3 Medical Necessity is a new program that conducts a pre-service review using evidence-based guidelines to deter- mine benefit coverage for services, tests or procedures that are medically appropriate for an individual member. When seeking services from a UnitedHealthcare in-network provider, your provider will facilitate the Prior Autho- rization process for you. However, it is your responsibility to ensure that the provider received Prior Authorization before a service is rendered. When seeking services from an out-of-network provider, you are responsible for obtaining prior authorization by contacting UnitedHealthcare. Artificial Insemination and InVitro Fertilization coverage will now be the same as the POS In-Network coverage. Diabetes Care™—Diabetes continues to be one of our top 5 complex chronic conditions throughout our WSSC population. As such, we are adding a new program, Transform Diabetes Care™, that will improve members’ health outcomes, lower pharmacy costs and improve medication adherence, A1c control and lifestyle management. We are also implementing select proven utilization management protocols to ensure members receive the ap- propriate care while helping to manage overall pharmacy costs. They are: Advanced Controlled Formulary, Drug Savings Review, Evidence Based Plan Design, Enhanced Safety & Monitoring and Opioid Management Program. General Anesthesia and IV Sedation will now be covered as a standard benefit. Dependent Life Insurance for eligible children will increase from $10,000 to $15,000. Supplemental Life Insurance semi-monthly premium for employees who are age 75 and above will be reduced. MetLife Advantages Programs for all employees: • Travel Assistance – Protection You Can Take With You • Dignity Funeral Planning Guide – new Funeral Discount and Planning Services • Delivering the Promise – new beneficiary support program about claims & financial needs • Willscenter.com – new online wills and power of attorney preparation service MetLife Advantages Program for employees with Supplemental Life Coverage: • MetLife Will Preparation Services – expert legal resources to prepare a will • Estate Resolution Services – expert legal guidance to settle an estate with ease Highlights of Plan Changes for 2018 UnitedHealthcare EPO & POS UnitedHealthcare EPO CVS/caremark Delta Dental PPO MetLife Open Enrollment Activity Dates Open Enrollment begins October 16, 2017 Open Enrollment information sessions See calendar on page 4 Open Enrollment ends November 13, 2017 Benefit plan elections take effect January 1, 2018 New benefit deductions begin January 10, 2018 Open Enrollment Timeline