Open Enrollment 2015 Central Ohio Technical College

1. Open Enrollment 2015Central Ohio Technical College 10/27/14 to 11/7/14

2. Agenda • Medical Plans • Prescription Drug Plans • Completing your PHA • Your Plan for Health – Incentive Program • Dental Plan • Vision Plans • Life Insurance Options (if applicable)

3. Open Enrollment 2015 • Open Enrollment Period: • October 27 – November 7 • Make an active plan election • Review other open enrollment options

4. Open Enrollment 2015 • Enroll through Affiliated Group • Enroll in or change your medical, dental, vision plans • Add or drop dependents based on eligibility • Elect or increase Dependent Group Life Insurance coverage, if applicable Return forms to the Office of Human Resources Sherry Abbott (abbott.123@osu.edu)

5. Open Enrollment Processing Deadlines • 11/7/14—Last day to turn in Open Enrollment forms to Human Resources • Employees who sign-up for medical coverage or make changes to their medical coverage will receive new cards by 1/1/15. All others will receive new cards, not necessarily by 1/1/15, but old cards may still be used until new cards are received.

6. Eligible Dependents - Health Plans • Legal spouse • Dependent Children up to age 26 • Adult Dependent Children 26 to 28 • Disabled dependent (over the age of 26) • Same-sex domestic partner* • Includes children of same-sex domestic partner • Sponsored dependent * • Includes opposite-sex domestic partner • Eligibility requirements and affidavits are available online at hr.osu.edu *Affidavit required

7. Dependent Verification Ohio State’s goal is to continue providing affordable, high-quality health care benefits. If you have not previously verified eligibility for enrolled dependents, you will be required to do so in 2015. Here’s what you need to do: • During OE – review eligibility for dependents that you currently cover and make any changes you need to • Before February 1 – gather documentation that you will need to provide during the verification process, which might include, birth or marriage certificates and tax returns

8. Network Plan Features • Network Plans have a Statewide Network • Inside Franklin County: OSU Health Plan Network • Outside Franklin County: Ohio PPO Connect • Provider Directory found at: osuhealthplan.com • Preventive Care • Covered at 100% according to OSU Health Plan guidelinesavailable at: osuhealthplan.com • New medical/prescription cards will be mailed for 2015

9. Common Terms • Deductible • Amount each covered person owes for eligible expenses FIRST before the plan starts to pay • Annual Out-of-Pocket Maximum • Total amount a covered person (or a family) owes in deductibles, coinsurances and copays for the year. Then the plan will pay 100% for the rest of the plan year. Not all services are applied to the annual out-of-pocket max

10. Common Terms • Copayment • A flat dollar amount you owe for covered services. The copay differs by plan and type of service you receive and are not subject to the annual deductible • Coinsurance • A percentage of the contracted provider’s fee schedule or usual, customary and reasonable rate (UCR) that you pay for covered services after the meet the annual deductible • Primary Care Provider (PCP) • Family medicine, general internal medicine, geriatric medicine, pediatrician or nurse practitioner who practices with a PCP

11. Changes at a Glance • Infertility Services • Paid at 50% of UCR after separate $1,000 annual deductible; $15,000 lifetime maximum • Gender Reassignment Surgery • Newly covered service, subject to plan deductible/coinsurance or copay

12. Overview of Medical Plans Participating Plans – PHA Completion Required • Prime Care Advantage • Prime Care Choice • Out-of-Area Plan Non-Participating Plans – No PHA Completion • Basic PPO Plan • Basic Out-of-Area Plan

13. Medical Plans - PHA Completion Required

14. Prime Care Advantage OverviewNetwork Plan

15. Prime Care Choice OverviewNetwork Coverage

16. Prime Care Choice OverviewOut-of-Network Coverage

17. Special Eligibility Requirements • Out-of-Area Plan • Available to individuals who live in select areas without adequate network access

18. Out-of-Area Plan OverviewNo Network Access – PHA Completion

19. Medical Plans - No PHA Completion

20. Basic PPO Plan OverviewNetwork Coverage

21. Basic PPO Plan OverviewOut-of-Network Coverage

22. Basic Out-of-Area Plan OverviewNo Network Access – No PHA Completion

23. Prescription Drug Benefits

24. Prescription Drug StructurePrime Care Advantage, Prime Care Choice, Out-of-Area Prescription Drug Annual Out-of-Pocket Maximum is $2,500 per person/$5,000 family

25. Prescription Drug StructureBasic PPO and Basic Out-of-Area Prescription Drug Annual Out-of-Pocket Maximum is $3,100 per person/$6,200 family

26. Step Therapy Program • New program to manage the rising costs of medications for certain conditions. • (High cholesterol, diabetes, depression, for example) • Program requires if filling a new prescription to first try generic or lower-cost formulary before higher-cost formulary or non-formulary • * If already taking medications identified for Step Therapy, will be able to continue that medication • List of drug categories at: mybenefitsplan.osu.edu

27. Value-Based Design Prescription Drug Plan Care Coordination for chronic conditions Diabetes, Heart disease, Asthma, COPD • Participation may reduce prescription costs • Generic copays waived • Formulary brand-name cost reduced by 50% • Non-formulary not eligible for VBD discount • Basic PPO Plan Participants not eligible for VBD • Effective 1/1/15, no longer required to have maintenance medications filled through home delivery • hr.osu.edu/hrpubs/ben/RxVBDGuide.pdf

28. Your Plan for Health PHA & Incentive Program

29. PHA - Important Deadlines • yp4h.osu.edu • If hired on or before 7/31/14 and enrolled in medical coverage: • PHA completed by 9/30/14 to have plan choice for 2015 • If PHA not completed in 2014, will default to Basic PPO • Hired or Newly benefits after 8/1/14 – 1/5/15 and enrolled in medical coverage: • PHA completion required by March 5, 2015 • If PHA not completed by that date, members will be moved to the Basic PPO plan for remainder of 2015 • To maintain premium credit and plan choice employee needs to complete the PHA annually. • PHA available online until November 30, 2014

30. My Health. My Plan. My Actions. Incentive Program • Get In (level 1): • Complete a biometric screening or get health values from your PCP and take the PHA. Rewards: • Affiliated Group employees enrolled in a medical plan will receive up to a $360 annual premium credit • Additional $120 PHA premium credit in 2015 when your spouse/same-sex domestic partner also completes the PHA—take by November 30

31. My Health. My Plan. My Actions. Incentive Program • Get Going (level 2): • Participate in challenges and track health and wellness activities to accumulate 2,000 points. • Reward: To be determined for 2015 • Get Results (level 3): • Participate in challenges and track health and wellness activities to accumulate 3,000 points. • Rewards: To be determined for 2015 Get Results (level 4): • Participate in challenges and track health and wellness activities to accumulate 4,000 points. • Rewards: Entry in grand prize drawing

32. yp4h - Spouse/Same-Sex Domestic Partners • Eligible to receive one on-campus Biometric Health Screening each calendar year. • After taking the PHA, the spouse/SSDP’s faculty/staff member will receive an additional $120 PHA premium credit. • Can participate in My Health. My Plan. My Actions. Incentive Program to earn Amazon gift cards and entry into the grand prize drawing. • The availability of medical plan choice is not dependent on a spouse/SSDP completing the PHA.

33. Dental and Vision Plans

34. Dental Coverage(No benefit changes) Delta Dental of Ohio • Preventive Care • - Oral exams and bitewing X-rays are covered at 100% (no deductible) • Maximum annual benefit remains at $1,200 per person • Orthodontia • - $1,200 lifetime maximum • - Limited to age 18 or younger

35. Vision PlanVSP Basic Coverage • Change in vision network from Signature to Choice • Eye Exam • - Once per plan year • Frames ($25 copay) • - Once every other plan year up to $155 • Lenses* • - Once per plan year • Contact Lenses* • - Once per plan year up to $130 • *Only one lens benefit per plan year

36. Vision PlanVSP Premier Coverage New Vision Plan Option for 2015!! • Eye Exam • - Once per plan year • Frames ($25 copay) • - Once every plan year up to $200 • Lenses* • - Once per plan year • Contact Lenses* • - Once per plan year up to $200 • *Only one lens benefit per plan year

37. Dependent Group Life Insurance (DGTLI) • You may enroll in or increase current DGTLI coverage • Purchase life insurance for your spouse, same-sex domestic partner and dependent children up to age 26

38. Answers to your questions • Online: Visit hr.osu.edu • By phone: Call Customer Service • (614) 292-1050 or 1-800-678-6010 • TDD (614) 688-3730 • By e-mail: Send an e-mail to service@hr.osu.edu Open Enrollment Questions: Contact Human Resources, Sherry Abbott (abbott.123@osu.edu)