It’s time to make benefits choices to keep you and your family

physically and financially well in 2020.

Up and Atom.It’s Open Enrollment!October 7 - October 28, 2019

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Additional information available at:

https://benefits.caltech.edu/Openenrollment

What We’ll Cover

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• Open Enrollment• Open Enrollment Checklist• What’s new in 2020• Monthly Rates• How to Enroll and Update Beneficiaries

• The More You Know…• Flexible Spending Accounts• Free: Grand Rounds Health Advocacy Program• Free: Medical Evacuation and Repatriation (MER)• Anthem Virtual Office Visit—Live Health Online• Life, Accident and Disability Coverage

• A Closer Look at the High Deductible Plans (HDHP)• Health Savings Accounts

• Questions

October/November 2016

This presentation provides only highlights of your benefits. It is not a contract. It does not change the terms of your benefit plans or the official documents that control them. Consult the individual plan booklets for specific details of benefit coverage. To permit a brief summary of benefits and services, use of actual contract language has been minimized. This summary comparison does not replace the legal documents that establish the plans. Final interpretation of any provision of the plans will be governed by the master policies and service agreements, which are on file in the office of the plan administrator. Caltech reserves the right to change, suspend or terminate its benefits programs, in whole or in part, at any time and for any reason.

October 2019 3

Open Enrollment….

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Benefits Open Enrollmentfor Faculty, Postdoctoral Scholars and Staff

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October 7 -

October 28

What You Need to Do

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Give Your Benefits an Annual Checkup

Are you saving enough for a healthy financial future?

Review your current voluntary Caltech Retirement Plan

contributions and update them, if you’d like

Will your current elections still work for you next year?

We’ve made changes for 2020. Review your options and

update your elections if needed

Do you cover any dependents?

You must certify their eligibility on an annual basis. Also confirm

we have their Social Security numbers

Want to save on taxes?

Choose your Flexible Spending Account (FSA) or

Health Savings Account (HSA) contributions for 2020

Are your beneficiaries still current?

From MyBenefits, you can review and update your beneficiary

designations for Caltech Life benefits and Retirement Plans

with TIAA

What’s New in 2020

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Anthem High Deductible Health Plan (HDHP)

PPOs:

• The names and deductibles of the High

Deductible Health Plans (HDHPs) are

changing:

HDHP 1350 HDHP 1400

HDHP 2700 HDHP 2800

• The IRS changed the minimum deductibles

required to be considered High Deductible

plans

Kaiser California HMO

• Primary Care Physician office

visit and urgent care copays

are increasing from $15 to $20

(specialist copay will still be

$30)

• Brand and specialty drug copay

is increasing to $50 for a 30

day supply

Anthem HMO

• The prescription drug brand copay is

increasing from $45 to $50.

• All other Rx copays (including mail

order) are staying the same

Infertility Benefits

• Anthem Infertility Benefits

added to all plans

• Kaiser Infertility drug copays

are changing to 50%

coinsurance

What’s New in 2020

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Vision:

• VSP Vision plan now covers lenses (or contacts) every year, rather

than every other year.

• Frame allowance remains $150 every other year.

• New provider network: Choice

• Check that your provider is still in-network before getting

services

No Changes in benefits or costs for:

• Dental

• Life

• Disability

• Personal Accident Insurance

Infertility Benefits

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Your Monthly Contributions–Medical

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Medical

Rates

Anthem Anthem Kaiser Anthem

HDHP 1400 HDHP 2800 HMO HMO

2019 2020 2019 2020 2019 2020 2019 2020

Employee

only:$120 $125 $50 $52 $125 $139 $150 $164

Employee +

Spouse:$285 $296 $109 $124 $305 $339 $356 $390

Employee +

Child(ren):$251 $261 $105 $109 $270 $300 $313 $343

Employee +

Family:$450 $468 $187 $194 $488 $542 $556 $609

Your Monthly Contributions–Dental(no change from 2019)

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Dental

Rates

Delta Dental Safeguard/MetLife

2019 2020 2019 2020

Employee

only:$13 $13 $2 $2

Employee +

Spouse:$33 $33 $4 $4

Employee +

Child(ren):$29 $29 $5 $5

Employee +

Family:$52 $52 $10 $10

Your Monthly Contributions–Vision

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Vision Rates

VSP

Vision

2019 2020

Employee only: $2 $2.28

Employee + Spouse: $3 $3.44

Employee +

Child(ren):$3 $3.42

Employee + Family: $6 $6.70

New RDP Rules beginning 1/1/2020

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In 2020, California legislation will allow opposite-sex

Registered Domestic Partners to be added to

benefits, regardless of age.

Once you are registered with the State of California

as Registered Domestic Partners, you have 31 days

to add coverage for your partner, or you can add

coverage during Open Enrollment.

How to Enroll and

Update Beneficiaries

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How to Enroll and

Update Beneficiaries

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What You Need to Do

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Give Your Benefits an Annual Checkup

Are you saving enough for a healthy financial future?

Review your current voluntary Caltech Retirement Plan

contributions and update them, if you’d like

Will your current elections still work for you next year?

We’ve made changes for 2020. Review your options and

update your elections if needed

Do you cover any dependents?

You must certify their eligibility on an annual basis. Also confirm

we have their Social Security numbers

Want to save on taxes?

Choose your Flexible Spending Account (FSA) or

Health Savings Account (HSA) contributions for 2020

Are your beneficiaries still current?

From MyBenefits, you can review and update your beneficiary

designations for Caltech Life benefits and Retirement Plans

with TIAA

The moreyou know….

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Flexible Spending Accounts

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Choose your contributions carefully — whatever you don’t use by year

end will be forfeited (except for $500 rollover in the Health Care FSA)

Health Care FSA Dependent Day Care FSA

Who Can Participate

Anyone who is not

enrolled in an

Health Savings Account

Anyone who has an

eligible dependent

Types of Expenses

Allowed

Eligible medical, prescription

drug, dental and vision

expenses

Eligible child and elder care

expenses (so you and your

spouse/domestic partner can

work or go to school)

How Much You Can

Contribute AnnuallyUp to $2,700 Up to $5,000

*You are not eligible for a 2019 FSA rollover if you have elected a Health

Savings Account (HSA) for 2020

Enter your

Caltech/JPL

credentials

Select

“Campus

Login”

Or

“JPL Login”

Company ID

=

“caltech”

Download the

Benefitfocus

App from the

Play store on

your device

Access MyBenefits from your mobile device to view your benefits, make your annual elections, or make changes during the year

How To Get The Mobile App

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The App works with Android and iPhones

Grand Rounds

Health Advocacy Service

• Grand Rounds services are free of charge to all employees

and family members enrolled in at Caltech medical plan

• Need help finding an in-network doctor or hospital?

• Grand Rounds will help you find the provider and schedule an

appointment

• Can’t get a diagnosis?

• Grand Rounds will gather your medical records and obtain a

diagnosis from one the worlds leading experts

• Activate your account online at grandrounds.com/caltech or

by calling (800)929-0926

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Medical Evacuation

and Repatriation Coverage

(MER)

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• All benefit-based employees and their family members get MER at

no cost; 100% paid by Caltech

• Built into Business Travel Accident policy; no election needed

• Applies to business or personal travel

LiveHealth Online

Virtual office visit with a board-certified doctor anytime, day or night, from your

computer, tablet or smartphone:

• $0 copay for Anthem HMO

members

• $49 copay for HDHP

members before you meet deductible

Mental Health Services by appointment:

• $0 copay for Anthem HMO members

• $85 for HDHP members before you

meet deductible

• Register today at LiveHealthOnline.com

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Get Healthy and See a Doctor Now!

Life, Personal Accident Insurance,

Disability

These benefits provide replacement income for you or your beneficiaries in

the event of disability, accident or death

Helps your family members maintain their standard of living if something

happens to you

How much your family needs depends on your personal situation — other

income sources, monthly expenses and short- and long-term debt such as

credit card or mortgage expenses, etc.

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Caltech offers a variety of options

If you already have Supplemental Life, you can increase coverage by 1x during Benefits Open Enrollment, without evidence of insurability (EOI)

Any other Supplemental Life or Supplement LTD elections require EOI

Thinking about a High Deductible PPO?….

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Choosing the Right Medical Plan for YouSingle Coverage –

Person who gets regular preventive care, no prescriptions

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EE Only CoverageHDHP

2800

HDHP

1400

Kaiser

CA

Anthem

HMO

Annual Premium $624 $1,500 $1,668 $1,968

Annual Preventive Exam and

Testing (in-network) $0 $0 $0 $0

Annual Cost of Ownership $624 $1,500 $1,668 $1,968

Family Coverage –

Family who gets regular preventive care, no prescriptions

EE + Family Coverage HDHP

2800

HDHP

1400 Kaiser

Anthem

HMO

Annual Premium $2328 $5616 $6504 $7308

Annual Preventive Exam and

Testing (in-network) $0 $0 $0 $0

Annual Cost of Ownership $2,328 $5,616 $6504 $7308

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PPO

HealthSavings Account

(HSA)

High Deductible PPO Plan

The High Deductible PPO Plans –

Taking a Closer Look

HDHPs: Key Features

Low monthly premiums

(but you pay more than HMO plans for non-preventive care)

Choice of doctors and hospitals

(you pay less if you use in-network providers)

Preventive care is covered at 100%

(as long as you use in-network doctors and facilities)

You pay 100% of the cost of your non-preventive care until you meet the annual

deductible

Then you pay 20% of cost (in-network) and 40% (out of

network)

Prescriptions (RX)

Preventive RX is covered for a copay

Non Preventive RX, you pay 100% until you reach the

Annual Deductible; then you pay 20% of the cost for RX

Plan pays 100% after you reach the annual out of

pocket maximum

(as long as you use in-network doctors and facilities)

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Comparison of HDHP Plan Options

Coverage HDHP 2800 HDHP 1400Rates $52/month - EE Only

$124/month - EE+SP

$109/month - EE+CH

$194/month - Family

$125/month - EE Only

$296/month - EE+SP

$261/month - EE+CH

$468/month - Family

Deductible

$2800 per person OR

$5600 per family

$1400, EE Only coverage

If you enroll only yourself, the

Employee Only deductible applies

$2800, EE+Dependent coverage.

If you enroll yourself and one or

more eligible family members, you

must satisfy the family deductible

before the plan begins to pay

Out of Pocket Max In-Network $4000 per person

$8000 per family

Comparison of HDHP Plan Options

Coverage HDHP 2800 HDHP 1400

Preventive Care You pay 0% if care is provided by in-network provider and/or facility

Coinsurance

In-NetworkYou pay 20% of negotiated rate after deductible (Plan pays 80%)

Prescription Drug

Retail

PreventiveRx drugs

No Deductible for Preventive RX; copays apply:

$15 generic

$45 brand-name formulary

$75 brand-name non-formulary

Prescription Drug

Retail

Non-Preventive Drugs

After deductible is satisfied, you play 20% of cost as follows:

20% coinsurance up to $100 per prescription for Generic

20% coinsurance up to $250 per prescription for brand-name formulary and

brand-name non-formulary

HDHPs: Points to Keep in Mind

• Choose your provider carefully!

• Use an in-network provider to ensure you receive the lowest

possible negotiated rates for services.

• If you receive services from an out-of-network provider and/or

medical facility, you are responsible for paying the difference

between the covered or allowable charges and the billed

charges

• Ways to find in-network providers

• Anthem Concierge – on Lab and on Campus

• Grand Rounds can help you find an doctor in-network

• Anthem.com/ca/Caltech - Find a Doctor

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HDHPs: Blue Distinction Centers

• Using a Blue Distinction Center can save you money

• The plan pays more if you utilize an in-network Blue Distinction

Center if you need any of the following procedures:

Spinal surgery | Hip/knee replacement | Bariatric |

Transplants | Cardiac Care

• Blue Distinction Centers are known for their expertise and quality

outcomes

Coinsurance

(The % of cost

the plan pays)

Blue Distinction

Centers

85%

In-Network

Providers

75%

Out-of-Network

Providers

60%

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HDHPs: How to Use The Plan

Caltech Retiree Benefitshr.caltech.edu/retirees

See the Doctor Anthem

Issues the

EOB

Doctor

sends you a

bill

Get Services

Allow Anthem to process the

claim

Match bill to Explanation

of Benefits and pay your share of costs

HDHPs: Health Savings Account

• Health Savings Account (HSA)

– Available if you are in HDHP

• Save for the current year’s expenses

• Save for the future – tax deferred

• Unused funds accumulate year over year

• Consider putting the money you are

saving in premiums in your HSA

Note: To be eligible to contribute to an HSA, you cannot be

enrolled in a non-HDHP plan or in any part of Medicare

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HSA Max – 2020

Under

Age 55 Age 55+

Single $3,550 $4,550

Family $7,100 $8,100

HDHPs: Learn moreVisit MyBenefits to view the High Deductible PPO Guide

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Need Help Deciding What Medical

Plan to Choose?

Get help with:

• Understanding what your plan covers

• Finding an Anthem doctor, hospital, lab, or other

provider — and even make appointments for

you

• Finding lower-cost medications and set up mail

order prescriptions

• Using Anthem's Estimate Your Cost tool to find

the right care at the right price

• Reading your explanation of benefits (EOB), resolve provider billing errors, and

understand the claim appeals process

• Getting answers to your HSA banking questions

• Getting answers to just about any question you might have about your Anthem

plan options

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Set Up an Appointment with Our On-Site Anthem Concierge

Caltech - Keita HeckardPhone: (626) 395-6628Email: kheckard@caltech.edu

JPL - Vida TechachaiponpojPhone: 818-354-7790Email: vidat@jpl.nasa.gov

Thank you for listening

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Value-Based Philosophy

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Pay more when you get services Pay less when you get services

Lower comparative value Higher comparative value

HDHPs HMOs

Lower monthly premiums Higher monthly premiums

HDHP 2800

HDHP 1400

Kaiser HMO

AnthemHMO