Insurance Plan Updates for 2020: State Health Plan Contributions and Cost Sharing

1. Insurance I 2020 Plan updates

2. State Health Plan contributions and cost sharing

3. State Health Plan monthly employer contributions No increase for 2020.

4. State Health Plan monthly subscriber premiums No increase for 2020.

5. No changes in employee cost sharing for 2020

6. Express Scripts’ Patient Assurance Program • Standard and Savings Plan members pay a $25 copay for a 30-day supply of insulin. • This program is available on a year-to-year basis. • May not be available in subsequent years. • Medicare primary members enrolled in Express Scripts’ Part D plan are not eligible for the program.

7. Adult well visit: covered years • Benefit available to all non-Medicare primary adults age 19 and older. • Eligible network providers. • Plan covers only one visit in covered years, based on the following: • Ages 19-39 once every three years. • Ages 40-49 once every two years. • Ages 50 and older once a year.

8. Adult well visit: covered years • Includes evidence-supported services, based on United States Preventive Services Task Force (USPSTF) A and B recommendations. • Adult well visits are subject to copayments, deductibles and coinsurance in covered years.

9. Adult well visit: non-covered years • If a member chooses to have an adult well visit in a non-covered year: • Member is responsible for 100 percent of the State Health Plan’s negotiated rate for the covered services; and • Member liability will not apply toward the deductible or coinsurance maximum. • Includes evidence-supported services, based on USPSTF A and B recommendations. • Only one adult well visit per year allowed at the negotiated rate in a non-covered year. • Go to peba.sc.gov/wellvisits.html for more information.

10. Telehealth update

11. Blue CareOnDemand • Available 24/7/365. • Nationwide availability ideal for travel and college students. • Non-emergent care services. • Behavioral health services. • Lactation consultations.

12. Blue CareOnDemand • Expanded services include behavioral health counseling and lactation consultations. • $14 copayment plus the remaining allowed amount until deductible is met for non-emergent and behavioral health visits. • Lactation consultations through Blue CareOnDemand are provided at no member cost. • Users can receive care by: • Phone, web, video or mobile technology.

13. BlueCross-credentialed participating telehealth providers • In addition to Blue CareOnDemand. • Some participating State Health Plan providers can now offer telehealth services to members. • Members should ask their provider if they are a BlueCross-credentialed telehealth provider. • Must be in South Carolina to use this service. • Available to State Health Plan primary members only.

14. BlueCross-credentialed participating telehealth providers • $14 copayment plus the remaining allowed amount until deductible is met. • Non-emergent and behavioral health visits.

15. MUSC Health Virtual Care • Available 24/7/365. • User must be located in South Carolina to take advantage of virtual visit. • Non-emergent care services offering.

16. MUSC Health Virtual Care • Available at no cost to member or plan. • Funded through state-appropriated dollars. • Available to all State Health Plan members, including Medicare primary members. • User can receive care either by: • Online questionnaire, phone, video visits using web or mobile technology, or real-time chat using text messaging. • Online questionnaire users can be transitioned to another mode of communication for an appropriate diagnosis and treatment, if needed.

17. Health and wellness resources

18. PEBA Perks • No-Pay Copay. • Mammography. • Diabetes education. • Tobacco cessation. • Breast pump. • Lactation consultation through Blue CareOnDemand. • Preventive screening. • Flu vaccine. • Adult vaccines. • Well-child benefit. • Colorectal cancer screening. • Cervical cancer screening.

19. Blue365 member discounts • Exclusive health and wellness discounts for State Health Plan members: • Apparel and footwear. • Fitness: • Gym memberships and wearable devices. • Hearing aids and Lasik eye surgery. • Pet health insurance, vitamins and supplements. • Weight loss programs and meal kit services. • Personal care: • Skin care, teeth whitening products and eyewear. • Travel club discounts.

20. Additional tools • Naturally Slim. • PEBA HealthHub turnkey toolkits. • Relay text messaging- to register: • Call 844.284.5417 from your mobile phone; or • Text PERKS to 735-29. • Benefits on the go mobile apps. • BlueCross BlueShield of SC - My Health Toolkit. • Health and dental benefits. • Express Scripts - prescription drug benefits. • EyeMed - State Vision Plan benefits. • ASIFlex - Flexible spending accounts.

21. Dental Plan update

22. Dental plan update • BlueCross BlueShield of SC was awarded the new contract beginning January 1, 2020. • Two dental plan options: • Dental Plus; and • Basic Dental. • October 2019 is an open enrollment year for dental. • Change from one dental plan to another. • Enroll yourself or any eligible dependents in dental coverage. • Drop dental coverage for yourself or any dependents. • Changes are effective January 1, 2020.

23. Dental Plus • Pays more. • Higher allowed amounts. • Higher premiums, but less out-of-pocket expenses. • Network providers cannot balance bill. • Out-of-network benefits based on higher allowed amounts so member out-of-pocket costs are minimized.

24. Basic Dental • Pays less. • Lower allowed amounts. • Lower premiums, but more out-of-pocket expenses. • No network: • Providers can charge you for the difference in their cost and the allowed amount.

25. Employer monthly contributions • No change in contributions for Basic Dental for 2020. • $13.48 per month regardless of coverage level

26. Dental Plus employee premiums • Decrease in premiums for 2020. • No benefit changes. ¹2019 and 2020 monthly premiums are the combined Dental Plus and Basic Dental premiums.

27. Basic Dental employee premiums • No change in 2020. • Benefits remain the same.

28. Simplifying the Dental Plus enrollment process for 2019 • Enrollment process is changing; benefits are not. • Members who enroll during 2019 open enrollment: • Will automatically be enrolled in Basic Dental.1 • When using MyBenefits: • Members will see one combined premium for Dental Plus and Basic Dental. • Eliminates the need to add the two premiums. • Members will receive one consolidated Explanation of Benefits (EOB). 1To enroll in Dental Plus, subscribers must also be enrolled in Basic Dental and cover the same family members under both plans. The new process combines the two enrollments into one.

29. Simplifying the Dental Plus enrollment process for 2019 • Employers will not notice a difference on the EBS Console. • For members who elect Dental Plus: • Employers will still see them enrolled in Dental Plus and Basic Dental; and • Will continue to see the employer contribution for Basic Dental. • However, Summary of Coverage will only show Dental Plus.

30. State Vision Plan

31. 2020 update • EyeMed awarded the new contract beginning January 1, 2020. • No benefit changes. • Decrease in employee monthly premiums beginning January 1, 2020.

32. Life insurance changes during open enrollment

33. Optional Life insurance changes during open enrollment • MetLife will offer a limited-time opportunity for employees to apply for or apply to increase their Optional Life coverage up to the plan maximum of $500,000 by answering five health questions on the Supplemental Form. • Employees who answer yes to any of the questions must complete a full Statement of Health form to apply for or apply to increase Optional Life coverage. • Answering no to the five health questions does not automatically approve an employee for coverage. • Employers will receive a custom Supplemental Form from MetLife via email between September 3, 2019, and September 13, 2019. • The Supplemental Form cannot be used after October 31, 2019.

34. Other life insurance changes during open enrollment • Employees who wish to apply for or apply to increase their Dependent Life-Spouse insurance coverage must complete the full Statement of Health form. • Employees who wish to enroll in Dependent Life-Child insurance coverage can do so without answering any health related questions.

35. How to make changes to life insurance during open enrollment • All employees who wish to apply for or apply to increase their Optional Life insurance or Dependent Life-Spouse insurance coverage must complete a Notice of Election (NOE) form and submit it to their benefits administrator by October 31, 2019. • Optional Life insurance changes: Complete the Supplemental Form (or Statement of Health form) and submit it to MetLife by October 31, 2019. • Dependent Life-Spouse insurance changes: Complete the Statement of Healthform and submit it to MetLife by October 31, 2019. • MetLife will email weekly Statement of Health Reports to each employer contact who is currently receiving these reports.

36. Empower your employees with MetLife AdvantagesSM 1 Planning 2 Assisting 3 Supporting Employees must be enrolled in Optional Life insurance to be eligible for the Advantage services.

37. Help employees plan ahead for their families. See MetLife Advantage disclosures at the end of the presentation.

38. Help employees plan ahead for their families. See MetLife Advantage disclosures at the end of the presentation.

39. MetLife Advantage disclosures Will Preparation is offered by Hyatt Legal Plans, Inc., a MetLife company, Cleveland, Ohio. In certain states, legal services benefits are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, Rhode Island. For New York cases, the Will Preparation service is an expanded offering that includes office consultations and telephone advice for certain other legal matters beyond Will Preparation. Tax Planning and preparation of Living Trusts are not covered by the Will Preparation Service. MetLife Estate Resolution Services are offered by Hyatt Legal Plans, Inc., a MetLife company, Cleveland, Ohio. In certain states, legal services benefits are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, Rhode Island. Certain services are not covered by Estate Resolution Services, including matters in which there is a conflict of interest between the executor and any beneficiary or heir and the estate; any disputes with the group policyholder, MetLife and/or any of its affiliates; any disputes involving statutory benefits; will contests or litigation outside probate court; appeals; court costs, filing fees, recording fees, transcripts, witness fees, expenses to a third party, judgments or fines; and frivolous or unethical matters. MetLife Infinity is offered by MetLife Consumer Services, Inc., an affiliate of Metropolitan Life Insurance Company. MetLife Infinity is available to anyone regardless of affiliation with MetLife. Funeral Planning Assistance and Grief Counseling services are provided through an agreement with LifeWorks. US Inc. LifeWorks is not an affiliate of MetLife, and the services LifeWorks provides are separate and apart from the insurance provided by MetLife. LifeWorks has a nationwide network of over 30,000 counselors. Counselors have master’s or doctoral degrees and are licensed professionals. The Grief Counseling program does not provide support for issues such as: domestic issues, parenting issues, or marital/relationship issues (other than a finalized divorce). For such issues, members should inquire with their human resources department about available company resources. This program is available to insureds, their dependents and beneficiaries who have received a serious medical diagnosis or suffered a loss. Events that may result in a loss are not covered under this program unless and until such loss has occurred. Services are not available in all jurisdictions and are subject to regulatory approval. Not available on all policy forms. Subject to state law, and/or group policyholder direction, the Total Control Account (TCA) is provided for all Life and AD&D benefits of $5,000 or more. The TCA is not insured by the Federal Deposit Insurance Corporation or any government agency. The assets backing TCA are maintained in MetLife's general account and are subject to MetLife's creditors. MetLife bears the investment risk of the assets backing the TCA, and expects to earn income sufficient to pay interest to TCA Accountholders and to provide a profit on the operation of the TCAs. MetLife administers the Transition Solutions and Delivering the Promise programs, but has arranged for Massachusetts Mutual Life Insurance Company (MassMutual) to have specially-trained financial professionals offer financial education and, upon request, provide personal guidance to employees and former employees of companies providing these programs through MetLife.