2013 benefits highlights

Transcription

1 ...and much more disability retirement dental medical 2013 benefits highlights

2 2013 benefit highlights Your Benefits At Rex Contents 1 Eligibility Symbols 1 How to Enroll 4 Medical Coverage 5 Prescription Drugs 5 $4 Generic Drugs at Rex 5 Taking Care of You 6 Premium 8 Standard 10 Blue Options HSA Plan 12 Vision Coverage 12 Dental Coverage 13 Disability Insurance 14 Life & AD&D Coverage 14 Whole Life Insurance with Long-Term Care 15 Critical Illness 15 Accident Coverage 15 Reimbursement Accounts 17 Retirement Program 19 Other Benefits 22 Glossary of Terms 22 Notice of Enrollment Rights 22 Women s Health and Cancer Rights Act 23 Newborns and Mothers Health Protection Act of Medicaid and the Children s Health Insurance Program 23 Reminder of Availability of HIPAA Privacy Notice 24 General Notice of COBRA Continuation Coverage Rights For more than 100 years, Rex Healthcare and its co-workers have been dedicated to the simple mission of providing healthcare for life for everyone in the community. Rex s steadfast commitment to the health and well-being of the community begins with its own co-workers. We are proud of the accolades we have received, which include the following: Carolina Parent magazine has placed Rex among The Top 50 Family-Friendly Companies for Working Parents for 15 consecutive years. In 2008, 2009, and 2011, Rex was listed as one of Modern Healthcare s Best Places to Work in the nation. Rex was named a Thompson Top 100 Hospital. Triangle Business Journal included Rex on their Best Places to Work list. Rex was named as one of the Top 50 Best Hospitals in the nation by Becker s Hospital Review. Wake County rated Rex Healthcare the hospital of choice. Employment at Rex Healthcare is so much more than just a job. We re focused on your health, your wealth and your career. This is an exciting organization, offering you a variety of opportunities to develop your career, while improving the health of your community. We realize your benefits are an important part of your workplace journey. Rex proudly offers co-workers and families a comprehensive benefit program that is flexible in its design, provides for varying levels of coverage, offers voluntary supplemental programs and provides personal tax advantages whenever possible.

3 introduction The benefits contained in this brochure are designed around improving your health, wealth and career, as well as providing quality, affordable benefits that are highly competitive within the healthcare industry. Consider this brochure your guide for choosing benefits that meet your needs. Please contact our Human Resources Department at or if you have any questions or need additional assistance. We look forward to working together as we continue to positively impact the lives of our patients and co-workers. Eligibility Symbols At Rex, we offer benefits to eligible full-time, part-time and casual co-workers. The symbols below represent each level of employment status with an abbreviation (i.e., full-time (FT), part-time (PT) and casual (C)). These symbols appear in each benefit section to help you quickly determine if you are eligible for that option. Be sure to review all of your coverage options. Full-time co-workers working at least 35 hours per week and certain RN positions working at least 60 hours per pay period. Part-time co-workers working hours per week and certain RN positions working between hours per pay period. Casual co-workers working less than 17.5 hours per week. FT PT C DISCLAIMER: This publication provides only a brief summary of the benefits available under the Rex Healthcare plans. In the event of a discrepancy between this summary and the Plan Document or insurance contracts, the Plan Document or insurance contracts will prevail. Rex Healthcare retains the right to modify or eliminate these or any other benefits at any time and for any reason. How to Enroll You will enroll for your Rex health, dental, vision, reimbursement accounts, whole life, critical illness, accident, and individual short-term disability benefits online at ebenefitsnow.com. Before you make your elections for 2013, we advise you to update your personal information. Keep in mind that you must re-enroll in health, dental, vision, and reimbursement accounts, even if you are not making changes. Here s How to use ebenefitsnow.com: 1 At any computer with an internet connection, go to 2 Enter your ebenefitsnow login ID and password. If you re logging in for the first time or during annual open enrollment, you will be prompted to create a new password (see instructions on next page). All previously created passwords will be reset. 3 Once you are successfully logged into ebenefitsnow.com, proceed to My Basic Information. 4 Review your information in the Personal Information section. Update any information that is incorrect; add any missing information, such as your home phone number, marital status, and emergency contact information. If your Social Security number is incorrect, please contact Human Resources at Once you have completed making your personal information updates, you will have the opportunity to save your changes and review. 6 To make changes to your benefits for 2013, click on My Benefits. Then click on each of the benefits listed to enroll in or decline coverage. 7 Use the Logout button to exit ebenefitsnow benefit highlights < 1

4 2013 benefit highlights About Your Login ID and Password Your login ID is as follows: First name + First letter of last name + Last 4 digits of your Social Security number (SSN). When you log on for the first time, you will enter all nine digits of your SSN as your password. You will then be prompted to create a new password. (Your password cannot remain as your SSN because it cannot be your SSN on your ebenefitsnow ID.) Passwords must be at least six characters long (but not more than 15 characters) and contain both numbers and letters. Things to Consider As you think about your benefit options for the upcoming year, keep these things in mind: Think about what has changed in your life during the past year. Do you need to add or remove a dependent from your coverage? What kind of healthcare expenses do you anticipate in 2013? Would you rather pay a higher premium and get a higher level of benefits? Or would you rather pay a lower premium and assume the risk of incurring higher out-of-pocket expenses only when you use your insurance? You must elect the Blue Options HSA Plan if you want to participate in the Health Savings Account (HSA). Make sure you understand how the HSA works and how it works in conjunction with the Medical Reimbursement Account before deciding how much money to contribute to your HSA FSA elections will not roll over into 2013 if you elect the Blue Options HSA Plan. If you would like to contribute to a Medical or Dependent Care Reimbursement Account in 2013, you must actively elect the contribution amount(s). Note: If you re age 65 and enrolled in Medicare, you may not contribute to the Health Savings Account. Tobacco users will pay higher medical premiums. When you enroll on ebenefitsnow.com, you will be asked if you are a tobacco user. If you answer yes or do not answer, you will pay an additional $20 per pay period. The tobacco user status applies to co-workers only, not spouses or dependent children. Compare medical plan options and costs. Log on to ebenefitsnow.com and use the medical plan comparison tool to see which plan is right for you and your family. For example, benefit1 is a valid password. Also, your new password cannot contain the same number/letter repeated in succession more than twice (for example, ab2222). If you need assistance with your login ID or password, please contact ebenefitsnow support at Please note: All passwords will be reset prior to the annual open enrollment period. Dependent Eligibility In addition to covering yourself, you may enroll your eligible dependents for Rex Healthcare benefits too. Your eligible dependents include: Legally married spouse; Children up to the age of 26*, including natural children, stepchildren, and legally adopted children (including children living with you before the adoption is final) who are your dependents or for whom you are required to provide healthcare coverage under a Qualified Medical Child Support Order; and Unmarried children of any age who are dependent upon you for support when such children are incapable of supporting themselves because of a disability or illness. * For medical coverage, your dependents are eligible for coverage up to age 26, regardless of student or marital status. For all coverages other than medical, your dependents are eligible for coverage up to age 19 and, if a full-time student, up to age 26. Note: Insurers may not deny coverage to children under age 19 with pre-existing conditions. 2

5 enrolling Changes are Limited after Enrollment! The options you select during your enrollment period will be in effect through the 2013 calendar year. Federal law limits your ability to change your elections after the enrollment period. Changes are allowed only if there is a qualifying event and the change requested is consistent with the event. In addition, the change must be made within 30 days of the event. Qualifying events include, but are not limited to: Marriage, divorce, or legal separation Birth or adoption (or placement of adoption) of a child Death of a covered dependent Loss or gain of eligibility for group insurance coverage for you or a covered dependent Change in your employment status (i.e. changing from full-time to part-time or from casual to benefits eligible and vice versa) Change in dependent s employment status, including termination or commencement of employment for a covered dependent Change in health insurance eligibility due to a relocation of residence or workplace Change in full-time student status You will need to provide documentation, such as a birth, marriage or death certificate, divorce decree, loss of other coverage, etc. Both the change in ebenefitsnow as well as the documentation must be completed within 30 days from the date of the Qualifying Event in order for the changes to be approved. If you have any questions, please call Human Resources at Your Medical Plan Options for 2013 For 2013, Rex will offer three medical plan options from which you may choose: Premium, Standard, and the Blue Options Health Savings Account (HSA) Plan. The Premium and Standard Plans are standard PPO plans. The Blue Options HSA plan is a High Deductible Health Plan (HDHP) with the opportunity to use a Health Savings Account (HSA). The HSA offers a tax-free way to help you pay for current or future out-of-pocket healthcare expenses. There are two ways to get money into your HSA: 1 Rex contributes to your HSA 2 You also can contribute to your HSA tax-free When you have eligible out-of-pocket expenses including your and coinsurance you can use HSA funds to pay for them. As your HSA balance grows each year, it accrues tax-free interest. And any unused balance in your HSA will roll over from year to year, so you can use the funds you invest today for future expenses. See the medical plan charts beginning on page 6 for details about all three medical plans available to you in See page 16 for a chart that compares HSAs and FSAs benefit highlights < 3

6 2013 benefit highlights Wellness Compliant Co-worker Rates Per Pay Period FT Premium Standard HSA Co-worker Only $68.75 $44.93 $32.86 Co-worker + Child(ren) $ $ $94.73 Co-worker + Spouse $ $ $ Co-worker + Family $ $ $ These rates reflect a $20 discount for non-tobacco users. Co-worker Rates Per Pay Period PT Premium Standard HSA Medical Coverage FT Blue Cross and Blue Shield of North Carolina The first step towards improving your health is signing up for great medical coverage. The medical plan is administered by Blue Cross Blue Shield of North Carolina. Coverage is effective on the first day of employment. You will be able to pick one of three plan options. Co-workers that meet the requirements outlined in the Taking Care of You program will be eligible for the Wellness Compliant rates. Non-tobacco Users Receive Preferred Rates It is important as healthcare providers to set a healthy example for our community. When you enroll for your 2013 medical coverage, you will be asked if you are a tobacco user. As an incentive for non-tobacco users, the preferred rates on this page will be in effect for Tobacco users will not be eligible for the $20 discounted rates that appear on this page, regardless of participation in the Taking Care of You program. If it is unreasonably difficult for you to stop smoking due to a medical condition, or if it is medically inadvisable for you to attempt to do so, contact Human Resources at and we will work with you to develop another way to avoid the surcharge. PT Co-worker Only $ $ $97.86 Co-worker + Child(ren) $ $ $ Co-worker + Spouse $ $ $ Co-worker + Family $ $ $ These rates reflect a $20 discount for non-tobacco users. Wellness Non-Compliant Co-worker Rates Per Pay Period FT Premium Standard HSA Co-worker Only $ $94.93 $82.86 Co-worker + Child(ren) $ $ $ Co-worker + Spouse $ $ $ Co-worker + Family $ $ $ These rates reflect a $20 discount for non-tobacco users. Co-worker Rates Per Pay Period PT Premium Standard HSA Co-worker Only $ $ $ Co-worker + Child(ren) $ $ $ Co-worker + Spouse $ $ $ Co-worker + Family $ $ $ These rates reflect a $20 discount for non-tobacco users. 4

7 medical Prescription Drugs $4 Generic Drugs at Rex FT PT C Rex Outpatient Pharmacy offers more than 100 generic drugs for only $4 per prescription to all co-workers. There are many benefits to making Rex Outpatient Pharmacy your pharmacy of choice: it will save you money, it s convenient, and the Rex Outpatient Pharmacy will provide better care and safety for you, because all of your prescriptions can be filled at one facility. A list of eligible generic prescription drugs can be accessed on the RexWeb home page. Walgreens Exclusion Effective January 1, 2013, all Walgreens pharmacies will be considered out-of-network pharmacies. Taking Care of You FT Taking Care of You is Rex Healthcare s wellness program. As a healthcare provider, we want to set an example in the community. We want to help all co-workers and your families to live a healthy lifestyle. In order to live a healthy lifestyle, you ve got to know your starting point. Rex Healthcare offers a Health Assessment program to help all co-workers set that starting point. It only takes about 20 minutes on the Blue Cross Blue Shield of North Carolina website ( As an incentive,* Rex significantly reduces the healthcare premium each pay period upon completion of the Health Assessment and three wellness activities. Co-workers who are covered by a Rex medical plan prior to August 1, 2012 will qualify for the discount if they: Complete their Health Assessment between January 1, 2012 and November 30, 2012; and Complete three of the items listed in the Take Care of You program between January 1, 2012 and September 30, Co-workers hired after August 1, 2012 and covered by a Rex medical plan will receive the Taking Care of You premium discount in 2013 but must meet the wellness criteria of the plan to qualify in PT Please note that the online Health Risk Assessment may not be completed until a BCBS identification card has been issued and received by the member. Qualified Taking Care of You activities include the following: Empower Yearly Check-up (Rex Wellness Center) Cardiac Health Screening (discounted cost) offered at Rex Diagnostic Services (78-HEART) Annual physical from a medical doctor Mammogram Pap smear Prostate exam Colonoscopy MedGem (metabolism counter) offered at a Rex Wellness Center Attendance at Rex diabetes education classes (if diabetic) ( ) Completion of a Rex smoking cessation class ( ) Completion of Healthy Way offered at a Rex Wellness Center Completion of asthma education classes (if asthmatic) ( ) Skin cancer assessment (dermatologist) Routine eye exam must be covered by BCBS or Superior Vision (one per plan year) Routine dental exam must be covered by Ameritas (one per plan year) Three nutrition visits (Rex Wellness Centers only) As part of the Taking Care of You program, you have access to other Blue Cross Blue Shield of North Carolina programs. These include pregnancy management, health coaching, disease management for those with chronic conditions, and case management for those with serious conditions requiring major treatment. * For 2013, your spouse and dependents are not required to take a Health Assessment for you to receive the incentive. More Preventive Care for Women 100% Covered In accordance with the Patient Protection and Affordable Care Act, more in-network preventive health care services for women, such as contraceptives, screenings for cervical cancer and prenatal care, will be 100 percent covered benefit highlights < 5

8 Premium summary of benefits Service Physician Office Services Office Visits (Includes office surgery, consultation, X-rays and labs, and a benefit period maximum of four office visits for the assessment of obesity in and out of network. See Inpatient and Outpatient Services. ) Preventive Care in the Office Therapies (Short-Term Rehabilitative) Urgent Care Centers & Emergency Room Primary Care Provider (PCP) Specialist Ambulatory Surgical Center & Outpatient Surgery Inpatient & Outpatient Hospital Services Hospital Inpatient Primary Care Provider (PCP) Specialist Chiropractic (12 visit limit per Benefit Period) Physical/Occupational (30 visit limit per Benefit Period) Speech (30 visit limit per Benefit Period) Urgent Care Centers Emergency Room Visit (Copayment waived if admitted) *Benefit differences only apply to Rex and UNC Hospital and Ambulatory Surgical facility services. Copayments do not apply to or coinsurance maximums. **Notice: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the payment obligations for BCBSNC and its members. 1 Inpatient/Outpatient Certification is required. Call Magellan Behavioral Health at Hospital Only Other Services Maternity (Delivery includes prenatal & post-delivery care) Transplants Infertility & Sexual Dysfunction Services (Diagnosis and treatment, up to $5,000 per lifetime) Vision Care Lifetime Benefit Maximum Deductibles Coinsurance Maximum Prescription Drugs (Up to 30-day supply day supply is two copayments and day supply is three copayments. Infertility drugs up to $5,000 lifetime maximum. MAC C Pricing, Open Formulary.) Mail Order Drugs (90-day supply, copayment is 2.5 per 30-day tier copayment) Medical Supplies Mental Health Services Substance Abuse Services Other Hospital Outpatient Services Professional Services Outpatient Labs and Mammograms without surgery or other services Outpatient Labs and Mammograms with surgery or other services All Other Diagnostic services including X-Rays, CT and PET scans, MRA s and MRI s, including physician s office Skilled Nursing Facility (60 days per Benefit Period) Ambulance Durable Medical Equipment Home Healthcare and Hospice Hospital Services (Delivery) Professional Services (Delivery) Hospital Services Professional Services Primary Care Provider Specialist Hospital Services Inpatient and Outpatient Professional Services Routine Eye Exam (All services combined) Individual (per Benefit Period) Family (per Benefit Period) Individual (per Benefit Period) Family (per Benefit Period) Tier 1 (Generic) Tier 2 (Preferred Brand) Tier 3 (Brand) Walgreens pharmacies are out-of-network. Tier 1 (Generic) $37.50 copayment Tier 2 (Preferred Brand) $ copayment Tier 3 (Brand) $ copayment Office Inpatient Outpatient Inpatient and Outpatient Professional Services Office Inpatient Outpatient Inpatient and Outpatient Professional Services 6

9 Rex* UNC* Other In-Network Out-of-Network $20 copayment $20 copayment $20 copayment 65% after $40 copayment $40 copayment $40 copayment 65% after medical $0 $0 $0 not covered $0 $0 $0 not covered $40 copayment $40 copayment $40 copayment 65% after $20 copayment $20 copayment $20 copayment 65% after $20 primary / $40 specialist $20 primary / $40 specialist $20 primary / $40 specialist 65% after $40 copayment $40 copayment $40 copayment $40 copayment $150 copayment $150 copayment $150 copayment $150 copayment 90% after $200 copayment 85% after $300 copayment 75% after $350 copayment 65% after $500 copayment 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 85% after 75% after 65% after 90% after 90% after 90% after 65% after 100% 85% after 75% after 65% after 90% after 85% after 75% after 65% after 90% after 85% after 75% after 65% after 90% after 85% after 75% after 65% after 90% after 90% after 90% after 90% after 90% after 90% after 90% after 65% after 90% after 85% after 75% after 65% after 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 90% after 90% after 65% after 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 90% after 90% after 65% after $20 copayment $20 copayment $20 copayment 65% after $40 copayment $40 copayment $40 copayment 65% after 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 90% after 90% after 65% after $0 $0 $0 not covered unlimited unlimited unlimited unlimited $250 $250 $250 $500 $500 $500 $500 $1,000 $2,250 $2,250 $2,250 $4,500 $4,500 $4,500 $4,500 $9,000 $10 copayment $15 copayment $15 copayment copayment + charge over $40 copayment $45 copayment $45 copayment in-network allowed amount $55 copayment $60 copayment $60 copayment 100% after (Rex only) certified 1 certified 1 certified 1 non-certified** $40 copayment $40 copayment $40 copayment 65% after 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 85% after 75% after 65% after 90% after 90% after 90% after 65% after certified 1 certified 1 certified 1 non-certified** $40 copayment $40 copayment $40 copayment 65% after 90% after $450 copayment and 85% after $600 copayment and 75% after $750 copayment and 65% after $1,000 copayment and 90% after 85% after 75% after 65% after 90% after 90% after 90% after 65% after 2013 benefit highlights < 7

10 Standard summary of benefits Service Physician Office Services Office Visits (Includes office surgery, consultation, X-rays and labs, and a benefit period maximum of four office visits for the assessment of obesity in and out of network. See Inpatient and Outpatient Services. ) Preventive Care in the Office Therapies (Short-Term Rehabilitative) Urgent Care Centers & Emergency Room Ambulatory Surgical Center & Outpatient Surgery Inpatient & Outpatient Hospital Services Hospital Only Other Services Maternity (Delivery includes prenatal & post-delivery care) Transplants Infertility & Sexual Dysfunction Services (Diagnosis and treatment, up to $5,000 per lifetime) Primary Care Provider (PCP) Specialist Primary Care Provider Specialist Chiropractic (12 visit limit per Benefit Period) Physical/Occupational (30 visit limit per Benefit Period) Speech (30 visit limit per Benefit Period) Urgent Care Centers Emergency Room Visit (Copayment waived if admitted) Hospital Inpatient Other Hospital Outpatient Services Professional Services Outpatient Labs and Mammograms without surgery or other services Outpatient Labs and Mammograms with surgery or other services All Other Diagnostic services including X-Rays, CT and PET scans, MRA s and MRI s, including physician s office Skilled Nursing Facility (60 days per Benefit Period) Ambulance Durable Medical Equipment Home Healthcare and Hospice Hospital Services (Delivery) Professional Services (Delivery) Hospital Services Professional Services Primary Care Provider Specialist Hospital Services *Benefit differences only apply to Rex and UNC Hospital and Ambulatory Surgical facility services. Copayments do not apply to or coinsurance maximums. **Notice: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the payment obligations for BCBSNC and its members. 1 Inpatient/Outpatient Certification is required. Call Magellan Behavioral Health at Vision Care Lifetime Benefit Maximum (All services combined) Deductibles Coinsurance Maximum Prescription Drugs (Up to 30-day supply day supply is two copayments and day supply is three copayments. Infertility drugs up to $5,000 lifetime maximum. MAC C Pricing, Open Formulary.) Mail Order Drugs (90-day supply, copayment is 2.5 per 30-day tier copayment) Medical Supplies Mental Health Services Substance Abuse Services Inpatient and Outpatient Professional Services Routine Eye Exam Individual (per Benefit Period) Family (per Benefit Period) Individual (per Benefit Period) Family (per Benefit Period) Tier 1 (Generic) Tier 2 (Preferred Brand) Tier 3 (Brand) Walgreens pharmacies are out-of-network. Tier 1 (Generic) $37.50 copayment Tier 2 (Preferred Brand) $ copayment Tier 3 (Brand) $ copayment Office Inpatient Outpatient Inpatient and Outpatient Professional Services Office Inpatient Outpatient Inpatient and Outpatient Professional Services 8

11 Rex* UNC* Other In-Network Out-of-Network $25 copayment $25 copayment $25 copayment 60% after $45 copayment $45 copayment $45 copayment 60% after medical $0 $0 $0 not covered $0 $0 $0 not covered $45 copayment $45 copayment $45 copayment 60% after $25 copayment $25 copayment $25 copayment 60% after $ 25 primary / $45 specialist $ 25 primary / $45 specialist $ 25 primary / $45 specialist 60% after $45 copayment $45 copayment $45 copayment $45 copayment $150 copayment $150 copayment $150 copayment $150 copayment 85% after $250 copayment 85% after $350 copayment 75% after $450 copayment 60% after $500 copayment 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 80% after 75% after 60% after 85% after 85% after 85% after 60% after 100% 80% after 75% after 60% after 85% after 80% after 75% after 60% after 85% after 80% after 75% after 60% after 85% after 80% after 75% after 60% after 85% after 85% after 85% after 85% after 85% after 85% after 85% after 60% after 85% after 80% after 75% after 60% after 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 85% after 85% after 60% after 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 85% after 85% after 60% after $25 copayment $25 copayment $25 copayment 60% after $45 copayment $45 copayment $45 copayment 60% after 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 85% after 85% after 60% after $0 $0 $0 not covered unlimited unlimited unlimited unlimited $350 $350 $350 $700 $700 $700 $700 $1,400 $2,750 $2,750 $2,750 $5,500 $5,500 $5,500 $5,500 $11,000 $10 copayment $15 copayment $15 copayment copayment + charge over $40 copayment $45 copayment $45 copayment in-network allowed amount $55 copayment $60 copayment $60 copayment 100% after (Rex only) certified 1 certified 1 certified 1 non-certified** $45 copayment $45 copayment $45 copayment 60% after 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 80% after 75% after 60% after 85% after 85% after 85% after 60% after certified 1 certified 1 certified 1 non-certified** $45 copayment $45 copayment $45 copayment 60% after 85% after $500 copayment and 80% after $650 copayment and 75% after $800 copayment and 60% after $1,000 copayment and 85% after 80% after 75% after 60% after 85% after 85% after 85% after 60% after 2013 benefit highlights < 9

12 HSA Plan summary of benefits *Benefit differences only apply to Rex and UNC Hospital and Ambulatory Surgical facility services. Copayments do not apply to or coinsurance maximums. **Notice: Your actual expenses for covered services may exceed the stated coinsurance percentage or copayment amount because actual provider charges may not be used to determine the payment obligations for BCBSNC and its members. 1 Inpatient/Outpatient Certification is required. Call Magellan Behavioral Health at Service Physician Office Services Office Visits (Includes office surgery, consultation, X-rays and labs, and a benefit period maximum of four office visits for the assessment of obesity in and out of network. See Inpatient and Outpatient Services. ) Preventive Care in the Office Therapies (Short-Term Rehabilitative) Urgent Care Centers & Emergency Room Ambulatory Surgical Center & Outpatient Surgery Inpatient & Outpatient Hospital Services Hospital Only Other Services Maternity (Delivery includes prenatal & post-delivery care) Transplants Infertility & Sexual Dysfunction Services (Diagnosis and treatment, up to $5,000 per lifetime) Vision Care Lifetime Benefit Maximum Deductibles Rex HSA Contribution Coinsurance Maximum Prescription Drugs (Up to 30-day supply, day supply is two copayments and day supply is three copayments. Infertiliy drugs up to $5,000 lifetime maximum. MAC C Pricing, Open Formulary.) Walgreens pharmacies are out-of-network. Mail Order Drugs (90-day supply, copayment is 2.5 per 30-day tier copayment) Medical Supplies Mental Health Services Substance Abuse Services Primary Care Provider (PCP) Specialist Primary Care Provider (PCP) Specialist Chiropractic (12 visit limit per Benefit Period) Physical/Occupational (30 visit limit per Benefit Period) Speech (30 visit limit per Benefit Period) Urgent Care Centers Emergency Room Visit (Copayment waived if admitted) Hospital Inpatient Other Hospital Outpatient Services Professional Services Outpatient Labs and Mammograms without surgery or other services Outpatient Labs and Mammograms with surgery or other services All Other Diagnostic services including X-Rays, CT and PET scans, MRA s and MRI s, including Physician s Office Skilled Nursing Facility (60 days per Benefit Period) Ambulance Durable Medical Equipment Home Healthcare and Hospice Hospital Services (Delivery) Professional Services (Delivery) Hospital Services Professional Services Primary Care Provider Specialist Hospital Services Inpatient and Outpatient Professional Services Routine Eye Exam Individual (per Benefit Period) Family (per Benefit Period) Individual (per Benefit Period) Family (per Benefit Period) Individual (per Benefit Period) Family (per Benefit Period) Tier 1 (Generic) Tier 2 (Preferred Brand) Tier 3 (Brand) Tier 1 (Generic) Tier 2 (Preferred Brand) Tier 3 (Brand) Office Inpatient/Outpatient Inpatient and Outpatient Professional Services Office Inpatient/Outpatient Inpatient and Outpatient Professional Services 10

13 Rex UNC Other In-Network Out-of-Network 85% after 85% after 85% after 65% after 85% after 85% after 85% after 65% after medical 100% 100% 100% 65% after 100% 100% 100% 65% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 85% after 85% after 85% after 85% after 85% after 100% after 90% after 80% after 65% after 100% after 90% after 80% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 100% after 90% after 80% after 65% after 100% after 90% after 80% after 65% after 100% after 90% after 80% after 65% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 85% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 85% after 85% after 85% after 65% after 85% after 85% after 85% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 100% 100% 100% 65% after Unlimited Unlimited Unlimited Unlimited $1,250 $1,250 $1,250 $2,500 $2,500 $2,500 $2,500 $5,000 $500 $500 $500 $500 $1,000 $1,000 $1,000 $1,000 $1,250 $1,250 $1,250 $2,500 $2,500 $2,500 $2,500 $5,000 90% after 85% after 85% after 85% after + charge over in-network allowed amount 80% after 75% after 75% after 75% after + charge over in-network allowed amount 70% after 65% after 65% after 65% after + charge over in-network allowed amount 90% after 85% after 85% after 80% after 75% after 75% after Not Covered 70% after 65% after 65% after 100% after (Rex only) 85% after 85% after 85% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 85% after 85% after 85% after 65% after 100% after 90% after 80% after 65% after 100% after 100% after 100% after 65% after 2013 benefit highlights < 11

14 2013 benefit highlights Vision Coverage FT PT Dental Coverage FT PT > Superior Vision > Ameritas The Rex Healthcare Vision plan provides comprehensive coverage and is effective the first of the month following 30 days of employment. Co-worker Rates Per Pay Period Co-worker Only $4.99 Co-worker + Spouse $9.90 Co-Worker + Child(ren) $9.69 Co-worker + Family $ Summary of Benefits In-Network Allowance: Out-of-Network Allowance: Vision Exam Covered in full Ophthalmologist up to $44 Optometrist up to $39 Frame Allowance Up to $125 allowance Up to $64 Lenses (Per Pair) Single Vision Covered in full Up to $34 Bifocal Covered in full Up to $48 Trifocal Covered in full Up to $64 Lenticular Covered in full Up to $88 Lens Options (Upgrades) Polycarbonate Lens $40 N/A UV Coating $15 N/A Anti-Reflective $50 N/A Coating Tints $25 N/A Scratch Resistance $13 N/A Contact Lenses (Per Pair) Standard Fitting Covered in full N/A Exam Medically Necessary Covered in full Up to $210 Cosmetic/Elective Up to $120 Up to $100 Frequency of Services Vision Exam Once each calendar year Lenses Once each calendar year Frames Once each calendar year Contact lenses Once each calendar year Lasik Discount Discount plan for select providers (20% discount off of usual and customary fees) For customer service, call A list of network providers is at The dental plan provides comprehensive coverage and encourages preventive care. Under this plan, you are free to go to the dentist of your choice. If your dentist is an Ameritas provider, you do not have to file a claim form. Also, you will save money. The benefit amounts payable under the plan are listed below. Payment for dental services is based on usual, customary, and reasonable fees (UCR). The amount is the patient s responsibility. Coverage is effective on the first day of employment. Summary of Benefits Benefits Payable Diagnostic, Preventive and 100% UCR Maintenance Services Basic Services 80% UCR Surgical Dentistry 80% UCR Prosthetic and Complex Restorative 50% UCR Periodontics 50% UCR Orthodontics (adult and children) 50% UCR Lifetime Orthodontic Maximum $1,000 Deductible (per patient/per year) $75 (out-of-network only) Annual Maximum $1,200* *This amount could increase by $250 in 2014 if you meet the following conditions: 1. Visit a dentist between January 1 and December 31, Submit a claim for a covered procedure by March 31, Total benefit paid for 2013 is $500 or less. If you use a network dentist, the $250 amount will increase to $350. Full-Time Part-Time Co-worker Only $4.35 $11.28 Co-worker + One $16.36 $22.18 Co-worker + Family $32.77 $38.00 Your portion of the premium is paid with pre-tax dollars and is payroll deducted every pay period. For more information on covered dental services or to find a network dental provider, you may call or log on to 12

15 vision dental disability Disability Insurance Short Term Disability (STD) > Lincoln Financial FT Rex pays the cost of this benefit. For an approved disability, STD coverage begins 15 days after an accident, illness or hospitalization occurs, and provides income replacement of 70% of your base salary (up to a maximum of $2,800 per week) for weeks three through eight, and 60% of your base salary beginning in week nine, up to a maximum of 26 weeks. Coverage is effective on the first day of the month following 12 months of employment. Voluntary Short Term Disability (STD) > UNUM FT PT Voluntary STD coverage allows you to purchase additional STD coverage should you become unable to work due to a covered sickness or accident. The premium is based upon the covered benefit amount selected. Coverage is effective the first of the month following 30 days of employment. The following points highlight the benefits of additional STD coverage: Only disability benefit coverage option available for co-workers during first 12 months Maternity benefits are included (if giving birth occurs nine months after coverage is effective) Coverage is provided for both on and off the job Pays in addition to all other benefits With voluntary STD, you can select the elimination period and the benefit duration. Elimination Periods 0 day (accidents) / 14 days (sickness) 7 days (accident and sickness) 14 days (accident and sickness) Benefit Duration 3 months 6 months Long Term Disability (LTD) > Lincoln Financial FT Rex pays the cost of this benefit. For an approved disability, LTD coverage begins after eligibility for STD expires (180 days). LTD provides 50% of your base salary up to a maximum of $13,000 per month and continues in accordance with plan limits (see the Plan document for specific details). Coverage is effective on the first day of the month following 12 months of employment. Long Term Disability (LTD) Buy-Up Option > Lincoln Financial FT Eligible co-workers may purchase an additional 10% of LTD coverage. Premiums are based upon annual base salary and age. Total benefits, including any elected buy-up amounts, are subject to a $13,000 per month maximum. Coverage becomes effective on the first day of the month following 12 months of employment. If you decline coverage when first eligible, you must wait until the next open enrollment period to enroll in this benefit. At that time, you will also be required to provide medical evidence information in order to receive coverage. Enrollment in the plan after your original eligibility date is subject to approval through Lincoln Financial. The rates for this benefit are age-banded. To determine your premium, use the following calculation: Annual Base Salary 100 x Premium (see below) 26 Age Rate Age Rate <30 $ $ $ $ $ $1.56 Sample Calculation You are: 35 years old Earn: $23, per year Your premium would be: $23, x $ = $5.41 Part-Time Long Term Disability (LTD) > Lincoln Financial PT Eligible co-workers may purchase LTD insurance equal to 50% of their base salary. For an approved disability, benefits begin on the 180th day after disability occurs and continues in accordance with plan limits. Coverage is effective on the first day of the month following 12 months of employment. If you decline coverage when first eligible, you must wait until the next open enrollment period to enroll in this benefit. At that time, you will also be required to provide medical evidence information in order to receive coverage. Enrollment in the plan after your original eligibility date is subject to approval through Lincoln Financial. To determine your premium, use the following calculation: Annual Base Salary x Sample Calculation Your premium would be: $23, x $ = $10.56 Your premium is paid with post-tax dollars and is payroll deducted every pay period benefit highlights < 13

16 2013 benefit highlights Life & AD&D Coverage Basic Life and Accidental Death and Dismemberment (AD&D) FT > Lincoln Financial Rex pays the cost of this benefit. You are eligible for basic life insurance equal to 1.5 times your annual base salary (maximum $750,000). The AD&D benefit is an additional 1.5 times your annual base salary (maximum $750,000). Coverage is effective the first day of the month following 30 days of employment and coverage ends on the last day of the month your employment ends. Supplemental Life and AD&D > Lincoln Financial FT PT Supplemental term life insurance is available in increments of.5 to 3.5 times your annual base salary (maximum $750,000). Coverage is effective on the first day of the month following 30 days of employment. If you decline coverage when first eligible, you must wait until the next open enrollment period to enroll in this benefit. At that time, you will also be required to provide medical evidence information in order to receive coverage. You will also be required to provide medical evidence information in the event you request an increase in coverage due to a qualified life event. Enrollment in the plan after your original eligibility date is subject to approval through Lincoln Financial. Supplemental life also includes AD&D coverage, subject to the limitations listed above. The rates for this benefit are age banded. To determine your premium, use the formula below. Annual Base Salary (rounded up to next thousand) x Election Amount 1000 x Premium x = Per Pay Period Premium Age Rate Age Rate* <25 $ $ $ $ $ $ $ $ $ $ $ $2.08 Sample Calculation PT You are: 35 years old Earn: $23, per year Elect 3x your annual salary in coverage Your premium would be: $24,000* x x $.09 x = $2.99 *Round premium per period to the next $1,000. Your premium is paid with post-tax dollars and is payroll deducted every pay period. Dependent Life Insurance > Lincoln Financial FT PT Dependent life insurance for your spouse and all legal dependents up to age 19 (or up to age 26 if a full-time student) in coverage amounts of $5,000, $10,000 or $25,000 is also available. Coverage is effective on the first day of the month following 30 days of employment. If you decline coverage when first eligible, you must wait until the next open enrollment period to enroll in this benefit. At that time, you will also be required to provide medical evidence information on your dependents in order to receive coverage. Enrollment in the plan after your original eligibility date is subject to approval through Lincoln Financial. The rates for this benefit are as follows: Coverage Amount Co-worker Rates $ 5,000 $0.83 $10,000 $1.66 $25,000 $4.15 Whole Life Insurance with Long-Term Care > Unum FT PT Whole life insurance builds cash value at a guaranteed minimum interest rate; under current law, your interest earnings are tax-deferred. Policyholders can also take loans from their cash value account. In addition, Long Term Care benefits provide you access to your policy s death benefit to help cover the expenses related to long term care. Co-workers who work at least 17.5 hours per week are eligible for this coverage. Coverage is available for co-worker, spouse, and children up to age 25 (with rider). Coverage is effective the first of the month following 30 days of employment. If you enroll at the time you are first eligible to do so, your policy is guaranteed issue. That means you do not need to answer any medical questions; your coverage becomes effective on the date you sign the application. If you decline coverage when first eligible, you must wait until the next open enrollment period 14

17 life & AD&D reimbursement to enroll in this benefit. At that time, you will also be required to provide medical evidence information in order to receive coverage. Enrollment after your original eligibility date is subject to approval through Unum. The co-worker-paid rate is based on age and coverage level selected; you pay your premiums through convenient payroll deduction. In addition, you are the owner of the policy(ies) if you leave Rex, you can take it with you and still pay the same premium. Critical Illness > CAIC (an AFLAC company) FT PT Critical illness coverage provides cash payments if you are diagnosed with or undergo treatment for any of the following conditions: Cancer Carcinoma in Situ Heart Attack Stroke Coronary Artery Bypass Major Organ Transplant End Stage Renal Failure The cash payments are in addition to any other benefits payable through our plan or other coverage you may have. Enrollment in this benefit is at the time of hire or during the annual open enrollment period. If you enroll at the time you are first eligible to do so, your policy is guaranteed issue. That means you do not need to answer any medical questions; your coverage becomes effective on the date you sign the application. If you decline coverage when first eligible, you must wait until the next open enrollment period to enroll in this benefit. At that time, you will also be required to provide medical evidence information in order to receive coverage. Enrollment after your original eligibility date is subject to approval through CAIC. When you enroll, you can choose the dollar amount of coverage you want $5,000, $10,000, or $15,000. Coverage is also available for your spouse and children. Accident Coverage > Unum FT PT Voluntary accident insurance covers a wide variety of injuries and accident-related expenses (such as hospitalization, physical therapy, hospital intensive care, transportation, and lodging) as they relate to loss of income due to a covered on- or off-the-job accident. For example: up to $100,000 for death benefit; fractures up to $10,000; employee catastrophic accident benefit of $100,000; ER is $150; hospital confinement of $400 per day and $800 per day (ICU). Each plan is different, so it is important to carefully review your options to determine if this benefit, which is paid in addition to all other coverage, is right for you. Reimbursement Accounts FT PT > Total Administrative Services Corp (TASC) The Medical and Dependent Care Reimbursement Accounts provide a great opportunity for you to save taxes (state, federal, and FICA) on out-of-pocket healthcare expenses for you and your family members as well as dependent day care expenses. You decide the amount to be deducted from your pay pre-tax and then receive reimbursements during the plan year as you incur claims. More details about the Reimbursement Accounts will be provided to you during our annual enrollment period or in your new co-worker materials. New co-workers who work 17.5 hours or more per week are eligible to participate on the first day of the month following 30 days of employment. You must re-enroll annually for the plan year that runs from January 1 through December 31. Medical Reimbursement Account Contribute up to $2,500 per year. Eligible healthcare expenses include: Deductible and copays Prescription drugs Eyeglasses and contact lenses Contact lens supplies Lasik eye surgery Speech and physical therapy Hearing aids Some over-the-counter (OTC) drugs, with a prescription Coverage is effective the first of the month following 30 days of employment benefit highlights < 15

18 2013 benefit highlights Dependent Care Reimbursement Account Contribute up to $5,000 per year (if single or married filing a joint tax return). Eligible dependent care expenses include: Licensed day care center Before or after school care Daytime summer recreational camp Adult day care center Adult private sitter In-home care for dependents unable to care for themselves Plan Features: Instant reimbursement for certain expenses: No need to wait; use the convenience card for immediate reimbursement. Note: You may still be asked to submit receipts for proof of qualifying purchases. Direct deposit: When a paper claim is necessary, expedite the reimbursement process by utilizing the direct deposit feature. For more information on eligible and ineligible expenses, call Human Resources If you choose the Blue Options HSA Plan Your participation in the Medical Reimbursement Account will be limited. You may only spend these dollars on eligible dental or vision care expenses; your HSA funds will be used toward eligible medical expenses. Important: IRS allows an extended period of two and one-half months for co-workers to incur (date of service) expenses against their Medical and Dependent Care Reimbursement Accounts. Rex Healthcare will give you until March 15, 2014 to incur eligible expenses against your 2013 plan year elections. This extra two and one-half month extended grace period is designed to give you more time to incur expenses to reduce your chance of losing money under the Reimbursement Accounts. How does an FSA differ from an HSA? There are several differences between an FSA and an HSA, as shown in the table below: Definition Can unused funds remain in your account from year to year? HSA Health Savings Account is an individual taxexempt trust or custodial account used to pay for qualified medical expenses Yes FSA Flexible Spending Account is an employer group health plan that allows you to set aside money on a pre-tax basis to pay for eligible medical expenses not covered by a group health plan No Who can contribute to your account: You, your employer and third parties You and your employer Are the funds portable? Yes Generally no Can the funds be invested to potentially grow? Can you use the funds for expenses other than qualified medical expenses? Will your account remain open if you switch jobs? Yes Yes, but taxes and penalties may apply Yes No No No Can you make catch-up contributions? Yes No 16

19 reimbursement retirement Retirement Program Rex Healthcare Retirement Program FT PT C The Rex Healthcare Retirement Program is designed to provide retirement benefits that meet the diverse needs of our workforce. It is a program that is for co-workers at all levels, supports Rex Healthcare s mission and is easy for co-workers to understand. It is also a very important part of your benefits package. The Retirement Program rewards you financially at retirement for your hard work and long-term commitment to Rex Healthcare. So, how do you ensure that you have an adequate retirement income when you retire? You start by taking advantage of all your income sources, including the Rex Healthcare Retirement Program, to create balanced income sources during retirement. Definitions FAC Final Average Compensation the average of the highest five consecutive years of which you worked. CC Covered Compensation the annual average of the maximum Social Security taxable wage base. YOS Years of Service any plan year in which the co-worker is credited with working 1,000 hours or more. Rex Hospital, Inc. Pension Plan Rex Hospital closed the pension plan to new participants hired or rehired on or after February 1, Co-workers currently participating in the plan continue to earn benefits in the plan. All participating co-workers who work at least 1,000 hours in the plan year are credited with one year of service. Co-workers are fully vested after five years of service in which you work 1,000 hours. Normal retirement age under the plan is age 65. In addition, there is a provision for a reduced early retirement benefit for co-workers age 55 with 10 years of vested service. The retirement benefit under this program is determined by using the following two-part calculation: The benefit is typically paid as a monthly benefit. For participants that are vested, survivor benefits provide security for your family. Rex pays the full cost of this benefit. Your Pension Plan benefit is calculated using your five highest consecutive years of service over your employment with Rex Healthcare, regardless of when they occur. This allows eligible co-workers to adjust the hours they work prior to retirement without causing any loss of benefit. Rex Hospital, Inc. 403(b) Retirement Savings Plan FT PT C Rex Hospital, Inc 403(b) Retirement Savings Plan administered by Diversified Investment Advisors, allows you to save for retirement by making voluntary pre-tax contributions to the Plan. When you make pre-tax contributions, Rex Healthcare will provide an employer matching contribution based on your length of service (based on your adjusted hire date). Since you are immediately eligible to join the plan, unless you elect otherwise by contacting Diversified, you will automatically begin saving and investing 4% of your pay. You are vested in your contribution immediately and are vested in the company match contributions after completing two years of service in which you work at least 1,000 hours per plan year. You may contribute up to 100% of your salary, not to exceed the annual limit; if you are age 50 or older, you may make an additional catch-up contribution of $5,500 (based on 2012 IRS limits) for The Rex matching contribution increases based upon your length of service (based on your adjusted hire date), as shown below. Length of Service Match Amount 0 3 years 50% of the first 6% 3 8 years 50% of the first 8% 8+ years 50% of the first 10% Calculation for Co-Workers Hired Prior to 1/1/04: (1% of FAC +.5% of FAC over $6,600) x YOS prior to 1/1/04 plus (1% of FAC +.5% of FAC over CC) x YOS after 1/1/04 Calculation for Co-workers Hired After 1/1/04: (1% of FAC +.5% of FAC over CC) x YOS 2013 benefit highlights < 17

20 2013 benefit highlights Why Participate in a Retirement Savings Account? Below are some other advantages to participating in the Retirement Savings Plan: Contributions may be made with pre-tax dollars through convenient payroll deduction. You can choose from a wide variety of investment options designed to meet your retirement savings objectives. No minimum investment is required. You reduce your current tax obligation because federal and most state income taxes on your contribution are deferred until you withdraw the money from your account. Interest and earnings on your account accumulate on a tax-deferred basis. You receive quarterly account statements which show the current status of your account as well as all account activity. If you have an existing retirement plan account with a prior employer, you may transfer or roll over that account into the Program at any time. You can access your account information 24 hours a day via the Internet at or through the toll-free line at You can schedule an appointment with the Diversified on-site representative by calling The Retirement Program rewards you financially at retirement for your hard work and long-term commitment to Rex Healthcare. Through Diversified Direct Online at you can: Set your retirement income goal Create or fine-tune your retirement planning strategy Monitor activity and conduct transactions in your account Check investment performance Stay informed about economic conditions, tax regulations and Social Security Rebalance your investments (automatically if you sign up!) Choose an appropriate distribution option when you retire or leave your job Create a plan for investing during retirement First-time users: Go to At the top right, click on Sign in to Your Account, then Diversified Direct Online. Click on Get Started and follow the instructions to establish a password and access your account. 18