A review of Duke's benefits, coverage and costs for health, dental, vision and reimbursement account benefits for 2015.

1. Duke University & Health System
Open Enrollment for
2015 Benefits
Oct. 27 – Nov. 7, 2014

2. 2
Perception of Benefits at Duke
DUHS Work Culture Survey
I am satisfied with my
benefits.
Difference
from Natl
Health
Care Avg
2014 3.91 +.27
2013 3.86 +.18
2012 3.87 +.18
2011 3.79 +.12
2010 3.75 +.06
2009 3.75 +.09
3.95
3.9
3.85
3.8
3.75
3.7
3.65
3.6
3.55
3.5
AS RELATION TO NATIONAL
PERCENTILE
50th Percentile DUHS Score
2009 2010 2011 2012 2013 2014
2014 Higher Education Insight Survey©
Honor Roll Category - Compensation, Benefits & Work/Life
Balance

3. 3
What’s Your Story?

4. 4
Current Status
• Covered Lives: 63,400
• Cost:
– Total: $248 million
– Net: Duke paid $171 million (minus employee
premiums)
• Experience: Costs lower than national average
– Favorable contract with Duke providers
– DukeWell: disease management
– Rx utilization: generic and mail order

5. 5
Pharmacy Usage Trends
Generic Dispensing Rate

6. 6
Duke’s medical insurance plans
•Duke offers 4 plans:
–Duke Basic (HMO with Triangle network primarily of
Duke physicians)
–Duke Select (HMO with Triangle network primarily of
Duke physicians)
–Blue Care (BCBS HMO with statewide network)
–Duke Options (PPO plan with international network)
Cigna Medical Benefits Abroad provides employer paid
coverage for international business travel of less than
6 months for full-time benefits eligible employees

7. 7
Duke’s medical insurance plans
• Five tiers of coverage
–Employee
–Employee Spouse/Same-Sex Partner
–Employee Child
–Employee Children
– Family

8. 8
Medical insurance premiums
• Premium increases will again be less than the
projected increases nationally
Individual Family
2014 2015 2014 2015
Duke Basic $29 $29 $269 $276
Duke Select $72 $74 $425 $436
Blue Care $128 $132 $569 $589
Duke Options $123 $127 $563 $583

9. 9
What if you had to be hospitalized

10. 10
Tobacco Surcharge
• In 2015, tobacco use surcharge
will increase from $20 to $30
per month for health insurance.
• The surcharge does not apply to
dependents.
• Surcharge will be removed if
employee successfully
completes a tobacco cessation
program.

11. 11
Duke Basic: Reimbursement Account
• Due to IRS regulations, the Duke contribution to the
Health Care Reimbursement Account for those with
family coverage must be reduced.
Coverage 2014 contribution 2015 contribution
Employee $200 $200
Employee + child $300 $300
Employee + children $400 $400
Employee/spouse or
same-sex partner
$400 $400
Family $600 $500

12. 12
Expanded Coverage: Weight Loss
• Some individuals who experience significant
weight loss suffer serious health issues related
to excess skin.
• In 2015, a non-cosmetic procedure to remove
excess skin called a panniculectomy will be
covered when medically necessary.
• Coverage available under Duke Select, Blue
Care, and Duke Options after a $2,500 copay.

13. 13
Open Enrollment for 2015
PHARMACY PLAN

14. 14
Pharmacy Plan
• No increases in co-payments or
deductibles for generic, formulary or non-formulary
drugs (third consecutive year)

15. *The 50% co-pay will also be subject to a min. & max co-pay. Minimum $10 for generics, $55 for brand and
$65 for non-formulary. $Max: $25 for generic, $125 for brand, and $135 for non-formulary.
15
15
Retail pharmacy
Express Scripts Mail
Order or on-site
Duke pharmacies
Up to a 34-day supply Up to a 90-day supply
First 3 purchases of
any medication
After 3rd purchase of
long-term medication
Anytime
Generic (no deductible
except for participants
covered by Duke Basic)
$10 (or cost of drug
if less)
50%*
$20
(or cost of drug if less)
Brand ($100 per person
deductible applies. No
deductible for 90-day supply
through mail order or
participating Duke
pharmacies.)
$40 50%* $100
Non-formulary ($100
per person deductible
applies. No deductible for 90
– day supply through mail
order or participating Duke
pharmacies.)
$55 50%* $138

16. 16
Open Enrollment for 2015
VISION PLAN

17. 17
Duke’s vision plan for 2015
• Materials co-pay: increase from
$15 to $20
• Premium: minor premium increase
Individual
Employee
& Child
Employee &
Children
Employee
&
Spouse/
Partner
Family
$9.66 $18.49 $19.46 $18.50 $29.97

18. 18
Open Enrollment for 2015
DENTAL PLAN

19. PPO $36.86 $38.44 $111.66 $116.46
19
Duke’s Dental Plans for 2015
• PPO Plan: adding a $50 calendar year deductible per
person for major procedures
• Premiums: PPO and Dental Plan A - modest premium
increase, Dental Plan B - no increase
Individual Family
2014 2015 2014 2015
Dental Plan A $39.58 $41.28 $119.89
Dental Plan B $12.18 $12.18 $45.24
$125.05
$45.24

20. 20
Dental Plan A vs. PPO Plan
Sample Cost Savings
Procedure % covered
under plan
Plan A
Your Cost
PPO Plan
Your Cost
Savings
Exam 100% $0 $0 N/A
Cleaning 100% $0 $0 N/A
Filling 80%
90%
100%
$44.01
$32.21
$0
$19.80
$9.90
$0
$24.21
$22.31
N/A
Simple
extraction
80%
90%
100%
$65.47
$51.47
$0
$21.80
$10.90
$0
$43.67
$40.57
N/A
Root canal 65% $682.66 $442.00 $240.66
Crown 50% $572.86 $396.00 $176.86
Example based upon average cost in zip code 27708 at 50% to 75% percentile depending on procedure.

21. 21
Late Entrant
• Late entrant: if you or a dependent are
planning to enroll for 2015 but are not
currently enrolled for dental coverage at Duke
– Only covers two preventive care exams (not
including X-rays), two cleanings, and one fluoride
application (for children under age 19) for the first
12 months
21

22. 22
Open Enrollment for 2015
REIMBURSEMENT ACCOUNTS

23. 23
Save with reimbursement accounts
• Pre-tax savings is about $30-$40 for every $100
of eligible expenses
• Health Care Reimbursement Account
• Dependent Care Reimbursement Account
• The maximum contribution for a health care
reimbursement account is $2,500.
• The maximum for dependent care is $5,000

24. 24
Many ways to save
• WageWorks Health
Care Card
• App for iPhones,
Androids and
Blackberries
• Website
• Paper forms
(fax/mail)

25. 25
Dependent Eligibility Audit
• In 2015, Duke will conduct a dependent eligibility
verification audit.
• One of the ways that Duke can ensure
compliance with federal regulations and help
manage the increasing cost of health care is by
ensuring that only eligible dependents are
enrolled in its plans.
• All employees are encouraged to review the
criteria to ensure that only eligible dependents
are covered.

26. 26
Social Security Numbers
for Dependents
• As part of compliance with Affordable Care Act,
Duke must ask all employees to confirm or
provide Social Security numbers for enrolled
dependents.
• Can review or add dependent Social Security
numbers through the enrollment process on the
Duke@Work self-service website or by calling the
Open Enrollment Service Center at 1-919-684-
5600.

27. 27
Open Enrollment for 2015
LOOKING AHEAD

28. 28

29. 29
Decision: Pay or Play?

30. 30
Summary for 2015
• Modest premium increases, less than national average
• Expanded coverage for excess skin removal due to
weight-loss
• Minor increase in dental premiums for Plan A and PPO,
$50 annual deductible for PPO for major procedures.
• Minor increase for vision premiums, materials co-pay
• $10 increase in surcharge for tobacco users
• Dependent eligibility audit
• Continue assessing potential changes for 2016

31. 31
Open enrollment: Oct. 27 - Nov. 7
1. Enroll online
through the
Duke@Work
Self-Service
website
Or
2. By phone at
919-684-5600
hr.duke.edu/selfservice

32. 32
What’s next?
When What
Sept. 10 HR Forum: overview
Oct. 7 HR Forum: details changes for 2015
Oct. 8 Guide: Print guide mailed home.
Oct. 8 Manager Memo/Presentation: Open enrollment
changes for 2015 benefits
Oct. 13 Article: Open enrollment for 2015 benefits
Oct. 27 Open Enrollment Period Begins
Oct. 27 Email: Open enrollment period begins
Nov. 4 Article: Reminder about deadline
Nov. 6 Email: Reminder about deadline
Nov. 7 Open Enrollment Period Ends

33. Duke University & Health System
Questions?
Open Enrollment for 2015