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Premium Changes

Review the YBR website during the annual open enrollment period for your 2015 premium costs.

Vision and Legal Coverage Will Become Voluntary Benefits

Effective January 1, 2015, vision and legal coverage will become “voluntary benefits.” As such, they will no longer be sponsored by Alcatel-Lucent. As a result, if you elect vision or legal coverage for 2015 and later, you will pay the full cost of coverage and your premiums will be deducted from your paycheck on a post-tax basis.

Enrollment for vision, legal and a new health advisory service coverage takes place at the same time as the annual open enrollment period for your Alcatel-Lucent health and welfare benefits. (This is different than the situation for your other voluntary benefits — identity management services and auto and home insurance — in which you may add or drop coverage anytime during the year.) Note, however, that the enrollment information in this guide does not apply to your voluntary benefits. Information about voluntary benefits may be found at www.addedbenefitsaccess.com or by calling Added Benefits at 1-800-622-6045.

Note: If your COBRA coverage begins before January 1, 2015, vision coverage will continue to be offered through COBRA.

Univera HMO Will No Longer Be Offered

Effective January 1, 2015, Univera HMO will not be available. If you are currently enrolled in this HMO, you will need to choose another medical option for 2015 or you will be enrolled in default coverage. For more information about default coverage, see “Check Your Default Coverage.”

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Higher Medical Annual Deductibles and Out-of-Pocket Maximums

Effective January 1, 2015, your medical annual deductibles and out-of-pocket maximums will increase as follows:

	Point of Service (POS)		Traditional Indemnity
Feature	2014	2015	2014	2015
Annual Deductible	In-Network: None Out-of-Network: Individual: $600 Two-person: $1,200 Family: $1,800	In-Network: None (no change) Out-of-Network: Individual: $750 Two-person: $1,500 Family: $2,250	Individual: $300 Two-person: $600 Family: $900	Individual: $350 Two-person: $700 Family: $1,050
Annual Out-of-Pocket Maximum	In-Network: Individual: $1,250 Two-person: $2,500 Family: $3,750 Out-of-Network*: Individual: $3,500 Two-person: $7,000 Family: $10,500	In-Network: Individual: $1,550 Two-person: $3,100 Family: $4,650 Out-of-Network*: Individual: $4,350 Two-person: $8,700 Family: $13,050	Individual: $1,500 Two-person: $3,000 Family: $4,500 Excludes deductible	Individual: $1,850 Two-person: $3,700 Family: $5,550 Excludes deductible

*Excludes deductible

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Higher Point-of-Service (POS) Copayments for Certain Services

Effective January 1, 2015, copayments for certain services will increase as shown below. Please note that this is only a partial listing; please see the 2015 Benefits At-a-Glance and Resource Contact Information booklet for a more complete list of affected services.

	Point of Service (POS) Copayments
Feature	2014	2015
Emergency Room — Emergency Use	In-Network and Out-of-Network: You pay $60 copayment/visit (waived if admitted)	In-Network and Out-of-Network: You pay $65 copayment/visit (waived if admitted)
Emergency Room — Nonemergency Use	In-Network and Out-of-Network: Plan pays 75% after you pay $60 copayment/visit	In-Network and Out-of-Network: Plan pays 75% after you pay $65 copayment/visit
Inpatient Hospitalization/Surgery	In-Network: Plan pays 95% after you pay $100 copayment/admission Out-of-Network: Plan pays 75% after deductible is satisfied and you pay $300 copayment/admission	In-Network: Plan pays 95% after you pay $125 copayment/admission Out-of-Network: Plan pays 75% after deductible is satisfied and you pay $375 copayment/admission
Physician Office Visits (non-preventive)	In-Network: You pay $30 copayment/visit Out-of-Network: Plan pays 75% after deductible is satisfied	In-Network: You pay $35 copayment/visit Out-of-Network: Plan pays 75% after deductible is satisfied (No change)

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Higher Prescription Drug Annual Deductibles, Out-of-Pocket Maximums and Copayments

Effective January 1, 2015, your prescription drug annual deductibles, out-of-pocket maximums and copayments will increase as follows:

	Point of Service (POS) and Traditional Indemnity
Feature	2014	2015
Annual Deductible*	In-Network: Retail and mail order: None Out-of-Network: Individual: $100 Two-person: $200 Family: $300	In-Network: Retail and mail order: None Out-of-Network: Individual: $125 Two-person: $250 Family: $375
Annual Out-of-Pocket Maximum* (in-network retail and mail order)	In-Network: Retail and mail order: $1,250/individual Out-of-Network: None	In-Network: Retail and mail order: $1,550/individual Out-of-Network: None
Retail Copayments (up to a 30-day supply using an in-network pharmacy)	In-Network: Level One (Generic): $10 Level Two (Formulary Brand): $25 Level Three (Formulary Brand): $35 Level Four: Nonformulary Brand: $45 Out-of-Network: Plan pays 70% after deductible is satisfied	In-Network: Level One (Generic): $10 (No change) Level Two (Formulary Brand): $30 Level Three (Nonformulary Brand): $50 Out-of-Network: Plan pays 70% after deductible is satisfied (No change)
Mail-Order Copayments (up to a 90-day supply)	In-Network: Level One (Generic): $20 Level Two (Formulary Brand): $50 Level Three (Formulary Brand): $70 Level Four: Nonformulary Brand: $80 Out-of-Network: Not applicable	In-Network: Level One (Generic): $20 (No change) Level Two (Formulary Brand): $60 Level Three (Nonformulary Brand): $100 Out-of-Network: Not applicable

*The deductibles and out-of-pocket maximums for the Prescription Drug Program are separate from the deductibles and out-of-pocket maximums for POS and Traditional Indemnity coverage.

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New Prescription Drug Coverage Management Programs

Alcatel-Lucent is committed to keeping the cost of your prescription drugs down while providing you with the coverage you need. With this goal in mind, effective November 1, 2014, Express Scripts will implement a set of coverage management programs to determine whether certain medications meet the Plan’s coverage requirements.

These programs may review some or all of the following information:

• The diagnosis or condition for which the prescription drug is being prescribed
• Dosing and/or duration of therapy
• Patient drug history for prior and simultaneous medication use
• Age and gender of the patient

Express Scripts will notify you if you are impacted by any of these programs.

Effective January 1, 2015, the following will be implemented:

• “Member Pays the Difference” Program: If you purchase a brand-name retail or home delivery medication when a generic equivalent is available, you will pay the generic copayment, plus the difference in cost between the brand-name and generic medication.
• You will pay double your retail copayment if you purchase a maintenance medication* more than three times at an in-network retail pharmacy. You will pay only your home delivery copayment if you purchase the maintenance medication through the Express Scripts Pharmacy^SM.

*Maintenance medications are those used on an ongoing basis to treat conditions such as high blood pressure, high cholesterol and asthma.

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