An overview of the enrollment options for 2017 benefits at Duke University and Duke University Health System.

1. Duke University & Health System
Oct. 24 – Nov. 4, 2016
Open Enrollment for 2017
Benefits

2. 2
Duke’s medical insurance plans
Duke offers 4 plans:
–Duke Basic (HMO administered by Aetna with Triangle
network primarily of Duke physicians)
–Duke Select (HMO administered by Aetna with Triangle
network primarily of Duke physicians)
–Blue Care (BCBS HMO with statewide network)
–Duke Options (BCBS PPO plan with international
network)

3. 3
Duke’s medical insurance plans
Five tiers of coverage
–Employee
–Employee & Spouse
–Employee & Child
–Employee & Children
–Family

4. 4
Medical insurance premiums
• Premium increases will again be less than the
projected increases nationally
$648$606$141$132Duke Options
$656$613$147$137Blue Care
$461$445$78$75Duke Select
$292$282$31$30Duke Basic
2017201620172016
FamilyIndividual

5. 5
What if you had to be hospitalized

6. 6
Medical Plan Changes
• Coventry is now Aetna, and new member ID cards for January
• Inpatient hospitalization copay increase:
– From $450 to $600 for Duke Select, Blue Care, and Duke Options at Duke hospitals
– Options and Blue Care copay for non-Duke In-Network hospitals will move to $700, Out-of-
Network hospitals under Options will move to $900.
• Outpatient Surgery copay increase from $200 to $250 for Duke Select and Blue Care
• Out-of-Network annual deductible for Duke Options:
– from $500 to $650 for individuals, and from $1,500 to $1,950 for family
• Duke Options Out-of-Network coinsurance maximum:
– from $3,000 to $4,000 for an individual and from $9,000 to $12,000 for family
• Specialty Drug dispensing limited to Accredo (Express Scripts) or Duke Pharmacies
unless medication is required immediately
• Coverage added to Duke Options for ABA Therapy (Applied Behavioral Analysis) an
intensive, early intervention program for children with Autism Spectrum Disorder
when medically necessary and by a certified provider.
– Details on www.hr.duke.edu
• Dollar maximum for transgender surgery will be eliminated from Duke Options

7. 7
Tobacco Surcharge
• In 2017, tobacco use surcharge
will increase from $40 to $50
per month for health insurance
• The surcharge does not apply to
dependents
• Surcharge will be removed if
employee successfully
completes a tobacco cessation
program available at no charge
through Live for Life

8. 8
PHARMACY PLAN
Open Enrollment for 2017

9. 9
Pharmacy Usage Trends
Each 1% increase in Generic Dispensing Rate = reduces plan costs $1m

10. 10
*Participants in the Duke Basic plan have a $100 deductible for all prescription drugs, including generic, mail order and on-
site Duke Pharmacies.
Retail pharmacy
Express Scripts Mail
order or on-site Duke
Pharmacy
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)* $15
(or cost of drug if
less)
50%*
Min. $15, Max. $30
(or cost of drug if less)
$25
(or cost of drug if less)
Brand ($100 per person annual
deductible applies. No deductible
for mail order or on-site Duke
pharmacies.)*
$50
50%*
Min. $70, Max. $165
$130
Non-formulary ($100 per
person annual deductible applies.
No deductible for mail order or
on-site Duke pharmacies.)*
$70
50%*
Min. $85, Max. $180
$180

11. 11
Pharmacy Plan
• Increase in co-pays (up to 34 day supply) for:
• Generic from $10 to $15 for up to 34-day supply
• Formulary drugs by from $45 to $50
• Non-formulary drugs from $65 to $70
• Increases in Mail Order 90-day supply* co-pays for:
• Generic from $20 to $25
• Brand from $120 to $130
• Non-Formulary from $155 to $180
*obtained via mail order or on-site Duke Pharmacies
• Specialty medications available through Duke Pharmacy or Accredo only,
unless STAT medication

12. 12
VISION PLAN
Open Enrollment for 2017

13. 13
Duke’s vision plan for 2017
Individual
Employee
& Child
Employee &
Children
Employee
&
Spouse
Family
$9.66 $18.49 $19.46 $18.50 $29.97
• No changes to premiums for 2017
• Increase in frame allowance from $130 to
$150 once every 24 months

14. 14
DENTAL PLAN
Open Enrollment for 2017

15. 15
Dental Premiums for 2017
• PPO Plan: Modest increase in premium
• Dental Plan A: Modest increase in premium
• Dental Plan B: No premium increase
Individual Family
2016 2017 2016 2017
PPO $38.44 $39.21 $116.46 $118.79
Dental Plan A $42.11 $44.13 $127.55 $133.67
Dental Plan B $12.18 $12.18 $45.24 $45.24

16. 16
Dental Late Entrant
• If you or a dependent are planning to enroll
for 2017 but are not currently enrolled for
dental coverage at Duke
– Coverage will only include two preventive care
exams (not including X-rays), two cleanings, and
one fluoride application (for children under age
19) for the first 12 months

17. 17
REIMBURSEMENT ACCOUNTS
Open Enrollment for 2017

18. 18
Save with reimbursement accounts
• Pre-tax savings is about 30 percent of every dollar you put
in the accounts
• Health Care Reimbursement Account: $2,550 maximum
• Health Care Reimbursement Account allows for up to $500
to be carried over from one plan year to the next plan year
• Dependent Care Reimbursement Account: $5,000
combined household maximum (carry over not allowed)

19. 19
Managing Your Account
• WageWorks Health
Care Card
• App for iPhones,
Androids and
Blackberries
• Website
• Paper forms
(fax/mail)

20. 20
Summary for 2017
• No increase in co-pay for Primary Care Physician (PCP) or
Specialist office visit
• Moderate premium increase for health plan, significantly less
than national average
• Modest increase in pharmacy co-pays
• Increase in inpatient admission and outpatient surgery copays
• No premium increases to vision
• No premium increases to Dental Plan B, moderate increase to
Dental Plan A and Dental PPO

21. 21
Open enrollment: Oct. 24 - Nov. 4
1. Enroll online
through the
Duke@Work
Self-Service
website
Or
2. By phone at
919-684-5600

22. 22
What’s next?
When What
Sep 13 HR Forum
Oct. 3 Manager Memo/Presentation: Open enrollment
changes for 2017 benefits
Oct. 6 Guide: Print guide mailed home.
Oct. 10 Article: Open enrollment for 2017 benefits
Oct. 24 Open Enrollment Period Begins
Oct. 24 Email: Open enrollment period begins
Oct. 31 Article: Reminder about deadline
Nov. 3 Email: Reminder about deadline
Nov. 4 Open Enrollment Period Ends

23. Duke University & Health System
Questions?