Primary Navigator/Assistor Contacts. Field Representation Product Offering. Other Pertinent Information 11/12/2014

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1 Indiana Qualified Health Plans in the Marketplace Anthem BlueCross and BlueShield October 28, 2014 Joe Gilbert, CLU, ChFC, RHU Regional Vice President Individual and Small Group Sales Background Anthem BlueCross and BlueShield is Indiana s largest Health Insurance Company Medicaid Medicare Individual Small Group (2 49) Large Group (50+) Honored to meet the Healthcare needs of the 4 Million Hoosier s who rely on Anthem for their financial protection Purpose: Together, we are transforming health care with trusted and caring solutions Vision: To be America s Valued Health Partner 2 Primary Navigator/Assistor Contacts Field Representation Primary contact point for Navigators/Assistors Able to help Navigators with supply orders, questions, facilitation of events Able to make broker connections for complex situation Able to help Navigators with Local Events 3 4 Other Pertinent Information 2015 Product Offering Sold 116,1794 Individual ACA Members in % were ON EXCHANGE 85% received Subsidies (APTC) Top Selling Plans Silver (59%) Bronze (33%) Average Age 42.5 Average Tax Credit Received to Offset Premium $332 Percentage of Hispanic 6% 5 6 1

2 Product Naming Convention 2015 On Exchange Plans PCP Office Visit On exchange Example: 2014 Alpha Code 2015 Product Name Deductible Deductible OOPM OOPM Coins Single Family Single Family # of OV with Copay OV Copay RX Before Ded NA Anthem Catastrophic Pathway X $6600/0% $6,600 $13,200 0% $6,600 $13,200 3 $40 Ded/Coins caaa Anthem Bronze Pathway X 5750/20% $5,750 $11,500 20% $6,600 $13,200 2 $40 $25/$55/20%/20% caae Anthem Bronze Pathway X 6250/30% $6,250 $12,500 30% $6,600 $13,200 2 $45 $20/$50/25%/25% caca Anthem Bronze Pathway X POS 5000/40% $5,000 $10,000 40% $6,600 $13,200 2 $50 Ded/Coins caar Anthem Bronze Pathway X 0% for HSA $6,300 $12,600 0% $6,300 $12,600 None NA Ded/Coins cabm Anthem Bronze Pathway X 20% for HSA $4,500 $9,000 20% $6,450 $12,900 None NA Ded/Coins American Indian and Subsidy plans will take on the name of their parent plan. This includes an indicator in the plan name that will distinguish between the plans (AI) for American Indian and an (S) for subsidy: Anthem Bronze Pathway X 6250/30% AI Anthem Silver Pathway X 2500/10% S04 cabr Anthem Bronze Pathway X 4300/20% $4,300 $8,600 20% $6,600 $13,200 2 $35 Ded/Coins cbaa Anthem Silver Pathway X 3500/0% $3,500 $7,000 0% $4,500 $9,000 unlimited $45 $15/$40/0%/0% cbds Anthem Silver Pathway X 2500/10% $2,500 $5,000 10% $6,600 $13,200 3 $40 $15/$40/10%/10% cbbg Anthem Silver Pathway X 10% for HSA $3,000 $6,000 10% $4,000 $8,000 None NA Ded/Coins NA Anthem Blue Cross and Blue Shield Silver DirectAccess, a Multi State Plan $2,000 $4,000 20% $6,600 $13,200 3 $35 $15/$40/20%/20% NA Anthem Blue Cross and Blue Shield Gold DirectAccess, a Multi State Plan $1,000 $2,000 10% $6,000 $12,000 unlimited $30 $15/$40/10%/10% Off Exchange Plans View Network on anthem.com PCP Office Visit 2014 Alpha Code 2015 Product Name Deductible Deductible Coins Single Family OOPM Single OOPM Family # of OV with Copay OV Copay RX Before Ded NA Anthem Catastrophic Pathway $6600/0% $6,600 $13,200 0% $6,600 $13,200 3 $40 Ded/Coins caac Anthem Bronze Pathway 5750/20% $5,750 $11,500 20% $6,600 $13,200 3 $45 $25/$55/20%/20% caal Anthem Bronze Pathway 6000/30% $6,000 $12,000 30% $6,600 $13,200 3 $45 Ded/Coins cacb Anthem Bronze Pathway POS 5000/40% $5,000 $10,000 40% $6,600 $13,200 3 $50 Ded/Coins caap Anthem Bronze Pathway 0% for HSA $6,000 $12,000 0% $6,450 $12,900 None NA Ded/Coins cabp Anthem Bronze Pathway 20% for HSA $4,000 $8,000 20% $6,450 $12,900 None NA Ded/Coins cbam Anthem Silver Pathway 2850/15% $2,850 $5,700 15% $6,600 $13,200 unlimited $30 $15/$40/15%/15% cbei Anthem Silver Pathway 2500/10% $2,500 $5,000 10% $6,600 $13,200 unlimited $30 $15/$40/10%/10% cbfg Anthem Silver Pathway 10% for HSA $2,500 $5,000 10% $4,000 $8,000 None NA Ded/Coins cbjc Anthem Silver Pathway 1750/20% $1,750 $3,500 20% $6,600 $13,200 3 $35 $15/$40/20%/20% ccaf Anthem Gold Pathway 1250/10% $1,250 $2,500 10% $3,900 $7,900 unlimited $30 $15/$40/10%/10% 9 10 Choose the Pathway/Pathway X Network Pathway and Pathway X is the narrow network for Individual Plans (on and off exchange) 11 Anthem s Individual On and Off Exchange Network is an Open Access HMO Network There are NO Primary Care Physician (PCP) Gatekeeper requirements The member does not need to select a Primary Care Physician All services should be received from IN Network providers to be eligible for coverage The member can directly access care from any of the available IN Network physicians No referral process is needed when accessing services from IN Network providers Please note that Prior Authorization may apply for specific IN Network services (See Summary of Benefits for pre authorization details) Routine Out Of Network services are not covered 12 Anthem s Network 2

3 Participating Professional Providers Professional Providers contracted as of 10/27/2014 Over 1,500 Primary Care Providers Over 9,000 Specialty Care Providers Professional Group agreements with Free Standing Imaging Center, PT/OT/ST, Sleep Centers, Labs, etc. 48% of Essential Community Providers (ECPs) have a contract with our Individual Exchange Network Emergency and Urgent Care Emergency and Urgent Care services are eligible for coverage from IN Network and Out Of Network providers Emergency care and Urgent care services are covered If a member is seen by an out of network provider for emergency services (due to the seriousness of the illness or injury), these charges will be covered as IN Network benefits If the visit is not a medical emergency, a claim may deny and the member may be responsible for costs incurred See Summary of Benefits for Emergency care Utilizing Anthem.com New Quote Demographics Marketing banner ads New field to identify2014 SEP or 2015 OEP Determine if Provider is in the Network (Pathway/Pathway X) Start the Shopping Experience 15 Addition of StandaloneDental Option 16 Integrated Subsidy Estimator Subsidy Estimator Results No longer takes you to an external Subsidy Calculator. Now linked to the Anthem Subsidy Estimator tool. 17 Subsidy results auto loaded to quotes. 18 3

4 Help Me Choose" Path Enhanced Plan Listing Page Determine if prescriptions are covered Subsidy and demographics always present. New Doctor Search and Help Me Choose. Drives the Recommended Plans on the Plan Listing Page. New Recommended and Most Popular Plans. Products shown in rows instead of columns. Filters always present. Clarity on plans with subsidy applied Find Your Doctor" Search Find Your Doctor" Search Enter a portion or all of the doctors name. Displays number of doctors based on the search criteria. Matches shown by closest distance or best name match. Can search without name and just by distance from zip code. Shows if doctor is accepting new patients Find Your Doctor" Results How to Use Insurance What does the insurance card look like Adds My Doctor Filter to show only plans with a match. Determine if prescriptions are covered Displays number of doctor matches for that plan. Doctor matches shown, with ability to view details. 23 Provider Directory (including urgent care) Membership ID Prescriptions Provider Finder Estimate Cost View Claims When to expect the insurance card Next Day on Smart Phone 7 to 10 Days in the Mail 24 4

5 Key Contact Numbers Broker Service Center (helps navigators/assistors) Source for resources and materials Customer Service ACA Plans On Exchange ACA Plans OFF Exchange Pay by Phone Any way for assisters to get answers when helping a consumer pick a plan Anthem Telesales Anthem Plans will be available in ALL COUNTIES in ALL 17 Regions Coverage Area (Map) Posey Lake Newton Porter Jasper St Joseph La Grange La Porte Elkhart White Marshall Kosciusko Whitley Fulton Cass De Kalb Allen Wabash Huntington Adams Miami Wells Benton Carroll Grant Howard Blackford Jay Warren Tippecanoe Clinton TiptonMadison Delaware Fountain Randolph Hamilton Boone Montgomery Henry Wayne Marion Hancock Vermillion Parke Hendricks Rush Union Fayette Putnam Shelby Johnson Vigo Morgan Clay Franklin Decatur Owen Bartholomew Brown Dearborn Sullivan Monroe Ripley Greene Jennings Ohio Jackson Lawrence Switzerland Jefferson Martin Scott Knox Daviess Washington Orange Clark Pike Dubois Crawford Floyd Gibson Warrick VanderburghSpencer Starke Pulaski Perry Harrison Noble Steuben Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region10 Region11 Region12 Region13 Region14 Region15 Region16 Region17 QHP Organization Contact info Joe Gilbert, CLU, ChFC, RHU Regional Vice President, Individual and Small Group Sales Anthem BlueCross and BlueShield (317) Joseph.gilbert@anthem.com This is a project of ACA Marketplace Stakeholders in Indiana, which invited all health insurance organizations participating in the ACA Health Insurance Exchange Marketplace to provide a quick overview of their plan options. We want to affirm that no preference is given to any provider, as the same template format and opportunity is provided to each of the health plan organizations. We d like to thank the following organizations for their support: 27 The ASPIN Health Navigator Project is supported by Funding Opportunity Numbers CA NAV from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of oral, written, and electronic communications are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies unless cited otherwise. The UWW/IaUW Navigator was supported by Funding Opportunity Number CA NAV from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies. 28 5