1. 2010-2011 Plan Year Effective September 1, 2010

2. 2 Your TRS-ActiveCare ID card will be mailed to your home  Enroll by May 19 to receive ID card by September 1  ActiveCare 1-HD, 1, 2 and 3 –All enrollees, including existing plan participants, will receive new ID cards –New! Separate cards for medical and prescription drugs Blue Cross and Blue Shield of Texas Medco

3. PPO Medical Plans ActiveCare 1-HD, 1, 2 & 3 Plans

4. 4 PPO Network for ActiveCare 1-HD, 1, 2 and 3 Network There is no need to : –Select a Primary Care Physician –Obtain referrals for specialist care Receive the highest level of benefits: –Pay less for care –No balance billing No claim forms –Provider files claim for you Non-Network:  You pay more of the cost of out-of-network benefits –Higher deductibles, coinsurance  You may need to file your own claim  You could be balance billed for amounts over allowed amount Always verify provider network status New for 2010-2011: The allowable amount for non-contracting providers will be limited to 50% of billed charges

5. 5 PPO Plan Overview (Network Level of Benefits) Plan Features ActiveCare 1-HDActiveCare 1ActiveCare 2ActiveCare 3 Deductible (individual/family) $2,400/$2,400$1,200/$3,000$500/$1,500None Out-of-Pocket Maximum (does not include deductibles) $3,000/$5,000$2,000/$6,000 $1,000 per individual Coinsurance (Plan pays/participant pays) 80% / 20% New Deductibles for 2010-2011 (per IRS rules) ActiveCare 1-HD and ActiveCare 1

6. 6 PPO Plan Overview (Network Level of Benefits) Services ActiveCare 1-HDActiveCare 1ActiveCare 2ActiveCare 3 Office Visit Copay20% after deductible$30 for primary $50 for specialist $20 for primary $30 for specialist Preventive Care  Routine physicals*  Well-woman exams*  Routine mammograms*  Eye exams*  Well-baby exams  Immunizations  Hearing exams  PSA screenings  Colorectal screenings  Osteoporosis screenings * Services limited to one per person per plan year $0 copay up to $500 per person, per plan year Remaining charges subject to deductible and coinsurance $30 for primary $50 for specialist Includes all preventive care services billed with an office visit by a network doctor Coinsurance applies when no office visit is billed or when services are performed outside the office (deductible waived) $20 for primary $30 for specialist Includes all preventive care services billed with an office visit by a network doctor Coinsurance applies when no office visit is billed or when services are performed outside the office (no deductible) New Copays for 2010-2011 ActiveCare 2

7. 7 ActiveCare 1-HD vs. ActiveCare 1 Plan FeaturesActiveCare 1-HDActiveCare 1 Meets IRS definition of High Deductible Health Plan Yes, for all coverage categories (employee only, employee and spouse, employee and child(ren) and employee and family) Yes, for employee-only coverage No, for other coverage categories Deductible $2,400 for employee only $2,400 for family $1,200 per individual $3,000 per family Maximum Coinsurance $3,000 for employee only $5,000 for family $2,000 per individual $6,000 per family Out-of-Pocket Maximum (includes deductibles) $5,400 for employee only $7,400 for family $3,200 per individual $9,000 per family Monthly Premium Cost Lower premium than ActiveCare 1 in all coverage categories except employee and family Higher premium than ActiveCare 1-HD in all coverage categories except employee and family New for 2010-2011: Deductible and out-of-pocket maximum amounts increased per IRS guidelines

8. 8 Important: Bariatric surgery procedures for weight loss, such as lap band and gastric bypass, must be performed at one of the Blue Distinction Centers for Bariatric Surgery or the procedure will not be covered by TRS-ActiveCare Blue Distinction Centers for Bariatric Surgery  List of Blue Distinction Centers for Bariatric Surgery is subject to change  Refer to the Doctors and Hospitals section of the Web site, www.bcbstx.com/trs or call Customer Service for most current list

9. How to Enroll 2010-2011 Plan Year

10. 10 Enrollment  Enrollment Periods for 2010-2011 Plan Year: –April 21,22,23 (HISD Spring Enrollment) –August date TBA (HISD Summer Enrollment)  Preexisting condition exclusion applies to those that previously declined coverage; may be reduced by prior creditable coverage  All employees must attend enrollment to: –Change TRS-ActiveCare plan option –Add or drop dependents –Cancel and/or decline coverage –Enroll for TRS-ActiveCare coverage with a different participating district/entity –Change name or address or correct date of birth or Social Security number

11. 11 Eligible Dependents  Spouse (including a common law spouse)  Unmarried children under age 25 –Natural child –Adopted child –Stepchild –Foster child  Other eligible dependents listed in Enrollment Guide –Grandchildren (unmarried) –Disabled children (unmarried, of any age)

12. 12 Special Eligibility Situations  If employee and spouse both work for a participating district/entity: –A spouse may be covered as an employee or as a dependent of an employee –Only one parent can cover dependent children  A child (under age 25) employed by a district/entity and a contributing TRS member cannot be covered as a dependent  The child must be covered as an employee  If the child is not a contributing TRS member, the child may be covered as a dependent

13. 13 Preexisting Condition Waiting Period and Creditable Coverage  Pre-x does not apply to employees that initially enroll when the district/entity begins participating in TRS-ActiveCare or to new hires who enroll within 31 days after their actively-at-work date  A 12-month pre-x condition waiting period may apply due to: –A special enrollment event –A future plan enrollment period (to be determined by TRS for each plan enrollment period) –A transfer to another participating district/entity (or rehire) if the employee or any covered dependent has any remaining preexisting waiting period or a gap in coverage of 63 or more consecutive days  Pre-x waiting period may be reduced by creditable coverage Exception: If a participant has been covered by TRS-ActiveCare at any time since 2002, pre-x may apply if employee is hired by another participating district/entity (or rehired by same district/entity)

14. 2010-2011 Plan Year Cost for Health Coverage

15. 15 Monthly Cost for Coverage  See page 27 of Enrollment Guide  $225 in district/entity and state funds to help pay for coverage

16. 16 Cost of Coverage (Cont’d) Employee and family coverage for ActiveCare 1-HD is more expensive than ActiveCare 1 because the deductible and out-of-pocket maximum amounts for family are less and the plan may begin paying 100% benefits sooner PPO Plans ActiveCare 1-HDActiveCare 1 Coverage CategoryYour Cost Employee Only$37$72 Employee and Spouse$417$452 Employee and Child(ren)$184$249 Employee and Family$615$521 Family Deductible$2,400$3,000 Family Out-of-Pocket Maximum $7,400$9,000

17. 17 Cost of Coverage (Cont’d) New Copays for 2010-2011 (Active Care 2) $30 for an office or preventive care visit for primary and $50 for specialist. PPO Plans ActiveCare 2ActiveCare 3 Coverage CategoryYour Cost Employee Only$171$308 Employee and Spouse$676$988 Employee and Children$405$625 Employee and Family$766$1,109 Family Deductible$1,500None Family Out-of-Pocket Maximum $7,500$1,000 per individual

18. 18 Application to Split Premium  Married couples working for different participating entities may “pool” funds  Optional  Requires an Application to Split Premium form to be completed by both employees and employers

19. 19 Can Changes in Coverage Be Made After Your Application Has Been Submitted?  Changes can be made up to the end of your enrollment period  Plan choices will remain in effect through August 31, 2011 unless there’s a special enrollment event such as: –Marriage or divorce –Birth, adoption or placement for adoption of a child –A child marries or reaches age 25 –A court order to provide health coverage for an eligible child –Loss of coverage  Changes must be made within 31 days after the event date (special rules apply to newborns)  New application must be submitted for any change

20. 20 Newborns  Covered first 31 days if employee has coverage  Must add newborn within 60 days after the date of birth or up to one year after the date of birth if: –Employee has “employee and family” or “employee and child(ren)” coverage at the time of birth and at the time of enrollment  Not necessary to wait for newborn’s Social Security number –Submit application without SSN to enroll –Re-submit another form after SSN is issued

21. 21 Online member management tool  Check claim status, view claim summaries and print EOBs (Explanations of Benefits)  Order additional ID cards, and print temporary ID  Monthly health articles  Links to health information and wellness tools and resources, including the Personal Health Manager Send secure e-mail messages to BCBS Customer Advocates available Monday thru Friday, 7 a.m. to 10 p.m. (CT) Blue Access ® for Members

22. Available online Enrollment Video Application Form Enrollment Guide Benefits Booklet 24/7 Nurseline, Lifestyle and Condition Management and Special Beginnings phone numbers www.bcbstx.com/trs

23. 23 Blue Care Connection ®  Whether you decide to skip fast food, quit smoking, or walk more, every day decisions can have a positive impact on your health; Blue Care Connection offers guidance at every level of health Complex / CatastrophicWell MembersLow- RiskModerate- RiskHigh-Risk > > Total Care Approach to Health and Wellness

24. 24 Condition Management Support from Blue Care Advisors—clinical professionals who can help you manage chronic health conditions such as: asthma, diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disorder and other health conditions Understanding and following your physician’s orders Review medications, side effects, compliance, refills and current services Establish goals with you and caregivers, scheduling follow-ups as appropriate If you have a chronic condition, we offer support. 1-800-462-3275

25. 25 Self-Paced Approach Online program and resources available in the Personal Health Manager Secure e-mail outreach to keep members on track Lifestyle Management Support Counseling and coaching with licensed Wellness Coaches 24/7 Nurseline Referrals when appropriate Tobacco Cessation and Weight Management 1-800-462-3275

26. 26 Special Beginnings ® Special Beginnings helps expectant mothers and their babies get off to a healthy start by providing prenatal and postnatal health education and guidance at no additional cost Once enrolled in the program, plan participants receive: Pregnancy risk assessment and ongoing communication/monitoring Educational material covering pregnancy and infant care topics Frequent, personal contact with program staff from early pregnancy through six weeks after delivery Assistance in managing high-risk conditions such as gestational diabetes and preeclampsia Program components are available in English and Spanish 1-888-421-7781

27. 27 Advice anytime. Round-the-clock health and the wellness advice from licensed professionals 24/7 Nurseline Advice isn’t just needed from 9 to 5. 24/7 Nurseline is here to help.  Nurses provide health advice and information about high fevers, earaches, cuts and bruises and more  Audio health library on topics such as kicking the smoking habit and ways to get a good night’s rest Available in English and Spanish 24/7 1-800-581-0368

28. 28 Personal Health Manager (PHM) Your online wellness experience begins with the Personal Health Manager Features include:  Lifestyle Management tools:  Weight Management  Tobacco Cessation  Fitness and Nutrition Plans  Stress Reduction  Health Risk Assessment  “For Your Health” features  Blue Points SM Rewards  “Ask-A” feature – health and wellness questions via secure e-mail  Online health encyclopedia  Interactive symptom checker

29. 29 Personal Health Manager – Home Page Use the Interactive Symptom Checker Read the latest health news, search for specific health topics or explore the prescription drug index Ask a Question to a certified Nurse, Trainer, Dietitian or Life Coach Access Member Care Profile Take a Health Risk Assessment Read secure messages Review member alerts Explore topics in the Health Information and Care Center

30. 30 Ask the experts. Expert advice from licensed professionals via the Personal Health Manager “Ask A” Online Advisor Expert advice at your fingertips. Our “Ask A” feature is here to help. Ask A Trainer, Dietitian or Life Coach: Send questions about fitness, nutrition, or managing stress. Ask A Nurse: Interact online with a Blue Care Advisor on non- emergency, health- related questions using the secure “Ask A Nurse” feature. Confidential and Secure – Receive an e-mail response within one business day

31. 31 Receive Personalized report and next steps: Report provides member with summary of health risks and areas where they could improve Recommended ‘next steps’ and suggestions to make positive changes to your lifestyle. Health Risk Assessment – Easy To Use Complete the assessment in as little as 10 to 15 minutes Choose your assessment topic: Health & well-being * Sleep Stress management Nutrition Fitness & physical activity Back & joint health *We recommend completing the Health & Well-being assessment first. 123

32. 32 Health Risk Assessment (HRA) A Health Risk Assessment helps assess your health risks, interests and readiness to change  Examines your overall health and well-being  Provides a detailed report with overall health and well-being score and sub-scores for:  Medical health, job satisfaction, life load, risk and lifestyle, mood, nutrition, sleep, stress, pain and body weight  Recommends areas for improvement  Confidential and secure (results are not shared with employers) Be informed about your overall health and well-being Earn Blue Points SM

33. 33 Stay motivated. Earn Blue Points in the Personal Health Manager Blue Points SM Incentives TRS-ActiveCare PPO plan participants and their covered dependents accumulate Blue Points in the Personal Health Manager  Complete designated health and wellness activities  Report completed activities in the Personal Health Manager  Track your available balance  Redeem earned Blue Points for a variety of items!

34. Prescription Drugs ActiveCare 1-HD,1, 2 & 3

35. 35 Your Medco Prescription Drug Plan  Medco administers your prescription drug plans on behalf of TRS –ActiveCare 1-HD, 1, 2, and 3 plans  Benefit includes both a retail and mail component  Medco has its own mail-order pharmacy – Medco By Mail – where specialist pharmacist focus on compliance and lower cost options for the patient, and the automated filling system ensures the prescription is filled accurately.* Medco’s mail-order pharmacies fill about 2 million prescriptions per week through a highly automated process that is 99.9997% accurate and is 23 times more accurate than a retail pharmacy “Dispensing Error Rate in a Highly Automated Mail-Service Pharmacy Practice”; Nov. 2007, Pharmacology, a peer-reviewed journal of the American College of Clinical Pharmacy

36. 36 Prescription Drug Benefits - Network Level Features ActiveCare 1-HDActiveCare 1ActiveCare 2ActiveCare 3 Drug Deductible (per person, per plan year) Subject to plan year deductible $50 Retail Short-Term (up to 30-day supply) Generic/Preferred Brand/Non- Preferred Brand 20% coinsurance after deductible $10 $25* $45* $10 $25* $40* Retail Maintenance (after second fill, up to 30-day supply) Generic/Preferred Brand/Non- Preferred Brand $15 $35* $60* $15 $35* $55* Medco by Mail (up to 90-day supply) Generic/Preferred Brand/Non- Preferred Brand $20 $62.50* $112.50* $20 $62.50* $100* * If you obtain a brand-name drug when a generic equivalent is available, you are responsible for the generic copayment plus the cost difference between the brand-name drug and the generic drug. Chart illustrates benefits when network pharmacies are used. Non-network benefits are also available; see Enrollment Guide for more information.

37. 37 Specific Rx Benefit Information  Retail pharmacies are ideal for acute (short-term) and new medication you may be trying for the first time In compliance with SB 0704, 81 (R) Texas Legislature, TRS will make available through Medco a retail maintenance network effective September 1, 2010. Retail pharmacies who choose to participate in this network will be able to dispense up to a 90-day supply of medication. Please contact Medco customer service for more information on pharmacies that may choose to participate in the retail maintenance network. Medco is in the process of soliciting this network. We will not know which pharmacies will choose to participate until later this summer.

38. 38 Specific Rx Benefit Information  If you are taking a long-term medication, filling your prescriptions through Medco’s mail-order pharmacy provides several benefits: –You can receive up to a 90-day supply of your medication at a lower copay –Prescriptions are delivered directly to you and you can order refills online and check the status of your orders –You have access to specialist pharmacists Specifically trained in specific conditions Review all of your incoming prescriptions for potential safety issues and will contact you and your doctor to discuss any issue –Medco only buys medication from the most reputable suppliers You have access to specialist pharmacists whether you fill your prescription at a retail pharmacy or at Medco By Mail. Your medication questions can be answered by calling 1-866-355-5999

39. 39 My Rx Choices ® Your online savings tool  Lower your cost for prescriptions with My Rx Choices ® –Features include: Personal assessment of cost-saving opportunities based on your prescription plan and the medications you use Print a kit to help your doctor better understand the economic impact of different medication alternatives Alternative medications are based upon greatest cost savings to you presented in order, starting with the highest value Brand-to-generic and retail-to-mail comparisons are shown The average amount saved by My Rx Choices ® users is $294!  Simply visit www.medco.com/save. You’ll need to take a moment to register before using this service. You can also call 1-866-355-5999  You have to shop your benefit. Prices can vary at different retail pharmacies

40. 40 My Rx Choices ® Available through Customer Service or on www.medco.com  The My Rx Choices ® home page allows the user to: –Select a patient within a household (pre- populated with all under age 18 dependents and spouse information will be shown if authorization has been given) –Select a drug to compare from a pre- populated list of prescriptions for the user.  Your potential savings are clearly presented  Members may print a kit to discuss with their doctor  Generic alternatives are provided

41. 41 Information Resources  TRS Web site – www.trs.state.tx.us/trs-activecare –Pharmacy Benefit Highlights –List of maintenance medications –FAQs –Download forms  Medco Member Web site – www.medco.com –Prior authorization list –Formulary information –Locate a participating pharmacy –Health and wellness information –My Rx Choices ® / Price a Medication –Online ordering –Order Medco By Mail refills –Download forms –Medco widget  Customer Service 1-866-355-5999  Benefits Booklet

42. 42 Customer Service 1-866-355-5999 What if I Have Questions?  Call TRS-ActiveCare customer service for: –Claim questions/status –Network provider information –Membership and eligibility –Medical coverage questions –Inquiries (telephone and e-mail) –ID card requests –Transition of care information –Help with online tools! Personalized Service

43. Thank you for attending