The IBIS 105 Advantage Plan

1. The IBIS 105 Advantage Plan Presented by: Iowa Bankers Insurance and Services

2. IBIS 105 Advantage Plan • Employer-sponsored plan • Employer and employee share in the cost of the deductible and out of pocket expenses of the plan

3. IBIS 105 Advantage Plan - Two Plans • Plan One • Employer purchases a high deductible plan • Called the purchased plan or insured plan • Plan Two • Employer designs an employee plan • Plan has a lower deductible and out -of-pocket • Called the partial self-funded or “buy-down plan”

4. 105 Window – Shared Costs • The employer and the employee share in the cost between the purchased plan and the buy-down plan • Known as the 105 window

5. Example of 105 Window Deductible Purchased Plan $2000/Single $4000/ESP/ECH/F Buy-Down Plan $ 500/Single $1500/ESP/ECH/F Out-of-Pocket Purchased Plan $4000/Single $8000/ESP/ECH/F Buy-Down Plan $1500/Single $3000/ESP/ECH/F

6. Deductible Cost Sharing • Using the single plan option • Purchased plan is $2000 Buy-Down plan is $500

7. Out-of-Pocket Cost Sharing • Using the single plan option • Purchased plan is $4000 Buy-Down plan is $1500

8. Out-of-Pocket Note: • Insured under the Iowa Bankers Benefit Plan (IBBP) • Deductible is part of the total out-of-pocket • When you meet your buy-down deductible, you enter into the out-of-pocket expense of the 10% co-insurance • When you meet your total out-of-pocket in the buy-down plan, the employer and the insurance company cover the claims

9. 105 Advantage Claim Process • Insured under the IBBP plan • Provider files claim directly with Wellmark BC/BS, claims payer for IBBP • Wellmark BC/BS processes under the purchased plan • Wellmark BC/BS sends the claim to Iowa Bankers Insurance and Services (IBIS) • IBIS reprocesses claim through the 105 window • Employee is responsible for the balance, which is the buy-down plan • Payments due the employee are made through direct deposit to employee-designated account

10. Plan Responsibilities • Purchased Plan • Expenses paid by Wellmark BC/BS for the IBBP • Paid to participating providers • 105 Window • Shared costs between employer and employee • Payments made by employer directly to employee • Buy-down Plan • Employee’s responsibility to pay provider directly • Expenses sent directly to 125 Advantage plan for participants

11. For 125 Advantage Participants • Employee responsibility for deductible/out-of-pocket expenses in the buy-down plan are sent directly to the 125 Flex Advantage Plan for payout • Payout made from the 125 Flex Advantage Plan is made by direct deposit to the employee-designated account

12. Explanation of Benefits (EOB) • 105 participants will receive two EOBs: • Wellmark BC/BS EOB for the purchased plan • IBIS EOB for the employer costs in the 105 window

13. Reimbursement Process • Automated • Paid weekly on Friday • Paid by direct deposit to employee-designated account • Participant will receive electronic notification of claim processed and direct deposit • EOB will be mailed or available online • Online access to EOB history

14. Online Access • Must enroll online for access to EOB information • www.bankers-ins.com • Log in to Employee Self Service menu • View EOB history • Request paper copies vs. online access

15. COBRA Issues • When choosing COBRA • Will have access to the buy-down plan • Cost is market rate of plan premium plus 2%

16. Advantage of Participation • Premium cost savings • Employer-sponsored plan • Automated claim process • Reimbursement through direct deposit • Automated claim filing to 125 Advantage Plan • Online EOB history • Toll-free customer service

17. For more information visit www.bankers-insurance.com

18. Presented by: Iowa Bankers Insurance and Services 8800 NW 62nd Avenue PO Box 6210 Johnston, IA 50131-6210 Toll-free: 800-258-1415 Fax: 515-286-4244 Email: flexadmin@bankers-ins.com