Tenet 2011 Benefits EE Presentation Benefits Fair

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2011 Benefits—If You Remember Only Five Things 1. Almost everybody will spend less through the Health & Savings Plan (formerly HDHP) than under any other option. You’ll receive an additional contribution if you choose it in 2011. 2. The Health Savings Account—funded by Tenet and you—can be used now, next year, OR for retiree medical coverage. 3. Use Tenet facilities whenever available! 4. Nothing is more important than your health and wellness. Use the preventive benefits! 5. Tenet spends FOUR times the amount you do to provide YOUR benefits.

Annual Enrollment – November 8 - 23 2

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Health and Welfare Benefits

• Pre-tax benefits – – – –

Medical Rx Health Savings Account Wellness

• Pre-tax benefits (other) – Dental – Vision – Spending Accounts

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• After-tax benefits – Disability – Basic & Supplemental Life – Basic & Supplemental AD&D – Long-Term Care – Hyatt Legal Plan

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NEW! United Healthcare Network! • Expanded Network & Minimal Disruption – Almost nobody will have to change doctors • “Transition of Care” may be available if your physician is out of network – Continue to receive services for specified medical and behavioral conditions – For a defined period of time – With out-of-network health care professionals at network rates

• You must apply for Transition of Care at enrollment, or no later than January 30, 2011.

UHC Contact Information Access UHC provider directories on www.HealthyatTenet.com or by calling UHC Member Services at 1-877-690-9994.

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2011 Medical Plans • EPO – – – – –

Exclusive Provider Organization Highest premium (regardless of usage) No Deductible Co-pays ($) Unlimited Co-pays

• PPO – – – – –

Preferred Provider Organization Lower Premiums Moderate deductible Coinsurance (%) Out of pocket max - $4,000 to $12,000

• Health & Savings Plan – – – – – – –

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All three plans: • Have the same physician network • Cover the same procedures • Require the same pre-authorization • “More expensive doesn’t equate to better care”

High Deductible Health Plan Lowest Premiums Highest deductible Coinsurance (%) Health Savings Account eligible Steerage to Tenet facilities Out of pocket max - $5,200 to $10,400

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2011 Employee Contributions

2011 Bi-Weekly Medical & Rx Contributions (Full time only)

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EPO

$800 PPO

HSP

Employee Only

$51.28

$18.77

$12.36

Employee + Child

$109.48

$39.39

$26.39

Employee + Spouse

$187.88

$69.80

$45.28

Employee + Children

$166.36

$59.71

$40.10

Employee + Family

$259.47

$92.83

$62.54

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Health – How does it work? Traditional Health Plans (PPO, EPO): Emphasize insurance-style coverage You



You pay larger monthly premiums

Medical Plan

Plan pays most of cost when you need care

Health & Savings Plan: Balances savings and insurancestyle coverage You Medical You pay smaller Plan



monthly premiums

You save money in an HSA

You can use HSA for your share of qualified medical expenses

HSA You pay a smaller amount when you need care

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Care Providers

Plan pays part of cost when you need care

Care Providers

$ save $

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Health & Savings Plan HDHP and HSA = The Health & Savings Plan Why is this plan the best? What’s the same compared to other Tenet Plans? • Comprehensive coverage for health care services

• Full coverage for preventive services

• Highest coverage when using a Tenet facility

• Financial protection from catastrophic illness or injury • Tenet pays a significant share of the cost

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What’s different? • How you pay for coverage – Premium costs are different – Deductible and copay/coinsurance amounts are different

• Health & Savings Plan includes a savings component – For 2011 - Tenet provides an HIGHER annual contribution to your HSA of $950 employee only, $1,900 family – Wellness Incentives are higher on the HSP

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EXAMPLE: Family Coverage in Health & Savings Plan

PLAN PAYS 100% OF COVERED CHARGES after you reach your annual out-of-pocket maximum

YOUR COINSURANCE

PREVENTIVE CARE

10%-50% (In-Network) 60% (Out-of-Network) 2

Many services covered at 100% without copayment or using HSA

ANNUAL OUT-OF-POCKET MAXIMUM $10,400 (In-Network) Your share of the out-of-pocket maximum = $8,000

ANNUAL DEDUCTIBLE 1

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$2,400 (Family)

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HEALTH SAVINGS ACCOUNT Employee Contributions Up to $6,150 per year (Includes $1,900-$2,400 HSA funded by Tenet)

Medical: 2011 HSP w/HSA Pay for expenses Now OR Save to Pay For Retiree Medical

• Health Savings Account (HSA) advantages – Tenet contributes to your account – Earn 2010 Wellness incentive $250 employee & $250 spouse – Carry over remaining money year to year – Money in your HSA is yours to keep – Earnings on your account grow tax-free* – Eligible distributions are never taxed. – You may contribute through pre-tax deductions* • Up to $3,050 for employee-only coverage • Up to $6,150 for coverage that includes dependents • Catch-up contributions if age 55 or older (maximum) – add $1,000 to above *State taxes may or may not apply. See your tax advisor for more information on the state tax implications on HSAs. 11

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Medical: 2011 HSP w/HSA • Health & Savings Plan (HSP) considerations – Certain preventive coverage paid entirely by plan • Not subject to the deductible – Certain preventive prescriptions not subject to the deductible

– For other services, must meet deductible before plan begins This is your Retiree paying • $1,200 individual, OR

Medical Benefit!!!

• $2,400 family

– Non-preventive Rx is applied to the deductible

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Potential Health Savings Account Growth Hypothetical Annual Account Contribution

Account growth

$1,000

$2,000

$3,000

After 1 year

$1,020

$2,040

$3,085

After 5 years

$5,562

$11,621

$17,741

After 10 years

$13,236

$27,886

$42,624

After 20 years

$39,093

$82,696

$126,471

Hypothetical example assumes annual contribution amounts as stated above made on Jan. 1 each year until 1, 5, 10 and 20 year periods. Assumes tax-deferred you receive 2% investment growth on funds in the default account and that once the balance in this account reaches $2,500, excess funds will earn 7%. Assumes compounding in an HSA. Final balances prior to any eligible medical expenses and taxes may be due on distribution. Actual returns will be based on actual returns within the HSA. Source - Fidelity 13

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Deductible covered in 2011 Employee Only Deductible 2011

$1,200

HSA Seed Sign-on

Ongoing

$450

$500

*Wellness Opportunity $250

Remaining Deductible $0- $250

Family Deductible 2011

$2,400

HSA Seed Sign-on

Ongoing

*Wellness Opportunity

$900

$1,000

$500

*2010 Wellness incentive opportunity; funded to HSA in January 2011

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Remaining Deductible $0 - $500

What is the 2011 employee financial model? Employer Contributions to the HSA* (A) Plan HSP with HSA $800 PPO EPO

Employee Only $950 $0 $0

Employee and Family $1,900 $0 $0

Employee Premiums (B) Plan HSP with HSA $800 PPO EPO

Employee Only $321 $488 $1,333

Employee and Family $1,626 $2,414 $6,746

Average Employee Out of Pocket Expenses (C) Plan

Employee Only

Employee and Family

HSP with HSA $800 PPO EPO

$750 $900 $400

$1,200 $1,600 $1,200

Plan HSP with HSA $800 PPO EPO

Employee Only $121 $1,388 $1,733

Average Employee Net Cost (B) +(C) – (A)

* Doesn’t include added value of wellness incentive 15

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Employee and Family $926 $7K savings $4,014 $7,946

2011 Wellness Incentives Wellness Incentives – 2011 Plan Participation Level – Wellness Credits

Health Plan HSP

Other (including opt-out)

Employee Spouse(1) Employee

Spouse(1)

Bronze – 50 (a)

$150

$150

$100

$50

Silver – 100

$250

$250

$200

$100

Gold – 150 (b)

$350

$350

$250

$150

Platinum - 200

$450

$450

$300

$250

Incentive Type

Contribution to HSA

Taxable cash

(a) Health Assessment required to achieve bronze level and above (b) Annual physical required to earn gold level and above (1)

Only spouses that are covered under one of Tenet’s medical plans are eligible to receive the wellness incentive.

Note: 2011 incentives are earned in 2011 and paid/funded in 2012. The wellness program and incentives are reviewed and updated annually. All employees can join Wellness challenges, issue their own challenges to co-workers, track results and have fun living healthy! California union employees can participate in the HealthyatTenet Wellness Program but are not eligible for the Wellness Incentives. 16

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Plan Design Changes • Work Here…Receive Care Here….For your Health, Family and Future

– Services in a Tenet facility • HSP / PPO - plan pays 90% (after deductible in HSP) • EPO - $250 / $500 co-pay • Improved benefits for CMA physicians (90% instead of 80%)

– New Non-Tenet 2011 Coverage….If you don’t receive care here but could have. • Non-Tenet In-Network Services paid at 50% (after deductible) • Non-Tenet Out-of-Network Services paid at 40% (after deductible)

– New for 2011 - If you can’t receive care here • Emergency, if the service isn’t offered at a Tenet facility, or the facility is further than 45 miles from your home • Same coverage as if you received care at a Tenet facility! 17

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2011 Rx Plan Simplification 2011 Proposed Plan Design Retail – 30 Day Supply Generic

$5

Formulary Brands

35% with $30 min/$100 max

Non-Formulary Brands

50% with $40 min/$150 max

Mail – 90 Day Supply Generic

$10

Formulary Brands

35% with $75 min/$200 max

Non-Formulary Brands

50% with $100 min/$300 max

– Out-of-pocket costs are applied to HSP deductible – Prescriptions are qualified HSA and HCSA (FSA) expenses 18

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Health Care Reform Changes • Dependent children under age 26 will be eligible for health care coverage, regardless of student status – Special enrollment rights apply to: • A dependent child between the ages of 19 up until 26, who you were previously unable to cover in the Tenet medical plans due to student status or age limitations

– Extended enrollment period through December 8 – Enroll online through November 23rd. After November 23rd call My Benefits Customer Support Center to add eligible individuals during the extended enrollment period – Birth certificate required

• Over-the-counter medications must be prescribed by a doctor to qualify as eligible expenses under the Health Savings Account or Health Care Spending Account • Mental Health Parity Act - Mental health & substance abuse claims will be paid at the same reimbursement level as Tenet Hospitals

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Enrollment Steps Enrollment Exclusively Online www.HealthyatTenet.com Look for the Annual Enrollment Banner

Quick access to:

• What’s New • Medical Plan Comparison • Tools—Use the Medical Expense Estimator to see if the HSP saves you money (it does for employees in almost any situation). • HSP Video—Explore the HSP ……AND EARN 5 WELLNESS CREDITS to start off 2011.

• HSA Mythbusters • FAQs—Find quick answers to your benefits questions 20

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Tips • Evaluate your needs for benefits • • •

• • •

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– Planning could save you thousands Utilize tools available via HealthyAtTenet – Medical Plan Estimator; Health Savings Account Value Modeler Use Tenet Hospitals & outpatient centers to lower your out of pocket expenses Make healthy living a priority! – If you or your covered dependent smoke, quit now! – Preventive benefits: the most underused and potentially valuable set of benefits we offer Earn your Wellness Incentive Enroll by the deadline! Look for information during the year on SMART PLAN USE

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Tenet Benefits Strategy

Simply the best medical coverage for a lifetime Create a culture of employee health and wellness…. engage in understanding and manage your health and your family’s Promote employee financial health and savings….for now and the future

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