CHOOSE MY BEST PLAN OPTION (PLAN FINDER) INSTRUCTIONS Anthem Medical Plan For Employees Working In the US February 10, 2012 Page 1
IMPORTANT NOTES YOU SHOULD CONSIDER BEFORE USING THE TOOL The Choose My Best Plan Option (Plan Finder) tool assumes you are modeling a full calendar year of health care services. For best results, include services you ve received to date plus your estimated services for the balance of the year. The tool also assumes you are participating in the Eaton benefit plans for the period January 1, 2012 through December 31, 2012. As a result the tool will show that Eaton will add its full annual $400 contribution to your Health Savings Account (HSA) if you elect Employee Only medical coverage or $800 if you elect Employee + Others medical coverage. Note, however, Eaton s actual 2012 contribution to your HSA, if you choose to participate, will be based on when you became eligible for medical benefits as indicated in the chart below. Eligibility Date Employee Only Employee + Others Jan 1 $400 $800 Jan 2-Feb 1 $363 $726 Feb 2-Mar 1 $330 $660 Mar 2-Apr 1 $297 $594 Apr 2-May 1 $264 $528 May 2-Jun 1 $231 $462 Jun 2 Jul 1 $198 $396 Jul 2 Aug 1 $165 $330 Aug 2 Sep 1 $132 $264 Sep 2 Oct 1 $ 99 $198 Oct 2 Nov 1 $ 66 $132 Nov 2 Dec 1 $ 33 $ 66 Dec 2 Dec 31 $ 0 $ 0 The tool assumes that you have earned the maximum Healthy Incentives credits toward the medical plan contribution that is deducted from your pay each pay period. If you are a new hire or transferred from an employee group that is not eligible for Eaton medical benefits to an employee group that is eligible for Eaton medical benefits, then you will automatically receive the maximum Healthy Incentives credits for the remainder of the year. Page 2
STEP 1 Getting to the Tool If you are accessing the tool from the Internet: Enter www.eatonbenefits.com into your internet browser. Select Eaton Service Center at Fidelity from the list at the left side of the page (see arrow below). If you are accessing the tool from JOE: Go to JOE Select Go to EatonBenefits.com Select Eaton Service Center at Fidelity from the list at the left side of the page (see arrow below). Page 3
STEP 1 (continued) Once you are logged on to the Eaton Service Center at Fidelity NetBenefits web site Select Enroll on the Health and Insurance line (see arrow below) Once you are on the Health & Insurance Welcome page Select Get Started Now (see arrow below) If you have already made annual enrollment elections, then select Make changes to your benefits Page 4
STEP 1 (continued) Select Next (see arrow below) Note that these instructions assume that you are not making any enrollment elections at this time. Select Review/Update Your Benefits in the Medical section (see arrow below) Page 5
Select Plan Finder (see arrow below) on the Medical Options page. This will take you into the Choose My Best Plan Option (Plan Finder) tool. Page 6
STEP 2 Complete Your Personal Profile You are now in the Choose Your Best Plan Option (Plan Finder) tool. Complete the questions shown in the boxes shown below and note the following: Medical Coverage Level Reference to Spouse includes Domestic Partners. Tax Profile Input Annual Household Income but do not include the comma (40,000 should be entered as 40000). Input a Federal Tax Rate. If you do not input these two numbers, the tool cannot calculate your tax savings. Employer Health Savings Account (HSA) Contribution Indicate that you will withdraw the Eaton contribution to pay for all or part of your share of the cost for your expected 2012 medical services. OR Indicate you will not withdraw the Eaton contribution in 2012. After completion, click the Next button located at the bottom on the right side of your screen (see arrow above). Page 7
STEP 3 Estimate Use of Medical Services Click on the Self tab (see circle below). In the Estimate Use column select the number of times you expect to use the services listed in the Types of Medical Service column during 2012 (see box below). Click on the Spouse/Domestic Partner tab. Select the number of times you expect your spouse/domestic partner to use these medical services during 2012. This tab will not appear if you selected Employee Only or Employee + Children coverage. Click on the Child tab. Select the number of times you expect your child or children to use these medical services during 2012. This tab will not appear if you selected Employee Only or Employee + Spouse coverage. Instructions for Step 3 are continued on next page Page 8
STEP 3 Estimate Use of Medical Services (continued) If you have more than one child, add together all of your children s expected number of services for each type of medical service. For example, if you expect that 1 of your 2 children will have 3 nonpreventive care primary care office visits and the other child will have 1, input 4 in the Estimate Use column for Office visit primary care doctor. The Types of Medical Service costs shown in the Estimated Cost column are based on a national average. You can change the cost of a particular medical service if you wish by highlighting the number in the Estimate Cost column, typing in a different number and hitting Enter on your keyboard. The list of medical services includes common services, but may not show every type of service that you would like to include in your estimate. You may be able to include a service that is not listed by: Using the X-ray, Lab or Outpatient Surgery category if you don t need it for yourself and your dependents and revising the service s cost to reflect the cost of the service that is not listed. Using the X-ray, Lab or Outpatient Surgery category even if you need it for yourself and your dependents but revising the number of services so the number of services times the cost of the listed service is approximately equal to the total cost of the listed service plus the unlisted service. After completion, click Next, located at the bottom on the right side of your screen (see arrow on previous page of these instructions). Page 9
STEP 4 Add Health Care Reimbursement Account (HCRA) Contributions If you wish to participate in the HCRA Indicate the total amount you plan to contribute to the account for the year of 2012 (see box below). After completion, click Next, located at the bottom on the right side of your screen (see arrow above). Page 10
STEP 5 Add Health Savings Account (HSA) Contributions If you wish to contribute to the HSA Indicate the total amount (if any) that you plan to contribute in 2012 and will withdraw in 2012 to pay for your share of the cost for some or all of the 2012 medical services that you input in Step 5 (see first box below). Indicate the total amount (if any) that you plan to contribute in 2012 and will NOT withdraw in 2012 (see second box below). After completion, click Next, located at the bottom on the right side of your screen (see arrow above). Page 11
STEP 6 Review Results Your medical plan options will be listed in order, starting with the option with the lowest estimated annual cost to you (see boxes below). You can make changes to the information you input in any of the previous steps by selecting the appropriate tab at the top of the screen (see circle below). The costs produced by this tool are estimates only and assume you have earned the maximum Health Incentives credits. You actual costs will vary depending on the credits you earn, the medical services you and your dependents receive and the cost of those services, your tax rate and the amount of your HSA or HCRA contributions. Select Start Tool in the drop down box (see arrow above) if you would like to continue to the Comparison Module of this tool. This module provides a comparison of the copays, deductibles, coinsurance and out-of-pocket maximums for all 3 medical plan options. Instructions for using this part of the tool begin on the next page. Page 12
STEP 7 Select Coverage Level Select your coverage level (see box below). Reference to Spouse includes Domestic Partners. After completion, click Next, located at the bottom on the right side of your screen (see arrow above). Page 13
STEP 8 Select Plan Options Select the medical plan options that you would like to compare (see box below at left of screen). You can also click Select All if you wish to compare all plan options (see box below at top right of screen). After completion, click Next, located at the bottom on the right side of your screen (see arrow above). Page 14
STEP 9 Select Plan Provisions Select the medical plan provisions that you would like to compare (see two long boxes below). You can also click Select All if you wish to compare all plan provisions (see first box below at left of screen). After completion, click Next, located at the bottom on the right side of your screen (see arrow above). Page 15
STEP 10 Review Results Review the results for all medical plan options and attributes that you selected (see arrows below). You can make changes to the information you input in any of the previous steps by selecting the appropriate tab at the top of the screen (see circle below). Page 16