Retiree Health Care Plan Benefits 2012 Enrollment Guide. Medical Coverage: Pre-Medicare Retirees

Medical Coverage:

Pre-Medicare Retirees

You’ll choose from four medical plans: Basic, Comprehensive, Health Reimbursement Arrangement (HRA) and Health Savings Account (HSA).

Each option:

has the same network of healh care providers (Highmark Blue Cross Blue Shield, which uses the National Blue Cross Blue Shield PPO network of providers)

covers the same services

includes the same prescription drug plan. When you enroll yourself and your eligible dependents in one of the medical options, you automatically are enrolled for prescription drug

coverage.

has different deductibles, coinsurance amounts (depends on what kind of provider you see and where you receive services), and annual out-of-pocket maximums

has different contributions as shown in your enrollment materials.

The chart on the next page shows how the options differ in deductible, coinsurance, and out-of-pocket maximum amounts. Because more than 95% of Alcoa’s medical claims are for services in the Highmark Blue Cross Blue Shield network, this chart highlights in-network care only.

To find out if your physician or hospital is in the Highmark network, go online to

www.highmarkbcbs.com

Deductible

The deductible is the amount you must pay for covered expenses before Alcoa pays for any expenses.

Coinsurance

After you meet the applicable deductible, you pay a percentage of the cost, and Alcoa pays the rest. This is the coinsurance amount. With the Basic and Comprehensive options, there are three different coinsurance levels:

PCP Office Care: Services provided by a primary care physician (PCP) in his or her office. A PCP is defined as a family practitioner, general

practitioner, internist, or pediatrician.

Specialty Office/Emergency Room Care: Services provided by any other physician (examples include

cardiologist, allergist, gynecologist, or physical therapist) in his or her office or in an emergency room.

Other Services: Surgery,

hospitalization, laboratory services, X-rays, durable medical equipment, and more.

Out-of-Pocket Maximum

The out-of-pocket maximum limits the amount you pay for covered medical expenses in one calendar year. After you meet your out-of-pocket maximum, Alcoa pays 100% of all covered expenses for the rest of the calendar year. Note: The annual out-of-pocket

maximum includes deductible and coinsurance amounts for medical services. It does not include prescription drug expenses.

Retiree Health Care Plan Benefits

2012 Enrollment Guide

Medical Coverage for Pre-Medicare Retirees continued What You Need to Know About Each Plan

When selecting a medical plan, think about your and/or your family’s health care needs. You should look at more than just the contributions that will come from your paycheck. It’s important to also review the plan design. For example, all plans cover routine

preventive care at 100%, and the Basic and Comprehensive plans cover some services with no deductible.

Basic

The Basic option has the lowest contribution, but it may cost you more when you use medical services.

This option offers coverage without a deductible for many services, including physician office visits and emergency room care.

Comprehensive

The Comprehensive option has the highest contribution, but it may cost you less when you use medical services.

This option offers coverage without a deductible for PCP office visits. You’ll have to meet the deductible first for all other types of medical services.

Health Reimbursement Arrangement (HRA)

The HRA has higher deductibles and out-of-pocket costs, but Alcoa puts money into an account to help you pay for health care costs.

Alcoa puts $750 in the account if you cover only yourself or $1,500 if you cover two or more people.

You can use your HRA money to reimburse yourself for health care expenses during the year. Whatever you don’t use rolls over to the next year as long as you stay in the HRA.

Health Savings Account (HSA) The HSA is made up of two parts:

o A medical plan that covers eligible medical and prescription drug expenses after you meet your deductible*, and

o A savings account that both you and Alcoa can contribute to. This account is controlled by you.

There are higher out-of-pocket costs in this plan, but Alcoa puts money in your HSA to help you cover those costs.

Alcoa puts $400 in your HSA if you cover only yourself or $800 if you cover two or more people. Plus, you can add your own money to the account: up to $2,700 pre-tax when you cover only yourself or up to $5,400 pre-pre-tax when you cover two or more people.

Medical Coverage for Pre-Medicare Retirees continued

You must open your HSA account directly with ACS/Mellon and accrue funds before paying for eligible services. Alcoa’s full annual contribution is deposited in January if you open your account during annual enrollment. If you open your account later, Alcoa’s full annual contribution is deposited as soon as administratively possible. The entire account – your money and Alcoa’s contribution – belong to you.

You can’t enroll in an HSA if you have other medical coverage, including coverage from a spouse’s plan or veteran coverage.

*Important: Your medical and prescription drug expenses apply toward your

deductible in the HSA. This means that you must meet your annual deductible before the plan starts to pay any medical or prescription drug expenses, including free generics by mail. Also, if you cover two or more people, you must meet the family deductible and out-of-pocket maximum, not the individual levels.

Medical Coverage for Pre-Medicare Retirees continued

Basic

Comprehensive

HRA

HSA

ANNUAL HRA/HSA CONTRIBUTION AMOUNT

ALCOA’S N/A N/A $750/employee only $400/employee only*

CONTRIBUTION $1,500/two $800/two

or more people or more people*

ANNUAL EMPLOYEE N/A N/A N/A Up to $2,700/person*

CONTRIBUTION Up to $5,450/family*

IN-NETWORK

ANNUAL DEDUCTIBLE $1,000/person $250/person $1,500/person $1,500/employee only $2,000/family $500/family $3,000/family $2,500/two

or more people

(Medical + Drug)

COINSURANCE

Alcoa pays 100% Alcoa pays 100% Alcoa pays 100% Alcoa pays 100% Routine

Preventive Care no deductible no deductible no deductible no deductible PCP Office Visits Alcoa pays 90% Alcoa pays 90% Alcoa pays 90% Alcoa pays 90%

no deductible no deductible after deductible after deductible Specialist Office Visits Alcoa pays 70% Alcoa pays 80% Alcoa pays 90% Alcoa pays 90% and ER Care no deductible after deductible after deductible after deductible Other Services Alcoa pays 70% Alcoa pays 80% Alcoa pays 90% Alcoa pays 90% after deductible after deductible after deductible after deductible

ANNUAL $3,000/person $2,500/person $3,000/person $3,000/employee only

OUT-OF-POCKET $4,500/family $3,750/family $6,000/family $4,500/two

MAXIMUM or more people

(Medical + Drug)

* Per IRS, total maximum contributions are $3,100/$6,250. Retirees age 55 and older can make up to an additional $1,000 in “catch-up” contributions in 2012.

Prescription Drug Plan

Pre-Medicare and Medicare-eligible retirees have the same prescription drug coverage.

There’s only one prescription drug plan, which is automatic with any of the medical options.

Three coverage categories in the drug plan: Generic Drugs

• No deductible

• Free when you fill through the mail order program

• At retail, you’ll typically never pay more than 10%

Brand 80/20 Drugs

• Brand-name prescription drugs with no or limited generic alternatives to treat your condition

• Brand-name drugs that treat asthma or diabetes

• No deductible

• Alcoa pays 80% of the cost and you pay 20%

Brand 50/50 Drugs

• Brand-name prescription drugs with appropriate generic alternatives

• $50/$100 (individual/family) deductible, combined for retail and mail

• Alcoa pays 50% of the cost and you pay 50%

Your Out-of-Pocket Costs

• The deductible is combined for retail pharmacy and mail delivery. It only applies to Brand 50/50 drugs. The deductible is $50 for an individual and $100 for

families.

• If you choose a brand-name drug when a generic equivalent is available, Alcoa

pays only the cost that would apply if you chose the generic drug. You pay the generic coinsurance plus the difference in cost between the brand-name and generic drugs.

• If your doctor believes that a brand-name medicine is medically necessary, he or

she can provide clinical reasons to the CVS Caremark Prior Authorization

Department. If the brand-name drug is approved, you’ll pay the brand-name drug coinsurance.

• If you fill your prescription for a maintenance medication more than three times at your retail pharmacy, you’ll pay 10% extra. Avoid the extra costs by using mail order.

• The maximum coinsurance you’ll pay per fill is $100 at a retail pharmacy or $200

if you use mail order. This maximum applies to the coinsurance but does not apply to any extra costs if you choose a brand-name drug over a generic or purchase a maintenance drug at a retail pharmacy instead of through mail order.

What will your medications cost?

To find out what your current prescriptions will cost when you purchase them through CVS Caremark in 2012, you can use a convenient estimating tool. If you currently use a brand-name medication, you can find information about its generic equivalent as well. Follow these steps:

1. Call CVS Caremark at 1-888-291-6372 and select Option 1 for members.

2. When prompted, say “No” or press 2 to calling about a refill. 3. Select the menu option for “Get a Drug Price.”

4. Say “No” or press 2 to your Member ID having letters and when prompted, enter

the following information:

ID number: 777-888-999

Date of Birth: 01-01-1960

5. Say the drug name, strength, and daily quantity when prompted.

6. If the drug is available through the mail-order service, you’ll hear both the retail (for a 30-day supply) and mail-service (for a 90-day supply) costs. The retail and mail-order prices will be significantly different because the quantities are different. 7. If you request a brand-name drug for which a generic is available, you’ll also hear

the price for the generic.

8. If you speak to a CVS Caremark customer service representative, say that you are

an Alcoa member seeking information about your 2012 drug coverage. You’ll need to provide the ID number and other information in Step 4.

Note: The estimator assumes you’ve already met your annual retail deductible. Costs provided are estimates only.

Retail Mail

Prescription Drug Network

You have two ways to purchase covered prescription drugs:

• At a participating CVS Caremark retail pharmacy, including most chain and many local pharmacies. Your deductible applies, and you pay the

coinsurance for up to a 30-day supply.

• Through the CVS Caremark mail-order service for long-term medications or any prescriptions not needed immediately. No deductible applies, and you pay the coinsurance for up to a 90-day supply.

If you use an out-of-network pharmacy, you pay the full cost of the prescription and then submit a claim form and receipt to CVS Caremark. You’ll be reimbursed at the in-network retail level for covered prescriptions minus the applicable

deductible and coinsurance. You also must pay any difference between the CVS Caremark negotiated rate and the pharmacy’s actual charge.

For a list of participating pharmacies or to find out how much you’ll pay for your prescriptions, go online to www.caremark.com or call 1-888-291-6372.

If you are Medicare-eligible

You are not required to choose prescription drug coverage through Medicare. Alcoa will continue to provide your retiree prescription drug coverage for 2012. If you enroll in Medicare prescription drug coverage, you will be required to pay a monthly premium to the Medicare drug plan and a share of the costs for your medications - so you will be paying more for additional insurance that you may not need. Medicare prescription drug coverage will not supplement your Alcoa retiree drug plan, and your Alcoa retiree drug plan will not supplement Medicare prescription drug coverage. There will be no coordination between the two plans. Medicare prescription drug coverage may not cover all medications that the Alcoa plan covers.

Alcoa’s retiree drug plan is considered “creditable” by Medicare, which means, on average, it is at least as good as Medicare prescription drug coverage. Therefore, for most Alcoa retirees, there will be no advantage to signing up for the Medicare plan.

For more information about the Medicare drug plans offered in your area, you can call 1-800-MEDICARE (1-800-633-4227) or log on to www.medicare.gov.

If you have a limited income and resources, you may be eligible for assistance from the government to help pay for the Medicare coverage. You can call the Social Security Administration at 1-800-772-1213 for more information about this assistance.

PRESCRIPTION DRUG COVERAGE RETAIL PHARMACY

Up to 30-day supply

Additional 10% coinsurance for a maintenance drug at a retail pharmacy after 3 fills.

MAIL SERVICE Up to 90-day supply

COINSURANCE COINSURANCE DEDUCTIBLE

GENERIC You pay 10%

Alcoa pays 90%

Maximum coinsurance: $60

You pay nothing Alcoa pays 100%

NONE for retail or mail service

BRAND 80/20

Brand-name with no or few generic alternatives

When Brand 80/20 drug has a generic equivalent but you choose brand

You pay 20% Alcoa pays 80%

Maximum coinsurance: $100

You pay 10% of the generic drug cost PLUS difference in cost between brand-name and generic drug.

Maximum coinsurance: $100. There is no maximum for difference in cost or for the additional 10% for filling maintenance drug at retail.

You pay 20% Alcoa pays 80%

Maximum coinsurance: $200

You pay the difference in cost between the brand-name and generic drug.

Maximum coinsurance: $200.

There is no maximum for difference in cost.

NONE for retail or mail service

BRAND 50/50

Brand-name with appropriate generic alternatives

When Brand 50/50 drug has a generic equivalent but you choose brand

You pay 50% after deductible Alcoa pays 50%

Maximum coinsurance: $100

You pay 10% of the generic drug cost PLUS difference in cost between brand-name and generic drug.

Maximum coinsurance: $100 There is no maximum for difference in cost or for the additional 10% for filling maintenance drug at retail.

You pay 50% after deductible Alcoa pays 50%

Maximum coinsurance: $100

You pay the difference in cost between the brand-name and generic drug.

Maximum coinsurance: $200.

There is no maximum for difference in cost.

$50 person $100 family (One deductible that includes drugs purchased at retail and mail service)

Medical Coverage for Medicare-Eligible Retirees

Alcoa Medicare Supplement Plan

Once you are eligible for Medicare, your primary health care coverage is provided through Medicare. To help pay for some costs that Medicare does not cover, Alcoa offers the Alcoa Medicare Supplement Plan. The Alcoa Medicare Supplement Plan supplements Medicare Part A (hospital) benefits, such as the inpatient deductible and daily copayments, and certain limited Medicare Part B (physician and other medical services) benefits.

Please note that, when you become eligible for Medicare, Alcoa will always pay your claim as if you have Medicare Part B, whether or not you are enrolled. If you become eligible for

Medicare before age 65, you need to notify Alcoa immediately.

MedOption

You can purchase the voluntary MedOption Plan if you enroll in the Alcoa Medicare Supplement Plan. This plan helps fill the gap between Medicare Part B and the Alcoa Medicare Supplement Plan.

MedOption is not an Alcoa plan. It is provided by your medical claims administrator, and Alcoa provides access to the plan as a convenience. You pay the full monthly cost if you purchase the MedOption Plan. If you choose to enroll in MedOption, the cost will be deducted from your pension check or you can choose to be billed each month. Your retiree health care credits

cannot be used to purchase MedOption coverage. Please refer to your Enrollment Worksheet for MedOption pricing information. You may enroll in MedOption coverage at any time.

Please note that there are other similar supplemental plans available through insurance companies and AARP that may better suit your needs and budget.

You may also have a Medicare HMO available in your area. If this option is available, it will be listed on your Enrollment Worksheet. Contact the HMO directly for details about the plan. This chart shows how Medicare, the Alcoa Medicare Supplement Plan, and MedOption work together.

Medical Benefits for Medicare-Eligible Retirees

Medicare Alcoa Medicare MedOption Plan

(up to Medicare-approved Supplement Plan (up to Medicare-approved

Services

amount after Parts A & B (up to Medicare-approved amount) deductibles are met)* amount)

AMBULANCE SERVICE 80% No Coverage 20%

AMBULATORY 80% No Coverage 20%

SURGICAL FACILITY

ASSISTANT SURGERY 80% No Coverage 20%

BONE MASS 80% No Coverage 20%

MEASUREMENT

CARDIAC 80% No Coverage 20%

REHABILITATION

CHEMOTHERAPY 80% No Coverage 20%

(provided by

licensed professional)

DIABETES MONITORING 80% No Coverage 20%

Services Medicare

Alcoa Medicare

Supplement Plan Med-Option Plan

DOCTOR VISITS 80% No Coverage 20%

(includes skilled nursing

facility, inpatient, office,

or home visits)

DURABLE MEDICAL 80% No Coverage 20%

EQUIPMENT AND

PROSTHETIC DEVICES

EYEGLASSES AFTER 80% 20% No Coverage

CATARACT SURGERY

HEMODIALYSIS 80% No Coverage 20%

OUTPATIENT HOSPITAL

HOME HEALTH CARE 100% No Coverage No Coverage

HOSPICE 80% 20% No Coverage

IMMUNIZATIONS Limited Coverage 20% for immunizations No Coverage If administered in a doctor’s covered by Medicare;

office or health care facility otherwise 80%

(excludes immunizations

for travel outside the U.S.)

INPATIENT HOSPITAL 100% Medicare Part A inpatient No Coverage

after inpatient deductible deductible and daily and daily copayments copayments (if applicable)

OUTPATIENT HOSPITAL 80% No Coverage 20%

PHYSICAL

REHABILITATION

OUTPATIENT MENTAL 50% 50% No Coverage

HEALTH/SUBSTANCE

ABUSE TREATMENT

OUTPATIENT SURGERY

• Surgeon 80% 20% No Coverage

• Anesthesia 80% 20% No Coverage

• Facility 80% No Coverage 20%

PAP TEST AND 80% No Coverage 20%

PELVIC EXAM

PHYSICAL OR 80% No Coverage 20%

OCCUPATIONAL THERAPY

RADIATION THERAPY

(doctor’s fees only)

• Inpatient 80% 20% No Coverage

• Outpatient 80% No Coverage 20%

SCREENING FOR:

• Prostate cancer 80% No Coverage 20%

(digital rectal exam)

• Colorectal cancer 80% No Coverage 20%

SKILLED NURSING 100% for first 20 days; 100% of copayment for No Coverage FACILITY copayment required from days 21 through 100; then

day 21 through day 100% beyond day 100

VISITING NURSE No Coverage 80% No Coverage

Services of a registered

nurse (R.N.) or a licensed

practical nurse (L.P.N.)

X-RAY/LABORATORY

• Inpatient 80% 20% No Coverage

• Outpatient 80% No Coverage 20%

* You are responsible for enrolling in Medicare Part B when you are first eligible. When you become eligible for Medicare, Alcoa will pay your claim as if you have Medicare Part B, whether or not you are enrolled.

A Reminder About Privacy

Alcoa’s health care plans comply with Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements. Details are available in Alcoa’s Notice of Privacy

Practices. This notice explains how certain health information about you and your covered dependents may be used or released by Alcoa’s health care plans.

If you wish to review the Notice of Privacy Practices, go to

http://resources.hewitt.com/alcoa. Scroll over the "Knowledge Center" tab, then click on "Plan Information" under the "Health and Insurance" heading. Or call 1-888-ALCOA123 (1-888-252-6212) to request a copy by mail.

How to Enroll

You can enroll in your Alcoa retiree benefits or learn more about them on Your Benefits Resources™ website at http://resources.hewitt.com/alcoa. The website is available 24 hours each day except Sunday, when it is available after 1 p.m. Eastern Time.

Note: You will need your user ID and your password to log on to the website. By Phone

If you are unable to enroll via the Your Benefits Resources™ website, you can enroll by calling 1-888-ALCOA123 (1-888-252-6212) weekdays between 9 a.m. and 5 p.m. Eastern Time.

When prompted, enter or say the last four digits of your Social Security number and your date of birth.

Please refer to your Enrollment Worksheet for price information and the deadline to enroll.

This booklet is for Alcoa retirees covered under Choices. This enrollment kit is part of the Summary Plan Description (SPD). It also is a Summary of Material Modifications under federal law and should be kept with your SPD. It contains important information about the Employees’ Group Benefits Plan of Alcoa Inc. Please read it carefully and keep it with your SPD for future reference. If there are any differences between this enrollment kit and the plan document, the plan document will govern. Alcoa may change the level of benefits provided under the plan at any time, subject to any collective bargaining agreements that may exist for covered participants. If a change is made, benefits for claims incurred after the date the change takes effect will be paid according to the revised plan provisions. In other words, once a change is made, there are no rights to benefits based on earlier plan provisions.

Published by Alcoa Corporate Affairs October 2011

Copyright © 2011 by Alcoa Inc. All rights reserved.

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