UNIVERSITY OF MISSOURI SYSTEM

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1 UNIVERSITY OF MISSOURI SYSTEM Your Benefits At A Glance 2015 FACULTY AND STAFF BENEFITS GUIDE

2 What s inside Be prepared & take action 1 Medical plan options 2 Healthy Savings Plan Custom Network Plan PPO Plan Other health benefits 6 Dental Vision Long Term Disability Life 7 Basic Term Supplemental Spouse/Dependent Accidental Death Retirement benefits 8 Core Voluntary Educational assistance 8 Employees Spouse/Dependents Resource list 9 Be prepared Take action Enrollment must be completed within 31 days of your date of hire or the date you became benefit eligible. Read this short decision guide. It will help you learn about your benefit plans. Go to the mybenefit Decision Center, located in myhr, to compare benefits and out of pocket expenses, as well as see how a Health Savings Account can save you money on taxes and can grow to cover future health care expenses. Enroll online through the University of Missouri s myhr self service application at Provide Proof of Relationship for any dependents you are adding to your benefit plans. Proof of Relationship must be provided within 31 days. View Proof of Relationship requirements at https:// uminfopoint.umsystem.edu/sites/hr/benefits/ ProofofRelationship.pdf 1 If you do not actively select and submit a medical plan choice or waive coverage, you will be defaulted to the Healthy Savings Plan on an after-tax basis.

3 Medical The university offers a choice of three medical plan options: 1) Healthy Savings Plan, 2) new Custom Network Plan, or 3) PPO Plan. Healthy Savings Plan The Healthy Savings Plan offers lower premiums than your other medical options, along with the opportunity to benefit from a Health Savings Account (HSA), which can help reduce your taxable income and provide a health care financial nest egg for the future. Although your deductible will be higher, part of that cost is covered by university contributions to your HSA. Are you eligible for this plan? Any benefit-eligible employee can choose this plan. How the plan works The Healthy Savings Plan covers the same medical services as the other medical plan options, and you ll have access to the same broad provider network as the PPO Plan. The main difference is in how the plan works. You have the choice of seeing in-network or out-of-network providers. If you stay in-network, your costs may be much lower. Monthly premiums Healthy Savings Plan Employee University Self $85 $340 Spouse Child(ren) $170 $680 $145 $578 The university contributes to an HSA for you. Your HSA can be used for eligible medical, prescription, dental and vision expenses. If you don t spend all the money in your HSA in 2015, it will roll over and can be used in future years. In-network preventive care is covered at 100% (meaning there is no charge to you and no deductible applies). Preventive care includes annual physical exams (including associated lab and X-ray services), immunizations and well-child care. You can find preventive care guidelines at After you meet the deductible, you ll pay 10% of the cost of covered in-network services until you reach the out-of-pocket maximum, which includes deductibles, coinsurance and prescription drug charges. Once you meet your annual out-of-pocket maximum, the plan will pay 100% of covered expenses for the rest of the calendar year. See page 5 for coverage details. How the Healthy Savings Plan covers prescription drugs Under the Healthy Savings Plan, you benefit from the prescription drug discount but pay the full cost of covered prescription drugs until you meet the deductible. After you meet the deductible, you pay 10% of covered prescription costs until you reach the combined medical and prescription drug out-of-pocket maximum. At that point, the plan pays 100% of covered prescription costs for the rest of the calendar year. 2 Self, Spouse & Child(ren) $238 $952 *The Custom Network Plan and PPO Plan have separate out-of-pocket limits for medical and prescription drug expenses. However, the Healthy Savings Plan combines medical and prescription drug out-of-pocket limits.

4 Medical 3 Custom Network Plan If you live or work in the Columbia area, the Custom Network Plan offers you an attractive combination of low premiums, comprehensive coverage and a high-quality provider network affiliated with the University of Missouri Health System. Are you eligible for this plan? To enroll in the Custom Network Plan, you must live or work in one of the following counties: Audrain Cole Moniteau Boone Cooper Osage Callaway Howard Randolph About network providers This innovative network gives you access to University of Missouri Health Care and Capital Region Medical Center providers, clinics and hospitals, as well as others. Visit to see the list of network providers. How the plan works With this plan, you have the choice of seeing in-network or out-of-network providers. If you stay in-network, your costs may be much lower. Monthly premiums Custom Network Plan Employee University Self $115 $365 Spouse Child(ren) Self, Spouse & Child(ren) $230 $729 $196 $620 $322 $1021 You ll pay no deductible for in-network services or prescription drugs. In-network preventive care is covered at 100% (meaning there is no charge to you and no deductible applies). Preventive care includes annual physical exams (including associated lab and X-ray services), immunizations and well-child care. You can find preventive care guidelines at Your in-network office visit copayment will be only $5 for non-specialists and $25 for specialists. You ll also have access to Mizzou Quick Care Clinics at each of the Columbia Hy-Vee stores for only a $5 copayment. Once you meet your annual out-of-pocket maximum, the plan will pay 100% of eligible expenses (including coinsurance and copayments) for the rest of the calendar year. If you do not currently have a university provider, you can call on an ongoing basis to help identify primary care and specialty physicians. See page 5 for coverage details. Prescription drug coverage Custom Network Plan Retail Prescriptions (up to 31-day supply) Mail Order Prescriptions (up to 90-day supply) Includes University of Missouri Health System Pharmacies Prescription Drug Out-of-Pocket Maximum No deductible Formulary Generic: greater of $7 copay or 20% coinsurance Formulary Brand: greater of $15 copay or 20% coinsurance Non-Formulary Brand: greater of $30 copay or 50% coinsurance No deductible Formulary Generic: greater of $15 copay or 20% coinsurance Formulary Brand: greater of $30 copay or 20% coinsurance Non-Formulary Brand: greater of $60 copay or 50% coinsurance *Custom Network Plan has separate out-of-pocket limits for medical and prescription drug expenses.

5 Medical PPO Plan The PPO Plan has the same traditional Coventry provider network as in previous years. You ll pay higher premiums than for the other two plans. Unlike the Custom Network Plan, you ll need to pay a deductible even if you use innetwork providers. Are you eligible for this plan? Any benefit-eligible employee can choose this plan. How the plan works With this plan, you have the choice of seeing in-network or out-of-network providers. If you stay in-network, your costs may be much lower. In-network preventive care is covered at no charge (meaning there is no charge to you and no deductible applies). Preventive care includes annual physical exams (including associated lab and X-ray services), immunizations and well-child care. You can find preventive care guidelines at For most covered expenses, you ll pay out of your pocket until you reach the annual deductible. Your in-network office visit copayment will be $15 for non-specialists and $25 for specialists. For in-network retail prescription drugs, you ll pay a $75 deductible plus a copayment or coinsurance. Once you meet your annual out-of-pocket maximum, the plan will pay 100% of expenses (including deductibles, coinsurance and copayments) for the rest of the calendar year. See page 5 for coverage details. Monthly premiums PPO Plan Employee University Self $152 $411 Spouse Child(ren) Self, Spouse & Child(ren) $304 $822 $258 $699 $426 $1150 Prescription drug coverage PPO Plan Retail Prescriptions (up to 31-day supply) Mail Order Prescriptions (up to 90-day supply) Includes University of Missouri Health System Pharmacies Prescription Drug Out-of-Pocket Maximum $75 deductible Formulary Generic: greater of $7 copay or 20% after deductible Formulary Brand: greater of $15 copay or 20% after deductible Non-Formulary Brand: greater of $30 copay or 50% after deductible No deductible Formulary Generic: greater of $15 copay or 20% coinsurance Formulary Brand: greater of $30 copay or 20% coinsurance Non-Formulary Brand: greater of $60 copay or 50% coinsurance 4 *The PPO Plan has separate out-of-pocket limits for medical and prescription drug expenses.

6 Compare your medical plan options 2015 coverage cost and contributions overview Self Spouse Child(ren) Self, Spouse & Children Annual Premium Healthy Savings Plan Custom Network Plan PPO Plan Healthy Savings Plan Custom Network Plan PPO Plan Healthy Savings Plan Custom Network Plan PPO Plan Healthy Savings Plan Custom Network Plan $1,020 $1,380 $1,824 $2,040 $2,760 $3,648 $1,740 $2,352 $3,096 $2,856 $3,864 $5,112 PPO Plan What you pay for in-network covered expenses in 2015* Healthy Savings Plan Custom Network Plan Custom Network Plan PPO Plan Deductible In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network $1,500/single coverage $3,000/family coverage $3,000/single coverage coverage $0 $500/person $1,500/family $350/person $1,050/family $700/person $2100/family Preventive Services $0 30% after deductible $0 30% after deductible $0 20% after deductible Primary Care Office Visit Specialist Office Visit 10% after deductible 30% after deductible $5 (includes Mizzou Quick Care) 30% after deductible $15 copay 20% after deductible 10% after deductible 30% after deductible $25 copay 30% after deductible $25 copay 20% after deductible Urgent Care 10% after deductible 30% after deductible $50 copay $50 copay $50 copay $50 copay Lab & X-ray 10% after deductible 30% after deductible No charge 30% after deductible Outpatient Visit 10% after deductible 30% after deductible $100 copay/visit 30% after deductible Inpatient Visit 10% after deductible 30% after deductible $300 copay/confinement ($0 copay for maternity delivery) 30% after deductible Emergency Room 10% after deductible 30% after deductible $100 copay/visit $100 copay/visit Medical Plan Out-of-Pocket Limit Prescription Drug Out-of-Pocket Limit* Combined Medical & Prescription Drug Out-of-Pocket Limit* N/A N/A N/A N/A $3,000/single coverage coverage $6,000/single coverage $12,000/family coverage $3,600/person $7,200/family $7,500/person $15,000/family No charge after annual deductible $100 copay/visit after deductible $300 copay/confinement after deductible $100 copay/visit after deductible $3,600/person $7,200/family 20% after deductible 20% after deductible 20% after deductible $100 copay/visit after deductible $7,500/person $15,000/family N/A N/A N/A N/A

7 Other health benefits Dental Dental coverage is offered for three classes of expenses, not to exceed a maximum annual benefit of $1,500 for each enrolled individual. The annual deductible is $100 per individual, or $300 per family. Dental services and coverage Dental Class A Services (Preventative care for routine oral exams, cleaning, x-rays, sealants and fluoride.) Class B Services (For treatments such as fillings, oral surgery, and extractions) Class C Services (Major treatment such as bridgework, dentures, and crowns) 100% (No deductible) 80% after annual deductible 50% after annual deductible Monthly premiums Dental Self $14.76 Spouse $29.52 Child(ren) $35.82 Self, Spouse & Child(ren) $50.58 Vision University of Missouri System offers coverage for a number of eye-care expenses. Charges on amounts over the indicated limits and for optional features are discounted by 20%. Vision coverage and expenses Vision Monthly premiums Vision Eye Exam $10 copay Self $5.88 Glasses ($25 copay) Contacts (No copay) Lasik Surgery Disability Lenses: once per calendar year Frames: once every other calendar up to $140 limit* Fitting and Exam: maximum $60 copay Lenses: once per calendar year up to $140 limit* Discounts up to 15% available Spouse $11.73 Child(ren) $12.80 Self, Spouse & Child(ren) Long Term Disability Long Term Disability coverage is available to provide eligible employees with replacement income due to disability. Long Term Disability options Long Term Disability Option A Option B* $ % of eligible salary Premium paid by the University 66 ⅔% of eligible salary Employee premium required at $0.20 per $100 of monthly salary (up to $12,500 per month) 6 *LTD plan benefits are reduced when the total amount received from all income combined equals 85% of your basic monthly earnings (see LTD SPD for more info.)

8 Life insurance Basic Term Life Basic Term Life insurance is divided into two coverage levels: Basic Term Life plan options Plan A One times base salary 100% paid by University Basic Term Life Plan B Two times base salary University and employee paid (Employee cost is $.03 per $1,000 of coverage) Supplemental Term Life Supplemental term life insurance is offered at one, two, or three times the annual base salary to a maximum amount of $1,000,000 and a minimum of $20,000 (even if you earn less than that for your annual salary). Rates vary by age and the cost is 100% employee paid. See the Monthly Benefit Premiums sheet for details. Dependent Life Dependent Spouse life insurance is available in increments of $10,000 up to a maximum of $50,000. Evidence of insurability is required for amounts above $20,000. Dependent Child life insurance is available in increments of $5,000 up to a maximum of $25,000. Evidence of insurability is required for amounts above $5,000. Coverage is 100% employee paid for both spouses and children. See the Monthly Benefit Premiums sheet for details. 7 Accidental Death & Dismemberment Accidental Death and Dismemberment insurance is available up to $150,000 in increments of $25,000. You may also purchase coverage for your family at a percentage of your coverage. Coverage is 100% employee paid. FSA Accidental Death & Dismemberment premiums (per coverage amount listed) Accidental Death & Dismemberment Coverage Amount Employee Only Employee & Family $25,000 $.53 $. 73 $50,000 $1.05 $1.45 $75,000 $1.58 $2.18 $100,000 $2.10 $2.90 $125,000 $2.63 $3.63 $150,000 $3.15 $4.35 Health Care & Dependent Care Flexible Spending Account Employees are eligible to participate in the Flexible Spending Account Programs. Pre-tax deductions are available to employees for Health Care and Dependent Care expenses. You may contribute up to $2,500 to the Health Care account and up to $5,000 to the Dependent Care account.

9 8 Tax favored health accounts Differences between HSA and Health Care FSA Tax Favored Health Accounts University contributes Retirement Core Retirement The University provides the following retirement benefits to vested employees (based on date of hire). Employees must become vested in the Core Retirement Plan to receive a benefit: UM contributes an average of 7.25% Reduced benefits are available for early retirement Pre-retirement death benefit is provided (this is in addition to any life or accidental death insurance) Employees are required to contribute 1% of the first $50,000 in salary, and 2% of salary earned in excess of $50,000. HSA (Healthy Savings Plan) $400 Self $800 Spouse Educational assistance Voluntary Retirement The Voluntary Retirement Plans allows an employer to set aside a portion of an employee s salary to purchase an annuity contract or make a deposit into a mutual fund. A wide variety of investment companies are available. The pre-tax amounts set aside are taxable upon withdrawal. You may defer as little as $200 per year or up to the maximum allowed by law. Only the 403b allows after-tax deferrals. There are three types of programs offered: 403b Tax Deferred Annuity Plan 457b Deferred Compensation Plan 401a Supplemental Retirement Plan Commuter Parking Program Monthly parking fees may be paid on a pre-tax basis by employees who have payroll deductions for University parking fees in connection with University employment. $800 Children $1200 Self, Spouse & Children* Educational Assistance Program Employees may receive a 75 percent reduction of the educational and supplemental fee for six credit hours per semester (three credit hours for a summer semester) at any University of Missouri System Campus after successful completion of the six month probationary period. Online and evening courses also apply. FSA (Custom Network or PPO Plan) University does not contribute 2015 IRS contribution limit: $3,350 individual/$6,650 family You may contribute up to $2,500 individual/$5,000 family* If you leave, you take money with you Can be used for medical, prescription, dental and vision Unused funds can roll over; funds must be available prior to use * is pro-rated for enrollment in 2nd, 3rd, and 4th quarters. Visit for details. If you leave, money stays in account through end of year Can be used for medical, prescription, dental and vision Funds must be used in the plan year *If spouse is also a UM employee, they would need a separate individual account. Spouses and dependents of employees may receive a 50 percent reduction of eligible educational fees at any University of Missouri System Campus after five years of benefit-eligible employment. Online and evening courses also apply. Campuses are located in Columbia, Kansas City, Rolla, and St. Louis.

10 Resource list To contact plan providers... Resource Administrator Phone Website Medical Plans Coventry Prescription Drugs Custom Network and PPO Plans: Express Scripts Accredo (specialty drugs) Healthy Savings Plan: Coventry Healthy for Life Wellness Program Healthy for Life Flexible Spending Accounts ASI Health Savings Account Health Equity To contact your campus benefits representative... Campus Phone/Fax /Web MU, UM System, MUHC UMKC Missouri S&T UMSL This Benefits Guide provides a summary of various plans included in the University of Missouri System benefit program effective January 1, Complete details of the plans are included in the University of Missouri Collected Rules and Regulations (CRR) and policies. If there is a difference between this Benefits Decision Guide and the CRR, then the CRR will govern in every instance. In addition, the University of Missouri System reserves the right to change or terminate the benefits program, individual plans or any provisions of any plans at any time.

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