Benefit Plans. Individual Products. Available On and Off Marketplace

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1 Benefit Plans Products Available On and Off Marketplace

2 PLAN NAME, WHAT DOES IT ALL MEAN? Example plan: BlueCross Silver S04 -C Indicates metal level of plan Indicates metal level plan number Indicates cost sharing level (if applicable) BlueCross Plans for Your Clients On and Off Marketplace BlueCross BlueShield of Tennessee s new health plans offer your clients more choices, benefits and coverage than ever before. This booklet includes information about our plan options, including those available on and off the Health Insurance Marketplace. Your clients who shop on the Marketplace will only have access to plans for which they are eligible. All new health plans cover: Preventive care, annual checkups, shots and screenings covered at 100 percent when using a network provider Doctor and specialist visits with no referral needed Wide range of prescription medicines Emergency services and hospital stays Maternity care for mothers-to-be and routine nursery care for newborns Preventive and wellness services for children Dental and vision services for covered members under 19 Care and services, including certain devices, to help recover from an injury or illness (rehabilitative services) Treatment for behavioral and mental health conditions All BlueCross plans also feature: No annual or lifetime dollar limits for essential, covered care Access to a Nurseline 24/7 for health advice any time Coverage in Tennessee, all 50 states and around the world Special discounts on health-related products and services The plan grids on the following pages provide you a significant amount of information, so we ve included a key to make sure the details are clear to you. 1

3 Base Level Plans The grid on this page indicates all base level individual BlueCross plans All plans are available off the Marketplace with Provider Network options of P or S Plans available on the Marketplace are noted with a check mark and include Provider Network S (Network E is also available in some areas of the state - see page ) Marketplace BlueCross Bronze B01 $2,500 $6,50 50% BlueCross Bronze B02 $4,000 $6,50 50% BlueCross Bronze B0 $4,000 $6,50 80% BlueCross Bronze B04 $5,00 $5,00 100% BlueCross Bronze B05 $6,250 $6, % BlueCross Bronze B06 $6,50 $6,50 100% HSA Compatible $/$75/$250 BlueCross Silver S01 $0 $6,50 50% BlueCross Silver S02 $1,000 $6,250 50% $/50% BlueCross Silver S0 $1,000 $6,50 50% $60/$100 $/50% BlueCross Silver S04 $2,000 $4,000 50% BlueCross Silver S05 $2,000 $6,50 50% $40/$70 $/50% BlueCross Silver S06 $2,000 $6,50 50% $55/$95 $/$50/$100 BlueCross Silver S07 $1,500 $6,50 70% BlueCross Silver S08 $2,000 $5,000 80% BlueCross Silver S09 $2,500 $4,500 80% BlueCross Silver S10 $2,500 $5,500 80% BlueCross Silver S11 $2,500 $5,500 80% BlueCross Silver S12 $4,000 $5,500 80% $10 $8/$5/$60 after $500 Brand $8/$5/$60 BlueCross Silver S1 $4,000 $5,500 80% $10 $/$100/$250 BlueCross Silver S14 $5,500 $6,50 80% $10/$40 $/$50/$100 BlueCross Silver S15 $5,500 $6,50 80% $5/$50 $/$5/$75 BlueCross Silver S16 $,500 $, % BlueCross Silver S18 $6,50 $6,50 100% $5/$50 $/$50/$100 2

4 Tennessee Marketplace Service Areas DAVIDSON KNOX SHELBY HAMILTON BlueCross BlueShield of Tennessee is the only carrier in two regions and the only payer with plans statewide. - Marketplace Service Areas Network E Available - Marketplace Service Areas - Marketplace Service Area Boundaries Marketplace BlueCross Gold G01 $0 $5,250 65% BlueCross Gold G02 $0 $6,50 75% BlueCross Gold G0 $1,000 $4,000 80% $5/$50 $8/$5/$60 after $500 Brand BlueCross Gold G04 $1,000 $4,000 80% $5/$50 $8/$5/$60 BlueCross Gold G05 $1,500 $4,500 80% $5/$50 $8/$5/$60 after $500 Brand BlueCross Gold G06 $1,500 $4,500 80% $5/$50 $8/$5/$60 BlueCross Gold G07 $2,000 $6,50 80% $10 $/$25/$50 BlueCross Gold G08 $2,100 $2, % HSA Compatible BlueCross Gold G10 $,500 $, % $5/$50 50% BlueCross Gold G11 $,500 $, % $5/$50 $8/$5/$60 BlueCross Platinum P01 $0 $1,800 50% $20/$40 $/$25/$50 BlueCross $0 $1,500 75% Platinum P02 BlueCross Platinum P0 $0 $,000 75% $10/$40 $/$25/$50 BlueCross Platinum P04 $1,500 $1, % $10 $/$25/$50

5 Financial Assistance Most individual BlueCross plans offer identical benefits on or off the Marketplace; the difference between the two is availability of federal financial assistance. Depending on your clients income and family size, they may qualify for financial assistance to lower their premiums and/or out-of-pocket costs. These savings are only available with coverage purchased through the Marketplace. Premium Tax Credit For your clients who qualify, this new tax credit gives them a choice of how they want to use it. The tax credit is available for all Marketplace plans. Lower monthly premiums by taking the tax credit in advance. The credit will be applied throughout the year to their monthly health insurance premium and will be paid directly to BlueCross. Your clients only pay the amount remaining each month. Pay the full amount of the monthly health insurance premium; your clients can then claim the full credit on their tax return. Cost-Sharing Reduction This cost savings option lowers the deductible and out-of-pocket maximum, while increasing the amount paid by the health plan. Your clients who qualify for this savings and want to take advantage of it, will need to choose one of the Silver level plans below or on the following pages. Limited-cost share and zero-cost share versions of the Marketplace plans are available at each metallic level for American Indians and Alaskan Natives who are members of federally-recognized tribes. (Note: Plans are not displayed on the grids in this guide.) Marketplace Silver Level Plans Income: % of Federal Poverty Level High-level CSR plans (-C suffix) available at the Silver level only to qualified members with household income between 100% - 150% FPL (provides 94 percent actuarial value) Plans available at this level on the Marketplace include Provider Network S (Network E is also available in some areas of the state) - see page 4 BlueCross Silver S01-C $0 $550 50% BlueCross Silver S02-C $0 $600 50% $/50% BlueCross Silver S04-C $0 $550 50% BlueCross Silver S07-C $0 $650 70% BlueCross Silver S08-C $0 $800 80% BlueCross Silver S09-C $0 $800 80% BlueCross Silver S11-C $0 $750 80% $8/$5/$60 BlueCross Silver S12-C $0 $1,100 80% $10 BlueCross Silver S14-C $0 $850 80% $10 /$40 $/$50/$100 BlueCross Silver S16-C $500 $ %

6 Marketplace Silver Level Plans Income: % of Federal Poverty Level Mid-level CSR plans (-B suffix) available at the Silver level only to qualified members with household income between 151% - 200% FPL (provides 87 percent actuarial value) Plans available at this level on the Marketplace include Provider Network S (Network E is also available in some areas of the state) - see page 5 BlueCross Silver S01-B $0 $1,450 50% BlueCross Silver S02-B $0 $1,500 50% $/50% BlueCross Silver S04-B $0 $1,450 50% BlueCross Silver S07-B $0 $2,000 70% BlueCross Silver S08-B $00 $2,000 80% BlueCross Silver S09-B $00 $2,000 80% BlueCross Silver S11-B $500 $1,500 80% $8/$5/$60 BlueCross Silver S12-B $750 $2,000 80% $10 BlueCross Silver S14-B $750 $2,000 80% $10 /$40 $/$50/$100 BlueCross Silver S16-B $1,150 $1, %

7 Marketplace Silver Level Plans Income: % of Federal Poverty Level Low-level CSR plans (-A suffix) available at the Silver level only to qualified members with household income between 201% - 250% FPL (provides 7 percent actuarial value) Plans available at this level on the Marketplace include Provider Network S (Network E is also available in some areas of the state) - see page BlueCross Silver S01-A $0 $5,200 50% BlueCross Silver S02-A $1,000 $4,400 50% BlueCross Silver S04-A $1,000 $,650 50% BlueCross Silver S07-A $1,500 $,950 70% BlueCross Silver S08-A $2,000 $,650 80% BlueCross Silver S09-A $2,000 $,650 80% BlueCross Silver S11-A $2,500 $4,150 80% Office Visit Copay (PCP or Specialist) HSA Compatible No $/50% No No $8/$5/$60 No BlueCross Silver S12-A $,000 $5,000 80% $10 No BlueCross Silver S14-A $4,500 $5,200 80% $10 /$40 $/$50/$100 No BlueCross Silver S16-A $2,950 $2, % BlueCross BlueShield of Tennessee 1 Cameron Hill Circle Chattanooga, TN 7402 bcbst.com BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield Association BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. 6 1PST2478 (10/1) Marketplace Benefit Plans Booklet