1 Benefits Committee September 24, 2014

2 Benefits Committee Our Focus

3 Our Goal Benefits CommitteeGoal is to support the budget process for that supports the District’s Mission and Vision while balancing the need to improve employee benefits while achieving a balanced budget that does not require a tax increase. Goals will be to help assure current insurance benefits are appropriately structured and financed to support institutional needs, including recruiting and retaining faculty and staff.

4 Roles and ResponsibilitiesBenefits Committee Roles and Responsibilities Serve in an advisory capacity to the district leadership team Engage in productive dialogue Be objective and maintain a district level perspective Explore possibilities Communicate committee work and outcomes to colleagues Confer with principal following each meeting Gather input from colleagues

5 Desired Outcomes of MeetingBenefits Committee Desired Outcomes of Meeting Financial update Review of benefits for 2015 What’s new for 2015? Review of medical plan parameters Overview of Pharmacy & Clinical Programs Where do we go from here?

6 Benefits Committee January-August 2014 Health Plan Performance FBISD Contributions $24,523,604 Employee Contributions $14,206,857 Total Revenue for Health Plan $38,730,461 Plan Expenses Fixed Cost Administration Fees $1,710,983 Stop Loss - $450,000 $653,457 Affordable Care Act Fees $453,984 Total Fixed Cost $2,818,424 YTD Claims $29,669,333 Total Expenses $32,487,757 YTD Surplus $6,242,704

7 Benefits Committee Effective 1/1/2015 there will not be any changes to the following benefits: Benefit Carrier Vision VSP Short Term Disability Lincoln Financial Long Term Disability Basic Life / AD&D Voluntary Life* *Employees may see a change in their deduction amount if they fall into a higher age band as of 1/1/2015.

8 Benefits Committee Dental – Will Remain with Guardian for 2015 Current Dental Cleaning Frequency 2015 Dental Cleaning Frequency 1 every 6 months 2 per calendar year

9 Employee Assistance Program (EAP):What’s New for 2015??? Employee Assistance Program (EAP): An Employee Assistance Program will be offered for 2015 Up to 6 face to face counseling sessions available at no cost to the employee and their family members Confidential services Counselors can assist with resolving stress, grief, marital issues, emotional problems, substance/alcohol abuse, etc. Up to 3 phone or face-to-face consultations per financial issue and a discount of up to 25% on continued consultations Legal consultations and advice are also available on a telephonic basis to assist employee with wills, personal/family law as well as additional consumer and civil issues

10 What’s New for 2015??? Telehealth: A Telehealth service will be available to employees and their families beginning 1/1/15 – Members can call a board certified physician 24 hours a day, 7 days a week to seek care and treatment for issues such as cold & flu, sinus infections, children’s ear pain and general non-emergent conditions A Telehealth doctor can recommend appropriate treatment and in many cases call in a prescription directly to your local pharmacy Member pays only a $40 copay per telephonic consultation, typically avoiding costly and time consuming urgent care and emergency room visits

11 Medical Plan Name Changes for 2015: Current Plans with CignaBenefits Committee Medical Plan Name Changes for 2015: Current Plans with Cigna 2015 Plans with UHC Open Access Plus Choice Plus Choice HRA Choice Plus HRA The current plans listed above will have no benefit changes in The current plan listed below will have benefit changes in 2015, please see next slide for details. LocalPlus IN Choice Premium Tier

12 Medical Plan Benefit Changes for 2015:Benefits Committee Medical Plan Benefit Changes for 2015: (the only plan experiencing benefit changes is the current LocalPlus IN plan) The Choice Premium Tier plan is an open-access In-Network Only plan that encourages members to seek care from certain providers and facilities to obtain the highest level of coverage. Better choices can have a direct affect on healthcare costs. Under the Choice Premium Tier plan, there are two level of coverage available: Tier 1: Methodist Hospital System United Healthcare Premium Tier 1 Providers (including those specialties not currently evaluated for Tier 1 status) Tier 1 Tier 2 PCP Copay $25 $45 Specialist Copay $35 $55 Coinsurance 80% 60% Deductible (Individual) $750 $1,500 Deductible (Family) $3,000 Out-of-Pocket (Individual) $3,750 $6,600 Out-of-Pocket (Family) $7,500 $13,200 Preventive Care 100% Emergency Room $250 copay, plus deductible & coinsurance Inpatient Copay $0 $250 per admission Urgent Care $75 Tier 2: All other United Healthcare Choice Network Providers Since the Choice Premium Tier plan is an open-access plan, members can seek care from any in-network provider within the Choice Network, but they will pay more out-of-pocket expenses when they do not seek care from a Tier 1 provider.

13 Choice Premium Tier 1 Specialties:Benefits Committee Choice Premium Tier 1 Specialties: Why choose a Methodist Hospital System or Premium Tier 1 provider? You pay lower copays, lower deductibles and lower coinsurance, and you receive a higher quality of care. Look for the UnitedHealth Premium Tier 1 symbol on myuhc.com to quickly and easily find doctors who have been recognized for providing value. These specialties are listed below: Allergy Cardiology Cardiology – Electrophysiology Cardiology – Interventional Endocrinology Family Practice General Surgery General Surgery – Colon/Rectal Internal Medicine Nephrology Neurology Neurosurgery – Spine OB-GYN Ophthalmology Orthopaedics – General Orthopaedics – Foot/Ankle Orthopaedics – Hand Orthopaedics – Hip/Knee Orthopaedics – Shoulder/Elbow Orthopaedics – Spine Orthopaedics – Sports Medicine Pediatrics Pulmonology Rheumatology Urology

14 Choice Premium Tier Participants:Benefits Committee Choice Premium Tier Participants: (must choose a provider in the Choice network – there is no out of network coverage) The Methodist Hospital arrangement at the Tier 1 level is in the Houston area ONLY. When a member is outside of the Houston area and they utilize a provider outside of the specialist’s categories listed in the previous slide that are designated Tier 1, the benefit under this plan will pay at Tier 2. When a member is within the Houston area and they utilize a specialist that is outside of the list of Tier 1 specialty groups, their claim will be paid at Tier 1.

15 Benefits Committee FSA Change for 2015: Moving the administration of the medical FSA and dependent care FSA to UHC. The debit card can now be swiped at daycares that have this capability. If you have the HRA, the FSA debit card can only be used for prescriptions, dental and vision expenses.

16 Prescription Drug List: Tier PlacementBenefits Committee Prescription Drug List: Tier Placement Our standard Prescription Drug List (PDL) has 3 tiers and aligns tier placement and copay value with the overall health care value of the drug. Tier 1 Tier 2 Tier 3 $ Lowest Cost $$ Midrange Cost $$$ Highest Cost Making the highest-value medications more affordable for your employees Medications can move to any tier so that the highest value drugs are always the most affordable.

17 Best Resource: Prescription Drug ListBenefits Committee Best Resource: Prescription Drug List Electronic and printed Prescription Drug Lists show cost tier placements of the Top 750 medications and help answer frequently asked questions. For you: United Healthcare representative Posted online: UHC.com/pharmacy For your employees: Call number on the back of ID card Posted online: myUHC.com

18 2014-2015 Benefits Committee Clinical Programs Overview:Promoting safety and appropriate use Step Therapy Most medical conditions have several medication options Although these medication options may work in a similar way, their cost may vary widely With this program you need to try a lower-cost medication first, before a higher-cost medication may be covered Notification/ Prior Authorization Requires physicians to populate additional information to verify benefit coverage Physician Prior Authorization Web Portal allows real-time approvals and less member disruption Physicians submit real-time, online PA requests, auto-population feature intuitively provides 95% of a member’s information Supply Limits A supply limit is the largest quantity of medication covered per copayment or in a time period Based on FDA guidelines for medication dosage, clinical guidelines or usage patterns Applied to approximately 500 medications, supply limits help address safety concerns, reduce waste, remove excess costs, and provide opportunities for dose optimization Select Designated Pharmacy Participants choose one of three options to continue receiving network benefits: Move to a lower-cost medication and save up to $480 per year Use mail service and save up to $96 per year Do both and save up to $500 per year On average, members save $360 annually

19 2014-2015 Benefits Committee Step Therapy Program:Directing members to less expensive yet equally effective medications Member is prescribed Rx Try a Step 1 Rx first (a lower-cost medication) Before Step 2 Rx is covered (high-cost medication)

20 Promoting safety and reducing costsBenefits Committee Prior Authorization: Requiring physicians to provide additional information to verify benefit coverage Covered Actiq for cancer pain approved for treating cancer-related pain in members already taking a long-acting pain medication (opioid / narcotic) Not Covered Actiq for migraines Not indicated or proven safe for patients that are not regularly taking a long-acting pain medication (opioid/narcotic) for cancer pain Promoting safety and reducing costs

21 Physician Prior Authorization Web Portal:Benefits Committee Physician Prior Authorization Web Portal: Real-time approvals and less member disruption Prescriber Enters Detail Accessible. Easy. Immediate. Prior Authorization Approved Real-Time Decision Physicians submit real-time, online prior authorization (PA) requests Auto-population feature intuitively provides 95% of a member’s information Majority of prior authorizations are approved real-time for no member disruption Communication to Member

22 Specialty Pharmacy Program Overview:Benefits Committee Specialty Pharmacy Program Overview: Members using specialty drugs suffer from complex, rare or life debilitating diseases. Anemia Crohn’s Disease Cystic Fibrosis Endocrine Growth Hormone Deficiency Hemophilia Hepatitis B Hepatitis C HIV/AIDS Inflammatory Bowel Disease Immunodeficiency Immune Modulator Infertility Iron Overload Multiple Sclerosis Neutropenia Oncology Osteoarthritis Parkinson’s Disease Psoriasis Pulmonary Hypertension Respiratory Syncytial Virus Rheumatoid Arthritis Transplant personal, high-touch support Specialized clinical experts, not generalists synchronized health care services Uniquely able to navigate the complexity of both medical and pharmacy benefits improved outcomes and high satisfaction Client spend is lower for members who participate in the program

23 2014-2015 Benefits Committee 1 business day 1-3 business daysSpecialty Pharmacy Program: Shipping and Delivery Tuesday through Friday Saturday delivery is available if needed Refrigerated Medications Non-refrigerated Medications 1 business day 1-3 business days Can ship to alternative addresses Free Supplies and Additional Information Included Welcome Letter Specialty Pharmacy Program Brochure Clinical Management Program Brochure Condition-Specific Information Refill Magnet Cannot deliver to P.O. Boxes Signatures are required for over a certain dollar amount and/or doctor office deliveries

24 United Healthcare National Pharmacy Network:Benefits Committee United Healthcare National Pharmacy Network: Convenient Member Access 67,000 locations– leading chains, mass merchants and grocery stores Pharmacies include: Walgreens, Rite Aid, Wal-Mart, Target, Duane Reade, Medicine Shoppe, Ralphs, Kroger, Meijer, Shopko, CVS, HEB Includes a 30-day supply benefit and zero balance copayment logic Our strong network ensures members get nationwide access to care when and where they need it.

25 UnitedHealthcare’s OptumRX Mail Service PharmacyBenefits Committee UnitedHealthcare’s OptumRX Mail Service Pharmacy Choose one of these ways to fill your first prescription using OptumRx® Mail Service Pharmacy: By mail  Get a prescription from your doctor for up to a three-month supply, plus refills for up to one year (if needed).  Go to myuhc.com and download an order form.  Mail the new prescription and order form to the address provided on the form. With your doctor  Ask your doctor to fax your prescription to OptumRx Mail Service Pharmacy. Your doctor can call the number on the back of your plan ID card for instructions. (Faxed prescriptions must come from your doctor’s office.) Our strong network ensures members get nationwide access to care when and where they need it.

26 2014-2015 Benefits Committee Online Member Portal:Review benefit highlights and coverage Access to Mail Service Pharmacy prescriptions My Prescription Dashboard to refill, renew and manage prescriptions My Medicine Cabinet to manage and price prescription and OTC medications Locate a retail pharmacy Explore lower-cost alternatives and options Download order forms Access general health information

27 Benefits Committee

28 Open enrollment this fall Other Benefits (Survey to be sent out)Benefits Committee Where do we go from here? Open enrollment this fall Other Benefits (Survey to be sent out) Leave Incentives Other iNGAGED HEALTH

29 2014-2015 Benefits Committee How are we doing?Have we accomplished our goal for this meeting? Financial update Review of benefits for 2015 What’s new for 2015? Review of medical plan parameters Overview of Pharmacy & Clinical Programs Questions? Concerns? Feedback? Next meeting: Benefits Committee – October 29, 2014 4:00p.m. Annex

30 Benefits Committee Meetings:Date Time August 20th 4:00 – 6:00 September 24th 4:30 – 6:00 October 29th November 19th January 21st February 25th March 25th April 22nd May 27th