OPEN ENROLLMENT FACULTY AND STAFF GUIDE Make your Elections for your 2016 benefits. November 9 - 30, 2015

WHAT’S NEW FOR 2016?

Open Enrollment - Faculty and Staff Open Enrollment is a once-a-year opportunity for you to make changes to your health care benefits and to enroll or re-enroll in the Flexible Spending Plan, Health Savings Account and Retirement Medical Savings account. Make an informed decision about your benefits during the Open Enrollment period. Table of Contents What’s new in 2016? 3 Did you know? 6 Facts about Open Enrollment and health care benefits. Health Plan Comparisons 7 2016 Employee Health Premiums

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Savings Accounts

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Information about health care benefits

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Online enrollment and Dependent Verification

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Learn more about Open Enrollment Open Enrollment Meetings Contact information

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WHAT’S NEW FOR 2016?

Single Health Plan Vendor

Effective 1/1/2016, all University health plans will be administered by UnitedHealthcare (UHC). Although the administration of the Excel and Basic PPO plans will change from Anthem Blue Cross Blue Shield (BCBS) to UHC, the general coverage provisions of those two plans, i.e., the deductibles, co-insurance, and out-of-pocket maximums, will not change.

Information on providers

There will be minimal disruption in relation to participating providers, as there is significant overlap between UHC’s and Anthem’s provider networks in the St. Louis metropolitan area. To find UHC network providers or to verify whether your current health care provider is a UHC network provider, select the “Find a Physician, Laboratory, Facility” link on www.myuhc.com. When asked, “What plan are you looking for,” select “Choice Plus.” Please note that LabCorp is UHC’s preferred independent lab facility. Quest Diagnostics is not a UHC network provider. A listing of Labcorp locations throughout the St. Louis metropolitan area can be found on the UnitedHealthcare Plan details page of the HR/Benefits websites. Current Excel and Basic PPO plan participants should inform their medical providers of this change to UHC. Claims for medical services received on or after 1/1/2016 should be filed with UHC.

Resources for UnitedHealthcare Plan Participants Register on www.myuhc.com with your UHC member number (or SSN) and WUSTL’s group number (#702111) for on-line access to your health plan benefits. Through myUHC.com, you can: • Locate network providers anywhere in the United States. • Order additional ID cards and/or print a temporary ID card. • Review and manage your claims. • Learn about programs and discounts that are available to UHC participants. • Use the treatment cost estimator to estimate or compare provider fees for medical services in your area. • Set up and manage a personal health record for you and your family members. Health4Me Mobile App: Download the free Health4Me Mobile App to access your benefits and claims and locate network providers while you are on the go. Health Pregnancy Program: If you are starting or adding to your family, enroll in the Healthy Pregnancy Program for 24/7 access to nurses, first- and second-trimester risk screenings, educational materials and resources. Healthy Mind Healthy Body newsletter: Look for this monthly newsletter that provides information on how to get and stay healthy. Virtual physician visits: Take advantage of new coverage for video-based “virtual physician visits,” where you can access a physician via mobile phone, tablet or computer 24 hours a day. The co-pays or co-insurance for covered virtual physician visits will be the same as for in-network physician office visits. 3

WHAT’S NEW FOR 2016?

ID Cards

Participants of the Excel and Basic PPO plans will receive new UHC ID cards by the end of December. UHC ID cards list not only your name but also the names of your covered dependents. Please start using your new UHC ID card for medical appointments beginning January 1, 2016. Current participants of the Choice HMO Plan, Choice Plus POS Plan, and High Deductible Health Plan will receive new UHC ID cards ONLY if they make a plan or coverage level change. To avoid a delay in receiving your new ID cards, please verify that your home address is correct in HRMS. New ID cards will not be issued by Express Scripts or Advantica Dental unless you are newly enrolling or changing your coverage level.

WUDirect© The WUDirect© program, introduced in January 2015, provides University health plan participants priority access for initial appointments with Washington University’s network of over 1300 physicians. In addition to receiving world-class medical care, seeing a WUDirect© physician lowers your out-of-pocket costs through reduced co-pays and co-insurance. Visit https://wudirect.wustl.edu to locate WUDirect© physicians and locations, and for appointment scheduling assistance. To access this website, enter #702111 as your health plan group number. Physician Office Services (non-preventive) Primary Care Physician

HMO/POS Plans Co-pays

WUDirect© provider - $15

WUDirect© provider – 10%

WUDirect provider - $25

WUDirect© provider – 10%

Other network provider - $25 Specialist

PPO Plans (including HDHP) Co-insurance after deductible

©

Other network provider - $40

Other network provider – 20% Other network provider – 20%

Employee Wellness Program - Wellness Connection

Through the Office of Human Resources, Wellness Connection provides wellness opportunities and programming for benefits-eligible faculty, staff, postdoctoral appointees and clinical fellows. Employee wellness opportunities include: • The WashU WebMD Portal - track and manage your personal health goals through the Portal. Sign up for a biometric screening and take the health assessment to start tracking your progress. • Activity challenges to incorporate movement into your daily life • Wellness seminars to educate employees on wellness topics of interest. • Health Happenings - employee wellness fairs • Mammography screenings on campus • Smoking Cessation Program • ...and more! 4

WHAT’S NEW FOR 2016?

Eligibility for Full-Time Health Premiums In accordance with the Employer Shared Responsibility provisions of the Affordable Care Act (ACA), employers with 100 or more “full-time” employees may be subject to a penalty if they do not offer medical coverage to “full-time” employees that provides Minimum Essential Coverage, is affordable, and meets minimum value requirements. This employer responsibility is also referred to as the “Employer Mandate.” See Page 13 for related IRS reporting requirements. The ACA defines “full-time” as working an average of 30 hours or more per week. Per IRS guidelines, WUSTL implemented the “Look-Back Measurement Method” for measuring hours worked. A look-back measurement period of October 3, 2014 to October 2, 2015 was used to determine eligibility for full-time health premiums for calendar year 2016. In accordance with those guidelines, each employee’s actual paid hours were reviewed. If an employee worked the average minimum paid hours of 30 per week during the measurement period, the employee will be eligible for full-time health premiums during the next calendar year (January 1 through December 31, 2016), as long as they remain employed in a regular faculty or staff position, regardless of the numbers of hours they actually work during the year. Only eligibility for full-time health premiums is impacted by this Employer Shared Responsibility requirement. Eligibility rules for all other benefit plans offered by WUSTL are not affected.

Salary Threshold for Health Plan Premiums and Spouse Surcharge The salary threshold for determining health plan premiums and applicability of the Spouse/Domestic Partner Health Premium Surcharge for employees eligible for full-time health premiums will increase from $41,000 to $43,000. See health premium schedules on page 10. The amount of the monthly Spouse/Domestic Partner surcharge will remain $80.

Health Savings Account (HSA) Changes The maximum annual contribution for family coverage (Individual + Spouse/Partner, Individual + Child/ren, or Family) will increase from $6,650 to $6,750. The maximum annual contribution for individual coverage will remain at $3,350. Participants who are age 55 or older may contribute up to an additional $1,000. The University’s HSA contribution will remain at $800 for family coverage and $400 for individual coverage.

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Did you know? • The health plans are Washington University plans. Washington University’s health plans are self-funded by the University. UHC (and formerly Anthem Blue Cross Blue Shield) have been contracted by the University to administer those plans and to process and pay claims in accordance with the written plan provisions on behalf of the University. • Open Enrollment does not include the Life Insurance or 403(b) Retirement Savings Plans. You can make changes to those plans at any time. • If you are enrolled in a WUSTL health plan, you cannot enroll your family members in Dental-Only coverage. Your covered dependents must be enrolled in exactly the same coverage as you. • Basic vision coverage through VSP is included automatically with enrollment in any WUSTL health plan. You can, however, elect to purchase VSP’s Buy-Up coverage. If you elect the vision Buy-Up coverage, you must cover the same dependents under that option as are covered under your health plan. • VSP providers can locate you in VSP’s system using your nine-digit VSP member ID, which is your six-digit WUSTL ID preceded by three zeros. • If you participated in the Health Care FSA or the Health Savings Account(HSA) in 2015 and re-enroll for 2016, you will not receive a new CYC healthcare payment card. Since the card is valid for three years, your 2016 election will be loaded onto your existing card. • If you are enrolled in the Health Care FSA for 2015 and enroll in the HSA for 2016, you must have a $0 balance in your FSA as of December 31, 2015 or your HSA enrollment will be delayed until April 1, 2016. • You may click the “I Have No Changes” button on your personalized benefit enrollment page in HRMS Employee Self Service to continue your Individual Only health/dental and/or RMSA election for 2016. • Open enrollment elections must be finalized by midnight on Monday, November 30, 2015. • For your convenience, Connect Your Care (CYC), UnitedHealthcare, Express Scripts, and WebMD offer apps available through your smartphone’s App Store so that you may access your information on the go.

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Health Plan Comparison - Washington University Health Plans

The following comparison is a summary of the benefits of the Washington University health/dental plans and is not intended to replace the plan documents/summary plan descriptions (SPD) which are available on the HR website at http://hr.wustl.edu. For specific plan details and exclusions see plan document/SPD. Annual Calendar Year Deductible

HMO/EPO

POS

HDHP PPO

EXCEL PPO

BASIC PPO

In-Network

None

None

$1,500

$500

$750

Out-of-Network

N/A

$300

$1,500

$500

$750

None

None

$3,000

$1,500

$2,250

N/A

$900

$3,000

$1,500

$2,250

Individual Family

In-Network Out-of-Network

Out-Of-Pocket Maximum

(Includes co-pays, deductibles, co-insurance)

Individual

In-Network Out-of-Network

Family

In-Network Out-of-Network

Chiropractic/ Spinal Manipulation

In-Network

$1,500

$2,750

$2,000

$3,250

N/A

$3,300

$4,000

$3,500

$5,750

$3,000

$3,000

$5,500

$4,000

$6,500

$6,600

$8,000

$7,000

$11,500

N/A

Co-Payment/ Co-Insurance $40

$40

20%

20%

20%

Out-of-Network

N/A

30%

40%

40%

40%

In-Network

20%

20%

20%

20%

20%

Out-of-Network

N/A

30%

40%

40%

40%

Durable Medical Equipment

$1,500

Emergency Room Care

$150 (waived if admitted)

20%

Covered as In-Network

Covered as In-Network

Inpatient Hospital, Rehab, Skilled Nursing In-Network

$300

$300

20%

20%

20%

Out-of-Network

N/A

30%

40%

40%

40%

$0

$0

$0

$0

$0

Out-of-Network

N/A

30%

40%

40%

40%

In-Network

10%

10%

20%

20%

20%

Lab & X-Ray Services PREVENTIVE In-Network

NON-PREVENTIVE

N/A

30%

40%

40%

40%

In-Network

20%

20%

20%

20%

20%

Out-of-Network

N/A

30%

40%

40%

40%

$0

$0

$0

$0

$0

Out-of-Network

N/A

30%

40%

40%

40%

In-Network

10%

10%

20%

20%

20%

Out-of-Network MAJOR RADIOLOGIC DIAGNOSTIC

Maternity PRENATAL OFFICE VISIT

LAB TESTS/ULTRASOUND

In-Network

Out-of-Network INPATIENT DELIVERY

In-Network Out-of-Network

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N/A

30%

40%

40%

40%

$300

$300

20%

20%

20%

N/A

30%

40%

40%

40%

Co-Payment / Co-Insurance

HMO/EPO

POS

$300

$300

Out-of-Network

N/A

30%

40%

In-Network

WUDirect - $25

WUDirect - $25

Other - $40 N/A

Mental Health & Substance Use In-Network Disorders IN-PATIENT OUT-PATIENT

Out-of-Network

ABA Therapy for Autism

O/P In-Network

O/P Out-of-Network

EXCEL PPO

BASIC PPO

20%

20%

40%

40%

WUDirect - 10%

WUDirect - 10%

WUDirect© - 10%

Other - $40

Other - 20%

Other - 20%

Other - 20%

30%

40%

40%

40%

WUDirect - $25

WUDirect - $25

WUDirect - 10%

WUDirect - 10%

WUDirect© - 10%

Other - $40

Other - $40

Other - 20%

Other - 20%

Other - 20%

N/A

30%

40%

40%

40%

WUDirect© - $15

WUDirect© - $15

WUDirect©–10%

WUDirect©– 10%

WUDirect© – 10%

Other - $25

Other - $25

Other - 20%

Other - 20%

Other - 20%

N/A

30%

40%

40%

40%

WUDirect - $25

WUDirect - $25

WUDirect - 10%

WUDirect - 10%

WUDirect© - 10%

Other - $40

Other - $40

Other - 20%

Other - 20%

Other - 20%

N/A

30%

40%

40%

40%

©

©

©

©

HDHP PPO 20% ©

©

©

©

Office Visit PRIMARY CARE

In-Network

Out-of-Network SPECIALIST

In-Network

Out-of-Network

Preventive Exams

In-Network Out-of-Network

©

©

©

©

$0

$0

0%

0%

0%

N/A

30%

40%

40%

40%

Surgery IN-PATIENT

$0

$0

20%

20%

20%

N/A

30%

40%

40%

40%

$150

$150

20%

20%

20%

Out-of-Network

N/A

30%

40%

40%

40%

In-Network

WUDirect© - $25

WUDirect© - $25

WUDirect©- 10%

WUDirect© - 10%

WUDirect© - 10%

Other - $40

Other - $40

Other - 20%

Other - 20%

Other - 20%

N/A

30%

40%

40%

40%

$35

$35

20%

20%

20%

N/A

30%

40%

40%

40%

In-Network Out-of-Network

OUT-PATIENT

In-Network

Therapy Services PT/OT/Speech

Out-of-Network

Urgent Care

In-Network Out-of-Network

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Prescription Drug, Vision and Dental Plans

Enrollment in any of the health plans automatically includes coverage under the prescription drug, vision and dental plans. You may enroll in Dental-Only coverage if you do not need health plan coverage.

Express Scripts Prescription Drug Plan All health plans except HDHP PPO

Co-Payments/ Co-Insurance 30-Day Retail

90-Day Mail-Order

$10*

$25*

25%

25%

$40 min - $80 max

$100 min - $200 max

50%

50%

$60 min - $120 max

$150 min - $300 max

Tier One Tier Two

Tier Three

HDHP PPO

Specialty Drugs

30-Day Retail

90-Day Mail Order

20% co-insurance after deductible

Generic - $10 per 30-day supply Brand - $100 per 30-day supply

Out-of-Pocket Maximum

HDHP Out-of-Pocket Maximum applies

$2,500 – Individual; $5,000 - Family

*For generic drugs used to treat diabetes and heart disease (high cholesterol and hypertension), co-pay is $4 retail, $10 mail-order.

VSP Vision Service Plan Basic Coverage1

Co-Payment & Discounts Routine Eye Exam Per Calendar Year

$20 co-pay

$20 co-pay

Allowance up to $50

Allowance up to $50

20% discount on lenses and frames/ Allowance up to $50

$40 co-pay (single vision, lined bifocal, trifocal lenses) Frames - $150 allowance (170 for featured brands) +20% discount

Allowance up to $50

$50 - $100 allowance, based on product

In-Network

Allowance up to $50

$150 allowance for eyeglass frames or contact lenses

Out-of-Network

Allowance up to $50

Allowance up to $105

15% discount on exam fee

15% discount – Exam fee not to exceed $60

In-Network

Out-of-Network

Per Calendar Year: PRESCRIPTION EYEGLASSES

In-Network Out-of-Network

OR CONTACT LENSES

Buy-Up Coverage2

Contact Lens Exam & Fitting

Advantica Dental PPO Plan Annual Calendar

Individual

Year Deductible

Family

Employee Co-Insurance

Benefit Plan Maximums

Preventive Care

9

In-Network

$50 $150

Out-of-Network

$50

Out-of-Network

$150

3

10%

3

40%

3

50%

In-Network

0%

Out-of-Network

Basic Services

In-Network

20%

Out-of-Network

Major Services

In-Network

50%

Out-of-Network

Orthodontia

In-Network

50%

Out-of-Network

3

50%

Calendar year benefit maximum per person (excludes orthodontia)

$1,500

Orthodontia lifetime maximum (employees; covered dependents up to age 26)

$1,250

Included with health plan Not available to Euclid Power Plant bargaining unit employees 3 Out-of-Network benefits are based on Advantica’s fee schedule. 1

2

In-Network

2016 Monthly Health Premiums and Surcharge The monthly premiums for the five Washington University health plan options include medical, dental, prescription drug and basic vision coverage and are effective January 1, 2016 through December 31, 2016. You may elect Dental Only if you do not need health plan coverage; however, your covered dependents must be enrolled in the same coverage as you. The vision Buy-Up Option is only available if you are enrolled in a health plan.

Full-Time Health Insurance Premiums Tier 1 - Annual Salary