welcome to kentuckyone health

Welcome to KentuckyOne Health

New Hire Benefits 2014

CHI Healthy Spirit Program

• Welcome to CHI/KentuckyOne Health!

• We want to partner with you and your family for good health and financial well-being

• That’s why we created the Healthy Spirit Program

• Purpose of the program: to raise the level of the overall well-being of CHI employees and their families

CHI Healthy Spirit Program

How the Healthy Spirit Program can make a difference in your life:

•Provides you competitive and affordable benefits

•Educates you and your family about what it takes to build financial security for your life

•Offers comprehensive medical plan options

•Provides tools and resources to help improve fitness and overall wellness for you and your family

•Supports lower income families by offering the Health Care Assistance Program

Today’s agenda

Healthy Spirit Program:

Eligibility

Review of CHI benefit plans

Healthy Spirit Wellness Program

What you need to do

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TipWatch throughout the presentation for the tip boxes to learn more about your CHI benefits.

Eligibility

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Eligibility

• You:

o Full-time: regularly scheduled to work 36+ hours per pay period; or

o Part-time: regularly scheduled to work 20 - 35 hours per pay period

Adult dependents:

o Your spouse of the opposite sex who is legally married to you

OR

o Any other adult of the opposite or same sex that is financially supported by you and lives with you

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Eligibility

Child dependents:

o Up to age 26

o Includes child dependents of eligible adult dependents

o Physically and mentally handicapped children who are unmarried and financially dependent on you as long as they became disabled prior to age 26 and were added and approved as a disabled dependent on your employer-sponsored health care plan continuously since reaching age 26

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Dependent Verification

• If you add a dependent to the CHI medical, dental and/or vision plans, you will receive an audit notice and will be required to provide documentation.

• Unverified dependents will not be eligible for coverage.

• The audit notice will be sent to your home shortly after you enroll in your benefits

• The notice will include instructions and a list of options for supporting documentation

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TipBe sure to return your dependent audit notice by the deadline or else your dependents may not be eligible for coverage.

CHI Health Benefits

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CHI Health Benefits

CHI Health Benefits:

Medical and Prescription


Dental

Vision

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Medical Plan Options

Terms to Know

Copayment: a flat-dollar amount you are required to pay for a covered service

Coinsurance: the percentage of the cost that is your responsibility

Covered Services: services that are covered under the CHI Medical Plan – refer to

the Summary Plan Description for the comprehensive list

Deductible: the amount you have to pay before the plan begins to pay for a portion of

the costs

Clinically integrated network: a network within the CHI Medical Plan of health care

providers, facilities and ancillary services collaborating to improve the health of CHI

employees and dependents

In-Network: refers to a national network of providers within the CHI Medical Plan

Out-of- Network: refers to providers that are not within the CHI Medical Plan network

Out-of-Pocket Maximum: the annual maximum amount you will pay for services

through the CHI Medical Plan 11


Our Clinically Integrated Network: KentuckyOne Health Partners

Clinically integrated networks shift the focus from traditional sick care to proactive well care

Supports our focus on improving the health of people and communities around us

Our local clinically integrated network, referred to as KentuckyOne Health Partners, is the preferred network with the highest level of benefits in the CHI Medical Plan

If you seek care from a provider within the KentuckyOne Health Partners, your out-of-pocket costs may be lower

More importantly your care will be better coordinated through shared data, better communication, streamlined services, avoidance of duplicate services, etc.

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Our Clinically Integrated Network: KentuckyOne Health Partners

•A more holistic approach to your health and wellness through your primary care physician and other network providers

•Your primary care physician functions as your “primary care medical home” – a central hub for your medical care

•Whether you have a chronic illness or you are relatively healthy, your primary care medical home can help you manage your health If you enroll in the CHI Medical Plan, you must designate a primary

care physician (PCP) Designation must be a family practitioner, pediatrician, an

internal medicine physician or a corresponding mid-level provider (nurse practitioner or physician assistant) preferably within the local KentuckyOne Health Partners

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If you enroll in a CHI Medical Plan,please designate a provider…


What does the KentuckyOne Health Partners Network do for you?

Holistic approach through coordination of more effective, safe and efficient care

Encourages you to be more proactive in your own care

Health information is accessible to any provider within the local network responsible for your care

Health benefits, such as: better care results, fewer hospital admissions for chronic diseases, etc.

Ensures the right care is provided at the right time

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While on the enrollment website…

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See if your doctor is within our local clinically integrated network.

TipYou can also search for network providers through the My Healthy Spirit website


Your CHI Medical Plan options:

Integrated Core

Integrated Basic

Integrated High Deductible with Health Savings Account (HD/HSA)

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Integrated Core Integrated Basic Integrated HD/HSA

Annual deductible – the amount you pay before the plan begins to pay benefits

KentuckyOne Health Partners Network

Anthem Network

Out-of-Network

$1,000 Individual/$2,000 Family








Office Visits – the amount you pay for covered office visits (preventive care covered 100%)


Anthem Network

Out-of-Network

Primary Care: $10Specialist: $25

Primary Care: 20%Specialist: 25%

50% After Deductible

Primary Care: $20Specialist: $35

Primary Care: 30%Specialist: 35%


After Deductible:Primary Care: 15%

Specialist: 20%

After Deductible:Primary Care: 20%

Specialist: 25%


Most Services – the amount you pay for covered services


Anthem NetworkOut-of-Network

10% No deductible for Facility Charges; 10% After deductible

for Physician Charges

25% After deductible50% After deductible

15% No deductible for Facility Charges; 10% After deductible

for Physician Charges


15% After deductible



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Integrated High Deductible with Health Savings Account (HD/HSA)

Must meet the deductible before the plan begins to pay for medical AND prescription expenses (preventive medical care is the exception which is covered at 100%)

Once deductible is met, you and CHI share in the cost of services (coinsurance)

Once out-of-pocket maximum is met, CHI pays 100% for the rest of the year for covered services – including prescriptions

Family deductible and works differently than the Integrated Core and Integrated Basic Plan options – family must meet entire family deductible before the plan benefits begin

Similarly the family out-of-pocket maximum must also be met before plan pays 100 percent

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HD/HSA option includes a health savings account

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Health Savings Account (HSA)

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Want to calculate how much to contribute? Use the online calculator at www.healthequity.com/ed/chi under “Tools & Forms”


Health Savings Account (HSA)

Eligibility (per IRS)

Must be enrolled in a qualified medical plan – such as the HD/HSA

Have no other medical coverage – including Medicare or a spouse’s plan

You and your family cannot be enrolled in a general health care flexible spending account, including a spouse’s flexible spending account – you can enroll in the CHI limited health care flexible spending account

You cannot be claimed on someone else’s tax return

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Transferring Your HSA Funds

You can keep your HSA funds with your current administrator or roll over your funds to the CHI HSA

If you enroll in the HD/HSA, your before-tax HSA contributions will go to the CHI HSA through HealthEquity

Want to transfer?

Download Transfer/Rollover Form at www.healthequity.com/form

Complete the form and submit it to HealthEquity via mail or fax

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Prescription Coverage

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Integrated Core Integrated Basic Integrated HD/HSA

Retail (30-day supply): CHI/KentuckyOne Health Pharmacy (if available)

GenericPreferred BrandNon-preferred Brand

$510% ($15 min/$37.50 max)20% ($25 min/$62.50 max)

$515% ($17.50 min/$50 max)

25% ($30 min/$75 max)

After Deductible:$5

10% ($15 min/$37.50 max)20% ($25 min/$62.50 max)

Retail (30-day supply)


$1020% ($30 min/$75 max)

40% ($50 min/$125 max)

$1030% ($35 min/$100 max)50% ($60 min/$150 max)

After Deductible:$10

20% ($30 min/$75 max)40% ($50 min/$125 max)

Mail Order (90-day supply): CHI/KentuckyOne Health Mail Order or Retail 90 fill (if available)


$1010% ($37.50 min/$62.50 max)20% ($62.50 min/$125 max)

$1015% ($42.50 min/$75 max)25% ($75 min/$150 max)


10% ($37.50 min/$62.50 max)20% ($62.50 min/$125 max)

Mail Order (90-day supply)


$2020% ($75 min/$125 max)

40% ($125 min/$250 max)

$2030% ($85 min/$150 max)

50% ($150 min/$300 max)


20% ($75 min/$125 max)40% ($125 min/$250 max)


Things to Consider: Prescription Coverage

If you fill a brand-name prescription when a generic equivalent is available, you will pay:

Brand-name coinsurance + difference between generic and brand-name amount

Maintenance medications must be filled using the mail order pharmacy or a CHI-owned retail pharmacy

All prescriptions filled from a CHI-owned pharmacy will cost you 50% less than the copay/coinsurance you will pay for the same drug filled at a local retail pharmacy

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Contraceptives - Women’s Preventive Health Mandate

Our prescription drug and health plan administrators are required to work directly with you if you would like to access these services and/or prescription drugs at no cost to you:

Medical services: Patient education and counseling on contraceptives, administration of certain contraceptives (such as the insertion of IUD’s or injections) and women’s sterilization procedures

Prescription drugs: Generic contraceptives, over-the-counter contraceptives with a doctor’s prescription and multi-source brand contraceptives (when a doctor determines it medically necessary)

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There is no obligation to participate

Program is free and confidential

Available to all employees, even those not enrolled in the medical plan

Spouses enrolled in CHI’s Medical Plan can also participate in the program

The Healthy Spirit wellness incentive is earned per quarter

CHI partners with Preventure to help manage our wellness program

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Tools available include:

• Personal Health Assessment

• Biometrics screenings

• Health and wellness workshops

• Health coaching

• Disease/condition management

• Variety of trackers and logs

• Activity tracking devices

• Mobile technology

• Fitness club discounts

• Quarterly themed challenges

TipWatch the video on My Healthy Spirit to learn more about the Healthy Spirit Wellness Program

Helping You Manage Your Health Condition

For employees who are managing chronic conditions:

If you have a chronic disease or health condition, your care can be managed by a “lifestyle coach” and your information will be highly confidential

You may be invited to join a disease or chronic condition program

Free, confidential and voluntary for participants of CHI’s Medical Plan

Spouses participating in the CHI medical plan also can take advantage of this program

Children with asthma or diabetes participating in the CHI Medical Plan also may participate

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Dental Plan Options

Your CHI Dental Plan options:

Core

PPO

CHI Dental Plan is administered by MetLife

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Dental Plan Options

Dental: PPO and Core options

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PPO Option Core Option

In-network Out-of-Network In-network Out-of-network

Deductible $50 individual/$150 family $50 individual/$150 family

Annual Max $1,500 $1,000

Preventive & Diagnostic

$0 $0 $0 $0

Basic Restorative

10% 20% 50% 50%

Major Restorative

40% 50% 50% 50%

Orthodontia 50%, up to $1,500 50%, up to $1,000

Vision Plan

Vision Plan through EyeMed

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EyeMed Select Network Benefit

Exam $15Limited to one exam every 12 months

Contact Lens fit & follow-up Up to $40

Lenses (single, lined bifocal and lined trifocal)

$15Limited to once every 12 months

Frames $120 allowance, plus 20% discount available Limited to once every 24 months

Contact lenses (allowance covers materials only)

$105 allowanceConventional or disposable lenses in lieu of glasses

Limited to once every 12 months

Note: Out-of-network coverage is also available if you see a provider who is not in the EyeMed Select network.

CHI Financial Well-being Benefits

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CHI Financial Well-being Benefits

CHI Financial Well-being Benefits:

Flexible spending accounts

Disability

Life insurance

Retirement savings

Tuition reimbursement

Adoption assistance

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Flexible Spending Accounts

Flexible spending accounts A flexible spending account allows you to set aside before-tax money

from your paycheck to pay for eligible health care or dependent care expenses

Three types of flexible spending accounts: Health care flexible spending account – helps you pay for certain health

care expenses, such as deductibles or prescriptions. You cannot enroll in this type of flexible spending account if you enroll in the HD/HSA medical plan option.

Limited purpose post-deductible health care flexible spending account – if you enroll in the HD/HSA medical plan option, you can contribute to this limited account for eligible dental and vision expenses. Once your HD/HSA deductible is met, you can use the account to reimburse yourself for eligible medical, dental or vision expenses paid out of pocket.

Dependent care flexible spending account – helps you pay for certain dependent care expenses, such as daycare.

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Using your health care flexible spending account debit card You will receive a debit card from

HealthEquity when you enroll

The debit card allows you to purchase eligible health care items without paying out of pocket

The card is loaded with the total available balance from your health care flexible spending account selection

The card comes with instructions on how to use it

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Things to Consider: Flexible Spending Accounts

You can use your 2014 flexible spending account funds for expenses incurred through March 15, 2015

Expenses must be submitted to HealthEquity by March 31, 2015

Learn more about the flexible spending accounts at www.healthequity.com/ed/chi

General flexible spending accounts overview

List of eligible expenses

Flexible spending accounts tax savings worksheet

If you enroll in a flexible spending account, you can check your flexible spending account balance and submit for reimbursement through the HealthEquity website or mobile application

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Disability Insurance

Automatically enrolled in short-term disability

Benefits begin after a 7-day elimination period – must use paid time off

Provides 80% of your base pay for 5 weeks after the 7-day elimination period and then provides 60% for remaining 20 weeks, if approved

•If eligible for long-term disability:

• Available for full-time employees

• Provides 60% of your base pay if you are disabled beyond 26 weeks

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Life Insurance

Will be automatically enrolled in:

Basic life and AD&D – two times base pay

Business travel accident – three times base pay

Have the option to enroll in:

Supplemental life for you – up to five times base pay (up to a combined maximum with basic life of $750,000)

Supplemental life for your spouse – up to $200,000

Supplemental life for your children – up to $20,000 per child

Evidence of insurability may be required

For you: amounts over three times base pay or $500,000 whichever is less

For your spouse: amounts over $50,000

• Remember to designate your beneficiary40

Retirement Plans

CHI 401(k) Retirement Savings Plan•You can make pre-tax and Roth after-tax contributions, up to IRS maximum•If you do not elect a contribution rate, you will be automatically enrolled in the plan at a 4 percent pre-tax contribution rate•CHI will match your contribution 100% on the first 1% + 50% on the next 5% of eligible pay. If you contribute at least 6% of eligible pay, that means CHI will provide a maximum rate of match of 3.5% of pay

o You are eligible for the match the first pay period after you have been paid for 1,000 hours

•You can choose to opt out of the plan, increase or decrease your contributions at any time

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TipYou can learn more about the CHI 401(k) Retirement Savings Plan by watching the retirement video on My Healthy Spirit website

Retirement Plans

• CHI may also make an annual employer contribution of 2.5%* of eligible pay ($1,000 minimum) to your 401(k) plan account regardless if you contribute any of your pay if:o You must have been paid for at least 1,000 hours prior to the end of

year; ando You must be employed on the last day of the yearo Contributions will generally be made to your 401(k) plan account after

the close of the year end that you are receiving a credit

• If you save at least 6% of your own pay, CHI would contribute up to an additional 6% to your 401(k) account

• To become fully vested for both matching contributions and the annual employer contribution you must have completed three years of vesting service (1,000 paid hours of service each year)

*Note: Employees of CHI Physician Services (CHIPS) and Mountain Management are not eligible for annual employer contribution.

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Retirement Plans

• CHI 457(b) Non-qualified Deferred Compensation Plan is available to certain employees whose base pay rate is equal to or greater than $115,000 OR who is a Physician status (regardless of pay)o Allows for additional employee contributions to be deferred on a

pre-tax basis up to the allowable IRS maximum limito Is subject to the risk of creditors claims should CHI become

insolvento Eligible participant should consider maximizing contributions

under the CHI 401(k) plano Investment options are similar to what is offered under the CHI

401(k) plan with the exception of the Self-Directed Brokerage Window which cannot be legally offered under this plan

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Tuition Assistance

• Tuition Assistance

o Annual reimbursement up to $3,000 for full-time employees and $1,500 for part-time employees.

o After the course is completed, you are committed to maintaining employment with our organization for 12 months from the date the reimbursement is paid or you will have to repay the total tuition reimbursement amount.

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Adoption Assistance

• Adoption Assistance

o Annual reimbursement will be $4,000 for full-time employees and $2,000 for part-time employees. There is no additional reimbursements beyond the annual reimbursement listed above.

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Other Benefits

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Employee Assistance Program

• Employee Assistance Program is available to your and your family free of charge

• The program provides access to confidential, professional counseling that can make it easier to cope with a variety of personal issues and life changes

• Program is available 24/7

• ValueOptions is the administrator

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Next Steps

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Next Steps

Things to consider before you enroll:• Evaluate your needs.

• What benefits and services did you pay for and use this past year?

• What do you expect to need for the near future?

• Could you use the HD/HSA medical plan option to help save on taxes and build up savings for medical care you may need over the longer term?

• Look at your medical and prescription claims history online using your medical and prescription administrator’s websites. There is also a medical expense estimator tool available on the enrollment website.

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Next Steps

Things to consider before you enroll:• If you are interested in possibly selecting the HD/HSA, consider the

following:

• Review the HD/HSA plan to make sure you understand how it works

• Visit the HealthEquity website, www.healthequity.com/ed/chi, to understand how the HSA can be used to build medical savings for the future expenses

• Determine how much you can afford to save from your paycheck into the HSA (remember CHI is contributing too!)

• Watch your mail for details about the steps to log in to the enrollment website

• While on the enrollment site, take a moment to enroll in the CHI 401(k) Plan

• Visit the My Healthy Spirit website to learn more about the CHI benefits available to you, including our benefits video library

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Next Steps

While enrolling… go paperless

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Next Steps

Once you enroll and become eligible for benefits:• If you enroll in the CHI Medical Plan, be sure to designate your

primary care provider through the My Healthy Spirit website

• Start participating in the Healthy Spirit Wellness Program

• Make sure you have designated beneficiaries for your life insurance and retirement benefits

• Watch your mail for additional information, such as ID cards

• Check your paycheck to ensure your benefit deductions are accurate

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For More Information...

About your CHI benefits:

My Healthy Spirit website

Enrollment website

Spirit magazine

My Handbook

HR/Payroll Connection at 1-888-450-9450

Your local HR representative

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For More Information...

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Questions

Health Care Assistance Program

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Making health care affordable for employees

•Offering assistance is based in the tradition of social justice

•The program supports our commitment to offer affordable health care to employees within CHI

• Consistent with our highest advocacy priority: access andcoverage for all

•Long before health care reform became such a prominent debate, CHI began planning for this program because we believe it’s the right thing to do

•The health of our employees and their families will improve as more people have access to preventive care and health information

•Healthier employees means stronger work teams and better quality of life at home and work

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Financial assistance for medical plan out-of-pocket expenses

•Based on household income, employees may qualify for financial assistance to help with out-of-pocket costs such as deductibles, coinsurance for doctor’s visits, prescriptions, etc.

The program is available annually and the application process typically occurs in July – watch for more information on My Healthy Spirit website

Employees approved to participate in the program will be sent more information to their mailing address

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Next steps for employees accepted to participate in the program

• If approved for the Health Care Assistance Program, you will need to sign up for the Integrated Basic medical plan option, including the dependents you want to cover to receive assistance

• We will send you details about how to use your financial assistance to pay for eligible health care expenses

• Expenses will be handled through a health reimbursement account (HRA), that will work like a flexible spending account, through HealthEquity

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