Benefits Overview 2009

1. Benefits Overview 2009

2. Open Enrollment Benefits • Best Choice Plus - no plan changes • VISTA - will no longer be available in 2009 • Basic Dental - no plan changes • Safeguard Dental - no plan changes • STD/LTD – new carrier/The Hartford Company • TCA’s Flexible Spending Accounts – no plan changes • Aetna Select – no plan changes • Aetna Choice – no plan changes • Aetna’s Health Savings Account – deferrals limits updated

3. Best Choice Plus – PPO • Preferred Provider Organization (PPO) • Features both in-network and out-of-network benefits. • The in-network approach allows members to seek care without having to designate a primary care physician. As a result, it is not necessary to obtain a referral before visiting another physician or specialist. • The out-of-network portion of the plan provides the participant with the ability to see any physician or hospital, but at a greater cost. • Out-of-network may be considered in-network due to 911/emergency. • In-network Broward County coverage only.

4. VISTA – HMO • Broward Health will no longer offer VISTA-HMO. • Employees will have the option of transferring to either Best Choice Plus or Aetna. • Please note employees currently enrolled with VISTA will be automatically enrolled in the Best Choice Plus plan, at current coverage levels, if a new health plan application is not submitted by November 14, 2008.

5. Basic Dental – Indemnity Plan • Provides payment for dental treatment on a traditional fee-for-service basis. • This plan will cover 80 percent of the cost of eligible treatment subject to plan allowable. • Where the cost of the dental treatment for the individual has not been fully covered by insurance, the patient makes up the difference. • The dollar amount of coverage provided is subject to a maximum dollar benefit ($1,000). • Indemnity dental insurance plans employ an "open panel" of dentists. • Your Dentist may file the claim OR you may file the claim with TCA. • Nationwide coverage.

6. Safeguard Dental - HMO • Each enrolled family member may choose their own dentist from the SafeGuard directory • There are no waiting periods, calendar year maximums or deductibles and no claim forms. • There are no out-of-network benefits. • If the cost of the dental treatment for the individual is not fully covered by insurance, the patient makes up the difference. Co-pays are required for many procedures such as root canal, crowns, etc. • The network is supported by over 10,700 dentists in California, Florida, and Texas.

7. STD, LTD & Voluntary Life • VOLUNTARY SHORT TERM DISABILITY • This will be an opportunity for eligible employees to purchase short-term disability coverage for up to 60% of basic weekly earnings/disability payments subject to pre-existing condition limitation. This is a Voluntary Program offered by The Hartford Company. Program features include: 29 day elimination period, payments up to 9 weeks and, $1,000.00 maximum weekly benefit (maximum salary limit: $86,000.00). The cost per $100.00 of salary is 72 cents. For an employee earning $25,000.00 per year, the employee’s bi-weekly payroll deduction will be: $6.92. • VOLUNTARY LONG TERM DISABILITY • This will be an opportunity to purchase long term disability coverage subject to pre-existing condition limitation. which provides for up to 60% of basic weekly earnings/disability payments until you are able to return to work. This is a Voluntary Program offered by The Hartford Company. Applicants are not required to provide Evidence of Insurability. The maximum monthly staff benefit is $5,000.00 (physicians and management subject to higher benefit limit). Broward Health will pay 50% of the cost for this insurance plan; however, ½ of the disability payment will be taxed due to Broward Health’s contribution towards this benefit. The cost per $100.00 of salary is $1.02. For an employee earning $25,000.00 per year, the employee’s bi-weekly payroll deduction will be: $4.90. • VOLUNTARY LIFE INSURANCE – WHOLE LIFE • This will be an opportunity for eligible employees to purchase additional life insurance coverage for themselves and/or dependents/domestic partner. Policies are initiated for employees and dependents according to age limitations of the life insurance product and medical insurability. Broward Health provides Term Life Insurance at no cost to employees (1 x annual salary).

8. TCA’s Flexible Spending Accts • Health/Medical Care FSA • You may set aside pre-tax dollars from your paychecks to pay for out-of-pocket health care expenses that will not be paid by insurance or reimbursed from any other source. The money you set aside in the account is available for your expenses and the expenses of anyone you claim as a dependent on your tax return. You can set aside from $5 to $192 per paycheck, up to a maximum of $5,000 a year for eligible expenses including prescription drugs co-pays, many over-the-counter medications and other medical, dental and vision expenses. • Dependent Day Care FSA • You may set aside pre-tax dollars from your paychecks for day care expenses you have for your eligible dependents while you and your spouse work or your spouse goes to school full-time. Your eligible dependents are: 1) Children under age 13 who you claim as dependents on your tax return; or 2) Anyone age 13 or older who lives with you at least eight hours a day and needs supervised care, such as an elderly parent or disabled spouse or dependent. In most cases, you can set aside up to $5,000 annually.

9. Flexible Spending Account Administration • Reimbursement will occur for qualifying expenses incurred during the 2009 plan year. However, you will have until March 31, 2010 to file claims for expenses incurred for the 2009 plan year. If you terminate employment you may choose to continue your health care FSA through COBRA. Any monies remaining in a flexible spending account after the 2009 plan year claim deadline of March 31, 2010 will be forfeited. This "use it or lose it" rule is based upon Internal Revenue Services (IRS) regulations. FSA dollars are not invested and do not earn interest. • If you have any questions about potential tax savings, you should consult your tax advisor before enrolling in either program.

10. Aetna Select - EPO • Exclusive Provider Organization (EPO) • In-network benefits only; except emergency. • Authorizations not required for diagnostic treatment, but it is necessary to obtain a referral before visiting another specialist. • A primary care physician within the EPO handles coordination of care. • Nationwide coverage.

11. Aetna Select Plan Design • In-network inpatient hospital benefits are paid at 100% after a $250 per-confinement co-pay. • ER is covered at 100% after a $25 co-pay. • Outpatient surgery 100% after $50 co-pay. • Outpatient diagnostic (i.e. lab, radiology, etc.) services are paid at 90% of the negotiated fee after the plan deductible has been met. • Must I.D. primary care provider - office visit co-pay is $15.00. • Specialist referrals are required on the plan. • Rx co-pays are $10 generic/$25 brand formulary/$40 brand non-formulary. • Out of state student coverage is available.

12. Aetna Choice - HDHP High Deductible Health Plan On Line Tools Health Savings Account

13. High Deductible Health Plan • A High Deductible Health Plan (HDHP) provides comprehensive coverage for medical events and a tax-advantaged way to help you build savings for future medical expenses. • Also called CDHP – Consumer Driven Health Plan. • The HDHP gives you flexibility and discretion over how you use your health care benefits. • The $1,500 single and the $3,000 family deductible must be met before any medical claims (including RX claims) are paid, except for preventive care. • Preventive care and preventive RXs are not subject to the deductible.

14. Preventive Care • Medical • Routine Physical • Immunizations • Well Child • Gynecological • Mammograms • Colorectal/Prostate • RXs • Hypertension • Diabetes • Cholesterol • Asthma

15. BENEFITS OF A HDHP • Preventive care is covered at 100% with no deductible. • Using in-network providers will save you money. • There is out-of-network coverage too. • Intended to cover serious illness and injury. • Less expensive bi-weekly payroll deductions • Allows employee to have a health savings account to save for future medical claims.

16. HDHP Deductibles • There are higher deductibles and out-of-pocket limits when you use out-of-network providers. • The HDHP has minimum deductibles of: • $1,500 self and $3,000 family for in network coverage • $3,000 self and $6,000 for out-of-network. • Out- of –pocket limits $5,000 self and $10,000 family in network/$10,000 self and $20,000 family out-of-network . • Once family deductible is met all family members will be considered as having met their deductible.

17. AETNA Choice (POS II)Health Fund - HDHP • Nationwide coverage and utilizes the services of over 50 hospitals in the tri-county area. • In most cases, in-network hospital benefits are paid at 80% of allowable and out-of-network benefits are paid at 60% of allowable; after deductible. • Pre-certification is required for hospital admissions; however, specialist referrals and diagnostic authorizations are not required. • The in-network physician office co-insurance is 80% of allowable. Preventive care is paid at 100% and deductible is waived. • In-network RX co-insurance is 80% of allowable; after deductible except for preventive RX.

18. Health Savings Account • A Health Saving Account is used to set aside dollars pre-tax to pay for qualified medical expenses. IRS rules state that in order to open an HSA and make tax deductible contributions, you must be enrolled in a high-deductible health plan. • You can use your HSA funds to pay for eligible medical expenses for anyone you claim as a dependent for tax purposes (typically excludes domestic partners), whether or not they are enrolled in your Medical Plan coverage option.

19. HSA Administration • The money in your HSA belongs to you and you keep it if you change jobs or enroll in another medical plan. • You don't have to worry about "use it or lose it" rules - in fact, the HSA operates with a "use it or keep it" philosophy. This makes it different than a Flexible Spending Account. HSA account balances "carry forward" - letting you save for future healthcare expenses, even retiree healthcare costs. • After you leave Broward Health, and you are no longer covered by a high-deductible medical plan, you cannot continue to contribute to your HSA. However, the HSA is still yours and you can use the money or save it to pay for future qualified medical expenses.

20. HSA Benefits • Voluntary payroll deductions are pre-tax • Tax-deferred interest bearing account or investment options • Tax-free withdrawals for qualified medical expenses. • Unused balance rolls over year to year • Portability; the account is owned by you and is yours to keep - even when you retire, change jobs or health plans • Provides a tax-advantaged way to save for future medical expenses. • Your own HSA contribution is deductible on your income tax return if you make additional post-tax non-payroll deductions on your own.

21. More HSA Benefits • Account entirely owned by Employee. • Employees can choose to pay health care expenses from their account or save dollars for future use. • While employed, the monthly administrative fee your HSA is paid by Broward Health. Employee may incur charges related to ATM withdrawals, checks, etc. • Don’t pay taxes on withdrawals as long as they are used to pay for qualified health care expenses. • Employees should consult with their tax advisor to determine eligibility requirements and tax advantages for participating in the HSA plan.

22. Aetna Choice - HDHP • Enrollment in either the HDHP or the HSA is voluntary. • You can be in a HDHP and not have an HSA. • You can not contribute to a HSA without a HDHP. • You can not have TCA’s Health Care/FSA and contribute to Aetna’s HSA concurrently.

23. How Much May I Contribute to my HSA? • You contribute pre-tax by a payroll deduction. • Payroll contributions you make are prorated over 26 pay periods • You may also make personal (not via payroll deduction) tax-deductible lump sum deposits directly to your HSA at any time during the year, up to the IRS maximum allowable amount • Contributions for single/individuals up to $3,000 and family $5,950. • Individuals age 55 to 64 may make catch up contributions of $1,000 for 2009. • Contribution limit maximums are typically adjusted by the Federal Government/IRS each year. • Medicare eligibles may not contribute to an HSA.

24. Using Your HSA • You may use your HSA towards your medical plan deductible or any coinsurance or copayments. • You may use your HSA for qualified health care expenses as allowed by the IRS. The following list provides some typical examples:

25. Eligibility Requirements • Must be enrolled in a high deductible health plan • Cannot be enrolled in another health plan as secondary unless it’s a high deductible health plan • Flexible Spending Account • You or Spouse may NOT enroll in a HC/Medical Spending Account. • You may be enrolled in a Dependent Care Account. • You can not be claimed as a dependent on someone’s tax return • Can not be covered by VA benefits and have used VA medical services within 3 months. • You cannot be enrolled in Medicare Part A or Part B.

26. How Do I Access My HSA? Each employee will be issued an HSA debit card:

27. HSA Medical Claims Payment Process • Present your ID card when seeking medical care • The provider submits the claim to Aetna. • Aetna processes the claim and issues an explanation of benefits to the member identifying the claim payment. • If there is member payment due the provider will bill the member. • The member may issue payment by utilizing the debit card or HSA checks (optional). • The member may pay out of pocket if there are not sufficient funds in the HSA account or if the member wants to save HSA funds.

28. HSA Prescription Drug Payment Process • Present your ID card when obtaining a prescription. • The pharmacist submits the claim to Aetna and the prescription is available to you. • If there is member payment due you may: • Utilize the debit card or HSA checks (optional) to pay for the prescription. • Pay out of pocket if there are not sufficient funds in the HSA account or if you want to save HSA funds.

29. Claims and Customer Service • Customer Service is available from 8:00 a.m. – 6:00 p.m. EST, Monday through Friday. • Call Customer Service Toll Free at 877-245-1813. • Once enrolled, you may e-mail Customer Service through Navigator, your personal Aetna website. • Your voluntary contribution is made directly to an IRS approved trustee (J P Morgan Chase) administering the HSA. • You may also open a non-Aetna HSA; however you may not use the convenient payroll deduction option.

30. Internal Revenue Service (IRS) • Neither Aetna nor Broward Health monitors your use of your HSA. You are responsible for making sure that your HSA funds are spent on qualified medical expenses, and for paying any applicable taxes and/or penalties if your funds are not spent on qualified medical expenses. • The IRS has the right to audit your use of HSA dollars, so keep receipts for the medical services you pay for, or are reimbursed for, from your HSA. • The IRS has not set a limit on the total amount of money that can be accumulated in an HSA over your life time. • More information at www.treas.gov (click on health savings accounts) • Use of an HSA for non-qualified medical expense is taxable and subject to 10% penalty; until age 65.

31. Tools and Information Aetna Navigator™ • Secure, personal website • Find a doctor, view claims, e-mail customer service • Health information on conditions & alternative options • Quality of participating providers Simple Steps To A Healthier Life® • Interactive Online Health and Wellness Program • Health Risk Assessment Tool • Personalized Action Plan • Wellness counseling Informed Health® • Speak to a registered nurse, 24 x 7 availability • Health and wellness information • Promotes healthy lifestyles and disease prevention • Promotes communication with physicians

32. Enrolling • You must complete your enrollment (including dependent documentation) form and return it to Human Resources by November 14th. • BH Health Application • Required for all health & dental plans. • Payroll Deduction Form for Aetna’s HSA (and enrollment kit.) • Payroll Deduction Form for STD, LTD & Life Ins. • Payroll Deduction for TCA’s FSA.

33. Benefits Open EnrollmentCustomer Service Lines • BEST CHOICE PLUS 954-767-5500 • VISTA 888-679-9148 • AETNA 877-245-1813 • WWW.BrowardHealth.ORG, for Employees, Employee Benefits. • Intranet – HR/Benefits. • Contract your HR Dept if you have additional questions.