2015 BENEFIT INFORMATION

Open Enrollment and New Hires

MEDICAL BENEFITSadministered by

• Remaining with current carrier, UMR (a UnitedHealthcare company)

• Reduced Tier 1 (Berger Health System) Office Visit copays – $10 / $25; plus, $0 when you visit a Nurse Practitioner!

• Reduced Tier 1 (Berger Health System) Out-of-Pocket Maximum – $2,000 / $4,000

• New Rx Out-of-Pocket Maximum – $2,000 / $4,000

DENTAL BENEFITS administered by

NO CHANGES TO DENTAL PLAN!• $50 Deductible/person/year• Benefit Max – $1,000 /person/year• Ortho Benefit Max – $1,500/person/lifetime• Diagnostic/Preventive – 100%• Basic Services – 80%• Major Services – 50%• Orthodontic Services – 60%

VISION BENEFITS administered by

NO CHANGES TO VISION PLAN!• WellVision Exam (every 12 months)– $5 Copay

• Prescription Glasses (every 24 months)– $10 Copay

• Frames (every 24 months)• Lenses (every 12 months)• Special member pricing and discounts!

INCOME PROTECTIONadministered by

• Group Life/AD&D – Company Paid• Group LTD – Company Paid• Voluntary Life/AD&D – Employee Paid; for

employees and dependents• Voluntary STD – Employee Paid; benefit

coordinates with Group LTD• Voluntary Long Term Care – Employee Paid;

different options available

FSA: FLEXIBLE SPENDING ACCOUNTadministered by

• Health Care FSA – New maximum election amount up to $2,500

Use for:• Deductibles, copays, coinsurance• Dental and vision expenses

• Dependent Care FSA – Maximum election amount up to $5,000

Use for:• Expenses are reimbursable for dependent children to

age 13 and eligible dependent adults

EAP: EMPLOYEE ASSISTANCE PROGRAMadministered by

NEW effective 1/1/2015!• LifeBalance is available to employees, family

members and anyone significant to an employee.

• LifeBalance program offers fast, free, confidential help whenever you need it.

• Services include:– 24/7 Toll-Free Access– Face-to-Face Assistance– Web Resources

2015 EMPLOYEE CONTRIBUTIONS

Type Cost per Pay*Employee $77.00Employee + Child(ren)

$126.00

Employee + Spouse $158.00Family $183.00

Type Cost per PayEmployee $6.50Employee + One $15.25Family $29.00

Type Cost per PayEmployee $3.50Family $10.50

All premium amounts listed below will be deducted from the employees pay on a pre-tax basis.

MEDICAL

*Spouses that have access to health insurance, but chose to be enrolled in Berger Health System’s group health plan will be assessed a $50 per pay surcharge, automatically deducted from the employee’s paycheck.

DENTAL

VISION

WELLNESS

Day Time Day TimeOctober 27, 2014, Community Room 6:00am – 1:00pm November 14, 2014,

Class Room 1 & 2 6:00am – 1:00pm

October 28, 2014, Class Room 1 & 2 6:00am – 1:00pm November 21, 2014,

Class Room 1 & 2 8:00am – 12:00pm

November 13, 2014, Class Room 1 & 2 1:00pm – 4:00pm NO OTHER DATES WILL BE SCHEDULED

Onsite Health Screening Schedule

Berger Health System Wellness Program Criteria

Health Screening Tests

Wellness Target Alternative Goal Points

Earned Premium CreditDeductible

Credit(Single / Family)

Body Mass Index < 29.9Meet wellness target, see improvement from last year or enroll in programs through Rite for You

1 $5.00 $250 / $500

Blood Pressure < 140/90Meet wellness target, see improvement from last year or enroll in programs through Rite for You

1 $5.00 $250 / $500

LDL Cholesterol < 130Meet wellness target, see improvement from last year or enroll in programs through Rite for You

1 $5.00 $250 / $500

Online Health Assessment Completed

1 $5.00 $250 / $500

TOTAL $20.00 $1,000 / $2,000

TOBACCO CESSATIONDID YOU KNOW?

TOBACCO CESSATION (cont.)Berger Health System offers employees smoking

cessation programs FREE! If you are a smoker and complete one of the below scheduled programs, the smoking surcharge will be waived.

January 2015 – 1/15, 1/22, 1/29February 2015 – 2/5, 2/12, 2/19

For more information, please contact HR.

IMPORTANT: THINGS TO REMEMBER• Mandatory Enrollment – you must complete

an enrollment form.• Biometric Screenings – you will receive a

scorecard in early December with your results and credits you qualified for.

• ID Cards – you will receive new ID cards for the medical plan effective 1/1/2015, however, ID numbers are not changing. Updated ID cards may also be obtained at umr.com.

IMPORTANT: THINGS TO REMEMBER

• Forms that MUST be turned in to HR:

– Enrollment Form – even if you are not making any changes or are waiving coverage.

– Tobacco Affidavit – if a form is not received, you will be assessed the tobacco surcharge ($25/pay).

– Spousal Surcharge Form – if a form is not received, you will be assessed the spousal surcharge ($50/pay).

– Over Age Dependent Form – complete and return if you have a dependent age 26 or older.

– Beneficiary Form – now is the best time to update your beneficiary information.

– Primary Care Provider (PCP) Questionnaire – do you have a PCP?

Resources• Human Resources• UMR – 1-800-826-9781; www.umr.com• Delta Dental – 1-800-524-0149;

www.deltadentaloh.com• VSP – 1-800-877-7195; www.vsp.com• LifeBalance – 1-877-259-3785;

www.lifebalance.net (user ID: berger, password: health)