Educated Choices

1. Educated Choices 2014 Benefits overview Stanford Benefits This is a summary presentation only. If there are any differences between the information in this presentation and the information in Stanford’s Educated Choices Plan documentation an/or insurance certificates, the Plan documentation and/or insurance certificates will govern.

2. Agenda • Your Benefits Team • How the Educated Choices Plan Works • 2014 Benefits Overview We encourage you to visit benefits.stanford.edu to view full plan information and make your enrollment elections.

3. Your Benefits Team and How the Educated Choices Plan Works

4. Stanford Benefits • Call 650-736-2985, or 877-905-2985 (press option 9) • Coordinates the enrollment/change process • Answers your questions • Can research issues between you and your insurance provider • Assists in most languages • Log into MyBENEFITS • Click on Contact Us • Send an email or chat online • Add stanford.benefits@acs-inc.com to your email address book to receive important messages about your benefits

5. Educated Choices: Who’s Eligible? • Employees • Dependents • Opposite-sex or same-sex spouse or registered domestic partner • Children up to age 26 • Must verify your dependents’ eligibility within 30 days • No double coverage at Stanford • You can either be enrolled as an employee or a dependent • Only one parent may cover eligible children • Details at benefits.stanford.edu • For eligibility information go to Medical & Life>Overview > Eligibility • For general information, read the Educated Choices summary plan description. Go to the Resource Library > Search “Benefits”

6. Educated Choices: How Is the Cost Shared? [Full-time employees] • The university pays the full cost of: • Medical coverage for employee only in two plans • Delta Dental Basic PPO, Basic Life, Long-Term Disability (LTD) • You share the cost for dependent medical • You pay the difference to: • Buy up to another medical plan and Delta Dental Enhanced PPO • You pay the full cost for: • Vision, Supplemental Life, Accidental Death & Dismemberment (AD&D) and Long-Term Care

7. Educated Choices: How Is the Cost Shared? [Part-time employees] • The university pays the full cost of Basic Life and LTD • The university pays half of the full cost of: • Medical coverage for you in the lowest-cost plan • Delta Dental Basic PPO • You pay the additional difference to: • Buy up to another medical plan and Delta Dental Enhanced PPO • You pay the full cost for: • Vision, Supplemental Life, Accidental Death & Dismemberment (AD&D) and Long-Term Care

8. Medical Contribution Assistance Program (MCAP) MCAP provides financial assistance to certain employees. It subsidizes the employee contribution of the lowest-cost medical plan when you cover your spouse and/or your children. • Eligibility • You must work in a benefits-eligible position that is at least 75% full time • Your combined family Adjusted Gross Income (AGI), as stated on your most recent federal income tax return, must be $60,000 or less • Details • For general information, read the MCAP plan guidelines online. Go to the Resource Library > Type “MCAP” in the Search box

9. Educated Choices Don’t need health coverage through Stanford? • You can waive/decline coverage except Basic Life and LTD • Full-time employees receive $25 in taxable income per pay period when waiving medical coverage • Part-time employees receive $12.50 in taxable income per pay period when waiving medical coverage

10. Health Benefits

11. Medical Plan Options HMO: Kaiser Permanente (California only except for emergency care) • Copayments only, no claims to file, no deductible • Must use Kaiser doctors and facilities (except for emergency care) • Must live within the service area (based on your home zip code) Stanford HealthCare Alliance • Copayments only, no claims to file, no deductible, personalized assistance • Must use network doctors and facilities (except for emergency care) • Must live within the service area (based on your home zip code) EPO: Blue Shield • Copayments only • Must use network doctors and facilities (except for emergency care) • Access to Blue Shield’s nationwide network (in-network only) Details • Medical and Life > Medical, Dental & Vision > Medical Plans

12. Medical Plan Options Two PPO plans through Blue Shield • PPO Plan: Deductibles, coinsurance, copayments • High-Deductible Health Plan: Deductibles and coinsurance; compatible with Health Savings Accounts • Access to Blue Shield’s nationwide network (in network and out of network) Details • Medical and Life > Medical, Dental & Vision > Medical Plans

13. Mental Health and Substance Abuse • Benefits are provided through the medical plans • No visit limits for medically necessary care • Office copayments are the same as for any other medical condition • Kaiser Permanente—contact Kaiser to make appointments with Kaiser providers • Stanford HealthCare Alliance – contact SHCA Member Care Services • Blue Shield—contact Blue Shield to help you find a network provider

14. Stanford HealthCare Alliance (SHCA) Stanford HealthCare Alliance: • Must use network doctors and facilities (except for emergency care) • Regional plan servicing the Greater Bay Area • You must live within the service area (based on your home zip code) • $20 copay (generalist), $50 copay (specialist) • No deductible • No claims to file • Primary physician required • Personalized Member Care Services 855-345-7422 • Schedule appointments • Help you select physicians • Answer claims and billing issues

15. Kaiser HMO and Blue Shield EPO Kaiser Permanente HMO: • Must use network doctors and facilities (except for emergency care) • $20 copay (generalist), $50 copay (specialist) • Primary physician required Blue Shield EPO: • Must use network doctors and facilities (except for emergency care) • $20 copay (generalist), $50 copay (specialist) • No primary care physician required • Pre-authorization required on certain services • Reduced benefit for not pre-authorizing; does not apply to out-of-pocket maximum

16. Kaiser, Stanford HealthCare Alliance and Blue Shield EPO Prescription Drugs • Kaiser: • $10 generic / $30 brand (30-day supply per copayment) • 100-day mail-order supply for two copayments • Stanford HealthCare Alliance: (uses Blue Shield pharmacy network) • $10 generic / $30 brand / $75 non-formulary (30-day retail supply per copayment) • 90-day mail-order supply for two copayments • Blue Shield EPO: • $10 generic / $30 brand / $75 non-formulary (30-day retail supply per copayment) • 90-day mail-order supply for two copayments

17. Blue Shield PPO Out-of-Network • Use any licensed provider • Deductibles apply • $1,000 per person • $3,000 family • 60% benefit coverage after deductible for most services (based on Blue Shield’s allowable amount) • Out-of-network ambulatory service center charges per visit covered at 60% of allowed charges up to a maximum benefit of $2,400 • Balance billing Network • Must use network provider • Deductibles apply • $500 per person • $1,500 family • $20 or $50 copay for office visits • 80% benefit coverage after deductible for most services • Prescription drugs: $10 generic$30 brand, $75 non-formulary

18. Blue Shield High-Deductible Health Plan Deductible:$1,500 Individual Coverage / $3,000 family Coverage*Prescription Drugs covered at 80% after deductible Network • Must use network provider • 100% benefit coverage for preventive care • 80% benefit coverage after deductible for all other services Out-of-Network • Use any licensed provider • Preventive care not covered • 60% benefit coverage after deductible (based on Blue Shield’s allowable amount) • Out-of-network ambulatory service center charges per visit covered at 60% of allowed charges up to a maximum benefit of $2,400 • Balance billing *Family deductible applies to claims for all family members until it is met. There is no individual limit for each covered family member.

19. Health Savings Account (HSA) • Only available if enrolled in the High-Deductible Health Plan • A special savings account you open and fund • Use account to pay unreimbursed health care expenses • No year-end forfeiture; it’s your money in your HSA • Contribute up to $3,300 (individual) or $6,550 (family) for 2014 • If you open an account with HealthEquity, Stanford contributes to your account—even if you don’t! • Up to $300 (employee only); up to $600 (employee plus family members) • Find more information: • Review HSA Frequently Asked Questions • Listen to HSA & Blue Shield: Making Them Work Together > Medical and Life >Health Savings Account

20. Blue Shield Health Advocate Program • Dedicated Health Advocate Nurse • Good resource for being directed to the right care in non-emergency situations • Provides health counseling, provides help in accessing and coordinating care • Staffed by registered nurses • NurseHelp 24/7 • Nurse advice hotline available 24 hours a day/7 days a week • No cost to Blue Shield members

21. Decision Tools Make an informed decision • Find the plan that’s right for you and your family: • Medical and Life > Medical, Dental & Vision • Look at each plan’s Summary with all plan details at Benefits website. • Compare medical plans • Review rates • Read the FAQs

22. BeWell@Stanford Incentive Program • The BeWell@Stanford Employee Incentive Program encourages Stanford employees and their spouses or registered domestic partners to live a healthy lifestyle. • Visit bewell.stanford.edu to get started, or call 650-721-2984.

23. Dental Plan Options Two plans available through Delta Dental • Delta Dental Basic PPO • Annual maximum benefit of $1,000 • Implants & orthodontia not covered • Includes Delta PPO dentists, plus additional Delta dentists • Offered at no cost • Delta Dental Enhanced PPO • Annual maximum benefit for in-network care of $3,000 • Implants & orthodontia covered • Out-of-network care paid at a lower rate after deductible • Requires contribution each pay period

24. Dental Plan Options Remember: • Delta Dental Basic PPO plan is offered at no charge to you if you are a full-time employee • Delta Dental Basic PPO has a larger network, but a lower annual maximum benefit, and no coverage for implants or orthodontia • Delta Dental Enhanced PPO requires a contribution each pay period • Waiving dental coverage is a two-year decision • Qualifying Life Event may allow you to elect sooner

25. Vision Plan One plan available through Vision Service Plan (VSP) • Offers one benefit allowance for glasses or contacts every calendar year • Covers a routine eye exam every 12 months • In-network benefits • Lenses: single-vision, bi-focal, tri-focal, $40 charge for progressive • Frames or contacts: $150 retail allowance every calendar year • NEW in 2014 • TruHearing -- discount hearing aid program available to VSP members and dependents • Can add up to 4 guest members (parents, grandparents, siblings) at an additional annual cost per member • Call TruHearing 877-396-7194 or visit vsp.truhearing.com

26. Flexible Spending Accounts (FSAs) Administered Through Benesyst(a TASC company) • Manage your account via partners.benesyst.net/stanford • Submit claims electronically, view account balance(s), contributions • Mobile app allows you to submit reimbursement requests, view account balances and transactions, upload pictures of receipts, and more • Claims processed daily with reimbursement through direct deposit or loaded on to your debit card • Health care and dependent day care participants will receive a debit card • Benesyst Customer Care Specialists available • Call Monday – Friday 8 A.M. – 5 P.M. PST • Toll Free 855-842-4913

27. Health Care Flexible Spending Account • A special account you fund from pre-tax payroll deductions • Use account to pay for qualified out-of-pocket health care expenses for you and your family • You receive a debit card with your annual amount immediately available • Maximum annual contribution is $2,500 • Cannot enroll in a Health Savings Account (HSA) • Remember: Use it or lose it!

28. Dependent Day Care Flexible Spending Account • Special account you fund from pre-tax payroll deductions • Use account to pay child (up to age 13) and elder day care expenses • Pays nursery school, day camp, day care, practical nursing care for an adult only if it allows you and your spouse to work • Maximum annual contribution is $5,000 per family • Child Care Subsidy Grant Program (CCSG) -- worklife.stanford.edu • Does not cover health care expenses • Remember: Use it or lose it!

29. Flexible Spending Accounts (FSAs) • Expenses must be incurred by December 31 • That means the date of the service or purchase • Deadline of April 30 to submit claims for reimbursement • Election changes during the year are not retroactive • DETAILS • For Frequently Asked Questions, the Plan Summary, and more, go online to Medical & Life>Flexible Spending Accounts

30. Life and Disability Benefits

31. Employee Life Insurance and AD&D • No-cost Basic Life Insurance – 1 times salary up to $50,000 • Supplemental Life – up to 8 times base salary up to $1,500,000 • Enroll or increase coverage – complete EOI questionnaire • Accidental Death & Dismemberment (AD&D) insurance • Up to 8 times base salary up to $1,500,000 • No EOI required • Business Travel Accident Insurance • Stanford pays the full cost of coverage • Choosing your beneficiaries • Go to MyBenefits and update your beneficiaries at any time

32. Dependent Life Insurance and AD&D Optional coverage you can buy • Supplemental Life Insurance for spouse/partner • $25,000 – no Evidence of Insurability (EOI) required • 1 to 4 X your salary to $250,000 – must complete EOI questionnaire Supplemental Life Insurance for children – $5,000; $10,000 ; or $25,000 • Accidental Death & Dismemberment (AD&D) insurance for spouse/partner up to 4 X salary or a maximum of $250,000; children 15% of employee coverage up to $25,000 • No EOI required • For Frequently Asked Questions, Plan Summaries and more: Go online toMedical & Life> Life Insurance

33. Voluntary Disability Plan (VDI) • Required benefit (California mandate) • You pay the cost • Stanford Voluntary Disability Insurance (VDI) • Short-term non-work related disability • Family Temporary Disability for Family Care or Bonding • Can opt-out to participate in California SDI: opt-out form on Benefits website Details: • For general information, go online to Medical and Life > Disability

34. Long Term Disability (LTD) Wage Replacement • Benefits begin after 90 days of total disability due to a serious health condition • Plan pays 66-2/3% of your pre-disability base salary • Paid by Stanford • Taxable benefit Details: • For general information: Medical and Life > Disability

35. Long Term Care Insurance • If you are unable to care for yourself due to injury or chronic illness, this coverage helps with expenses • Available to you, your spouse/partner, parents and grandparents • Only new hires can enroll without submitting medical information • Enrollment and customer service is done through CNA Details: • For general information, visit benefits.stanford.edu, and go to Medical and Life > Long-Term Care

36. Enrolling “NOW what?”

37. Benefits Website You have 31 days from your hire date to enroll!

38. Benefits Website • Go to the Benefits website at benefits.stanford.edu • Review benefits information • Enrollment checklist • Benefit Summaries for facultyand staff • Medical and dental plan comparison charts • Summary of Benefits and Coverage (SBC) for each health plan • Logon to MyBENEFITSand click on Planning Tools

39. Benefits Website Click on MyBENEFITS • Choose how you would like to logon: • SUNetID and Password, or • Your University ID number and Personal Identification Number (PIN) • You can also use email and chat • To send email or chat online with a Stanford Benefits representative,log on to MyBENEFITSand click Contact Us • To receive email, addstanford.benefits@acs-inc.comto your email address book so messages get to your inbox

40. What If I Forget to Enroll? “Default” Coverage: • Full-time employee • Blue Shield High-Deductible Health Plan and Delta Dental Basic PPO for yourself only • Basic Life insurance of 1x salary, up to $50,000 • Long-Term Disability • Part-time employee • No medical coverage • No dental coverage for two years • Basic Life insurance of 1x salary, up to $50,000 • Long-Term Disability

41. Getting Services Before You Get Your ID Card Blue Shield • Log on to MyBENEFITS • Print a copy of your enrollment Confirmation Statement • Call Stanford Benefits for help • Tell your physician or pharmacy that you are new to the plan • If pre-payment of services is required, pay and then file a claim afterward Kaiser Permanente: Call Stanford Benefits Stanford HealthCare Alliance: Call Member care Services

42. Changing Your Elections During annual Open Enrollment only, or Qualified Life Event Change • Qualified Life Event Changes are effective on the date of the change • Stanford Benefits requires proof of eligibility • You have 31 days from the date the event occurred to logon and make the change • Examples: • New baby • Marriage/divorce

43. Things to Remember • Enroll by the deadline • Review your enrollment Confirmation Statement (online) for accuracy • Print your Confirmation Statement for your records • Verify your dependents eligibility within 30 days of enrollment or they will receive no coverage

44. Thank you! Benefits.stanford.edu Stanford Benefits