July 1, 2012 – June 30, 2013 Benefit Overview

1. July 1, 2012 – June 30, 2013 Benefit Overview Dysart\2012\Open Enrollment\12 open enrollment presentation 0430.ppt

2. Annual Open Enrollment • The Dysart open enrollment period for the 2012 employee benefit plan year will begin May 1, 2012 and conclude on May 18, 2012. • Open enrollment changes will be effective July 1, 2012. • This is your once a year opportunity to add, drop or change existing coverage. • Next opportunity to make a change without a qualifying event will be May 2013 for a July 1, 2013 effective date.

3. Key Changes for 7/1/12 Plan Year Medical Plan Changes: • No increase to rates!!! • HMO $500 and HMO $0 plans will continue to be offered • Current PPO plan will be replaced with $750 PPO Plan that includes a Health Reimbursement Account (HRA) • District will contribute $250 on 7/1/12 into each employee’s HRA account • In addition, each employee may have an additional $250 contribution to the HRA upon successful completion of the Blue Cross online Health Risk Assessment • Continue to offer the $1,500 HSA Saver plan but increase District HSA contribution • District contribution of $1,000 for 7/1/12 plan year ($500 on 7/1/12 and $500 on 1/1/13) • In addition, each employee may have an additional $250 contribution to the HSA upon successful completion of the Blue Cross online Health Risk Assessment

4. Key Changes for 7/1/12 Plan Year Medical Plan Changes – Wellness/Preventive: • Preventive care – claims as a result of an initial visit with an in-network provider are to be paid at in-network level of benefits even if provider/facility are out of network • On all “non-HSA” plans (not allowed on HSA plan due to regulations) an additional $250 wellness allowance per participant will be available: • Employees/dependents are able to use the $250 calendar year allowance for any “wellness” procedure that is not on list of approved services under PPACA and, thus, not on the IRS preventive list of procedures.  This benefit is available for both in and “out of network” wellness.  After the full $250 is used, any amount over $250 is then subject the medical plan deductible and coinsurance. • Example: Male prostate exam is NOT on the approved list.  So for this exam, the participant would have $250 to use toward this exam… If the exam was $300, then the full $250 would be paid in full, then the person would pay $5 (10% of the remaining $50) assuming deductible has been met.

5. Key Changes for 7/1/12 Plan Year Medical Plan Changes – Vision Therapy: • Vision therapy, also known as visual training, vision training, or visual therapy, is a broad group of techniques aimed at correcting and improving binocular, oculomotor, visual processing, and perceptual disorders.  • Vision therapy will be a covered benefit on all medical plans at the Specialist Office Visit copay applicable to each medical plan.  It will become a part of the eligible benefits under the Saver HSA plan and paid according to the current benefit structure.

6. Key Changes for 7/1/12 Plan Year • Domestic Partners (same and opposite sex) are eligible for Medical, Dental, Vision and Life. • Affidavit and documentation will be required as proof of Domestic Partnership. • Health Flexible Spending Account (FSA) maximum election reduced from $3,000 to $2,500 due to health reform. Dependent FSA will remain at $5,000.

7. Annual District Contributions • Medical $4,960 • Dental $118 • Increased Health Savings Account District Contribution • $1,000 + opportunity to earn an additional $250 by completing a health risk assessment!!! • Implementation of a Health Reimbursement Account with District Contribution • $250 + opportunity to earn an additional $250 by completing a health risk assessment!!! • 100% cost of Basic Life/AD&D for employee coverage

8. Medical “26 Pay Period” Employee Contributions 7/1/12 When enrolling in the $1,500 plan you can receive up to $1,250 in your HSA!!! When enrolling in the $750 plan you can receive up to $500 in your HRA!!!

9. Additional Benefits Dental, Vision, Life, Optional Life, Short Term Disability, AFLAC, and 457 • No change to plans offered. • Dental PPO rates increased 6%, no increase to Prepaid Dental rates. • Please log onto the benefitsCONNECT system for payroll deduction information.

10. Changes You Can Make Online Using benefitsCONNECT • All benefit eligible employees will be required to re-enroll in medical insurance, AND re-elect FSA/HSA contributions. If you do NOT waive or enroll in medical you will be default enrolled in the $750 HRA plan as “employee only” and will have payroll deduction. • However, the system will assume you will remain in your current selections for dental, vision, life, disability, etc. unless you make a change in the system…

11. Dysart Employee Benefit WebsiteProvides you with Access to: • benefitsCONNECT – The District’s online enrollment system • Benefit summaries • Links to search for providers • 2012-2013 benefit guide • Open enrollment presentation • All links and tools discussed during the presentation today can be found here!!!

12. Dysart Employee Benefit Website

13. Medical Plan Presentation

14. Worksite Wellness Program • During 2011, Dysart began to offer a monthly Wellness newsletter to all employees to educate on current health topics and benefit information. • During 2011, Dysart offered on-site flu vaccination clinics for benefitted staff. • Health education classes like Healthy Pregnancy and Nutrition were offered at the District Office for all employees and family for no cost. • Two Weight Watchers At Work meetings were coordinated at one school and the District Office for all employees and family members. • Nutrition class offered for all Dysart Unified staff in March 2012.

15. Worksite Wellness Program • A Health Assessment Campaign was promoted to Dysart staff in February/March 2012. Participants were entered to win 1 of 50 $20 Sprouts Gift Cards. • A Wellness Interest survey was promoted in February/March 2012, to learn what employees wanted to see offered in 2012-2013 Wellness Program. Participants were entered to win one of twenty $25 Target gift cards. • In March 2012, Dysart Unified coordinated Mobile Onsite Mammography at multiple sites in the district for onsite screenings. • Future class considerations include sexual assault prevention and successful retirement.

16. Health Reform Update Health FSA maximum contribution reduced from $3,000 to $2,500. No other major changes for 2012. The changes below were implemented in prior plan years… • Dependent child “up to age 26” on Medical, Dental, Vision and Voluntary Life (this change was made effective 7/1/10 at Dysart) • Removal of pre-existing conditions for children up to age 19 • No copay/cost for preventive care services • Lifetime limits will become “unlimited” • FSA/HSA - Prescription required for over the counter medication • Health Savings Account (HSA) penalty increased from 10% to 20% + ordinary income tax

17. HSA vs. HRA vs. FSA

18. Medical Definitions Copayment: The fixed dollar amount you must pay directly to a physician at the time certain covered services, such as prescription drugs or office visits, are received. Deductible: The fixed dollar amount you must pay for covered services each calendar year before BCBS begins to pay benefits. Coinsurance: Sharing, between yourself and BCBS, of the cost of covered services. Out-of-Pocket Maximum: The maximum dollar amount you have to pay under the terms of the BCBS contract in a calendar year for covered services.

19. Blue Cross Medical Plan Options Items in red font indicate changes from the 7/1/11 plan year benefits.

20. Medical Plan Options Items in red font indicate changes from the 7/1/11 plan year benefits. * = subject to deductible

21. Pharmacy Benefits

22. Examples of Preventive Care Services Benefits are available for the following services on a preventive basis, as appropriate for your age and gender and as recommended by your provider: • Preventive physical examination, i.e. routine physical examination, including the following services when done for screening purposes only: • Annual well child • Mammogram • Bone density testing for osteoporosis • Screening - colonoscopy • Routine gynecologic exam including pap test and other cervical cancer screening tests Refer to Dysart employee benefit website for complete list of preventive services

23. Provider Network BlueCross BlueShield of Arizona (BCBSAZ) • All 4 Dysart medical plans have access to over 15,000 BCBSAZ contracted Physicians and Specialists • Referrals to specialists are notrequired

24. Nurse On Call 866-422-2729 Speak with an experienced registered nurse anytime, day or night. Online Services • Ask a Nurse • Health News • Online Health Videos

25. HSAPresentation

26. Who is Eligible for an HSA? • Must be covered under the BCBS BluePreferred Saver $1,500 Deductible plan • Cannot also be covered under a health plan that is not a high deductible health plan (specific illness/accident policies are okay) • Not enrolled for benefits under Medicare or Tricare • Not covered as a dependent under another person’s tax return

27. Why Enroll in the BCBS BluePreferred Saver $1,500 Deductible with the HSA? • Pre-Tax contributions via payroll deduction and tax free distributions for eligible expenses • Lower premiums offer an affordable cost option to cover dependents vs. the $750 plan and 2 HMO plans • District will contribute $500 to your savings account on 7/1/12 and again on 1/1/13 this year AND you have the opportunity to earn an additional $250 by completing the health risk assessment • Once enrolled, you will receive a debit card to pull money from the savings account to pay for qualified medical expenses • You own the savings account and the money stays with you • The balance rolls over from one year to the next (no use-it-or-lose-it rule) • Long-term savings for healthcare expenses after retirement

28. HSA“How To” – Doctor Visits

29. HSA “How To” – Pharmacy Prescriptions

30. ExampleBluePreferred Saver $1,500 Deductible with Health Savings Account (HSA)

31. HSA Example Why this employee selected the Saver HSA $1,500: • Opportunity to save on taxes and save for future health care expenses • Preventive care covered at no cost

32. Year One Assumes all network care – different coinsurance levels on non-network care apply.

33. HRAPresentation

34. Who is Eligible for a HRA?Benefits of the HRA? • Must be covered under the BCBS BluePreferred $750 Deductible plan • Contributions to the HRA by Dysart are excluded from your gross income • Use money from the account to pay for eligible medical expenses that go toward your deductible, coinsurance and out of pocket maximum • Lower premiums offer an affordable cost option to cover dependents vs. the 2 HMO plans (but more expensive than the HSA Saver plan) • District will contribute $250 to your HRA AND you have the opportunity to earn an additional $250 by completing a health risk assessment • Once enrolled, as you incur qualified medical expenses that go toward your deductible, coinsurance, and out of pocket maximum (no reimbursement for copays…) Health Equity will mail checks to your home address to reimburse you up to the amount you have in your HRA account • Please note ‘unlike’ the HSA, the HRA balance will “not” roll over from one year to the next

35. HRA Example Why this employee selected the $750 HRA plan: • District contribution of $500 to the HRA • Preventive care covered at no cost

36. Year One

37. Health Equity Help Line Member services call center open 24 hrs a day / 7 days a week / 365 days a year: 1.866.960.8026

38. Medical ID Card • All employees will receive new ID cards. The cards will be shipped to your home mailing address. • Continue to use your current ID cards until 6/30/12. Use the new ID cards effective 7/1/12.

39. Online Tools & Resources The tools listed below can be found under the “Medical” tab on the Dysart employee benefit website • Medical plan evaluator tool • BCBSAZ cost & quality comparison tool • Health Equity tool which allows you to schedule payments to providers, schedule electronic funds transfer & more

40. Medical Plan Evaluator Tool Demonstration

42. Age, Gender, Health Status Entry

43. Side by Side Comparison of Premium Cost & Benefits

44. Side by Side Comparison of Premium Cost & Benefits

45. Side by Side Comparison of Premium Cost & Benefits (Takes District HSA/HRA Contribution Into Account)

46. Healthcare Claims Projection

47. Final Output – Best Option Saver HSA for this Individual’s Family

48. Total Dental Administrators You can select from 2 dental plans

49. Dental A500S – Lower Cost Dental Option • District pays $118.06 annually toward either Dental plan option • No annual maximum • Must use dentist within the network

50. Dental PPO – Higher Cost Dental Option • Larger network of dentists • May pay less “out of pocket” for certain procedures vs. lower cost option • Predetermination of benefits is recommended for treatment over $300