Benefits 2014

2014 Benefit Changes

Conference Call for ESC Represented Employees November 19, 2013

1

Agenda

•

New Medical Plan for 2014

–

New Resources - where to get more information

–

What’s changing?

–

New Plan Design for 2014

•

Question and Answer Period Benefits 2014 2

New Resources

Provant – Your One-Stop Shop for Health and Wellness Questions

Talk to a health advocate for: • Billing Questions • New Health Account Plan questions • Dental or Vision Plan Questions • Questions about health screenings, health accounts

PROVANT

Phone support: 866-271-8144, M-F, 5am-5pm. Pacific Time Email support: [email protected]

Benefits 2014 3

New Resources

New Website: www.mypgebenefits.com

• • • • • Details on the new Anthem and Kaiser HAP for 2014 Accessed from any computer with internet access What to expect at the doctor and pharmacy on your first visit in 2014 How to use your different cards Where to get more information as you use the plans

Benefits 2014 4

What’s Changing?

What Isn’t Changing?

Dental

Delta Dental

What Is?

New coverage for dental implants

Vision

VSP

Medical

Monthly Premium Discounts on non-covered services are different New Health Account Plan in effect for both Kaiser and Anthem: two provider networks-same plan design Hearing Aids covered for all employees and retirees

Benefits 2014 5

What’s Changing?

Rules for Covering Children

• Children can be covered under your PG&E medical, dental and vision plan until their 26 th Birthday • They no longer have to be • students • unmarried • your tax dependent • They can be employed and be offered benefits (

New

)

Benefits 2014 6

New Medical Plan for 2014

The Health Account

• All active employees enrolled in Anthem or Kaiser will have a Health Account • Both the Anthem and Kaiser PG&E plans for active employees will be called the Health Account Plan, or HAP

Benefits 2014 7

New Medical Plan for 2014

The Health Account

Health Account Deposits Single Coverage Family Coverage

2014 2015 through 2020 • You automatically get: • If you take a health screening: • If you test tobacco-free or complete PG&E’s tobacco cessation program: • Total • You automatically get: • If you take a health screening: • If you test tobacco-free or complete PG&E’s tobacco cessation program: • Yearly Total

• $ 750 • $ 250 • $ 250 • $ 1,250 • $ 500 • $ 250 • $ 250 • $ 1,000 • $1,500 • $ 500 • $ 500 • $ 2,500 • $ 1,000 • $ 500 • $ 500 • $ 2,000 Remember: If you don’t use all your credits in one year, they roll over

Benefits 2014 8

New Medical Plan for 2014

Earning Health Account Credits

• Health Screening consists of four tests: • Weight/Height to get BMI • Blood Pressure • Glucose Level (non-fasting) • Cholesterol Level • Tobacco use test is optional and swab done with an oral • Tobacco users can skip the tobacco use test and complete a tobacco cessation course with Provant to earn credits Employees with family coverage will earn credits for their entire family – their dependents do not need to do a screening to earn credits

Benefits 2014 9

New Medical Plan for 2014

Health Screenings and Tobacco Use Test

• Three ways to get a Health Screening/Tobacco Test • On-site event: enroll online at www.provantevents.com/pge or call Provant • Concierge: call Provant at 1-866-271-8144 to schedule at your home or office • Take a form to your doctor: doctor’s offices don’t do tobacco screenings; you’ll need to walk into any on-site screening form from – no appointment needed. Download the screening www.mypgebenefits.com

• Check for your results at www.provantonline.com

• Have until Sept. 30, 2014 to earn credits for 2014 plan year

Benefits 2014 10

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Using Health Account Credits

• Pay for plan deductibles and other out-of-pocket expenses • Credits can be used for: – medical, dental and/or vision expenses – for you or your family members – unused credits roll over year after year and can be used for PG&E Retiree Medical Plan expenses • You can still contribute to a Health Care Flexible Spending Account (FSA)

Benefits 2014 11

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Using Health Care Flexible Spending Account

• NEW! Can roll over $500 from one year to next, amounts above $500 left in account at end of year are still a “use-it-or-lose-it” • Will work with the Health Account • Administrators: – Your Spending Account (for Anthem Blue Cross members) – Kaiser (for Kaiser members) • Will automatically use the Health Care Flexible Spending Account

first Benefits 2014 12

How the Plan Works – Health Account Debit Cards

YSA (Anthem HAP)

• • • • • Use card to pay expenses for: Medical Mental health Pharmacy Dental Vision

Kaiser HAP

• Use card to pay expenses for: Kaiser pharmacy Kaiser medical expenses and mental health expenses automatically taken out of your account after your visit to Kaiser • • Submit claims to pay for Dental Vision

13 Benefits 2014

New Medical Plan for 2014

How the Health Account Plan (HAP) Works

• 4 free primary care visits per year for every covered family member • First choice for everything from chronic disease management, physicals, everyday ailments • Choose a family doctor who knows you and cares about your “whole person” health • Primary Care Doctors • General or family practitioners (including nurses) • Internal Medicine doctors • Pediatricians • OB/GYNs • Urgent care

Benefits 2014 14

New Medical Plan for 2014

Other Free Services

• Some free preventive screening services (e.g., mammograms, pap smears, colonoscopies, immunizations) • Some free prescription drugs for preventive care and chronic conditions (e.g., insulin for diabetes) • Free maternity and well-baby office visits to age two Go to www.mypgebenefits.com

for lists of which preventive services and prescription drugs are free

Benefits 2014

Tip: free doctor visits may include additional tests or services performed during your visit – these are covered, but may not be free

15

New Medical Plan for 2014

A few terms to understand … Annual Deductible

For services that aren’t free, amount you’re responsible to pay for first before the plan will start to pay

Co-insurance

You pay a percent of the cost of a medical service

Out-of-Pocket Maximum

The limit on the amount you have to pay every year for covered services

Benefits 2014 16

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Annual Deductible

• If you have single coverage, annual deductible is $1,000 • If you have family coverage, annual deductible is $1,000 per person but no more than $2,000 for your entire family Remember: if you earn all your Health Account credits, you’ll have enough to pay your whole deductible from your Health Account

Benefits 2014 17

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Coinsurance

• You’ll be responsible for either 10% or 20% of the covered cost and the HAP will pay the other 90% or 80% respectively. • There are no copayments under the HAP, so instead of paying a flat $10 or $20 copayment at the time of service, you’ll pay 10% or 20% for services that are not free • But, your expense is limited by the Out of Pocket Maximum….

Benefits 2014 18

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Out-of-Pocket Maximum

• Limits how much you are responsible for paying every year • Once out-of-pocket maximum is reached, all covered services are free for the rest of the year • Includes all money you spend on covered medical services, prescription drugs and mental health services • Includes credits you used from your Health Account for medical expenses • Includes deductible and co-insurance

Benefits 2014 19

New Medical Plan for 2014

How the Health Account Plan (HAP) Works Out-of-Pocket Maximum

• If you have single coverage, the annual out-of-pocket maximum is $2,400 • If you have family coverage, the annual out-of-pocket maximum is $2,400 per person but no more than $4,800 for your entire family

Single Coverage Family Coverage Your Maximum 2014 Health Account Credits: Your Annual Out-of-Pocket Maximum:

(includes annual deductible)

Your 2014 Effective Out-of-Pocket Maximum: $1,250 – $2,400 <$1,150> $2,500 – $4,800 at the most <$2,300 at the most>

All covered expenses paid at 100% for the rest of the calendar year

Benefits 2014 20

How the Plan Works – Coinsurance

15% generic 25% brand 10% generic 20% brand

21 Benefits 2014

New Medical Plan for 2014

Things to note about pharmacy

• Express Scripts will continue to be the pharmacy provider for Anthem Blue Cross; Kaiser provides pharmacy benefits for its members • Free medications for Anthem HAP must be obtained from Express Scripts mail order • Free medication from Kaiser can be from any Kaiser pharmacy or mail order • Anthem HAP members will have mandatory mail order for many maintenance drugs – drugs you take on a long-term basis – In 2014, can get three fills at a retail pharmacy, then must get the drugs through Express Scripts mail order, or pay 100% of the cost – Can sign up now with Express Scripts mail order if currently enrolled in Anthem – Most narcotics, ADHD drugs and compound drugs are not included – you will continue to have coverage for these at a retail pharmacy

Benefits 2014 22

What do you need to do now?

• Schedule a Health Screening to maximize your Health Account credits for 2014 • If you want a flexible spending account, enroll by November 21, 2013 • Review Health Account Plan User Guide that will be sent to you in late December • Visit www.mypgebenefits.com

for more information on the new Health Account Plan • Contact Provant with detailed questions 866-271-8144, M-F, 5am-5pm, Pacific Time [email protected]

Benefits 2014 23

Benefits 2014

Question & Answer

24

Benefits 2014

Thank You

Questions?

Log onto www.mypgebenefits.com

information for more Email [email protected]

Or call Provant at

1-866-271-8144

for medical plan questions

25