2016 Benefits Guide TM

Health System 1

Your Ochsner Benefits It is our pleasure to provide your 2016 Benefits Guide, which outlines your Ochsner Benefits for the upcoming plan year. Your contributions to making Ochsner a successful organization are greatly appreciated and your benefits package is a part of your total rewards program. We recognize that our total rewards - benefits and pay - are a key to attracting and retaining people like you. This guide contains an overview of your benefits offerings for the 2016 plan year. In addition, please refer to your addendum which is available in Employee Service Center (ESS) where you will complete the enrollment process. Ochsner offers a comprehensive benefits package designed to accommodate the diverse needs of its employees. Before you enroll in your benefits, take time to read through the materials available to you. Consider your choices as well as your anticipated needs before selecting your benefits. If you need more detail than this guide provides, please refer to your Summary Plan Description (SPD) or contact the HR Employee Service Center by calling (504) 842-4748 or by emailing [email protected]. Please note: This guide is intended to provide a brief summary of your Ochsner Health System benefits. It is not intended to include all of the benefit plan details. The complete details about how the plans work are included in the SPD and plan documents, which are available to all employees. If there are any discrepancies between this Benefits Guide and the official plan documents, the plan documents will govern. The company reserves the right to amend, change, or terminate any of the plans at any time for any reason. This document does not constitute a contract or offer of employment. If you are an Executive, Senior Physician, Senior Professional Staff, Staff Physician, Professional Staff, Assistant Professional Staff, Certified Nurse Anesthetists, Advanced Practice Provider (APP), Resident and Fellow or Management specific eligibility and benefits differences are described in a separate addenda available via your Employee Self Service account.

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CONTENTS

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Benefits Basics__________________________________________

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Enrollment _____________________________________________

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Medical_______________________________________________ 11 Pharmacy______________________________________________ 20 Dental_________________________________________________ 23 Vision_____________________________________________ 25 Flexible Spending Accounts (FSA)______________________ 26 Life and AD&D________________________________________ 29 Disability______________________________________________ 32 Employee Assistance Program (EAP)/Work-Life Plan____ 34 Paid Time Off (GPT) ___________________________________ 35 MyOchsner____________________________________________ 37 Pathway to Wellness___________________________________ 38 Important Contacts____________________________________ 39

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BENEFITS BASICS Eligibility For You You are eligible for benefits on the first of the month following one month of service, provided you are in an active payroll status. For the effective dates of coverage, however, please refer to the specific benefit section. If you are eligible for coverage, you can also enroll your eligible dependents for medical, dental, vision, life insurance and accidental death and dismemberment insurance (AD&D). ELIGIBLE EMPLOYEES Full–Time Employees who work 72 hours or more each pay period Part–Time Employees who work 8-71 hours each pay period (The term “regular part-time” may be used to refer to part-time employees who work 40-71 hours each pay period) SSP/PRN Employees Employees who work SSP/PRN are eligible to participate in the Medical Plan Only

Your Eligible Dependent(s) Spouse • Your legally married same-sex or opposite-sex spouse • Common-law spouses are eligible for medical coverage as a Domestic Partner

Children • • • •

Your natural children Your stepchildren Legally adopted children (or children legally placed with you for adoption) Foster children (through age 25 if the child was your foster child upon reaching limiting age under the foster child program) • Any child for whom you have legal custody (through age 25 if you had legal custody of the child upon his or her reaching limiting age under the legal guardianship agreement or law) • Your unmarried handicapped child of any age, provided the handicap begins while the child is covered and before reaching the limiting age specified above, and provided the child spends 8 hours or more per day in your home

Domestic Partner • Your same-sex or opposite-sex partner who lives in the same domicile as you (Eligible for medical benefits only and must be approved through the Dependent Eligibility Verification process) • Dependents of domestic partners are not eligible for coverage • You pay 100% of the cost of your domestic partner’s benefits on an after-tax basis

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IMPORTANT TO KNOW: ACTIONS YOU MUST COMPLETE Dependent Eligibility Verification Ochsner requires verification of eligibility for any dependent newly enrolled for coverage under the medical, dental, vision and dependent life plans. A Proof of Eligibility packet is mailed from Xerox HR Solutions to your home address which explains the process and the information required to prove eligibility. If you fail to provide the required documentation within the timeframe specified in the packet, coverage for your dependents will end as specified in the termination letter. If a dependent is found to be ineligible, you will not receive any refund of premiums or contributions.

Spousal Access Fee Verification If your spouse or domestic partner has the option of obtaining coverage through his or her own employer but you are choosing to enroll your spouse or domestic partner in Ochsner’s medical coverage instead, an additional $37.50 Spousal Access Fee will be deducted from your semi-monthly paycheck on a pre-tax basis. Ochsner requires verification of any spouse/domestic partner you enroll in an Ochsner Medical Plan that has access to medical benefits through his/her own employer. Xerox HR Solutions will mail to your home address a Spousal Surcharge Evaluation Form, which explains the process and the information you must provide in order to waive the spousal access fee.

Other Medical Coverage Affidavit Ochsner requires that employees attest to whether they have other medical coverage. All full-time employees who indicate they do not have other coverage and do not elect medical coverage will be automatically enrolled in the OchPlus 2 medical plan at the employee-only level.

Tobacco Use Affidavit Ochsner requires that employees attest to whether they are tobacco users during benefits enrollment. Your attestation determines whether you pay a tobacco-free or tobacco-user premium. A tobacco test is included in the new hire drug screen. New Hires who test positive for tobacco will be assigned a tobacco-user premium. Ochsner will conduct random tobacco testing during Open Enrollment and annual TB testing throughout the year. Any employee who tests positive for tobacco will be assigned a tobacco-user premium. Failure to submit to testing or abide by the tobacco-free guidelines will be subject to HR Policy on falsification of employment information on Ochweb, Progressive Discipline Policy, OHS.HR 502.

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ENROLLMENT You can enroll in your benefits: • Within 31 days of the date you are hired or become newly eligible for benefits. • During the annual open enrollment period held each fall, with your benefit choices becoming effective on January 1 of the following year.

Once you enroll in your benefits, your elections remain in effect through the end of the plan year. You cannot change your benefit elections during the year unless you experience a qualifying change in status as described in the section “Changing your Benefits Coverage Due to a Qualifying Change in Status,” or qualify for a special enrollment period as described in the section “Special Enrollment Period.”

If You Do Not Enroll By the Deadline If you do not enroll in your benefits by the deadline you are given (within 31 days of being hired or becoming newly eligible, or the end of the enrollment period during open enrollment), you will receive limited “default” benefits that may not include all the coverage you want or need. Default benefits consist of: • Employee-only coverage under OchPlus 2 for medical coverage (you will not be re-enrolled in your previous coverage) • Employer paid Basic Life & AD&D Insurance • Employer paid Business Travel Accident Insurance (full-time employees only) • Employee Assistance Program (EAP)/Work-Life Plan • Disability coverage, if you meet the eligibility requirements You will not have any optional benefits coverage, and you will have to wait until the next open enrollment period to change your benefits, unless you experience a qualifying change in status or qualify for a special enrollment period.

Open Enrollment Each fall, you can change your benefits elections for the upcoming calendar year. Coverage elected during open enrollment becomes effective on January 1 of the following year.

Your Login User Name and Password Upon hire you receive an Ochsner user name and password which is also used as your login to Employee Self Service/Benefits Enrollment. If you have questions about your user name or password, please contact the IS Help Desk by calling (504) 842-3610.

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The Enrollment Process It is important to complete all the necessary steps when enrolling. We have enclosed some tips, because the order of these steps are important to accurately record your enrollment. ENROLLING VIA THE INTRANET/OCHWEB •

Go to Ochweb on the Intranet.

•

Click on the Employee Self Service link to the right of the Ochweb homepage under Human Resources.

•

Enter your login user name and password.

•

During Open Enrollment, click on the tab entitled “Open Enrollment for 2016” to enroll in your benefits for the 2016 plan year.

•

If you are a new hire, click on the tab entitled “New Hire Enrollment” to enroll in your benefits for the 2016 plan year. Enroll in New Hire Enrollment first, then enroll in Open Enrollment.

ENROLLING VIA THE INTERNET •

Access the Internet.

•

Type ohslink.ochsner.org into your web browser/address line. (Do not enter the link into a search engine – i.e. Google, Bing, Yahoo, etc.)

•

Enter your user name and password (the same one used to log in to your computer at work).

•

Click on the Lawson ESS icon located on the left side of the screen. (If you receive a pop up box with access questions, select “Full Access” and “Never Ask Me Again” to continue.)

If You Become Eligible to Enroll or Change Your Benefits Due to a Qualifying Change in Family Status or Status Change If you become eligible to enroll because you have experienced a qualifying change in family status you must fill out a Change of Family Status Form found on Ochweb under Human Resources, HR Forms. You must complete and return the Change of Family Status Form to Human Resources within 31 days of your qualifying change in family status event. If you do not have access to Ochweb, you may obtain a Change of Family Status Form by emailing MyHR@ ochsner.org.

ENROLLMENT TIPS •

First click on the Dependents link on the left hand side of the screen first. Ensure all your dependents are added and their information is correct

•

After you finish enrolling in your benefits, click on the “update” button. If you do NOT click the Update button, your benefits elections will not be saved

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When given the option, print your benefits elections summary and save for your records

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When You Enroll, You Should • • • • •

Read and be familiar with your benefits materials and deadlines Review all your current elections, and all available options Ensure all your eligible dependents are enrolled and their information is correct Review your benefits elections Print your Election Summary page (keep as documentation)

Paying for Your Benefits Ochsner provides you with the following benefits at no cost to you. • Basic life insurance • Basic AD&D coverage • Short-term disability (STD) – if you are a full-time employee with at least 12 months of service • 60% long-term disability (LTD) – if you are a full-time employee with at least three years of service • Business travel accident insurance – if you are a full-time employee • Employee Assistance Program (EAP)/Work-Life Plan You and Ochsner share in the cost of some benefits. Flexible Spending Accounts and Health Savings Accounts are fully funded by your contributions. Your cost for each plan is available during your online enrollment process or by viewing your specific premium/addendum in your Employee Self Service account. You pay your share of the cost of your benefits with pre-tax dollars for medical, dental, vision, optional life, voluntary AD&D, LTD and flexible spending account and health savings accounts benefits. Paying for your benefits with pre-tax dollars reduces your taxable income, so you pay less in taxes. You pay the cost of dependent life insurance and domestic partner medical coverage on an after-tax basis. Your benefits premiums will be deducted from your pay check 24 times a year. This means you will not have benefits deductions during the months there are three pay periods.

Choosing the Right Benefits Coverage Whether you are enrolling for benefits the first time as a new employee or newly eligible employee, or re-electing your benefits as required for open enrollment, it makes sense to carefully evaluate your benefit needs to make the right choices for you and your family. Here are some questions to consider as you make your benefit choices: • How often do I plan to visit my physician and dentist? What about visits for my covered family members? • Were last year’s plans and coverage levels right for me? How much did I spend out-ofpocket? • Are my needs expected to change during the year? If you are a new employee of Ochsner, do not just try to duplicate the coverage you had with your last employer. Think about your needs and choose the coverage that is right for you and your family based on your current situation and take the best advantage of the benefits opportunities offered to you by Ochsner.

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Changing Your Benefits Coverage Due to a Qualifying Change in Status Because you pay for most of your benefits on a pre-tax basis, the IRS does not allow changes to any benefits during the year unless you experience a qualified change in status. You have 31 days from the date of the qualified change in status to change your coverage. The change in coverage must be consistent with the change in status. If the qualifying change in status is not reported appropriately within 31 days, of the event, the change in coverage cannot take place until the next open enrollment period. Your qualifying change in status can be family or job related. During the year, IRS rules permit you to change your benefits for the following reasons: • Legal change in marital status: marriage, divorce or legal annulment • Change in number of dependents: birth or adoption • Dependent child’s loss of eligibility due to age • Significant gain or loss of coverage through your spouse’s (or domestic partner’s) employer • Your spouse’s or domestic partner’s gain or loss of employment • Increase or decrease in hours worked by you, your spouse (or domestic partner), or your eligible dependents that affect your family’s eligibility for benefits • Issuance or cancellation of a Qualified Medical Child Support Order (QMCSO) • You or your spouse going on, or returning from, some type of unpaid leave of absence • Entitlement to Medicare or Medicaid • Death of a spouse, dependent child, or domestic partner Contact the HR Employee Service Center by calling (504) 842-4748 or email [email protected] for further rules regarding qualified changes in status. When submitting a Change of Family Status Form, you must submit a Spousal Access Fee form.

Dual Coverage if Your Spouse and/or Child(ren) are Employed by Ochsner If you and your spouse or domestic partner both work for Ochsner and are in benefits-eligible positions, you may each take employee coverage, or one of you may cover the other as a dependent. You cannot be covered as both an employee and a spouse for the same coverage. Also you may not carry one another on spouse life insurance, and only one of you may cover any eligible dependent children for dependent life insurance coverage. If you have a dependent child under the age of 26 who is a benefits-eligible employee of Ochsner, you may cover him/her as a dependent under your medical, dental and/or vision benefit plans. However, your dependent child may not be covered as a dependent under your child life insurance benefit. Dependent daughters are ineligible for maternity benefits.

Special Enrollment Period In addition to your qualified change in status rights, the IRS has created special enrollment rights that allow you to change your medical coverage within 31 days of the occurrence of one of the following:

If You Acquire a New Dependent If you acquire a new dependent as a result of marriage, birth, adoption or placement for adoption, you may enroll yourself and your new dependent in one of the OchsnerPlus medical plans. If you are already enrolled in an Ochsner Medical Plan when you acquire a new dependent, you may enroll your dependent in your current option, or enroll yourself and your family members in a different option. In order to take advantage of this right, you must enroll a new dependent within 31 days of the date you acquired the new dependent. If you miss this deadline, you will not be permitted to enroll the dependent until the next open enrollment period. 9

If You or Your Dependent Loses Other Coverage You may decide not to elect medical coverage for yourself and/or your eligible dependents because you or your dependents have other group coverage. If you or your dependents lose that coverage for one of the following reasons, you may enroll yourself and/or your dependents in an OchPlus medical plan within 31 days of the date the other coverage ends: • You and/or your dependents are no longer eligible for other coverage. • Another employer stops making contributions toward the other coverage. • The coverage was provided under a COBRA continuation provision, and the right to that continued coverage has ended. • You and/or your dependents no longer have access to a medical coverage plan service area, and there is no alternative benefit option.

You Qualify for Premium Assistance From Medicaid or the Children’s Health Insurance Program (CHIP) If you are eligible for health coverage from your employer, but are unable to afford the premiums, most states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you require additional information, please refer to your SPD. Please note that this is only a summary of the rules and legal restrictions regarding changing your benefits elections during the year. If you have a qualifying change in status, please contact the HR Employee Service Center by calling (504) 842-4748 or email [email protected] for more information. Remember, you must notify the HR Employee Service Center within 31 days of your qualifying event in order to change your elections consistent with your status change.

When Coverage Ends Your benefits coverage ends on the earliest of the following dates: • Last day worked at Ochsner Health System • The beginning of the period for which you fail to make the required contributions • The day on which you no longer meet eligibility requirements Coverage for your dependents ends on the earliest of the following dates: • The day your coverage ends • The day on which your dependents no longer meet eligibility requirements

COBRA If your coverage ends, you may be able to continue your medical, dental, vision and Health Care Flexible Spending Account and Pathway to Wellness participation through COBRA. Please refer to your SPD or call the HR Employee Service Center for more information about COBRA coverage. You will also receive Cobra election information from Conexis, Ochsner’s administrator.

Family and Medical Leave Act/Uniformed Services Employment and Reemployment Rights Act You may also be eligible to continue health coverage under the provisions of these acts. Please refer to your SPD or contact the HR Employee Service Center for more information.

Coverage After Retirement If your coverage ends due to retirement at attaining age 55 and you have at least 10 years of service, or at attaining age 65 and you have at least 5 years of service, you may elect to continue your medical and vision coverage, provided you pay the required contributions. Vision and dental coverage alone cannot be elected. 10

MEDICAL Ochsner offers you three comprehensive medical plan options, which include prescription drug coverage. The three options offer employees choices between affordable premiums or out-ofpocket expenses.

Requirement to Have Medical Coverage The Affordable Care Act requires individuals to maintain health insurance coverage. As a health care provider, Ochsner believes all employees should have medical coverage. All fulltime employees who do not elect medical coverage through another source, such as through the plan of your spouse or parent, will be automatically enrolled in OchPlus 2 plan at the employee-only level.

Spousal Access Fee The Spousal Access Fee is a supplemental pre-tax contribution by an Ochsner employee who elects to cover an employed spouse or domestic partner who has access to medical benefits through his or her own employer. The employee covering a spouse or domestic partner will pay an additional $37.50 per pay period unless the spouse or domestic partner is • Not employed • Employed but is not eligible for medical benefits from that employer, or the employer does not offer benefits to employees • Employed by Ochsner Availability of coverage through an exchange or Medicare/Medicaid will NOT be considered “other coverage” for purposes of the Spousal Access Fee. Your timely response to Xerox HR Solutions verification process determines whether you will be assessed the Spousal Access Fee.

Reconstructive Surgery Following Mastectomies If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient for: • All stages of reconstruction of the breast on which the mastectomy was performed • Surgery and reconstruction of the other breast to produce a symmetrical appearance • Prostheses • Treatment of physical complications of the mastectomy, including lymphedema These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under the Ochsner medical plans.

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SNAPSHOT OF THE MEDICAL PLANS You have a choice of three OchsnerPlus Medical Plans. All plans are comprehensive point-of-service (POS) medical plans that give you the flexibility to use any Ochsner in-network physician or facility to receive the highest level of benefits. In-network wellness care (including appropriate preventive screenings) is covered at 100% with no deductible required.

Consumer Profile

Employee prefers stability of higher premiums (paycheck deductions) and lower co-pays when using benefits. Most expensive plan but easier to understand and predict expenses

Middle of the road plan with lower premium than OchPlus 1 and higher deductible. Good choice for employees who have fewer expenses and can save $$ on the premium but also pay the deductible when expenses occur.

Medical Plan Choices

1 OchPlus 1

2 OchPlus 2

Employee Cost

Higher Premium ($$$) Low Out-of-Pocket

Market Premium ($$) Market Out-of-Pocket

Eligibility for Pre-Tax Account Prescription (4 tier cost)

Tier Tier Tier Tier

Low premium and high deductible expenses. Employee must have resources to pay high deductible when care is needed. New, tax deferred savings plan available to set aside outof-pocket expenses.

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OchPlus 3 Lower Premium ($) High Out-of-Pocket

Flexible Spending “use it or lose it”

Health Savings “portable – you own it”

No Deductible

Some preventative drugs available with $0 co-pay

Co-Pay after Deductible

1 Lowest cost brands and generics 2 Higher priced brands and generics 3 High cost brands with lower cost options 4 Specialty

OchPlus 1, 2 and 3 cover the same services, including office visits, inpatient and outpatient care and prescriptions, with different levels of coverage. All options are co-pay plans. OchPlus 1: You generally pay less out of your own pocket when you seek care (in exchange for somewhat higher premiums that you pay for as deductions from your paychecks). You pay $0 deductible before paying co-pays for medical or prescription services. OchPlus 2: You generally pay more out of your own pocket when you seek care (in exchange for lower premiums). You must pay a $750 deductible, even for most in-network care, before the plan begins to pay its share of medical expenses. You pay $0 deductible before paying copays for prescriptions. You will pay slightly more out of your own pocket when you seek care— but in exchange you will pay lower rates for coverage as deductions from your paychecks. With OchPlus 1 and 2, you can use the Health Care Flexible Spending Account (HCFSA) to help pay your deductible, coinsurance and certain other out-of-pocket healthcare expenses. Because you enjoy tax savings when you use the HCFSA, this will help offset these out-of-pocket costs. OchPlus 3: You pay more out of your own pocket when you seek care (in exchange for the lowest premiums). You must pay a high deductible of $3,000 before the plan begins to pay for medical or prescription services. With the high deductible plan, you are eligible to contribute to a Health Savings Account (HSA) to help pay your deductible, coinsurance and certain other out-of-pocket healthcare expenses. Because you enjoy tax savings when you use the HSA, this will help offset your out-of-pocket costs. 12

More About Deductibles Deductibles are a common feature of many medical plans today. A deductible is the amount you must pay each calendar year before a medical plan begins to pay its share of expenses. Until you meet the deductible, you pay the full cost of a medical expense (aside from any discounts or reductions that apply when you use network providers, etc.). This gives you both the knowledge and incentive to consider alternate forms of treatment, if available, that are effective but less costly, so you can get the greatest value from your health care dollar. Requiring the payment of a deductible reduces a plan’s coverage costs. This means you can generally obtain coverage under a deductible plan at lower rates, meaning smaller deductions from your paycheck.

Individual vs. Family Deductibles: How Do They Work? OchPlus Medical plans have both an “individual” and a “family” deductible. This is how they work together: • Individual deductible: You must meet your individual deductible before the plan begins paying its share of medical expenses. • Family deductible: If you are covering family members, whatever you pay out-of-pocket for each covered individual counts toward both that person’s individual deductible and the family deductible. Once the family deductible is met, through any combination of payments for any covered individuals, the plan begins paying its share of expenses for all covered family members. In other words, you do not necessarily have to pay the individual deductible for each person. Once the family deductible is met, the plan pays benefits as if all the individual deductibles for each covered family member have been met as well.

The Out-of-Pocket Maximum All medical plans have an out-of-pocket maximum, which is a limit on the amount you are required to pay out-of-pocket for covered expenses in a calendar year. Once you reach this maximum, the plan pays 100% of covered expenses for the balance of the year. All medical plans have a three-level out-of-pocket maximum (individual, two covered persons, and family). What does this mean? • If you cover three persons or more, you still need to reach the family out-of-pocket maximum before the plan starts paying 100% for everyone in your family. However, if you cover yourself plus another person only, you only need to reach the two-person out-of-pocket maximum before the plan starts paying 100% for both of you, instead of the higher family maximum. As a result, it is easier for smaller families (two persons) to enjoy the protection of the out-of-pocket maximum.

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Using the Medical Plan Network All of our medical plans feature the use of a provider network. The plans give you the flexibility to use any physician or facility you choose for most services. But if the provider you choose is not in the network, you will receive out-of-network benefits and pay more out of your pocket. Outof-network benefits are also subject to reasonable and customary limits. Our medical plans have their own “OchsnerPlus Regional Network.” This network is customized and is not the same as Humana’s network. It is important that you check the OchsnerPlus Regional network listing to ensure your provider is a participant. Humana is our medical plan administrator. The list of available providers is accessible at www.Humana.com, by selecting to view the “OchsnerPlus Emp Med Plan” listing when you log in.

IN-NETWORK

OUT-OF-AREA

Coverage provided only when you and The highest level of benefits your dependents live outside of the local when you use OchsnerPlus geographic area and as a result, cannot Regional Network. This provides use the OchsnerPlus Regional Network. you the most cost-effective *** health care. This is not a voluntary election

OUT-OF-NETWORK Provides the lowest level of benefits. You pay a much higher portion of the cost, when the OchsnerPlus Regional Network is available to you, but you choose to use a provider or facility that is not in the network.

Deductible

According to plan election

According to plan election

$3,000 | $9,000

Employee Share of Benefit Cost

Co-Pays according to plan election

20% of cost

50% of cost

Out-of-Pocket Max Rx

According to plan election

If select Humana Network

If select Out-of-Network

According to plan election

Unlimited

Co-pay

N/A

Unlimited

Not covered

Out-of-Area Dependent Notification If you live inside the local geographic area but your dependent or spouse lives outside the local geographic area and cannot use an Ochsner provider or facility or other providers within the OchsnerPlus Regional Network, please email [email protected] or call the Human Resources Service Center to request an Out-of-Area Dependent Notification form. This form gives Humana your dependent’s or spouse’s non-local address for proper claims processing.

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Coverage Options You may choose medical coverage for your eligible dependents as well as yourself, in one of the following combinations: • You only • You and your legally married same-sex or opposite-sex spouse • You and one child • You and your children • You and your family • You and your domestic partner • You, your domestic partner, and child(ren) To enroll your dependents in the OchPlus Medical Plan, you must all enroll in the same option.

HumanaBeginnings For members enrolled in the OchsnerPlus medical plan, HumanaBeginnings is a voluntary program for expectant mothers to learn more about their pregnancy, their baby’s development, and how to practice healthy habits during pregnancy. The program increases the level of awareness about pre-term birth and educates women about risk factors, preventative measures and the symptoms of pre-term labor.

Notice Regarding the Newborns’ and Mothers’ Health Protection Act Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

PREAUTHORIZATION: Utilization Management (UM) Certain services require prior authorization by Humana. All inpatient hospital, extended care facility and hospice admissions require prior authorization as do certain outpatient services such as durable medical equipment, speech therapy and infertility services. Referrals out-of-network by Ochsner physicians require review and authorization by Humana prior to obtaining any services. If you fail to follow the UM procedures, your benefits may be reduced. For complete information on the UM process and services that require prior authorization, please refer to your SPD.

INSURANCE CARDS Once you enroll, your ID cards will be mailed to your home address approximately 10-14 business days following enrollment. Your ID card will include both medical and pharmacy information.

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HIGHLIGHTS OF THE OCHSNERPLUS MEDICAL PLANS In-Network OchPlus 1 OchPlus 2 Employee premium

Out-of-Area

Out-of-Network

OchPlus 3

$$$

$$

$

Employee out-of-pocket expenses

$

$$

$$$

FSA/HSA eligibility: the type of pre-tax account you may contribute to depends on your elected medical plan option

Flexible Spending Account

Flexible Spending Account

Health Savings Account

The amount you pay before the plan covers any medical benefits

Medical annual deductible

Individual

$0

$750

$3,000

Same as your elected option

$3,000

Family

$0

$1,500

$6,000

Same as your elected option

$9,000

The amount limit you are required to pay for covered Medical + Prescription expenses in a calendar year includes deductibles, co-pays and co-insurance for in-network and out-of-area eligible services and excludes out-of-network deductibles, bariatric surgery and infertility treatments.

Out-of-pocket maximum

$3,000 Individual

$3,000

$4,300

Medical + Rx combined $9,000

Family

$9,000

If Humana Network

If OON

Same as your elected option

Unlimited

Unlimited

$12,900

Medical + Rx combined

Same as your elected option

Unlimited

The amount you pay prior to the plan covering any prescription

Prescription deductible

Individual

$0

$0

$3,000 plan deductible

N/A

Not covered

Family

$0

$0

$9,000 plan deductible

N/A

Not covered

When you or your covered dependent live outside the Ochsner service area and receives care from Humana Network or Outof-Network

Humana PPO providers and in-area services from Out-of-Network providers

Service limitations: when benefits apply

For Services from OchsnerPlus network providers and for services not provided through the OchsnerPlus network when authorized by Humana and the Ochsner Clinic Foundation Health and Welfare Plan Committee

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HIGHLIGHTS OF THE OCHSNERPLUS MEDICAL PLANS In-Network

Out-of-Area

Out-of-Network

OchPlus 1

OchPlus 2

OchPlus 3

Employee out-of-pocket costs

$

$$

$$$

After you meet the deductible

$0

$750

$3,000

Same as elected plan

$3,000

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

$40 co-pay

$60 co-pay

$75 co-pay

20% after deductible

50% after deductible

$150

$350

$500 20% after deductible

50% after deductible

Povider Services

Primary care visit

care, consultation, dental care for accidental injury, (in-office surgery)

Specialist visit

care, consultation, second surgical opinion, dental care for accidental injury, (in-office surgery)

Maternity Care (physician fees)

Wellness Care

Dependent daughter not covered

One time charge per pregnancy

Routine physical examinations and tests1

$0 co-pay*

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Annual gynecological exam & routine mammograms

$0 co-pay1*

$0 co-pay1*

$0 co-pay1*

$0 co-pay*

50% after deductible

Well child care

$0 co-pay1*

$0 co-pay*

$0 co-pay1*

$0 co-pay*

Not covered

Immunizations

$0 co-pay*

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Annual PSA screening

$0 co-pay*

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Routine Colonoscopy, Proctosigmoidoscopy & Sigmoidoscopy

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Not covered

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Not covered

$0 co-pay*

$0 co-pay*

$0 co-pay*

$0 co-pay*

Not covered

Hearing screening

1 per year for child up to age 18

Diabetic education & nutritional counseling2

1 visit per year unless in connection with diabetes, hyperlipidemia or hypertension

* If utilizing an Ochsner Provider or Humana PPO Provider. Otherwise, subject to 20% after deductible * Payable at 100% if utilizing an Ochsner Provider or Humana PPO Provider. Otherwise, subject to 20% after deductible.

17

HIGHLIGHTS OF THE OCHSNERPLUS MEDICAL PLANS In-Network

Out-of-Area

Out-of-Network

OchPlus 1

OchPlus 2

OchPlus 3

Employee Co-Pays & OOP

$

$$

$$$

After you meet the deductible

$0

$750

$3,000

Same as elected plan

$3,000

$200/day Up to $600 per admission

$250/day Up to $750 per admission

$250/day Up to $750 per admission

20% after deductible

50% after deductible

Outpatient Surgery Facility2*

$50 co-pay

$100 co-pay

$100 co-pay

20% after deductible

50% after deductible

Emergency Room3

$250 co-pay

$250 co-pay

$250 co-pay

Same co-pay as elected plan

$350 co-pay

Urgent Care

$40 co-pay

$60 co-pay

$75 co-pay

$100 co-pay

50% after deductible

Ambulance3*

$0

$0

$0

$0

$0

Lab & X-Ray

$0 co-pay

$40 co-pay Per provider/per day

$50 co-pay Per provider/per day

20% after deductible

50% after deductible

Advanced Diagnostic Imaging MRI, MRA, PET, CAT, SPECT Scans

$75 co-pay

$100 co-pay

$125 co-pay

20% after deductible

50% after deductible

Extended care/skilled Nursing Facility2 Limited to 90 inpatient days per calendar year

$200/day Up to $600 per admission No co-pay if direct transfer from hospital stay

$250/day Up to $750 per admission No co-pay if direct transfer from hospital stay

$250/day Up to $750 per admission No co-pay if direct transfer from hospital stay

20% after deductible

50% after deductible

Cardiac or Pulmonary Rehab Services Max 36 sessions each

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

Physical & Occupational Therapy Max 30 combined visits per calendar year

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

Speech Therapy Max 30 visits per calendar year

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

Chiropractic Care Max 30 visits per calendar year

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

Not covered

Mental Health – Inpatient2

$200/day Up to $600 per admission

$250/day Up to $750 per admission

$250/day Up to $750 per admission

20% after deductible

50% after deductible

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

Substance Abuse Inpatient2

$200/day Up to $600 per admission

$250/day Up to $750 per admission

$250/day Up to $750 per admission

20% after deductible

50% after deductible

Substance Abuse Outpatient

$20 co-pay

$40 co-pay

$50 co-pay

20% after deductible

50% after deductible

Inpatient Hospital Inclusive of room & board, intensive care, physician services, therapies, other inpatient services & supplies*

Other Services

Rehabilitation

Facility Services

2

Mental Health Outpatient

18

HIGHLIGHTS OF THE OCHSNERPLUS MEDICAL PLANS In-Network

Out-of-Area

Out-of-Network

OchPlus 1

OchPlus 2

OchPlus 3

$

$$

$$$

$0

$750

$3,000

Same as elected plan

$3,000

Home Health care Limited to 60 visits/days per calendar year

$0

20%

20%

20% after deductible

50% after deductible

Home hemodialysis services

$0

20%

20%

20% after deductible

50% after deductible

Hospice2 Limited to 180 days

$0

20%

20%

20% after deductible

50% after deductible

Durable Medical Equipment, Prosthetic Appliances & Ostomy Supplies2

20%

20%

20%

20% after deductible

50% after deductible

Insulin pump & accessories

20%

20%

20%

20% after deductible

50% after deductible

TMJ and Orthognathic surgical & nonSurgical treatment2 $1,000 lifetime max benefit

20%

20%

20%

Not covered

Not covered

Oral Surgery2 (provider only) $1,000 annual max benefit. Inpatient co-pays apply for facility charges

20%

20%

20%

20% after deductible

50% after deductible

$0

$0

$0

20% after deductible

50% after deductible

$250/day Up to $750 per admission

Not covered

Not covered

Employee Co-Pays & OOP After you meet the deductible

Other Services

2

Smoking cessation therapy Organ transplants2 Only if performed in an Ochsner Facility or authorized National Transplant Network when covered procedure not available at Ochsner Facility Cochlear implants2 Bariatric procedures4 (i.e. gastric bypass, lap-band) Employee & Spouse only

Infertility2

Healthy Back program

$200/day $250/day Up to $600 per Up to $750 per admission admission

50%; $20,000 lifetime max benefit; subject to plan deductible. Device only. $5,000 co-pay; $25,000 lifetime max benefit

50%; lifetime maximum of $5,000 medical/$5,000 Rx; deductible does not apply.

Not covered

50% after deductible; lifetime maximum of $5,000 medical/$5,000 Rx

100% up to $4,500 Deductible does not apply

Not covered

Not covered

Not covered

Not covered

If there is no charge for an office visit, no co-pay is required for these services Requires authorization through the Utilization Management Program ($$ amount). Only authorized providers are covered for these benefits unless the service is unavailable at an Ochsner facility and preauthorized. 3 Network benefits apply if emergency is life threatening. ER Co-pay is waived if member is admitted to hospital. Inpatient co-pays will then apply. 4 Requires authorization through the Utilization Management Program. Benefits are available only to employees or spouse who has been continuously covered under the Ochsner medical plan for one year immediately preceding the surgery. 50% of the co-pay is reimbursed following proof of completion of a post-surgical regimen prescribed by the treating physician. Coverage is not available for children. 1 2

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PHARMACY How the plan works You will be automatically enrolled in pharmacy coverage for prescription drugs when you enroll in an Ochsner medical plan. Humana Pharmacy Solutions has been contracted to provide administrative services related to the Medical Plan’s prescription drug benefit. • Ochsner Pharmacy and Wellness: You are encouraged to use Ochsner Pharmacy and Wellness for all your prescription needs. 30 and 90 days supplies are available through mail order. Please call (504) 842-3205 or visit www.ochsnerpharmacy.com for more information on accessing Ochsner Pharmacy and Wellness. Please note: Specialty medications are only covered if obtained through Ochsner Pharmacy and Wellness. Ochsner Pharmacy assistance representatives can assist employees in determining if they qualify for assistance with co-pays for specialty drugs. •

CVS Pharmacies and Wal-Mart/Sam’s Club Pharmacies: You can choose to purchase your immediate needs and maintenance medications through a CVS Pharmacy or any Wal-Mart/ Sam’s Club Store Pharmacy. You can purchase up to a 90-day supply of most medications for a flat co-pay. CVS stores are conveniently located near each Ochsner facility.

•

Humana Pharmacy (Mail Order): You may have medications filled through mail order by Humana Pharmacy, Humana’s mail order organization. You may contact RightSourceRx by calling (800) 379-0092 or www.HumanaPharmacy.com. Remember to ask your physician to write you a 90-day supply for medications. You may also have your prescriptions for maintenance medications filled at Ochsner Pharmacy and Wellness.

1

Co-Pays

Deductible before co-pays

Ochsner Pharmacy OchPlus 1 OchPlus 2

$0

Wal-Mart, Sam’s Club, CVS

OchPlus 3 $0 preventive ** $3,000 Combined Med + Rx for other scripts

$0

OchPlus 1 OchPlus 2

$0

$0

OchPlus 3 $0 preventative ** $3,000 Combined Med + Rx for other scripts

Tier 1 – Lowest cost drugs

$9

$9

$9

$9

$9

$9

Tier 2 – Higher priced brands and generics

$25

$25

$25

$30

$30

$30

Tier 3 – High cost brands with less expensive options

$45

$45

$45

$50

$50

$50

Tier 4 – Specialty

25% up to $250 per 30 day script

Co-pays in table are for 30 day supply. Employees may request prescription by mail through an Ochsner Pharmacy and Wellness. 90 day supply is available through Ochsner Pharmacy and Wellness, Wal-Mart, Sam’s Club, CVS and RightSourceRx. A 90-day supply co-pay is three times the co-pays shown in the table.

Prescriptions must be on the formulary (the plan’s list of covered drugs) to be covered under the plan. You must meet the deductible in OchPlus 3 before copayments apply.

Generic Substitution Unless your physician specifically indicates “Dispense as Written” on the prescription, you must have your prescription filled with generic medications whenever possible. If you choose to receive the brand-name drug when a generic is available, you will pay the difference in cost plus the co-pay.

Smoking Cessation Products The drug plan covers only smoking cessation products/medications requiring a prescription from the physician. If you purchase an over-the-counter product, you will pay the full cost of the item. For prescribed smoking cessation products, the plan pays 100% after the deductible. 20

Prior Authorizations Some prescription drugs may be subject to prior authorization. If authorized, the prescription drug will fall under the corresponding co-payment levels. If a prescription drug is not authorized, the prescription drug will not be covered. To verify if a prescription drug requires prior authorization, call the toll-free customer service phone number on the back of your ID card or contact Humana by calling (800) 601-9372.

Dispensing Limits and Specialty Drugs Some prescription drugs may be subject to dispensing limits. Also, specialty and injectable medications are only covered if obtained through Ochsner Pharmacy and Wellness.

Medicare Part D If you have Medicare or will become eligible for Medicare in the next 12 months, Medicare Part D provides you with more choices regarding your prescription drug coverage. The following notice provides additional information. Important Notice from Ochsner About Your Prescription Drug Coverage and Medicare: Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Ochsner and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1.

Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2.

Ochsner has determined that the prescription drug coverage offered by the OchPlus plan, on average for all plan participants, is expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 through December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two-month Special Enrollment Period (SEP) to join a Medicare drug plan.

21

What Happens to Your Current Coverage if You Decide to Join a Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Ochsner coverage will be affected. If you remain covered as an active employee, or dependent, and enroll in a Medicare Part D Plan, the OchPlus plan will continue to be the primary payer and Medicare Part D will be secondary. If you do decide to join a Medicare drug plan and drop your current Ochsner coverage, be aware that you and your dependents will not be able to get this coverage back unless you are an active employee and you enroll during open enrollment or because you have experienced a change in status. Please contact the HR Employee Service Center for more information about what happens to your coverage if you enroll in a Medicare prescription drug plan.

When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Ochsner and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following enrollment period to join. For more information about this notice or your current prescription drug coverage, please contact the Employee Service Center by calling (504) 842-4748. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Ochsner changes. You also may request a copy of this notice at any time.

More Information About Your Options Under Medicare Prescription Drug Coverage More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: • Visit www.medicare.gov • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help • Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security online at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty). 22

DENTAL Ochsner offers two plans which are administered by Humana: • Comprehensive Dental PPO: The Comprehensive Plan covers preventative, basic and major care, and orthodontia, and includes the option to use a PPO.  You will generally pay less for dental work when you use a dentist who participates in Humana’s Dental PPO network. • Preventive Plus Dental PPO: The difference between the Comprehensive Dental PPO and the Preventive Plus Plan is that the Preventive Plus plan only covers preventative, diagnostic and basic services.  You will also generally pay less for dental work when you use a dentist who participates in Humana’s Dental PPO network. The Dental PPO services are subject to the exclusions and limitations listed in the SPD.

Coverage Options You may choose dental coverage for you and your eligible dependents, in one of the following combinations: • You only • You and your legally married same-sex or opposite-sex spouse • You and your children • You and your family

Humana Dental PPO Plan The Humana PPO plan provides dental coverage through a “passive” PPO plan. You may choose any dentist and you pay a yearly deductible and a percentage of the cost for covered care other than preventive services. The Humana Dental PPO includes participating and nonparticipating providers. If you select a participating provider, your cost will generally be less than if you select a non-participating provider. You will receive a separate dental ID card if you enroll in either plan option.

Using PPO Dentists The Humana Dental Plans include the option of using Humana’s PPO network. You may choose to use a network or non-network dentist each time you seek treatment. You do not have to receive a referral before seeking specialty treatment. The plan covers the same percentage of covered charges whether you receive care from a network or non-network dentist, as shown in the chart on the next page. However, since network dentists have agreed to limit their charges to Humana’s fee allowance, you will generally pay less in coinsurance (the percentage you pay) if you use a network dentist. Benefits paid for non-network services are based on “reasonable and customary fees.” If your non-network dentist charges more than the reasonable and customary amount, you pay the difference, in addition to your deductible and coinsurance percentage. A list of dentists participating in Humana’s PPO network is available by contacting Humana at (800) 233-4013 or visiting Humana’s website: humanadental.com (when prompted, select the Traditional/Preferred network).

23

SCHEDULE OF BENEFITS Comprehensive Dental PPO

Preventive Plus Dental PPO

$50 per individual $150 per family

$50 per individual $150 per family

$1,500 per individual excluding orthodontia

$1,000 per individual

Annual Deductible Annual Plan Max

Routine Oral Exams 2 per calendar year

Preventive Care

Basic Care

Cleaning 2 per calendar year

Routine Oral Exams 2 per calendar year Plan pays 100% no deductible

Routine X-rays

Routine X-rays

Fillings

Fillings

Extractions

Plan pays 80% after deductible

Root canal therapy

Major Care

Dentures Bridges

Orthodontia

Cleaning 2 per calendar year

Braces

Plan pays 50% after deductible Plans pays up to 50% with a $1,250 lifetime max per person no deductible

24

Non-surgical extractions

Plan pays 100% no deductible

Plan pays 80% after deductible

Not covered

Not covered

Not covered

Not covered

Not covered

Not covered

Not covered

Not covered

VISION You may purchase supplemental vision insurance coverage for yourself and your eligible dependents through HumanaVision’s VCP. This supplemental vision plan provides you with: • Annual eye examination ** • Eyeglass lenses every 12 months (contact lenses may be substituted for glasses) • Frames every 24 months Ochsner’s Opthamology, Optometry and Optical Shop participate in the Vision Care Plan. The Vision Care Plan is accepted at all Ochsner locations. ** “Annual Eye Exam” is defined as a routine annual eye exam which evaluates your need for glasses/contact lenses or to adjust a prescription for your eyewear. Any eye exam resulting from a medical condition/issue will be billed through the medical plan.

For Information Contact VCP by calling (866) 537-0229 or visiting www.HumanaVisionCare.com for more information about this benefit.

Vision Care Plan Exam with dilation as necessary

See a participating provider

See a nonparticipating provider

100% after $10 co-pay

$35 allowance

100% after $15 co-pay 100% after $15 co-pay 100% after $15 co-pay

$25 allowance $40 allowance $60 allowance

Lenses • Single • Bifocal • Trifocal

$45 wholesale allowance

Frames

(equivalent to $90-$135 retail)

$40 retail allowance

Contact lenses1 • Elective 2 (conventional and disposable)

• Medically necessary

$110 allowance

$110 allowance

100%

$210 allowance

Once every 12 months Once every 12 months Once every 24 months

Once every 12 months Once every 12 months Once every 24 months

Frequency (based on date of service) • Examination • Lenses or contact lenses • Frame

If a member prefers contact lenses, the plan provides an allowance for contacts in lieu of all other benefits (including frames) (Vision Care Plan only). 2 The contact lens allowance applies to professional services (evaluation and fitting fee) and materials. Members receive a 15% discount on in-network professional services. The discount for professional services is available for 12 months after the covered eye exam. 1

Additional Plan Discounts • Members receive additional fixed copayments on lens options including: anti-reflective and scratch-resistant coatings. • Members also receive a 20% retail discount on a second pair of eyeglasses. This discount is available for 12 months after the covered eye exam and available through the VCP network provider who sold the initial pair of eyeglasses. • After co-pay, standard polycarbonate available at no change for dependents less than 19 years old. 25

FLEXIBLE SPENDING/HEALTHCARE SAVINGS ACCOUNTS Flexible Spending and Healthcare Savings Accounts are great tools to help you save money. Did you know that you can save anywhere from 10% – 30% on your taxes by utilizing an FSA or HSA? Please visit http://health_fsa_educational_video.bankofamericacdhc.com to learn more about the Bank of America FSA/HSA cost savings tools available. Both are pre-tax deductions. Both plans allow you to pay for eligible medical expenses not covered by your medical, dental or vision plan, incurred by you and your dependents – tax-free. Such expenses are co-pays, deductibles, prescriptions, eye glasses, eye exams, etc. Following are a few critical differences between FSA and HSA plans.

Healthcare Flexible Spending Account FSA

Health Savings Account HSA

Eligible if you enroll in OchPlus 1 or OchPlus 2 or Eligible if you do not enroll in Ochsner Medical

Only eligible if you enroll in OchPlus 3

Use it or Lose it any funds left in your account at the end of a plan year’s grace period (for the 2016 plan year, this is March 15, 2017) will be forfeited

Carries over year to year - Portable if you leave Ochsner

Funds are available (up to your annual contribution) as soon as you begin participation in the plan year

versus

Funds are available only after your payroll deductions are deposited to account

No age limitation

Not eligible in if enrolled in Medicare

Minimum contribution =$120

Minimum contribution = $0

Maximum contribution =$2,550

Maximum contribution = Individual $3,350 Family $6,750

No catch-up contributions

$1,000 catch-up contribution for those 55 and older

The money in your account cannot earn interest

The money in your account can earn interest tax-free

HSA - Eligibility Requirements Since an HSA account is a new offering in 2016, there are a few special eligibility requirements you should be aware of before electing an HSA. You are eligible to open an HSA account only if you elect OchPlus 3 and meet the following requirements: • You are not covered by any other health plan, such as a spouse’s plan • You are not enrolled in Medicare • You do not receive military health care benefits • You cannot be claimed as a dependent on another person’s tax return • You cannot be covered by a traditional health care FSA or HRA

26

How it Works • Step 1 - Estimate your medical, dental and vision expenses for the upcoming year to decide how much to contribute • Step 2 –Active your HSA/Health FSA Visa Debit card that you will receive in the mail along with an enrollment packet from Bank of America • Step 3 – Set up your Bank of America Online account – this portal gives your 24-hour access for you to check your claims activity, payment history and enter eligible claims for reimbursement • Step 4 – Pay for qualified expenses in three convenient ways – HSA/FSA Visa debit card – most doctors’ offices, hospitals, pharmacies and retail stores accept this card – Provider payments – when you receive an invoice from a health care provider for a qualified expense, you can request your provider be paid directly from your HSA or FSA just like an online bill service program – Reimbursement requests – If you pay for qualified products or expenses out of your own pocket, you can reimburse yourself from funds in your HSA or FSA by electronic or check reimbursement

Documenting Your Eligible Expenses When you enroll in either an HCFSA or HSA, you will need to maintain accurate records of any payments that you make since this is an IRS tax benefit. You do not have to send the receipts in with your tax return, but if you are ever audited, you will need to produce them. Also, with an HCFSA, you may receive a request from Bank of America for a receipt for any charges that do not match our co-pay plans, such as vision, charges, dental charges, etc. An HSA does not require substantiation of claims; however we still recommend that you save all receipts for eligible expense in the event that they are needed for verification.

27

Dependent Child/Elder Care Flexible Spending Account The DCFSA (Dependent Child/Elder Care Flexible Spending Account) allows you to pay for eligible dependent child care and elder care expenses with pre-tax dollars. If you are paying for child care for your child under the age of 13 or care for an elder who is not capable of taking care of himself or herself and lives with you for at least 8 hours a day, this may save you tax dollars. This account is managed separately from the HCFSA with its own rules and procedures. ENROLLING IN THE DCFSA • • • • •

Estimate your child care or elder care expenses for the upcoming year Decide how much to contribute (minimum $240/maximum $5,000 per year, per household) Maximum is $2,500 if you are married and file a separate tax return Pay for your expenses Submit a claim and receive reimbursement using Bank of America’s online portal bankofamerica.com/benefitslogin

How The Plan Works If you choose to participate in this account, you will designate an annual dollar amount that will be deducted over the course of the plan year from your paycheck on a pre-tax basis. These funds will be deposited into your DCFSA. You can contribute a minimum of $240 and up to a maximum of $5,000 per year, per household.

Accessing Your DCFSA You will pay for your eligible expenses to your day care or elder care provider so you (and your spouse) can work (or actively look for work). You must then submit claims and receipts for eligible expenses directly to Bank of America for reimbursement. Claim forms are available on Ochweb under HR Forms or from Bank of America. Reimbursement checks will be mailed directly to your home address, or you may choose to have them direct deposited. Dependent Care FSA reimbursement checks will be processed on a daily basis. This gives you convenient access to your Dependent Care FSA funds. Note that the IRS has expanded the period for which you can incur and submit claims for reimbursement by 2 ½ months. This extra time is called a grace period. For the 2016 plan year, the grace period runs from January 1, 2017, through March 15, 2017 Under the grace period, you can incur eligible dependent care expenses through March 15, 2017, for reimbursement from your 2016 DCFSA.

Dependent Care Eligible Expense Examples: • Expenses related for day care (children under age 13) while parents are at work, such as day camp, private sitter exclusive of immediate family members, or nursery school Overnight camp is not a qualified expense • Expenses for preschool and after school child care. (Expenses/receipts must indicate that they are for day care and not tuition) • Cost of a housekeeper whose primary duties include care of a qualified dependent. • Elder care for defined dependents Please refer to the IRS Publication 503 at www.irs.ustreas.gov for further rules. 28

LIFE AND AD&D About Life Insurance Ochsner provides you with life insurance and accidental death and dismemberment (AD&D) coverage to protect you and your family if you die or become seriously injured. The plans allow you to select the level of insurance you feel is appropriate to provide long-term financial security for your family or other beneficiary. Life and AD&D options provide you with around-the-clock protection both on and off the job. Ochsner provides you with employer paid basic life and basic AD&D insurance at no cost to you, and offers optional coverage for yourself. The company also allows you to purchase life and AD&D for your dependents, such as your spouse and children. Life and AD&D coverage is offered to all full-time and part-time employees working at least 40 hours per pay period.

BENEFICIARIES Regardless of whether you are required to pay for life and AD&D coverage, it is especially important to designate a beneficiary. By naming a beneficiary, you make sure you life insurance benefit is being passed on the way you want.

Employer Paid Basic Life and AD&D Employer paid basic life insurance is term life insurance payable in the event of death. AD&D coverage offers additional coverage if your death is the result of an accident. AD&D also offers you protection if you suffer dismemberment due to an accident, with the benefit payable equal to a percentage of your principal sum, based on the severity of the injury.

EMPLOYER PAID BASIC LIFE & AD&D COVERAGE If you are a full-time or part-time employee working at least 40 hours per pay period, Ochsner provides, at no cost to you, basic life and AD&D coverage in an amount equal to half your annual base pay, rounded up to the next higher $1,000, with a minimum coverage amount of $10,000. Certain classes of employees may have different insurance benefits and should see their addendum for details.

29

Optional Life and AD&D Ochsner also offers you the option of purchasing additional term life and matching AD&D insurance coverage. The plan offers a variety of options that provide different amounts of coverage based on your annual base pay. Base pay is your base earnings excluding overtime, bonuses, shift differentials, premiums and special compensation. Optional life insurance premiums are paid by you with pre-tax dollars.

Proof of Good Health for You You may choose to purchase optional life insurance for yourself at your initial enrollment when you first become eligible for benefits. If you do not elect the highest option initially, you are given the opportunity each year at open enrollment to increase your coverage one level without having to answer any medical questions. If you choose to increase optional life coverage by more than one level, you will be required to provide evidence of insurability (EOI). You will also be required to submit evidence of insurability if the amount of your employer paid basic and optional life insurance equals $650,000 or more. If evidence of insurability applies, you will receive information from Minnesota Life. Your increased coverage will not go into effect until you receive approval from Minnesota Life. OPTIONAL LIFE OPTIONS • ½ times annual base pay • 1 ½ times annual base pay • 2 ½ times annual base pay • 3 ½ times annual base pay • 4 ½ times annual base pay Optional life coverage is rounded to the next higher multiple of $1,000. The minimum benefit is $10,000 and the maximum benefit is $1,150,000 for employer paid basic and optional life insurance combined.

SPOUSE LIFE INSURANCE COVERAGE LEVELS • $5,000 • $10,000 • $15,000 • $25,000 • $50,000 • $75,000 • $100,000

Spouse Life Ochsner also offers you the option of purchasing life insurance coverage on your spouse. The plan offers a variety of options that provide different amounts of coverage. Spouse life premiums are paid on an after-tax basis.

Proof of Good Health for Your Spouse You may choose to purchase spouse life at your initial enrollment when you first become eligible for benefits. At any subsequent enrollment period, you may choose to increase your spouse’s coverage. Your spouse does not have to provide evidence of insurability unless you increase the amount of your spouse’s coverage by more than one level, or at any time you choose spouse coverage of more than $50,000. If EOI is required, you will receive information from Minnesota Life. Your spouse’s increased coverage will not go in effect until you receive approval from Minnesota Life. Keep in mind that coverage will be delayed for a spouse confined to a hospital on the date any coverage or increase in coverage would become effective, until the date the spouse is no longer confined. Important Notes: • If you and your spouse both work for Ochsner and are both benefits-eligible employees, you may not enroll your spouse as a dependent under spouse life. • You may not elect an amount greater than your own total life amount (employer paid basic life and optional life coverage combined). 30

Child Life Ochsner also offers you the option of purchasing life insurance coverage on your children. The plan offers a variety of options that provide different amounts of coverage. Child life premiums are paid on an after-tax basis. Coverage will be delayed for any dependent confined in a hospital on the date any coverage or increase in coverage would become effective until the date the dependent is no longer confined. Important Note: If you and your spouse both work for Ochsner and are both benefit-eligible employees, only one of you may cover your dependent children under the child life benefit plan. If your child is also a benefits-eligible Ochsner employee, your child may not be considered your dependent. He or she must elect coverage as an employee under his/her own life policies.

CHILD LIFE INSURANCE COVERAGE LEVELS • $2,500 • $5,000 • $10,000

VOLUNTARY AD&D OPTIONS 1) Employee Only or If you elect Employee & Family coverage, your dependents 2) Employee & Familywill receive a percentage of the amount of coverage you choose as follows: Coverage Options Spouse: 50% of coverage amount • $ 100,000 Child(ren): 15% of coverage amount • $ 200,000 • $ 300,000 • $ 400,000 • $ 500,000

Voluntary AD&D Ochsner offers you the option to purchase additional AD&D coverage on yourself and your dependents. AD&D offers you protection if you suffer dismemberment due to an accident, with the benefit payable equal to a percentage of your principal sum, based on the severity of the injury. You may not elect an amount greater than 10 times your annual salary.

Business Travel Accident (BTA) Business travel accident coverage provides extra protection if you die or sustain certain types of injuries in an accident while you are traveling on Ochsner business. Ochsner provides full-time employees with business travel accident coverage at no cost. While part-time employees are not eligible, full-time employees are automatically enrolled in this benefit. The amount of your coverage is $75,000. Additional coverage is provided for certain individuals who travel aboard aircraft operated by Ochsner for the purpose of emergency medical treatment. Please refer to your SPD for further details. BTA death benefits will be paid to the person you have designated as your beneficiary under your Ochsner group life insurance coverage. Certain classes of employees may have different BTA benefits and should see their addenda for details. 31

DISABILITY About Disability Ochsner offers disability income plans which are designed to offer you financial protection when you are sick or injured and unable to work. Certain classes of employees may have different disability benefits and should see their addenda for details.

Short-Term Disability (STD) Short-term disability coverage offers you coverage when you will need to be away from work for a short period of time due to an illness or injury that is not work-related. Ochsner provides STD benefits to full-time employees who have completed 12 months of employment. Coverage begins on the first day of the calendar month following the 12-month waiting period. Part-time employees working at least 20 hours per week or 40 hours per pay period are eligible to enroll in the STD plan by paying the full cost of this coverage. You must be employed at least 12months to become eligible for STD. There is one enrollment period each year for eligible part-time employees to enroll in the plan. Part-time employees meeting their 12-month anniversary between January 1 and December 31 may enroll in the plan during the open enrollment period, for a January 1 effective date. If an employee does not enroll by the end of the enrollment period, coverage may be elected only during the next open enrollment period or following a qualified change in status. Refer to the “General Provisions” section of the SPD for more information.

STD Coverage SHORT-TERM DISABILITY COVERAGE Benefits Begin....................After 14-day waiting period The Plan Pays.....................60% of your weekly base pay* Benefits Continue..............Up to 26 weeks * Weekly base pay means your pay rate times the number of average hours worked over a 26-week period or your budgeted hours, whichever is less, at the time your disability begins. It does not include overtime, shift differential, on-call pay or any other special pay.

You must use your General-Purpose Time (GPT) benefits to receive pay during the STD elimination period/waiting period. By request only to [email protected], you may also use your GPT in combination with your STD benefits to bring your pay up to 100%.

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Long-Term Disability (LTD) Long-term disability coverage provides you with an income when you need to be away from work for a long period due to an injury or illness. Ochsner offers you three LTD options from which to choose, allowing you to select the level of financial protection that works best for you. Ochsner offers the LTD 60% of pay option to full-time employees who have completed 3 years of employment at no cost. You can still choose to purchase the LTD 66 2/3% option and pay the difference in cost between the two options. If you are a full-time employee with less than three years of service, or a part-time employee working at least 20 hours per week or 40 hours per pay period, you are eligible to enroll in the LTD plan immediately by paying the full cost of this coverage. If you do not enroll within 31 days of the date you become eligible, you can elect to enroll only during the next open enrollment period or due to a change in status, and you will have to provide satisfactory evidence of good health. Your new coverage will not go into effect until you receive approval from Liberty Mutual. PROOF OF GOOD HEALTH You may choose to purchase the highest option of LTD coverage at your initial enrollment when you first become eligible for benefits. If you do not enroll when initially eligible and you later choose to enroll for contributory coverage, you will be required to complete Evidence of Insurability (EOI). Your coverage will go into effect the first of the month following approval from Liberty Mutual.

Pre-existing Conditions The LTD plan will not provide benefits for any disability that occurs within the first 12 months of coverage or an increase in coverage, if you have received any care or treatment for the illness or injury causing the disability within the three months preceding the effective date of coverage or increase in coverage.

LTD Options LONG-TERM DISABILITY OPTIONS





Options

% of Base Monthly Pay1

Maximum Monthly Benefit

1 2 3

50% 60% 66 2/3 %

$ 13,333 $ 16,000 $ 17,787

Benefits Begin............... Benefits Continue.........

After 180-day waiting period2 Until age 653

1) Base monthly pay means your pay rate times the number of budgeted hours you are regularly scheduled to work each month at the time your disability begins. It does not include overtime, shift differential, on-call pay or any other special pay. 2) If you are eligible and qualify for short-term disability benefits, STD benefits may be paid during the LTD waiting period. 3) Please refer to your SPD for more details about when LTD benefits end.

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EMPLOYEE ASSISTANCE PROGRAM (EAP)/WORK-LIFE PLAN Ochsner recognizes and acknowledges that concerns in your personal life can affect your work life and vice versa. Ochsner provides EAP coverage to all employees and their household members at no cost to you, which is available upon your first day of employment. You and your family members can receive confidential, personal counseling to help you deal with issues by contacting LifeSynch, our EAP provider, at (866) 440-6556. LifeSynch can help you set up an appointment with a counselor, therapist, etc. Under this program you can receive up to five nocost counseling visits per year. Your use of this service is confidential and any request to use this service, or your actual use of this service, will not be reported to your supervisor or any others within Ochsner (except in extreme cases in which it is determined by the Health and Welfare Plan Committee, to be a danger to yourself or others). EXAMPLES OF EAP CONCERNS • Relationship problems • Parenting issues • Alcohol or drug abuse (by yourself or a family member) • Emotional problems: such as feelings of anger, depression, or stress • Grieving the loss of a loved one • Dealing with job changes • Legal and financial concerns • Approaching retirement • Other concerns with your home or work life

Ochsner recognizes that achieving a healthy balance between work, family and personal lives can be challenging. The Work-Life program offers resources to help employees fulfill the often competing responsibilities of work, family, and personal lives. LifeSynch can assist you with many of these issues.

EXAMPLES OF WORK LIFE SERVICES • Child care • Adoption planning • College planning • Estate planning • Legal forms • Debt management

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PAID TIME OFF General Purpose Time (GPT) Ochsner provides you with General Purpose Time to allow you time off from your everyday work routine. GPT can be used as vacation, to provide time away for illness, funerals, or to take care of personal business. The number of GPT days you earn each year depends on your length of service with Ochsner and your budgeted hours. Full-time and part-time employees working at least 40 hours per pay period begin earning GPT on the first day of work, and may begin using it during the pay period following three months of employment. Certain classes of employees may have different time-off benefits and should see their addenda for details. GENERAL PURPOSE TIME Years Worked

GPT Accrued Per Hour

GPT Accrued Annually

0 – 4 Years 5 – 9 Years 10 –15 Years 15+ Years

0.0693 0.0885 0.1000 0.1077

144 hours – 18 days 184 hours – 23 days 208 hours – 26 days 224 hours – 28 days

Employees accrue GPT each pay period based on years of service. The maximum amount of GPT that can be accrued is 280 hours. At the end of each year a maximum of 240 hours of accrued GPT can be carried into the next year.

Selling GPT Ochsner also offers a GPT sellback program through which you can sell GPT for cash during the year in 40 hour increments. The “GPT Sellback Form” can be found on Ochweb under HR Forms. You must sell back a minimum of 40 hours. You can sell some of your GPT days and receive some of the value of those days as compensation in your paycheck. The following chart shows you how much of your base pay you will receive for your GPT time: SELL BACK SCHEDULE Less than 5 years of service 5 years but less than 10 years of service 10 or more years of service

50% 60% 70%

As you consider the amount to sell, keep in mind that the maximum amount of GPT you may keep in your “bank” is 30 days (240 hours) at the end of a calendar year. Any days in excess of 30 will be forfeited if you do not sell them. When you sell GPT, the money from your sale is subject to income tax withholding and retirement deductions (401(k), 403(b), and catchup plan) when it is paid to you. Since the payout is added to your regular paycheck (either at the end of January or in equal installments during the year, depending on your election), this can result in a higher tax bracket for withholding purposes on that paycheck. If you overpay taxes during the year, you can make an adjustment on your annual income tax return. 35

Philanthropy Donation You may donate your earned GPT at full value to the Philanthropy Division of Ochsner Clinic Foundation during the annual enrollment period, or to a fellow employee who is on FMLA leave, experiencing a serious medical condition or other catastrophic event at any time during the year. Retirement deductions (401(k), 403(b), and catchup plan) and payroll taxes will be deducted from the donation before submission to the Philanthropy Division. When selling GPT or donating to the Philanthropy Division, you must always maintain a minimum balance of 40 hours.

Holiday Pay Ochsner provides full-time employees seven paid holidays each year. You must work your scheduled days before and after a holiday to be paid for that holiday. You are eligible for the seven designated holidays when you start working for Ochsner.

Personal Holiday In addition to the seven paid holidays, full-time employees are also given a “Personal Holiday,” which can be used on a day you select with your leader’s approval. You may take your “Personal Holiday” after completing three months of employment. You must take your Personal Holiday by December 31 or you will lose it. Certain classes of employees may have different Personal Holiday benefits and should see their addenda for details. HOLIDAY SCHEDULE • New Year’s Day • Mardi Gras Day * • Good Friday

• Independence Day • Labor Day • Thanksgiving

• Christmas • Personal Holiday

* In lieu of the Mardi Gras holiday, Baton Rouge employees receive an additional Personal Holiday

Bereavement Pay Full time employees are eligible to receive 3 days (up to 24 hours) of bereavement pay per occurrence for the death of an immediate family member or in-law. You must use GPT if you need additional bereavement time. “Immediate family” includes spouse or domestic partner; natural-born, legally adopted and foster children; mother, father, sister, brother, grandmother, grandfather or grandchildren, “step” relations of these family members, and children where the employee is the legal guardian. “In-law” includes the mother, father, sister, brother, son or daughter of the employee’s current spouse or domestic partner, as well as the current spouse or domestic partner of the employee’s, sister, brother, son or daughter.

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MY OCHSNER More convenience. Less paper. MyOchsner. Ochsner employees are Ochsner patients, too. And they recognize the value of the MyOchsner online patient portal in connecting them with their healthcare. The powerful benefits associated with MyOchsner help patients registered to the portal schedule appointments online, access their visit progress notes and lab results, better navigate our system and quickly and efficiently find information - improving access and reducing no-show rates.  Enhancements to MyOchsner are introduced frequently. Here are a few ways you can make MyOchsner work for you.

Direct Scheduling Current established Ochsner patients can schedule a new patient or regular appointment in Primary Care, Pediatrics or OB/GYN. Schedule your appointment online today by visiting my.ochsner.org.

Online Bill Pay Pay your Ochsner medical bills quickly and securely at your convenience through the MyOchsner web site or your MyChart mobile app. If you have a question about your bill, you can still contact the billing department at 1-800-343-0269.

Wait List Feature Patients registered with MyOchsner can update their wait list standing for most upcoming appointments directly from the MyOchsner web site and mobile app. This feature automatically searches for openings that match wait list entries and then offers those openings to patients after regular business hours.

Progress Notes Ochsner is the first health system in Louisiana and the Gulf South to provide patients online access to their progress notes. Patients have the ability to view their notes online through MyOchsner and be better prepared to engage in the shared decision-making process between patient and physician. This feature not only drives transparency, it involves patients more actively in all aspects of care and communication. Physicians describe strengthened relationships with their patients, including enhanced trust, transparency, communication and shared decision-making.

If you’re not already registered with MyOchsner, register today at My.Ochsner.org.

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WELLNESS PROGRAM Pathway to Wellness (PTW) This innovative program is designed to enhance the health and wellness of Ochsner employees as they enjoy the benefits of working toward their health and wellness goals. The PTW program offers you access to a variety of physical and educational health-promoting activities, screenings and technologies to help you track the state of your health, and more. Once enrolled in Ochsner medical benefits, you are eligible to participate in the PTW program. You are required to register through Virgin Pulse portal to activate your membership. Eligible employees not participating in an Ochsner medical plan can choose to pay a modest fee through after-tax payroll deductions to participate in the program. In addition to receiving the health benefits from PTW, employees who register and participate in the program have the opportunity to earn cash awards during the plan year. The PTW program is a quarterly game where you earn a cash award for each level you reach during the quarter. Cash awards can be redeemed upon earning, in ten dollar increments or greater, throughout the plan year or you can let it build from quarter to quarter. You have two years to redeem from the date your reward is earned. Every quarter a new game begins.

For Full-Time, Part-Time, SSP Eligible after January 1, 2016 If you are newly hired and elected “PTW only” or became a new participant in an Ochsner medical plan as a full-time, part-time or SSP employee after January 1, 2016 you can register for the program through Virgin Pulse when your benefits become active. You can participate in the current quarterly game and all quarter games that follow for the remaining 2016 plan year.

Reasonable Alternative If you have a medical condition or disability that makes it unreasonable or medically unsafe for you to achieve or attempt any of the tasks for earning awards under the PTW program, or if it is medically inadvisable for you to do so, contact Virgin Pulse Support at 1-888-671-9395.

For More Information For more details and enrollment questions, please contact Corporate Wellness by calling (504) 736-4688 or email [email protected].

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IMPORTANT CONTACTS

Provider

Medical

Humana, Inc. P.O. Box 14601 Lexington, KY 40512-14601

Service

Phone

Contact for questions about medical benefits, claims, or to verify eligibility

(800) 601-9372

Contact to pre-certify medical and surgical procedures

(866) 265-9342

Website

www.humana.com

Pharmacy

Humana Pharmacy Solutions P.O. Box 14140 Lexington KY, 40512-14140

Contact for questions regarding pharmacy benefits and eligibility

(800) 601-9372

www.humana.com

Dental

Humana, Inc. P.O. Box 14611 Lexington, KY 40512-14611

Contact for questions about dental benefits claims, verification of eligibility, also to locate a participating PPO dentist

(800) 233-4013

www.humanadental.com

Vision

Humana, Inc. P.O. Box 14610 Lexington, KY 40512-4610

Contact for Vision Care plan questions

(866) 537-0229

www.humanavisioncare.com

FSA

Bank of America P.O. Box 25165 Lehigh Valley, PA 18002-5165

Contact for questions about eligible FSA expenses or claims

(800) 328-5394

www.bankofamerica.com/ benefitslogin

HSA

Bank of America P.O. Box 25165 Lehigh Valley, PA 18002-5165

Contact for questions about eligible HAS expenses or claims

(866) 791-0250

www.bankofamerica.com / benefitslogin

HR Employee Services

HR Employee Service Center 1450 Poydras St. Suite 2600 New Orleans, LA 70112

Contact for general benefit questions

(504) 842-4748 [email protected]

N/A

Life and AD&D

Minnesota Life Insurance Company A Securian Company 400 Robert Street North St. Paul, MN 55101

Contact for questions on life and AD&D

(866) 293-6047

www.lifebenefits.com

Physician Benefits

Office of Professional Services 1514 Jefferson Hwy Professional Staff Services 1st Floor New Orleans, LA 70121

Contact for general Physician benefit questions

(504) 842-5781 [email protected]

N/A

EAP/Work-Life

LifeSynch EAP/Work-Life 2101 West John Carpenter Freeway Irving, TX 75063

Contact to receive confidential, personal counseling to help deal with life concerns

(866) 440-6556

www.humana.com/eap

Pathway to Wellness

Virgin Pulse PO Box 7026 Beverly, MA 01915

Contact for questions regarding the wellness program

(866) 852-6898 or pathwaytowellness@ ochsner.org

www.virginpulse.com/ochsner

Disability

Liberty Mutual 175 Berkeley Street Boston, MA 02117

Contact about questions concerning leave of absence, short-term disability and long-term disability

(866) 501-8736

COBRA

Conexis 6191 North State Hwy 161 Suite 400 Irving, TX 75038 or P.O. Box 226101 Dallas, TX 75222-6101

Contact with questions concerning COBRA

(877) 452-6272

N/A

Verification Services

Xerox HR Solutions Attn: Ochsner Health System Dependent Eligibility Verification P.O. Box 980 Maumee, OH 43537

Contact with questions concerning the Dependent Eligibility Verification/Spousal Access Fee.

(877) 670-7913

N/A

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www.mylibertyconnection. com Company Code: OCHSNER