Solutions at Work. Look to Anthem for solutions that meet your clients needs today and as they evolve. For businesses with 101 or more employees

Transcription

1 Solutions at Work Look to Anthem for solutions that meet your clients needs today and as they evolve. For businesses with 101 or more employees CABENABC Rev. 08/17

2 Table of Contents New for 2018!... 2 Savings... 4 Clear Value Pool NEW... 5 HMO portfolio... 8 Vivity portfolio...13 Anthem Act Wise consumer-driven health plans...16 PPO portfolio Rx portfolio Elements Choice EQ plans Anthem Balanced Funding portfolio Alternative funding Dental, vision, life and disability portfolio...33 EAP... 45

3 Solutions at Work Our Large Group portfolio offers the best plans and resources to meet your clients needs today and as their businesses evolve It takes a powerful vision to deliver life-changing health care for members and cost-saving approaches for our clients. And at Anthem Blue Cross (Anthem), it s more than just our goal, it s our promise! We re committed to delivering better health care from every angle cost of care, provider collaboration and the consumer s experience so that members get and stay healthy, and you have solutions that bring greater savings. We proudly offer: Plan options for today s real world needs. A personalized health care experience that s simple, engages members and helps drive down costs. Access to large networks for more in-network care. A local team that understands your type of business needs. On-the-go tools like LiveHealth Online and our mobile app. We are committed to supporting our members need to be actively involved in and informed about their own health care. We want to empower members to make smarter health choices to reach their own best health. And we offer plans that cover a member from head to toe our dental, vision, life and disability plans tie into our health coverage to create the ultimate Anthem Whole Health Connection SM member experience. Let our solutions work for you Our goal is to offer you and your clients affordable, comprehensive and quality benefits that meet everyone s needs and that are priced for every budget. This brochure will guide you through our Large Group product portfolio in a logical, easy-to-follow format so you can help your clients find affordable solutions that work for everyone. If you have any questions or would like additional information, contact your Anthem Sales representative. 1

4 NEW Solid benefit plans, choices and affordability Introducing additions and updates to our 2018 Large Group portfolio. The highlights of the changes and latest updates are listed below, with more detailed information about our plans on the following pages. Here s what s new: NEW Additional plans to round out our Large Group portfolio: NEW Clear Value Pool portfolio of plans (four HMO plans, four PPO plans and three CDH plans). Save 8-13% over our standard pooled product portfolio with no-hassle fixed pricing. Our goal is single-digit renewal increases to help keep your costs down. One NEW EPO plan with no out-of-network benefits. One NEW Solution PPO plan. One NEW Anthem Elements Choice PPO plan. NEW Member Claim Reimbursement for out-of-network providers Anthem is in compliance with California Assembly Bill (AB) 72. In certain situations, AB72 requires that coverage for services from out-of-network doctors, while being treated at an in-network hospital or facility, is reimbursed at the same rate as an in-network doctor (out-of-network cost shares still apply). In these situations, the out-of-network doctor may not charge more than an in-network doctor can, without written consent from the member. NEW Our plan names have been refreshed to comply with SB137 which requires that plan names are consistent and always include an identifier such as HMO, PPO, etc. NEW Anthem Act Wise CDHP Our new, streamlined portfolio of affordable plans are paired with valuable benefits that offer flexibility and savings! With 11 different plans four HMO plans, four PPO plans and three CDH plans you can choose from among our best plans while maximizing savings. The simple, smart, and supportive advantages include: A stable, secure platform and website. One debit card for all accounts. Single point of contact for customer service. One implementation path, website and mobile app. Refined, expansive reporting capabilities and tools. 2

5 Take advantage of our strengths Advantages for your clients with 101 or more employees: Full complement of health, dental, vision, life and disability plans Variety of plan designs ranging from high-option benefit plans to cost-efficient ones with increased member cost sharing Administrative ease integrated billing and customer service make it easy for benefit administrators to manage many different plans Unique advantages for pooled ( ) groups Pricing Advantage A group that participates in our pool will realize lower premium rates mostly due to the use of standard benefits, streamlined administration, and a uniform renewal process. Rates for these groups are primarily a function of the group demographics and the aggregate claims experience of all Anthem pooled groups of similar size and risk characteristics. Other advantages include: Additional savings by bundling employer-sponsored dental, vision, life and/or disability coverage with health products. Ten percent savings 1 on workers compensation premium when a group purchases our Integrated MediComp SM product. 2 Additional opportunities for non-pooled groups that do not want to participate in a pooled product Plans designed specifically for non-pooled groups offer a greater choice of options, including: Additional health and pharmacy plan offerings, designed specifically for larger employers. Opportunities to customize benefits to meet employees needs. For our experience-rated groups, premium rates reflect the claims utilization of the group, enabling a group to benefit when its claims utilization is favorable. For nonexperienced-rated groups, premium rates reflect the demographics of the group and rating requirements for the nonexperience-rated block of business. Advantages 1 Workers compensation savings reflect administrative savings resulting from multi-line purchases. 2 Workers compensation insurance and services are offered through Employers Compensation Insurance Company. 3

6 Savings One Solution Savings: An opportunity to save time, money and paper Your clients can get all the coverage they need from one source: Health plans from Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company. Dental, vision, life and disability coverage. That means one contact and one convenient, combined bill from one trusted and reliable source. Even better, when groups purchase dental, vision, life and disability products along with health products, they ll save money! Wrap our products together and wrap up the savings Pooled and non-pooled groups (up to 300 lives) can save up to 4% on their health premiums when they also purchase dental, vision, life and disability products. Here is how the savings can add up: Purchase and save on health premium 1 Health + Dental 1% Health + Vision 1% Health + Life 1% 2 Health + STD 0.5% Health + LTD 0.5% Health + All 5 products 4% This program does not apply to the Elements Choice EQ plans, or voluntary specialty products. In some cases, One Solution Savings may cover the cost of adding a product. Take vision, for example. The 1% savings off a group s health premium can significantly offset the cost of adding vision coverage. Assume that your client s annual cost for health insurance with Anthem is $840,000 and the annual cost for the proposed vision coverage is $14,400. When the 1% savings of $8,400 is applied to a group s health premium, the net cost of vision coverage, when packaged with health coverage, is only $6,000 a year ($14,400 - $8,400 = $6,000)! That s like getting vision coverage at more than 58% off! For more information on how to save by bundling dental, vision, life and disability products with our health offerings, refer to the Dental, vision, life and disability section at the end of this brochure or visit anthem.com/specialty. Additional savings for groups with lives When pooled clients integrate workers compensation coverage from EMPLOYERS 3 with Anthem health (together, they re called Integrated MediComp SM ), they ll receive an automatic 10% savings off their workers compensation premium. 4 Managing benefits made easy Large groups can get the sophisticated online support they need to enroll, manage and track all their information! The Anthem online benefits management system, EmployerAccess SM, makes managing your health, dental, vision, life and disability benefits much easier by allowing groups to: Manage online enrollment. Perform contract maintenance. Handle benefit inquiries. Access reports. Pay bills online and more all from one website! 4 1 The health premium savings apply when new dental, vision, life and disability products are added to fully insured groups with employees when purchasing or renewing an Anthem Blue Cross or Anthem Blue Cross Life and Health Insurance Company health product. Other restrictions may apply. Your clients savings reflect administrative savings resulting from multi-line purchases. 2 Savings apply when the total life schedule is insured and there is at least an equivalent volume of $25,000 per covered employee. 3 Copyright 2008 EMPLOYERS. All rights reserved. EMPLOYERS and America s small business insurance specialist are registered trademarks of Employers Insurance Company of Nevada. Workers compensation insurance and services are offered through Employers Compensation Insurance Company. 4 Workers Compensation savings reflect administrative savings resulting from multi-line purchases.

7 Maximizing savings with Clear Value Pool portfolio of plans Save a projected 8-13% over our standard pooled portfolio with our new Clear Value portfolio. Our new, streamlined portfolio of affordable plans are paired with valuable benefits that offer flexibility and savings! With 11 different plans four HMO plans, four PPO plans and three CDH plans you can choose from among our best plans while maximizing savings. Real. Clear. Value. Strongly discounted plan pricing. Save a projected 8% to 13% when you compare to other pooled plans! No-hassle fixed pricing. Tired of haggling over your premiums? The low quote you get is the premium price you pay. It s that easy. Our goal of single-digit, fixed renewal increases to help you keep costs down. Real benefits to save you both time and money. By only choosing Anthem plans, you re getting the power of one of California s biggest health companies. But it s not our size that matters, it s what our negotiating power can do. Better premium pricing and stronger network discounts are just two advantages. Choice of dental, vision, life or disability products. With the Clear Value Pool, you ll add at least one of our specialty lines: Dental best in class service and implementation Vision largest network in the nation paired with market-leading discounts Life caring, one-on-one service with full suite of valuable extras Disability superior claims management and personalized support And with the Clear Value Pool, you get expedited electronic enrollment. Through our enhanced EmployerAccess online tool, you re getting a host of features that simplify your experience with Anthem. EmployerAccess lets you get back to focusing on your business. You choose the plan and network you want. Within each plan, you have multiple network options. You get to pick the doctors that fit your needs. Clear Value Pool HMO plans are offered on our Traditional, Select, and Priority Select California networks. While Clear Value Pool PPO plans are offered on our PPO and Select PPO networks. Affordable pharmacy coverage. The streamlined Essential formulary creates even more value through managing pharmacy costs. This closed formulary drives savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Clear Value 5

8 Clear Value Large Group Clear Value Portfolio for Pooled Groups of (Plans effective 01/01/2018) HMO Plan Options 1 Calendar-Year Out-of-Pocket Maximum Physician Office Visit Member Copay Anthem Clear Value HMO offered on Traditional, Select HMO, and Priority Select HMO Networks Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Surgery Member Copay 2 Anthem Clear Value HMO 20/20% $4,500/$9,000 $20 PCP/$40 Specialist 20% 20% Anthem Clear Value HMO 20/250day/4D/20% $4,000/$8,000 $20 PCP/$40 Specialist $250 per day, four-day max 20% Anthem Clear Value HMO 2000/30/30% $7,000/$14,000 $30 PCP/$60 Specialist $2,000 Deductible, then 30% of charges Anthem Clear Value HMO 30/30% $5,500/$11,000 $30 PCP/$60 Specialist 30% 30% Prescription Drug Plans 3 Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary 6 1 All plans are offered by Anthem Blue Cross. 2 Applies to all outpatient and Ambulatory Surgical Center (ASC) facility services. 3 The Essential Formulary is a closed formulary that drives savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. HMO networks: Traditional our most comprehensive statewide network; Select our high-performance narrow network; Priority Select our most efficient network Additional PPO Plans Continue on next page

9 Large Group Clear Value Portfolio for Pooled Groups of (Plans effective 01/01/2018) PPO Plan Options 1,2 Calendar-Year Deductible Anthem Clear Value PPO - offered on PPO and Select PPO Networks Anthem Clear Value PPO 500/25/20/45 $500/$1,500 In-Network $1,500/$4,500 Out-of-Network Annual Out-of-Pocket Maximum $8,000/$16,000 In-Network $12,000/$24,000 Out-of-Network Embedded/ Non-Embedded Physician Office Visit Member Copay (Deductible Waived) Member Coinsurance In-Network/ Out-of-Network Embedded $25 PCP/$50 Specialist 20%/45% Prescription Drug Plans 3 Tier 1/Tier 2/Tier 3/Tier 4 In-Network Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Clear Value Anthem Clear Value PPO 1000/30/25/50 $1,000/$3,000 In-Network $3,000/$9,000 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network Embedded $30 PCP/$60 Specialist 20%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Anthem Clear Value PPO 2500/35/30/50 $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $6,500/$13,000 In-Network $19,500/$39,000 Out-of-Network Embedded $35 PCP/$70 Specialist 30%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Anthem Clear Value PPO 3500/40/30/50 $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $7,350/$14,700 In-Network $22,050/$44,100 Out-of-Network Embedded $40 PCP/$80 Specialist 30%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary PPO PLAN OPTIONS 1,2 Calendar-Year Deductible Annual Out-of- Pocket Maximum (Medical and Rx combined) Embedded/ Non-Embedded Physician Office Visit Member Coinsurance In-Network /Out-of-Network (After Deductible) Member Coinsurance In-Network /Out-of-Network (After Deductible) Prescription Drug Plans 3 Tier 1/Tier 2/Tier 3/Tier 4 (After Deductible) In-Network Anthem Clear Value PPO - HSA Members and employers may make pretax contributions Anthem Clear Value HSA 2700/20/50 $2,700/$5,400 In-Network $8,100/$16,200 Out-of-Network $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network Embedded 20% 20%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Anthem Clear Value HSA 3500/30/50 $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $5,500/$11,000 In-Network $16,500/$33,000 Out-of-Network Embedded 30% 30%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary Anthem Clear Value HSA 4500/30/50 $4,500/$9,000 In-Network $13,500/$27,000 Out-of-Network $6,650/$13,000 In-Network $19,950/$39,900 Out-of-Network Embedded 30% 30%/50% Rx Option 1: $5/$15/$40/$60/30% Essential Formulary Rx Option 2: $5/$20/$40/$70/30% Essential Formulary 1 All plans are offered by Anthem Blue Cross. 2 We offer a selection of PPO plans for California residents and non-california residents. 3 The Essential Formulary is a closed formulary that drives savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives Networks: PPO our most comprehensive nationwide network; Select PPO our high-performance narrow California network Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. This chart compares the plans in this category. Refer to each plan s Benefit Summary for more details. 7

10 HMO Clear portfolio Value HMO products for Pooled and Non-Pooled groups of 101 or more Combining preventive care and predictable costs with lower out-of-pocket expenses Why choose an HMO? Members who choose Anthem HMO plans receive comprehensive benefits from an integrated network of participating doctors and hospitals. Members choose a primary care physician (PCP) who oversees their total health care, and focuses on overall health improvement and care management. Our traditional HMO plan options provide access to approximately 45,000 primary care physicians and specialists and over 400 hospitals in California. 1 Anthem HMO plans offer predictable costs for physician services, inpatient care and alternative medicine benefits, as well as wellness resources to help members improve and maintain their health. HMO plan options Our HMO products offer flat-dollar copays for physician services and an array of health care reform compliant benefit designs to meet employee needs. Employers can choose either generous benefits with 100% coverage for inpatient and outpatient hospital care, or plans with member cost sharing and lower premiums. HMO network options: reducing costs without reducing benefits All of our HMO plans can now be sold using any of the below networks, giving you various levels of cost savings: 1. Traditional HMO network This network includes about 45,000 California physicians and specialists and more than 400 hospitals Select HMO network Providers in this high-performance network have demonstrated the most cost-efficient practice patterns and hospital referrals. The Select HMO network has locations in 22 counties. 3. Priority Select HMO network Our regional provider network, specially catering to Southern California counties at a lower cost than the Select HMO network. Note: Priority Select HMO is only available in partial areas of Los Angeles, Riverside, San Diego, San Bernardino counties and the entire county of Orange. These options allow you to develop the right combination of networks and plans to meet your clients needs at a price they can afford. Additional plans for Non-Pooled Groups Larger clients can take advantage of uniquely designed HMO plans to attract and retain employee talent. These plans are: Advantage HMO, Classic Choice HMO and POS plans. 8 1 Internal network report (July 2017). 8

11 Large Group HMO Plans for Groups of 101 or more (Plans effective 01/01/2018) HMO Plan Options offered on Traditional HMO, Select HMO, and Priority Select HMO Networks Calendar-Year Out-of-Pocket Maximum Physician Office Visit Member Copay Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Surgery Member Copay Premier HMO our richest level of coverage with 100% hospital coverage and single office visit copay for PCP and specialists Premier HMO 10/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $10 No Copay No Copay Premier HMO 15/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $15 No Copay No Copay Premier HMO 20/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $20 No Copay No Copay Premier HMO 30/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $30 No Copay No Copay Classic HMO includes member per admission hospital copay and separate PCP and specialist copays Classic HMO 10/30/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) $2,000/$4,000 $10 PCP/$30 Specialist $250 per Admit $125 per Admit Classic HMO 20/40/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) Classic HMO 30/40/500 admit/250 OP (Rx Essential $5/$15/$30/$50/30%) Classic HMO 35/45/750 admit/375 OP (Rx Essential $5/$15/$30/$50/30%) $2,000/$4,000 $20 PCP/$40 Specialist $250 per Admit $125 per Admit $2,500/$5,000 $30 PCP/$40 Specialist $500 per Admit $250 per Admit $2,500/$5,000 $35 PCP/$45 Specialist $750 per Admit $375 per Admit Value HMO Copay includes per day inpatient copays, outpatient hospital copay or coinsurance and separate PCP and specialist office visit copays Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Essential Formulary 3 $5/$15/$25/$45/30% Essential Formulary 3 $5/$15/$30/$50/30% HMO portfolio Value HMO 20/40/250/3 day (Rx Essential $5/$20/$30/$50/30%) $2,500/$5,000 $20 PCP/$40 Specialist $250 per day, 3-day max $125 per Admit Essential Formulary 3 $5/$20/$30/$50/30% Value HMO 20/40/250/3 day/20% (Rx Essential $5/$20/$40/$60/30%) $3,000/$6,000 $20 PCP/$40 Specialist $250 per day, 3-day max 20% 2 per Admit Essential Formulary 3 $5/$20/$40/$60/30% Value HMO 30/40/500/3 day (Rx Essential $5/$20/$30/$50/30%) $2,500/$5,000 $30 PCP/$40 Specialist $500 per day, 3-day max $250 per Admit Essential Formulary 3 $5/$20/$30/$50/30% Value HMO 30/40/500/3 day/20% (Rx Essential $5/$20/$40/$60/30%) $3,000/$6,000 $30 PCP/$40 Specialist $500 per day, 3-day max 20% 2 per Admit Essential Formulary 3 $5/$20/$40/$60/30% Value HMO 35/45/750/3 day (Rx Essential $5/$20/$40/$60/30% $150 Ded) $3,500/$7,000 $35 PCP/$45 Specialist $750 per day, 3-day max $375 per Admit Value HMO Coinsurance lower-cost plans with coinsurance for inpatient and outpatient hospital admissions and separate PCP and specialist office visit copays Essential Formulary 3 $5/$20/$40/$60/30% $150 Deductible 1 Value HMO 20/30/20% (Rx Essential $5/$20/$40/$60/30%) $3,500/$7,000 $20 PCP/$30 Specialist 20% per Admit 20% of charges 2 Essential Formulary 3 $5/$20/$40/$60/30% Value HMO 30/40/30% (Rx Essential $5/$20/$40/$60/30% $150 Ded) $5,000/$10,000 $30 PCP/$40 Specialist 30% per Admit 30% of charges 2 $5/$20/$40/$60/30% $150 Deductible 1 Essential Formulary 3 1 The deductible is waived for tier 1. 2 Applies to all outpatient and Ambulatory Surgical Center (ASC) facility services. 3 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional HMO our most comprehensive statewide network; Select HMO our high-performance narrow network; Priority Select HMO our most efficient network. Plans offered by Anthem Blue Cross. 9

12 HMO portfolio Large Group HMO Plans for Groups of 101 or more (Plans effective 01/01/2018) HMO Plan Options offered on Traditional HMO, Select HMO, and Priority Select HMO Networks Calendar-Year Out-of-Pocket Maximum Physician Office Visit Member Copay Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Surgery Member Copay Value Deductible HMO plans include a facility deductible for inpatient and outpatient facility admissions; offer separate PCP and specialist office visit copays Value Deductible HMO /40/10% (Rx Essential $5/$20/$40/$75/30%) Value Deductible HMO /40/20% (Rx Essential $5/$20/$40/$75/30%) Value Deductible HMO /40/25% (Rx Essential $5/$20/$40/$75/30%) Value Deductible HMO $1,500 25/40/25% (Rx Essential $5/$20/$40/$75/30% $250 Ded) Value Deductible HMO $2,000 30/45/25% (Rx Essential $5/$20/$40/$75/30% $250 Ded) $3,000/$6,000 $20 PCP/$40 Specialist $250 Deductible, then 10% of charges $3,000/$6,000 $20 PCP/$40 Specialist $500 Deductible, then 20% of charges $3,000/$6,000 $25 PCP/$40 Specialist $750 Deductible, then 25% of charges $3,000/$6,000 $25 PCP/$40 Specialist $1,500 Deductible, then 25% of charges $3,500/$7,000 $30 PCP/$45 Specialist $2,000 Deductible, then 25% of charges Healthy Support HMO plans for the more health-conscious that help keep them healthy by offering earned rewards and special incentives for taking steps toward wellness Healthy Support HMO 15/30/250 admit/125 OP (Rx Essential $5/$15/$50/$65/30%) Healthy Support HMO 35/50/500 3 day/250 admit (Rx Essential $5/$15/$50/$65/30%) $2,500/$5,000 $15 PCP/$30 Specialist $250 per admit $125 per Admit $4,500/$9,000 $35 PCP/$50 Specialist $500 per day, 3-day max $250 per Admit Elements Choice HMO plans designed to be cost-effective and meet the 60% minimum value coverage requirement for employers under the Affordable Care Act Anthem Elements Choice HMO 1500 (Rx Essential $5/$20/$50/$65/30%/$500 Ded) Anthem Elements Choice HMO 3000 (Rx Essential $5/$20/$50/$65/30%/$500 Ded) Anthem Elements Choice HMO 5900 (Rx Essential $5/$20/$50/$65/30%/$500 Ded) $6,400/$12,800 $25 PCP/$50 Specialist $1,500 Deductible, then 30% of charges $6,400/$12,800 $30 PCP/$50 Specialist $3,000 Deductible, then 30% of charges $6,400/$12,800 $35 PCP/$70 Specialist $5,900 Deductible, then 30% of charges Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Essential Formulary 2 $5/$20/$40/$75/30% Essential Formulary 2 $5/$20/$40/$75/30% $250 Deductible 1 Essential Formulary 2 $5/$15/$50/$65/30% Essential Formulary 2 $5/$20/$50/$65/30% $500 Deductible The deductible is waived for tier 1. 2 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional HMO our most comprehensive statewide network; Select HMO our high-performance narrow network; Priority Select HMO our most efficient network. Plans offered by Anthem Blue Cross.

13 Large Group Vivity HMO Plans for Groups of 101 or more (Plans effective 01/01/2018) HMO Plan Options 1 offered on our Vivity Network Calendar-Year Physician Office Visit Member Copay Premier HMO our richest level of coverage with 100% hospital coverage and single office visit copay for PCP and specialists Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Surgery Member Copay Premier HMO 10/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $10 No Copay No Copay Premier HMO 15/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $15 No Copay No Copay Premier HMO 20/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $20 No Copay No Copay Premier HMO 30/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $30 No Copay No Copay Classic HMO includes member per admission hospital copay and separate PCP and specialist copays Classic HMO 10/30/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) $2,000/$4,000 $10 PCP/$30 Specialist $250 per Admit $125 per Admit Classic HMO 20/40/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) $2,000/$4,000 $20 PCP/$40 Specialist $250 per Admit $125 per Admit Classic HMO 30/40/500 admit/250 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $30 PCP/$40 Specialist $500 per Admit $250 per Admit Classic HMO 35/45/750 admit/375 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $35 PCP/$45 Specialist $750 per Admit $375 per Admit Value HMO Copay includes per day inpatient copays, outpatient hospital copays and separate PCP and specialist office visit copays Prescription Drug Plans 2 Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Essential Formulary 1 $5/$15/$25/$45/30% Essential Formulary $5/$15/$30/$50/30% HMO portfolio Value HMO 20/40/250/3 day (Rx Essential $5/$20/$30/$50/30%) $2,500/$5,000 $20 PCP/$40 Specialist $250 per day, 3-day max $125 per Admit Essential Formulary Value HMO 30/40/500/3 day (Rx Essential $5/$20/$30/$50/30%) $3,000/$6,000 $30 PCP/$40 Specialist $500 per day, 3-day max $250 per Admit $5/$20/$30/$50/30% Value HMO 35/45/750/3 day (Rx Essential $5/$20/$40/$75/30%) $3,500/$7,000 $35 PCP/$45 Specialist $750 per day, 3-day max $375 per Admit Value HMO 35/45/1000/3 day (Rx Essential $5/$20/$40/$75/30%) $3,500/$7,000 $35 PCP/$45 Specialist $1,000 per day, 3-day max $500 per Admit Essential Formulary $5/$20/$40/$75/30% Essential Formulary $5/$20/$40/$75/30% Healthy Support HMO plans that are for the more health-conscious members and help keep them healthy by offering earned rewards and special incentives for taking steps toward wellness Healthy Support HMO 15/30/250 admit/125 OP (Rx Essential $5/$15/$50/$65/30%) Healthy Support HMO 35/50/500 3 day/250 OP (Rx Essential $5/$15/$50/$65/30%) $2,500/$5,000 $15 PCP/$30 Specialist $250 Admit $125 Admit $4,500/$9,000 $35 PCP/$50 Specialist $500 per day, 3-day max $250 Admit Essential Formulary $5/$15/$50/65%/30% 1 All plans are offered by Anthem Blue Cross. 2 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Vivity our integrated health system network in Los Angeles and Orange counties. Plans offered by Anthem Blue Cross. 11

14 HMO portfolio Large Group HMO and POS Plans for Non-Pooled Groups (Plans effective 01/01/2018) HMO Plan Options Calendar Year Out-of-Pocket Maximum Physician Office Visit Member Copay Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Hospital Services Member Copay Advantage HMO available on the Advantage HMO and Traditional HMO network with a unique benefit design designating a low copay for low-copay medical groups and a higher copay for high-copay medical groups. Empowers members to consider cost and quality before selecting a PMG/IPA Advantage HMO 20 or day/250 admit $2,500/$5,000 $20/visit or $40/visit $500 per day, 3-day max $250 per Admit Advantage HMO 30 or day $2,500/$5,000 $30/visit or $40/visit $750 per day, 3-day max $375 per Admit Classic Choice HMO Traditional HMO, Select HMO, Select Plus HMO and Priority Select HMO Networks Classic Choice HMO 10/30 $3,500/$7,000 Point of Service (POS) Traditional HMO and Prudent Buyer PPO Networks POS S1 Calendar-Year Out-of-Pocket Maximum $2,500/$5,000 HMO $3,750/$7,500 In-Network $3,750/$7,500 Out-of-Network Deductible for POS 1 $0 HMO $250/$750 In-Network $250/$750 Out-of-Network $10 PCP/ $30 Specialist $10 HMO Copay $20 PPO 30% Non-PPO 20% per Admit 20% of charges $500 per Admit HMO 30% PPO 30% Non-PPO $250 per Admit HMO 30% PPO 30% Non-PPO 12 1 Separate in-network and out-of-network deductible. Networks: Traditional HMO our most comprehensive statewide network; Select HMO our high-performance narrow network; Priority Select HMO our most efficient network. Plans offered by Anthem Blue Cross.

15 Vivity plans Giving employees convenient access and the best value Anthem Blue Cross (Anthem) and seven top health systems in Los Angeles and Orange counties have come together in a joint venture relationship to create Anthem Blue Cross Vivity (Vivity) a better alternative for comprehensive care and coverage. Vivity is the first plan of its kind and offers access to high-quality care that is affordable, easy-to-use and sustained through technology and ongoing teamwork among the eight founding organizations. This cutting-edge solution allows employers to offer high-quality coverage at a competitive, predictable cost. Vivity portfolio A strong network allows members to access care close to where they live or work: More than 1,400 primary care physicians along with hundreds of available specialists are in our Vivity network throughout Los Angeles and Orange counties. Members are covered 24 hours a day, seven days a week for services anywhere in the world. It s simple and easy Vivity is built to respect the busy lives of its members. The network covers Los Angeles and Orange counties to provide convenient access to some of the best doctors in every member s neighborhood. Vivity has greatly simplified access to health care, and costs are much more predictable. When Vivity members go to the doctor, have a medical procedure or pick up a prescription, all they pay is their copay. They don t have to worry about meeting deductibles or figuring out complicated medical bills. The Vivity plan supports doctors so they can optimize the health of their patients. This includes helping to make sure healthy members get the preventive care they need; telling members about wellness programs; proactively managing members who have chronic conditions and much more. We give doctors the information they need and also help them reach out to their patients. And doctors are rewarded for helping to improve their patients health, not just for each office visit or test. 13

16 Vivity portfolio Large Group Vivity HMO Plans for Groups of 101 or more (Plans effective 01/01/2018) HMO Plan Options 1 offered on our Vivity Network Calendar-Year Physician Office Visit Member Copay Premier HMO our richest level of coverage with 100% hospital coverage and single office visit copay for PCP and specialists Inpatient Hospital Services Member Copay and/or Calendar-Year Deductible Outpatient Surgery Member Copay Premier HMO 10/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $10 No Copay No Copay Premier HMO 15/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $15 No Copay No Copay Premier HMO 20/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $20 No Copay No Copay Premier HMO 30/100% (Rx Essential $5/$15/$25/$45/30%) $1,500/$3,000 $30 No Copay No Copay Classic HMO includes member per admission hospital copay and separate PCP and specialist copays Classic HMO 10/30/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $10 PCP/$30 Specialist $250 per Admit $125 per Admit Classic HMO 20/40/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $20 PCP/$40 Specialist $250 per Admit $125 per Admit Classic HMO 30/40/500 admit/250 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $30 PCP/$40 Specialist $500 per Admit $250 per Admit Classic HMO 35/45/750 admit/375 OP (Rx Essential $5/$15/$30/$50/30%) $2,500/$5,000 $35 PCP/$45 Specialist $750 per Admit $375 per Admit Value HMO Copay includes per day inpatient copays, outpatient hospital copays and separate PCP and specialist office visit copays Prescription Drug Plans 2 Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Essential Formulary 1 $5/$15/$25/$45/30% Essential Formulary $5/$15/$30/$50/30% Value HMO 20/40/250/3 day (Rx Essential $5/$20/$30/$50/30%) $2,500/$5,000 $20 PCP/$40 Specialist $250 per day, 3-day max $125 per Admit Essential Formulary Value HMO 30/40/500/3 day (Rx Essential $5/$20/$30/$50/30%) $3,000/$6,000 $30 PCP/$40 Specialist $500 per day, 3-day max $250 per Admit $5/$20/$30/$50/30% Value HMO 35/45/750/3 day (Rx Essential $5/$20/$40/$75/30%) $3,500/$7,000 $35 PCP/$45 Specialist $750 per day, 3-day max $375 per Admit Value HMO 35/45/1000/3 day (Rx Essential $5/$20/$40/$75/30%) $3,500/$7,000 $35 PCP/$45 Specialist $1,000 per day, 3-day max $500 per Admit Essential Formulary $5/$20/$40/$75/30% Essential Formulary $5/$20/$40/$75/30% Healthy Support HMO plans that are for the more health-conscious members and help keep them healthy by offering earned rewards and special incentives for taking steps toward wellness Healthy Support HMO 15/30/250 admit/125 OP (Rx Essential $5/$15/$50/$65/30%) Healthy Support HMO 35/50/500 3 day/250 OP (Rx Essential $5/$15/$50/$65/30%) $2,500/$5,000 $15 PCP/$30 Specialist $250 Admit $125 Admit $4,500/$9,000 $35 PCP/$50 Specialist $500 per day, 3-day max $250 Admit Essential Formulary $5/$15/$50/65%/30% 14 1 All plans are offered by Anthem Blue Cross. 2 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Vivity our integrated health system network in Los Angeles and Orange counties.

17 15 Vivity portfolio

18 Act Wise CDHPs Consumer-Driven Health Plans Simple. Supportive. Smart. Anthem Act Wise CDHP Giving employees more control over their health and their health care dollars At Anthem, we are continually looking for ways to give members more choice and more control over their health care experience. Our Anthem Act Wise Consumer-Driven Health Plans (CDHPs) are built to maintain and improve consumers health. They offer an approach that engages and encourages members to make better choices about their health and their health care dollars. Poor lifestyle and behavior choices (such as too little exercise, bad diet, smoking and others) contribute to 50 to 60% of health care costs. 1 So good health is good for everyone. All of our Consumer-Driven Health Plans: Include 100% coverage for nationally recommended preventive care services (including annual physicals) when utilizing in-network providers. The deductible is waived for in-network preventive care services. Include traditional health coverage (for example, coinsurance) and annual out-of-pocket maximums to protect against large medical expenses. Provide members with tools to become more informed about their health and health care options. Allow members to spend or save dollars specifically for health care out-of-pocket expenses. Provide access to specialists with no referrals. Provide access to substantial provider discounts from thousands of doctors and hospitals nationwide. Offer personalized member services online and by phone to help members maintain and improve their health. Give members incentives and the support they need to make healthy lifestyle changes. 2 NEW simple, smart, and supportive advantages of our CDHP portfolio: A stable, secure platform and website. One debit card for all accounts. Single point of contact for customer service. One implementation path, website and mobile app. Refined, expansive reporting capabilities and tools. There are tax advantages, too As you probably know, health insurance premiums are treated as a general business expense, so employers can usually deduct both their premiums and other health benefit costs, such as reimbursed employee health expenses or contributions made to employees Health Savings Accounts (HSAs). Consultation with a tax advisor is recommended. Anthem offers integrated HSA banking options for the administration of the Consumer-Driven Health Plans. Welcome to the only option in the market that offers a fully integrated, single-branded solution Anthem Act Wise CDHP Adapted from Indiana University-Purdue University, Fort Wayne (IPFW) Study (2006). 2 Availability of incentives varies by product.

19 What is a Health Savings Account (HSA)? A Health Savings Account (HSA) enables participants to pay for current health expenses and save for future health care and retiree health expenses on a taxfree basis. Both the employer and the employee may contribute to an HSA. With an HSA, participants have the added protection of a comprehensive health plan. Employers get: Potential savings on health premiums. Employee engagement in their health care decisions. Tax advantages. And employees get: A tax-free way to help pay for out-of-pocket health care expenses. HSA account portability. HSA balance rollover from year to year, with no limit on the amount that can be carried over. Integrated banking options, which offer online tracking of account balances, claims and benefits. Preventive drugs at zero dollar copay All standard HSA plans waive the deductible and copay for drugs on our PreventiveRx Plus drug list. PreventiveRx Plus covers drugs that may keep members healthy because they may prevent illness and other health conditions. HSA plan designs All Anthem CDHP plan benefits comply with state and federal legislation. There are IRS guidelines that dictate minimum deductible and out-of-pocket maximum requirements for HSA plans specifically. These plans have calendar-year deductibles depending on if the employee is enrolled on a self-only contract or enrolled with dependents on a family contract, in addition to an embedded family deductible for the family. It is important that clients and their employees understand this unique distinction. What is a Health Reimbursement Account (HRA)? A Health Reimbursement Account (HRA) is a type of Consumer-Driven Health Plan whereby the employer allocates a certain amount of money that each employee can use to pay for health care and prescriptions while still having the protection of a traditional health plan. But there s even more. Employees receive: An HRA funded by the employer, which helps pay the cost of the employee s health care and prescription drugs. The ability to earn rewards by taking certain steps to improve their health. Rollover of HRA funds from one year to the next. HRA rollover options Employers have the choice to limit the rollover of funds in employees accounts from year to year -- employers can choose to roll over unlimited, one or two times their annual allocation amounts. That way, employers can better plan for future health care expenses. What is a Health Incentive Account (HIA) Plus? A Health Incentive Account (HIA) Plus works just like an HRA. Employees receive annual allocations to their health accounts. These funds offer first-dollar coverage and unused funds roll over from year to year, which can help reduce potential out-of-pocket expenses. Plus, employees can earn additional dollars for taking steps to improve their health. The only difference with this plan: Anthem funds the health accounts. Act Wise CDHPs HRA and HIA Plus plans are only available to Non-Pooled clients to provide the most flexibility in customizing contributions and rollover amounts. 17

20 Act Wise CDHPs Large Group Consumer-Driven Health Plans for Groups of 101 or More (Plans effective 01/01/2018) Anthem PPO HSA Portfolio The Anthem PPO HSA plans are Anthem health plans that are qualified high-deductible health plans to be used with a separate health savings account that enable the employer and member to make pretax contributions to pay for health expenses and save for future health care and retiree health expenses on a tax-free basis. Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum (medical and Rx combined) Embedded/ Non-Embedded 2 Physician Office Visit Member Coinsurance In-Network/ Out-of-Network (After Deductible) Member Coinsurance In-Network/ Out-of-Network (After Deductible) Anthem PPO HSA plans where the calendar-year member or family deductible applies to both medical and pharmacy expenses. Once deductible is met, member pays coinsurance for medical expenses or pharmacy copays for prescription drugs. Available networks: Traditional Prudent Buyer PPO; BlueCard Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/ Tier 3/Tier 4 (After Deductible) In-Network Anthem PPO HSA 1350/ /30 (LHSA287H) 5 In-Network: $1,350/member for self-only coverage; $2,700/member and $3,000/ family for family coverage Out-of-Network: $4,050/member for self-only coverage; $4,050/member and $8,100/family for family coverage In-Network: $3,000/member for self-only coverage; $3,000/member and $6,000/family for family coverage Out-of-Network: $9,000/member for self-only coverage; $9,000/member and $18,000/family for family coverage 10%/30% 10%/30% Anthem PPO HSA 1500/ /30 (LHSA497H) 5 Anthem PPO HSA 1500/ /40 (LHSA708H) 5 In-Network: $1,500/member for self-only coverage; $2,700/member and $3,000/ family for family coverage Out-of-Network: $4,500/member for self-only coverage; $4,500/member and $9,000/family for family coverage In-Network: $1,500/member for self-only coverage; $2,700/member and $3,000/ family for family coverage Out-of-Network: $4,500/member for self-only coverage; $4,500/member and $9,000/family for family coverage In-Network: $3,000/member for self-only coverage; $3,000/member and $6,000/family for family coverage Out-of-Network: $9,000/member for self-only coverage; $9,000/member and $18,000/family for family coverage In-Network: $3,000/member for self-only coverage; $3,000/member and $6,000/family for family coverage Out-of-Network: $9,000/member for self-only coverage; $9,000/member and $18,000/family for family coverage Embedded 10%/30% 10%/30% 20%/40% 20%/40% National Formulary 4 $5/$15/$40/$60/30% Anthem PPO HSA 2000/ /40 (LHSA2153H) 5 In-Network: $2,000/member for self-only coverage; $2,700/member and $4,000/ family for family coverage Out-of-Network: $6,000/member for self-only coverage; $6,000/member and $12,000/family for family coverage In-Network: $3,000/member for self-only coverage; $3,000/member and $6,000/family for family coverage Out-of-Network: $9,000/member for self-only coverage; $9,000/member and $18,000/family for family coverage 20%/40% 20%/40% Anthem PPO HSA 2700/0 $2,700/$5,400 In-Network $8,100/$16,200 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network None/30% None/30% Anthem PPO HSA 2700/20 $2,700/$5,400 In-Network $8,100/$16,200 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network 20%/50% 20%/50% Essential Formular 3 $5/$15/$40/$60/30% Anthem PPO HSA 3000/20 $3,000/$6,000 In-Network $9,000/$18,000 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network 20%/40% 20%/40% 18 1 All plans are offered by Anthem Blue Cross. 2 Embedded accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. 3 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents. 4 National Formulary Anthem s broadest drug list with brand-name and generic FDA-approved medications that are selected for their safety, effectiveness and value. 5 These plans have a different per member deductible amount depending on whether the subscriber is enrolled as self only, or has enrolled dependents within the plan. Plans have been designed in this manner to comply with both AB1305 and IRS minimum deductible and out-of-pocket maximum requirements for embedded high-deductible health plans. Non-Pooled clients also have access to HRA (Health Reimbursement Account) or HIA Plus (Health Incentive Account Plus) CDHP plans that can be customized to fit their needs.

21 Large Group Consumer-Driven Health Plans for Groups of 101 or More (Plans effective 01/01/2018) Anthem PPO HSA Portfolio The Anthem PPO HSA plans are Anthem health plans that are qualified high-deductible health plans to be used with a separate health savings account that enable the employer and member to make pretax contributions to pay for health expenses and save for future health care and retiree health expenses on a tax-free basis. Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum (medical and Rx combined) Embedded/ Non-Embedded 2 Physician Office Visit Member Coinsurance In-Network/ Out-of-Network (After Deductible) Member Coinsurance In-Network/ Out-of-Network (After Deductible) Anthem PPO HSA plans where the calendar-year member or family deductible applies to both medical and pharmacy expenses. Once deductible is met, member pays coinsurance for medical expenses or pharmacy copays for prescription drugs. Available networks: Traditional Prudent Buyer PPO; BlueCard Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/ Tier 3/Tier 4 (After Deductible) In-Network Act Wise CDHPs Anthem PPO HSA 3500/20 $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $5,500/$11,000 In-Network $16,500/$33,000 Out-of-Network 20%/50% 20%/50% Anthem PPO HSA 4000/20 $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network $5,500/$11,000 In-Network $16,500/$33,000 Out-of-Network Embedded 20%/50% 20%/50% Essential Formulary 3 $5/$15/$40/$60/30% Anthem PPO HSA 4500/20 $4,500/$9,000 In-Network $13,500/$27,000 Out-of-Network $6,000/$12,000 In-Network $18,000/$36,000 Out-of-Network 20%/50% 20%/50% Anthem PPO Healthy Support HSA plan for the more health-conscious members to help keep them healthy; plus earn rewards and special incentives for taking steps toward wellness. Available networks: Traditional Prudent Buyer PPO; Select PPO; BlueCard Anthem PPO Healthy Support HSA 2700/20 $2,700/$5,400 In-Network $8,100/$16,200 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network Embedded 20%/40% 20%/40% Anthem PPO Elements Choice HSA plans designed to be as cost-effective as possible while meeting the 60% minimum value coverage requirement for employers under the Affordable Care Act. Available networks: Traditional Prudent Buyer PPO; Select PPO; BlueCard Anthem PPO Elements Choice HSA 4500/20 Anthem PPO Elements Choice HSA 6350/0 $4,500/$9,000 In-Network $13,500/$27,000 Out-of-Network $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network $6,950/$13,300 In-Network $19,950/$39,900 Out-of-Network Embedded 20%/50% None/50% Essential Formulary 3 $5/$15/$50/$65/30% Essential Formulary 3 $5/$15/$50/$65/30% 1 All plans are offered by Anthem Blue Cross. 2 Embedded accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. 3 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents. 19

22 Act Wise CDHPs Large Group Consumer-Driven Health Plans for Non-Pooled Groups of 101 or More (Plans effective 01/01/2018) Anthem PPO HIA Plus Portfolio The Anthem PPO HIA Plus plans are Anthem health plans that come with a health incentive account (HIA) where Anthem funds annual allocations to the account. These funds offer employees first-dollar coverage and unused funds roll over from year to year, which can help reduce potential out-of-pocket expenses. Plus, employees can earn additional funds for taking steps to improve their health. These plans are only offered to non-pooled clients and the standard plans listed can be customized according to our guidelines. Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum (medical and Rx combined) Embedded/ Non-Embedded 3 Physician Office Visit Member Coinsurance In-Network/ Out-of-Network (After Deductible) Member Coinsurance In-Network/ Out-of-Network (After Deductible) Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/ Tier 3/Tier 4 (After Deductible) In-Network Anthem PPO HIA Plus plans where HIA funds apply to both medical and pharmacy expenses and once deductible is met, member pays nothing for in-network medical expenses and pharmacy copays for in-network pharmacy expenses. Available networks: Traditional Prudent Buyer PPO; BlueCard Anthem PPO HIA Plus 3000/0 $3,000/$6,000 In-Network $9,000/$18,000 Out-of-Network ($1,500/$3,000 Allocation) $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network Anthem PPO HIA Plus First Dollar Copay plans where deductible and HIA funds are waived for in-network office visits and prescription drug copays. Available networks: Traditional Prudent Buyer PPO; BlueCard Embedded None/30% None/30% Essential Formulary 2,4 $5/$15/$40/$60/30% Anthem PPO HIA Plus Copay 1500/20/10 Anthem PPO HIA Plus Copay 2000/30/20 $1,500/$3,000 In-Network $4,500/$9,000 Out-of-Network ($750/$1,500 Allocation) $2,000/$4,000 In-Network $6,000/$12,000 Out-of-Network ($1,000/$2,000 Allocation) $3,425/$6,850 In-Network $10,275/$20,550 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network Embedded $20 2 /30% 10%/30% $30 2 /40% 20%/40% Essential Formulary 2,4 $5/$15/$40/$60/30% Anthem PPO Deductible First HIA Plus where member pays the upfront deductible before the Anthem allocation kicks in. Anthem allocations cannot pay for upfront deductible or first dollar benefits. Both the upfront deductible and Anthem contribution accumulates towards the applicable calendar year deductible. Available networks: Traditional Prudent Buyer PPO; BlueCard Anthem PPO Deductible First HIA Plus 3500/25/20 $750/$1,500 upfront deductible; $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network ($1,000/$2,000 Allocation) $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network Embedded $25 3 /40% 20%/40% Essential Formulary 2,4 $5/$15/$40/$60/30% 20 1 All plans are offered by Anthem Blue Cross. 2 Deductible is waived; copays are not reimbursed by HRA/HIA Plus allocation. 3 Embedded accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. 4 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; BlueCard for non-california residents.

23 Large Group Consumer-Driven Health Plans for Non-Pooled Groups of 101 or More (Plans effective 01/01/2018) Anthem PPO HRA Portfolio The Anthem PPO HRA plans are Anthem health plans that come with a health reimbursement account (HRA) where the employer funds annual allocations to the account. These funds offer employees first-dollar coverage and unused funds roll over from year to year with (limit set by employer), which can help reduce potential out-of-pocket expenses. Plus, employees can earn additional funds for taking steps to improve their health. These plans are only offered to non-pooled clients and the standard plans listed can be customized according to our guidelines. Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum (medical and Rx combined) Embedded/ Non-Embedded 3 Physician Office Visit Member Coinsurance In-Network/ Out-of-Network (After Deductible) Member Coinsurance In-Network/ Out-of-Network (After Deductible) Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/ Tier 3/Tier 4 (After Deductible) In-Network Act Wise CDHPs Anthem PPO HRA Embedded plans where HRA funds apply to both medical and pharmacy expenses and once deductible is met, member pays nothing for in-network medical expenses and pharmacy copays for in-network pharmacy expenses. Available networks: Traditional Prudent Buyer PPO; BlueCard Anthem PPO HRA 3000/0 Unlimited Rollover Anthem PPO HRA 3000/0 1X Rollover $3,000/$6,000 In-Network $9,000/$18,000 Out-of-Network ($1,500/$3,000 Allocation) $3,000/$6,000 In-Network $9,000/$18,000 Out-of-Network ($1,500/$3,000 Allocation) $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network Embedded Anthem PPO HRA First Dollar Copay plans where deductible and HRA funds are waived for in-network office visits and prescription drug copays. Available networks: Traditional Prudent Buyer PPO; BlueCard Anthem PPO HRA Copay 1500/20/10 Unlimited Rollover $1,500/$3,000 In-Network $4,500/$9,000 Out-of-Network ($750/$1,500 Allocation) $3,425/$6,850 In-Network $10,275/$20,550 Out-of-Network None/30% None/30% None/30% None/30% $20 2 /30% 10%/30% Essential Formulary 2,4 $5/$15/$40/$60/30% Anthem PPO HRA Copay 1500/20/10 1x Rollover Anthem PPO HRA Copay 2000/30/20 Unlimited Rollover $1,500/$3,000 In-Network $4,500/$9,000 Out-of-Network ($750/$1,500 Allocation) $2,000/$4,000 In-Network $6,000/$12,000 Out-of-Network ($1,000/$2,000 Allocation) $3,425/$6,850 In-Network $10,275/$20,550 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network Embedded $20 2 /30% 10%/30% $30 2 /40% 20%/40% Essential Formulary 2,4 $5/$15/$40/$60/30% Anthem PPO HRA Copay 2000/30/20 1x Rollover $2,000/$4,000 In-Network $6,000/$12,000 Out-of-Network ($1,000/$2,000 Allocation) $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network $30 2 /40% 20%/40% Anthem PPO Deductible First HRA where member pays the upfront deductible before the Employer allocation kicks in. Employer allocations cannot pay for upfront deductible or first dollar benefits. Both the upfront deductible and Employer contribution accumulates towards the applicable calendar year deductible. Available networks: Traditional Prudent Buyer PPO; BlueCard Anthem PPO Deductible First HRA 3500/25/20 Unlimited Rollover $750/$1,500 upfront deductible; $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network ($1,000/$2,000 Allocation) $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network Embedded $25 2 /40% 20%/40% Essential Formulary 2,4 $5/$15/$40/$60/30% 1 All plans are offered by Anthem Blue Cross. 2 Deductible is waived; copays are not reimbursed by HRA/HIA Plus allocation. 3 Embedded accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. 4 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; BlueCard for non-california residents. This chart compares the plans in this category. Refer to each plan s Benefit Summary for more details. 21

24 PPO portfolio Balancing employees needs with employers budgets Why choose a PPO? Our Preferred Provider Organization (PPO) plans give members access to one of the largest provider networks in California, with over 62,000 physicians and over 400 hospitals. 1 Through this extensive network, members can realize significant savings when they choose Anthem-contracted providers. PPOs give members the ability to self-direct their care and, if they choose, to see any doctor (including specialists) without a referral. All of our health care reform-compliant PPO plans begin with: In-network and out-of-network benefits. 2 Comprehensive inpatient benefits. 2 Prescription drug benefits. Affordable monthly premiums. Unlimited lifetime benefits. Nationwide coverage PPO members have access to our extensive network of PPO providers in California, as well as more than 93% of doctors and 97% of hospitals in the United States through the BlueCard PPO provider network. 1 Additional PPO network option Select PPO This is a narrow network of PPO providers in California that offers high-quality care in a cost-efficient manner. A methodology was used to find physicians who practice with the most cost efficiency in all areas of care, including professional, institutional, diagnostic testing, inpatient/outpatient care and prescription drug costs. By identifying these physicians and physician groups, we can offer an exceptional network at a lower cost. We offer the Select PPO network alongside certain standard PPO plans, as indicated in the benefit grids that follow. $10 copay for LiveHealth Online, which promotes a lower-cost alternative Internal data (July 2017). 2 Please refer to the benefit charts for additional information.

25 Large Group PPO Product Portfolio for Groups of 101 or More (Plans effective 01/01/2018) PPO Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum Embedded/ Non-Embedded 6 Physician Office Visit Member Copay In-Network (Deductible Waived) Member Coinsurance In-Network/ Out-of-Network Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Premier Plus PPO offers premium benefits including infertility treatment, greater out-of-network reimbursement schedule and coverage for prescription drugs on the National Formulary drug list. 3 Available on the Traditional Prudent Buyer PPO and BlueCard networks. PPO portfolio Premier Plus PPO 250/20/10 $8,000 Infertility Calendar Year Max (Rx $5/$15/$25/$40/30% with infertility) $250/$750 2 $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network Embedded $20 10%/30% National Formulary $5/$15/$25/$40/30% with infertility Premier PPO offers rich benefits with a combined in- and out-of-network deductibles, greater out-of-network reimbursement schedule and coverage for prescription drugs on the National Formulary drug list. 3 Available on the Traditional Prudent Buyer PPO and BlueCard networks. Premier PPO 150/10/10 (Rx $5/$15/$25/$45/30%) $150/$450 2 $2,000/$4,000 In-Network $6,000/$12,000 Out-of-Network $10 10%/30% Premier PPO 250/15/10 (Rx $5/$15/$25/$45/30%) Premier PPO 250/20/20 (Rx $5/$15/$25/$45/30%) $250/$750 2 $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $250/$750 2 $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network Embedded $15 10%/30% $20 20%/40% National Formulary 3 $5/$15/$25/$45/30% Premier PPO 500/20/20 (Rx $5/$15/$25/$45/30%) $500/$1,500 2 $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $20 20%/40% Classic PPO 5 offers comprehensive benefits and a fee schedule of services for out-of-network providers. Available on the Traditional Prudent Buyer PPO and BlueCard networks. Classic PPO 250/20/10 (Rx Essential $5/$15/$30/$50/30%) $250/$750 In-Network $750/$2,250 Out-of-Network $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $20 10%/30% Classic PPO 250/20/20 (Rx Essential $5/$15/$30/$50/30%) $250/$750 In-Network $750/$2,250 Out-of-Network $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $20 20%/40% Classic PPO 500/20/10 (Rx Essential $5/$15/$30/$50/30%) $500/$1,500 In-Network $1,500/$4,500 Out-of-Network $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $20 10%/30% Essential Formulary 4 $5/$15/$30/$50/30% Classic PPO 500/20/20 (Rx Essential $5/$15/$30/$50/30%) $500/$1,500 In-Network $1,500/$4,500 Out-of-Network $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network Embedded $20 20%/40% Classic PPO 500/30/20 (Rx Essential $5/$15/$30/$50/30%) $500/$1,500 In-Network $1,500/$4,500 Out-of-Network $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network $30 20%/40% Classic PPO 750/30/20 (Rx Essential $5/$20/$30/$50/30%) Classic PPO 1000/35/20 (Rx Essential $5/$20/$30/$50/30%) $750/$2,250 In-Network $2,250/$6,750 Out-of-Network $1,000/$3,000 In-Network $3,000/$9,000 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network $5,000/$10,000 In-Network $15,000/$30,000 Out-of-Network $30 20%/40% $35 20%/40% Essential Formulary 4 $5/$20/$30/$50/30% Classic Select PPO 5 offers comprehensive benefits and a fee schedule of services for out-of-network providers. Available on the Select PPO and BlueCard networks. Classic Select PPO 250/20/10 (Rx Essential $5/$15/$30/$50/30%) Classic Select PPO 500/30/20 (Rx Essential $5/$15/$30/$50/30%) $250/$750 In-Network $750/$2,250 Out-of-Network $500/$1,500 In-Network $1,500/$4,500 Out-of-Network $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network Embedded $20 10%/30% $30 20%/40% Essential Formulary 4 $5/$15/$30/$50/30% 1 Plans are offered by Anthem Blue Cross. 2 Combined deductible. 3 National Formulary - Anthem s broadest drug list with brand-name and generic FDA-approved medications that are selected for their safety, effectiveness and value. 4 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. 5 Fee schedule reimbursement for out of network. 6 Embedded Accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents. Additional PPO Plans Continue on next page 23

26 PPO portfolio Large Group PPO Product Portfolio for Groups of 101 or More (Plans effective 01/01/2018) PPO Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum Embedded/ Non-Embedded 5 Physician Office Visit Member Copay In-Network (Deductible Waived) Member Coinsurance In-Network/ Out-of-Network Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Solution PPO 2 lower-priced, higher-deductible PPO plans have first-dollar coverage for office visits, preventive care and pharmacy, as well as fee schedule for out-of-network providers. Available on the Traditional Prudent Buyer PPO and BlueCard networks. Solution PPO 1500/15/20 (Rx Essential $5/$20/$40/$60/30%) $1,500/$3,000 In-Network $4,500/$9,000 Out-of-Network $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $15 20%/40% Solution PPO 2000/20/20 (Rx Essential $5/$20/$40/$60/30%) $2,000/$4,000 In-Network $6,000/$12,000 Out-of-Network $4,000/$8,000 In-Network $12,000/$24,000 Out-of-Network $20 20%/40% Solution PPO 2500/25/20 (Rx Essential $5/$20/$40/$60/30%) Solution PPO 3500/30/30 (Rx Essential $5/$20/$40/$60/30%) $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network $6,350/$12,700 In-Network $19,050/$38,100 Out-of-Network Embedded $25 20%/40% $30 30%/50% Essential Formulary 4 $5/$20/$40/$60/30% Solution PPO 4500/30/30 (Rx Essential $5/$20/$40/$60/30%) $4,500/$9,000 In-Network $13,500/$27,000 Out-of-Network $7,000/$14,000 In-Network $21,000/$42,000 Out-of-Network $30 30%/50% Solution PPO 5500/30/30 $5,500/$11,000 In-Network $16,500/$33,000 Out-of-Network $7,350/$14,700 In-Network $22,050/$44,100 Out-of-Network $30 30%/50% Healthy Support PPO 2 plans for the health-conscious members to help keep them healthy; plus earn rewards and special incentives for taking steps toward wellness Available on the Traditional Prudent Buyer PPO, Select PPO and BlueCard networks. Healthy Support PPO 500/20/10 (Rx Essential $5/$15/$50/$65/30%) Healthy Support PPO 2500/30/30 (Rx Essential $5/$15/$50/$65/30%) $500/$1,500 In-Network $1,500/$4,500 Out-of-Network $2,500/$5,000 In-Network $7,500/$15,000 Out-of-Network $3,500/$7,000 In-Network $10,500/$21,000 Out-of-Network $6,000/$12,000 In-Network $18,000/$36,000 Out-of-Network Embedded $20 10%/30% $30 30%/50% Anthem Elements Choice PPO 2 plans designed to be cost-effective while meeting the 60% minimum value coverage requirement for employers under the Affordable Care Act. Available on the Traditional Prudent Buyer PPO, Select PPO and BlueCard networks. Essential Formulary 4 $5/$15/$50/$65/30% 1 All plans are offered by Anthem Blue Cross, except Solution PPO plans are offered by Anthem Blue Cross Life and Health Insurance Company. 2 Fee schedule reimbursement for out of network. 3 The deductible is waived for Tier 1. 4 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. 5 Embedded Accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents. 24 This chart compares the plans in this category. Refer to each plan s Benefit Summary for more details. Additional PPO Plans Continue on next page

27 Large Group PPO Product Portfolio for Groups of 101 or More (Plans effective 01/01/2018) PPO Plan Options 1 Calendar-Year Deductible Annual Out-of-Pocket Maximum Embedded/ Non-Embedded 4 Physician Office Visit Member Copay In-Network (Deductible Waived) Member Coinsurance In-Network/ Out-of-Network Prescription Drug Plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 In-Network Exclusive PPO offers non-california members certain in-network benefits with dollar copays similar to an HMO-type experience. Pair offering with complementary Classic and Value HMO plans for in-state employees. Available on the BlueCard network. Exclusive Classic PPO 20/250 admit/125 OP (Rx Essential $5/$15/$30/$50/30%) Exclusive Classic PPO 20/250 3 Day/125 OP (Rx Essential $5/$15/$30/$50/30%) Exclusive Classic PPO 30/500 admit/250 OP (Rx Essential $5/$15/$30/$50/30%) Exclusive Value PPO 30/30 (Rx Essential $5/$15/$30/$50/30%) None In-Network $3,000/$9,000 Out-of-Network None In-Network $3,500/$10,500 Out-of-Network None In-Network $3,500/$10,500 Out-of-Network None In-Network $3,500/$10,500 Out-of-Network $2,500/$5,000 In-Network $9,000/$18,000 Out-of-Network 2,500/$5,000 In-Network $10,000/$20,000 Out-of-Network $2,500/$5,000 In-Network $10,000/$20,000 Out-of-Network $5,000/$10,000 In-Network $10,000/$20,000 Out-of-Network Embedded $20 None/50% 2 $20 20%/50% 2 $30 20%/50% 2 $30 30%/50% 2 EPO plans offer benefits for in-network PPO providers only with no coverage for out-of-network providers. Available on the Traditional Prudent Buyer PPO and BlueCard networks. EPO 600/15/20 (Rx Essential $5/$15/$30/$50/30%) EPO 1200/15/20 (Rx Essential $5/$20/$40/$60/30%) EPO 2000/25/20 (Rx Essential $5/$20/$40/$60/30%) $600/$1,800 In-Network $4,500/$9,000 In-Network $15 20% $1,200/$3,600 In-Network $5,500/$11,000 In-Network $15 20% Embedded $2,000/$4,000 In-Network $6,500/$13,000 In-Network $25 20% EPO 3000/25/20 NEW $3,000/$6,000 In-Network $7,350/$14,700 In-Network $25 20% Essential Formulary 3 $5/$15/$30/$50/30% Essential Formulary 3 $5/$15/$30/$50/30% Essential Formulary 3 $5/$20/$40/$60/30% PPO portfolio 1 Plans offered by Anthem Blue Cross. 2 In-network cost share varies with type of service. 3 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. 4 Embedded Accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. Networks: Traditional Prudent Buyer PPO our most comprehensive statewide network; BlueCard for non-california residents. This chart compares the plans in this category. Refer to each plan s Benefit Summary for more details. 25

28 Rx portfolio Prescription drug plans for Non-Pooled groups Introduction to pharmacy plans Non-Pooled groups have a range of pharmacy plan options that can be mixed and matched with a health plan to meet the employer s needs. Formulary Options National formulary An important component of any prescription drug plan is the access patients have to medications. Through Anthem s Drug List, members have broad access to thousands of prescription medications. The Anthem Drug List is a list of FDA-approved brand-name and generic medications that have been reviewed and recommended for their quality and effectiveness by the National Pharmacy and Therapeutics (P&T) Committee. Anthem s drug list is organized into several different categories, or tiers. A tiered drug list offers members many ways to save: Tier 1, usually limited to generic drugs, has the most affordable copay and is split into Tier 1a (lowest generic copay tier) and Tier 1b (higher generic copay tier). Tier 2 and Tier 3 are often composed of brand-name drugs or more expensive generics, and cost slightly more. Tier 4, commonly reserved for specialty drugs, has the highest cost share. Essential formulary is a closed formulary that drives savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. This can be offered as a solution to clients wanting to manage pharmacy costs. We offer standard Rx plans alongside National and Essential formularies that Non-Pooled clients can customize to fit their needs. Narrow Rx Choice tiered network an option for Non-Pooled clients to lower costs by driving utilization to preferred pharmacies. Ask your Sales representative for details. 26

29 Large Group prescription drug standard and Vivity plans for Non-Pooled groups (Plans effective 01/01/2018) National Formulary Anthem s broadest drug list with brand-name and generic FDA-approved medications that are selected for their safety, effectiveness and value. Plans with National Formulary Standard Plan Options 1 Vivity Plan Options Deductible 2 Retail 30 days 4,5 Home Delivery 4 Tier 4 3,4 Tier 4 3,4 Home Delivery Rx portfolio $5/$15/$25/$40/30% with INFERTILITY 6 Y Y None $5/$15/$25/$40 $12.50/$37.50/$75/$120 30% to $250 max $5/$15/$25/$45/30% Y Y None $5/$15/$25/$45 $12.50/$37.50/$75/$135 30% to $250 max $5/$15/$30/$50/30% Y Y None $5/$15/$30/$50 $12.50/$37.50/$90/$150 30% to $250 max $5/$20/$30/$50/30% Y Y None $5/$20/$30/$50 $12.50/$50/$90/$150 30% to $250 max $5/$20/$30/$50/30%/$150 Ded Y $150 $5/$20/$30/$50 $12.50/$50/$90/$150 30% to $250 max $5/$20/$40/$60/30%$150 Ded Y $150 $5/$20/$40/$60 $12.50/$50/$120/$180 30% to $250 max 30% to $250 max copay for Specialty Drugs 30-day $5/$20/$40/$60/30% Y Y None $5/$20/$40/$60 $12.50/$50/$120/$180 30% to $250 max $5/$20/$40/$75/30% Y Y None $5/$20/$40/$75 $12.50/$50/$120/$225 30% to $250 max $5/$20/$40/$75/30%/$250 Ded Y $250 $5/$20/$40/$75 $12.50/$50/120/$225 30% to $250 max Essential Formulary a closed formulary that drives savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. Plans with Essential Formulary Standard Plan Options 1 Vivity Plan Options Deductible 2 Retail 30 days 4,5 Home Delivery 4 Tier 4 3,4 Tier 4 3,4 Home Delivery Essential Formulary $5/$15/$25/$45/30% Y Y None $5/$15/$25/$45 $12.50/$37.50/$75/$135 30% to $250 max Essential Formulary $5/$15/$30/$50/30% Y Y None $5/$15/$30/$50 $12.50/$37.50/$90/$150 30% to $250 max Essential Formulary $5/$15/$50/$55/30% Y Y None $5/$15/$50/$55 $12.50/$37.50/$150/$165 30% to $250 max Essential Formulary $5/$15/$50/$65/30% Y Y None $5/$15/$50/$65 $12.50/$37.50/$150/$195 30% to $250 max Essential Formulary $5/$20/$30/$50/30% Y Y None $5/$20/$30/$50 $12.50/$50/$90/$150 30% to $250 max Essential Formulary $5/$20/$30/$50/30%/$150 Ded Y $150 $5/$20/$30/$50 $12.50/$50/$90/$150 30% to $250 max Essential Formulary $5/$20/$40/$55/30% Y Y None $5/$20/$40/$55 $12.50/$50/$120/$165 30% to $250 max Essential Formulary $5/$20/$40/$55/30%/$150 Ded Y $150 $5/$20/$40/$55 $12.50/$50/$120/$165 30% to $250 max 30% to $250 max copay for Specialty Drugs 30-day Essential Formulary $5/$20/$40/$60/30% Y Y None $5/$20/$40/$60 $12.50/$50/$120/$180 30% to $250 max Essential Formulary $5/$20/$40/$60/30%/$150 Ded Y $150 $5/$20/$40/$60 $12.50/$50/$120/$180 30% to $250 max Essential Formulary $5/$20/$50/$65/30%/$500 Ded Y $500 $5/$20/$50/$65 $12.50/$50/$150/$195 30% to $250 max Essential Formulary $5/$20/$40/$75/30% Y Y None $5/$20/$40/$75 $12.50/$50/$120/$225 30% to $250 max Essential Formulary $5/$20/$40/$75/30%/$250 Ded Y $250 $5/$20/$40/$75 $12.50/$50/$120/$225 30% to $250 max 1 For non-pooled groups, multiple plan variations are available. Contact an Anthem Blue Cross Sales representative for options and pricing. 2 The deductible is waived for Tier 1. Pharmacy deductible does not apply to the medical plan deductible (if any). 3 Tier 4 Home Delivery provides a 30-day supply for the copay listed above. Subject to deductible where applies. 4 Member cost shares included in the medical Out-of-Pocket Maximum. 5 Standard Rx plan options include the Retail90 network where members can opt to receive up to a 90-day supply of maintenance drugs at a Retail90 pharmacy. Member pays additional Rx copays per 30-day supply. 27

30 Anthem Elements Choice EQ portfolio Anthem Elements Choice EQ product portfolio A product suite to meet the Affordable Care Act Employer Mandate requirement Anthem Elements Choice EQ plans available to newly eligible, full-time equivalent employees, not previously covered, working 30 to 39 hours per week or 130 hours of service per calendar month. The Affordable Care Act (or health care reform law) says an employer with 50 or more full-time (or full-time equivalent) workers will get a penalty if: The employer does not offer at least 95% of its workers health coverage and if any employee gets government aid (also called subsidies or advance premium tax credits) to lower their coverage cost through the Health Insurance Marketplace (also called the health insurance exchange). The employer takes out more than 9.5% of a worker s income for self-only coverage. The employer does not provide at least one plan option that gives minimum essential coverage of at least 60% minimum value (meaning it covers at least 60% of the cost of covered benefits). Of course, there are exceptions stated in the law. You may want to consult with a legal representative to determine your client s required compliance with the Employer Mandate. These Elements Choice EQ standard benefit designs (with no client modifications) have been tested and confirmed to meet the ACA 60% minimum value coverage requirement. They were also carefully designed to be cost-effective. Note: There are specific requirements that an employer and employee must meet in order to enroll in the Elements Choice EQ product. Please refer to your Anthem representative for details. 28

31 Anthem Elements Choice EQ Product Portfolio Benefit Grid (Effective 01/01/18) Available for newly eligible full-time equivalent employees working 30 to 39 hours per week or 130 hours of service per calendar month. Anthem Elements Choice EQ HMO 4 Calendar-year out-of-pocket maximum (member/family) Physician office visit member copay Inpatient hospital services member copay Outpatient hospital surgery (including ASC) member copay Anthem Elements Choice EQ HMO 1500 $6,400/$12,800 $25 PCP/$50 Specialist $1,500 deductible, then 30% of charges Anthem Elements Choice EQ HMO 3000 $6,400/$12,800 $30 PCP/$50 Specialist $3,000 deductible, then 30% of charges Anthem Elements Choice EQ HMO 5900 $6,400/$12,800 $35 PCP/$70 Specialist $5,900 deductible, then 30% of charges Available networks Traditional our most comprehensive statewide network; Select HMO our high-performance narrow network; Priority Select our most efficient network Anthem Elements Choice EQ HSA 4 Anthem Elements Choice EQ HSA 4500 Anthem Elements Choice EQ HSA 6350 Calendar-year deductible all providers (member/family) $4,500/$9,000 in-network $13,500/$27,000 out-of-network $6,350/$12,700 in-network $19,050/$38,100 out-of-network Annual out-of-pocket maximum (member/family) (medical and Rx combined) $6,350/$12,700 in-network $19,050/$38,100 out-of-network $6,650/$13,300 in-network $19,950/$39,900 out-of-network Embedded/ Nonembedded 5 Embedded Physician office visit member coinsurance in-network/out-of-network (after deductible) 20%/50% Prescription drug plans Tier 1a/Tier 1b/Tier 2/Tier 3/Tier 4 in-network Essential Formulary 1 $5/$20/$50/$65/30% /$500 Deductible 2 Member coinsurance in-network/ out-of-network Available networks Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents Anthem Elements Choice EQ PPO 3,4 Anthem Elements Choice EQ PPO 6000 Anthem Elements Choice EQ PPO 5900 Anthem Elements Choice PPO 6500 NEW Calendar-year deductible (member/family) $6,000/$12,000 in-network $18,000/$36,000 out-of-network $5,900/$11,800 in-network $17,700/$35,400 out-of-network $6,500/$13,000 In-Network $19,500/$39,000 Out-of-Network Annual out-of-pocket maximum (member/family) $6,500/$13,000 in-network $19,500/$39,000 out-of-network $6,500/$13,000 in-network $19,500/$39,000 out-of-network $7,350/$14,700 In-Network $22,050/$44,100 Out-of-Network Embedded/ Nonembedded 5 Embedded Physician office visit member copay $35 PCP/$60 specialist (deductible waived) None/50% $35 copay for the first 3 visits. After 3rd visit, deductible applies. $35 applies for the first 3 visits (deductible waived). After 3rd visit, member pays deductible Member coinsurance in-network/ out-of-network Available networks Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents 0%/50% 0%/50% Prescription drug plans Tier 1a/Tier 1b/Tier 2/Tier 3/ Tier 4 embedded Rx (after deductible) in-network Essential Formulary 1 $5/$15/$50/$65/30% Prescription drug plans Tier 1a/Tier 1b/Tier 2/Tier 3/ Tier 4 in-network Essential Formulary 1 $5/$20/$50/$65/30% /$500 Deductible 2 $5/$20/$50/$65/30% Essential Formulary Anthem Elements Choice EQ portfolio 1 The Essential Formulary is a closed formulary that drives cost of care savings by removing drugs that have over-the-counter and/or lower-cost formulary alternatives. 2 The deductible is waived for tier 1. 3 Fee schedule reimbursement for out of network. 4 Plans are offered by Anthem Blue Cross. 5 Embedded Accumulation: The family deductible and out-of-pocket maximum are embedded meaning the cost shares of one family member will be applied to the individual deductible and out-of-pocket maximum; in addition, amounts for all family members apply to the family deductible and out-of-pocket maximum. One family member will contribute no more than the individual amount. Note: There are specific requirements that an employer and employee must meet in order to enroll in the Elements Choice EQ product. Make sure to review the assumptions and conditions listed on your rate quote with your broker to ensure you and your employees meet these qualifications. 29

32 Anthem Balanced Funding portfolio Anthem Balanced Funding Gives employers the savings of a self-insured health plan, with the peace of mind that comes with a fully insured plan With Anthem Balanced Funding, businesses have predictable monthly payments and a limit to their financial responsibility. They also have the flexibility of a self-funded plan, and can get money back if their claims experience is favorable. A plan with the right combination Fully insured plan advantages: Predictable, fixed monthly payments No deficit carry-forward Coverage for claims run-out (also known as terminal liability) A cap on financial responsibility Self-insured plan advantages: Savings potential for favorable claims experience Standardized reports for a more comprehensive understanding of plan costs Savings on premium tax and future health care reform taxes Plan design options Providing an added layer of protection Having an integrated stop-loss policy relieves some of the financial burden, by sharing the responsibility with Anthem. The client is protected from significant financial losses if they get hit with higher-than-expected overall claims costs. Anthem Blue Cross is responsible for costs that exceed certain limits, which are outlined in the policy. Includes two kinds of stop-loss coverage: 1. Specific Stop Loss protects the plan from high individual claims 2. Aggregate Stop Loss provides additional protection when your plan has higher-than-expected claims, in aggregate, for all plan members You can offer more benefit dental, vision, life and disability coverage on a fully insured basis. Or you can add riders to your coverage such as: infertility diagnosis and treatment; autism; or a religious contraceptive exclusion. Health and Wellness Incentives! Encouraging employees to be healthier with incentives We are pleased to introduce Health and Wellness incentive programs that can be purchased with an Anthem Balanced Funding plan. These packages offer rewards and incentives for actions most healthy people are already doing, like going to the gym and getting an annual flu shot. By adding these, you can support employees who need a little motivation to be healthier and reward your employees who are already focused on their health. Talk to your Anthem Sales representative for details and options: Preventive wellness exam and flu shot $100 in gift cards Online health assessment $50 gift card Tobacco-free certification $50 gift card Gym reimbursement up to $400 in cash Online Wellness Toolkit up to $150 in gift cards Exclusion of many costly state-mandated benefits Staying ahead of the curve Anthem Balanced Funding gives clients the flexibility and cost savings they want, while limiting the risk. It s the perfect balance! Limited customization options We offer a variety of standard plans with the ability to customize the benefits that really matter such as copays, deductible, coinsurance, out-of-pocket, and pharmacy formulary and copays.* * Contact your Anthem representative to discuss limited customization options. 30

33 Anthem Balanced Funding plans (Plans effective 01/01/2018) Consider these important benefits: Predictability of a fully insured plan Savings potential and flexibility 1 of a self-funded plan Peace of mind from stop loss coverage In-network Out-of-network Deductible 3 Out-of-pocket 3 Deductible 3 Out-of-pocket 3 In-network/ Out-of-network Plan options 2 Single Family Single Family Single Family Single Family coinsurance PPO plans Available networks: Traditional Prudent Buyer PPO; BlueCard 5 Cost transparency and visibility through standard reports Option to buy dental, vision, life and disability coverage on a fully insured basis Office visit/ Specialist copay (In-network) ER copay 4 Anthem Balanced PPO 0/15/1500 $0 $0 $1,500 $3,000 $500 $1,500 $4,500 $9,000 10%/30% $15/$15 $150 Anthem Balanced PPO 0/20/2000 $0 $0 $2,000 $4,000 $200 $600 $6,000 $12,000 20%/40% $20/$20 $150 Anthem Balanced PPO 250/10%/2000/10 $250 $750 $2,000 $4,000 $750 $2,250 $6,000 $12,000 10%/30% $10/$10 $150 Anthem Balanced PPO 250/10%/2000/15 $250 $750 $2,000 $4,000 $750 $2,250 $6,000 $12,000 10%/30% $15/$15 $150 Anthem Balanced PPO 250/10%/3500 $250 $750 $3,500 $7,000 $750 $2,250 $10,500 $21,000 10%/30% $20/$20 $150 Anthem Balanced PPO 250/20%/3000/15 $250 $750 $3,000 $6,000 $750 $2,250 $9,000 $18,000 20%/40% $15/$15 $150 Anthem Balanced PPO 250/20%/3000/20 $250 $750 $3,000 $6,000 $750 $2,250 $9,000 $18,000 20%/40% $20/$20 $150 Prescription Drug Plans Tier 1a/Tier 1b/ Tier 2/ Tier 3/ Tier 4 In-Network Anthem Balanced Funding portfolio Anthem Balanced PPO 500/20%/3000 $500 $1,500 $3,000 $6,000 $1,500 $4,500 $9,000 $18,000 20%/40% $20/$20 $150 Anthem Balanced PPO 750/20%/4000 $750 $2,250 $4,000 $8,000 $2,250 $6,750 $12,000 $24,000 20%/40% $30/$30 $150 PPO Plans below - Available networks: Traditional Prudent Buyer PPO; Select PPO; BlueCard 5 National Formulary 6 $5/$15/$30/$50/30% Anthem Balanced PPO 1500/20%/5500 $1,500 $3,000 $5,500 $11,000 $4,500 $9,000 $16,500 $33,000 20%/40% $35/$35 $150 Anthem Balanced PPO 2500/25%/6000 $2,500 $5,000 $6,000 $12,000 $7,500 $15,000 $18,000 $36,000 25%/50% $35/$35 $150 Anthem Balanced PPO 3500/30%/6500 $3,500 $7,000 $6,500 $13,000 $10,500 $21,000 $19,500 $39,000 30%/50% $40/$40 $150 EPO plans (no Out-of-network benefits) Available networks: Traditional Prudent Buyer PPO; Select PPO; BlueCard 5 Anthem Balanced EPO 0/10/1500 $0 $0 $1,500 $3,000 N/A N/A N/A N/A 10% $10/$10 $150 Anthem Balanced EPO 0/15/1500 $0 $0 $1,500 $3,000 N/A N/A N/A N/A 10% $15/$15 $150 Anthem Balanced EPO 0/20/2000 $0 $0 $2,000 $4,000 N/A N/A N/A N/A 20% $20/$20 $150 HSA plans Available networks: Traditional Prudent Buyer PPO; Select PPO; BlueCard 5 Anthem Balanced PPO 1500/10%/3000 w/ HSA $1,500 $3,000 $3,000 $6,000 $4,500 $9,000 $9,000 $18,000 10%/30% 10% after deductible $150 Anthem Balanced PPO 2000/20%/3425 w/ HSA $2,000 $4,000 $3,425 $6,850 $6,000 $12,000 $10,275 $20,550 20%/40% 20% after deductible $150 Anthem Balanced PPO 3000/20%/3425 w/ HSA $3,000 $6,000 $3,425 $6,850 $9,000 $18,000 $10,275 $20,550 20%/40% 20% after deductible $150 National Formulary 6 $5/$20/$40/$60/30% 1 Limited customization options are available for certain benefits such as copays, deductible, coinsurance, out of pocket, and pharmacy formulary & pharmacy copays. See your sales representative for details. 2 All plans offered by Anthem Blue Cross Life and Health Insurance Company. 3 HSA plans include a non-embedded accumulation for deductible and out-of-pocket maximum. All other plans are embedded. See Summary of Benefits for more detail. 4 Additional member cost shares apply. Please review the Summary of Benefits for details. 5 Traditional Prudent Buyer PPO our most comprehensive statewide network; Select PPO our high-performance narrow network for California residents; BlueCard for non-california residents. 6 National Formulary Anthem s broadest drug list with brand-name and generic FDA-approved medications that are selected for their safety, effectiveness and value. 31

34 Alternative funding Alternative funding offers control and flexibility Employers who qualify may have additional options for their employee health benefits beyond traditional fully insured plans. These groups may choose to consider alternative funding plans. The most common types of alternative funding plans offered by Anthem Blue Cross are: Administrative services only (ASO), which is available for PPO products. Minimum premium, which is available for HMO, POS and PPO products. While the fixed monthly costs for these plans are significantly lower than for fully insured plans, you should understand that the financial risk is also greater. Consequently, we only recommend these types of plans for groups who are large enough and have the financial resources to tolerate significant fluctuations in monthly claims costs. Advantages of ASO plans ASO plans differ from fully insured plans because the employer assumes the insurance risk for its employees benefit claims. The employer funds an account from which claims are paid. The unique advantages for groups that choose an Anthem Blue Cross ASO product include: Greater flexibility Employer groups with ASO funding have a greater say in the benefit plan designs they offer because they are subject to fewer legislative constraints. Transparent pricing Employers pay a low, fixed monthly fee for administrative expenses, and they fund their actual claims through a bank account. Administrative ease Anthem Blue Cross handles all administrative aspects of employees coverage, including customer service, claims processing and medical management. Competitive stop loss To protect ASO groups from unexpected catastrophic loss, specific and aggregate stop-loss insurance is available. Minimum premium is similar to ASO and available for PPO, POS and HMO Minimum premium funding is similar to ASO: Employers pay low, monthly fixed costs and fund their actual noncapitated claims through an account. The difference is that minimum premium includes claim liability limits and pooling, which protect groups from catastrophic loss. As with ASO, this funding option should be considered by employers that have the financial resources to tolerate fluctuations in the payment of actual claims. At Anthem Blue Cross, we believe in offering you the options and flexibility to create employee health solutions that are right for your clients. For more information and details on how alternative funding options can work for your clients, contact your Anthem Blue Cross Sales representative. We have benefit plans for your clients unique needs. 32

35 For all your health care needs, Anthem is your total health solution See how our health, dental, vision, life and disability plans work together for your employees health and your bottom line. Meet your one carrier, one solution: Anthem Whole Health Connection SM. We believe health care should serve the whole person head to toe, at each stage of life. It should also be easy to administer, so you don t get bogged down in paperwork. You can have one solution for all your health benefits needs. Through electronic health records, we get claims and clinical data from network dentists, eye doctors, primary care physicians and care coordinators, which allows us to create more complete health profiles for our members. The advantages can t be matched by even the best stand-alone carriers. Dental, vision, life and disability Medical Dental Disability Vision Life Strong alone. Better together. Clinically coordinated care through our connected health plan portfolio: Benefits from one source, so you spend less energy managing multiple plans Strong local and national networks Competitive pricing A brand you can trust One bill, one payment, one ID card 33

36 Dental Dental We have the right dental plans for your clients unique needs Choosing a dental plan for employees is all about balance. Cost matters. But so does employees health. That s why your clients have choices with Anthem dental. We ll help them find the right mix of benefits that can have the best impact on their employees health. And no matter which dental plans they choose, they can count on: Solid coverage at a good price. Benefits that make sense for dental health and total health. Service they can trust. Strong network access. Dental plans that work hard for your clients Your clients and their employees will enjoy these standard services: Easy-to-access information. Employees can go online any time to get their claims and dental plan details. Plus, they ll find helpful materials that promote dental health. Expert customer service. We re committed to giving our members the best service. Calls are answered quickly (typically within 15 seconds) 1 by reps with dental expertise. Swift claims payments and data-based benefits. On average, we pay claims in 2.1 days or less. We also track data from the millions of claims we process each year. And we ve got financial accuracy rates of more than 99.9%. 1 So your clients can be sure payments are prompt and correct. Members who travel or work outside of the U.S. have access to emergency dental services in more than 100 countries. With one call, we ll help them find a credentialed, English-speaking dentist for urgent dental care. We can even help them with translation services when they call the dentist s office. Services members receive through this program 2 are covered at 100% and don t count toward their annual maximum, if their plan has one. Our Dental Care Cost Estimator tool provides estimates for common dental procedures and treatments, giving our Dental Complete members even more opportunities to understand their dental care costs prior to receiving their care. Our Dental Health Assessment tool helps Dental Complete members better understand their oral health and predict their risk of developing tooth decay, gum disease, tooth wear and oral cancer. Ask a Hygienist Members can get personalized advice on dental health care with our Ask a Hygienist service. Preventive dental services Preventive dental services are used more than any other dental services. They can help find dental and other health problems early on. That s why all of our Dental Complete and Dental Net plans cover routine cleanings, exams and X-rays 100% at network dentists. Other preventive services include: Special treatments for kids. We cover sealants for children up through age 15 and fluoride treatments up through age 18 to protect teeth from decay and promote better dental health. Brush biopsy benefits. A brush biopsy may help diagnose oral cancer when combined with a lab analysis and a surgical biopsy with lab analysis. Extra services for members with certain health conditions. We offer an extra cleaning or periodontal maintenance procedure each year for members who are pregnant or living with diabetes. Additionally, those actively engaged in a care management program are auto-enrolled for an extra cleaning. That includes health conditions such as: Heart conditions heart disease, an enlarged heart and mitral or aortic valve prolapse. Organ or bone marrow transplant. Cancer (any type) treated with chemotherapy. Head or neck cancer treated with chemotherapy and/or radiation therapy. Anthem dental network advantages With us, employees have access to a more extensive network of PPO dentists and specialists than most carriers on the block. And we have a large DHMO network of nearly 3,200 providers, as well. The Dental Net network has more than 10,800 general dentist and specialist access points in California. Flexibility and choice are critical, too Whether your clients want a basic plan, comprehensive coverage or something in between, they ll find it among our wide range of dental plans Customer service results: 2016 year-to-date results. 2 The International Emergency Dental Program is managed by DeCare Dental. DeCare Dental is an independent company offering dental management services to Anthem Blue Cross.

37 Dental Complete: Plans with more coverage options When we created the Dental Complete plans, we made sure they could be custom fit. That means lots of choices in coverage, including options for: Dental implants. Composite (tooth-colored) fillings on any teeth, not just the front teeth. Orthodontic benefits for kids and adults, or kids only. Annual maximum carry-in, which is a one-time opportunity available only when your company switches dental insurance to Anthem. If your previous dental insurance carrier allowed you to earn or roll over benefit dollars from year to year, you can carry-in those dollars to your new Anthem dental plan carry-over account, so you don t lose what you have already earned. The most you can carry into your Anthem dental plan is $1,000. Annual maximum carry-over, which is is a yearly opportunity for you to earn a $250 reward if your annual dental claims are less than $500. You can earn up to a maximum of $1,000 for each person covered on your Anthem dental plan. (The maximum of $1,000 is the total of any carry-in dollars and earned carry-over rewards.) Our network is broad and easy to use Our national network is one of the largest PPO networks in the country and includes dentists in all 50 states so your employees can find a dentist wherever they live, work or visit. Dental Complete members have access to our national network, a broad network (for the most access) with nearly 17,800 unique dentists (nearly 42,100 access points) in California. This network has more than 125,100 unique providers nationwide (more than 369,400 access points). When members see a network dentist, they get: Savings: We agree on pricing with network dentists and pass that lower price on to members. Freedom from paperwork: Network dentists file your clients employees claims directly with us. No balance billing: If network dentists charge more than the agreed-upon price, they cover the difference not your clients employees. Members pay only their deductible or coinsurance (or both). We review Dental Complete data to make sure our dental plan designs are in line with evidence-based dentistry At Anthem, we re always reviewing the latest clinical research. This helps us keep our dental contracts up-to-date based on changes in dentistry. We focus on what s known as evidence-based dentistry. This means it matches the plan coverage with services and frequencies that makes sense from a clinical point of view to provide the best care while being cost-effective. An example of this is coverage for sealants once every 24 months rather than once per lifetime. We ve found that when people have sealants and they ve taken care of them, it can help lower future restoration costs, which could be much higher. So this really helps lower costs for both your clients and their employees. It also promotes better dental health for the member. We offer you a choice of active or passive benefits: Active dental plans provide a higher level of benefits when members use network providers. Passive dental plans have the same level of benefits in and out of network. Out-of-network reimbursement: FAIR Health 80th offers a level of reimbursement based on data from an industry-standard third-party vendor called FAIR Health. At the 80th percentile, the amount we pay for a service is equal to 80% of the charges for that service in a given ZIP code. In other words, 80% of dentists in the ZIP code charge that amount or less for the service. FAIR Health 90th works the same as FAIR Health 80th, except at the 90th percentile. The MAC fee schedule offers a cost-effective level of reimbursement for out-of-network claims. Dental Net DHMOs: Plans with more affordability Our Dental Net DHMOs have no annual maximums,* no deductibles and no waiting periods. That s unlike many dental plans that limit the amount of services members can receive in a year. Also, members can get a good idea of their costs because Dental Net plans have set member copays for nearly 300 different procedures, including fillings, crowns and night guards. Dental Net even covers things like composite (tooth-colored) fillings on any tooth and general anesthesia for oral surgery. Plus, members will really like Dental Net s orthodontic coverage. The costs are lower than you might expect. These are just $1,695 for children up to age 18 and $1,895 for adults, plus $200 for retention/retainers. Without insurance, these services would cost a lot more. The Dental Net network has nearly 3,200 general dentist and specialist access points in California. Services must be received from Dental Net providers. Members choose a primary care dentist who coordinates any specialty care or orthodontic services that are needed. Anthem dental advantages: Largest network access Flexibility in dental plan design options A commitment to outstanding claims accuracy and customer service International emergency dental services Dental * There is no maximum or age limitation for pediatric dentistry performed by your participating dental office. If in the professional judgment of your participating dentist or in professional review by plan it is determined that the participating dentist is unable to render care to a child, referral to a pediatric dentist would be a benefit under the age of 5 with a $750 maximum. Exceptions are made on a preapproval basis only. 35

38 Dental Complete plans offer 14 ways to customize plans With Dental Complete, large group employers can choose the exact level of benefits that fit their needs and budget. Dental Options listed in the benefits menu below are available for both employer-paid and voluntary plans. Voluntary plans are available when your clients maintain at least five enrolled employees. This overview provides only a brief description of some of the plan s features. This is not the insurance contract and only the Certificate of Coverage (Certificate) provisions apply. Please refer to the applicable Certificate, which sets forth, in more detail, the benefits, limitations and exclusions. If there are any conflicts between the terms of the Certificate and the information outlined below, the terms of the Certificate will prevail. 36 Benefits menu 1. Active/passive plan designs Choose: 1. Active plan designs, which provide a higher level of benefits to employees when members use network providers 2. Passive plan designs, which have the same level of benefits in and out of network 2. Diagnostic and preventive services Choose the percentage Anthem will pay 100% to 50% (cleanings, exams and X-rays) 3. Basic services (fillings) Choose the percentage Anthem will pay 100% to 40%, or not covered 4. Major services (crowns, bridges, dentures, etc.) Choose the percentage Anthem will pay 100% to 40%, or not covered 5. Annual deductible Choose: 1. Amount ranging from $0 to $100, or $100 lifetime deductible 2. Family aggregate of two or three times single member deductible, or no limit 3. Whether or not to waive the deductible for diagnostic and preventive services 6. Annual benefit maximum (per member) Choose: 1. Benefit maximum amount: Groups of : $500 to $2,500 Groups of 301 or more: $500 to $3, Calendar or contract year 7. Benefit category Choose category for: 1. Endodontic services: Pay at the same level as basic services or at the same level as major services 2. Periodontal services: Pay at the same level as basic services or at the same level as major services 3. Oral surgery services: Pay at the same level as basic services or at the same level as major services 4. Sealants: diagnostic and preventive or basic 8. Benefit frequency for bitewing X-rays Choose: 1. Covered once every 12 months for members under age 18, and once every 24 months for members age 18 or older 2. Covered twice every 12 months 9. Orthodontic coverage Choose: 1. Child only coverage, adult and child coverage or no coverage 2. Choose the percentage Anthem will pay 100% to 40%, or not covered 3. Lifetime maximum Groups of : $500 to $2,500 Groups of 301 or more: $500 to $3, Waiting periods Choose: 1. Whether or not to add a waiting period 2. Which services to add the waiting period to: Basic, Major and/or Orthodontics 3. Length of waiting period: Six months (except on orthodontia); 12, 18 or 24 months 11. Coverage options Choose whether to add or change the following coverage options: 1. Add annual maximum carry-in 2. Add annual maximum carryover 3. Add coverage for dental implants 4. Composite (tooth-colored) fillings on posterior (back) teeth paid at the amalgam level (standard coverage is to pay at the composite level) 5. Add a brush biopsy benefit (for oral cancer screening) 12. Network Dental Complete contracted network 13. Out-of-network reimbursement Choose: FAIR Health 50th to 90th percentile (in increments of 10) or MAC fee schedule 14. Contract length Choose one or two years

39 Dental Net DHMO This overview provides only a brief description of some of the plan s features. This is not the insurance contract and only the Certificate of Coverage (Certificate) provisions apply. Please refer to the applicable Certificate, which sets forth, in more detail, the benefits, limitations and exclusions. If there are any conflicts between the terms of the Certificate and the information outlined below, the terms of the Certificate will prevail. Member s copay CDT code Benefit Plan 2000A Plan 2000B Plan 2000C Diagnostic services D0120 Periodic oral examinations $0 $0 $0 D0210 Intraoral X-rays complete series (include bitewings) $0 $0 $0 Preventive services D1110 or D1120 Teeth cleaning (prophylaxis) adult or child 2 per year $0 $0 $0 D1208 Topical fluoride, covered to age 18 $0 $0 $0 D1351 Sealants, per tooth, through age 15 $7 $5 $0 Restorative services, filling - permanent D2140 Amalgam (silver-colored) one-surface fillings $0 $0 $0 D2330 Resin-based composite (tooth-colored) fillings on anterior (front) tooth, one surface $0 $0 $0 D2391 Resin-based composite (tooth-colored) fillings on posterior (back) tooth, one surface $30 $20 $10 D2393 Resin-based composite (tooth-colored) fillings on posterior (back) tooth, three surfaces $55 $45 $30 Oral surgery services D7140 Simple extraction of erupted tooth or exposed root $15 $5 $5 D7210 Surgical extraction of erupted tooth $30 $25 $20 D7220 Removal of impacted tooth soft tissue $50 $45 $40 D7230 Removal of impacted tooth partial bony $70 $60 $50 D7240 Removal of impacted tooth completely bony $100 $70 $60 Endodontic services D3220 Therapeutic pulpotomy (excluding final restoration) $20 $15 $10 D3310 Root canal: anterior (front tooth) (excluding final restoration) $90 $70 $65 D3320 Root canal: bicuspid (excluding final restoration) $125 $80 $75 D3330 Root canal: molar (excluding final restoration) $160 $140 $130 Periodontic services D4210 Gingivectomy: four or more contiguous teeth, per quadrant $95 $70 $55 D4211 Gingivectomy: one to three teeth touching each other (contiguous), per quadrant $48 $20 $15 D4261 Osseous surgery: one to three contiguous teeth, per quadrant $150 $115 $90 D4342 Periodontal scaling and root planing: one to three teeth, per quadrant $23 $15 $10 D4910 Periodontal maintenance $25 $13 $13 Prosthodontic services D2750 Crown: porcelain fused to high noble metal (Example: gold) $175* $170* $90* D5110 or D5120 Complete upper or lower denture $175 $150 $125 D5211 or D5212 Partial upper or lower denture, resin base (including conventional clasps, rests and teeth) $150 $125 $100 D5730, D5731, D5740 or D5741 Denture reline: chairside $40 $20 $0 D6240 Pontic (bridge), porcelain fused to high noble metal (Example: gold) $175* $150* $125* Orthodontic services 24 months of standard orthodontic coverage, exclusive of records/retention fees D8080 Child (up to age 18) $1,695 $1,695 $1,695 D8090 Adult $1,895 $1,895 $1,895 D8680 Retention (placement of retainers) $200 $200 $200 Other services Out-of-area emergency care maximum payment $100 All charges over $100 All charges over $100 All charges over $100 D9215 Local anesthesia $0 $0 $0 D9220 General anesthesia first 30 minutes $160 $145 $130 D9440 Office visit: after hours $25 $25 $25 D9940 Occlusal guards (mouth guards) $100 $75 $50 * Plus costs for noble or high noble metal, not to exceed $125, and/or costs for porcelain, not to exceed $100. Dental Net is available in these counties: Alameda, Contra Costa, Fresno, Los Angeles, Marin, Orange, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Luis Obispo, Santa Barbara, Santa Clara, Solano and Sonoma. Dental Net has limited availability in these counties: El Dorado, Kern, Kings, Monterey, Placer, Riverside, San Mateo, Santa Cruz, Tulare and Ventura. 37 Dental

40 Blue View Vision SM Vision Vision coverage with an eye for better health Regular eye exams can help detect some major health conditions, like diabetes and cardiovascular disease, early on. And of course, early detection can mean lower health care costs. Features of our vision plans include: Factory scratch coating on standard eyeglass lenses at no additional cost. }Transitions } and polycarbonate lenses for children under 19 years of age at no additional cost. }Transitions lenses for adults at a fixed price of $75. Tiered pricing for premium progressive lenses and premium antireflective coatings, helping to limit members out-of-pocket costs. Coordinated care for groups with our health and wellness product. These features are included within a variety of plan designs and funding options (fully insured, ASO and voluntary), so you can find the combination that works best for your client. There s more to offer with our vision and health plans: Two-way communication between network eye care and health care providers Diabetics identified during an eye exam may be referred to our Diabetic ConditionCare program so they can get help in managing their condition Nurse coaches to help employees stay on top of their conditions We help connect the information and all of our network providers so they can all see eye-to-eye on our members care. Extensive network with greater choice Blue View Vision members can visit a private practice doctor, call or go online 24/7 at Glasses.com, ContactsDirect.com and CONTACTS or choose from convenient local and national optical stores that include: LensCrafters, Sears Optical, Target Optical and JCPenney Optical. Ninety-seven percent of our claims are in network, 1 meaning that the majority of members find what they re looking for within our network. That s, in part, because we offer true in-network retail access with extended-hour locations that make it easier for members to get vision care when it s convenient, rather than during the workday. And some locations even fill orders in as little as an hour. More savings In addition to their plan allowance, members can get 20% off any remaining balance on eyeglass frames. 2 They can also save 15% to 40% on noncovered materials 3 such as spare glasses, additional supplies of conventional contact lenses, lens treatments and other items. Discounts can be used for unlimited purchases even after vision benefits for the coverage period are exhausted. Plus, through SpecialOffers@Anthem SM, members can get discounts on laser vision correction surgery, additional contact lenses via mail order, and offers on many other products and services. A commitment to care 38 Our vision and health plans work together to deliver a bigger, better picture of member health. Through Anthem Whole Health Connection SM, we integrate data from health and vision claims, as well as dental, life, disability, behavioral health and pharmacy, to create more complete member health profiles. 1 Internal data, December Unless the manufacturer has imposed a no-discount policy on the frame. 3 Except where state law prohibits provider discounting. The advantage is clear: Care: Eye doctors have a better view of members overall health through our Anthem Whole Health Connection SM. Convenience: Combined administration and integrated capabilities provide ease and efficiency for both employers and employees. Choice: Employees get what they want, where they want, when they want. Savings: Members can save on popular lens options and upgrades through any network provider, anytime. 3

41 Blue View Vision This overview provides only a brief description of some of the plan s features. This is not the insurance contract and only the Certificate of Coverage (Certificate) provisions apply. Please refer to the applicable Certificate, which sets forth, in more detail, the benefits, limitations and exclusions. If there are any conflicts between the terms of the Certificate and the information outlined below, the terms of the Certificate will prevail. Plan benefits include: Comprehensive eye exam (various copay options) Frequency Plan A Plan B Plan C Plan D Eye exam once every 12 months Eye exam once every 12 months Eye exam once every 12 months Eye exam once every 24 months Lens options Member add-on cost from network providers* Factory scratch coating $0 Tint $15 Vision UV coating $15 Standard polycarbonate (covered child) $0 Frame allowance Eyeglass frames once every 12 months Eyeglass frames once every 24 months Eyeglass frames once every 24 months Eyeglass frames once every 24 months Standard polycarbonate (adults) $40 Transitions lenses (covered child) $0 Transitions lenses (adults) $75 Eyeglass lenses (various copay options) Choice of: Eyeglass lenses once every 12 months Eyeglass lenses once every 12 months Eyeglass lenses once every 24 months Eyeglass lenses once every 24 months Progressive lenses Standard $65 Premium Tier 1 $85 Single vision Premium Tier 2 $95 Bifocal Premium Tier 3 $110 Trifocal Premium Tier 4 20% off retail price Contact lens allowance (in lieu of eyeglass lenses) Contact lenses once every 12 months Contact lenses once every 12 months Contact lenses once every 24 months Contact lenses once every 24 months Antireflective coating Standard $45 Premium Tier 1 $57 Premium Tier 2 $68 Extra pairs of glasses Other upgrades and accessories 40% off retail price 20% off retail price *Reflects discount pricing for plans that cover materials. Discounts do not apply where prohibited by state law. 39

42 Life Life A new philosophy on life Anthem s Group Life plans offer more than just a benefit check. We provide services employees can use now, like emotional, financial and legal counseling employees and their families can use today, as well as when they re dealing with a loss. Features include: Resource Advisor support services provide face-to-face and telephone counseling, legal help and financial advice and a robust website with tools to help employees prepare a will, download more than 100 legal forms, plan for the future and live for today. And we provide all these services, plus grief counseling to beneficiaries to help them through a stressful time. Beneficiary Companion services give over-the-phone, one-on-one help to beneficiaries in settling their loved ones estate. Travel assistance if there s an emergency while traveling away from home. Living benefits so members can get a portion of their life insurance benefit early if they re diagnosed as terminally ill. Beneficiaries can order copies of The Healing Book Facing the Death and Celebrating the Life of Someone You Love, a book for kids affected by loss, at no additional charge. Products that fit your clients needs We offer a wide variety of product options, with outstanding support services, to tailor a benefits program to employees. Our group term life plan and accidental death and dismemberment (AD&D) coverage are available on a fully insured, voluntary (employee-paid) or optional (employee buy-up) basis. 40

43 Group Term Life and Optional Group Term Life This overview provides only a brief description of some of the plan s features. This is not the insurance contract and only the Certificate of Coverage (Certificate) provisions apply. Please refer to the applicable Certificate, which sets forth, in more detail, the benefits, limitations and exclusions. If there are any conflicts between the terms of the Certificate and the information outlined below, the terms of the Certificate will prevail. Rates Composite-rated Rate guarantee Two years Guaranteed Issue amount Group term life benefit payments Optional group term life benefit payments AD&D benefits Dependent life benefit Participation Based on your group size; ask your sales representative. One to five times the employee s salary or a specific dollar amount from $15,000 to $500,000 to a maximum of five times annual earnings. A lower maximum may be set by Underwriting. Groups can offer the following options. Employee chooses his or her benefit within the options offered: A specific dollar amount or incremental benefit options from $15,000 to $500,000 to a maximum of five times annual earnings. One to five times their salary, to a maximum of $500,000. A lower maximum may be set by Underwriting, and optional dependent life benefits are also available. Ask your Anthem representative. AD&D benefits are available with both Group Term Life and Optional Group Term Life. The AD&D benefit is equal to the life benefit. Half of the benefit is payable for loss of sight in one eye, a limb, hearing or speech. One-quarter of the benefit is payable for the loss of multiple digits on the same hand and one-eighth is payable for loss of all toes on the same foot. The full benefit may be payable for multiple losses. Benefits are also payable for paralysis. The following additional benefits are paid for specified losses: Benefit Description Payment amount Seat belt benefit: Payable when an employee is wearing a seat belt and dies $15,000 or 10% of employee s AD&D benefit, whichever is less in a covered accident Air bag benefit: Payable when an accident involves an employee traveling $10,000 or 10% of employee s AD&D benefit, whichever is less in a car with an air bag and death occurs Child education benefit: Pays a benefit per academic term to help cover a child s college tuition if the employee dies in a covered accident Repatriation benefit: Payable for an employee s death that occurs more than 75 miles away from home due to a covered accident Coma benefit: Pays a benefit if an employee is in a coma for at least 31 days due to a covered accident Common carrier benefit: Pays a benefit for an employee s death in a public transportation accident involving an airplane, train or bus $5,000 or 5% per academic year of employee s AD&D benefit, whichever is less; up to $40,000 is payable over four years for each eligible child Up to $5,000 in preparation and transportation expenses 1% per month for each month of coma, up to the employee s full AD&D benefit 25% of the employee s AD&D benefit You may select from one of the following options, or you may elect to offer multiple options under a class-based plan: Spouse Coverage Dependent Coverage $20,000 $10,000 for each child $15,000 $7,500 for each child $10,000 $5,000 for each child $5,000 $2,500 for each child $2,000 $1,000 for each child Dependent coverage may not exceed 50% of the employee s life benefit amount. For group term life insurance, all eligible employees must be enrolled if coverage is employer-paid; 75% participation is necessary when employees contribute to the plan (employer must contribute at least 25% of the group term life premium for employee coverage). For optional group term life, 25% of eligible employees must participate. Life For eligibility information and other life coverage information, contact your Anthem representative. 41

44 Disability Disability Getting employees back to health, back to work and back to life Employees can take comfort in the fact that our claim metrics, including claim turnaround time, audit process and payment accuracy, are outstanding, exceeding industry standards in a recent consultant audit. 1 And there s rarely a hassle. We simply do everything we can to make the benefit check process smooth and efficient. Productivity Solutions With Productivity Solutions, short-term disability plans provide a proactive, integrated approach to employers health, absence and disability management programs. We help employers leverage employee benefit dollars, while helping employees get back to health, back to work and back to life as quickly and safely as possible. Employees covered by an Anthem health plan who are experiencing a disabling illness or injury are connected with a health coach, who is also a registered nurse, to serve as the employee s advocate throughout the claims and care management process. Health coaches work one-on-one with employees to help identify and resolve all issues that affect their ability to be productive. With this support, employees may return to work more quickly and, in some cases, may be able to stay at work and avoid a disability claim altogether. For Anthem health plans with the MyHealth Coach program, Productivity Solutions includes additional services, like health risk assessments, pre-admission/ post-discharge assessments to identify members whose health conditions could lead to a disability, and proactive two-way referrals (both from Disability Case Managers to MyHealth Coach when a member files a disability claim, and from MyHealth Coach to Disability Case Managers when the MyHealth Coach identifies members with health conditions that may lead to disability). But our job doesn t end there. We work hard to provide employees the support services and tools they need to become productive again, including: Resource Advisor services to help employees with everything from legal advice and finding a childcare provider to face-to-face counseling. Referrals to your employee assistance program or behavioral health program for substance abuse or behavioral issues. }SpecialOffers@Anthem } SM discounts that can help them manage a disability, like gym memberships, coaching programs, eyewear and more. Newborn and Parenting Resources to help new mothers adjust to a new baby and return to work after maternity leave. }Anthem initiates the transition from short- to long-term disability claims for employees when you place both your short- and long-term plans with us. Assistance with filing for Social Security benefits. We can also help avoid a disability claim or enable employees to return to work sooner by modifying employees work spaces, adapting equipment to their needs or changing their duties. If those steps don t work, we can assist employees with job training or a new job search. Products that fit your clients needs We offer a wide variety of product options, with outstanding support services, to tailor a benefits program to your clients. Products include: Short-term disability insurance Voluntary short-term disability coverage FMLA administration services Long-term disability insurance Voluntary long-term disability coverage Anthem advantages: Support services that offer more than just a benefit check to help get employees back to health, back to work and back to life One of the fastest claim turnaround times (within two days) and the highest financial accuracy rates in the industry 2 }Financially strong company with an A (Excellent) rating from A.M. Best Company 42 1 Hewitt, Mercer consulting broker audit, internal data, 2011.