Specialty products. A group producer s guide.

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1 INDIANA OHIO Three reasons why you should consider Anthem for all of your specialty needs: 1 Administrative efficiencies and clinically integrated health, dental, vision and disability products. 2 We have over 34 million members nationwide. 6 3 Anthem Life Insurance Company has more than 50 years of experience and an A.M. Best financial rating of A Excellent. To offer a complete benefits portfolio from one convenient source, visit anthem.com/specialty or contact your Anthem Blue Cross and Blue Shield sales representative today! First Quarter Earnings Report Specialty products. A group producer s guide. One point of contact and a lot more choices make it easier for you to meet all your clients benefit needs. Life and Disability products underwritten by Anthem Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Ohio: Community Insurance Company. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association. The International Emergency Dental Program is administered by DeCare Dental. No such relationship other than that of independent parties under an arrangement with each other solely for the purposes of providing dental care to Anthem Blue Cross and Blue Shield members may be deemed to exist between DeCare Dental and participating dentists. DeCare Dental is an independent company offering dental administrative services to Anthem Blue Cross and Blue Shield plans DeCare Dental does not offer Blue Cross or Blue Shield products or services. DeCare Dental is solely responsible for its products and services MUBENABS 11/11

2 Maximize employee participation Group enrollment meetings In order to maximize participation, Anthem has developed and recommends a group enrollment strategy that: Includes mandatory enrollment meetings. Includes face-to-face employee meetings. Limits the number of options presented to employees at one time. Obtains employer support. Includes employee communications provided by Anthem. Pre-qualifies cases. Offers products that fit an existing benefit package. Please contact your Anthem sales representative/account manager for additional information on group enrollment meetings. Communication tools to help educate employees. We ll provide the materials to help employees make an informed decision when enrolling. Here s what you ll get: Anthem Voluntary offering announcement a letter/ template that announces the offering of one or more voluntary products. Open enrollment meeting announcement a letter/ template that announces the date, time and location of an open enrollment meeting. Worksite posters posters that can be placed around common areas in the workplace to promote the open enrollment meeting. Payroll stuffers colorful payroll stuffers that promote the open enrollment meeting. What s inside Why Choose Anthem Blue Cross and Blue Shield?...1 Dental Prime and Complete...2 Blue View Vision SM...6 Anthem Life and Disability insurance...10 Short-term and Voluntary Short-term Disability...18 Long-term and Voluntary Long-term Disability...22 Our Enrollment booklet makes it easy for employees to enroll. Your Anthem sales representative or account manager can provide employees with a customized enrollment booklet for each eligible employee. The booklets include: A cover letter Helpful health-related information for vision and dental products A guide to understanding how much life insurance an employee might need and why disability insurance is important Product overviews Summary of benefits Enrollment form All of this is provided at no cost to the employer, so be sure to contact your Anthem Blue Cross and Blue Shield sales representative to find out how to order these materials so that you ll have them in plenty of time to boost employee participation. Voluntary Accidental Death and Dismemberment...26 Anthem Voluntary...28 anthem.com 29

3 Anthem Voluntary A win-win solution for you and your clients. As the cost of providing health care benefits to employees continues to rise, many companies are offering voluntary benefits. If your clients aren t offering their employees a full benefits package or are reducing their benefits due to costs, take a look at our Anthem Voluntary product portfolio. Anthem Voluntary gives employers the opportunity to provide a more robust benefits offering at no cost to them. That s because the employees choose what benefits they want and only pay for the benefits they choose. Employees pay premiums based on group rates, rather than more expensive individual plans. Why sell Anthem Voluntary? Employers can choose to offer one or all of the portfolio products Dental, Vision, Term Life, Short-term Disability and Long-term Disability. Employees have access to more comprehensive coverage for themselves and their families. Large groups (51+ employees) can have participation waived if they participate in the Enrollment Partnership Program (EPP). Communication materials are provided by Anthem to help maximize employee enrollment. Benefits are provided by Anthem Blue Cross and Blue Shield one of the most trusted and respected names in health benefits. Anthem will assist in the enrollment at no cost to you or your client. Voluntary Enrollment Partnership Program With our Enrollment Partnership Program, employers may be able to save more benefit dollars. We ve had years of success with voluntary employee benefits programs, and we ve found that the programs that catch on always seem to have two things in common: Employers fully support the program. Employees are fully educated about their choices. That s where our Enrollment Partnership Program comes in. By working together, we ll waive participation requirements, and the employer will agree to fully support the benefits offering to help maximize the number of employees who participate. Here s all you have to do to get up and running with Anthem Voluntary: Promote enrollment meetings in employee communications. Hold mandatory group enrollment meetings. Normal business activities must continue; therefore at least 75% of eligible employees are required to attend the meetings. Allow plenty of time during normal business hours to present the program and enrollment. In turn, we ll agree to waive participation requirements and: Provide favorable rates to employees. Educate employees about their options and choices. Provide affordable access to high-quality benefits. Consider better underwriting terms. When you choose Anthem Blue Cross and Blue Shield, you offer your clients a complete benefits package with more of the choices they re looking for. Here s what we bring to the table to make it easier for your clients from every angle: A commitment to outstanding customer service. Local account management teams are ready to support your needs. Vision customer service is open seven days a week with extended hours. Life and disability representatives answer every customer call personally so you don t have to deal with an automated system. We re among the fastest in the industry in paying life claims - within two days. 1 Our dedicated dental customer representatives strive for first-call issue resolution. Average claims are paid in 3 days or less, with a claims accuracy rate of 99%. 2 The advantages of choosing a complete benefits package. One account management contact Clinically integrated health, vision, dental and disability products Administrative ease Flexibility. Flexible product designs Various funding arrangements (employer-paid, voluntary, ASO) Specialty products can be added to an existing health plan or sold as stand-alone Products that are strong alone but even better together. Adding vision, dental, life or disability to an existing Anthem Blue Cross and Blue Shield health plan can make a difference in an employee s life and in an employer s business. Our Clinical Integration features can help improve the health and productivity of employees by providing additional benefits, guidance and resources to members with pregnancies, chronic health conditions and diabetes. 1 LIMRA MarketScan Internal data anthem.com 1

4 Dental Prime and Dental Complete Eligibility and underwriting Choose a dental plan that s designed for better health When we created our new dental plans, we took overall health into account. Most or all of our dental plans offer: 100% coverage when employees see a network dentist for most diagnostic and preventive care services like cleanings and X-rays, which can be key to long-term oral health. Benefits for brush biopsy which together with a surgical biopsy may help to diagnose oral cancer, a potentially deadly disease. Some of our plans also include orthodontic benefits for children and adults. Affordability is critical, too For employer groups 2-50, Anthem dental offers flexible plan designs that fit into our Value, Classic and Enhanced categories. So employers can choose the benefit level that meets their needs and budget. Employer groups with 51+ employees have additional flexibility by choosing coinsurance, deductible, annual maximum and orthodontic coverage options. Employers can customize a plan that works best for them. In addition, we also offer voluntary dental plans, which allow employers to offer dental coverage to employees without adding to their expenses. And, our voluntary plans only require that 5+ employees enroll. Dental networks that work hard for you Anthem s Dental Prime contracted network has more than 91,000 nationwide provider locations. So employees won t have trouble finding a provider. Anthem s Dental Complete contracted network is our larger network with more than 102,000 dentist and specialist locations nationwide. When employees see a network dentist, they can count on: Savings: We agree on pricing with our network dentists and then pass that lower price on to employees. Freedom from paperwork: Network dentists file your employees claims with us. Freedom from balance billing: If our network dentists charge more than the agreed-upon price, employees would only be responsible for the applicable deductible or coinsurance. And for members traveling outside the U.S., we automatically include coverage for emergency dental services through a worldwide network of English-speaking dentists -- including 24/7 assistance finding a network dentist. Service and stability you can trust from a local and national leader Companies have trusted Anthem not only for solid benefits, but for service that helps make their lives easier. And employees have access to our customer service team that is committed to delivering excellent results: Average claim paid in three days or less Claim accuracy of 99% Typically less than a 20-second wait to talk to a customerservice representative Of course financial strength ratings are also very important in today s world. We ve earned an A (Excellent) rating from A.M. Best Company. So you can feel confident that we ll be here for all your dental needs today and for years to come. Additional plan advantages. Annual Maximum Carryover Provision may allow members to carry over some unused benefit dollars from one year to the next. No waiting periods for both large and small groups Promoting healthy mouths for pregnant and diabetic members. Members who are pregnant or living with diabetes can receive one additional dental cleaning or periodontal maintenance procedure a year. And we ll also reach out to them with our Future Moms and ConditionCare: Diabetes programs if they are enrolled in the 360 Health program. These members know how important it is to take care of their bodies and watch what they put in their mouths. But they also need to take extra special care of the mouth itself, which includes the teeth and gums. Emergency dental treatment for international travel. When our dental members work or travel abroad, their dental benefits travel with them. The International Emergency Dental Program, administered by DeCare Dental*, provides comprehensive emergency dental benefits to Anthem dental members while traveling or working nearly anywhere in the world. The International Emergency Dental Program s participating dentists are credentialed, speak English and meet the requirements to practice dentistry in their home countries. To find a participating dentist, members can visit or call the International Emergency Dental Program customer service center. *DeCare Dental is a wholly owned subsidiary of the parent company of Anthem Blue Cross and Blue Shield. Voluntary Accidental Death and Dismemberment Below is a summary of eligibility and underwriting guidelines that are subject to change at any time. Please contact your Anthem sales representative for additional information. General employee eligibility requirements General underwriting requirements Participation requirements Employer contribution Rate basis ASO funding availability Employees must work at least 20 hours per week to be eligible for coverage. Employees must be actively at work for coverage to become effective. No open enrollment for existing cases. Annual enrollments allowed but require Evidence of Insurability (EOI). The greater of 20% of eligible employees, or 10 employees, must enroll. The employee pays the entire cost of VAD&D coverage. The employer does not contribute toward the cost but performs administrative functions, including payroll deduction and premium remittance. VAD&D rates are either individual or family rates and are per $1,000 of coverage. Voluntary Accidental Death and Dismemberment Frequently Asked Questions What are the eligibility requirements for dependents? Children are eligible if they are age 15 days to 26 (27 in Wisconsin) years. Spouse benefits begin reducing at age 65. Spouse coverage ends when employee coverage ends. How often do rates change? Anthem Life reviews age bands just at the end of the rate guarantee period on a group s policy anniversary. If an employee has moved into a new five-year age band, the new rate will be reflected at that time. Anthem Life will notify the group by mail prior to any rate changes. Are there any exclusions? Please ask us for a certificate to see a complete list of accidental death and dismemberment exclusions. 2 anthem.com 27

5 Voluntary Accidental Death and Dismemberment (VAD&D) coverage at a glance VAD&D coverage is only available for groups of 51+. The coverage noted below is just an overview of benefits available. Anthem Life offers many plan designs for large groups. Talk to your Anthem representative about tailoring an insurance plan to fit your clients unique needs. Large group (51+) Rate guarantee Guaranteed issue Coverage amounts AD&D benefits Family coverage One or two years. All amounts of coverage are guaranteed issue. Employees may select a flat dollar benefit amount from $10,000 to $500,000 in $10,000 increments. Benefits are payable if an employee suffers a qualified loss within 365 consecutive days after an accident. A portion of the benefit is paid for the loss of sight or limb, certain digits, hearing, speech and paralysis. The benefit for all losses cannot exceed 100% of the principal sum. Employees may elect coverage for their family in the following amounts: Spouse: 50% of employee coverage Dependent Children: 10% of employee coverage All amounts of dependent coverage are guaranteed issue. Dependent coverage is available for children age 15 days to 26 years (27 in Wisconsin). (Benefits are not payable for children from birth to 14 days old.) AD&D seat belt benefit An additional benefit equal to the lesser of 10% of the AD&D benefit amount or $15,000 is paid if an employee dies in a motor vehicle accident while wearing a seat belt. AD&D air bag benefit AD&D child education benefit AD&D repatriation benefit AD&D common carrier benefit AD&D coma benefit An additional benefit equal to the lesser of 10% of the AD&D benefit amount or $10,000 is paid if an employee dies in a motor vehicle accident and the employee was wearing a seat belt; and the vehicle was equipped with an air bag. If an employee dies in an accident, an additional benefit equal to the lesser of 1.25% or $3,500 of the AD&D benefit amount is paid per academic term to each dependent child that is currently enrolled at an accredited post-secondary institution. A dependent child who is in the 12 th grade at the time of the employee s death and enrolls at an accredited post-secondary institution within one year from the employee s death will also qualify for an education benefit. The maximum benefit amount is $20,000 and the maximum benefit period is four years from the date of the first payment. If an employee dies in an accident at least 75 miles from home, Anthem Life will reimburse for preparation and transportation expenses, up to $5,000. If an employee dies in a public conveyance accident (e.g., airplane, train, bus), the AD&D benefit amount will be increased by 20%. An additional benefit is paid if an employee lapses into a coma for at least 31 days as a result of an accident. Dental Prime and Dental Complete coverage at a glance The plan designs noted below are ranges for various contributory (employer-paid) and voluntary (employee-paid) options. Additional options may be available only as contributory plans or only as voluntary plans. Talk to your Anthem sales representative about tailoring a Dental Blue plan to fit your clients needs. Plan designs available to groups with 2-50 Value Classic Enhanced Passive Active Passive Active Passive Active In-network/Out-of-network In-network/Out-of-network In-network/Out-of-network Diagnostic and preventive 100/100% 100/80% 100/100% 100/80% 100/100% 100/80% Basic 80/80% 80/60% 80/80% 80/60% 90/90% 90/70% Major Not covered Not covered 50/50% 50/50% 60/60% 60/50% Annual deductible (waived for D&P with family aggregate x 3) $50 $25 or $50 $25 or $50 Annual benefit maximum (per member) $500 or $1,000 $1,000 or $1,500 $2,000 Endodontic, periodontal and oral surgery category Basic Not covered Basic or Major Basic Orthodontic coverage (lifetime maximum to No coverage, 50% children only No coverage, 50% children only Not covered match annual maximum) or 50% adults and children or 50% adults and children Waiting periods (major and ortho) No waiting period No waiting period No waiting period Annual maximum carryover Not covered Optional Optional Voluntary Passive Active In-network/Out-of-network In-network/Out-of-network Diagnostic and preventive 100/100% 100/80% Basic 80/80% 80/60% Major 50/50% 50/50% Annual deductible (waived for D&P with family aggregate x 3) $25 or $50 Annual benefit maximum (per member) $1,000 or $1,500 Endodontic, periodontal and oral surgery category Major Orthodontic coverage (lifetime maximum to match annual maximum) No Coverage or 50% children only Waiting periods (major and ortho) 12 months* Annual maximum carryover Optional Plan designs available to groups with 51 or more employees Active or passive Diagnostic and preventive services coinsurance Basic services coinsurance Major services coinsurance Annual deductible or contract year option (Waive for diagnostic and preventive or family aggregate options of 2X, 3X, or none) Annual benefit maximum (per member) Endodontic, periodontal and oral surgery category Orthodontic coverage (no coverage, children only, or adults and children options) Waiting periods (vountary, major and orthodontic services have a 12 month waiting period waived if employer shows prior comparable coverage with enrollment paperwork) Annual maximum carryover Coinsurance options (5% increments): Coinsurance options (5% increments): Coinsurance options (5% increments): % % or not covered % or not covered $0, $15 - $100, or a $100 lifetime maximum (in $5 increments) $500 - $2,500 (in $250 increments) Basic or Major Coinsurance options 100% - 50% or not covered (5% increments): Lifetime max options $500 - $2,500 or not covered ($250 increments): Frequency options Basic and Major: None, 6, 12, 18, or 24 months Orthodontics: None, 12, 18, or 24 months Optional 26 anthem.com 3

6 Eligibility and underwriting Dental Prime and Dental Complete Below is a summary of eligibility and underwriting guidelines for Dental Prime and Dental Complete that are subject to change at any time. Contributory (employer-paid) Waiting periods No waiting periods for standard plan options and small groups (<50 employees). Waiting periods can be included for groups 51+ employees. Participation requirements The greater of 2 enrolled employees or 60% of the net eligible employees. ASO availability New business: underwriting will typically consider ASO funding arrangements for new groups greater than 100 lives. Orthodontia requirements Orthodontic coverage is available for groups of 10 or more enrolled. Options for 12, 18, 24 month or no waiting periods for new groups or new hires. Coverage options for child only orthodontic coverage for dependents age 8 through 18 or adult and child orthodontic coverage from age 8. Voluntary (employee-paid) Small group: 12-month waiting period for major and ortho, but it is waived if there is prior comparable coverage. Large group: all waiting periods are optional. A minimum of 5 employees must enroll in standalone dental; there is no further participation requirement. Orthodontic coverage is available for groups of 10 or more enrolled. Options for 12, 18, 24 month or no waiting periods for new groups or new hires. Coverage options for child only orthodontic coverage for dependents age 8 through 18 or adult and child orthodontic coverage from age 8. Long-term/Voluntary Long-term Disability Frequently Asked Questions What is an elimination period? The elimination period is the period of time that an employee must have a continuous disability before benefits can be paid. The employee must be disabled, unable to perform his or her regular job and under the care of a physician. To avoid duplicating benefits, the employer s plan design should include an elimination period that ends when Short-term Disability coverage ends. When do benefits start and how long do they last? See the LTD and VLTD benefit charts for elimination period duration options. The standard benefit duration is to Social Security Normal Retirement Age as long as the employee has a disability and is unable to perform his or her regular job. For payments to continue past two years, the employee must be unable to perform any job for which he or she is qualified and still have at least 40% loss in pre-disability earnings. Other benefit durations that are available as standard offerings are two years, five years and to Social Security normal retirement age. Other options are available with approval from an Anthem Life underwriter. What if an employee is partially disabled? Partially disabled employees can take advantage of the 12-month work incentive benefit that s included as a standard feature. During this time, partially disabled employees can work, and the combination of their work earnings and Long-term Disability benefits can equal up to 100% of their pre-disability earnings. After that period, monthly benefits are reduced by part-time earnings based on a proportionate loss formula. What is the Pre-existing condition limitation? Options for Pre-existing condition limitation periods are shown in the Long-term Disability chart. Are there any exclusions? Benefits will not be paid if there is no income lost due to disability. Benefits will not be paid in any of the following instances: if the disability is caused because employees injure themselves intentionally, are injured on the job, participate in a riot or civil commotion, participate in a felony, are injured during military service or are injured during war. Benefits will not be paid for any accident or illness resulting from the employee being under the influence of any illicit drug, or from operating a motor vehicle while intoxicated or on drugs. The maximum benefit period for mental illness, substance abuse or certain special conditions named in the certificate is 24 months. Refer to the certificate for a complete list of exclusions. 4 anthem.com 25

7 Eligibility and underwriting Long-term/Voluntary Long-term Disability Below is a summary of eligibility and underwriting guidelines and are subject to change at any time. Please contact your Anthem Blue Cross and Blue Shield sales representative for additional information. Groups must meet local Anthem Blue Cross and Blue Shield medical underwriting requirements for the definition of an employer group for both combined medical/life and stand-alone life business. Long-term Disability General employee eligibility requirements Employees must work at least 30 hours per week. Participation requirements All eligible employees must participate when coverage is non-contributory (entirely employer-paid). 75% participation is necessary when employee contribution is required. Stand-alone (without medical and/or without another life and disability product) 10 or more employees are required if LTD is sold as stand-alone (without medical or another life and disability product). If less than 10 employees, then LTD must be sold with medical or another life and disability product. Contribution requirements The minimum employer contribution for LTD or STD insurance coverage (not including dependent coverage) is 25% for contributory plans and 100% for non-contributory plans. Age-banded rates/composite rates 2-9 employees age-banded rates (each employee s premium is based on the group s rate table, using five-year age bands) employees composite rates (each employee s premium is based on the group rate, regardless of age). ASO funding Consideration will be given on a case-by-case basis for groups of at least 2,000 employees. Voluntary Long-term Disability Employees must work at least 20 hours per week. Minimum of 10 employees enrolled or 20% participation, whichever is greater. If the Enrollment Partnership Program (EPP) is selected, participation percentage is waived and a minimum of 10 enrolled employees is required. May be sold with medical or as stand-alone. No employer contribution. Age-banded rates (each employee s premium is based on the group s rate table, using five-year age bands). Dental Prime and Dental Complete Frequently Asked Questions What are Dental Prime and Dental Complete s competitive advantages in the marketplace? Employers no longer have to modify benefits in order to lower premiums. Members get access to one of the nation s largest dental networks with built-in fee discounts. Additional benefits for members like brush biopsy for early cancer detection and an extra cleaning for diabetic and pregnant members. No waiting periods. Annual Maximum Carryover Provision may allow members to carry over some unused benefit dollars from one year to the next. What services does your website make available? Employers can go to anthem.com and enroll employees online, view or change member information/coverage, add/cancel members, request ID cares, view bills and download forms. Dental members can go to anthem.com/mydentalvision to view online eligibility, request an ID card, view online claims, find a provider, access dental health education materials, and download forms Is the Dental Prime and Complete product administered differently than your previous dental products? Yes, we now have customer service and administration unit dedicated to dental. This means there is a dedicated dental application, dental bill and ID card. If a member applies for coverage more than 31 days after his/her eligibility date, can the member enroll as a late entrant? Similar to medical, dental has an open enrollment period. The member would have to wait until the next open enrollment period, unless they are otherwise eligible to enroll under a Special Enrollment Period as outlined in the Certificate. How will members know which network they have enrolled in? Their ID card will clearly indicate which Dental Prime and Dental Complete network they re enrolled in. Keep in mind that while members have access to all network providers, they can realize the greatest savings when they visit a dentist in their network. Both members and providers can confirm eligibility and benefits by calling the phone number listed on the ID card. Is there a benefit available if a member reaches his/her calendar year maximum? Yes, Dental Prime and Dental Complete dentists have agreed to extend their discounted fees to members enrolled in their network who have reached their calendar year maximum. 24 anthem.com 5

8 Blue View Vision SM Vision coverage is one of the most important health benefits. And with us, it s one of the most affordable. With Blue View Vision SM, members get a highly flexible plan that gives them the coverage they need to help maintain healthy eyes. Employers can count on its affordability to help them maintain a healthy bottom line. Convenient, national network More than 50,000 providers and provider locations Independent optometrists and ophthalmologists National retail locations like LensCrafters, Pearle Vision, Sears Optical SM, Target Optical and JCPenney Optical Convenience for our members Prescription eyewear delivered quickly in as little as an hour in some locations. Customer service hours are among the longest in the industry - available 7 days a week. Rich benefits Comprehensive eye exams. $130 standard frame allowance. $130 elective contact lens allowance. Frame allowance that covers up to 70% of manufactured frames. Factory scratch-coating on eyeglass lenses included at no additional cost. Transitions and polycarbonate lenses for children under 19 years old at no charge. Transitions lenses for adults at a fixed price of $75. Eye-opening savings In addition to their allowances, members get 20% off any remaining balance on frames. 15% to 40% savings on non-covered materials such as extra pairs of glasses, conventional contact lenses, lens treatments, specialized lenses and other items. This discount can be used for unlimited purchases even after vision benefits are exhausted. SpecialOffers@Anthem SM enables members to access discounts on all kinds of healthy living products, like laser vision correction surgery. Easy-to-use benefits for members Online ProviderFinder members can go to anthem.com and click on Find a Doctor. To access benefits, members simply show their Anthem Blue Cross and Blue Shield ID card at a network provider s office. Members never have to file claim forms when visiting an in-network provider. Flexible plan and funding options Full-service (exam and materials) Materials only Exam plus Fully insured Administrative Services Only (ASO) Voluntary (employee-paid) Indemnity and ASO (only available for large groups with underwriting approval) Improved diabetes management for our vision members Similarly, members who have our vision coverage and our 360 Health ConditionCare Diabetes program may be enrolled in the program if their vision claims include a diabetic-related diagnosis. We ll proactively reach out to tell them how they can learn more about managing their diabetes and how it can affect their vision and overall health. They ll get access to our 24-hour phone support line staffed by registered nurses, special health evaluations, online resources and more. Voluntary Long-term Disability coverage at a glance The coverage noted below is just a summary of benefits available for Voluntary Long-term Disability. Anthem Life offers many plan designs for both small and large groups. Talk to your Anthem sales representative about tailoring an insurance plan to fit your clients unique needs. Small group Rate guarantee Two years Guaranteed issue Large group : Two Years 300+: One Year Employees qualify for standard benefit amounts based on the group size, as well as industry and occupation classes. Medical questionnaires are required for coverage above the standard amounts and for late enrollees. Benefit payments 50% of monthly earnings 60% of monthly earnings Benefit maximum (per month) Groups of 10-50: $1,000 to $6,000 (up to $10,000 with Anthem Life underwriter approval for qualifying groups) Elimination period 90 or 180 days Maximum benefit period options Two years with reducing benefit duration Five years with reducing benefit duration To age 65 To Social Security normal retirement age Partial disabilities After 12 months, part-time earnings are offset using a proportionate loss formula. Maternity benefits Coverage for pregnancy is the same as coverage for any illness-related disability. $1,000 to $10,000 6 anthem.com 23

9 Long-term Disability coverage at a glance The coverage noted below is just a summary of benefits available for Long-term Disability. Anthem Life offers many plan designs for both small and large groups. Talk to your Anthem sales representative about tailoring an insurance plan to fit your clients unique needs. Small group (2-50) Large group (51+) Definitions Disability due to illness or injury, the employee is unable to perform all material and substantial duties of his or her regular occupation through the elimination period and the next 24 months of disability and, as a result, the employee must have a 20% loss in pre-disability earnings. For payments to continue beyond two years, the employee must be unable to perform any occupation for which he or she is suited and still have at least a 40% loss in pre-disability earnings ( own occupation periods of 2 years, 3 years, 5 years, to age 65 or to Social Security Normal Retirement Age are also available). Rate guarantee Two years Guaranteed issue 2-5 employees: medical questionnaires are required employees: all standard benefit amounts are guaranteed issue. Benefit payments 50% of monthly earnings 60% of monthly earnings Benefit maximum (per month) employees: $1,000 or $6, employees: $3,000 to $6,000 Elimination period Groups of 10-50: 90, 180 or 365 days Groups of 2-9: 90 or 180 days only Pre-existing condition 5 Groups of 25-50: 3/6/12, 3/12, 6/12/24, 12/6/24 Groups of 10-50: 12/6/24 or 6/12/24 Groups of 2-9: 12/6/24 Partial disabilities After 12 months, part-time earnings are offset using a proportionate loss formula. Maternity benefits Coverage for pregnancy is the same as coverage for any illness-related disability. All amounts are guaranteed issue. 50% of monthly earnings 60% of monthly earnings 67% of monthly earnings (66.67% in MO and WI) $1,000 to $15,000 60, 90, 120, 180 or 365 days for all groups 3/6/12, 3/12, 6/12/24, 12/6/24, 12/24 Blue View Vision coverage at a glance The plan designs noted below are ranges for various contributory (employer-paid) and voluntary (employee-paid) Blue View Vision options. Additional options may be available only as contributory plans or only as voluntary plans. Talk to your Anthem sales representative about tailoring a Blue View Vision plan to fit your clients needs. The Blue View Vision network consists of in-network independent optometrists and ophthalmologists, LensCrafters, Target Optical, Sears Optical SM, JC Penney Optical and Pearle Vision stores. 5 How to read pre-existing condition numbers: Using 12/6/24 as an example: An illness or injury is pre-existing if, during the 12 months before an employee s effective date, they received treatment for the illness or injury or there were symptoms present that would cause them to seek treatment. A disability that begins within the first 24 months after the employee s effective date will not be covered if the disability results from a pre-existing condition, unless 6 consecutive months pass after the effective date without treatment. Exam* Limited to one exam per member every 12 or 24 months Prescription lenses One pair of basic (plastic) lenses Single vision lenses Bifocal lenses Trifocal lenses Limited to one pair of lenses per member every 12 or 24 months. *A copayment may apply to the exam and eyeglasses lenses. Frames Limited to one set of frames per member every 12 or 24 months Prescription contact lenses May choose to receive contact lenses in lieu of the eyeglass lens benefit and receive an allowance toward the cost of contact lenses. Limited to one pair of contacts per member every 12 or 24 months. Any remaining amount over the allowance may apply toward the contact lens fitting fee. 22 anthem.com 7

10 Eligibility and underwriting Blue View Vision Below is a summary of eligibility and underwriting guidelines that are subject to change at any time. Please check with your Anthem sales representative for additional information. Groups must meet local Anthem Blue Cross and Blue Shield medical underwriting requirements for the definition of an employer group for both combined medical/vision and stand-alone vision business. Contributory (employer-paid) General employee eligibility requirements Groups 51+ employees Employees must work at least 30 hours per week. Groups 2-50 Hours worked vary by state. Contact your sales representative for details. Waiting periods No waiting periods for standard vision plans. Participation requirements Vision sold with medical or dental: Participation should match medical. If it is less than medical, must be at least 75% of net eligibles with a minimum of two enrolled. Small group: Type of coverage (single, family) must match medical; if no medical, then it must match dental. Vision stand-alone: Available for groups with 2+ eligible employees and 75% of net eligibles enrolled. Contribution requirements 50% of the single rate, 25% of the total premium. ASO availability New business: Underwriting will typically consider ASO funding arrangements for new groups greater than 250 lives. Existing business: ASO funding will be considered check with your Anthem sales representative. Indemnity plans Minimum group size of 500 employees. Voluntary (employee-paid) Employees must work at least 20 hours per week. Participation of 10 enrolled employees is required. Requires no employer contribution. Short-term/Voluntary Short-term Disability Frequently Asked Questions What is an elimination period? The elimination period is the period of time that an employee must have a continuous disability before benefits can be paid. The employee must be disabled, unable to perform his or her regular job and under the care of a physician. When do benefits start and how long do they last? Standard options are shown in the Short-term Disability chart under Plan designs. Standard benefit duration options are available for 13, 26 or 52 weeks. See the Short-term Disability Chart under Benefit Options. Large groups may elect a benefit duration to integrate with their Long-term Disability elimination period. What if an employee is partially disabled? Employees whose disability qualifies under the plan may receive partial disability benefits if they are working and earning less than 80% of their pre-disability earnings. Groups of 51+ may elect a Total Disability plan that does not include partial disability benefits. What if an employee has a recurring disability? An employee who returns to work and again becomes disabled due to the same condition for which he or she received benefits may not have to satisfy another elimination period. If the employee returned to work for 14 days or less, the employee will not have to satisfy another elimination period. Are there any exclusions? Benefits will not be paid if there is no income lost due to disability. Benefits will not be paid in any of the following instances: if the disability is caused because employees injure themselves intentionally, are injured on the job, participate in a riot or civil commotion, participate in a felony, are injured during military service or are injured during war. Benefits will not be paid for any accident or illness resulting from the employee being under the influence of any illicit drug, or from operating a motor vehicle while intoxicated or on drugs. Please refer to the certificate for a complete list of exclusions. 8 anthem.com 21

11 Eligibility and underwriting Short-term/Voluntary Short-term Disability Below is a summary of eligibility and underwriting guidelines that are subject to change at any time. Please contact your Anthem Blue Cross and Blue Shield sales representative for additional information. Groups must meet local Anthem Blue Cross and Blue Shield medical underwriting requirements for the definition of an employer group for both combined medical/life and stand-alone life business. Short-term Disability General employee eligibility requirements Employees must work at least 30 hours per week. General underwriting requirements No open enrollment for existing cases. Annual enrollments are allowed but require Evidence of Insurability (EOI). Participation requirements All eligible employees must participate when coverage is non-contributory (entirely employer-paid). 75% participation is necessary when employee contribution is required. Stand-alone (without medical and/or without other life and disability products) 10 or more employees are required if STD is sold as stand-alone (without medical or another life and disability product). If less than 10 employees, then STD must be sold with medical or another life and disability product. Contribution requirements The minimum employer contribution for STD insurance coverage (not including dependent coverage) is 25% for contributory plans and 100% for non-contributory plans. Rate basis 2-9 employees age-banded rates (each employee s premium is based on the group s rate table, using five-year age bands). 10+ employees composite rates (each employee s premium is based on the group rate, regardless of age). ASO funding 250+ enrolled employees FMLA administration Available for groups of 500+ Voluntary Short-term Disability Employees must work at least 20 hours per week. No open enrollment for existing cases. Annual enrollments are allowed but require Evidence of Insurability (EOI). 12/12 pre-existing condition limitation. Groups of 51+ also have the option to elect 3/12 pre-existing condition limitation. Minimum of 10 employees enrolled or 20% participation, whichever is greater. If the Enrollment Partnership Program (EPP) is selected, participation percentage is waived and a minimum of 10 enrolled employees is required. May be sold with medical or as stand-alone No employer contribution Age-banded rates (each employee s premium is based on the group s rate table, using five-year age bands). Blue View Vision Frequently Asked Questions Are contact lens fitting fees included in the vision exam? Professional contact lens fitting fees are not considered part of a routine eye exam and are not included in the vision exam. However, members who receive a contact lens fitting from a provider who also dispenses contact lenses can apply the excess of their materials benefit, if any, toward the cost of the fitting. It is important to remember that contact lenses must be purchased from the same provider who performed the fitting, and that only the balance of the materials benefit, after purchasing contact lenses, can be applied toward the fitting fee. Are disposable contact lenses covered? Disposable contact lenses and daily wear are covered under the contact lens allowance. Can a member purchase contact lenses and glasses? Members who choose the contact lens benefit elect to receive contact lenses instead of frames and spectacle lenses. However, members are able to purchase additional eye wear from Blue View Vision providers at a 15% - 40% discount. Does Blue View Vision cover nonprescription items like sunglasses? Blue View Vision providers offer members discount pricing that is significantly below retail (15% - 40% or more) on additional purchases of eyewear, contact lenses, lens treatments, specialized lenses and other items. How does a member locate a network provider? Members can visit anthem.com or contact customer service at Do members have to use a Blue View Vision network provider? No, however the Blue View Vision network includes over 44,000 providers and provider locations nationwide. For those members who prefer to visit an out-of-network provider, a separate benefit is available for most plans. What is covered in a comprehensive eye exam? Coverage for a comprehensive eye exam includes: case history, evaluation of the visual system s status, refractive status, binocular function, assessment, diagnosis and treatment plan. 20 anthem.com 9

12 Anthem Life and Disability insurance When it comes to life and disability benefits, Anthem Life Insurance Company (Anthem Life) has something for everyone. Employees get the protection they re looking for, thanks to a wide range of flexible plans, and employers get the convenience that comes from doing business with one point of contact. Why Anthem Life? We re part of the largest health benefits company in the nation based on health membership. Over 50 years of experience in the life and disability business Together with our sister companies, we cover more than 89,000 groups and approximately 5 million members. 4 Anthem Life - A.M. Best Rating of A (Excellent) 4 Each affiliated company is a separate, independent legal entity for financial purposes and is solely responsible for its own contractual obligations and liabilities. Service excellence Personal service representative who is your single point of contact for enrollment, billing and customer service needs Dedicated disability claims representative who acts as a single point of contact for employees with a disability and helps them through the entire claims process Vocational rehabilitation consultant who works with members with a disability to get them back to work Anthem Access Advantage program conveniently distributes life benefit payments of $10,000 or more in an interest-bearing check draft account, enabling beneficiaries to use the funds for immediate needs Resource Advisor Included with disability and life insurance coverage from Anthem Life, Resource Advisor gives employees and family members free and confidential access to valuable work/life support services, including: Face-to-face visits with a counselor for beneficiaries and employees with a disability. Legal/financial consultations. 24/7 telephone counseling and referral services. Website resources including wills and power-of-attorney forms. Life insurance beneficiaries can order a free copy of The Healing Book: Facing the Death - and Celebrating the Life - of Someone You Love to share with a child affected by their loss. Beneficiary companion program to help loved ones close accounts and finalize the estate. Identity theft resolution helps members in the case of their identity being stolen. Travel assistance When traveling 100 or more miles from home, employees and dependents can take comfort in knowing that they have access to a 24-hour multilingual call center to help them with: Emergency medical assistance and emergency evacuation. Travel services and pre-departure information (passport requirements, immunization requirements, exchange rates, weather conditions and more). Repatriation, dependent and travel companion assistance. Voluntary Short-term Disability coverage at a glance The coverage noted below is just a summary of benefits available for Voluntary Short-term Disability. Anthem Life offers many plan designs for both small and large groups. Talk to your Anthem sales representative about tailoring an insurance plan to fit your clients unique needs. Small group (10-50) Large group (51+) Rate basis Age-banded rates (each employee s premium is based on the group s rate table, using five-year age bands). Rate guarantee Two years Guaranteed issue 51-99: Two years 100+: One year Employees qualify for standard benefit amounts based on the group size, as well as industry and occupation classes. Medical questionnaires are required for coverage above the guaranteed issue amounts and for late enrollees. Benefit payments 50% or 60% of weekly earnings or a specific dollar amount of $200 or $250 per week. Maximum benefit is $1,350 per week. Underwriting may set a lower maximum benefit. Plan designs Plan benefits can begin: On the first day for disability caused by an accident, and on the eighth day for an illness-related disability. On the eighth day for disability caused by an accident or illness. On the 15th day for disability caused by an accident or illness. On the 30th day for disability caused by an accident or illness. Benefit periods Maximum benefit is $1,500 per week. Underwriting may set a lower maximum benefit. Plan benefits can begin: On the first day for disability caused by an accident, and on the eighth day for an illness-related disability. On the eighth day for disability caused by an accident or illness. On the 15th day for disability caused by an accident or illness. On the 30th day for disability caused by an accident or illness. 13 weeks, 26 weeks or 52 weeks 13 weeks, 26 weeks or 52 weeks. (9, 11, 12, 13, 22, 24, 25, 48, 50 or 51 weeks are also available to coordinate with LTD. Not available in MO and WI). Newborn and parenting resources Anthem Life s unique program helps new mothers with the transition back to work after maternity leave. New mothers with approved short -term disability maternity claims can sign up for eight weeks of free life coaching services to help them ease into being working moms. Promoting healthy solutions for employees with chronic conditions and complicated pregnancies Members who have our short-term disability coverage and our 360 Health ConditionCare will get the extra support they need to help them cope with chronic conditions and complicated pregnancies. We proactively reach out to members with these conditions and provide information and assistance in reaching health goals. We also offer guidance to achieve the best possible outcome so that they can get back to health, life and work sooner. 10 anthem.com 19

13 Short-term Disability coverage at a glance The coverage noted below is just a summary of benefits available for Short-term Disability. Anthem Life offers many plan designs for both small and large groups. Talk to your Anthem sales representative about tailoring an insurance plan to fit your clients unique needs. Small group (2-50) Large group (51+) Definitions Disability due to illness or injury, the employee is unable to perform all material and substantial duties of his or her regular occupation, with at least a resulting 20% loss in pre-disability earnings. To receive benefits, the employee must be receiving regular care from a physician for the illness or injury causing the disability. Residual benefit included. Rate guarantee Two years Rate basis 2-9 employees age-banded rates. 10+ employees composite rates. Guaranteed issue 2-5 employees: $500 per week. Medical questionnaires are required for amounts over $ employees: all amounts are guaranteed issue. Benefit payments 50%, 60% or 67%* of weekly earnings or specific dollar amount of $100, $150, $200 or $250 per week. Maximum benefit is $1,350 per week. A lower maximum benefit may be set by underwriting. Plan designs Plan benefits can begin: On the first day for disability caused by an accident, and on the eighth day for an illness-related disability. On the eighth day for disability caused by an accident or illness. On the 15th day for disability caused by an accident or illness. Benefit periods employees: Two years 100+ employees: One year All amounts are guaranteed issue. 50%, 60% or 67%* (70% option for non-contributory plans) of weekly earnings or specific dollar amount of $100, $150, $200 or $250 per week. Maximum benefit is $2,500 per week A lower maximum benefit may be set by underwriting. Plan benefits can begin: On the first day for disability caused by an accident, and on the eighth day for an illness-related disability. On the eighth day for disability caused by an accident or illness. On the 15th day for disability caused by an accident or illness. On the 30th day for disability caused by an accident or illness. 13 weeks or 26 weeks 13 weeks or 26 weeks (9, 11, 12, 13, 22, 24, 25, 48, 50 or 51 weeks are also available to coordinate with LTD.) First day hospital coverage *in MO and WI, 66.67% Optional Group Term Life coverage at a glance The coverage noted below is just an overview of benefits available. Anthem Life offers many plan designs for both small and large groups. Talk to your Anthem sales representative about tailoring an insurance plan to fit your clients unique needs. Small group (2-50) Large group (51+) Rate guarantee Two years Guaranteed issue amounts Two years $30,000 for 2-9 lives, variable by group size for Variable by group size Benefit amounts Specific dollar amount or 1 to 3 times annual salary Age reductions Benefits are reduced by 35% at age 65 and 50% at age 70. Benefits terminate at retirement. Accidental Death and Dismemberment (AD&D) benefits Included Dependent Life 1 to 5 times salary or a specific dollar amount, up to a maximum benefit of $500,000. Standard: Benefits are reduced by 35% at age 65 and 50% at age 70. Options: Benefits are reduced by 50% at age 70 Benefits are reduced by 35% at age 65, 60% at age 70, 72% at age 75 and 80% at age 80 Benefits are reduced by 35% at age 70 and 50% at age 75 Benefits are reduced by 35% at age 65, 40% at age 70, 30% at age 75 and 30% at age 80 No reductions, with Life and Disability Underwriting approval Benefits terminate at retirement. Included as a standard feature. Employer may choose to remove. Single options or multiple options under a class-based plan are available. Dependent coverage may not exceed 50% of the employee s life benefit amount. Spouse coverage: $2,000 to $10,000 Dependent coverage: $1,000 to $5,000 for each child Waiver of premium Standard for employee coverage. If an employee under age 60 becomes disabled, premiums are waived after the first six months of a total disability. Waiver ends at age 65 or at retirement, whichever comes first. Living Benefit Spouse coverage: $2,000 to $20,000 Dependent coverage: $1,000 to $10,000 for each child Standard: If an employee under age 60 becomes disabled, premiums are waived after the first six months of a total disability. Waiver ends at age 65 or at retirement, whichever comes first. Option: If an employee under age 65 becomes disabled, premiums are waived after the first nine months of a total disability. Waiver ends at age 70 or at retirement, whichever comes first. Standard. If an employee has a terminal illness, pays up to 75% of the life benefit, up to $125,000 for groups up to 50 and $250,000 for groups of 51+. Continuation of coverage Standard. If coverage ends due to a layoff or leave of absence, employees can continue coverage for up to three months by paying the premium. If coverage ends due to a disability, employees can get up to six months. 18 anthem.com 11

14 Eligibility and underwriting Group-term Life (Supplemental) and Voluntary Life Life and Disability Below is a summary of eligibility and underwriting guidelines that are subject to change at any time. Please contact your Anthem Blue Cross and Blue Shield sales representative for additional information. Groups must meet local Anthem Blue Cross and Blue Shield medical underwriting requirements for the definition of an employer group for both combined medical/life and stand-alone life business. Group Term Life General employee eligibility requirements Employees must work at least 30 hours per week. General underwriting requirements No open enrollment for existing cases. Annual enrollments are allowed but require Evidence of Insurability (EOI). Participation requirements All eligible employees must participate when coverage is entirely employer-paid. 75% participation is necessary when employee contribution is required. These participation requirements are the same for term life sold with or without medical and for term life sold with or without other life and disability products. Stand-alone (without medical and/or without other life and disability products) Can be sold as stand-alone down to two enrolled employees. All eligible employees must participate when coverage is entirely employer-paid. 75% participation is necessary when employee contribution is required. Contribution requirements Minimum employer contribution (not including dependent coverage) is 25% for contributory plans and 100% for non-contributory plans. Rate basis 2-9 employees age-banded rates. 10+ employees composite rates. ASO funding availability Frequently Asked Questions Why include the accidental death feature? Accidental death pays an additional benefit, equal to the life insurance amount, if an employee dies within 365 days after an accident. What are the eligibility requirements for dependents? Children are eligible if they are age 15 days to 26 (27 in Wisconsin) years. Spouse benefits begin reducing at age 65. Spouse coverage ends when employee coverage ends. How often do rates change? Anthem Life reviews age bands just once a year at a group s policy anniversary date. If an employee has moved into a new five-year age band, the new rate will be reflected at that time. Composite rated groups are reviewed every two years. Anthem Life will notify the group by mail prior to any rate changes. Are there any exclusions? Please ask us for a certificate for a complete list of accidental death exclusions. Optional (Supplemental) Life and Voluntary Life exclude suicide within two years of the employee s effective date. 12 anthem.com 17