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Get the Best of Both Worlds

with a Consumer-Driven Health PlanYour 2016 Guide

It’s More Than Meets the Eye with Your Consumer-Driven Health Plan

LOOK NO FURTHER. A CONSUMER-DRIVEN HEALTH PLAN (CDHP) GIVES YOU MEDICAL COVERAGE AND A SPECIAL HEALTH SAVINGS ACCOUNT (HSA) YOU CAN USE TO PAY FOR HEALTH CARE COSTS.

WATCH THISFind out more about how your CDHP options work. Text kssbenefits to 88202 to receive Kohl’s video library on your mobile device to understand all the benefits Kohl’s has to offer.*

*1 msg/transaction. Message and data rates may apply. By texting 88202 from your mobile number, you agree to receive a text generated by an autodialer from Guidespark to your number. Not required to make a purchase for goods or services.

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A CDHP IS THE RIGHT TYPE OF PLAN FOR A LOT OF ASSOCIATES, NOT JUST SINGLES OR HEALTHY PEOPLE OR OTHERS WHO NEVER GO TO THE DOCTOR! FLIP THROUGH THESE PAGES AND FIND OUT IF A CDHP CAN WORK FOR YOU.

The Savers Plan—Kohl’s Core Medical Plan

Kohl’s contributes to your HSA (up to $500 annually for single coverage; up to $1,000 annually if you cover a spouse/same-sex domestic partner and/or dependents) to help you pay for eligible medical expenses until you meet the deductible and the plan starts paying.

Need Less Coverage? Try the Basic Plan

If you feel that you need less coverage than the Savers Plan provides, consider enrolling in the Basic Plan. The Basic Plan works just like the Savers Plan, but with the Basic Plan there is a higher deductible and lower paycheck contributions. There are some differences with prescription drug coverage as well. With the Basic Plan, Kohl’s will not contribute to your HSA, but you can contribute your own pre-tax dollars.

Under all Kohl’s medical coverage, you’ll also receive free in-network preventive care and have the flexibility to choose any doctor. You’ll save money if you choose in-network doctors.

Your Health Savings Account

Need to Go to the Doctor?

Prescription Drug Coverage

Keep in Mind

Glossary

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About Medical Coverage

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The Savers Plan and the Basic PlanInsurance

Carrier Network:UnitedHealthcare or Anthem

(depending on where you work)

Services:You’re covered if you visit the doctor,

hospital or emergency room or receive prescription drugs. And remember,

you get free preventive care.

Costs:You pay less from your paycheck

and more when you go to the doctor or fill a prescription.

PREVENTIVE CARE

Services like annual physical

exams, well- child care and immunizations

Savers Plan (In-Network) and

Basic Plan (In-Network):

Plan pays 100%

ANNUAL OUT-OF-POCKET

MAXIMUM

The most you’ll pay in a single calendar year for services

Savers Plan (In-Network) and

Basic Plan (In-Network):

$5,000 single $10,000 family**

COINSURANCE

The percentage paid by the plan for your medical

services, after the deductible

Savers Plan (In-Network) and

Basic Plan (In-Network):

Plan pays 80% after deductible

ANNUAL DEDUCTIBLE

The amount you pay before the

plan covers your medical services

Savers Plan (In-Network): $1,300 single

$2,600 family*

Basic Plan (In-Network):$1,800 single

$3,600 family*

COPAY

A flat dollar amount you pay for health care

Savers Plan (In-Network) and

Basic Plan (In-Network):

No copays; deductible and

coinsurance only

Note: These plan details reflect in-network coverage.*Due to IRS limitations, if you elect family coverage in the Savers Plan or the Basic Plan, the entire family annual deductible must be met before any copays or coinsurance is applied for any individual family member. **If you elect family coverage under the Basic or Savers Plan, there is a per person out-of-pocket maximum of $6,850. Once someone reaches that maximum in a year, the plan pays 100 percent of that person’s remaining eligible expenses for the year.

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THE HEALTH SAVINGS ACCOUNT, OR HSA, ALLOWS YOU TO SAVE TAX-FREE MONEY FROM YOUR PAYCHECK TO PAY FOR CURRENT OR FUTURE HEALTH EXPENSES.

IT’S EASY. If you choose the Savers Plan, Kohl’s opens the HSA for you (regardless of whether you contribute your own money or not) and it is administered through HealthEquity. You can access your money via a debit card. If you choose the Basic Plan, Kohl’s will open the HSA for you when you elect to contribute your own money to the account.

SAVE ON TAXES FOR 2016. You may contribute up to $3,350 for single coverage and $6,750 if you cover a spouse and/or dependents. (These annual federal limits are for 2016 and include Kohl’s contributions too.)

SPEND NOW OR SAVE FOR LATER. You can use the HSA to pay for out-of-pocket medical, prescription drug, dental and

vision expenses today or in the future. (Go to IRS.gov for a full list of expenses.)

WATCH YOUR MONEY GROW. Once you save at least $2,000 in your HSA you can invest your money and it can grow tax-free.

YOURS TO KEEP. Your unused money rolls over each year. And, if you leave Kohl’s you take the account with you.

DON’T FORGET! Your entire contribution will not be available right away; your contributions are split evenly across your paychecks for the remainder of the year. For Savers Plan participants, Kohl’s contributions will be made each quarter.

If you enroll in the Savers Plan, Kohl’s contributes money to your HSA each quarter to help you pay for your expenses too!

• Up to $500 annually for single coverage ($125/quarter)

• Up to $1,000 annually if you cover a spouse and/or dependents ($250/quarter)

Your Health Savings Account

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YOU’RE COVERED

• Free preventive care (in-network)

• Office visits

• Hospitalization

• Emergency room care

• Prescription drugs

PAY WITH YOUR HSA

You can use your HSA debit card to pay for your bill, or you can save your HSA money for later and pay with money from your bank account.

YOU’LL PROBABLY NEED TO VISIT THE DOCTOR DURING THE YEAR. DON’T WORRY—YOU’RE COVERED. HERE’S WHAT TO EXPECT.

CHOOSE ANY DOCTOR. You’ll save money if you use a UnitedHealthcare or Anthem (depending on where you work) provider because they’re in-network.

YOU’LL RECEIVE A BILL AFTER YOU GO TO THE DOCTOR. You won’t pay anything at the doctor’s office.

YOU’LL PAY THE FULL COST OF YOUR CARE UNTIL YOU MEET YOUR DEDUCTIBLE. To save money, visit a doctor’s office or an urgent care clinic. Only go to the emergency room if it’s a true emergency.

ONCE YOU MEET YOUR DEDUCTIBLE, YOU AND THE PLAN WILL PAY. This is called coinsurance—in network, you’ll pay 20 percent and the plan will pay 80 percent up to your out-of-pocket maximum.

ONCE YOU REACH YOUR OUT-OF-POCKET MAXIMUM, THE PLAN WILL PAY 100 PERCENT. The out-of-pocket maximum is the most you will pay. The plan will pay your costs for the rest of the calendar year.

Need to go to the Doctor?

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Accident Protection Plan and Critical Illness Plan (Full-time Associates only)Kohl’s is offering the Accident Protection Plan as well as the Critical Illness Plan that’s designed to supplement your Kohl’s medical coverage. These voluntary benefits provide additional protection to help meet annual deductibles, copays and out-of-network expenses. Don’t forget to consider this coverage when you enroll.

TelemedicineIf you enroll in Kohl’s medical coverage (excluding Kaiser), you and your family will be able to access a telemedicine service—the Teladoc® network of physicians—when your primary doctor is unavailable or if it is after hours, or on the weekends. Teladoc is available to you 24/7 with a simple phone call.

DEDUCTIBLE? COINSURANCE?

To review key terms, check out the glossary at the end of this book!

Other Benefits to Supplement Your CDHP

PRESCRIPTION DRUG COVERAGE WORKS A LITTLE DIFFERENTLY WITH THE SAVERS AND BASIC PLANS. SO REVIEW THESE DETAILS CAREFULLY TO MAKE SURE THIS PLAN IS RIGHT FOR YOU.

To save money:GO GENERIC. Ask your doctor if a generic prescription drug is right for you. Generic prescription drugs are made of the same active ingredients as their brand-name counterparts but cost much less!

USE CVS CAREMARK. You can use any pharmacy, but you’ll save money with CVS Caremark, Kohl’s prescription drug partner. Manage your CVS Caremark account at caremark.com.

USE MAIL-ORDER. For long-term medications you can receive a three-month supply delivered to your door.

Prescription Drug Coverage

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SAVERS PLAN BASIC PLAN

RETAIL(30-day supply)

Generics Preventive: $10 Non-Preventive: Deductible then $10

Preventive: $10 Non-Preventive: Deductible and Coinsurance

Brand Formulary

Preventive: 30% ($30 min, $100 max)

Non-Preventive: Deductible, then 30% ($30 min, $100 max)

Deductible and Coinsurance

Brand Non-Formulary

Deductible, then 40% ($50 min, $150 max) Deductible and Coinsurance

MAIL(90-day supply)

Generics Preventive: $25 Non-Preventive: Deductible then $25

Preventive: $25 Non-Preventive: Deductible and Coinsurance

Brand Formulary

Preventive: 30% ($75 min, $250 max)

Non-Preventive: Deductible, then 30% ($75 min, $250 max)

Deductible and Coinsurance

Brand Non-Formulary

Deductible, then 40% ($125 min, $375 max) Deductible and Coinsurance

*If you take generic preventive prescription drugs you will pay a flat $10 copay—even if you haven’t met your deductible.

You pay the full cost of your prescription drugs until you meet your deductible.*

Once you meet your deductible, you’ll pay a percentage of the drug’s cost between a set minimum and maximum. See the table below for more details.

HOW MUCH WILL YOUR RX DRUGS COST?

To estimate your prescription drug costs in the Savers or Basic Plan go to caremark.com/kohls.

Keep In MindBECAUSE HSAs PROVIDE SOME ATTRACTIVE TAX SAVINGS, THE INTERNAL REVENUE SERVICE (IRS) HAS A FEW RULES YOU MUST FOLLOW IN ORDER TO MAKE CONTRIBUTIONS:

• You cannot be enrolled in Medicare (for most individuals this means you will no longer be eligible when you turn age 65. You lose eligibility as of the first day of the month you turn age 65);

• You cannot be claimed as a dependent on someone else’s tax return; and

• You cannot be covered under any other health insurance plan.

HSA funds can be used to pay for qualified medical expenses of any family member who qualifies as a dependent on your tax return, including spouses. Remember, if the dependent isn’t covered under your plan, his or her expenses won’t be applied toward your plan’s deductible.

In addition, you cannot participate in both a traditional flexible spending account (like Kohl’s Health Care FSA) and an HSA at the same time. However, you can participate in a limited-purpose FSA, which can be used for dental and vision expenses.

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GlossaryBENEFIT TERMS CAN BE CONFUSING. REVIEW THESE KEY DEFINITIONS.

DEDUCTIBLE: A deductible is the amount of money you pay each year before your insurance plan starts paying benefits.

For example, let’s say your deductible is $1,300. The plan won’t pay anything until you’ve paid the first $1,300 in medical expenses.

COINSURANCE: Coinsurance is when you share a percentage of the cost of medical services with your insurance plan, after you’ve met the deductible.

For example, if your coinsurance is 80%, that means the plan will pay 80% of the cost and you’ll pay 20%. Let’s say your doctor’s visit is $100. In that case the plan will pay $80 and you will pay $20.

OUT-OF-POCKET MAXIMUM: The out-of-pocket maximum is the total amount of money you’ll pay for your medical care in a year. Once you hit your out-of-pocket maximum the plan will pay 100% of your costs for the remainder of the calendar year (except for copayments, if applicable).

For example, the most you’ll pay for single coverage is $5,000. If you have family coverage, the most you will pay is $6,850 for one person or $10,000 in combined family expenses. This maximum protects you from very high medical costs.

COPAY: A copay is the flat dollar amount you pay for a covered expense.

For example, you’ll pay a $10 copay for a generic preventive prescription drug.

80% (plan pays)

20% (you pay)

Plan Pays

100%

SAVERS PLAN SINGLE COVERAGE EXAMPLE

Deductible

$1,300 (you pay)

Coinsurance

Out-of-Pocket Max

$5,000 (most you can pay)

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