: $3.51 Employee + 2 or more family members: $5.70 Premiums Effective 7/1/1526

27. When can I add or delete dependents from my insurance policies? Within 60 days of hire During Annual / Open Enrollment- Begins in May through early June for a July 1 effective date. Within 60 days of a “life event” such as marriage, divorce or birth/adoption. (Note: change must be consistent with the event.) The complete list of events can be found at www.maine.gov/deh. www.maine.gov/deh *Note: Dependent children can remain on the health, dental & vision insurance up to age 26. COBRA will be offered. 27

28. MaineSaves 457b Plan Voluntary retirement savings account Convenience of payroll deduction Contributions are pre-tax For more information or to enroll on line visit: www.MaineSaves457.com 28

29. Flexible Spending Accounts Set aside funds pretax for out of pocket medical and/or daycare expenses. Flex-Plan Services, Inc. www.flex-plan.comwww.flex-plan.com or 1-800-669-3539 Flex-Plan Services offers on line account maintenance and a debit card. 29

30. Living Resources Program (effective July 1, 2015) Confidential Counseling o Provides up to 5 short-term, confidential counseling visits per year to employees and members of the household at no cost Financial Information, Legal Support & Resources o Getting out of debt, credit card or loan problems, tax questions, etc. o Divorce and family law, debt and bankruptcy, real estate transactions, etc. Work-Life Solutions o Research and referral services regarding child/elder care, moving and relocation, college planning, pet care, etc. GuidanceResources® Online o www.guidanceresources.com (web ID: LivingME) www.guidanceresources.com 1-844-207-LINK (5465) available 24/7 30

31. Retirement Upon retirement there may be health benefits available to you It is especially important to keep this in mind if you cancel your insurance coverage during your employment; this could effect your retiree health insurance www.maine.gov/deh 31

32. Any Questions?? Call (207)624-7380 and ask to speak with a Benefits Specialist www.maine.gov/deh 32