State Employee Health Plan

1. State Employee Health Plan Open Enrollment 2011 Welcome to Open Enrollment for Plan Year 2011. We have a lot of information to cover today, so we ask that you hold your questions to the end. We may answer some of them along the way. At the end of the formal presentation, we will open the floor to any questions you may have. If you have a question on a personal claim matter or issue you do not wish to discuss with the group, I and the vendors will be here at the end and will stay and answer your individual questions. Welcome to Open Enrollment for Plan Year 2011. We have a lot of information to cover today, so we ask that you hold your questions to the end. We may answer some of them along the way. At the end of the formal presentation, we will open the floor to any questions you may have. If you have a question on a personal claim matter or issue you do not wish to discuss with the group, I and the vendors will be here at the end and will stay and answer your individual questions.

2. State of the Plan Claim expense continues to outpace revenue Plan reserves are low Bill passed requiring claim audits Audits to recover claims paid in error $9 million removed from health care fund 7/1/10 Health Care Commission voted to: Increase employee and employer rates Agencies will see a 15% increase Employee rates increase up to 8% Plan design changes for Plan A & B Over the last few years, the State Employee Health Plan has been using reserve account funds to supplement the premium revenue of the plan. In other words, we have been spending more than we are take in. We no longer have the reserves available to do this. Our reserve balance has dropped below the amount recommended by the plan actuaries. During the 2010 legislature, the Omnibus funding bill that passed took an additional 9.3 million dollar our of the health care fund. The legislature was given information by a vendor that felt they could recover this amount by doing claim audits of claims paid by the plan in error. The money was taken out of the fund on 7/1/10 in anticipation that an auditor will be able to find this amount of errors in claims paid by the plan. KHPA is in the process of hiring an auditor to comply with this requirement. The Kansas State Employees Health Care Commission reviewed a number of premium funding proposals for Plan Year 2011. The HCC voted to increase member premiums beginning 1/1/11. The actual increase depends on the plan you select and your salary tier. Agency contributions increased 12.5% on 7/1/10 and will increase by 15% on 7/1/2011. Employee rates increased up to 8%. Exact increase depends on the health plan selected, salary tier and coverage level. Over the last few years, the State Employee Health Plan has been using reserve account funds to supplement the premium revenue of the plan. In other words, we have been spending more than we are take in. We no longer have the reserves available to do this. Our reserve balance has dropped below the amount recommended by the plan actuaries. During the 2010 legislature, the Omnibus funding bill that passed took an additional 9.3 million dollar our of the health care fund. The legislature was given information by a vendor that felt they could recover this amount by doing claim audits of claims paid by the plan in error. The money was taken out of the fund on 7/1/10 in anticipation that an auditor will be able to find this amount of errors in claims paid by the plan. KHPA is in the process of hiring an auditor to comply with this requirement. The Kansas State Employees Health Care Commission reviewed a number of premium funding proposals for Plan Year 2011. The HCC voted to increase member premiums beginning 1/1/11. The actual increase depends on the plan you select and your salary tier. Agency contributions increased 12.5% on 7/1/10 and will increase by 15% on 7/1/2011. Employee rates increased up to 8%. Exact increase depends on the health plan selected, salary tier and coverage level.

3. Medical Plan Changes for 2011 Plan A Network Deductible $300/$600 Network Coinsurance maximum $1,400/$2,800 Office visit Copays Primary Care Provider $25 Specialist $45 Plan B Network Deductible $150/$300 Network Coinsurance 35% Network Coinsurance maximum $3000/$6000 No changes for Plan C For Plan Year 2011, there are changes to Plans A and B. Medical Plans Plan A The Network Deductible will each increase $150 for single and $300 for family. The Network Coinsurance will increase $200 for single and $400 for family. The office visit copay will increase $5. Plan B Network claims will now be subject to a deductible. The Network Coinsurance will increase 5% to 35%. The Network Coinsurance maximum will increase to $3000 for single and $6,000 for a family. There are no plan changes for Plan C. For Plan Year 2011, there are changes to Plans A and B. Medical Plans Plan A The Network Deductible will each increase $150 for single and $300 for family. The Network Coinsurance will increase $200 for single and $400 for family. The office visit copay will increase $5. Plan B Network claims will now be subject to a deductible. The Network Coinsurance will increase 5% to 35%. The Network Coinsurance maximum will increase to $3000 for single and $6,000 for a family. There are no plan changes for Plan C.

4. Senate Subs. For House Bill 2160 Requires a one-year pilot to provide coverage for: Autism spectrum disorder Birth to 7 years - not to exceed $36,000 Age 7 to 19 - not to exceed $27,000 Covered services subject to applicable deductible, coinsurance and copays Services must be medically necessary Report due to the legislature March 2012 Oral cancer medications Requires coverage of oral drugs in the same manner as IV cancer medications. Legislative Changes The has been a great deal of Legislative and Congressional action that will affect the health plan this year and for several years to come. First here in Kansas, Senate Substitute for House Bill 2160 was passed. This bill requires the SEHP to pilot coverage of autism spectrum disorder for one year and report back to the legislature on the pilot. The second part of this bill requires the SEHP to cover oral cancer medications in the same manner as IV or injectable cancer medications. The pilot project is limited to medically necessary services for the evaluation and treatment of autism up to a dollar cap. For children under age 7 the plan benefit can not exceed $36,000 a year. For children ages 7-19, the benefit is limited to $27,000 per year. Separate riders have been added to the medical and drug plan to provides oral cancer meds and IV and injectable meds in the same manner. The has been a great deal of Legislative and Congressional action that will affect the health plan this year and for several years to come. First here in Kansas, Senate Substitute for House Bill 2160 was passed. This bill requires the SEHP to pilot coverage of autism spectrum disorder for one year and report back to the legislature on the pilot. The second part of this bill requires the SEHP to cover oral cancer medications in the same manner as IV or injectable cancer medications. The pilot project is limited to medically necessary services for the evaluation and treatment of autism up to a dollar cap. For children under age 7 the plan benefit can not exceed $36,000 a year. For children ages 7-19, the benefit is limited to $27,000 per year. Separate riders have been added to the medical and drug plan to provides oral cancer meds and IV and injectable meds in the same manner.

5. Patient Protection & Affordable Care Act Signed into law on March 23, 2010 Incorporates modifications of the Health Care and Education Reconciliation Act of 2010 Signed into law on March 30, 2010 Jointly referred to as Health Reform Complex law Implementation is in phases The President signed into law on March 23, 2010 the Patient Protection and Affordable Care Act. This bill along with the Health Care and Education Reconciliation Act of 2010 are jointly referred to as Health Reform. The health reform requirements will be implemented in phases over the next few years. The plan designs presented today are based upon the information available about the requirements that are taking effect in 2010 and 2011. A good faith effort has been made to comply with all the provisions that apply to the State of Kansas. Should additional information be presented later that requires the plan benefits to be modified, we will notify the HR community and post those changes on our website. The President signed into law on March 23, 2010 the Patient Protection and Affordable Care Act. This bill along with the Health Care and Education Reconciliation Act of 2010 are jointly referred to as Health Reform. The health reform requirements will be implemented in phases over the next few years. The plan designs presented today are based upon the information available about the requirements that are taking effect in 2010 and 2011. A good faith effort has been made to comply with all the provisions that apply to the State of Kansas. Should additional information be presented later that requires the plan benefits to be modified, we will notify the HR community and post those changes on our website.

6. Key Provisions for 2010 Mandates coverage for children to age 26 No school or support requirements Can be married � (no coverage for spouses) Requirement effective for SEHP on 1/1/11 Enroll your dependents during Open Enrollment Prohibits lifetime maximums on �essential services� for medical plans If you have children who are under the age of 26 even if they are married, you may add them to your health plan coverage during this open enrollment. We will talk more about this later in today�s presentation. The new law prohibits lifetime maximums on certain services considered essential. If you have children who are under the age of 26 even if they are married, you may add them to your health plan coverage during this open enrollment. We will talk more about this later in today�s presentation. The new law prohibits lifetime maximums on certain services considered essential.

7. Key Provisions for 2010 Authorizes the FDA to approve generic versions of biologic drugs 12-year exclusivity period on biologic drugs Provides temporary reinsurance program for early non Medicare retirees (age 55-65) Limited to $5 billion dollars Reimburses the health plan for amount spent on high cost claims of early retirees Temporary expires in 2014 SEHP has applied for the program Requires coverage without cost sharing for preventive services The Food and Drug Administration has been struggling with biologic drugs and how long a manufacturer should have an exclusive to produce those before others can start making generic copies. This bill provides the frame work for generic biologic drugs to begin. Provides for plans that cover retirees prior to Medicare eligibility to obtain some assistance on paying for high cost claims. The SEHP has applied for this reinsurance and can use the money to reduce premiums or enhance benefits for this class of individuals if we receive any payments. The total fund is limited to 5 billion dollars and experts predict the money will run out long before the program expires in 2014. Preventive care services must be provided at no cost to the member. The services included do expand the services available under the plan some what. Many of the required items are things that you should be discussing with your provider at your annual well person exam. The Food and Drug Administration has been struggling with biologic drugs and how long a manufacturer should have an exclusive to produce those before others can start making generic copies. This bill provides the frame work for generic biologic drugs to begin. Provides for plans that cover retirees prior to Medicare eligibility to obtain some assistance on paying for high cost claims. The SEHP has applied for this reinsurance and can use the money to reduce premiums or enhance benefits for this class of individuals if we receive any payments. The total fund is limited to 5 billion dollars and experts predict the money will run out long before the program expires in 2014. Preventive care services must be provided at no cost to the member. The services included do expand the services available under the plan some what. Many of the required items are things that you should be discussing with your provider at your annual well person exam.

8. Covered Preventive Care Preventive care services are limited to one per person per year unless otherwise noted. A change in the preventive care under health reform has to do with office visits. We will cover one office visit for a well person check (except for babies) each year. The provider will need to code this as a preventive visit for this to be covered at 100%. Visits where a covered preventive service is provided but the main reason for the visit is treatment or consultation on a illness, injury or disease will be subject to an office visit copay. Make sure your doctor is aware that the primary reason for the visit is your well person check so that the office visit copay is not applied. This will be true not just of the SEHP but all insurance going forward will have this same requirement. Visits for the primary diagnosis of an injury, illness or disease, will be subject to the office visit copay requirement. Preventive care services are limited to one per person per year unless otherwise noted. A change in the preventive care under health reform has to do with office visits. We will cover one office visit for a well person check (except for babies) each year. The provider will need to code this as a preventive visit for this to be covered at 100%. Visits where a covered preventive service is provided but the main reason for the visit is treatment or consultation on a illness, injury or disease will be subject to an office visit copay. Make sure your doctor is aware that the primary reason for the visit is your well person check so that the office visit copay is not applied. This will be true not just of the SEHP but all insurance going forward will have this same requirement. Visits for the primary diagnosis of an injury, illness or disease, will be subject to the office visit copay requirement.

9. Key Provisions for 2011 Excludes over the counter (OTC) products without a prescription as eligible expenses: Health Care Flexible Spending Account (FSA) Plan C - Health Savings Account (HSA) Increases the taxes on HSA funds not used for medical purposes Employers required to disclose value of health benefits on W-2 form Beginning January 1, 2011 OTC drugs are only eligible under a health care flexible spending account or for Plan C members a health savings account. If you want to continue to receive these items, you will need a prescription from your provider after 1/1/11. The amount of taxes you will owe for use of your Plan C HSA fund for non medical purchases will increase. The value of your health benefit is now required to be shown on your W-2 form. This amount is not taxed at this time but must be listed on the form to show you how much your employer benefit is worth. Beginning January 1, 2011 OTC drugs are only eligible under a health care flexible spending account or for Plan C members a health savings account. If you want to continue to receive these items, you will need a prescription from your provider after 1/1/11. The amount of taxes you will owe for use of your Plan C HSA fund for non medical purchases will increase. The value of your health benefit is now required to be shown on your W-2 form. This amount is not taxed at this time but must be listed on the form to show you how much your employer benefit is worth.

10. 2011 SEHP Medical Plans Standardized Plan designs: All plans include preventive care All plans are Preferred Provider Organizations (PPO) Claims paid based on the network status Network providers accept the plan allowance as payment in full Non Network Providers can balance bill The SEHP provides a comprehensive health plan package but not all services are covered. You are encourage to review the plan documents that are available on the SEHP website. A copy will be sent to you in January for the plan you have elected. If you have questions, please contact the plan customer service representatives at the phone numbers listed in the front of your open enrollment booklet. The medical plans are standardized. All Plan A policies cover the same services. All Plan B are the same and all Plan C are the same. There are difference between them. Each plan has a rate that is based on the costs, discounts and claim experience of the plan so the rates vary between vendors. All of our medicals plans offer other services like websites with discounts, education tools and health promotions. Be sure to check out what they offer. Each of our medical plans are preferred provider organizations and use a different network of providers. To get the best benefits you must use a network provider.. You can review their networks on our website or you can contact the plan�s customer service at the phone number in the front of your Open Enrollment book or on the back of your ID card. The SEHP provides a comprehensive health plan package but not all services are covered. You are encourage to review the plan documents that are available on the SEHP website. A copy will be sent to you in January for the plan you have elected. If you have questions, please contact the plan customer service representatives at the phone numbers listed in the front of your open enrollment booklet. The medical plans are standardized. All Plan A policies cover the same services. All Plan B are the same and all Plan C are the same. There are difference between them. Each plan has a rate that is based on the costs, discounts and claim experience of the plan so the rates vary between vendors. All of our medicals plans offer other services like websites with discounts, education tools and health promotions. Be sure to check out what they offer. Each of our medical plans are preferred provider organizations and use a different network of providers. To get the best benefits you must use a network provider.. You can review their networks on our website or you can contact the plan�s customer service at the phone number in the front of your Open Enrollment book or on the back of your ID card.

11. Vendor Options The vendors and plan options remain the same for 2011.The vendors and plan options remain the same for 2011.

12. This slide provides a quick summary of the differences between Plans A, B and C when you use a network provider. A more complete comparison can be found in the Health Plan Comparison Chart in your open enrollment booklet. Using a non network provider will result in higher out of pocket costs for you than those shown here. As you can see each of the health plans offered has different amounts of out of pocket cost as well as different rates that you pay. You have to decide how much insurance does my family need and how much can I afford to pay in bi weekly contributions from my paycheck. Members who have little or no expenses may be willing to have a higher out of pocket and pay less for the cost of the coverage vs. those who have greater needs. The decision about which plan works best is one that only you can make and depends on your circumstances. We will take a close look at each of the plans. This slide provides a quick summary of the differences between Plans A, B and C when you use a network provider. A more complete comparison can be found in the Health Plan Comparison Chart in your open enrollment booklet. Using a non network provider will result in higher out of pocket costs for you than those shown here. As you can see each of the health plans offered has different amounts of out of pocket cost as well as different rates that you pay. You have to decide how much insurance does my family need and how much can I afford to pay in bi weekly contributions from my paycheck. Members who have little or no expenses may be willing to have a higher out of pocket and pay less for the cost of the coverage vs. those who have greater needs. The decision about which plan works best is one that only you can make and depends on your circumstances. We will take a close look at each of the plans.

13. Selecting a Medical Plan Pick a plan design (Plan A, B or C) Which plan design provides the coverage you and your family need? Review the Provider Networks Each of the medical plans uses a different provider network Not all providers are in the network Review the other services each medical plan offers Websites, discount programs, etc. 4. Review the premiums Review the open enrollment book for more information about plan design options. Which plan offers the coverage that you and your family need? Once you pick a plan design, you need to review the provider networks of the vendors to determine which ones have the doctors and hospital that you use. Consider the other services provided by each of the plans, and finally review the premiums to decide which plan provides the coverage you need and the cost of that coverage. Now that you have narrowed down your options, review the premiums on the comparison chart in your open enrollment booklet. Review the open enrollment book for more information about plan design options. Which plan offers the coverage that you and your family need? Once you pick a plan design, you need to review the provider networks of the vendors to determine which ones have the doctors and hospital that you use. Consider the other services provided by each of the plans, and finally review the premiums to decide which plan provides the coverage you need and the cost of that coverage. Now that you have narrowed down your options, review the premiums on the comparison chart in your open enrollment booklet.

14. Plan A � Network Providers Preventive Care Covered at 100% Office Visit Copays $25 for Primary Care Office Visits $45 for Specialist Office Visits $300/$600 Deductible 20% Coinsurance Coinsurance Max $1,400/$2,800 Quest Lab Card Benefit Preventive Care Services are covered in full by the plan. Office visits with a Primary Care Provider will be subject to a $25 Copay. All other providers will be considered Specialists and will be subject to a $45 Copay. The deductible applies to services other preventive care or office visits. The deductible applies once per year and is $300 per person a maximum of $600 for the family After you have paid the deductible , you and the plan share in the cost of your care and this is called coinsurance. The plan pays 80 percent and you pay 20 percent of your covered health care expenses. You will pay your share of coinsurance until you reach the coinsurance maximum of $1,400 per person and a maximum of $2,800 applies to a family. After the coinsurance maximum is met, the plan pays covered services at 100 percent for the remainder of the calendar year. Plan A includes the Quest LabCard benefit. Preventive Care Services are covered in full by the plan. Office visits with a Primary Care Provider will be subject to a $25 Copay. All other providers will be considered Specialists and will be subject to a $45 Copay. The deductible applies to services other preventive care or office visits. The deductible applies once per year and is $300 per person a maximum of $600 for the family After you have paid the deductible , you and the plan share in the cost of your care and this is called coinsurance. The plan pays 80 percent and you pay 20 percent of your covered health care expenses. You will pay your share of coinsurance until you reach the coinsurance maximum of $1,400 per person and a maximum of $2,800 applies to a family. After the coinsurance maximum is met, the plan pays covered services at 100 percent for the remainder of the calendar year. Plan A includes the Quest LabCard benefit.

15. Plan B � Network Providers Preventive Care Covered at 100% Primary Care Office Visits $20 Adult Copay $10 Children age 18 and under Copay Specialist Office Visits $40 Adult Copay $25 Children age 18 and under Copay $150/$300 Deductible 35% Coinsurance Coinsurance maximum $3,000/$6,000 Quest Lab Card benefit Preventive care is covered at 100%. Office visits for adults are covered at $20 for primary care and $40 for specialist. For dependent children age 18 under, the office visit Copay has been reduced to $10 for Primary Care providers and $25 for Specialists. A deductible for $150 for single and $300 per family has been added to Plan B. Services other than preventive care and office visits are subject to coinsurance. The plan pays 65 percent and you pay 35 percent of eligible services until your share reaches the coinsurance maximum of $3,000 per person or $6,000 for a family. After the coinsurance maximum is met, the plan pays at 100 percent for the remainder of the calendar year. Plan B includes the Quest LabCard benefit. Preventive care is covered at 100%. Office visits for adults are covered at $20 for primary care and $40 for specialist. For dependent children age 18 under, the office visit Copay has been reduced to $10 for Primary Care providers and $25 for Specialists. A deductible for $150 for single and $300 per family has been added to Plan B. Services other than preventive care and office visits are subject to coinsurance. The plan pays 65 percent and you pay 35 percent of eligible services until your share reaches the coinsurance maximum of $3,000 per person or $6,000 for a family. After the coinsurance maximum is met, the plan pays at 100 percent for the remainder of the calendar year. Plan B includes the Quest LabCard benefit.

16. Plans A & B Non Network Providers $500/$1,500 Deductible 50% Coinsurance Coinsurance Max $3,650/$7,300 Preventive care not covered If you choose to use a Non Network provider, you will be responsible for the first $500 of covered services as a deductible. A maximum of three deductibles will apply for a family. After the Deductible has been satisfied, you will be responsible for 50% Coinsurance until you reach the Coinsurance Maximums of $3,650 for single for $7,300 for a family. You are also responsible for any excess charges since the provider has not agreed to accept the health plan�s allowed charge. If you choose to use a Non Network provider, you will be responsible for the first $500 of covered services as a deductible. A maximum of three deductibles will apply for a family. After the Deductible has been satisfied, you will be responsible for 50% Coinsurance until you reach the Coinsurance Maximums of $3,650 for single for $7,300 for a family. You are also responsible for any excess charges since the provider has not agreed to accept the health plan�s allowed charge.

17. Quest Lab Card Optional Lab Card Program Benefits: 100% coverage of eligible outpatient lab tests Saves you and the plan money For non-emergency outpatient lab work only Testing must be performed and billed by Quest You will need to request to use Quest Or Visit a Quest collection site The decision is up to you and your provider You have a Quest ID card Your medical card ID also works Any provider may use the Quest lab service by calling Quest to pick up the sample. You and your provider will decide whether or not to do so. When you have covered outpatient lab work performed and billed by Quest, the plan pays 100 percent of the cost of the services. The plan can pay the additional amounts due to the negotiated discounts with Quest. Outside of the covered preventive care services, lab work not performed and billed by Quest is covered but subject to the plan deductible and coinsurance. Your id number is on both your Quest and medical cards. Either will work. Any provider may use the Quest lab service by calling Quest to pick up the sample. You and your provider will decide whether or not to do so. When you have covered outpatient lab work performed and billed by Quest, the plan pays 100 percent of the cost of the services. The plan can pay the additional amounts due to the negotiated discounts with Quest. Outside of the covered preventive care services, lab work not performed and billed by Quest is covered but subject to the plan deductible and coinsurance. Your id number is on both your Quest and medical cards. Either will work.

18. Quest Lab Card Savings Current Lab Fees Billed $194.83 Allowed: $155.86 Coinsurance 80% Plan pays $124.69 Member pays $31.17 Lab Card Fees Total Charges $35.33 Allowed: $35.33 Coinsurance 100% Plan pays $35.33 Member pays $0 Using the Quest Lab Card benefit saves you money. In this example a member goes and gets some common lab procedures done. Under Plan A, the plan allows $155.86 of the $194.83 billed. We assume here that you have already meet your deductible so the plan pays 80 percent or $124.69 and you pay $ 31.17. If Quest is used for these same services, the plan is billed $35.33 for these same services and pays this amount in full and you have no out of pocket cost for the service. If your doctor draws the sample in their office, they may charge a fee for drawing the sample. This is covered under your health subject to your deductible and coinsurance. Your share of the fee will still be substantially less than your coinsurance for using another lab provider. Using the Quest Lab Card benefit saves you money. In this example a member goes and gets some common lab procedures done. Under Plan A, the plan allows $155.86 of the $194.83 billed. We assume here that you have already meet your deductible so the plan pays 80 percent or $124.69 and you pay $ 31.17. If Quest is used for these same services, the plan is billed $35.33 for these same services and pays this amount in full and you have no out of pocket cost for the service. If your doctor draws the sample in their office, they may charge a fee for drawing the sample. This is covered under your health subject to your deductible and coinsurance. Your share of the fee will still be substantially less than your coinsurance for using another lab provider.

19. My doctor�s office said I had to use Quest for lab services or I would have no lab coverage. False. Quest is an optional program. You are not required to use it and you do have coverage at other labs. My provider said that I had to transport my pap smear specimen to a Quest site to have coverage. False. Preventive care services such as a pap smears are covered at 100% when provided by a network provider. Quest is one of the network providers. True or False We have encountered some difficulty this year and want to go over some key points about the Quest program. We had members who were told that if they didn�t use Quest they had no lab coverage and we asked to sign paperwork saying they would be responsible for the charges. Is this statement about the coverage true or false? False � you can use other labs and have coverage. Your coverage is the same as it has always been, subject to the deductible and coinsurance. 2. We had members told that it was their responsibility to transport samples like pap smears to a Quest site in order for the lab work to be covered. Is this statement about the coverage true or false? False - The SEHP never intended for members to be required to transport specimens. For this specific example the test is considered a preventive care services and is covered at 100% as long as a network provider is used. Other non-preventive lab work is covered subject to the plan deductible and coinsurance. We have encountered some difficulty this year and want to go over some key points about the Quest program. We had members who were told that if they didn�t use Quest they had no lab coverage and we asked to sign paperwork saying they would be responsible for the charges. Is this statement about the coverage true or false? False � you can use other labs and have coverage. Your coverage is the same as it has always been, subject to the deductible and coinsurance. 2. We had members told that it was their responsibility to transport samples like pap smears to a Quest site in order for the lab work to be covered. Is this statement about the coverage true or false? False - The SEHP never intended for members to be required to transport specimens. For this specific example the test is considered a preventive care services and is covered at 100% as long as a network provider is used. Other non-preventive lab work is covered subject to the plan deductible and coinsurance.

20. Plan A & B Drug Benefit Generic Drugs 20% Coinsurance Preferred Brand 35% Coinsurance Special Case Medications $75 per 30-day Supply Non Preferred Brand 60% Coinsurance Discount Tier 100% Member Responsibility Generic drugs are your �Best Buys.� In addition to a lower coinsurance than brand name products, they also cost less. Generic drugs are safe, effective and FDA-approved. Preferred Brand name drugs are listed on the Preferred drug list and have a 35% coinsurance. You can review the PDL on the KHPA website. or on Caremark.com Special case medications are high cost medications where the cost of 30 day supply exceeds $500. Your responsibility for a 30 day supply is capped at $75. Non Preferred brand name drugs are those products not listed on Preferred Drug List. You coinsurance for these products is 60%. Selecting a Non Preferred product will cost you more out of your pocket. The Discount tier (formerly Lifestyle) includes prescription items which are not covered by the plan but for which you can receive a discount on the purchase by using your Caremark card. A complete list is available on our website. Remember to: Review the Preferred Drug List (PDL) available on website and is updated quarterly Print out the PDL and take it with you and talk to your doctor about your prescription options. Use Generics drugs when possible. They will save you money. More information: www2.caremark.com/kse Generic drugs are your �Best Buys.� In addition to a lower coinsurance than brand name products, they also cost less. Generic drugs are safe, effective and FDA-approved. Preferred Brand name drugs are listed on the Preferred drug list and have a 35% coinsurance. You can review the PDL on the KHPA website. or on Caremark.com Special case medications are high cost medications where the cost of 30 day supply exceeds $500. Your responsibility for a 30 day supply is capped at $75. Non Preferred brand name drugs are those products not listed on Preferred Drug List. You coinsurance for these products is 60%. Selecting a Non Preferred product will cost you more out of your pocket. The Discount tier (formerly Lifestyle) includes prescription items which are not covered by the plan but for which you can receive a discount on the purchase by using your Caremark card. A complete list is available on our website. Remember to: Review the Preferred Drug List (PDL) available on website and is updated quarterly Print out the PDL and take it with you and talk to your doctor about your prescription options. Use Generics drugs when possible. They will save you money. More information: www2.caremark.com/kse

21. 2010 Flomax Cardizem La Skelaxin Cozaar Hyzaar Yaz Arimidex Effexor XR Amerge nn Generic Launches Each year we like to give you a preview of the drugs that have recently gone generic and those for which a generic launch is anticipated in 2011. The complete list is available on our website. Talk with your doctor and pharmacist about making the switch as soon as the generic becomes available. Each year we like to give you a preview of the drugs that have recently gone generic and those for which a generic launch is anticipated in 2011. The complete list is available on our website. Talk with your doctor and pharmacist about making the switch as soon as the generic becomes available.

22. Plan C � QHDHP w/ HSA Network Provider Coverage $1,500/$3,000 Deductible 20% Coinsurance $3,000/$6,000 Out-of-Pocket Maximum Preventive Care Services paid at 100% Non Network Provider Coverage $2,000/$4,000 Deductible 50% Coinsurance $3,650/$7,300 Out-of-Pocket Maximum Preventive Care is not covered The qualified high deductible health plan (QHDHP) is the final plan design option and includes a health savings account (HSA). If you select single coverage you will be responsible for paying the deductible which means the first $1,500 of covered expenses or the first $3,000 if family coverage is selected will be your responsibility to pay. You may use funds from you HSA account for this purpose. Then claims are paid by the plan at 80%, and you pay 20% until your total out-of-pocket limit of $3,000 if you have single coverage or $6,000 if you have family coverage. After that, eligible claims are paid at 100% for the remainder of the calendar year when you use network providers. Preventive care services are not subject to the Deductible and are paid at 100% when received from a Network Provider. If you use the services of a Non Network provider, you will have a Deductible of $2,000 for single and $4,000 for family. Once the Deductible has been satisfied you will share in the cost of services by paying 50% Coinsurance until your Coinsurance and Deductible reach the out-of-pocket maximum of $3,650 single and $7,300 for a family. After that, eligible claims are paid at 100% of the allowed charge for the remainder of the calendar year. The qualified high deductible health plan (QHDHP) is the final plan design option and includes a health savings account (HSA). If you select single coverage you will be responsible for paying the deductible which means the first $1,500 of covered expenses or the first $3,000 if family coverage is selected will be your responsibility to pay. You may use funds from you HSA account for this purpose. Then claims are paid by the plan at 80%, and you pay 20% until your total out-of-pocket limit of $3,000 if you have single coverage or $6,000 if you have family coverage. After that, eligible claims are paid at 100% for the remainder of the calendar year when you use network providers. Preventive care services are not subject to the Deductible and are paid at 100% when received from a Network Provider. If you use the services of a Non Network provider, you will have a Deductible of $2,000 for single and $4,000 for family. Once the Deductible has been satisfied you will share in the cost of services by paying 50% Coinsurance until your Coinsurance and Deductible reach the out-of-pocket maximum of $3,650 single and $7,300 for a family. After that, eligible claims are paid at 100% of the allowed charge for the remainder of the calendar year.

23. Plan C � QHDHP Drug Plan Drugs are subject to the Deductible then: Generic $10 Copayment Preferred Brand $30 Copayment Non Preferred Brand $55 Copayment Copayment is per 31-day supply Generic Incentive Provision Uses Caremark Preferred Drug List Not �creditable� drug coverage for Medicare Plan C has its own drug plan. Drugs are subject to the overall plan Deductible and then paid at the copayment levels listed above. This plan includes a generic incentive provision. That means if a drug is available as a generic and you elect to take the brand name drug instead, you will be responsible for the Copay and the difference in cost between the generic and the brand name drug. The Preferred Drug List is the same as the one used for Plans A and B. It is available on the KHPA website. For our more mature members, we want you to be aware that Medicare does not consider this drug benefit to be creditable coverage. For members who will be reaching Medicare age, this means that this is not considered a qualified plan under Medicare Part D. Since you are not allowed to carry this plan once you are eligible for Medicare, this may or may not present an issue for you. Plan C has its own drug plan. Drugs are subject to the overall plan Deductible and then paid at the copayment levels listed above. This plan includes a generic incentive provision. That means if a drug is available as a generic and you elect to take the brand name drug instead, you will be responsible for the Copay and the difference in cost between the generic and the brand name drug. The Preferred Drug List is the same as the one used for Plans A and B. It is available on the KHPA website. For our more mature members, we want you to be aware that Medicare does not consider this drug benefit to be creditable coverage. For members who will be reaching Medicare age, this means that this is not considered a qualified plan under Medicare Part D. Since you are not allowed to carry this plan once you are eligible for Medicare, this may or may not present an issue for you.

24. Dental Coverage Plan pays in full for two cleanings and oral exams each year for each member Plan Deductible Applies to Basic & Major Restorative Care $50 per person, maximum of 3 per family Orthodontic benefit $1,000 per person per lifetime Annual benefit maximum $1,700 per person per year You have access to two dental PPO provider networks: Delta Dental PPO is the smaller network of dentists who offer the larger discounts and Delta Dental Premier is the larger network. The dental Deductible applies to both basic and major restorative services and a maximum of $150 will apply to a family membership Orthodontic coverage is available and is limited to $1,000 per person per lifetime. The annual maximum benefit paid per person per year is $1,700. You have access to two dental PPO provider networks: Delta Dental PPO is the smaller network of dentists who offer the larger discounts and Delta Dental Premier is the larger network. The dental Deductible applies to both basic and major restorative services and a maximum of $150 will apply to a family membership Orthodontic coverage is available and is limited to $1,000 per person per lifetime. The annual maximum benefit paid per person per year is $1,700.

25. If you have NOT had a preventive exam or office visit for exam or cleaning of the teeth in the preceding 12-month period: Basic Benefit If you have NOT had a preventive exam or office visit for exam or cleaning of the teeth in the preceding 12 month period any basic restorative services the member requires will be paid at the basic benefit level. Preventive care is always paid at 100%. Ninety (90) days after a preventive exam or office visit for exam or cleaning of the teeth, the member will move to the enhanced benefit level. If you have NOT had a preventive exam or office visit for exam or cleaning of the teeth in the preceding 12 month period any basic restorative services the member requires will be paid at the basic benefit level. Preventive care is always paid at 100%. Ninety (90) days after a preventive exam or office visit for exam or cleaning of the teeth, the member will move to the enhanced benefit level.

26. If you have had at least one preventive or office visit for cleaning or exam of the teeth in the preceding 12-month period: Enhanced Benefits Members who have at least one cleaning or office visit for exam of cleaning will be eligible for the enhanced benefit level. The member cost for basic restorative services will only be 20% of the allowed charge. Members who have at least one cleaning or office visit for exam of cleaning will be eligible for the enhanced benefit level. The member cost for basic restorative services will only be 20% of the allowed charge.

27. Basic Plan Eye exams subject to $50 Copay $25 Materials Copay then: 100% single-vision, standard bifocal, trifocal lenticular lenses Up to $100 allowance for frames Elective Contact lens allowance $150 Enhanced Vision Plan includes Basic PLUS� Progressive lenses up to $165 High index lenses or Poly-carbonate lenses up to $116 Scratch and UV coating Contact Lens Fitting Fee - subject to $35 Copay Vision Plan Vision is an optional program. You may enroll in vision even if you don�t elect medical coverage. You may elect a different coverage level than your medical plan as well. There is no change to the Basic Vision Plan. This vision plan is designed to pay for basic eyeglasses and contact lenses. Remember that eye exams are paid at 100% under the medical plan when you use a network provider. Use your medical benefit for your eye exam and your vision insurance for hardware, lenses/frames or contact lenses The Enhanced benefit covers every that basic does plus the addition lens options. Enhanced benefits not available from Non Network Providers Vision is an optional program. You may enroll in vision even if you don�t elect medical coverage. You may elect a different coverage level than your medical plan as well. There is no change to the Basic Vision Plan. This vision plan is designed to pay for basic eyeglasses and contact lenses. Remember that eye exams are paid at 100% under the medical plan when you use a network provider. Use your medical benefit for your eye exam and your vision insurance for hardware, lenses/frames or contact lenses The Enhanced benefit covers every that basic does plus the addition lens options. Enhanced benefits not available from Non Network Providers

28. Flexible Spending Accounts Health Care Flexible Spending Account Deductibles, Copays & Coinsurance Eyeglasses, contacts, orthodontics & hearing aids Optional Debit Card for health care FSA Dependent Care Flexible Spending Account Day care services & Pre-school or Babysitters Pre-tax contributions Up to $5,000 per account per year Extended grace period for Health Care FSA Details on eligible expenses available at: Flexible Spending Accounts are a way for Plan A and B members to set aside up to $5,000 to pay for health care and dependent care. Contributions to these accounts are made on a pre-tax basis, which means no taxes are withheld on the money you put into the accounts. The Health Care Flexible Spending Account funds may be used to pay for you, your spouse, or your dependent children�s expenses regardless of whether or not they are insured by the State Employee Health Plan. Money you set aside must be spent for covered services. You do have a grace period after the end of the plan year to spend your Health Care FSA funds, but it is limited to the following March 15. For example, money you put into the Health Care FSA for 2010 must be spent on eligible expenses that you incur no later than March 15, 2011. You have until April 30, 2011, to submit those expenses for reimbursement. A Dependent Care FSA is used to set aside pre-tax funds to pay for child care expenses that enable you and your spouse to work. To qualify, you must be the custodial parent with over 50% custody. There is NO grace period for Dependent Care FSAs. If you have questions on what is eligible under a FSA account visit: www. Asiflex.com.Flexible Spending Accounts are a way for Plan A and B members to set aside up to $5,000 to pay for health care and dependent care. Contributions to these accounts are made on a pre-tax basis, which means no taxes are withheld on the money you put into the accounts. The Health Care Flexible Spending Account funds may be used to pay for you, your spouse, or your dependent children�s expenses regardless of whether or not they are insured by the State Employee Health Plan. Money you set aside must be spent for covered services. You do have a grace period after the end of the plan year to spend your Health Care FSA funds, but it is limited to the following March 15. For example, money you put into the Health Care FSA for 2010 must be spent on eligible expenses that you incur no later than March 15, 2011. You have until April 30, 2011, to submit those expenses for reimbursement. A Dependent Care FSA is used to set aside pre-tax funds to pay for child care expenses that enable you and your spouse to work. To qualify, you must be the custodial parent with over 50% custody. There is NO grace period for Dependent Care FSAs. If you have questions on what is eligible under a FSA account visit: www. Asiflex.com.

29. Optional Debit Card for health care FSA Information will be sent to you to elect debit card You pay a $12 service fee per year Non refundable fee is charged at the beginning of the year Debit cards roll from year to year Current debit card users must contact ASI to cancel debit card enrollment Must notify ASI no later than December 15, 2010 to avoid the $12 fee for 2011 Optional HCFSA Debit Card Members who enroll in the health care flexible spending accounts will receive in their new member kit sent from ASI information about an optional debit card. The debit card will allow the member to access their flex funds using a VISA card. The member will pay a $12 annual service fee for the convenience. The entire $12 fee will be deducted at the beginning of the year and is non refundable. The debit card will roll from year to year. If have a debit card in 2010 and do not wish to have a debit card in 2011, you will need to contact ASI to cancel it before 12/15/10 to avoid the $12 fee. Documentation on health care expenses paid for using the debit card may still be required by ASI. ASI will advise the member on those charges to provide the additional paperwork. Debit cards are optional. You may elect to continue to file your own claims using the methods listed above and receive payment from ASI. Members who enroll in the health care flexible spending accounts will receive in their new member kit sent from ASI information about an optional debit card. The debit card will allow the member to access their flex funds using a VISA card. The member will pay a $12 annual service fee for the convenience. The entire $12 fee will be deducted at the beginning of the year and is non refundable. The debit card will roll from year to year. If have a debit card in 2010 and do not wish to have a debit card in 2011, you will need to contact ASI to cancel it before 12/15/10 to avoid the $12 fee. Documentation on health care expenses paid for using the debit card may still be required by ASI. ASI will advise the member on those charges to provide the additional paperwork. Debit cards are optional. You may elect to continue to file your own claims using the methods listed above and receive payment from ASI.

30. Effective January 1, 2011, over the counter drugs will require a physician prescription to be eligible under an HFSA. Change due to the Patient Protection and Affordable Care Act For a list of OTC drugs that require a prescription go to: www.asiflex.com Debit card may not be used for OTC drugs after 1/1/11 Over the Counter Drugs As mentioned at the beginning of the program, effective 1/1/11, over the counter drugs will not be eligible under a health care flexible spending account if you do not have a physician�s prescription for the item. This also means you may not use your HCFSA debit card to purchase them. You will need to send the prescription to ASI before any claims for OTC products will be processed. For a complete list of the effected products, go to ASIflex.com. As mentioned at the beginning of the program, effective 1/1/11, over the counter drugs will not be eligible under a health care flexible spending account if you do not have a physician�s prescription for the item. This also means you may not use your HCFSA debit card to purchase them. You will need to send the prescription to ASI before any claims for OTC products will be processed. For a complete list of the effected products, go to ASIflex.com.

31. New limited FSA available for members on Plan C. Can set aside funds for dental and vision expenses only Cannot be used to fund medical expenses HSA account is designed for that purpose Debit card not available for use with this account Contribution limit same as Health Care FSA �Use it or lose it� applies to this account as well Limited FSA for Plan C New this year for Plan C members only will be a limited health care flexible spending account for their non reimbursed dental and vision expenses. This account will not a debit card and can not be used to pay for medical expenses. Medical expenses under Plan C are eligible under the Health Savings Account (HSA) so they are not eligible under the FSA.New this year for Plan C members only will be a limited health care flexible spending account for their non reimbursed dental and vision expenses. This account will not a debit card and can not be used to pay for medical expenses. Medical expenses under Plan C are eligible under the Health Savings Account (HSA) so they are not eligible under the FSA.

32. HealthQuest Health Screenings & Online Health Assessment $50 gift card for completion 24/7 Nurse Line Lifestyle Health Coaching Condition Management Programs Tobacco Cessation Program Employee Assistance Program (EAP) 24/7 confidential support Personal counseling & referrals HealthQuest Website, Portal, Newsletter & Blog Wellness Presentations Wellness Champion Network Other resources available to you for your health and wellness are provided by HealthQuest at no cost to you. Again next year HealthQuest will be offering statewide health screenings and online health assessments. You have access to a nurseline 24 hours a day/7 days a week (1-888-275-1205, option 2) for any health-related questions. You can work with a health coach by phone to make positive lifestyle changes like losing weight, getting more active, eating healthier and managing stress. Condition management programs help those with chronic conditions such as diabetes, heart failure, coronary artery disease, COPD and asthma. Quit For Life is the nation�s leading tobacco cessation program that you have access to. It�s successful because it integrates free medication, web-based learning and confidential phone-based support from expert Quit Coaches. The EAP provides short-term counseling for personal and family concerns (up to 4 visits for free), no-charge telephonic consultations for legal and financial issues, information and referrals from experienced childcare and geriatric specialists, as well as life coaching. You can find detailed information on any of the wellness offerings on the HealthQuest website. The member portal (www.KansasHealthQuest.com) is where you participate in online programs. You can subscribe to the HealthQuest blog to receive inspiring articles and videos. Monthly wellness newsletters are sent out through your HR office via email and the archives are available online. New to HealthQuest is the Wellness Champion Network. Wellness Champions at each agency will work with HealthQuest and the wellness vendor, Alere, to provide wellness programs and activities at the local level. For more information on becoming a Champion, or any of the HealthQuest and EAP programs, look in your open enrollment booklet or on the SEHP website. The open enrollment booklet provides you with more details on the wellness programs starting on page 21. Other resources available to you for your health and wellness are provided by HealthQuest at no cost to you. Again next year HealthQuest will be offering statewide health screenings and online health assessments. You have access to a nurseline 24 hours a day/7 days a week (1-888-275-1205, option 2) for any health-related questions. You can work with a health coach by phone to make positive lifestyle changes like losing weight, getting more active, eating healthier and managing stress. Condition management programs help those with chronic conditions such as diabetes, heart failure, coronary artery disease, COPD and asthma. Quit For Life is the nation�s leading tobacco cessation program that you have access to. It�s successful because it integrates free medication, web-based learning and confidential phone-based support from expert Quit Coaches. The EAP provides short-term counseling for personal and family concerns (up to 4 visits for free), no-charge telephonic consultations for legal and financial issues, information and referrals from experienced childcare and geriatric specialists, as well as life coaching. You can find detailed information on any of the wellness offerings on the HealthQuest website. The member portal (www.KansasHealthQuest.com) is where you participate in online programs. You can subscribe to the HealthQuest blog to receive inspiring articles and videos. Monthly wellness newsletters are sent out through your HR office via email and the archives are available online. New to HealthQuest is the Wellness Champion Network. Wellness Champions at each agency will work with HealthQuest and the wellness vendor, Alere, to provide wellness programs and activities at the local level. For more information on becoming a Champion, or any of the HealthQuest and EAP programs, look in your open enrollment booklet or on the SEHP website. The open enrollment booklet provides you with more details on the wellness programs starting on page 21.

33. Non Tobacco Users Discount You must disclose your tobacco status Discount available for: Non tobacco user - or - Tobacco users agreeing to enroll and complete the HealthQuest tobacco cessation program You may begin the tobacco cessation program now! You must complete 5 tobacco discussions by May 1, 2011 Discount is based on completing the program The State is again offering a discount to members that do not use tobacco products or for those who use tobacco products but agree to enroll and complete the HealthQuest tobacco cessation program. All employees must go online during this open enrollment and elect their tobacco status for the upcoming year if they want to get the discount. For those who qualify a discount of $20 for 24 pay periods off their health insurance premiums will be provided. Failing to take action will result in the loss of the discount. NEW THIS YEAR! Members who agree to participate in the HealthQuest tobacco cessation program through Free & Clear may begin their tobacco discussions with a quit coach as soon as they disclose their tobacco use status during the annual open enrollment period beginning October 1, 2010. There is no need to wait until January 2011. THIS YEAR, IT IS THE MEMBER�S RESPONSIBILITY TO PROACTIVELY CALL FREE & CLEAR AT THEIR TOLL FREE NUMBER, 1-888-275-1205 (OPTION 3) TO ENROLL IN THE CESSATION PROGRAM. Once enrolled, the member will receive a Welcome letter from Free & Clear describing program details. Tobacco users who enroll and complete the HealthQuest tobacco cessation program by May 1, 2011 will also be eligible for the $20 discount for 24 pay periods. You are not required to quit using tobacco but you are required to complete five (5) tobacco discussions with a Quit coach by May 1, 2011. The State is again offering a discount to members that do not use tobacco products or for those who use tobacco products but agree to enroll and complete the HealthQuest tobacco cessation program. All employees must go online during this open enrollment and elect their tobacco status for the upcoming year if they want to get the discount. For those who qualify a discount of $20 for 24 pay periods off their health insurance premiums will be provided. Failing to take action will result in the loss of the discount. NEW THIS YEAR! Members who agree to participate in the HealthQuest tobacco cessation program through Free & Clear may begin their tobacco discussions with a quit coach as soon as they disclose their tobacco use status during the annual open enrollment period beginning October 1, 2010. There is no need to wait until January 2011. THIS YEAR, IT IS THE MEMBER�S RESPONSIBILITY TO PROACTIVELY CALL FREE & CLEAR AT THEIR TOLL FREE NUMBER, 1-888-275-1205 (OPTION 3) TO ENROLL IN THE CESSATION PROGRAM. Once enrolled, the member will receive a Welcome letter from Free & Clear describing program details. Tobacco users who enroll and complete the HealthQuest tobacco cessation program by May 1, 2011 will also be eligible for the $20 discount for 24 pay periods. You are not required to quit using tobacco but you are required to complete five (5) tobacco discussions with a Quit coach by May 1, 2011.

34. Paying the Base Rate in 2011 The following will NOT be receiving the discount: Elects not to disclose Tobacco status Tobacco users not enrolled in the tobacco cessation program Failed to enroll online and disclose tobacco status Members who enroll but fail to complete the tobacco cessation program by May 1, 2011 will lose their discount for the remainder of 2011. For Plan Year 2011, employees who elect to not disclose their tobacco status, those who do not wish to complete the HealthQuest Tobacco cessation program and anyone who fails to go online and elect their tobacco status will be paying the base rates. Members who elect to enroll in the tobacco cessation program but who do not complete the required steps within the time period requirements will be notified and their discount revoked for the remainder of the calendar year. You will be eligible to participate in the tobacco cessation program and get the discount during the next plan year by reenrolling during open enrollment. For Plan Year 2011, employees who elect to not disclose their tobacco status, those who do not wish to complete the HealthQuest Tobacco cessation program and anyone who fails to go online and elect their tobacco status will be paying the base rates. Members who elect to enroll in the tobacco cessation program but who do not complete the required steps within the time period requirements will be notified and their discount revoked for the remainder of the calendar year. You will be eligible to participate in the tobacco cessation program and get the discount during the next plan year by reenrolling during open enrollment.

35. Annual Open Enrollment October 1 � October 31, 2010 Enroll online: Declare tobacco status (Annual enrollment required) Make health plan selections Add/drop dependents Enroll in Flexible Spending Accounts Enroll in HealthyKIDS Families at 250% of poverty level State pays 90% of children�s premium Same coverage Must enroll every year Coverage effective January 1, 2011 Now that we�ve discussed your options and who can enroll, let�s talk about what you need to do. Open enrollment takes place from October 1 through October 31, 2010. You must go online to: declare your tobacco status review and enroll in your health plan elections Make changes in who is covered by your plan Enroll in a flexible spending account Enroll in HealthyKIDS if eligible Remember, after October 31, unless you experience a qualifying event, you cannot change your coverage level until the next open enrollment period. The choices you make now will be effective starting January 1, 2011.Now that we�ve discussed your options and who can enroll, let�s talk about what you need to do. Open enrollment takes place from October 1 through October 31, 2010. You must go online to: declare your tobacco status review and enroll in your health plan elections Make changes in who is covered by your plan Enroll in a flexible spending account Enroll in HealthyKIDS if eligible Remember, after October 31, unless you experience a qualifying event, you cannot change your coverage level until the next open enrollment period. The choices you make now will be effective starting January 1, 2011.

36. Effective 1/1/11, dependents are eligible to be covered on the plan to age 26 even if: they do not live with you they are not a student they are not dependent on you for support, or are married Spouses of dependents are not eligible Grandchildren are only eligible under limited circumstances. You can add coverage for your eligible dependents during this open enrollment Dependent Eligibility Change One of the health reform changes that takes effect January 1, 2011 is the a change in the definition of an eligible dependent. You may now cover your children to age 26 even if: They don�t live with you They are not students They are married They are no supported by you. During this open enrollment you have 30 days to add your dependent children under age 26 to your health plan. Their coverage will be effective January 1. For dependents being re-added to the plan, you may be required to provide a birth certificate. One of the health reform changes that takes effect January 1, 2011 is the a change in the definition of an eligible dependent. You may now cover your children to age 26 even if: They don�t live with you They are not students They are married They are no supported by you. During this open enrollment you have 30 days to add your dependent children under age 26 to your health plan. Their coverage will be effective January 1. For dependents being re-added to the plan, you may be required to provide a birth certificate.

37. Required Documentation If you are adding a dependent, documentation of eligibility is required Birth certificates Marriage licenses Affidavit of common law marriage Social Security numbers required Document due by 11/1/10 If documentation is not received, dependents will not be added to your plan for 2011 If you are adding dependents during open enrollment to your health plan documentation of their eligibility is required. Please provide your HR office the above information for your spouse or children you are adding. Information is due to SEHP by November 1, 2010. The next opportunity to add the dependents will be open enrollment 2011 unless a qualifying event occurs. If you are adding dependents during open enrollment to your health plan documentation of their eligibility is required. Please provide your HR office the above information for your spouse or children you are adding. Information is due to SEHP by November 1, 2010. The next opportunity to add the dependents will be open enrollment 2011 unless a qualifying event occurs.

38. Identification Cards To receive a new ID card, your address in SHARP must be accurate. Last year we received over 15 tubs of returned mail due to incorrect member addresses ID cards delayed due to manual look-up required Plan A members will be getting new health plan ID cards Dental and Vision members will get new cards If you need a new ID card, call the vendor You need to notified your agency of address changes. The State send the health plans your address information based on what is in the SHaRP payroll system on the date the file is created. To prevent delayed or lost cards, make sure your address is up to date. All Plan A members will be getting new medical and labcard id cards. Plan B and C vendors, Superior and Caremark are only issuing new cards to members with changes. Superior will be issuing new cards to members. Reminder, ID cards are often inside your benefit description book. Be sure you open your books and pull your cards out! If you lose your id card contact the vendors directly at the numbers on the inside cover of the open enrollment book to request a new card. You need to notified your agency of address changes. The State send the health plans your address information based on what is in the SHaRP payroll system on the date the file is created. To prevent delayed or lost cards, make sure your address is up to date. All Plan A members will be getting new medical and labcard id cards. Plan B and C vendors, Superior and Caremark are only issuing new cards to members with changes. Superior will be issuing new cards to members. Reminder, ID cards are often inside your benefit description book. Be sure you open your books and pull your cards out! If you lose your id card contact the vendors directly at the numbers on the inside cover of the open enrollment book to request a new card.

39. Resources Review the Open Enrollment (OE) booklet ?�s call the health plan customer service Phone numbers in the front of the OE booklet Visit the KHPA website: www.sehbp.org Benefit descriptions available Provider directory listings Preferred drug list Information on the HSA and FSA accounts Email ?�s to SEHP: benefits@khpa.ks.gov You should take some time to review your options and determine what is best for you and your family. You have a number of resources available to assist you. The enrollment booklet provides an overview of your options, including a comparisons chart and the cost for coverage as well as information about enrolling. The phone numbers for each of the health plans is listed in the front of your open enrollment book. You may call customer service with any questions you have about the benefits, network and services provided to members. Additional information is available on the KHPA website. This site is available year round and provides you with update information about your plan. You may send questions to KHPA at benefits@khpa.ks.gov. This email address is available year round for you to send any questions you have about the SEHP. You should take some time to review your options and determine what is best for you and your family. You have a number of resources available to assist you. The enrollment booklet provides an overview of your options, including a comparisons chart and the cost for coverage as well as information about enrolling. The phone numbers for each of the health plans is listed in the front of your open enrollment book. You may call customer service with any questions you have about the benefits, network and services provided to members. Additional information is available on the KHPA website. This site is available year round and provides you with update information about your plan. You may send questions to KHPA at benefits@khpa.ks.gov. This email address is available year round for you to send any questions you have about the SEHP.

40. Open Enrollment Checklist Enrollment Online: Consider enrolling your dependent children under age 26 Review health plan selections Must declare tobacco status Enroll in HealthyKIDS Enroll in flexible spending accounts Confirmation statements Available online 12/15/10

41. Questions? We�ve presented a lot of important information today, and I�m sure many of you have questions. I�ll be happy to answer any questions you may have now.We�ve presented a lot of important information today, and I�m sure many of you have questions. I�ll be happy to answer any questions you may have now.

42. Option Slides Optional slides that may be added as needed or desired by presenter. Optional slides that may be added as needed or desired by presenter.

43. Network vs. Non Network We showed you this example last year to illustrate the benefit of using a network provider. This has been updated to reflect the plan design changes in Plan A. As you can see, using a network provider is still your lowest cost option. You can find out who is in the network by visiting our website or by calling the health plan customer service for assistance. We showed you this example last year to illustrate the benefit of using a network provider. This has been updated to reflect the plan design changes in Plan A. As you can see, using a network provider is still your lowest cost option. You can find out who is in the network by visiting our website or by calling the health plan customer service for assistance.

44. General practice Family practice Geriatrics Internal medicine Physician extenders Pediatrics Primary Care Providers (PCPs) The following will be considered primary care providers and eligible for the lower office visit copay. All other providers will be considered specialist. The SEHP does not require you to get a referral before seeing any providers. Using a network provider will have the lowest out of pocket cost for you. The following will be considered primary care providers and eligible for the lower office visit copay. All other providers will be considered specialist. The SEHP does not require you to get a referral before seeing any providers. Using a network provider will have the lowest out of pocket cost for you.

45. Covered in full: Prophylaxis/cleanings � twice per year. Oral examinations � twice per year. Bitewing x-rays � adults - 1x a year children under 18 - 2 x a year Full mouth x-rays � once each five (5) years. Limited coverage for children only: Sealants Space maintainers Topical fluoride Ancillary � emergency relief of pain. Dental Preventive Care

46. Basic Restorative Regular restorative dentistry � fillings Oral surgery Endodontics � root canals Periodontics � treatment of gum & bone disease Additional Diagnostic X-Rays Major Restorative Special restorative dentistry � crowns Prosthodontics � bridges, implants, dentures TMJ Treatment � Requires prior authorization Restorative care is subject to a $50 deductible Dental Restorative Services

47. Claiming Your Flex Funds Optional Debit Card for health care FSA Information will be sent to you to elect debit card You pay a $12 service fee per year Fee is charged at the beginning of the year You may still need to send documentation to ASI Reimbursements by check or direct deposit available Fill out a claim form, attach receipts, and mail or fax to ASI. Fill out form electronically, attach electronic copies of receipts, and email to: Members who enroll in the health care flexible spending accounts will receive in their new member kit sent from ASI information about an optional debit card. The debit card will allow the member to access their flex funds using a VISA card. The member will pay a $12 annual service fee for the convenience. The entire $12 fee will be deducted at the beginning of the year. Documentation on health care expenses paid for using the debit card may still be required by ASI. ASI will advise the member on those charges to provide the additional paperwork. You may elect to continue to file your own claims using the methods listed above and receive payment from ASI. Members who enroll in the health care flexible spending accounts will receive in their new member kit sent from ASI information about an optional debit card. The debit card will allow the member to access their flex funds using a VISA card. The member will pay a $12 annual service fee for the convenience. The entire $12 fee will be deducted at the beginning of the year. Documentation on health care expenses paid for using the debit card may still be required by ASI. ASI will advise the member on those charges to provide the additional paperwork. You may elect to continue to file your own claims using the methods listed above and receive payment from ASI.