Overview of Caterpillar Healthcare Benefit Changes Healthcare Benefits Annual Enrollment

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1 2015 Overview of Caterpillar Healthcare Benefit Changes Healthcare Benefits Annual Enrollment November 17-28, 2014 (Active employees) November 10-21, 2014 (Retirees, Survivors and COBRA)

2 Overview of 2015 Healthcare Benefit Changes In preparation for this fall s healthcare annual enrollment, we want to make you aware of changes to our benefits that may affect you. We re communicating a little earlier than usual because we want to provide more time for you to understand what s changing, determine if you may be affected and prepare for annual enrollment decisions in November. Summary of healthcare changes for 2015» New health plan option» Co-insurance added to prescription drug benefi t» New physician network requirements» Carryover option for FSA Market competitive benefits now and in the future Our current healthcare benefits are very market competitive, which means they are similar to the benefits offered by other large multinational companies we benchmark in fact our existing prescription drug benefit is better than what most companies provide and our benefits will remain very market competitive once the changes described in this booklet are implemented January 1, The healthcare industry is evolving, and Caterpillar benefit professionals continually research and evaluate what is changing by networking and benchmarking with other companies and industry experts. This helps them understand how changes may affect the coverage we provide and determine how to design healthcare benefits that are market competitive and sustainable into the future. Take Action! We often hear that participants don t think they need to do anything during healthcare annual enrollment. That is not true! Learn about the plan options available so you can choose the option that is best for your situation. If the plan option you are enrolled in today is no longer available to you next year, you will need to choose a new option or you will be defaulted into the Preferred Provider Organization (PPO) option for which you are eligible. Review the dependents you have enrolled in the plan. If they are no longer eligible, they should be removed by contacting the Caterpillar Benefits Center at or by visiting the Your Benefits Resources website. If you have questions about the content of this booklet, please contact the Annual Enrollment Hotline to speak to a Caterpillar benefits professional. Mon Fri 6:30 a.m. 5:00 p.m. (Central time) Mention Annual Enrollment to ensure your question is assigned correctly CATERPILLAR HEALTHCARE BENEFITS GUIDE

3 Replacing current regional HMO & EPO options with national Blue Cross Blue Shield EPO Who is affected by the change? If you are currently enrolled in an option other than the PPO administered by UnitedHealthcare, you will need to choose a new healthcare option for If you are enrolled in or eligible for the PPO, you may want to learn about the Blue Cross Blue Shield (BCBS) Exclusive Provider Organization (EPO) as a potential alternative for healthcare coverage in What is changing? Beginning next year, a nationwide BCBS EPO option will replace current Health Maintenance Organization (HMO) and EPO options. This change will provide a choice in medical carriers to the majority of eligible participants and is intended to help control escalating healthcare costs HEALTHCARE PLAN CHOICES» PPO (includes medical, dental, vision, Rx) ¾ UHC Network ¾ Caterpillar Network ¾ Out-of-Area Network» Aetna» Cigna (not Cigna dental)» Blue Cross Blue Shield of Illinois» Health Alliance Medical Plan» Kaiser Health Plans (Denver)» UHC Choice EPO 2015 HEALTHCARE PLAN CHOICES» PPO (includes medical, dental, vision, Rx) ¾ UHC Network ¾ Caterpillar Network ¾ Out-of-Area Network» National Blue Cross Blue Shield EPO (includes medical, dental, vision, Rx) Do I need to do anything during healthcare annual enrollment if I am enrolled in an HMO or the UHC Choice EPO? It is important for participants currently enrolled in an HMO or the UHC Choice EPO to review all plan options available and elect a choice during annual enrollment. If you do not make an election, you will be defaulted to the PPO option for which you are eligible. If you are currently enrolled in an HMO or EPO option, and do not make a choice during healthcare annual enrollment, you will be defaulted to the PPO option for which you are eligible. What you can expect The BCBS EPO will have different deductibles, co-pays, co-insurance and maximum out-of-pocket expenses compared to the current HMOs and the UHC Choice EPO. Depending on your current HMO plan, the BCBS EPO may have higher or lower costs. Many of the physicians and hospitals available today in the HMOs and UHC Choice EPO are also part of the BCBS network. The PPO and the BCBS EPO will provide the same prescription drug benefit. To learn more about the new national BCBS EPO now, visit CatHealthBenefits.com > Annual Enrollment Center. You will find information about deductibles, co-pays, co-insurance and major services covered CATERPILLAR HEALTHCARE BENEFITS GUIDE 3

4 Understand which network you are eligible for today No matter which healthcare option you are currently enrolled in, most health plans have a group of contracted hospitals or physicians that provide preferred pricing. If you go to a provider outside of the network you will be paying more for services. If you are currently enrolled in an HMO or EPO, you are using its network. If you are enrolled in the PPO, you have to determine which network applies to you. The following will help you determine the network that applies to you within the PPO option. I am a PPO participant. Which network am I in today? JoDaviess Stephenson Winnebago Boone McHenry Lake PPO - UnitedHealthcare (UHC) Network If you reside outside of Illinois or in a non-caterpillar Network county in Illinois, you are likely in the UHC network. To determine your network, refer to your healthcare ID card or contact UHC at PPO - Caterpillar Network If you reside in an Illinois county listed below, you are in the Caterpillar Network. Caterpillar has a team of professionals that contract with hospitals and physicians in central Illinois due to the large employee population in the area. Counties in Illinois included in the Caterpillar Network:» Bureau» Christian» DeKalb» DeWitt» DuPage» Fulton» Grundy» Kane» Kendall» Knox» LaSalle» Livingston» Macon» Marshall» McLean» Moultrie» Peoria» Piatt» Putnam» Shelby» Stark» Tazewell» Will» Woodford Knox Warren McDonough Fulton Hancock Henderson Rock Island Henry Mercer Stark Calhoun Carroll Ogle DeKalb Kane DuPage Cook Whiteside Lee Kendall Peoria Bureau Will LaSalle Grundy Putnam Kankakee Marshall Livingston Woodford Iroquois Tazewell McLean Ford Mason Schuyler DeWitt Vermilion Logan Champaign Menard Adams Brown Cass Piatt Macon Douglas Morgan Sangamon Edgar Pike Scott Moultrie Christian Coles Greene Shelby Clark Macoupin Montgomery Cumberland Jersey Effingham Fayette Jasper Crawford Bond Madison Clay Richland Lawrence Marion Clinton St. Clair Wayne Washington Monroe Jefferson Randolph Perry Hamilton Franklin Jackson Gallatin Williamson Saline Hardin Union Johnson Pope Pulaski Massac Alexander White Edwards Wabash PPO UnitedHealthcare Network adds a physician network Who is affected by the change? This change applies to participants who are enrolled in or eligible for the PPO using the UHC Network. If you reside outside of Illinois or in a non-caterpillar Network county in Illinois, you are likely in the UHC Network. This change does not apply to participants who are enrolled in the PPO using the Caterpillar Network or Out-of-Area Network. A list of Illinois counties included in the Caterpillar Network can be found above. What is changing? If you are enrolled in the PPO and use the UHC Network, you are currently required to use a network hospital to receive the highest level of coverage (80% / 20% co-insurance after deductible is met), but you are not required to use a network physician. Beginning next year, participants in the PPO using the UHC Network will be required to use both network hospitals and physicians to receive the highest level of coverage (80% / 20%). Physicians include general practitioners, OBGYN, chiropractors, mental health and substance abuse specialists, etc. To check if your physician is in the UHC PPO provider network visit the UHC website at myuhc.com or call the dedicated call center at If your physician is not in the network, you may want to consider switching to a network physician to receive the highest level of plan coverage CATERPILLAR HEALTHCARE BENEFITS GUIDE

5 2014 UHC PPO Network Requirements» UHC hospital network required for highest level of coverage» No physician network required 2015 UHC PPO Network Requirements» UHC hospital network required for highest level of coverage» UHC physician network required for highest level of coverage What you can expect Your physician may already be in the UHC physician network, which means you are paying the discounted network rate for your physician s services and receiving the highest level of plan coverage. If your physician is not in the UHC physician network, you can continue to see your physician next year, but you will pay more than you do today. (After you have met the deductible, you will pay 50% and the plan will pay 50% for an out-of-network physician versus you paying 20% and the plan paying 80% for a network physician.) For behavioral health services, you need to use UHC s United Behavioral Health (UBH) provider network to receive the highest level of plan coverage. PPO Caterpillar Network adds a chiropractic network Who is affected by the change? This change applies to participants who are enrolled in or eligible for the PPO using the Caterpillar Network. A list of Illinois counties included in the Caterpillar Network can be found on page 4. This change does not apply to participants who are enrolled in the PPO using the UHC Network or Out-of-Area Network. If you reside outside of Illinois or in a non-caterpillar Network county in Illinois, you are likely in the UHC Network. What is changing? If you are currently enrolled in the PPO and use the Caterpillar Network, you are not required to use a network chiropractor. Beginning next year, participants enrolled in the PPO using the Caterpillar Network will be required to use a network chiropractor to receive the highest level of coverage (80% / 20% co-insurance after deductible is met) PPO (Caterpillar Network) Network Requirements» No chiropractic network required 2015 PPO (Caterpillar Network) Network Requirements» Chiropractic network required for highest level of benefi t What you can expect The list of chiropractors in the network will be available in December on CatHealthBenefits.com under Search for a Doctor or Hospital on the homepage. At that time you can access the list of chiropractors who have contracted to be part of the Caterpillar Network. If your chiropractor is not in the Caterpillar Network, you can continue to see your current chiropractor next year, but you will pay more than you do today. (After you have met the deductible, you will pay 50% and the plan will pay 50% for an out-of-network chiropractor versus you paying 20% and the plan paying 80% for a network chiropractor.) If your chiropractor is not in the network, you may want to consider switching to a network chiropractor to receive the highest level of plan coverage CATERPILLAR HEALTHCARE BENEFITS GUIDE 5

6 Prescription Drug Benefit Changes Who is affected by the change? This change applies to participants enrolled in or eligible for the following: PPO UHC Network If you reside outside of Illinois or in a non-caterpillar Network county in Illinois, you are likely in the UHC Network. PPO Caterpillar Network A list of Illinois counties included in the Caterpillar Network can be found on page 4. PPO Out-of-Area Network Certain participants in remote locations are in an Out-of-Area Network (neither Caterpillar nor UHC Network). Blue Cross Blue Shield EPO Background Caterpillar has closely managed prescription drug costs for the past decade and therefore, most participants have paid the same co-pays since In comparison, the majority of large companies pass along cost increases annually to participants through higher co-pays. As a result, our prescription drug coverage provides a better benefit than what is offered by our comparator companies. Over the years the prescription drug market has been experiencing significant changes the price of brand medications has more than tripled in 10 years and high-cost specialty products are becoming more prevalent every year. We ve successfully preserved our current benefit from 2004 to 2014, but because costs are growing rapidly, some changes are necessary to help ensure sustainable, market competitive coverage in the future. Providing affordable benefits for the future also helps keep Caterpillar competitive, which is healthy for the company, employees and retirees. What is Changing?» Restat changing its name to Catamaran» Restat Network renamed out-of-network» Introduction of co-insurance for Tiers 2-4» Introduction of minimum and maximum payments for Tiers 2-4 Restat changing its name to Catamaran Restat was purchased by Catamaran, another pharmacy benefit administrator, and will be adopting the Catamaran name later this year. Participants who currently have a Restat ID card can expect to receive a Catamaran ID card with a new member ID later this year. When you receive your new ID card(s) in the mail you should replace your Restat ID card with the new Catamaran ID card. Watch for additional information during the annual enrollment period CATERPILLAR HEALTHCARE BENEFITS GUIDE

7 Prescription Drug Benefit Changes (cont.) Pharmacy networks renamed to Network and Out-of-Network pharmacies The current pharmacy networks of Select Preferred and Preferred will be referred to as Network Pharmacies, and the Restat Pharmacy Network will be referred to as Out-of-Network. Note that Restat is our current pharmacy benefit administrator and also manages a network of pharmacies. Network pharmacies will offer participants the lowest out-of-pocket costs. Network pharmacies include Walmart, Kroger, Walgreens (including their affiliates) and Community Pharmacy Prescription Drug Network (CPRxN) pharmacies. The current Restat network of pharmacies (i.e. CVS, Target, Rite Aid and others) will continue to have a higher participant cost share. (See 2015 co-pays and co-insurance chart on page 9.) Current Pharmacy Networks: Select Preferred: (Walmart and Kroger) Preferred: (Walgreens and CPRxN) Restat: (CVS, Target, Rite Aid and others) New Pharmacy Networks effective January 1, 2015: Network Pharmacies: Walmart, Kroger, Walgreens (including their affiliates) and CPRxN Out-of-network: All other pharmacies If you use specialty medication(s), you will continue to have them filled through ICORE Healthcare, which is the network pharmacy specifically for specialty medications. Specialty medications are generally high-cost prescription drugs that treat complex conditions and require special handling and monitoring. The medication may be self-administered or given in a doctor s office. Walgreens Mail Service If you use the Walgreens Mail Service to fill your 90-day prescriptions, following are the 2015 per prescription costs based on tier: Tier 0 medications: $0 co-pay Tier 1 medications: $15 co-pay Tier 2 medications: 20% co-insurance with $75 minimum and $180 maximum payments Tier 3 medications: 50% co-insurance with $225 minimum and $375 maximum payments Maintaining flat dollar co-pay amounts for Tier 0 and Tier 1 prescription medications The new design preserves the $0 and $5 co-pays at network pharmacies for medications that are in Tier 0 and Tier 1 that many people depend on to maintain their health (i.e. high blood pressure, high cholesterol and diabetes medications). These are primarily generic medications. Approximately 85 percent of participants already use Tier 0 and Tier 1 medications. Walmart, Kroger, Walgreens (including their affiliates) and CPRxN pharmacies will be network pharmacies and will continue to offer the lowest co-pays.» No change to fl at dollar co-pay amounts for lowest cost prescriptions (Tier 0 and Tier 1) at network pharmacies» Walmart, Kroger, Walgreens (including their affiliates) and CPRxN pharmacies remain in network Drug Tier Network: Walmart, Kroger, Walgreens, CPRxN Tier 0 $0 Tier 1 Walmart/Kroger $0 Walgreens/CPRxN $ CATERPILLAR HEALTHCARE BENEFITS GUIDE 7

8 Prescription Drug Benefit Changes (cont.) Eliminating flat dollar co-pays and replacing with co-insurance for Tier 2, 3 and 4 prescription medications Prescriptions in Tiers 2, 3 and 4 are primarily brand medications. These tiers will change from flat dollar co-pays to co-insurance. Prescription medication co-insurance is like the co-insurance paid for healthcare in which the participant pays a percentage of the cost. Minimum and maximum payments will also be added for Tier 2, 3 and 4 prescriptions. Maximum payments will protect the participant from very high costs compared to co-insurance alone and minimum payments ensure the participant pays the appropriate amount for a medication. The majority of our comparator companies use co-insurance, but many do not provide a maximum payment that limits participants costs. Summary of what s changing:» Co-insurance replacing fl at dollar co-pays for Tier 2, 3 and 4 medications» Co-insurance has minimum and maximum payment for Tier 2, 3 and 4 medications» Co-insurance and minimum and maximum payments are applicable per medication in Tiers 2, 3 and 4 Drug Tier Tier 2 Tier 3 Tier 4 (includes specialty) Network: Walmart, Kroger, Walgreens, CPRxN 20% co-ins $25 min $60 max 50% co-ins $75 min $125 max 50% co-ins $100 min $200 max Check out the new Pharmacy Benefit Tutorial to see examples of how co-insurance with minimum and maximum payments work. CatHealthBenefits.com > Annual Enrollment Center CATERPILLAR HEALTHCARE BENEFITS GUIDE

9 Prescription Drug Benefit Changes (cont.) 2015 Co-Pays and Co-Insurance NETWORK PHARMACIES OUT-OF-NETWORK PHARMACIES (Walmart, Kroger, Walgreens (including their affiliates) and CPRxN) (All other pharmacies) 2015 co-pays and co-insurance 2015 co-pays and co-insurance No change to co-pay Co-pays increase Tier 0 and Tier 1 Tier 0 and Tier 1 Co-pay of $0 or $5 Co-pay of $20 Apply co-insurance with minimum and maximum amounts Apply co-insurance with minimum and maximum amounts Tier 2 medications Tier 3 medications Tier 4 medications Tier 2 medications Tier 3 medications Tier 4 medications 20% co-insurance $25 min/ $60 max 50% co-insurance $75 min/ $125 max 50% co-insurance $100 min/ $200 max 30% co-insurance $50 min/ $120 max 50% co-insurance $150 min/ $250 max 50% co-insurance $150 min/ $250 max Learn more To help you determine how this change may affect the amount you pay for prescription medications and the pharmacies you visit, a tutorial is available on CatHealthBenefits.com > Annual Enrollment Center. It provides a more detailed explanation of the new prescription drug benefit with examples of how co-insurance with minimum and maximum payments work. You can also access frequently asked questions at CatHealthBenefits.com > Annual Enrollment Center CATERPILLAR HEALTHCARE BENEFITS GUIDE 9

10 2015 Prescription Drug Benefit Examples The following examples show how co-insurance with minimum and maximum payments work. More scenarios can be found by visiting CatHealthBenefits.com > Annual Enrollment Center. When you pay the actual cost of the prescription Tier 2 medications Prescription written by your doctor Look up the medication to find its tier on the drug formulary Prescription is a tier 2 medication Pharmacy you choose is a Network Pharmacy 20% co-insurance $25 min/$60 max Cost of drug $15 20% co-insurance Cost of the drug is $15, which is below the minimum amount of $25 You pay $15 When you pay the co-insurance amount Tier 2 medications Prescription written by your doctor Look up the medication to find its tier on the drug formulary Prescription is a tier 2 medication Pharmacy you choose is a Network Pharmacy 20% co-insurance $25 min/$60 max Cost of drug $250 x 20% co-insurance = $50 Co-insurance of $50 is between min of $25 and max of $60 You pay $50 When you pay the maximum amount Tier 4 medications Prescription written by your doctor Look up the medication to find its tier on the drug formulary Prescription is a tier 4 medication Pharmacy you choose is ICORE 50% co-insurance $100 min/$200 max Cost of drug $5,000 x 50% co-insurance = $2,500 Co-insurance of $2,500 is above the max of $200 You pay $200 Network pharmacy for specialty medications is ICORE Healthcare CATERPILLAR HEALTHCARE BENEFITS GUIDE

11 Flexible Spending Account Carryover (active employees only) A Flexible Spending Account (FSA) is a program offered by employers that allows active employees to pay for eligible out-of-pocket expenses with pre-tax dollars. The Healthcare FSA has an annual limit of $2,500, and if money is not used in a plan year it is forfeited. The Internal Revenue Service (IRS) changed the use-it-or-lose-it rule for Healthcare FSAs allowing employees to carry over up to $500 in unspent FSA money into the next plan year. Caterpillar has chosen to add the carryover feature to the Healthcare FSA. Here are some important things you need to know: The carryover does not count toward your annual maximum FSA contribution limit in the year it is carried over. You can elect the maximum amount ($2,500) for 2015 and have a carryover in the same plan year. Any amount over $500 is still subject to the use-it-or-lose-it rule and will be forfeited if not used. Plan your expenses carefully. You will not have to take any action to carry over unused amounts at the end of each plan year. The plan will automatically carry over the unused amounts, up to the $500 limit. The carryover amount can roll over for one plan year. If you terminate employment, unused FSA amounts, including any carryover amount, are forfeited unless you elect to continue FSA participation through COBRA. You must participate in the FSA annually to be eligible to carry over any unused amounts into the next plan year. If your spouse participates in a Healthcare FSA through his or her employer and both plans offer the carryover, both spouses can carry over up to $500. The carryover applies to Healthcare FSAs only. If you are participating in a Dependent Care FSA (i.e. an FSA for the expenses associated with childcare for working parents), you cannot carry over Dependent Care FSA contributions. Visit to learn more about FSA plans Healthcare Benefit Premiums The premium charged for healthcare coverage can vary based on the plan option available to you. Because premiums vary by plan option, specific premium amounts will be available to you during healthcare annual enrollment later this fall. To find out more about the premiums for the plan options available to you, visit the Your Benefits Resources website at the start of the Healthcare Annual Enrollment window. Dependent Eligibility Audit Watch for more information next year about a dependent eligibility audit a process used to confirm that dependents enrolled in the healthcare plan are actually eligible. The healthcare annual enrollment timeframe is the best time to review your enrolled dependents and remove them from coverage if they are no longer eligible CATERPILLAR HEALTHCARE BENEFITS GUIDE 11

12 Resources Caterpillar Benefits Center Aon Hewitt Mon-Fri 8 a.m. 6 p.m. (Central time) resources.hewitt.com/cat Restat (Catamaran as of January 1, 2015) Mon-Fri 7 a.m. 1 a.m. Sat-Sun 8 a.m. 5 p.m. (Central time) restat.com UnitedHealthcare (UHC) Mon-Fri 7 a.m. 5 p.m. (Central time) myuhc.com Blue Cross Blue Shield EPO Annual Enrollment Hotline Caterpillar Benefits Group Mon-Fri 6:30 a.m. 5:00 p.m. (Central time) In the event that the content of this document or any representations made by any person regarding Caterpillar s employee benefit plans or programs conflict with or are inconsistent with the provisions of the plan or program documents, the provisions of the plan or program documents are controlling. To the fullest extent permitted by law, Caterpillar reserves the right to amend, modify, suspend, replace or terminate any of its plans, policies or programs, in whole or in part, at any time and for any reason, by appropriate company action Caterpillar. All Rights Reserved. CAT, CATERPILLAR, BUILT FOR IT, their respective logos, Caterpillar Yellow, the Power Edge trade dress as well as corporate and product identity used herein, are trademarks of Caterpillar and may not be used without permission.

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