RUSH BENEFITS GUIDE. grow WEALTH. choose HEALTH. develop CAREER

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1 2014 RUSH BENEFITS GUIDE choose HEALTH grow WEALTH develop CAREER

2 CHANGES TO RUSH EMPLOYEE BENEFITS FOR 2014 Rush provides you with a full range of affordable employee benefits to enhance your health, help you prepare for retirement and protect you and your family against the unexpected. It s one of the many ways we re working to be an employer of choice in the Chicagoland area. This enrollment guide provides important details about your employee benefits for 2014, including several changes to your benefits options. Introducing the new Health Savings Advantage Plan In addition to the medical plans that are currently available, you will have a new medical plan option for 2014, the Health Savings Advantage plan. This plan is a special kind of PPO that provides you with 100 percent coverage for preventive and wellness care as well as financial protection against significant medical expenses. It is the only type of plan that enables you to open a Health Savings Account (HSA). Having an HSA gives you a tax-advantaged way to save for current and future health care costs even costs you might incur in retirement. Plus, Rush helps you fund your HSA by contributing money you can use to help pay your current deductible or save for future medical expenses ($750 per year for individual coverage or $1,500 per year for employee + spouse, employee + children, or family coverage). That s a real advantage. Dental Plan Improvements Rush offers a choice between a Dental PPO and Dental HMO plan. Both plans cover preventive care and minor and major restorative care. In 2014, the Dental PPO plan will change in two important ways: With a new Preventive Advantage Program, in-network preventive charges will not count toward the annual maximum benefit. Additionally, new hires enrolled in the Dental PPO plan will not need to wait 12 months before they receive coverage for major dental procedures. Your Online Benefits Resource As a Rush employee, you can go to https://rushbenefits.hrintouch.com anytime, anywhere for all your benefit needs. Enroll in your Rush benefits View your current benefit elections and costs View beneficiary and dependent information Make changes during the year after qualifying events (such as the birth of a child) Get details about Rush benefits and wellness programs that can help you improve your total health your physical, financial and personal well-being choose HEALTH develop CAREER grow WEALTH balance LIFE 1

3 Use Rush Providers and Save As an employee of Rush, you receive significant discounts when you use Rush Health physicians and facilities. This includes Rush University Medical Center, Rush Oak Park Hospital and Rush Copley Medical Center. Keep in mind, you still receive in-network benefits if you use a provider in the Cigna network, you just pay less if it s a Rush Health provider. In addition to lower costs, you ll get to experience Rush from the inside. As an employee, this is important because it can help you better understand our patients and what they experience when they visit a Rush provider or facility. As you may know, Rush is widely considered one of the best medical centers in the nation. A unique combination of research and patient care has earned Rush national rankings in nine of the 16 specialty areas in U.S. News & World Report s America s Best Hospitals issue, among other recognitions of our quality of care and accreditations. Why not make Rush your home for health care? We hope you find this benefits guide to be helpful and informative. As always, should you have any questions regarding your Rush benefits, please don t hesitate to contact human resources at (312) , Monday through Friday, 8 a.m. to 4 p.m., or contact our benefits providers through the information listed on page 55. We value you and your service to Rush and our patients. Please read this guide carefully and Put Rush Rewards to Work for You. balance LIFE choose HEALTH develop CAREER grow WEALTH 2

4 WHAT S INSIDE GENERAL INFORMATION ON RUSH BENEFITS Eligibility Table of eligibility start dates for new employees New Federal Rule about Same-Sex Marriage Definition of a dependent Civil Union coverage Coverage levels Table of benefits and eligibility Information on when you can make benefit changes Keeping your information current Choose Health RUSH MEDICAL PLANS Rush medical plans Coverage differences between the health plans Benefits provided by the health plans Understanding the new Health Savings Advantage Plan The Triple Tax Advantage How the Medical Plan and HSA Work Together Who is Eligible Using Your HSA Maximum Contributions to Your HSA for Basic, Premier, Health Savings Advantage or Select EPO: Which is right for you? What the Basic, Premier and Health Savings Advantage have in common How the Basic, Premier and Health Savings Advantage differ from one another Example: A visit to the doctor YOUR ANNUAL DEDUCTIBLE Comparison chart: Basic, Premier, Health Savings Advantage and EPO Plans Express Scripts Pharmacy Prescription coverage with the Health Savings Advantage plan Prescription out-of-pocket maximum costs Using your prescription drug benefits to your best advantage Infertility prescription and treatment coverage Smoking cessation prescription coverage Non-Union Tobacco Free Medical Rates per pay period Non-Union Tobacco User Medical Rates per pay period choose HEALTH develop CAREER grow WEALTH balance LIFE DENTAL PLANS Comparison chart: PPO and Dental HMO employee dental insurance rates per pay period VISION PLAN Vision plan covered services employee vision insurance rates per pay period FLEXIBLE SPENDING ACCOUNTS (FSAs) AND TRANSPORTATION MANAGEMENT ACCOUNTS (TMAs) Calculator showing annual FSA savings

5 choose HEALTH develop CAREER grow WEALTH balance LIFE Eligible expenses defined Health care FSAs are easy to use Signing up for Direct Deposit Dependent care FSAs Reimbursement for dependent care FSAs Transportation management accounts (TMAs) Reimbursement options for TMAs How deductions are made for FSAs and TMAs How to enroll Separation from Rush and your FSA/TMA accounts Federal laws and IRS regulations regarding FSAs and TMAs Save your receipts LIFE AND ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE General information about the Rush life insurance and AD&D benefit Who is eligible for supplemental coverage Determining the amount of supplemental coverage you may need Supplemental life insurance coverage amounts Evidence of health forms for new and existing employees Spouse/same-sex domestic or civil union partner (same or opposite)/child Determining the cost of supplemental coverage How to calculate your supplemental life insurance premium An example: Calculating the cost of your dependent coverage Conditions covered under this benefit How benefits are paid Other life insurance options available through Hartford Enrollment information SHORT-TERM DISABILITY Buy-up option Rate table for buy-up option How to calculate your STD premium Pre-existing condition limitation for disability (applies to STD and LTD core plans and both buy-up plans) Definition of disability Elimination period Taxability Additional information LONG-TERM DISABILITY Buy-up option Buy-up premium calculation Enrollment information RETIREMENT BENEFITS The 403(b) Retirement Savings Plan Who is eligible to participate Vesting in the 403(b) Retirement Savings Plan Compensation on which contributions are based Investments

6 Investment funds Employee contributions Contribution limits Criteria for financial hardship When payments begin Additional provisions in the 403(b) Retirement Savings Plan The Cash Balance Formula Retirement Plan Who is eligible to participate Vesting in the Cash Balance Formula Retirement Plan How the Cash Balance benefit is calculated How the Cash Balance benefit is paid Retirement benefits under the Traditional Formula Retirement Plan Commencing payment of your retirement benefits The Pension Plan (Teamsters-represented employees only) Who is eligible to participate Vesting in the Pension Plan How the Pension benefit is paid For additional information and assistance EMPLOYEE EDUCATION THROUGH LEAP PAID TIME OFF (PTO) How PTO accrual is calculated PTO accrual rates PTO maximum accrual banks Checking your PTO balance Recognized holidays PTO exceptions EMPLOYEE ASSISTANCE PROGRAM (EAP) Work-life resource and referral program Other EAP services ADDITIONAL SERVICES AVAILABLE THROUGH RUSH PerkSpot On-site child care (LADS) GLOSSARY OF TERMS choose HEALTH develop CAREER grow WEALTH balance LIFE NEED MORE INFORMATION Important: This guide contains only a brief overview of the medical and other benefit options available to you. For more information about any Rush benefit plan, please refer to the applicable summary plan description. Although every effort has been made to ensure that the information in this guide is accurate, if there is any conflict between this guide and the terms of a benefit plan as described in the summary plan description, the latter must control. Summary plan descriptions are available in human resources and online at https://rushbenefits.hrintouch.com. 5

7 choose HEALTH develop CAREER grow WEALTH balance LIFE GENERAL INFORMATION ON RUSH BENEFITS Eligibility Your eligibility for Rush benefits is largely determined by your employee status. Temporary and restricted part-time employees are ineligible for any benefits. Please see the chart on page 7 for detailed information on eligibility. Eligibility start dates for new employees Your start date for coverage is based on the type of benefit offered. The following chart provides an easy reference on the start date of coverage for non-union benefit plans. FIRST OF THE MONTH FOLLOWING 30 DAYS OF EMPLOYMENT Medical Dental Vision FIRST OF THE MONTH FOLLOWING 90 DAYS OF EMPLOYMENT Life insurance (basic, supplemental and dependent) Short-term disability Long-term disability Example: If your hire date was January 13, 2014, your medical, dental and vision coverage would become effective on March 1, If your hire date was January 13, 2014, your short- and long-term disability and life insurance coverage would become effective on May 1, New Federal Rule about Same-Sex Spouses In 2013, the U.S. Supreme Court ruled that same-sex spouses lawfully married under the law of a state or foreign jurisdiction are lawfully married for Federal tax and benefits purposes regardless of where they reside. IRS guidance based on this ruling is limited to same-sex spouses. Individuals (same-sex or opposite sex) who are recognized under state law as registered domestic partners or members of a civil union are not considered married for Federal tax or benefits purposes. In addition, the IRS guidance does not affect a state s determination of whether an individual is married for state income tax or other purposes. Definition of a dependent Civil Union Act Coverage* Employees who enter into a civil union can enroll their same sex or heterosexual partner into the following benefits: Health Insurance, Dental Insurance, Vision Insurance and Supplemental Life Insurance. The payroll deductions for health and dental insurance will be subject to federal tax but will be exempt from state tax. In addition, federal taxes will be applied to the fair market value of the benefit provided to the employee s partner. Legally recognized spouses, including same-sex spouses legally married under the law of any state or foreign jurisdiction. Same-sex domestic partner (contact human resources for eligibility information) * Importantly, the same restrictions that apply to marriage also apply to civil unions (no family, minors or people already married). Couples must get an application for a civil union license from the Illinois Department of Public Health. 6

8 Dependent child(ren), who fits the following criteria: is a married or unmarried biological child, step-child, child legally adopted or placed for adoption, foster child of the employee, child for whom the employee serves as legal guardian, or a biological child of the employee s same-sex domestic partner or civil union partner is up to age 26 (until the end of the month in which he or she reaches 26); additionally, unmarried adult children who have served in the United States military may also be covered as dependents under their parent s group health coverage until they reach age 30 Coverage may be continued beyond age 26 for an unmarried dependent child (as defined above) who is dependent upon the employee for over half of his or her financial support, and is permanently disabled. New employees must provide documentation to support dependent eligibility to human resources. Coverage levels You can select medical, dental and vision coverage for: Employee only Employee + spouse, same-sex domestic partner or civil union partner (same or opposite sex) Employee + child (or children) Employee + family Table of benefits and eligibility BENEFIT ELIGIBLE EMPLOYEES ELIGIBLE DEPENDENTS Medical Dental Vision Basic life insurance Supplemental life insurance All full-time; regular part-time salaried and hourly All full-time; regular part-time salaried and hourly All full-time; regular part-time salaried and hourly Non-union* full-time hourly and salaried; regular part-time salaried Non-union* full-time hourly and salaried; regular part-time hourly and salaried Spouse, same-sex domestic and civil union partner, dependent children Spouse, same-sex domestic and civil union partner, dependent children Spouse, same-sex domestic and civil union partner, dependent children Spouse, same-sex domestic and civil union partner, dependent children choose HEALTH develop CAREER grow WEALTH balance LIFE Long-term disability and voluntary buy-up Short-term disability and voluntary buy-up Paid time off Employee assistance program Non-union* full-time hourly and salaried; regular part-time salaried Non-union ± full-time hourly and salaried; regular part-time salaried Non-union* full-time hourly and salaried; regular part-time hourly and salaried All employees All family members as defined by employee * Employees represented by the ISSSA are eligible; Teamsters-represented employees are only eligible for benefits as determined by contract. ± Employees represented by the ISSSA are not eligible for PTO; Teamsters-represented employees are only eligible for benefits as determined by contract. 7

9 choose HEALTH Information on when you can make benefit changes Generally speaking, you may make changes to your benefits only during the annual open enrollment period.* After open enrollment, you can only change your benefits coverage from January 1 through December 31, if you have a qualified life event or a change in status. Qualified life events and changes in status that permit coverage changes include: develop CAREER grow WEALTH balance LIFE Employee moves from part-time to full-time employment or vice versa Employee gains an eligible dependent, e.g., through birth, legal adoption or legal guardianship Marriage, same-sex domestic partner or civil union partner (same or opposite sex) Divorce, annulment or legal separation Dissolution of a same-sex domestic partner or civil union partner (same or opposite sex) relationship Spouse, same-sex domestic partner, civil union partner (same or opposite sex) or dependent gains or loses coverage due to gaining or losing employment/eligibility with his/her current employer Death of a spouse or same-sex domestic partner or civil union partner (same or opposite sex) Death of a dependent child Spouse/same-sex domestic partner/civil union partner (same or opposite sex)/ dependent becomes Medicare/ Medicaid eligible or ineligible Any changes you make for yourself and your dependents must be consistent with, and on account of, your change in status. For example, you can enroll your newborn in medical coverage, but you cannot drop coverage for your spouse, same-sex domestic partner or civil union partner (same or opposite sex) or change medical options because of the birth of your child. Keeping your information current If you have a qualified life event or a change in status, you must make your benefit changes within 31 days of the actual event by logging onto https://rushbenefits.hrintouch.com. Otherwise you cannot make changes until the next open enrollment period. Please note: You must log onto https://rushbenefits.hrintouch.com to add your newborn within 31 days of birth. Failure to do so may result in unpaid claims. Most coverage changes due to a qualified life event or change in status are effective on the event date. If you move or change your primary contact number, you must notify your manager as soon as this change takes place. This is especially important for keeping you up-to-date on any important changes within the Rush benefits program and for income tax purposes. * Changes in qualified TMA parking and mass transit expense reimbursement choices may be made at any time. 8

10 Choose Health Choose Health is a comprehensive, voluntary wellness program for all employees participating in Rush medical plans. Participating in the Choose Health wellness program can help employees understand their health risks and take actions to make the most of life. Choose Health focuses on prevention and management of chronic disease. choose HEALTH To get started in Choose Health, employees take part in a free health screening that is held at Rush each year. The program then provides events and classes to help employees reduce their health risks and achieve their wellness goals. Choose Health also offers the OnTrack health condition management and health coaching program to help employees manage chronic medical conditions such as diabetes, asthma and high blood pressure and to provide special assistance for pregnant women. Additionally, Choose Health partners with the Rush employee medical plan to provide coverage for preventive screenings and treatment of illness and injury. Employees can save up to $775 or more by participating in the Choose Health program and completing specific activities including: Biometric screening and health risk questionnaire Health seminars Engagement in OnTrack chronic condition management Completing a smoking cessation course Maintaining tobacco-free status Losing 5 percent of body weight (if BMI > 30) based on prior year screening results Discounts on maintenance medications for participation in the OnTrack program Employees who complete the Choose Health screening and live tobacco free can save $600 on their medical plan premiums. For questions or more information about the Choose Health program please or call (312) For questions or more information about the Rush Health OnTrack program, please call (312) or Save up to $775 or more! *You must complete all requirements of the wellness screening program to be eligible for these rewards. Learn more about the choose HEALTH Program at inside.rush.edu. 9

11 choose HEALTH RUSH MEDICAL PLANS Rush medical plans are administered by Cigna. Cigna offers many services and online support through its website for Rush employees at Employees can receive confidential and personalized information on: Coverage and benefits details Provider resources, including locating a Rush or in-network physician to meet your needs Claim payment information and details Rush medical plans All eligible Rush employees have a choice between four medical plans. They are the Basic Plan, the Premier Plan, the Health Savings Advantage Plan and the Select EPO. If you use a Rush facility Rush University Medical Center, Rush-Copley Medical Center or Rush Oak Park Hospital your inpatient hospital stay or outpatient hospital visit is covered at a higher benefit level. The Basic, Premier and Health Savings Advantage plans allow you to choose out-of-network physicians and facilities, but you must meet an annual deductible before the plan will begin to pay. The Health Savings Advantage Plan is the only plan that enables you to open a Health Savings Account (HSA), which gives you a tax-advantaged way to save for current and future health care costs and receive HSA contributions from Rush. Read more on page 11. Coverage differences between the health plans PLAN RUSH HEALTH PROVIDER CIGNA NETWORK OUT-OF-NETWORK Premier Deductible (Single/Family) Co-Insurance () Out-of-Pocket Maximum (Single/Family) $300/$600 You pay 10% $1,500/$2,500 $500/$1,000 You pay 30% $3,000/$5,000 $700/$1,400 You pay 50% $10,000/$20,000 Health Savings Advantage Deductible (Single/Family) Annual Rush-funded HSA Contribution (Single/Family) Co-Insurance () Out-of-Pocket Maximum (Single/Family) $1,500/$3,000 $750/$1,500 $2,500/$5,000 $750/$1,500 $5,000/$10,000 $750/$1,500 You pay 5% $3,000/$6,000 You pay 30% $5,000/$10,000 You pay 50% $10,000/$20,000 Basic Deductible (Single/Family) Co-Insurance () Out-of-Pocket Maximum (Single/Family) $1,000/$2,000 You pay 10% $2,500/$5,000 $1,200/$2,400 You pay 30% $5,000/$10,000 $2,400/$4,800 You pay 50% $15,000/$30,000 EPO Plan Primary Care Specialist Emergency Room In-Patient Hospital $25 $40 $150 $0 $35 $60 $150 $750 N/A N/A $150 N/A 10

12 Benefits provided by the health plans All four plans provide many of the same benefits, such as the opportunity to see a specialist without a referral from your primary care physician. In addition, the plans provide an out-of-pocket maximum to protect you from financial hardship resulting from health care costs. All plans provide varying levels of prescription drug coverage and all plans include an infertility drug and medical treatment benefit, as well as smoking cessation prescription coverage. choose HEALTH The main difference between the plans (Basic, Premier and Health Savings Advantage) and the Select EPO is that under the Select EPO there will be no medical benefits paid if you choose to go to an out-of-network physician or facility (except in the case of a true emergency). 1 The other big difference between the plans is only the Health Savings Advantage Plan enables participants to open a Health Savings Account (HSA). Understanding the new Health Savings Advantage Plan You have a new medical plan option to consider in 2014 the Health Savings Advantage plan. It s a different type of PPO medical plan that enables you to open a Health Savings Account (HSA) and fund it with pre-tax dollars taken directly from your paycheck. Plus, Rush helps you fund your HSA by contributing money to your account ($750 per year for individual coverage or $1,500 per year for employee + spouse, employee + children, or family coverage). Rush s contributions to your HSA will be made in equal installments every quarter. You can then use those pre-tax dollars to pay for eligible medical expenses or save for future medical expenses. $ $ $ 1 A true emergency is defined by the prudent layperson standard, meaning the situation or illness would be considered to be an emergency by a prudent (cautious and sensible) non-medically trained person. 11

13 choose HEALTH The Triple Tax Advantage The HSA works to pay for your health care in the same way a 401(k) or 403(b) savings plan works to pay for your retirement. But unlike a 401(k) or 403(b), your HSA contributions provide three tax advantages. 1. Your contributions are deposited tax-free (from federal taxes), 2. They earn interest tax-free, and 3. They can be withdrawn to pay for eligible health care expenses tax-free. That s a triple tax benefit! Investment Options Once you have $2,000 in your HSA, you can choose to allocate some of your funds to various investment options that may help you grow your account and save for eligible medical expenses in retirement. How the Medical Plan and HSA Work Together The Health Savings Advantage plan consists of two parts: the PPO medical plan and the HSA. The PPO Medical Plan The Health Savings Advantage plan is a PPO medical plan that enables you to open a HSA. Like other PPO options, the medical plan gives you access to a wide range of physicians and providers. The plan provides you with 100 percent coverage for preventive and wellness care as well as financial protection against significant medical expenses. You ll have a deductible to meet before the medical plan begins sharing the cost of medical care or prescription drugs through coinsurance or copayments. For drugs classified as preventive, you won t have to meet the deductible before you start sharing the cost through copayments. The medical plan is considered a high deductible health plan by the federal government, which is what enables you to open a HSA with it. But Rush helps to offset the higher deductibles by making tax-free contributions to your HSA. You can use these contributions from Rush to help cover eligible medical expenses and meet your deductible. The Health Savings Account (HSA) A Health Savings Account (HSA) is a special type of savings account that can be used to pay for eligible health care expenses with pre-tax dollars. Your HSA contributions are deposited tax-free (from federal taxes), earn interest tax-free, and are withdrawn to pay for eligible health care expenses tax-free. Plus, Rush helps you fund your HSA by contributing money to your account on a quarterly basis ($750 per year for individual coverage or $1,500 per year for employee + spouse, employee + children, or family coverage). You own your HSA and the money in it. It is yours to keep, even if you choose to leave Rush. You decide whether to use your HSA funds to help pay for your deductible and current eligible health care expenses or let the funds grow tax-free year after year to pay for future eligible medical expenses even expenses you might incur in retirement. Unlike a Flexible Spending Account (FSA), the money in your HSA rolls over from year to year. There s no need to worry about losing money if you don t use it by the end of the year. 12

14 Who is Eligible? To establish a Health Saving Account, you: Must be covered ONLY by an HSA-qualified health plan Having other health coverage (including Medicare, a traditional health plan, or even a general purpose Health Care Flexible Spending Account) may disqualify you Cannot be claimed as a dependent on someone else s tax return If you enroll in a HSA, you won t be able to have a traditional Health Care FSA, but you can open a Limited-Purpose Health Care FSA. A Limited-Purpose FSA is much like a typical, general-purpose Health Care FSA, but eligible expenses are limited to qualifying dental and vision expenses. choose HEALTH Using Your HSA Your HSA will be administered by Health Equity. Health Equity provides you with powerful tools you can use to access and manage your account, including: A debit card Online tools A free mobile app Telephone access You can use your Health Equity access tools to: Check your account balance Review your transactions Review claims Submit new claims or documents Send payments and reimbursements Access tax documents If you select the Health Savings Advantage plan, Health Equity will send you additional information about using your HSA in December Maximum Contributions to Your HSA for 2014 The IRS limits the amount of money you and your employer can contribute to your HSA. The maximum HSA contributions for 2014 are: $3,300 for single coverage $6,550 for family coverage If you are age 55 or older, you can contribute an additional $1,000 to your HSA annually. 13

15 choose HEALTH Basic, Premier, Health Savings Advantage or Select EPO: Which plan is right for you? In determining whether one of the plans (Basic, Premier or Health Savings Advantage) or the Select EPO plan is a right choice for you and your family, there are many factors you will want to consider. Everyone s medical situation is different and we urge you to investigate your options thoroughly before making your decision on what medical coverage to go with for While we realize that the unexpected can happen at any time, the questions below are examples of items that should be taken into consideration when choosing your plan: Do you utilize Rush facilities? How often do you see your physician during the year? Is it mainly for wellness exams? Are you currently being treated for a chronic illness? Are you planning any upcoming surgeries, or are you having a baby in 2014? Do you or your family members require multiple or costly prescription drugs? What are your annual paycheck contributions compared to your out-of-pocket expenses throughout the year (e.g., deductibles, copayments, and coinsurance)? With the Basic, Premier and Health Savings Advantage Plans: Your paycheck deduction is lower than the EPO but you will be subject to a deductible and coinsurance for non-preventive care services such as diagnostic procedures (e.g., labs, X-rays, MRI and CT scans), inpatient hospital stays and specialty services. (Preventive services are covered at 100 percent.) You have an out-of-network benefit that covers you if you seek services outside the Cigna network. You have comprehensive prescription coverage options with a maximum out-of-pocket expense limit. This will be helpful if you or a family member take an extensive amount of prescription medication. With the Select EPO plan: You will have the highest paycheck deduction, but you will not have a deductible to satisfy and it pays 100 percent after applicable copayments are made. You may find this option preferable if you or a family member have a chronic medical condition or you know of an upcoming surgery or hospital stay in You are not required to choose a primary care provider. However, you must use a provider within the Select EPO network. You do not have any out-of-network benefits, only in-network providers are covered. In addition, no referral is needed for specialist care within the Select EPO network. Your prescription coverage does not have an out-of-pocket maximum, meaning prescription costs may be more expensive. Details about the plans and Select EPO are listed in this section and we encourage you to review them in more detail as you make your decision. If you have any questions, log onto https://rushbenefits.hrintouch.com. Did you know that even if your primary care physician is not a Rush physician, you can still utilize the services of onsite physicians, facilities, laboratory services and specialty care. Accessing these onsite services will help you save time and money! To find a Rush physician, please visit the Rush Health Internet site, If you are unsure whether or not your current physician is in-network or out-of-network, please visit the Cigna website at 14

16 What the Basic, Premier and Health Savings Advantage Plans have in common 1. Choosing a doctor You may choose to see any provider You are not required to choose a primary care provider You don t need to obtain referrals for care You receive in-network and out-of-network benefits, which means: Your out-of-pocket costs are lower if you choose Rush and in-network providers. When you use a Rush or in-network provider, you do not have to file a claim your provider will file a claim directly with Cigna. Depending on the type of service you receive, you pay a copayment (to a Rush or in-network physician for an office visit) or coinsurance, and the plan pays the remaining covered amount. choose HEALTH You can receive care from providers outside of the network, but your share of the cost is higher and you are responsible for paying any expenses that exceed the usual, customary and reasonable (UCR) limits. When you use an out-of-network provider, you pay the full cost to the provider and file a claim to be reimbursed a percentage of the covered expenses for medically necessary services, after you meet your annual deductible. 2. Meeting the deductible Once you meet your annual deductible, the Basic, Premier and Health Savings Advantage Plans pay a percentage of covered medical expenses. This percentage is the coinsurance. These amounts that you pay are called out-of-pocket expenses. Only the Health Savings Advantage enables you to have a Health Savings Account to help cover the cost of your deductible. 3. Out-of-pocket maximums The out-of-pocket maximum is your financial responsibility in any calendar year for coinsurance and deductible expenses. Your copayments do not count toward your out-of-pocket maximum for any year. Once you reach the annual out-of-pocket maximum, the Basic, Premier and Health Savings Advantage Plans pay most expenses at 100 percent. The limitations are dependent on which plan you choose, and how much coverage you need. If you use a Rush Health doctor or Rush network facility, you pay a lower deductible and coinsurance. How the Basic, Premier and Health Savings Advantage Plans differ from one another Basic Plan: Your deductible amount is higher than the Premier Plan. You pay lower payroll contributions in this plan than the Premier Plan. This plan may work best for you if you and your family are not frequent health care users. Health Savings Advantage Plan: Your deductible amount is higher than the Premier or Basic Plans, but you will have a Health Savings Account funded by tax-free contributions from Rush to help cover the deductible. You pay lower payroll contributions in this plan than the Premier Plan. Your payroll contributions will be slightly higher than the Basic Plan. This plan may work best if you and your family want to enjoy the tax advantages of a Health Savings Account to help pay your deductible and current eligible health care expenses or let the funds grow tax-free year after year to pay for future eligible medical expenses even expenses you might incur in retirement. 15

17 choose HEALTH Premier Plan: Your deductible amount is lower than the Basic Plan. You pay higher payroll contributions in this plan than the Basic Plan. If you and your family are frequent health care users, this plan may be best for you. Example: A visit to the doctor The amount you pay when you visit the doctor depends on the plan you participate in and the type of provider you choose. If you choose a Rush or Cigna doctor whether you choose the Basic or Premier Plan you pay a $20 copayment for an office visit with a primary care doctor (or a $40 copayment for an office visit with a specialist), then the plan pays 100 percent.* Your office visit copayment does not apply toward your deductible. If you choose an out-of-network provider, your out-of-network annual deductible applies. This means if you haven t met your out-of-network annual deductible, you pay the full cost of your office visit. Once you meet the out-of-network deductible, the plan will share your expenses. Specifically, when you visit the doctor, you will pay 50 percent of the cost and the plan will pay 50 percent. With the Health Savings Advantage Plan, if you choose a Rush or Cigna doctor, you will pay the total cost of your care until you meet the annual deductible. Then you will pay coinsurance (5% for an office visit with a Rush doctor or 30% for an office visit with a Cigna doctor.) Once you meet your annual out-of-pocket maximum, the plan will pay 100% of the cost. Please note: When you use an out-of-network provider, you may be responsible for additional charges beyond usual, customary and reasonable (UCR). * Charges for additional services that are performed during an office visit may be subject to your plan deductible and coinsurance. 16

18 YOUR ANNUAL DEDUCTIBLE Here s an example of how you meet your deductible in the Basic, Premier and Health Savings Advantage Plans. If you have family coverage and use in-network providers, it might look like this: SERVICE Annual deductible: Rush Network single/family* In-network single/family* Out-of-network single/family* Rush contributions to HSA (Single/Family) Preventive care: You and your family visit the doctor for annual physicals ± Office visits: You visit the doctor during the year ± Outpatient services: A member of your family requires surgery, which costs $3,000. You choose a Rush facility so your coinsurance is 5% to 10%, depending on the plan. Outpatient services: A different member of your family requires outpatient care, which costs $900. You choose a Cigna network provider so your coinsurance is 30%. BASIC PLAN HEALTH SAVINGS ADVANTAGE PLAN $1,000/$2,000 $1,500/$3,000*** $1,200/$2,400 $2,500/$5,000*** $2,400/$4,800 N/A $0 100% $0 100% $20 copayment (copay does not apply toward the deductible) $1,000 toward the individual deductible plus $200 (10% coinsurance on the remaining cost) $900 of family deductible (you must meet remainder of family deductible before plan pays coinsurance) 100% after copayment $1,800 (90% of remaining cost after you pay deductible) $5,000/$10,000*** $750/$1,500** 5% for Rush providers (after deductible) 30% for Cigna providers (after deductible) $3,000** toward the family deductible, which meets the Rush Network deductible and covers the cost of the surgery. No additional coinsurance payment is necessary. 95% for Rush providers (after deductible) 70% for Cigna providers (after deductible) $0 $0 $900 of the in-network family deductible since you chose a Cigna Network provider. $0 since you have not met the in-network family deductible. PREMIER PLAN $0 $300/$600 $500/$1,000 $700/$1,400 YOU PAY PLAN PAYS YOU PAY PLAN PAYS YOU PAY PLAN PAYS The examples above show what you pay under each plan, and what the plan pays for services. N/A $20 copayment (copay does not apply toward the deductible) $300 toward the individual deductible, plus $270 (10% coinsurance on the remaining cost) $300 of family deductible (you must meet remainder of family deductible) plus $180 (30% coinsurance on remaining cost) 100% 100% after copayment $2,430 (90% of remaining cost after you pay deductible) $420 (70% of remaining cost after you pay deductible) choose HEALTH * Please note that if you select family coverage, you can meet the total family deductible in one of two ways: Two members of your family separately meet the individual deductible (e.g., $1,000 each for Basic Plan in-network charges). Two or more of the members of your family together meet the family deductible amount (e.g., $2,000 in combined total in-network charges for Basic Plan regardless of how much incurred by each family member). ± Charges for additional services that are performed during an office visit may be subject to your plan deductible and coinsurance. **Please note that with the Health Savings Advantage Plan, you can use your Rush-funded HSA to help cover the cost of your deductible. ***If you have family coverage in the Health Savings Advantage Plan, you must meet the family deductible before the plan begins sharing the cost of medical expenses for any individual covered family member. 17

19 choose HEALTH Comparison chart: BASIC, PREMIER, HEALTH SAVINGS ADVANTAGE AND EPO PLANS SERVICE DESCRIPTION BASIC PLAN HEALTH SAVINGS ADVANTAGE PLAN RUSH NETWORK (INCLUDES RUSH PHYSICIANS) Single: $2,500 Family: $5,000 Single: $3,000 Family: $6,000 NON-RUSH IN-NETWORK FACILITY MAXIMUM ANNUAL OUT-OF-POCKET LIMITS Single: $5,000 Family: $10,000 Single: $5,000 Family: $10,000 OUT-OF- NETWORK FACILITY Single: $15,000 Family: $30,000 Single: $10,000 Family: $20,000 IN-NETWORK PHYSICIAN Single: $5,000 Family: $10,000 Single: $5,000 Family: $10,000 OUT-OF- NETWORK PHYSICIAN Single: $15,000 Family: $30,000 Single: $10,000 Family: $20,000 PREMIER PLAN SELECT EPO BASIC PLAN HEALTH SAVINGS ADVANTAGE PLAN PREMIER PLAN SELECT EPO INPATIENT HOSPITAL STAY BASIC PLAN $150 copay, plan pays 90% HEALTH SAVINGS ADVANTAGE PLAN PREMIER PLAN SELECT EPO OUTPATIENT HOSPITAL VISIT, INCLUDING LAB AND X-RAY BASIC PLAN Plan pays Plan pays Plan pays 90% after 70% after 50% after deductible deductible deductible HEALTH SAVINGS ADVANTAGE PLAN PREMIER PLAN Single: $1,500 Family: $2,500 Single: $6,350 Family: $12,700 Plan pays 95% after deductible $150 copay, plan pays 90% Copayment waived Plan pay 95% after deductible Plan pays 90% after deductible Single: $3,000 Family: $5,000 Single: $6,350 Family: $12,700 $300 copay, plan pays 70% Plan pays 70% after deductible $300 copay, plan pays 70% $750 copay, plan then pays 100% Plan pays 70% after deductible Plan pays 70% after deductible Single: $10,000 Family: $20,000 N/A RUSH-FUNDED HEALTH SAVINGS ACCOUNT (HSA) CONTRIBUTIONS N/A Single: $750 Family: $1,500 N/A N/A $600 copay, plan pays 50% Plan pays 50% after deductible $600 copay, plan pays 50% Not covered Plan pays 50% after deductible Plan pays 50% after deductible Single: $3,000 Family: $5,000 Single: $6,350 Family: $12,700 Plan pays 70% after deductible Plan pays 70% after deductible Plan pays 70% after deductible Plan pays 100% Plan pays 70% after deductible Plan pays 70% after deductible Plan pays 70% after deductible Single: $10,000 Family: $20,000 N/A Plan pays 50% after deductible Plan pays 50% after deductible Plan pays 50% after deductible Not covered Plan pays 50% after deductible Plan pays 50% after deductible Plan pays 50% after deductible SELECT EPO Plan pays 100% Plan pays 100% Not covered Plan pays 100% Not covered 18

20 Comparison chart: BASIC, PREMIER, HEALTH SAVINGS ADVANTAGE AND EPO PLANS (continued) SERVICE DESCRIPTION RUSH FACILITY (INCLUDES RUSH PHYSICIANS) NON-RUSH IN-NETWORK FACILITY OUT-OF- NETWORK FACILITY IN-NETWORK PHYSICIAN OUT-OF- NETWORK PHYSICIAN choose HEALTH EMERGENCY ROOM (TRUE EMERGENCY BASED ON PRUDENT LAYPERSON STANDARD)** BASIC PLAN $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% HEALTH SAVINGS ADVANTAGE PLAN Plan pays 70% Plan pays 70% Plan pays 70% Plan pays 70% Plan pays 70% PREMIER PLAN $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% SELECT EPO $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% $150 copay, plan then pays 100% URGENT CARE CENTER BASIC PLAN $40 copay, plan then pays 100% $40 copay, plan then pays 100% $40 copay, plan then pays 100% HEALTH SAVINGS ADVANTAGE PLAN Plan pays 95% Plan pays 70% Plan pays 70% PREMIER PLAN $40 copay, plan then pays 100% $40 copay, plan then pays 100% $40 copay, plan then pays 100% SELECT EPO $40 copay, plan then pays 100% $60 copay, plan then pays 100% Not covered $60 copay, plan then pays 100% Not covered OFFICE VISIT TO A PRIMARY CARE PHYSICIAN BASIC PLAN $20 copay, plan then pays 100%* $20 copay, plan then pays 100%* $20 copay, plan then pays 100%* HEALTH SAVINGS ADVANTAGE PLAN Plan pays 95% Plan pays 70% Plan pays 70% PREMIER PLAN $20 copay, plan then pays 100%* $20 copay, plan then pays 100%* $20 copay, plan then pays 100%* SELECT EPO $25 copay, plan then pays 100% $35 copay, plan then pays 100% Not covered $35 copay, plan then pays 100% Not covered continued on next page * Charges for additional services that are performed during an office visit may be subject to your plan deductible and coinsurance. 90 percent for all services billed through Rush facility; 70 percent for services billed independently. Copay waived if admitted. ** The prudent layperson standard means the situation or illness would be considered to be an emergency by a prudent (cautious and sensible) non-medically trained person. 19

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