TABLE OF CONTENTS - Baptist Health Health Benefits Guide | 3 BAPTIST HEALTH AND THE HATCHER AGENCY...

17 Core Term Life and AD&D Insurance and Dependent Life Insurance

18 Optional Accidental Death & Dismemberment (AD&D)

19 Vision Coverage

20 Flexible Spending Accounts

24 Additional Voluntary Benefits - 5 Star Term to 100 Life Insurance - Cancer Insurance - Accident Insurance - Interest-sensitive Whole Life Insurance - Group Critical Illness Insurance - Long Term Care Insurance

29 Additional Value Added Benefits - Employee Assistance Program - Group Auto and Home Insurance - VPI-Pet Insurance - Hyatt Legal Services

31 Baptist Health Retirement Savings Plan

33 InvestMap

33 Morningstar

34 Other Valuable Benefits - Personal Time Off Accrual (PTO) - Tuition Reimbursement - Make Breastfeeding Work

15 Important Contacts

TABLE OF CONTENTS2 Letter from Human Resources - All Benefit Eligible New Hires or Newly Eligible Employees

3 Hatcher Agency Contact information

4 Introduction

4 What is the Difference between Pre-tax and After-tax Deductions

5 Your Benefits Overview

6 Enrollment Worksheet

7 Employee Eligibility

7 Auto Enrollment

7 Dependent Eligibility

8 Changing Your Elections

9 Health Insurance - Health Advantage

10 Health Insurance - Baptist Health Physician Partners BHPP

10 Plan Overview: Baptist Health Physician Partners (BHPP) and Health Advantage Baptist Plan

12 Value Formulary Drug Plan

13 Member Savings Mail Order Program

15 Dental Insurance

16 Short Term Disability Insurance

17 Long Term Disability Insurance

WELCOME TO BAPTIST’S BENEFITS ENROLLMENT“ATTENTION: All Benefit Eligible New Hires or Newly Eligible Employees”

2 | Baptist Health Benefits Guide

Welcome! We are excited to have you as part of the Baptist Health family, and we are here to help answer any questions you might have. Enclosed you will find the benefits you are eligible to receive. In order to educate you about your benefits and to make enrollment as easy as possible, we have teamed with The Hatcher Agency and Benefit Communications Inc. (BCI). This letter will gives instructions and recommendations on how to enroll in your benefits. Your benefit elections are time sensitive; please do not delay in enrolling.Auto Enroll: Baptist Health provides benefits based on your employment status. Please enroll for benefits within your first 30 days of eligibility. If you do not enroll within 30 days, you will automatically be enrolled in medical coverage (employee only), 1x basic life (if eligible .75-1.0 FTE), STD, LTD, and Dental (Basic) if eligible.To Enroll:1. Gather dates of birth and Social Security

numbers for you and your dependents, along with address information for your beneficiaries.

2. Choose a PCP (Primary Care Physician) from the Health Advantage Website. a. Visit www.healthadvantage-hmo.com b. Click FIND A DOCTOR c. Scroll down to SEARCH A NETWORK OR PLAN d. Click on BAPTIST HEALTH EMPLOYEES/ DEPENDENTS/RETIREES. Click START SEARCH e. When you find your PCP, click on PROFILE then PRACTICE DETAILS. Write down the NPI NUMBER for yourself and each covered dependent.

3. Call the Employee Benefit Enrollment center at 501-202-2176 between 8 a.m. and 5 p.m., Monday through Friday, to review and enroll in your benefits.

You only have 30 days from date of hire or change of status to enroll.

Now that you have the above information, you can begin.

Please be aware that in order to keep employee and employer benefits cost down, Baptist Health has teamed with BCI to do dependent verification. This is a process to ensure that only eligible dependents are covered on our insurance plans. If verification is not done, thousands of dollars a year could be spent paying claims for dependents who are not eligible. Therefore, please be prepared to supply the following dependent information within 30 days of the day you enroll in the benefits:1. A copy of marriage certificate – our plan only

covers a spouse. Spouse means a participant of the opposite sex who is the husband or wife of an employee as a result of a marriage that is legally recognized in the State of Arkansas.

2. Birth certificates, adoption or legal guardianship paperwork – in order to cover your dependent child(ren).

3. A copy of your most recent tax return (first page only) would also serve as proof of your dependents.

These items can be sent via secure fax to 615-750-8669 or mailed to: Benefit Communications Inc., 2977 Sidco Drive, Nashville, TN 37204.Once you have completed your benefits enrollment, you can expect your health, dental and vision membership cards in approximately 30 days.Please refer to EmployeeNet for a listing of Human Resources and Benefit contacts, or email [email protected] to get benefit questions answered in the future. Also, check out the Human Resources page on EmployeeNet or visit the Employee Resource Center on your campus.Thank you.

PLEASE NOTE: Your enrollment will not be complete if you do not enroll through the Employee Benefit Enrollment Center.

*To enroll in Long Term Care call 800-359-3748 and ask for a Baptist Representative.

Baptist Health Benefits Guide | 3

BAPTIST HEALTH AND THE HATCHER AGENCY HAVE TEAMED UP TO PROVIDE YOU WITH “OUTRAGEOUS SERVICE”!

Baptist Health welcomes a new onsite Employee Benefits Enrollment Center to facilitate all of your benefit needs. The Hatcher Agency, known for their “Outrageous Service”, will conduct enrollments, discuss benefit plans and options, and answer questions to assist you in making the most informed benefits decisions possible for you and your families. The new Employee Benefits Enrollment Center is located on the ground floor, across from the Credit Union, near the Human Resources department.

Open to serve you from the hours of 8:00am to 5:00pm Monday through Friday.You are also welcome to call 501-202-2176 for benefit assistance during normal center operating hours.If you are a new hire, we would love to go over all of your benefits in detail and help you enroll. Please let us know if you would like to set an appointment. Please don’t hesitate to contact us with any and all of your benefit needs and questions - we are happy to serve you and look forward to providing each of you with “Outrageous Service”!

INTRODUCTIONBecause you play such a critical role in our success, Baptist Health provides you with the resources to protect and care for you and your family. One of the most important and valuable resources is your Personal Benefits Plan.

Your Personal Benefits Plan includes the following:

Medical, Dental and Vision Coverage

Who can be covered:

Employee OnlyEmployee & Child(ren)Employee & SpouseEmployee & Family

Core Term Life/AD&D Insurance, Short Term Disability and Long Term Disability Insurance

Who can be covered:

Employee only

5 Star Life - Term to 100, Supplemental Life Insurance, Supplemental AD&D Insurance, Accident Insurance, Cancer Insurance, Group Critical Illness,

Whole Life Insurance and Long Term Care

Who can be covered:

Employee andEligible Dependents

Your company-provided benefits are there for you day in and day out. They help to keep you healthy, secure and can give you peace of mind. We hope you will find this benefit booklet to be a helpful tool as you make your benefit choices. Review it carefully as it gives specific information about each of the benefits available to you.

WHAT IS THE DIFFERENCE BETWEEN PRE-TAX AND AFTER-TAX DEDUCTIONS?Pre-tax deductions are taken from your gross wages BEFORE taxes (federal income, Social Security/Medicare, etc.) have been calculated. With pre-tax deductions, you are essentially lowering your current taxable income. For example, if you earn $40,000 per year and your pre-tax health insurance deductions total $2,000 per year, you will pay taxes on $38,000 – not $40,000.On the other hand, after-tax deductions are taken from your gross wages AFTER taxes have been calculated. In the same example as used above, if you earn $40,000 per year and your after-tax health insurance deductions total $2,000 per year, you will pay taxes on $40,000.

“Your company-provided benefits keep you healthy, secure and can give you

peace of mind.”


YOUR BENEFITS OVERVIEWWe offer you coverage in several categories. Your benefits package includes:

Benefits Funding Coverage OptionsMedical administered byHealth Advantage

Baptist Health/Employee

• Provides benefits for office visits, preventive care, prescription drugs, and hospital services

Dental administered by Delta Dental of Arkansas

Baptist Health/Employee

• Provides benefits for preventive services, restorative care, periodontics, root canals and x-rays, including orthodontia coverage for children

Group Short Term Disability Insurance administered by Principal

Employee• Benefit can pay 60% of your pre-disability earnings up to $2,500

per week• Benefits begin to accrue after 14 days of disability due to an

accident or illness; benefit period is up to 24 weeks

Group Long Term Disability Insurance administered by Principal

Baptist Health (Full-time)Employee (Part-time)

• Benefit can pay 60% of pre-disability earnings to a maximum of *$15,000 per month; benefit begins after 180 consecutive days of disability *For those who qualify

Core Term Life / AD&D Insurance administered by Principal

1 times annual salary paid by Baptist Health

(Full-time)Employee (Part-time)

• Benefit of 1x annual base salary; see pg. 17 for more details

Supplemental Term Life / AD&D Insurance administered by Principal

Employee• Optional Buy-Up Guaranteed Issue, not to exceed $500,000 or 3x

annual salary• Benefit of up to $1.1 million available (with underwriting approval)

Dependent Life Insurance administered by Principal Employee • Benefits may be purchased for your spouse or children

• You choose who will receive benefits and how much

Optional AD&D Insurance administered by Principal Employee

• Voluntary coverage can pay a specific dollar amount for accidental death and dismemberment

• Family coverage also availableVision administered by Delta Vision Avesis Network Employee • Provides benefits for eye exams, lenses, frames, and/or contacts

Health Flexible Spending Account administered by DataPath Employee

• Medical expenses are paid using a mySource Card (a debit card for your own Flexible Spending Account); $2,500 limit

• Funds on current mySource Cards must be exhausted by February 28, 2015

Dependent Care Assistance administered by DataPath Employee • Account lets you set aside tax-free dollars to pay expenses for

your dependents (i.e. day care, elder care); $5,000 limitBaptist Health Retirement Savings Plan administered by Milliman Inc.

Baptist Health/Employee • Start saving now for your future

Employee Assistance Plan (EAP) administered by Southwest Baptist Health

• 24/7 services available to help you and your family with day-to-day issues

• These services are confidential and freeCancer Insurance administered by Guardian Employee • Pays directly to the insured

Accident Insurance administered by Unum Employee • Policy pays directly to insured in addition to other coverages

Interest Sensitive Whole Life Insurance administered by Unum Employee • Permanent, portable life insurance

• Insure family members even if you don’t participateCritical Illness administered by Unum Employee • Pays lump sum directly to insured

• Family coverage availableLong Term Care Insurance administered by Unum Employee • Protect your assets and savings in the event you need long term care

To enroll in the benefits below, call MetLife at 800-GetMet8 Pet insurance administered by MetLife Employee • Purchase insurance for your pet to help cover medical expenses

Group Auto and Home insurance administered by MetLife Employee • Discounts and convenient payroll deduction for coverage you’re

already spending money onGroup Legal Service administered by Hyatt Legal Services Employee • Legal services and representation on a wide range of covered

services with access to over 10,000 Plan Attorneys nationwide


ENROLLMENT WORKSHEETBenefit Deductions Per Pay Period (26) Notes Continuation

of Coverage

Health (pre-tax) — pg. 9 Employee Only

Employee + Child(ren)

Employee + Spouse

Employee + Family Child: benefits up to age

26 - Auto Enroll/See page 7 for details.

Continuation of Coverage -

COBRA A. Health Advantage 450 (.75 - 1.0) $34.94 $68.87 $89.73 $137.58

B. Part-time (.50 - .738 FTE) $38.44 $75.75 $98.71 $151.33

Dental (pre-tax) — pg. 15 Employee Only


Employee + Spouse

Employee + Family

Child: Benefits up to age 26 if unmarried and eligible under IRS Guidelines. Student status is not required. Auto Enroll/See page 7 for details.


COBRA A. Delta Plus $3.01 $23.15 $16.30 $27.97

B. Delta Basic $1.56 $9.05 $5.46 $11.18

Short Term Disability (STD) (after-tax) — pg. 16

60% of base paySee chart on page

16

Maximum Available Benefit is $2,500/wk. Refer to salary; does not pay with Workers’ Compensation; no pre-existing if you

sign up at initial enrollment; off work 14 days through 24 weeks.

Auto Enroll/See page 7 for details.

NO Continuation of Coverage

Long Term Disability (LTD) (after-tax) — pg. 17

60% of base payEmployer paid for full-time

Maximum available benefit = $15,000 per month

Charge if part-time employee

NO Continuation of Coverage

Employee Core Life & AD&D* (post-tax) — pg. 17

A. 3 times pay (Additional) #136,000 $5.08* *Estimate *FOR ILLUSTRATION PURPOSES ONLYD=Charge if part-time employee

# = Requires medical questionnaireMaximum benefit = $500,000 Guarantee Issue

$1.1 million available with underwriting approvalAuto Enroll/See page 7 for details.

Conversion (after the

Continuation of Coverage)

B. 2 times pay (Additional) #102,000 $3.39* *Estimate

C. 1 times pay (Additional) # 68,000 $1.69* *Estimate

D. 1 times pay (Basic) 34,000 $0.00* *Estimate

Dependent Life Insurance (after-tax) — pg. 17

$12,000 $10,000 $8,000 $6,000See page 17 for details.Child benefit up to age 26; student status not required.

NO Continuation of Coverage$3.33 $2.77 $2.22 $1.66

Optional AD&D (pre-tax)—pg. 18 $250,000 $200,000 $150,000 $100,000 $50,000

Employee Only $3.23 $2.58 $1.94 $1.29 $0.65 See page18 for plan pay-out information.

NO Continuation of Coverage Employee + Family $5.54 $4.43 $3.32 $2.22 $1.11

DeltaVision Avesis (pre-tax) — pg. 19 Employee Only


Employee + Spouse

Employee + Family

Child: Benefits up to age 26 if unmarried and eligible under IRS Guidelines. Student status is not required.


COBRA$4.96 $8.80 $8.98 $14.64

5 Star Term to 100 Life Insurance (after-tax) — pg. 24 Rates are determined by your age and the amount of coverage chosen.


Direct Bill

Cancer Insurance (pre-tax) — pg. 24 Employee Only Employee + Family Child: Benefits up to age 26


Direct Bill Cancer/Dread Disease/ICU $13.05 $23.60

Accident Insurance (after-tax) — pg. 26Employee

OnlyEmployee

+ Child(ren)Employee + Spouse

Employee + Family Child: Benefits up to age

26 if unmarried.


Direct Bill$7.37 $13.76 $11.92 $18.31

Interest-sensitive Whole Life Insurance (after-tax) — pg. 26

Rates are determined by your age, amount of coverage chosen and possibly tobacco use


Direct BillGroup Critical Illness (after-tax) — pg. 27

Long Term Care Insurance (after-tax) — pg. 28

* All deductions are bi-weekly (26 pay periods per year) 6 | Baptist Health Benefits Guide


EMPLOYEE ELIGIBILITY

Baptist Health provides benefits based on your employment status. Please enroll for benefits within your first 30 days of eligibility. Employees who are .5 FTE or higher are eligible for benefits.

AUTO ENROLLMENT

If you do not enroll within 30 days of eligibility you will automatically be enrolled in medical coverage employee only, 1x basic life (if eligible .75 - 1.0 FTE), STD, LTD, and Dental Basic if eligible. If you are auto enrolled, you will not be allowed to make changes to these elections until open enrollment or unless you have a qualifying event or submit a status change form documenting proof of medical insurance coverage within 30 days (with documentation attached). Benefits will be reviewed at BEST Orientation for new hires and Benefit Counselors will also explain coverage.

DEPENDENT ELIGIBILITYHealth � Your lawful spouse – Spouse means a

participant of the opposite sex who is the husband or wife of an employee as a result of a marriage that is legally recognized in the State of Arkansas

� Your dependent children – up to age 26**� Following are important notes concerning

eligible children:— A foster child is ineligible — A grandchild may be covered

- if child lives in a legal parent-child relationship with the subscriber (employee), the subscriber (employee) has a legal right to claim the child as a dependent on his/her federal income tax return, and is required to provide the first page of tax return - the subscriber (employee) has been appointed legal guardian of the child

Dental and Vision All above requirements except for dependent children� Your dependent children – up to age 26;

however, they must be unmarried and you are able to claim them on your federal income tax return

**To age 26 –

Employees’ dependents are eligible for health insurance on the Baptist Health Plan up to age 26 unless they are eligible for any other employer-sponsored plan - regardless of student status, married or unmarried, or whether or not you can claim them on your federal income tax return.

CHANGING YOUR ELECTIONSBaptist Health follows IRS guidelines for our Section 125 plan. Be sure to consider your choices carefully before you make benefit elections during the open enrollment period or at time of hire. Once you make your elections, they will remain in effect until the next open enrollment period, unless you have a qualified “change in status” during the year. Appropriate documentation is required for any change in status. Examples of qualified status changes include:� Change in marital status – marriage, death of

spouse, divorce, legal separation, or annulment� Change in number of dependents – birth, death,

or adoption of a child, or placement of a child for adoption

� Change in employment status – commencement or termination of employment, commencement or return from an unpaid leave of absence, or any of these events that may apply to the employee, the employee’s spouse, or the employee’s dependent(s). Note: IRS regulations specify that an employee must actually obtain coverage under the spouse’s or dependent’s plan for the election change to be consistent. The employee’s certification that he or she either has or will obtain the coverage is not sufficient proof.

� Significant change in coverage – a significant cost increase or reduction in coverage. Under this reason, however, only the election for plan coverage may be changed at mid-year; medical flexible spending accounts (FSAs) may not be changed mid-year on account of changes in cost of coverage.

� A substantial loss of providers available in a network option may be considered a coverage decrease; however, the loss of a single physician from a network where there are other physicians available in the network and in the geographic area covered by the plan would not be considered a coverage decrease.

� When a child is no longer eligible due to age, it is your responsibility to let Human Resources know. Eligibility extends through the end of the month following dependent’s 26th birthday for health insurance (to age 26 for dental and vision insurance).

If such an event occurs, you must make your changes within 30 days of the qualifying event. Proof of the event is needed for most changes to be made. Health Advantage, Delta Dental and Delta Vision status changes will become effective on the first day of the month following the status change depending on the qualifying change. Coverage for newborns (including adoptive children) is effective immediately after status change form is completed and returned to Human Resources. State law allows up to 90 days to add a newborn to your health plan. Benefits end at the end of the month you term.


“Remember, you must make your changes within 30 days of

a qualifying event to your benefit elections.”


HEALTH INSURANCE - HEALTH ADVANTAGE BAPTISTBaptist Health offers health coverage through Health Advantage – Arkansas BlueCross BlueShield’s HMO plan. With this plan, you are required to select a Primary Care Physician (PCP), and you are required to contact your PCP for referrals to specialists (except for in-network OB/GYN visits, routine mammogram, or routine eye exams). It is important to note that there is no out-of-network coverage. You must seek medical care from a Baptist Health Physician Partners (BHPP) network provider (see page 10 for more details) or Health Advantage network provider.A special note about the Health Advantage - Baptist is a self-insured employer; this not only means that the hospital pays your eligible medical expenses, but it also makes our employees exempt from the Any Willing Provider law enacted in 2005. Our provider network differs from other Health Advantage contracts. Other traditional HMOs (not self-insured) have open network directories unavailable to Baptist Health employees.Being knowledgeable about your network and coverage can save you hundreds of dollars:� Contact Health Advantage at 800-843-1329 or

501-378-2363 to confirm your Health Advantage coverage. Be sure to have your ID card available when you call.

� Contact the Baptist Health HealthLine at 227-8478 (B-A-P-T-I-S-T) OR 888-227-8478 (888-B-A-P-T-I-S-T) for assistance in selecting your network providers.

� Go online at www.healthadvantage-hmo.com, click on “Members” then “Find a Doctor,” and scroll to “Baptist Health Employees / Dependents / Retirees” list.

When making appointments for medical services, you may want to ask the following questions:1. Are you in the (BHPP) Network? 2. Can I have my services at a Baptist Health

facility in order to receive the 10% employee discount for me or my eligible family members?

3. Is the provider on staff at Baptist Health or any of the Arkansas in-network hospitals for Baptist Health employees?

4. Do I have a referral in place for my specialist, procedures, physical therapy, etc.?

5. Is my PCP or referred specialist referring me to services in the Baptist Health self insured network?

If the answer is no, you may be denied coverage for your claim. It is the patient’s responsibility to ask questions and ensure that all services or referrals are Baptist Health in-network so that your claims are paid properly. Failure to verify this information can result in additional out-of-pocket expenses for you.See page 10-11 for a brief overview of the Health plan.

Pre-tax

“It is the patient’s responsibility to ask questions and ensure that all services or referrals are Baptist Health in-network so that claims

are paid properly.”

HEALTH INSURANCE - BAPTIST HEALTH PHYSICIAN PARTNERS (BHPP)� Baptist Health Physician Partners: physician managed organization dedicated to improving quality

results, reducing costs, and enlisting physician support for quality initiatives through better collaboration among all points in healthcare delivery — Opportunity for increased savings

� A PCP (Primary Care Physician) must be designated for each covered member� Claims will be denied if a PCP is not designated� PCP must make referral for all Specialist visits and to other PCPs

PLAN OVERVIEW: BAPTIST HEALTH PHYSICIAN PARTNERS (BHPP) & HEALTH ADVANTAGE 450 NETWORKS

Services BHPP In-Network Benefits Health Advantage Baptist In-Network Benefits

Deductible $200 Individual$400 Family

Basic Guidelines

Services must be authorized in advance by the PCP except annual routine visits

gynecological visit, routine mammograms and annual routine vision exam

Services must be authorized in advance by the PCP except annual routine visits

gynecological visit, routine mammograms and annual routine vision exam

Primary Care Physician Office Visits $20 copayment per visit $40 copayment per visitWell Baby Care to 12 Months (with Immunizations) Full coverage (no copayment) Full coverage (no copayment)

Routine Mammograms and PAP Smears

Full coverage (no copayment) for annual routine gynecological visit

Full coverage (no copayment) for annual routine gynecological visit

Medical/Surgical Specialists $45 copayment per visit; 20% coinsurance after copayment

$75 copayment per visit; 30% coinsurance after copayment

Inpatient Hospital Facility $150 copayment per admission plus deductible

Deductible and 30% coinsurance$300 copay

Outpatient Hospital Services Chemotherapy/Radiation Deductible and 30% coinsurance Deductible and 30% coinsurance

Outpatient Diagnostic Services (Lab, X-ray)

Deductible and 30% coinsurance (performed outside PCP’s office) Deductible plus 30% coinsurance

Advanced Outpatient Diagnostic Services 30% coinsurance after deductible 50% coinsurance after deductible

Outpatient Surgery Deductible plus $100 copay Deductible plus $200 copayOutpatient Therapy (Physical, Speech, and Occupational Therapy; Chiropractic Services); Limited to 30 aggregate visits

$10 copayment per visitChiropractic Services: $40 copayment

per visit

$60 copayment per visitChiropractice Services: $40 copayment

per visit

Outpatient Cardiac RehabilitationLimited to 36 visits $10 copayment per visit $60 copayment per visit

All Inpatient Rehabilitative CareLimited to 60 days maximum

$150 copayment after deductible per admission

$300 copayment plus deductible and 30% coinsurance



Services BHPP In-Network Benefits Health Advantage Baptist In-Network Benefits

Mental Health/Substance Abuse Outpatient $45 copayment per visit $75 copayment per visit + 30%

coinsurance

Mental Health/Substance Abuse Inpatient/Partial Hospitalization

Inpatient Hosp. - $150 per admission after deductible; Partial Hosp. - $150 per

admission after deductible

Inpatient Hosp. - $300 per admission, and 30% coinsurance after deductible; Partial Hosp. - $300 per admission, and

30% coinsurance after deductible

Emergency1st visit $150 copayment 2nd visit $200 copayment

after second visit $250 copayment$250 copayment plus 30% coinsurance

Urgent Care $50 copayment $75 copayment

Ambulance for Emergency Transport to HospitalGround - Limited to $1,000/trip; Air limited to $5,000 per trip (one trip per contracted year)

Deductible and 30% coinsurance for airDeductible and 20% coinsurance for

ground

Deductible and 30% coinsurance for airDeductible and 20% coinsurance for

ground

DME/Prosthesis You pay 20% coinsurance You pay 20% coinsurance

Diabetic Management ServicesDiabetic supplies, shoes (per Medicare guidelines) and equipment

20% coinsurance 20% coinsurance

Diabetic Self ManagementDiabetic Self Management Training single visit or multiple visits (one program/lifetime)

$0 per program $0 per program

Vision Routine One exam per calendar year; no referral necessary (Eyewear is not covered)

Full coverage Full coverage

Pharmaceutical Services(See page 12)Mail Order Applies (see pages 13 and 14)

1st Tier (Generic) - $10 copayment2nd Tier (Generic) - $15 copayment

Retail Brand) - $45 copayment(Non Preferred Brand) - $70

Specialty Drugs - $100

Pre-existing Conditions None None

Annual Maximum Coinsurance Individual - $3,500; Family - $6,000

Lifetime Maximum Coverage Unlimited Lifetime Unlimited Lifetime

This summary is a brief outline of the services covered by Health Advantage. After you enroll, you will be mailed a new member kit that completely describes the benefits, limitations, and exclusions under this plan. In the event of any inconsistency between the Summary and the Evidence of Coverage and any riders, the Evidence of Coverage and riders will prevail.

VALUE FORMULARY DRUG PLAN (STEP THERAPY)


The Value Formulary is a low-cost formulary alternative that emphasizes the use of generic medications. The coverage list is focused on generics as the first line of prescribing. It also includes select brands in specific therapeutic classes.Tier 1 Includes all generics covered.Tier 2 Includes a limited number of brand-

name products in the preferred brand copayment. These are included to augment the generics available.

Tier 3 Includes all other single-source brands covered at the non-preferred brand copayment.

Tier 4 Includes all drugs otherwise considered non-covered. In this tier, the member will pay 100 percent of the copayment, but they will benefit from the network discount available through the drug card.

Specialty drugs may be covered based on plan design. Multisource brand products are those that have a generic equivalent; these products will be in Tier 4.

In selected classes, it is necessary to try a generic drug before a brand-name drug is covered. If you have questions about your pharmacy benefit, please contact Customer Service at the number listed on your pharmacy card.

Step Therapy / No Plan CoverageStep Therapy ensures that members use clinically appropriate drugs in a cost effective manner. Step therapy protocols are based on current medical findings, U.S. Food and Drug Administration (FDA) approved drug labeling and drug costs. No Plan Coverage of a class of drugs is used as a management tool when over-the-counter (OTC) options are available. Prescription products will be in Tier 4. Select brand-name drugs are not covered unless a plan participant tries and has complications using a generic alternative. Drug classes that are subject to Step Therapy, No Plan Coverage and tier differential in the Value Formulary are in the table below.

Therapeutic Class DescriptionBlood Pressure Medications (ACE-Inhibitors / ARBs)

Step Therapy. Step through generic ACE Inhibitor before ARBs or Tekturna. Step through generic ACE Inhibitor/diuretic combination before ARB/diuretic or Tekturna/diuretic combinations.

Cholesterol Medications (Statins) Step Therapy. Step through generic statin before single source brands and single source brand combinations.

BNSAIDs Step Therapy. Step through one generic NSAID before Celebrex; however, Celebrex is allowed if Plavix, warfarin or oral corticosteroid is in current drug profile.

Osteoporosis Step Therapy. Step through generic bisphophonate before single source brand products.Antidepressants (SSRI, SNRI) Step Therapy. Step through generic SSRI or SNRI before single source brands.Anti-Migraine Medications (Triptans) Step Therapy. Step through a generic triptan before a brand product is covered.

Nasal Steroids Step Therapy. Step through a generic nasal steroid before a brand product is covered.Sedative-Hypnotics, onbenzodiazepine Step Therapy. Step through a generic product before a brand product is covered.

Nasal Antihistamines Step Therapy. Step through generic before a single source brand; Generics: azelastine; Formulary Brand: Patanase

Overactive Bladder Step Therapy. Step through generic before a single source brand; Generics: oxybutynin, tolterodine, trospium; Formulary Brand: Enablex, Vesicare, Myrbetriq

Benign Prostatic Hyperplasia (BPH)

Step Therapy. Step through generic before a single source brand; Generics: afluzosin, tamsulosin, doxazosin, terazosin, finasteride; Formulary Brand: Avodart, Rapaflo

Glaucoma Step Therapy. Step through generic before a single source brand; Generics: latanoprost; Formulary Brand: Travatan Z, Zioptan

Lyrica Step Therapy. Step through gabapentin before LyricaVyvanse Step Therapy. Step through generic medication indicated for ADHD before Vyvanse**Short acting beta agonists Step Therapy. Step through Rescue inhalers; ProAir will be the only formulary option in 2015Proton Pump Inhibitors (PPIs) No Plan Coverage. All prescription products are on Tier 4. OTC options are available. Antihistamines No Plan Coverage. All prescription products are on Tier 4. OTC options are available.

**As a result of moving to a new formulary, it is not necessary to add a step to the short acting beta agonist class (rescue inhalers). ProAir will be the only option available on the formulary in this class. The group will still benefit in savings and pricing, because all members will have to change to ProAir. All other rescue inhalers are excluded on the formulary, but will be on tier 4 of the Value Formulary.


MEMBER SAVINGS MAIL ORDER PROGRAMWith prescription utilization and drug costs increasing, it now consumes an even-larger portion of overall medical expenses. To help curb these escalating expenses and provide you with additional cost savings, a mail order program for maintenance prescriptions will be implemented effective January 1, 2015 for all members and their dependents enrolled on the Health Advantage plan.

What are the Benefits of the Mail Order Program?CONVENIENCE:Home delivery for most of your maintenance prescription needs.

SAVINGS:This means a three-month (i.e., 90 day) supply of a drug for two co-payments. This is a savings of one co-payment.

What Prescriptions are Covered?Most maintenance medications that by law require a doctor’s prescription, and are covered under your prescription drug benefit. Certain injectable drugs require prior authorization and need to be obtained through a Specialty Pharmacy. If you have any questions, please call the toll-free Customer Contact Center at 1-800-863-5567 or go to www.healthadvantage-hmo.com.

How does it work?Effective January 1, 2015, all maintenance medications must be filled through the Mail Order Pharmacy Program. Maintenance medications (those taken regularly over an extended period of time) will no longer be dispensed at the retail pharmacy after three (3) fills in 2015.

How do I use the Maintenance Prescription Mail Order Program?1. After 1/1/15, ask your doctor for a prescription.

By law, your prescription provider can only fill your prescription with the quantity indicated. Generally, the maximum mail order benefit is a ninety- day supply at a time.EXAMPLE:1 tablet/capsule a day = 90 tablets/capsules2 tablets/capsules a day = 180 tablets/capsules3 tablets/capsules a day = 270 tablets/capsules

2. Make sure that your full name is on the prescription.3. Complete an order form, which includes a patient

profile questionnaire, and be sure to include your Health Advantage identification number on the order form. An order form can be obtained by calling the Customer Contact Center at 1-800-863-5567 or directly on the Internet at www.healthadvantage-hmo.com. You may also contact the Employee Benefit Enrollment Center at 501-202-2176.

4. Mail the completed order forms, original prescriptions (no photocopies) and your co-payment(s) to the address listed on the form. Mail Order will accept payment by check, money order, or credit card.

Or after 1/1/15, you may simply call the Customer Service Center at 1-800-863-5567 for enrollment in the Mail Order Program. Be ready with your ID card, name of long-term medicine(s), payment method and doctor’s information.

5. Prescriptions will be delivered at no charge to you, most by first-class mail directly to your home. (There is a charge, however, if you choose overnight mail service.) Your medication will arrive in a plain, weather-resistant package, ensuring its safety, security, and privacy. Please allow up to 10 days from the day you mail your order.

6. The Customer Service Center can provide you with additional information on the Program and answer any questions you may have.

“Effective January 1, 2015, all maintenance medications must be filled through the Mail Order

Pharmacy Program.”


Mail Order For Maintenance Drugs Frequently Asked Questions (FAQ)The purpose of this FAQ is to answer questions regarding Baptist Health’s new maintenance drug mail order program.

Q. What is a maintenance drug?A. Maintenance drugs are medications prescribed for chronic, long-term conditions and are taken on a regular, recurring basis. Examples of chronic conditions that may require maintenance drugs are: high blood pressure, high cholesterol, and diabetes.

Q. What is mail-order?A. It is a program that allows members to fill prescriptions and have them delivered to a desired location. Further, you can obtain a ninety (90) day supply for two co-pay amounts. You also have access to Customer Service Center twenty-four (24) hours a day, seven (7) days a week to answer any questions.

Q. How are these mail order prescriptions filled, re-filled and delivered to me?A. You will be provided with all the information explaining how to order and re-fill prescriptions via mail order. It is very easy. Re-fills are done via the telephone or online and may be requested up to 3 weeks prior to your script running out. As for delivery, most drugs are sent via ground delivery. If your drug requires special care (i.e. packing, air shipping or temperature control), it will be provided.

Q. What does mail order cost me?A. Your mail order co-pay is $20.00 or $30.00 for generic drugs, $90.00 for name brand drugs, and $140 for non-preferred drugs. This one co-pay covers a ninety (90) day supply To fill the same drugs retail, you would pay $30.00 or $ 45.00 for generic drugs, $135.00 for name brand drugs, and $210 for non-preferred drugs.

Q. Will everyone on maintenance drugs have to use mail order?A. Yes. As of January 1st, 2015, the program will begin for maintenance medications. After 3 (three) fills from a retail pharmacy, additional refills should be provided from the mail order pharmacy in order to continue coverage of your medication through the pharmacy plan.

Q. What is preferred vs. non-preferred name brand drugs?A. Most health benefit plans utilize formularies to calculate the cost of drugs. There are usually three tiers: (1) Generic; (2) Name-Brand Preferred; and (3) Name-Brand Non-Preferred. Tier 1, generic drugs are the least expensive and name-brand non-preferred are very expensive. That is why most co-pay structures have three (3) tiers, to encourage use of the most cost and clinically effective medications


DENTAL INSURANCE - DELTA DENTAL INSURANCE OF ARKANSAS We recognize that proper dental care improves your overall health, and therefore offer this as part of your benefits package. The Delta Dental of Arkansas plan allows you to see a network (PPO), Premier, or non-network (non-PPO) dentist; however, by using a network dentist you will receive a richer benefit, discounted fees, and the dentist will file all claims with Delta Dental on your behalf.

In order to obtain the deepest discounts and to incur the least amount of out-of-pocket expenses, please choose a dentist from the Delta Dental PPO network of providers. If you are unable to find a dentist from this network that meets your

criteria, you may also choose from the Delta Dental Premier network of providers. You may access both networks by visiting www.deltadentalar.com and select “Find a Provider” icon. You must select a network (Delta Dental PPO or Delta Dental Premier) and create a personalized directory based on your zip code and any other parameters you choose to set (i.e., within a 5-50 mile radius).

To receive greater savings, consult your Delta Dental provider directory to determine if your dentist is PPO (Best), Premier (Standard), or Non-participating. Your dental plan options follow:

Delta Dental of Arkansas

Delta Delta Plus

Preventive Services— Routine examinations limited to twice annually, diagnostic

x-rays – full mouth and panoramic x-rays limited to one in three years, cleaning and polishing twice annually

100%No deductible

100%No deductible

Calendar Year Deductible $50 per covered member $50 per covered member

Basic CareNo Waiting Period— Includes fillings, extractions, root canals, anesthesia, and

specific oral surgery

50%After deductible

75%After deductible

Major Care— Includes crowns, dentures, partial dentures, and dental

implants

50%After deductible

75%After deductible

Orthodontic Benefits— For dependent children to age 19 only; 6-month service

waiting period from effective date of coverage applies to orthodontia benefits

$1,000Lifetime Maximum Benefit

$2,000Lifetime Maximum Benefit

Calendar Year Maximum— Includes routine exams and cleaning $1,000 $2,000

Pre-tax

DISABILITY INCOME PROTECTION - PRINCIPALBaptist Health recognizes the importance of your financial well-being in the event of a disability. Most of us insure our homes, automobiles, and other assets, yet often overlook our most valuable asset – our ability to earn an income. For this reason, we make available this valuable coverage in the event of a short or long term disability. It is important to note that Short Term Disability insurance and Long Term Disability insurance cover employees only.


Short Term Disability Insurance - PrincipalUpon becoming benefits eligible, you will automatically be enrolled in Short Term Disability (pay check insurance). This plan pays 60% of your base salary up to a maximum benefit of $2,500 per week for qualifying non-work related disabilities. Since you pay for this benefit with after-tax dollars, any benefits received are income-tax free. There is a 14-day elimination period, which is the period of time you must remain disabled before benefits begin. You can use your PTO and EIB during the 14-day elimination period before STD benefits begin. Benefits may continue for up to 24 weeks.

If you enrolled in the STD plan when first eligible (at time of hire or benefits eligible), there is no pre-existing condition limitation and coverage is guaranteed issue. Once enrolled you have 30 days to notify Human Resources that you would like to opt out of this coverage. Any employee who chooses to opt out will not be allowed to sign up for this coverage until next year’s open enrollment and then will have a 12-month pre-existing conditions clause.The following chart illustrates sample weekly benefits and pay period deductions for the estimated salaries shown. Your hourly rate is multiplied by the number of authorized hours to calculate your Short Term Disability benefit. Other types of compensation, such as overtime or shift differential, are not included as part of your base pay in determining Short Term Disability benefits.

Examples of Short Term Disability Estimate (rate = $.60 per $100 of benefit)

Annual Salary ESTIMATED Weekly Benefit

ESTIMATED Cost PPD Annual Salary ESTIMATED

Weekly BenefitESTIMATED Cost

PPD$10,000 $115 $3.20 $28,000 $323 $8.95

$11,000 $127 $3.51 $29,000 $335 $9.27

$12,000 $138 $3.83 $30,000 $346 $9.89

$13,000 $150 $4.15 $32,500 $375 $10.38

$14,000 $162 $4.47 $35,000 $404 $11.18

$15,000 $173 $4.79 $37,500 $433 $11.98

$16,000 $185 $5.11 $40,000 $462 $12.78

$17,000 $196 $5.43 $45,000 $519 $14.38

$18,000 $208 $5.75 $50,000 $577 $15.98

$19,000 $219 $6.07 $55,000 $635 $17.57

$20,000 $231 $6.39 $60,000 $692 $19.17

$21,000 $242 $6.71 $65,000 $750 $20.77

$22,000 $254 $7.03 $70,000 $808 $22.37

$23,000 $265 $7.35 $75,000 $865 $23.96

$24,000 $277 $7.67 $80,000 $923 $25.56

$25,000 $288 $7.99 $85,000 $981 $27.16

$26,000 $300 $8.31 $90,000 $1,038 $28.76

$27,000 $312 $8.63

After-tax


Long Term Disability Insurance - PrincipalFor further financial protection, Baptist Health provides Long Term Disability coverage at no cost to full-time employees (part-time employees working .50 - .74 FTE are eligible to purchase the LTD coverage at your expense - after tax). The plan pays 60% of your salary up to a maximum benefit of $15,000 per month. Benefits begin after 180 consecutive days of a covered disability resulting from an injury or sickness. Benefits may continue until age 67 or longer depending upon your age at disability onset and may be reduced by deductible sources of income.

CORE TERM LIFE INSURANCE/ ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) INSURANCE - PRINCIPALLife insurance is an important part of your financial well being, especially if others depend on you for support. Baptist Health pays for a core life/AD&D plan of 1x basic annual base salary for all active, full-time employees who are authorized .75 FTE or higher. Employees authorized .5-.74 may purchase this coverage. You can elect additional employee life coverage options as follows: (A) 1x annual base salary; (B) 2x annual base salary, or (C) 3x annual base salary. There are some special rules regarding your life insurance:� Employees currently enrolled in the plan can

increase one level (up to the non-medical maximum) without providing Evidence of Insurability. Evidence of Insurability will be required for all amounts above the one level increment (i.e., 1x to 3x, 2x to 4x).

� New hires can elect coverage up to 4x annual base income, with a $1.1 million maximum (amounts exceeding $500,000 require Evidence of Insurability).

� For employee elected life, the rates are age banded, meaning they increase every five years based on age.

� The reduction schedule applies to all core term life insurance. The benefit reduces by 50% at age 70.

DEPENDENT LIFE INSURANCE - PRINCIPALAs an optional benefit, Baptist Health offers you an opportunity to purchase a limited level of life insurance at group rates for your legal spouse and eligible children ages 6 months up to 26 years.You can elect dependent spouse and/or child (age 6 months +) life options as follows: (A) $6,000; (B) $8,000; (C) $10,000; (D) $12,000. You are responsible for the entire premium for this coverage. This premium will be paid after taxes.

Delayed Effective Date of Coverage Employee: Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.Dependent: Insurance coverage will be delayed if a dependent is totally disabled on the date that insurance would otherwise be effective. Exception: infants are insured after 6 months.“Totally disabled” means that, as a result of an injury, a sickness or a disorder, your dependent is confined in a hospital or similar institution; is unable to perform two or more activities of daily living (ADLs) because of a physical or mental incapacity resulting from an injury or a sickness; is cognitively impaired; or has a life threatening condition.

After-tax

After-tax

“Remember to notify HR when a dependent is no

longer eligible in order for a deduction to be dropped.”

After-tax

OPTIONAL ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) - PRINCIPALAdditional Accidental Death and Dismemberment (AD&D) coverage is available to you at group rates through Principal. This coverage is optional. Therefore, you are responsible for the premium for this coverage, which will be funded from pre-tax dollars.

Accidental Death and Dismemberment (AD&D) insurance is a benefit that pays in the event of accidental death or dismemberment. Dismemberment refers to the loss of a limb, sight, speech or hearing, etc. Dismemberment benefits are paid to employees at 100 percent, 50 percent, or 25 percent of the insurance value based on the type of loss.

Core Term Life/Accidental Death and Dismemberment (AD&D)Loss of life 100%

Two or more members 100%

Quadriplegia 100%

Loss of speech and hearing of both ears 100%

Paraplegia 100%

Hemiplegia 100%

Loss of one member or speech or hearing of both ears 50%

Loss of hearing of one ear or thumb and index finger of the same hand 25%

Member - refers to hand, foot or eyesightHemiplegia - is total paralysis of both upper and lower limbs on one side of the bodyParaplegia - is total paralysis of both lower limbsQuadriplegia - is total paralysis of both upper and lower limbs

Family Options for Optional AD&D

Employee is insured for 100% of selected amount

— When spouse is added to coverage, spouse amount is equal to 60% of employee amount

— When spouse and child(ren) are added to coverage, spouse is insured for 50% of employee amount and child(ren)* are insured for 15% of employee amount

— When child(ren)* only are added to coverage, they are insured for 25% of employee amount

*Child(ren) Maximum Coverage Amount = $50,000

In the case of dismemberment, you will be the beneficiary of this benefit. The benefit is paid to you based on a combination of your loss. In the case of your accidental death, the benefit will be paid to your beneficiary. Dependents cannot be covered on more than one plan.


Pre-tax

VISION COVERAGE - DELTAVISION AVESIS NETWORKVision benefits are offered through DeltaVision’s Avesis network for you and your eligible family members. With this plan, you can choose any provider, but you will receive maximum benefits by choosing a preferred in-network provider (find providers at www.avesis.com). If elected, you pay 100% of the cost of coverage for yourself and/or family members.

In-Network Vision Benefits Out-of-Network Reimbursement*

Vision Examination — Every 12 months $10 $35

Frame (within Plan Allowance)— Every 12 months

Members receive any frame with an approximate retail value

between $100 - $150 (up to a $50 wholesale allowance). Frames from participating Walmart locations are

covered up to a $68 retail value.

$45

Spectacle Lenses – Every 12 months— Standard Single Vision— Standard Bifocal— Standard Trifocal— Standard Lenticular— Progressive Lenses

— Specialty Lenses

Covered in full after copayment(s)

— Up to 20% off retail, plus a $50 allowance— Up to 20% off retail, plus the corresponding standard lens allowance

$25$40$50$80$40

— Corresponding standard lens reimbursement

Contact Lenses – Every 12 months in lieu of spectacle lenses and frames— Elective (up to Plan Allowance)— Medically Necessary (prior

authorization required)

No copays for contact lenses. Members receive a contact lens allowance of

$150 that can be used for materials and services.

$150$250

Discounted Items (not insured benefits; discounts do not apply to Walmart)— Lens Options— Laser Vision Correction— Additional Purchases

— Up to 20% off on all lens options— 5% - 25% off on laser vision

correction— Up to 20% off on all additional

purchases or items not covered

No discounts available

*All reimbursement amounts listed above are up to the posted dollar amount.

Pre-tax



ADDITIONAL VOLUNTARY BENEFITS 5 Star Term to 100 Life InsuranceThe 5 Star life insurance policy is a term life insurance policy that will stay with you through retirement - all the way to 100! This policy has no benefit reduction once you reach age 65. The policy is portable, which means you can continue coverage should you leave Baptist Health. It can be purchased for you, your spouse and even your children and grandchildren (to age 23 and can be transferred to them at the same rate that the policy was originally purchased). Also, employees are not required to have the policy in order to purchase coverage for other eligible family members.The application process is easy — four simple questions to answer. This plan does not require a medical exam or blood profile, and there is no information about diabetes or smoking history on the application. Upon diagnosis of a terminal illness that will result in a limited life span of less than 12 months, the plan will pay 30% of the policy coverage amount in a lump sum.

Group Cancer Insurance - GuardianGuardian group voluntary coverage provides cash benefits for cancer and 29 specified diseases, and can help cover the costs of specific cancer and specified disease treatments and expenses as they happen. Being diagnosed with cancer or a specified disease can be difficult on anyone both emotionally and financially. Having the right coverage to help when sickness occurs or when undergoing treatments for cancer is important. Our cancer coverage can help provide added financial security when it is needed most. Cancer coverage can help offer peace of mind when a diagnosis of cancer or a specified disease occurs. Below is an example of how benefits might be paid.

Meeting Your NeedsOur cancer coverage can help offer you and your family financial support.� Benefits paid directly to you unless otherwise

assigned� Coverage for you and your entire family� No evidence of insurability required at initial

enrollment+

� Waiver of premium after 90 days of disability due to cancer for as long as your disability lasts*

� Includes coverage for 20 other specified diseases� Portable+Enrolling after your initial enrollment period requires evidence of insurability.

*Primary Insureds only

Benefit Coverage HighlightsCancer and specified disease benefits can help cover the costs of specific treatments and expenses as they happen. Terms and conditions for each benefit will vary. Specified Diseases: Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease), Muscular Dystrophy, Poliomyelitis, Multiple Sclerosis, Encephalitis, Rabies, Tetanus, Tuberculosis, Osteomyelitis, Diptheria, Scarlet Fever, Cerebrospinal Meningitis, Brucellosis, Sickle Cell Anemia, Thallasemia, Rocky Mountain Spotted Fever, Legionnaire’s Disease, Addison’s Disease, Hansen’s Disease, Tularemia, Hepatitis (Chronic B or C), Typhoid Fever, Myasthenia Gravis, Reye’s Syndrome, Primary Sclerosing Cholangitis (Walter Payton’s Disease), Lyme Disease, Systemic Lupus Erythematosus, Cystic Fibrosis, and Primary Biliary Cirrhosis.

Pre-tax

After-tax


These are just some of the benefits� Cancer Initial Diagnosis - Pays a one time benefit if

diagnosed for the first time with cancer (except skin cancer)

� Wellness - Pays each calendar year for one of the following: Biopsy for skin cancer; Blood tests for triglycerides, CA15-3 (breast cancer), CA125 (ovarian cancer), CEA (colon cancer) and PSA (prostate cancer); Bone Marrow Testing, Chest X-ray, Colonoscopy, Doppler screenings for carotids and peripheral vascular disease; Echocardiogram; EKG; Flexible sigmoidoscopy; Hemocult stool analysis; HPV Vaccination; Lipid panel (total cholestorol count; Mammography, including Breast Ultrasound; Pap Smear, including ThinPrep Pap; Serum Protein Electrophoresis (test for myeloma); Stress test on bike or treadmill; Thermography; and Ultrasound screening for abdominal aortic aneurysms.

� Intensive Care benefit - Pays daily for Intensive Care Unit Confinements (up to 45 days for each stay), Step-down Intensive Care Unit Confinements (up to 45 days for each stay) and air or surface ambulance to a hospital intensive care unit.

Limits, Exclusions and Exceptions� Pre-Existing Condition - (a) Guardian does not pay

for a pre-existing condition, during the 12-month period beginning on the date that person’s coverage starts. (b) A pre-existing condition is a disease or condition for which symptoms existed within the 12-month period prior to the effective date, or (c) medical advice or treatment was recommended or received from a medical professional within the 12-month period prior to the effective date. (d) A pre-existing condition can exist even though a diagnosis has not yet been made.

� Cancer and Specified Disease Benefits Exclusions and Limitations - (a) Guardian does not pay for any loss, except for losses due to cancer or a specified disease. (b) Benefits are not paid for conditions caused or aggravated by cancer or a specified disease.

Treatment and Services must be needed due to cancer or a specified and be received in the United States or its territories.

For the Surgery, New or Experimental treatment and Prosthesis benefits, Guardian pays 50% of the applicable maximum when specific charges are not obtainable as proof of loss.

For the Radiation/Chemotherapy for Cancer benefit, Guardian does not pay for: (a) any other chemical substance which may be administered with or in conjunction with radiation/chemotherapy, or (b) treatment planning consultation, management, or the design and construction of treatment devices, or basic radiation dosimetry calculation, or any type of laboratory tests, x-ray or other imaging used for diagnosis or monitoring, or the diagnostic tests related to these treatments, or (c) any devices or supplies including intravenous solutions and needles related to these treatments.

� Intensive Care Benefits Exclusions and Limitations - (a) Benefits are not paid for: (1) attempted suicide or intentional self-inflicted injury, (2) intoxication or being under the influence of drugs not prescribed by a physician, or (3) alcoholism or drug addiction. (b) Benefits are not paid for confinements to a care unit that does not qualify as a hospital intensive care unit including progressive care, subacute intensive care, intermediate care, private rooms with monitoring, step-down and other lesser care units. (c) Benefits are not paid for step-down confinements in the following units: telemetry or surgical recovery rooms, post anesthesia care, progressive care, intermediate care, private monitored rooms, observation units in emergency rooms or outpatient surgery units, beds, wards, or private or semi-private rooms, emergency labor or delivery rooms or other facilities that do not meet the standards for a step-down hospital intensive care unit. (d) Benefits are not paid for continuous intensive care confinements occurring during a hospitalization prior to the effective date. (e) Children born within 10 months of the effective date are not covered for confinement occurring or beginning during the first 30 days of the child’s life. (f) We do not pay for ambulance if paid under the cancer and specified disease ambulance benefit.

Coverage is provided by Limited Benefit Insurance, policy GVCP3 or state variation. The policy has exclusions and limitations. For costs and complete details of coverage, contact your insurance agent.


Accident Insurance - UnumWhile major medical coverage is a significant part of your benefit package, an accident can lead to expenses that may not be covered by medical insurance. Unum’s voluntary accident insurance is designed to help you with uncovered medical costs due to a qualified accident, on and off the job. The plan covers a wide range of injuries and accident-related expenses such as hospitalization, physical therapy, hospital intensive care, transportation and lodging.

Accident InsuranceWhat the Plan Covers

A wide range of on and off-the-job accidental injuries and other covered eventsThe plan is designed to help you pay for high out-of-pocket costs that may not be fully covered by traditional health insurance, such as:�� Copayments for doctor visits�� Emergency room visits� Hospital chargesYou may also cover eligible dependents.

Coverage Examples

Here are a few examples of the benefits provided by this plan:� Emergency Room Treatment - $150� Doctor’s Office Initial Visit - $50�� Hospital Admission - $1,000�� Hospital Confinement - $200/day for up to 365 days�� Hospital Intensive Care Unit - $400/day for up to 15

days

If you leave the company: Coverage is portable—you may take it with you.

Interest-Sensitive Whole Life Insurance - UnumUnum’s interest-sensitive whole life insurance is designed to provide death benefits to your beneficiaries at time of death, but it can also potentially build cash value that you can use as a living benefit. At an affordable guaranteed level premium, you can have the added financial protection you and your family may need during times of uncertainty.

Advantages of the plan� Unum’s interest-sensitive whole life insurance

plan is voluntary, which means you can choose whether or not to purchase coverage and buy only the amount that is right for your needs.

� In addition to providing death benefits, the policy can build cash value, which can be utilized during your working years.

� The policy’s accumulated cash value may also be used to buy a smaller, “paid up” policy on which no further premiums are due.

� Available for employees ages 15-80 who meet the eligibility requirements.

� Coverage for dependents is available.� Optional riders available include children’s term

rider and accidental death benefit rider.� The policy includes a Living Benefit Option as

a basic feature to all employee, spouse and child/grandchild policies. This feature allows the policy owner to request up to 100% of the death benefit, to a maximum of $150,000, if the insured is diagnosed with a medical condition that limits life expectancy to 12 months or less. MAY VARY IN SOME STATES.

� Your employer has elected for you to receive the waiver of premium rider.

Eligible employees must be actively at work to apply for coverage. Being “actively at work” means that on the day you apply for coverage, you are working at one of your company’s business locations, or you are working at a location where you are required to represent your company. If you are applying for coverage on a day that is not one of your scheduled workdays, then you will be considered actively at work if you meet this definition as of your last scheduled workday. You are not considered actively at work if your normal duties are limited or altered due to your health, or if you are on a leave of absence.

This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations, which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form L-21794 or contact your Unum representative.

Unum complies with state civil union and domestic partner laws when applicable.

Underwritten by:Provident Life and Accident Insurance Company1 Fountain Square, Chattanooga, TN 37402unum.comIn New York underwritten by:First Unum Life Insurance Company99 Park Avenue, 6th Floor, New York, NY 10016

©2009 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.

CU-090909 (date) – form number to be supplied by Unum’s Marketing Communications area

After-tax

After-tax


Group Critical Illness Insurance - UnumIf you or someone in your family suffers a serious disease, you can face immediate medical expenses and reduced income from being out of work. Health benefits will pay part of the medical bills and disability income protection coverage will help ensure a continuing income. However, many immediate expenses may not be covered. Unum’s group critical illness insurance can pay a lump sum benefit at the diagnosis of a covered illness. You choose the level of coverage – from $5,000 to $50,000 – and you can use the money any way you see fit.

Here are a few reasons to consider this coverage:1. You can use this coverage more than once. If

you receive a full benefit payout for a covered illness, your coverage can be continued for the remaining covered conditions. The diagnosis of a new covered illness must occur at least 90 days after the most recent diagnosis. Each condition is payable once per lifetime.

2. You get affordable rates when you buy this coverage through the company, and the premiums are conveniently deducted from your paycheck.

3. Coverage is portable. You may take coverage with you if you leave the company or retire without having to answer new health questions. Unum will bill you directly for the same premium amount.

Covered conditions include:� Heart attack � Major organ failure � End-stage renal (kidney) failure � Benign brain tumor� Blindness � Coronary Artery Bypass Surgery (pays 25% of

lump sum benefit)

Covered conditions with time limitations include:� Stroke – evidence of persistent neurological

deficits confirmed by a neurologist at least 30 days after the event

� Coma – coma resulting from severe traumatic brain injury lasting for a period of 14 or more consecutive days

� Permanent paralysis – complete and permanent loss of the use of two or more limbs for continuous 90 days as a result of a covered accident

Recurrence Benefit� Provides an additional payout (25% of original

face amount) for subsequent occurrence of benign brain tumor, coma, heart attack and stroke.

� Date of diagnosis between occurrences of the same condition must be separated by 12 months.

Wellness Benefit Wellness BenefitThis benefit is automatically included in your coverage and can pay $75 per calendar year per insured individual if a covered health screening test is performed, including:� Blood tests � Stress tests � Colonoscopies � Chest x-rays � Mammograms

Group Critical Illness Insurance Dependent OptionsSpouse: With an employee policy, this coverage

is available to eligible spouses ages 16 through 64. Face amounts are available from $5,000 to $30,000 in $1,000 increments.

Children: Children newborn through age 24 are automatically covered at 25% of the employee benefit amount at no additional cost. Eligible children are covered for the same conditions as the employee and the following specific childhood conditions: cerebral palsy, cleft lip or palate, cystic fibrosis, Down syndrome and spina bifida. Diagnosis must occur after the child’s coverage effective date.

Reduction of BenefitsThe benefit amount for the employee and spouse reduces by 50% on the first policy anniversary date after the insured individual’s 70th birthday. Premiums will not be reduced. For coverage purchased after age 70, benefit amounts will not be reduced.

After-tax


Long Term Care Insurance - UnumBaptist Health makes available Long Term Care Insurance through Unum. This insurance allows you to maintain choice and control over your life should you or a loved one need long term care due to illness or accident. Highlights of the plan include:� Coverage for both long term care facility

and professional home and community care expenses is available.

� You have a choice of four plan options, including a choice in facility monthly benefit amount and benefit duration.

� Additional financial protection is available with Compound Inflation Protection added to your policy.

� Eligible family members are also eligible for coverage. These include your spouse, siblings of you and your spouse and their spouses, children and spouses of your adult children, parents of you and your spouse, and grandparents of you and your spouse.

After-tax

� Coverage is Guarantee Issue (evidence of insurability not required) for employees who are newly eligible for benefits or new hires up to maximum monthly benefit of $9,000 with either a three-year or six-year duration. All late entrants enrolling after their initial enrollment period will need to provide evidence of insurability.

Your benefit counselor can provide more details and cost information about this valuable coverage at time of enrollment.

To enroll, please call 800-359-3748. Ask to speak with a Baptist Health representive for more information.


ADDITIONAL VALUE ADDED BENEFITSEmployee Assistance Program - Southwest - www.southwesteap.comYou and your family members have access to the Southwest Employee Assistance Program (EAP). There is no cost to you for this program. Short-term counseling is available for issues such as:� Eldercare referrals � Personal relationship information� Health information and online tools � Financial planning assistance� Career development � Stress management

Confidential assistance is available 24 hours a day, 7 days a week by calling 800-777-1797, local 663-1797.

Group Auto & Home Insurance - MetLifeMetLife’s MetPay Auto & Home program offers special group rates and discounts on many types of policies.

Advantages include:� Easy access to the tools you need to understand

your coverage and enroll� Convenience and Savings - payroll deduction

provides an additional discount and makes payments easy

� Coverage you can take with you

VPI Pet Insurance - MetLifeMetLife’s VPI Pet Insurance.

Plans include:� Coverage for x-rays, surgeries, cancer,

prescriptions, and hospitalization� Highest reimbursement payout� Maximum annual benefits


Hyatt Legal ServicesHyatt Legal is the Group Legal Plan made available by Hyatt Legal Plans, a MetLife® Company. Hyatt Legal offers legal services and representation on a wide range of covered services, with a Plan Attorney of your choice. Baptist Health employees have access to over 10,000 Plan attorneys nationwide. Call MetLife at 1 800 GET-MET8, to determine if the service you require information on is a fully-covered service available through the plan, or if the service is available as a consultation-only. This program has an annual enrollment period (fall of each year, coinciding with other benefits), and new employees may apply within 90-days of your benefit eligibilty. After the 90-day period you will have to wait until the next annual enrollment opportunity to participate.

*All services not available in all states. No service, including consultations, will be provided for: 1) employment-related matters, including company or statutory benefits; 2) matters involving the employer, MetLife and affiliates and plan attorneys; 3) matters in which there is a conflict of interest between the employee and spouse or dependents in which case services are excluded for the spouse and dependents; 4) appeals and class actions; 5) farm and business matters, including rental issues when the participant is the landlord; 6) patent, trademark and copyright matters; 7) costs and fines; 8) frivolous or unethical matters; 9) matters for which an attorney-client relationship exists prior to the participant becoming eligible for plan benefits. For all other personal legal matters, an advice and consultation benefit is provided. Additional representation is also included for certain matters. ** For Family Matters, different terms and exclusions apply.

Group legal plans and Family Matters provided by Hyatt Legal Plans, Inc., Cleveland, Ohio. In certain states, group legal plans and Family Matters are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and Affiliates, Warwick, RI. MetLaw® and MetLife® are registered trademarks of Metropolitan Life Insurance Company, New York, NY

L0609046675[exp0610][All States]


BAPTIST HEALTH RETIREMENT SAVINGS PLAN- MILLIMAN, INC.


OTHER VALUABLE BENEFITSPersonal Time Off Accrual (PTO)Personal Time Off is a concept for compensated time off from work that replaces the traditional vacation days, sick days, funeral leave, and holidays. It allows you to take time off with pay, subject to staffing requirements in your individual department. New employees are eligible to request PTO after three months of employment. Accrual rates vary, depending upon your length of service and as noted below:

Length of Service Full-time Employees (80 Authorized)Accrual Per Pay Period

Part-time Employees Accrual (40-79 Authorized Per Pay Period)

1 month through 59 months 7.69 hours/pay period (200/year) .0961 hour per hour worked60 months through 119 months 9.23 hours/pay period (240/year) .1154 hour per hour worked120 months and above 10.77 hours/pay period (280/year) .1346 hour per hour worked

You may use PTO hours for any reason you choose; however, 24 hours notice prior to the requested time off will be expected for PTO hours to be paid, unless this requirement is waived by the department director or supervisor.In November, your PTO hours in excess of 80, 120, or 160 hours will be reduced to the following amounts:� 12 – 59 months of employment 80 hours� 60 –119 months of employment 120 hours� 120+ months of employment 160 hours

Tuition ReimbursementTuition Reimbursement, when approved, will cover the costs of tuition and/or administrative fees up to $2,000 per year. Applications must be completed prior to the beginning of the first class. A grade of “A,” “B,” or “C” must be attained for reimbursement. Your annual tuition will not exceed $2,000 for full-time employees. Part-time employees (40-69 hours) will receive 50% of this amount, up to $1,000 per year.

Hospital Discount

Make Breastfeeding Work - An Employee Lactation Program offered through Baptist HealthThis program is designed to help employees get breastfeeding off to a good start and continue to breastfeed after returning to work. Benefits include:� Complimentary one month use of a Medela

Symphony Breastpump� Lactation areas equipped with breast pumps

are available at most hospital locations and at Practice Plus. Clinic sites, please contact your clinic manager regarding designated area

� Assistance from Baptist Health lactation consultants to help you make the transition back from maternity leave while continuing to breastfeed your baby

Please contact Jessica Donahue RN IBCLC for more information at 501-202-7378 or [email protected].

IMPORTANT CONTACTSProvider Telephone Number Web Address

Baptist Health HealthLine(for free Physician Referrals)

B-A-P-T-I-S-T (227-8478) or888-B-A-P-T-I-S-T www.baptist-health.com

Baptist Health Benefits 501-202-2176 Email: [email protected]

Baptist Health Federal Credit Union LR 501-202-2373NLR 501-202-3495 www.baptist-healthfcu.com

Health AdvantageMedical Plan (GRP# 044450)

800-843-1329501-378-2363 www.healthadvantage-hmo.com

Delta DentalDelta Plus (GRP# 2380)Delta (GRP# 2381)

800-462-5410501-835-3400 www.deltadentalar.com

DeltaVision Avesis Plan 927Vision Coverage (GRP# 2748V)

866-909-1082www.avesis.com/members.html

Network provider searchhttp://www.avesis.com

DataPathHealth Flexible Spending AccountDependent Care Assistance Program

877-685-0655local: 501-687-6954 www.datapathadmin.com

Milliman, Inc. Baptist Health Retirement Savings Plan

866-767-1212501-202-2573

www.millimanbenefits.comEmail: [email protected]

Southwest EAP 501-663-1797800-777-1797 www.southwesteap.com

5 Star Life Insurance Company 866-863-9753 www.5starima.com

PrincipalCore Term Life & AD&D Insurance (GRP# 1028784)AD&D and Dependent Life Insurance (GRP# 1028784)Long Term Disability (GRP# 1028784)Short Term Disability (GRP# 1028784)

LTD/Life Claims: 800-245-1522

STD Telephonic Claim Submission: 800-262-3283

Portability/Conversion: 800-986-3343 Ext. 76398

www.principal.com

UnumAccident InsuranceWhole Life Insurance Critical Illness InsuranceLong Term Care Insurance (GRP# 135579)

800-635-5597

800-858-6843

www.unum.com

GuardianCancer Insurance 800-627-4200 www.guardiananytime.com

MetlifeMetPay Group Auto & Home Insurance VPI Pet Insurance

800- GET MET8 www.metlife.com

HyattLegal 800- GET MET8 www.metlife.com



NOTES

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