Key Contact Information

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2 Key Contact Information The following table provides important phone numbers and websites that you may need when enrolling for your benefits and throughout the year. Health Insurance Options Website Group # Phone Number [ ] Pioneer Medical Plan # [ ] Kaiser Medical Plan pt/hr/benefits/insurance/plans /index.html # Dental Insurance [ ] Pioneer Dental Plan # [ ] Kaiser Dental Plan pt/hr/benefits/insurance/plans /index.html # Life Insurance [ ] Optional Group Term Life and AD&D (Buy-up) pt/hr/benefits/otherbenefits/li feinsurance/index.html # SUN-LIFE ( ) Flexible Spending Account [ ] Health Care [ ] Dependent Care [ ] Mass Transit Retirement Plans # [ ] Transamerica Retirement Solutions hhttps:// bportal/retire/index.html T AFLAC [ ] Accident [ ] Cancer [ ] Hospital [ ] Short-Term Disability [ ] Whole Life Insurance pt/hr/benefits/aflac/index.html KA555 (800) Pre-Paid Legal [ ] Family Legal Plan [ ] Identity Theft Shield groups/willametteuniversity/ #37588 (800) Still Have Questions? I m happy to help you: Katie Lahey HR Generalist, Benefits/HRIS klahey@willamette.edu

3 Willamette University Human Resources pen Enrollment is a time to evaluate your healthcare costs and services from the previous year and determine which plan best suits the needs of yourself and your family for the plan year. It is the one time during the year when you can change medical plans, add or remove eligible family members and enroll in other plans that aren t always open for enrollment. Open Enrollment: February 10 th February 28 th, 2014 After the 28 th, you can only make changes due to a qualifying event. (i.e. birth of a child, marriage, divorce, partner s job change, etc.) YOUR OPEN ENROLLMENT TO DO LIST Review this booklet and the detailed information on the Benefits website to help you make your benefit choices for the next plan year. If you are satisfied with your current plans, you need to do nothing more. Your plans will remain the same but at the 2014 rates. All employees currently enrolled in a flexible spending account or a medical waiver ( optout benefit) must remember to complete a new election or waiver for the new plan year. If you do not re-enroll, you will not be a participant in Attend an Open Enrollment Meeting for a review of the changes for benefit plans in Two such meetings will be held on Wednesday, February 12 th in the Alumni Lounge. The morning presentation is from am and the afternoon presentation is from 2-3 pm. Attend the Benefits & Wellness Fair on Thursday, February 27 th in Montag Den. A fun opportunity to meet our benefits vendors and a few wellness-oriented vendors. OVERVIEW OF 2014 PLAN CHANGES Willamette University strives to provide a high-value, competitive and comprehensive benefit program. We experienced a lot of positive news with our renewals this year and some unanticipated challenges. Starting with the good news first, our dental benefits will continue unchanged and we are pleased to report that the Pioneer Dental rates decreased 6.5% and the Kaiser Dental rates are unchanged, at a 0% increase. We are also happy to report that the Pioneer Medical plan will see a decrease in rates of 5.8% and benefit changes will be modest and solely related to regulatory changes required under the Affordable Care Act. The rate decrease is due to an anticipated reduction in claims for the upcoming year as projected by Milliman, the trust s actuarial consultant. This is obviously great news and we are pleased that Pioneer participants will see a few extra dollars in their pockets this year. We were not as fortunate with the Kaiser Permanente medical plan renewal. Because our claims history was higher than expected over the past two years, and based on projections that claims are expected to grow for our group, Kaiser calculated an initial increase of 23% for Willamette s plan. As a matter of policy, Kaiser capped our renewal rate at 17%. We received reports of similar increases being passed on by Kaiser to our peers at other institutions this year. As we were concerned about the impact that a 17% increase would have on paychecks, we asked Kaiser to present options for reducing the increase. In reviewing plan design options presented by Kaiser to reduce the increase, our focus was to continue to provide a high value plan design. The plan that was ultimately selected reduces the premium increase to 10%, while actually reducing co-pays for primary care,

4 Willamette University Human Resources urgent care, and basic labs & X-ray, and maintaining our vision and alternative care benefits. However, it also establishes a deductible and coinsurance for major services, such as in-patient and out-patient surgery, which may result in higher out-of-pocket expenses when using higher cost services such as an overnight hospital stay. To cap the potential cost to employees in a calendar year, there is a reasonable out-of-pocket maximum limit. Following are a few of the key changes in the Kaiser Medical plan: o The primary care office-visit copay is lowered from $25 to $15 per visit. o Basic diagnostic lab & X-ray services continue to be copay-based and are reduced from $25 to $15 per visit. Major/specialty (higher cost) imaging services are covered with a $100 copay. o The urgent care copay is reduced from $45 to $35. o Deductibles and coinsurance are established for major services, including outpatient and inpatient surgery, other inpatient hospital services, and emergency services. o Prescription copays change to a three-tier system, from two-tier, with a $20 copay for generic prescriptions (up from $15). This makes the prescription copay plan equivalent to the Pioneer plan. o Routine eye exam copays are reduced from $25 to $15. PREMIUM-SHARING CHANGES Each year, Willamette evaluates the premium sharing structure of our health and dental plans. In doing so, we consider affordability to employees, the budget, competitiveness of employee rates, and the year-to-year impact on paychecks. In order to minimize the impact on paychecks of the Kaiser 10% rate increase, and considering the amount of University subsidy associated with each level of coverage across the two plans, Willamette has decided to absorb the majority of the employee share of the Kaiser cost increase this year and make modest changes to the premium sharing structure. The structural change results in Kaiser family rates that provide for a more affordable choice for those who need coverage for dependents, and also completes a multi-year effort to align the two-party premium sharing rate with the family rate. A full summary of the premium sharing structure, including employee rates is found later in this guide. In summary, employee shares of premiums will change as follows: Pioneer Medical rates will decrease 5.8% across all salary and coverage tiers Pioneer Dental rates will decrease 6.5% across all salary and coverage tiers Kaiser Dental rates will not change (0%) across all salary and coverage tiers Kaiser Health single coverage rates will not change (0%) across all salary tiers Kaiser Health two-party coverage rates will increase by 5% across all salary tiers Kaiser Health family coverage rates will reduce by 10-16% depending on salary tier FLEXIBLE SPENDING CHANGES We also have exciting news to share about a change to the use-it-or-lose it feature of our flexible spending account plan. In lieu of offering a 2 ½ month incurred claims grace period as we do currently, beginning with the new plan year that starts on April 1, 2014 to March 31, 2015, you are now allowed up to $500 of carryover into the next plan year. We anticipate that this change will really benefit our flex participants as it has been difficult for our employees to plan a whole year s worth of medical expenses. The grace period provision still applies to the current flex plan year ending March 31, The dependent care and mass transit plans will remain the same. As always, we are happy to answer any questions you have. Please contact us at or hr@willamette.edu. Have a great Open Enrollment!

5 Medical and Dental Insurance Rates Employee s Salary: $0-$50,000 Pioneer Medical Plan Kaiser Medical Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $ $28.02 $ Employee $ $21.55 $ Employee + 1 $1, $ $ Employee + 1 $ $ $ Family $1, $ $1, Family $1, $ $ Pioneer Dental Plan Kaiser Dental Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $53.06 $0.00 $53.06 Employee $58.71 $0.00 $58.71 Employee + 1 $ $37.16 $69.00 Employee + 1 $ $41.09 $76.32 Family $ $66.87 $81.74 Family $ $73.44 $89.76 Employee s Salary: $50,001-$100,000 Pioneer Medical Plan Kaiser Medical Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $ $50.43 $ Employee $ $38.79 $ Employee + 1 $1, $ $ Employee + 1 $ $ $ Family $1, $ $ Family $1, $ $ Pioneer Dental Plan Kaiser Dental Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $53.06 $5.31 $47.75 Employee $58.71 $5.87 $52.84 Employee + 1 $ $42.46 $63.70 Employee + 1 $ $46.96 $70.45 Family $ $69.85 $78.76 Family $ $76.70 $86.50 Employee s Salary: $100,001+ Pioneer Medical Plan Kaiser Medical Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $ $67.24 $ Employee $ $51.72 $ Employee + 1 $1, $ $ Employee + 1 $ $ $ Family $1, $ $ Family $1, $ $ Pioneer Dental Plan Kaiser Dental Plan Total Employee Pays WU Pays Total Employee Pays WU Pays Employee $53.06 $7.96 $45.10 Employee $58.71 $8.81 $49.90 Employee + 1 $ $53.08 $53.08 Employee + 1 $ $58.71 $58.71 Family $ $74.31 $74.31 Family $ $81.60 $81.60 Willamette University

6 Medical Plan Comparison Plan Name & Provider Network Annual Deductible (January December) Annual Out-of-Pocket Maximum (January December) Preventive Care Primary and Specialty Care Urgent Care Diagnostic Lab & X-Ray Inpatient Stay/Surgery Outpatient Surgery Emergency Room Ambulance Services Durable Medical Equipment Alternative Care (Acupuncture, Chiropractic, Massage Therapy, Naturopathic) Prescription Retail (Up to 30 day supply) Mail Order Prescriptions (Up to 90 day supply) Vision Benefits (ages 18 & younger) Vision Benefits Pioneer Medical Regence BlueCross Blue Shield Network Kaiser Medical Kaiser Providers In-Network Out-of-Network In-Network Only Individual -$250 Individual -$500 Individual -$250 Family -$750 Family -$1,500 Family -$750 Individual -$2,000 Family -$6,000 $0 co-pay (deductible waived) $25 co-pay (deductible waived) $25 co-pay (deductible waived) 20% Coinsurance (deductible waived) 20% Coinsurance 20% Coinsurance (deductible waived) Individual -$6,000 Family -$18,000 40% Coinsurance 40% Coinsurance 40% Coinsurance Individual -$2,250 Family -$6,750 $0 co-pay (deductible waived) $15 co-pay Primary $25 co-pay Specialty (deductible waived) $35 co-pay (deductible waived) 40% Coinsurance $15 per department visit (deductible waived) 40% Coinsurance 40% Coinsurance $150 co-pay, then 20% Coinsurance (deductible waived if admitted) 20% Coinsurance 20% Coinsurance 40% Coinsurance 20% Coinsurance (deductible waived) Does not apply toward maximum co-insurance 24-visit limit every 12 months (calendar year) $20 generic $40 preferred $60 non-preferred $30 generic $60 preferred $90 non-preferred $0 co-pay (deductible waived) routine exam per year one pair standard frames every 12 months (calendar year) Annual exam $0 co-pay (deductible waived). Hardware: $250 every 12 months (calendar year) maximum benefits. 20% Coinsurance 20% Coinsurance 20% Coinsurance 20% Coinsurance 20% Coinsurance (self-referred) $25 co-pay $1,500 max for all services every 12 months (calendar year), 12-visit calendar limit on Massage Therapy only $20 generic $40 preferred $60 non-preferred $40 generic $80 preferred $120 non-preferred No charge for one pair standard frames and lenses or 6-month supply contact lenses every 24 months. Routine eye exam - $15 co-pay Prescription eyeglasses & contact lenses - balance after $250 credit every 24 months. Please note: This summary provides a brief description of the Plan benefits. Please refer to the Summary Plan Description for a complete list of benefits, the limitations, and exclusions that apply and a definition of medical necessity. Willamette University

7 Dental Plan Comparison Plan Name & Provider Network Annual Deductible Pioneer Dental Any Licensed Dentist Individual - $50 Family - $150 Kaiser Dental Kaiser Providers None Annual Maximum Benefit $1,500 per person $1,500 per person Office Visits None $15 co-pay Preventive Services Exams, cleanings, x-rays, fluoride treatment Employee pays 0% (deductible waived) Fully covered after office visit charge Basic Services Fillings, simple extractions Employee pays 20% after deductible Fully covered after office visit charge Major Services Crowns, Bridges, Dentures Employee pays 50% after deductible Employee pays 20% Emergency Treatment Orthodontia No age limit Employee pays 20% after deductible Employee pays 50% $1,500 per claimant lifetime maximum% (deductible waived) $25 co-pay in-network Plan pays up to $100 for out-of-area emergency Employee pays 50% $1,500 per claimant lifetime maximum Orthodontia Lifetime Maximum $1,500 $1,500 Please note: This summary provides a brief description of the Plan benefits. Please refer to the Summary Plan Description for a complete list of benefits, the limitations, and exclusions that apply and a definition of medical necessity. Willamette University

8 FSA - $500 Carryover Great news! Your Flexible Spending Account (FSA) plan includes a $500 carryover option. What does it mean for you? The IRS decided to make the FSA program a whole lot better. They ve done away with the Use-or-Lose rule, so you no longer risk losing your FSA dollars at the end of the year, or scramble to spend your remaining funds. How does it work? With the new $500 option, you can now carryover up to $500 of your unused FSA funds at the end of each plan year. Don t panic, there s no catch. You can still use your flex dollars to pay for eligible medical expenses. Carryover funds will be applied to your account after the claims run-out period, which is typically 90 days after your plan year ends. For example, if your plan ends December 31, the carryover would be applied to your account April 1. Please review your Summary Plan Document to verify if your plan includes the run-out period. Still unsure? Don t be. FSAs are a great way to stretch your benefit dollars and increase your overall spendable income. The money you put into an FSA is not taxed, so assuming you pay a combined 40% state and federal tax rate, you re saving 40% off healthcare expenses funded through the account. If you choose not to participate in the FSA program because of the Use-or-Lose mandate, it s time to take another look. Questions? Let s talk

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16 Annual Legal Notices THE WOMEN S HEALTH CANCER RIGHTS ACT OF 1998 (WHCRA) 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; and 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 this plan. NEWBORNS ACT DISCLOSURE FEDERAL 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). NOTICE OF PREEXISTING CONDITIONS If applicable, the existence and terms of a pre-existing condition exclusion clause are disclosed in your benefit booklet. Individuals have a right to request a certificate of creditable coverage from a prior plan or insurance issuer. If necessary, the plan can assist you in obtaining a certificate of creditable coverage. Please contact human resources for more information or to request assistance. NOTICE OF SPECIAL ENROLLMENT RIGHTS If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents other coverage). However, you must request enrollment within 30 days after your or your dependents other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption, or placement for adoption. Further, if you decline enrollment for yourself or eligible dependents (including your spouse) while Medicaid coverage or coverage under a State CHIP program is in effect, you may be able to enroll yourself and your dependents in this plan if: coverage is lost under Medicaid or a State CHIP program; or you or your dependents become eligible for a premium assistance subsidy from the State. In either case, you must request enrollment within 60 days from the loss of coverage or the date you become eligible for premium assistance. To request special enrollment or obtain more information, contact person listed at the end of this summary. NOTICE OF PATIENT PROTECTIONS THAT REQUIRE DESIGNATION OF A PCP Kaiser group health plans generally requires the designation of a primary care provider. You have the right to designate any primary care provider who participates in our network and who is available to accept you or your family members. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact Kaiser Customer Service. For children, you may designate a pediatrician as the primary care provider. MEDICAID AND THE CHILDREN S HEALTH INSURANCE PROGRAM (CHIP) OFFER FREE OR LOW-COST HEALTH COVERAGE TO CHILDREN AND FAMILIES If you are eligible for health coverage from your employer, but are unable to afford the premiums, some 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 or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for of these programs, you can either contact your State Medicaid or CHIP office or dial KIDS NOW or to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay

17 the premiums for an employer-sponsored plan. Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer s health plan is required to permit you and your dependents to enroll in the plan as long as you and your dependents are eligible, but not already enrolled in the employer s plan. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. You should contact your State for further information on eligibility OREGON Medicaid and CHIP Medicaid & CHIP Website: Medicaid & CHIP Phone: STATEMENT OF ERISA RIGHTS: As a participant in the plan you are entitled to certain rights and protections under the employee retirement income security act of 1974 ( erisa ). Erisa provides that all participants shall be entitled to: Receive Information about Your Plan and Benefits Examine, without charge, at the Plan Administrator s office and at other specified locations, the Plan and Plan documents, including the insurance contract and copies of all documents filed by the Plan with the U.S. Department of Labor, if any, such as annual reports and Plan descriptions. Obtain copies of the Plan documents and other Plan information upon written request to the Plan Administrator. The Plan Administrator may make a reasonable charge for the copies. Receive a summary of the Plan s annual financial report, if required to be furnished under ERISA. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report, if any. Continue Group Health Plan Coverage: If applicable, you may continue health care coverage for yourself, spouse or dependents if there is a loss of coverage under the plan as a result of a qualifying event. You and your dependents may have to pay for such coverage. Review the summary plan description and the documents governing the Plan for the rules on COBRA continuation of coverage rights. If you have creditable coverage from another plan, you may be entitled to a reduction or elimination of exclusionary periods (if applicable) of coverage for preexisting conditions under your group health plan. You should be provided a certificate of creditable coverage, free of charge, from your group health plan or health insurance issuer when you lose coverage under the plan, when you become entitled to COBRA continuation of coverage, when COBRA continuation of coverage ceases, if you request before losing coverage or if you request it up to 24 months after losing coverage. Without evidence of prior creditable coverage, you may be subject to a preexisting condition exclusion for 12 months (18 months for late enrollees) after your enrollment date in your coverage. Prudent Actions by Plan Fiduciaries: In addition to creating rights for participants, ERISA imposes duties upon the people who are responsible for operation of the Plan. These people, called fiduciaries of the Plan, have a duty to operate the Plan prudently and in the interest of you and other Plan participants. No one, including the Company or any other person, may fire you or discriminate against you in any way to prevent you from obtaining welfare benefits or exercising your rights under ERISA. Enforce your Rights: If your claim for a welfare benefit is denied in whole or in part, you must receive a written explanation of the reason for the denial. You have a right to have the Plan review and reconsider your claim. Under ERISA, there are steps you can take to enforce these rights. For instance, if you request materials from the Plan Administrator and do not receive them within 30 days, you may file suit in federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent due to reasons beyond the control of the Plan Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, and you have exhausted the available claims procedures under the Plan, you may file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose (for example, if the court finds your claim is frivolous) the court may order you to pay these costs and fees. Assistance with your Questions: If you have any questions about your Plan, this statement, or your rights under ERISA, you should contact the nearest office of the Employee Benefits and Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits and Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C

18 DISCLOSURE OF PLAN INFORMATION UNDER ERISA FOR WILLAMETTE UNIVERSITY EMPLOYEE BENEFIT PLANS The Employee Retirement Income Security Act of 1974 (ERISA) requires that we provide you annually with information - known as a Summary Annual Report - on the financial information filed with the Internal Revenue Service and the U.S. Department of Labor for the plans listed below in which you may be a participant, eligible to participate, or a beneficiary. As permitted by Department of Labor regulations, in lieu of a Summary Annual Report, a copy of the Annual Return/Report filed on behalf of the plan will be furnished to you free of charge, upon receipt of a written request. Reports are available for the following: Willamette University Defined Contribution 403(b) Retirement Plan Willamette University Long Term Disability Insurance Plan Willamette University Group Life Insurance Plan and ADD-Basic and Voluntary Pioneer Educators Health Trust (PEHT, filed by Trust Account Management) Willamette University Employee Welfare Benefit Plans, including: Willamette University Flexible Spending Plan Kaiser Permanente Health Plan Employee Assistance Program A copy of the Form 5500 and the Disclosure of Plan Information under ERISA Notice will be sent to you within 30 days of your request. Please submit your written request to: Keith Grimm, SPHR Director of Human Resources Willamette University 900 State Street Salem, OR 97301

19 Benefits & Wellness Fair February 27, 2014 Montag Den 10 a.m. 1 p.m. PRIZES! SAMPLES! Aflac Cascade Centers Costco Indigo Wellness Center Life Source Foods Pitchfork & Crow WU Health Center Willamette Art Center YMCA and many more! Questions? Contact HR: (503)

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