Total Lives Covered: 51,371

1. 2005 State Health Plan Enrollment 25,232 20,435 4,189 1,515 Total Lives Covered: 51,371 Total Lives Covered: 51,371

2. Employee Survey Concerns • Salary Issues. • Picking a Plan Design. • Pharmaceuticals.

3. Salary Issues • Respondents pointed to no across-the-board pay increases for the past three years and felt that their take-home pay has been reduced as a result of premium increases each year.

4. Picking a Plan Design • Respondents feel they have limited choices and many don’t want to pay for services they don’t use.

5. Pharmaceuticals • There was a great deal of concern about the significant increase in out-of-pocket expenses if we switched from a co-payment plan to a “co-insurance” plan. • Participants pay a percentage of the cost of medication each time a prescription is filled rather than a co-pay (e.g., $14 generic).

6. Outpatient Physical Therapy • Plan pays 80% of allowable charges after you meet your deductible. • The benefit is limited to $800 per insured per benefit period.

7. Inpatient Physical Therapy • Plan pays 80% of allowable charges after you meet your deductible. • The benefit is limited to $15,000 per insured per benefit period. • Within the network the plan pays 85% of allowable charges after you meet your deductible. • There is a $150,000 lifetime benefit limit.

8. Temporomandibular Joint Syndrome (TMJ) • Plan pays 80% of allowable charges after you meet your deductible. • The benefit is limited to $2000 per lifetime.

9. Transplant Services • Plan pays 80% of allowable charges after you meet your deductible. • The benefit is limited to $350,000 lifetime maximum per insured. • Within the network the plan pays 85% of allowable charges after you meet your deductible • Outside of the network the plan pays 70% of allowable charges after you meet your deductible.

10. Benefit Limits • All plans have a $350,000 lifetime maximum per insured in-network and out-of-network combined.