EXHIBIT A - 2015MED_PHAR_BH PLANDESIGNRECOMMENDATIONS_12_05_2014.DOCX

Exhibit A
Medical Plans
Proposed changes to the Cigna HMO are as follows:
 Discontinue alternative medicine benefits (naturopathic, acupuncture, biofeedback,
etc), and transition members to discount programs available for alternative
medicine through the health plans.
 Allow eligible, in-network Mental Health/Substance Abuse member out-of-pocket
expenses (e.g.; copays, coinsurance and deductibles) to accumulate under one
combined Medical In-Network Out-of-Pocket Maximum.
Proposed changes to the UnitedHealthcare PPO are as follows:
 Discontinue alternative medicine benefits (naturopathic, acupuncture, biofeedback,
etc), and transition members to discount programs available for alternative
medicine through the health plans.
 Change Out-of-Network coinsurance percentage from 70/30 to 50/50, resulting in
the Plan and the employee paying 50% of the cost for Out-of-Network services.
 Allow eligible, in-network Mental Health/Substance Abuse member out-of-pocket
expenses (e.g.; copays, coinsurance and deductibles) to accumulate under one
combined Medical In-Network Out-of-Pocket Maximum.
Proposed changes to the UnitedHealthcare HDHP with a Health Savings Account are as follows:
 Discontinue alternative medicine benefits (naturopathic, acupuncture, biofeedback,
etc), and transition members to discount programs available for alternative
medicine through the health plans.
 Change Out-of-Network coinsurance percentage from 70/30 to 50/50, resulting in
the Plan and the employee paying 50% of the cost for Out-of-Network services.
 Allow eligible, in-network Mental Health/Substance Abuse member out-of-pocket
expenses (e.g.; copays, coinsurance and deductibles) to accumulate under one
combined Medical In-Network Out-of-Pocket Maximum.
 Increase Deductibles (In-Network):
From $1,250 to $1,500 (Individual)
 From $2,500 to $3,000 (Family)
 Increase Deductibles (Out-of-Network):
From $2,500 to $3,000 (Individual)

From $5,000 to $6,000 (Family)
 Increase Annual Out-of-Pocket Maximums (In- Network):
From $2,000 to $3,000 (Individual)
From $4,000 to $6,000 (Family)
 Increase Annual Out-of-Pocket Maximums (Out-of-Network):
From $4,000 to $6,000 (Individual)
From $8,000 to $12,000 (Family)
 Increase HSA contribution limits (required by IRS):
From $3,300 to $3,350 (Individual)
From $6,550 to $6,650 (Family)
Pharmacy Plans
Proposed changes to the Catamaran Co-insurance Pharmacy Plan for those enrolled in the Cigna
HMO or the UnitedHealthcare PPO are as follows:
 Change coinsurance percentages
Generic mail order (90 day) - from 15% to 25%
Preferred brand retail 30 – from 30% to 25%
Preferred brand retail 90 – from 30% to 25%
Specialty Preferred brand mail order (30 day) – from $100 copay to 25%
Specialty Non-Preferred brand mail order (30 day) – from $100 copay to 50%
 Eliminate $100 copay on Specialty Preferred and Non-Preferred brand (30 day)
 Eliminate minimum coinsurance on applicable prescription tier levels
 Increase maximum coinsurance amounts on all prescription tier levels:
Generic retail 30 – from $12 to $18
Generic retail 90 – from $36 to $54
Generic mail order (90 day) – from $28 to $42
Preferred brand retail 30 – from $40 to $60
Preferred brand retail 90 – from $120 to $180
Preferred brand mail order (90) – from $70 to $105
Non-Preferred brand retail 30 – from no max to $110
Non-Preferred brand retail 90 – from no max to $330
Non-Preferred brand mail order (90 day) – from no max to $275
Specialty Preferred brand mail order (30 day) – from $100 copay to $105 max
Specialty Non-Preferred brand mail order (30 day) – from $100 copay to
$275 max

Behavioral Health Plans
Proposed changes to the United Behavioral Health Plan for those enrolled in the
UnitedHealthcare HDHP with Health Savings Account are as follows:
 Provide coverage for autism spectrum disorders along with the Applied Behavioral
Analysis (ABA)
 Continue to “Opt Out” of Mental Health Parity
Proposed changes to the Magellan Health Services Behavioral Health Plan for those enrolled in
the Cigna HMO or the UnitedHealthcare PPO are as follows:
 Eliminate coaching/counseling through Magellan Health Services for bariatric
surgery candidates
 Continue to “Opt Out” of Mental Health Parity
 Allow eligible, in-network Mental Health/Substance Abuse member out-of-pocket
expenses (e.g.; copays, coinsurance and deductibles) to accumulate under one
combined Medical In-Network Out-of-Pocket Maximum.