Rail Union Open Enrollment: Dates, Eligibility, and Medical Plan Choices

Open Enrollment Virtual Session Rail Union Employees Presented by: Milly Pimentel

Open Enrollment Dates Open Enrollment Begins May 11th Last Day to Enroll is May 29th 11:59 P.M. Any changes made are effective July 1, 2020

Eligibility 40 hours per week hired to work in a regular full time position Eligible Dependents: Your legal spouse Children up to age 26 Documentation required Marriage Certificate to add spouse Birth Certificate for spouse and child(ren) Social Security Cards for spouse and child(ren) First Page of Federal Tax Form 1040 with financial information redacted/masked to add a spouse/partner* *Please contact the Benefits department if you are unable to provide a redacted/masked copy of your Federal Tax Form 1040 Elections are effective July 1, 2020 June 30, 2021, unless you have a change in status or experience a qualifying life event such as marriage, divorce, or birth or adoption of a child. Remember - If you experience a qualifying event, you must contact the Employee Benefits Department within 31 calendar days of the date of the event to enroll a dependent or wait until the next open enrollment period. 3

Medical Plan Choices Administered through Horizon BCBSNJ Three Options: Preferred Provider Organization (PPO) Health Maintenance Organization (HMO) Direct Access 10 (DA10)

Important Features of a PPO and DA-10 Plan A unique network of doctors and hospitals No primary care physician required In and out-of-network benefits available No referrals required for specialists visits Flat co-pays and coinsurance applies to services Certain preventative care such as annual exams, well-baby care, and certain screenings will be covered with no cost sharing

Important Features of an HMO* Plan A managed care network of physicians and facilities A Primary Care Physician (PCP) coordinates your health care No coinsurance or claim forms to file Referrals required for specialists office visits Certain preventative care such as annual exams, well-baby care, and certain screenings will be covered with no cost sharing All services must be rendered at an in-network provider or facility *Employees hired after 07/01/2016, must enroll with the HMO for the 1st five (5) years of employment

Medical Plans Comparison At A Glance BlueCard PPO Direct Access (DA-10) HMO In-Network Out-of-Network In-Network Out-of- Network In-Network Out-of-Network $250 (single) $500 (family) $500 (single) $1000 (family) Deductibles None None None $10 copay (PCP) $20 (Specialist) Office Visits $5 copay, plan pays 100% 70% $5 copay, plan pays 100% 60% after deductible Diagnostic Laboratory/ Radiology 90% in office 100% at Outpatient facility 100% in office 70% 100% 60% after deductible $35 copay at Outpatient facility 70% after $500 copay 60% after deductible and $100 copay Inpatient Stays 100% 100% $100 copay then $100 Out-of-Network Services Are Not Covered Outpatient Surgeries 100% 70% $35 copay, plan pays 100% 100% after deductible 60% after deductible Durable Medical Equipment ex: CPAP machine 80% 70% 80% 100% after deductible 60% after deductible Emergency Room Visits 100% after $100 facility co-pay 100% after $100 facility co-pay $50 copay, plan pays 90% $35 copay, plan pays 100% $5 copay for exam $50 reimbursement for hardware Not Covered Vision Not Covered Telemedicine $5 Copay must register with AmericanWell at www.Horizoncareonline.com

Horizon Dental Triple Option Major Services Preventative Services (Class I) Basic Services (Class II) Orthodontia (Class IV) Maximum Benefit (Class III) 100% In- network PPO; 90% DDN; 80% Out-of- Network of R&C (reasonable and customary) 50% In- Network & 50% Out-of- Network of R&C (after deductible of $35 individual /$105 family) 80% In- Network PPO; 75% DDN; 70% Out-of- Network of R&C 50% In- Network & 50% Out-of- Network of R&C $2000 per plan year for all services Tooth removal, fillings, repairs, root canals, endodontic and periodontal treatments Covers routine exams, cleanings, x-rays $1000 lifetime maximum per plan participant Crowns, dentures, bridgework (first/ replacement)

Prescription Drug Plan At A Glance Administered by Express Scripts Inc. (ESI) Prescription Drug benefits are automatic when you enroll in one of the medical plan options The cost of the prescription drug is included with the medical premium You will receive a separate ID card from ESI once enrolled There is a mandatory mail order for all maintenance drugs 1st two fills at pharmacy then mail order Mail Order for Maintenance Drugs 90-day supply Generic 0% co-pay Brand name 20%, 30% co-pay where Generic available $35.00 Maximum Retail Pharmacy Generic 10% co-pay Brand Name 20%, 30% co-pay where Generic available $35.00 Maximum 34-day supply or 100 units

Vision Care Administered by EYEMED Benefit covers employees and eligible dependents Effective the same date as medical coverage Reimbursement for eye exam, prescription lenses and contacts once a year Service Type Co-Pay Eye Exam $0 Single Lenses $0 Frames 20% off retail price Contact Lenses $0 up to $80 allowance

Group Health Insurance Contribution Employees will contribute a flat rate for the medical, prescription, dental and basic life insurance plans. Weekly contributions are withheld the first pay after the effective date of coverage If you choose to opt out of coverage you must indicate your waiver on the enrollment form * Monthly Rates effective July 2020 Plan Single Parent/Child(ren) Employee/Spouse Family PPO $383.00 $383.00 $383.00 $383.00 Traditional (closed) $246.00 $246.00 $246.00 $246.00 HMO $160.00 $160.00 $160.00 $160.00 Direct Access -10 $195.00 $195.00 $195.00 $195.00 *Waivers are eligible for a $500 employer paid FSA account. Enrollment is required. Plan will not roll over into the next calendar year

Discount Programs Horizon BCBS Blue365 Discount Program NJT Transit Fitness discounts on gym memberships and Fitbits Healthy Eating discounts on meal prep services and more Lifestyle discounts on hotels, travel and more Website: Blue365deals.com

Enrollment Procedure Employee information including hire date and employee # will autofill upon logging in. Please review for accuracy Select the coverage requested for Health, Vision and Dental Health coverage option specifies who is being covered, i.e. EE Only, EE/Spouse If you would like to add/remove a dependent click button Be sure to email documents Check box to verify and click Submit Enrollment Form

Important Phone Numbers Contact Phone Email & Website NJ Transit Benefits Department P: 973-378-6016 P: 973-378-6033 P: 973-378-6035 mpimentel@njtransit.com npearson@njtransit.com srthomas@njtransit.com Horizon BCBSNJ Member Services Medical and Dental 877-241-8414 www.horizonblue.com/njtransit TASC FSA 888-595-2261 https://www.tasconline.com/ubaaccess Express Scripts Member Services 877-796-9759 www.express-scripts.com EYEMED Member Services 855-219-4576 www.eyemed.com NJ Transit Help Desk 973-491-4357 helpdesk@njtransit.com