BAART(Addiction Research &

Treatment, Inc.)

Benefits Presentation

BAART(Addiction Research &

Treatment, Inc.)

Benefits Presentation

Northern CA Ed.10/15/2008

Demonstrates commitment to employees

Provides a competitive and comprehensive package

Serves as a key component of total compensation

Strives to maintain reasonable costs for employees

Demonstrates commitment to employees

Provides a competitive and comprehensive package

Serves as a key component of total compensation

Strives to maintain reasonable costs for employees

Time to review your benefits and make any

changes …..

Time to review your benefits and make any

changes …..

“Managed” Health Care Must Use Only Contracting Facilities

and Doctors You do not need to elect a primary

care physician (PCP), but it is recommended

No Deductibles 100% Payment for Most Services No Claim Forms

“Managed” Health Care Must Use Only Contracting Facilities

and Doctors You do not need to elect a primary

care physician (PCP), but it is recommended

No Deductibles 100% Payment for Most Services No Claim Forms

Deductible None Coinsurance 100% Office Visit $15 copay Hospitalization 100% Chiropractic* $10 copay 30 visits/year maximum

benefit

Lab Services 100%

*Chiropractic care accessed through American Specialty Health Plan (ASHP) participating providers.

Deductible None Coinsurance 100% Office Visit $15 copay Hospitalization 100% Chiropractic* $10 copay 30 visits/year maximum

benefit

Lab Services 100%

*Chiropractic care accessed through American Specialty Health Plan (ASHP) participating providers.

Retail Prescription

Generic Formulary $10 copay

Brand Formulary $20 copay

Non-Formulary PCP Approval

Supply Limitation 100 days

Retail Prescription

Generic Formulary $10 copay

Brand Formulary $20 copay

Non-Formulary PCP Approval

Supply Limitation 100 days

Two Plans In One Annual Deductibles No PCP Requirements No Referrals Needed Cost Savings Using PHCS

Network Freedom of Choice How “Swing” Plan Works

Two Plans In One Annual Deductibles No PCP Requirements No Referrals Needed Cost Savings Using PHCS

Network Freedom of Choice How “Swing” Plan Works

NetworkNetwork Non-NetworkNon-Network

•DeductibleDeductible IndividualIndividual FamilyFamily

$500$500$1,500$1,500

•CoinsuranceCoinsurance 90% after ded.90% after ded. 70%, after ded.70%, after ded.

•Office VisitOffice Visit $25 copay$25 copay 70% after ded.70% after ded.

•HospitalizationHospitalization $250 copay, then $250 copay, then 90% after ded.90% after ded.

$500 copay, then $500 copay, then 70% after ded.70% after ded.

•Emergency Emergency RoomRoom

$100 copay, then 90% after ded.$100 copay, then 90% after ded.

NetworkNetwork Non-NetworkNon-Network

Lab ServicesLab Services 90% after ded.90% after ded. 70% after ded.70% after ded.

Chiropractic &Chiropractic &

AcupunctureAcupuncture

90% after ded.90% after ded.** 70%, after ded.70%, after ded.**

*$1,000 maximum benefit per calendar year for chiropractic and acupuncture services combined.*$1,000 maximum benefit per calendar year for chiropractic and acupuncture services combined.

Retail Prescriptions* Generic $15 copay Brand Name $40

copay Self-Administered Injectables 70%

(other than insulin) Supply Limitation 30 days

Retail Prescriptions* Generic $15 copay Brand Name $40

copay Self-Administered Injectables 70%

(other than insulin) Supply Limitation 30 days

If a member requests a brand name drug when a generic equivalent is available, then the member will pay the brand name copay PLUS the difference in cost between the brand name and generic drug. However, if a physician writes “dispense as written” on the prescription order, then only the brand name copay will apply.

If a member requests a brand name drug when a generic equivalent is available, then the member will pay the brand name copay PLUS the difference in cost between the brand name and generic drug. However, if a physician writes “dispense as written” on the prescription order, then only the brand name copay will apply.

Mail Order Prescriptions*Generic $30 copayBrand Name $80 copaySupply Limitation 100 days

(Self-administered injectables (other than insulin) are not available through the mail order program)

Mail Order Prescriptions*Generic $30 copayBrand Name $80 copaySupply Limitation 100 days

(Self-administered injectables (other than insulin) are not available through the mail order program)

If a member requests a brand name drug when a generic equivalent is available, then the member will pay the brand name copay PLUS the difference in cost between the brand name and generic drug. However, if a physician writes “dispense as written” on the prescription order, then only the brand name copay will apply.

If a member requests a brand name drug when a generic equivalent is available, then the member will pay the brand name copay PLUS the difference in cost between the brand name and generic drug. However, if a physician writes “dispense as written” on the prescription order, then only the brand name copay will apply.

Offers Helpful Resources Including:• Benefit & Open Enrollment Announcements• Carrier Contact Information & Group Numbers• Insurance Benefit Summaries• Frequently Asked Questions• HIPAA Compliance Materials• Carrier Links• And much more!

Offers Helpful Resources Including:• Benefit & Open Enrollment Announcements• Carrier Contact Information & Group Numbers• Insurance Benefit Summaries• Frequently Asked Questions• HIPAA Compliance Materials• Carrier Links• And much more!

Kaiser/KPIC members are eligible for an exciting discount program! This program is offered by American Specialty Health (ASH)

and includes a 25% discount on:

• Chiropractic, acupuncture and massage therapy

• Fitness Club Memberships• Health Tools and Health Products

Kaiser/KPIC members are eligible for an exciting discount program! This program is offered by American Specialty Health (ASH)

and includes a 25% discount on:

• Chiropractic, acupuncture and massage therapy

• Fitness Club Memberships• Health Tools and Health Products

To locate ASH providers visit: www.kp.org/healthyroads

or call 877.335.2746

To locate ASH providers visit: www.kp.org/healthyroads

or call 877.335.2746

BAART Medical Plans - HOT TOPICSHOT TOPICS

• Dependent age limitation is to age 19 or to age 24 if full time student.

• If you child has attained the age of 19 AND is a full time student, you MUST complete a student certification form. The form MUST be returned to human resources WITH a copy of the child’s school registration.

• Dependent age limitation is to age 19 or to age 24 if full time student.

• If you child has attained the age of 19 AND is a full time student, you MUST complete a student certification form. The form MUST be returned to human resources WITH a copy of the child’s school registration.

BAART Medical Plans - HOT TOPICSHOT TOPICS

• You will need to complete the student certification form ONCE a year in order for the child to remain on the insurance plan(s).

• Pre-Certification (PPO members)

• KPIC Billing Address (PPO Members) P.O. Box 26115 Plano, TX 75026

• You will need to complete the student certification form ONCE a year in order for the child to remain on the insurance plan(s).

• Pre-Certification (PPO members)

• KPIC Billing Address (PPO Members) P.O. Box 26115 Plano, TX 75026

BAART Medical Plan - HOT TOPICSHOT TOPICS

BAART Medical Plan - HOT TOPICSHOT TOPICS

It is YOUR responsibility to notify Human Resources upon your child’s attainment of age 19. Failure to notify human resources may result in your child being terminated from coverage, may result in claims being denied or delayed, and may forfeit the child’s right to COBRA continuation protection (should the child not be a full time student) as outlined under Federal legislation.

It is YOUR responsibility to notify Human Resources upon your child’s attainment of age 19. Failure to notify human resources may result in your child being terminated from coverage, may result in claims being denied or delayed, and may forfeit the child’s right to COBRA continuation protection (should the child not be a full time student) as outlined under Federal legislation.

DMOMember selects a primary care dentist. Dentist coordinates dental care; scheduled copays; no deductibles to be met

PPOTwo plans in one; deductibles in and out of network; cost savings when using network providers

DMOMember selects a primary care dentist. Dentist coordinates dental care; scheduled copays; no deductibles to be met

PPOTwo plans in one; deductibles in and out of network; cost savings when using network providers

Deductible None Preventive Services 100% Basic Services 100% Major Services 60% Calendar Year Max. None (Unlimited) Orthodontic Care Not a covered benefit

(Late entrants eligible for preventive services only for the first 12 months.)

(Late entrants eligible for preventive services only for the first 12 months.)

Network Non-Network Deductible* $50/person $50/person

Preventive Svcs. 100% 100% of UC Basic Services 80% 80% of UC Major Services 50% 50% of UC Cal. Year Max. $1,500 $1,500 Orthodontic Care Not covered--------------------

*Deductible waived for preventive services

Network Non-Network Deductible* $50/person $50/person

Preventive Svcs. 100% 100% of UC Basic Services 80% 80% of UC Major Services 50% 50% of UC Cal. Year Max. $1,500 $1,500 Orthodontic Care Not covered--------------------

*Deductible waived for preventive services

Aetna members have access to exciting discount programs that include:

• Alternative Health Care Discount Program

• Vision One Discount Program

• Fitness Discount Program

AND MUCH MORE!

Aetna members have access to exciting discount programs that include:

• Alternative Health Care Discount Program

• Vision One Discount Program

• Fitness Discount Program

AND MUCH MORE!

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Group Term Life Insurance

Flat $10,000 (all guarantee issue)

Convertible Within 30 Days

Beneficiary Designation -- May Change at Any Time

You are required to complete a Kaiser / KPIC medical enrollment form if you are electing medical coverage (or adding/deleting dependents). If you would like to make a change to the Aetna dental plan, you must also complete an enrollment form. All forms MUST be returned to Human Resources no later than DECEMBER 15, 2008. If you’ve had a life change since you enrolled in the Life/AD&D plan, you may want to update your beneficiary(ies) designation(s). Claim Issues -- contact Human Resources or BAART’s benefits broker at 877-866-2623 for assistance.

Questions and Answers…