UFCW HRQ F A Q HRQ website:

UFCW HRQ F A Q HRQ website: www.ufcwhrq.com Contents Health Risk Questionnaire... 3 What is the Health Risk Questionnaire (HRQ... 3 Where do I complete the HRQ?... 3 How long will the HRQ take?... 3 How much of a credit can I receive?... 3 What questions will be asked?... 3 Why should I complete the HRQ?... 3 Health Reimbursement Account... 4 What is a Health Reimbursement Account (HRA) and how does it work?... 4 How does the HRQ work with the HRA?... 4 Is the HRA contribution for doing the HRQ $200 for everyone, or does it matter whether they have Premier, Ultra, or Standard?... 4 When will I see my HRA credit?... 5 How will I know my HRA balance?... 5 Is there any limit as to how long I can keep my HRA or the amount that can accumulate?... 5 How are funds in my HRA accessed?... 5 How are claims paid using my HRA?... 5 Can I choose which claims my HRA will be used for?... 6 What types of expenses cannot be paid from the HRA?... 6 I cover my spouse and my child under my benefits. Does each of them have an HRA?... 6 If I m a Premier member and switch to an HMO, will I still have an HRA?... 6 What happens if I first become eligible for Standard benefits after January 1 of any year?... 6 Eligibility... 7 Who is eligible?... 7 What is the cutoff date?... 7 I have a pre-existing medical condition. Can I still get the HRA credit?... 7 What happens if I have a family status change after my HRA has been funded for the year?... 7 If I have a break in service, will I lose my HRA?... 7 What if I don t want to participate?... 7

Access to Private Information... 8 Who has access to my HRQ information?... 8 What will the Trust Fund or the Union Local do with the information collected?... 8 Is the HRQ compliant with HIPAA regulations?... 8 Who is the third party who processes my results?... 8 Biometrics... 8 How is Body Mass Index(BMI) calculated?... 8 What if I don t know my blood pressure or some other measurement?... 9 More Information... 9 I have a question that is not answered here. Who do I talk to?... 9 Questions About Privacy... 9

Health Risk Questionnaire What is the Health Risk Questionnaire (HRQ)? The HRQ is designed by health care experts to help you assess your health and identify possible health risks before they become serious health conditions. Individual results of the HRQ are confidential and are available only to you. Your completed HRQ will not affect your eligibility or benefit payments, but completing and returning it can add credit to your Health Reimbursement Account (HRA). Where do I complete the HRQ? The easiest place is the Internet just go online to www.ufcwhrq.com and register. You can then complete the entire HRQ in about 10 minutes. If you do not have Internet access, call us at 1-888-411-UFCW (1-888-411-8329) between 7 am and 7 pm Pacific Standard Time, Monday through Friday, to take the HRQ by phone or to request a paper questionnaire to be mailed to your home address. How long will the HRQ take? About 10 minutes. How much of a credit can I receive? Up to $200 credit if you complete the HRQ as an eligible member covered by the Trust Fund Up to $50 credit if your eligible spouse or domestic partner also completes the HRQ What questions will be asked? You are asked simple health questions about such factors as your lifestyle, diet, and exercise choices. The goal of the HRQ is to assist you in zeroing in on the aspects of your health that you can change for the better, and to give you the means to make these changes. Why should I complete the HRQ? Two good reasons. Reason No. 1: Your Health. The HRQ is designed by healthcare experts to help you assess your health and identify possible health risks before they become serious health conditions. The HRQ lets you take stock of what s going on with your health and what you can do specifically to live a more healthy lifestyle.

Reason No. 2: Your Reward. The Trust Fund is taking a good-faith step on your behalf: credit to your HRA account! This means a credit deposited directly into your Health Reimbursement Account (HRA) just for completing the HRQ: Up to $200 credit if you complete the HRQ as an eligible member covered by the Trust Fund An additional credit of up to $50 credit if your eligible spouse or domestic partner also completes the HRQ The Trust Fund believes in you and wants you to succeed in fulfilling your healthy potential. The HRQ is provided by MedExpert, a trusted partner that has helped thousands of UFCW members improve their healthcare. In short, this HRQ is an ideal platform from which to launch a healthier you! Plus, participants can compare their 2011 answers with answers from previous years to determine how their overall health has changed, making the HRQ an even more useful health tool. Health Reimbursement Account What is a Health Reimbursement Account (HRA) and how does it work? An HRA is an account from which funds are used to pay your portion of health care expenses not paid by the PPO Medical Plan, such as deductibles and coinsurance, and to reimburse you for prescription drug copays. The Trust Fund office administers the HRA and allocates money to each eligible member s HRA annually. In most cases, any remaining balance in your HRA as of Dec. 31 carries over to the next plan year if you remain an eligible PPO member. Your HRA is not a bank account and does not accrue interest. You cannot make deposits to it or withdraw funds from it. How does the HRQ work with the HRA? If you are an eligible member and complete the HRQ, a credit amount is added to your HRA. An additional credit is added to your HRA if your eligible spouse or domestic partner completes his or her own HRQ. Is the HRA contribution for doing the HRQ $200 for everyone, or does it matter whether they have Premier, Ultra or Standard? It DOES depend on which plan you have. See the following for specific information: Premier participant: $200 spouse: $50 Ultra participant: $150 spouse: $50 Standard participant: $150 spouse: $0

When will I see my HRA credit? The appropriate credit will automatically be applied within 30 days from the time you complete the HRQ. The credit will appear on the next Explanation of Benefit (EOB) you receive from the Trust Fund when a claim has been processed. How will I know my HRA balance? Your HRA balance will be included on every Explanation of Benefits (EOB) you receive from the Trust Fund office. The balance stated on the EOB will reflect the balance as of the date that claim was processed. If you call the Trust Fund office (800-552-2400) for your HRA balance, you will be told your HRA balance as of the date and time of your phone call. Is there any limit as to how long I can keep my HRA or the amount that can accumulate? At this time, there is no limit on how long you can keep your HRA (as long as you remain an eligible PPO member), nor is there a maximum amount that can accumulate in your HRA. How are funds in my HRA accessed? When the Trust Fund receives medical claims for you or your eligible family members, it automatically uses your available HRA funding to pay your deductible and coinsurance directly to a PPO provider and to send reimbursement for prescription drug copays directly to you approximately three weeks after you incur a copay. You do not have to submit a request for payment of your deductible or coinsurance to be made from your HRA or to be reimbursed for your prescription drug copays. If your benefits are assigned to a non-ppo provider, the reimbursement will be sent directly to the non-ppo provider. If you call the Trust Fund office (800-552-2400) for your HRA balance, you will be told your HRA balance as of the date and time of your phone call. How are claims paid using my HRA? When you use a PPO provider, your provider will submit claims to the Trust Fund on your behalf. The medical claim will be processed and eligible medical expenses, including your medical deductible and medical coinsurance, will be paid from your HRA until your HRA is exhausted. The Trust Fund will send payment directly to the provider who submits the claim. After your HRA is exhausted, you will be responsible for paying your providers for your portion of the cost of your care until you meet the remainder of your calendar-year deductible and your out-of-pocket maximum coinsurance. If you use a non-ppo provider who does not file a claim on your behalf, you will be required to pay the provider and submit a claim to the Trust Fund office for reimbursement of the covered amount.

The Trust Fund will automatically reimburse you from your available HRA funds for eligible prescription drug copays. After your HRA is exhausted, you will have to pay your prescription drug copays for the remainder of the year. Can I choose which claims my HRA will be used for? No, you cannot exclude certain services that you do not want your HRA to cover the funds will be applied to costs as they occur. For more information, you can talk to the Trust Fund office at 800-552-2400. What types of expenses cannot be paid from the HRA? Your HRA cannot be used for premium payments (such as COBRA or retiree health and welfare), expenses that are excluded from the medical and prescription drug programs (such as mental health treatment by a non-ppo provider), cosmetic procedures, or for non-medical items such as the dental deductible or eyeglasses. It cannot be used to pay expenses that exceed annual PPO benefit limits. (For example: If your chiropractic benefit has a $500 annual benefit limit and your expenses exceed the limit, your HRA funds cannot be used to pay additional chiropractic expenses.) Your HRA cannot be used to pay dental or vision expenses. I cover my spouse and my child under my benefits. Does each of them have an HRA? No, an HRA is only established for the covered member; however, claims for eligible dependent(s) will be processed using funds from your HRA. If I m a Premier member and switch to an HMO, will I still have an HRA? No. HRA funding is not available to HMO members. If there is a remaining balance in your HRA when your HMO coverage takes effect, it can only be used to pay expenses incurred before your PPO coverage ended. You will forfeit any remaining HRA funding that is not used to pay PPO claims. What happens if I first become eligible for Standard benefits after January 1 of any year? Your HRA will be established on the following January 1. No pro-rata amount is allocated for the partial year during which your eligibility for Standard benefits was established. New Standard employees who become eligible on Feb. 1 or later will continue to be covered under their existing plan benefits until Dec. 31. On the following Jan. 1, they will be covered under the new PPO plan benefits, which include an HRA.

Eligibility Who is eligible? All Trust Fund PPO members and their eligible spouses or domestic partners who are covered under a ratified 2007 CBA and meet the eligibility criteria for benefits as of Jan. 1, 2011. This also includes members who qualify for coverage during a leave such as family medical leave (FMLA) or an eligibility extension because of disability. What is the cutoff date? The HRQ must be completed by March 1, 2011. I have a pre-existing medical condition. Can I still get the HRA credit? Yes. As long as you complete the HRQ, you are eligible for the credit. This is a health awareness measure designed to increase your knowledge of your personal risk factors it is not a judgment of your health or lifestyle. Having a pre-existing condition will not affect your or your spouse/domestic partner s eligibility for coverage under this Plan. What happens if I have a family status change after my HRA has been funded for the year? When applicable, additional HRA and HRQ funding amounts will be pro-rated from the date of the family status change. You will not lose funding if your family status changes from a higher HRA benefit amount to a lower benefit amount. For example, if your HRA funding is based on family coverage at the beginning of the year, you would not lose that HRA funding if you divorce and move to a single coverage level later in the year. If I have a break in service, will I lose my HRA? In general, if you return to employment without a change to your previous status and benefits, you will also retain your associated HRA benefits. If you return to employment and are considered a new hire, any previously accumulated HRA amount is forfeited. What if I don t want to participate? The program is voluntary. If you choose not to participate, simply do not complete the HRQ. However, keep in mind that you will miss out on receiving the credit to your HRA (up to $250) unless you complete the HRQ.

Access to Private Information Who has access to my HRQ information? All information used for the HRQ is collected and processed by an independent third-party organization, MedExpert, solely for the purpose of determining what amount of credit you will receive. The HRQ complies fully with all federal HIPAA regulations concerning privacy and medical information. Your responses to the questionnaire will be compiled to create an assessment report available only to you. In addition MedExpert will provide the Trust Fund confirmation that you can receive the appropriate credit to your HRA. No individual information will be seen by the Trust Fund or the Union Local. The information collected in the questionnaire will NOT be used for any purpose other than the HRQ. What will the Trust Fund or the Union Local do with the information collected? No individual s information will be seen by the Trust Fund or the Union Local. All information used for the HRQ is collected and processed by an independent third-party organization, MedExpert, solely for the purpose of determining what amount of credit you will receive. The information collected will NOT be used for any purpose other than the HRQ. Is the HRQ compliant with HIPAA regulations? Absolutely. The HRQ is fully compliant with the Health Insurance Portability and Accountability Act (HIPAA), which was enacted by Congress in 1996. HIPAA addresses the need for security and privacy of health data. For more information on HIPAA and how it affects you, please visit www.hhs.gov/ocr/hipaa. Who is the third party who processes my results? The HRQ is administered by MedExpert, a trusted partner that has helped thousands of UFCW members improve their healthcare. We chose MedExpert because of their advanced engineering and data processing capabilities, as well as their reputation for complete respect for personal privacy and established reputation as a completely independent entity having no ties to insurance companies or any other organization. You can rest assured that with their unrivaled security systems and protocols, MedExpert will keep your data safe. Biometrics How is Body Mass Index (BMI) calculated? Body Mass Index (BMI) is a number calculated from a person s weight and height. BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.

What if I don t know my blood pressure or some other measurement? You can select I m Not Sure for some of the answers. However, the more accurate the information you supply, the more useful the results will be to you. And remember, the HRQ is confidential: Your individual HRQ results are just that yours. No one from the Trust Fund, your employer, or your Union Local will have access to them. The point of the HRQ is to assist you in zeroing in on the aspects of your health that you can change for the better, and to give you the means to make these changes. More Information I have a question that is not answered here. Who do I talk to? You can call MedExpert with your HRQ questions at 1-888-411-UFCW (1-888-411-8329) between 7 am and 7 pm Pacific Standard Time, Monday through Friday. MedExpert s friendly staff will be glad to assist you. For questions regarding your HRA balance or how to use your HRA, call the Trust Fund office (800-552-2400). Questions About Privacy The UFCW & Employers Benefit Trust Fund and the Health Risk Questionnaire (HRQ) Initiative take your privacy very seriously. The information collected for the HRQ initiative is used solely for two purposes: (1) helping you to improve your health and (2) making sure that you receive all appropriate credits to your Health Reimbursement Account (HRA) due to you from the program. No one from the UFCW & Employers Benefit Trust Fund, the Union Local, or your employer will have access to your personal health information. HIPPA Compliance. The HRQ is fully compliant with the Health Insurance Portability and Accountability Act (HIPAA), which was enacted by Congress in 1996. HIPAA addresses the need for security and privacy of health data. For more information on HIPAA and how it affects you, please visit www.hhs.gov/ocr/hipaa. The HRQ complies with all HIPAA regulations concerning privacy and medical information. Thus, your HRQ results will be available to you. Neither the UFCW & Employers Benefit Trust Fund, the Union Local, nor your employer will have access to your personal health information. Information about your completion of the HRQ will be transmitted to the UFCW & Employers Benefit Trust Fund only to calculate your HRA credits and to update your contact information such as telephone number and e-mail address. Of course, the company administering the HRQ, MedExpert International (MedExpert), will have access to the data, but only to comply with HRQ administration requirements and as necessary to provide you with appropriate credits and medical information. Your HRQ responses may also be shared with other third-party health care management service providers selected by the Trust Fund to offer you voluntary programs and services to help you manage or improve your health. Use of HRQ Information. All information used for the HRQ initiative is collected and processed by MedExpert, an independent third-party organization. The UFCW & Employers Benefit Trust Fund will not use any individual identifying information for any purpose other

than crediting your HRA account upon your completion of the HRQ and updating your contact information. The UFCW & Employers Benefit Trust Fund reserves the right to track aggregate data in order to assess overall population trends (e.g., factors such as BMI) over time. Such aggregation means that data pertaining to any individual cannot be discerned or inferred and no individual can be identified by the data.