2014 Benefit Changes BlueCross and BlueShield Service Benefit Plan

1. 2014 Benefit ChangesBlueCross and BlueShield Service Benefit Plan

2. Plan Overview • Preventive Care • Health Club Membership • Special Features 2014 Benefits Changes 2014 Rates Agenda

3. Service Benefit Plan Options • The Service Benefit Plan is a fee-for-service (FFS) plan • We have a Preferred Provider Organization (PPO) StandardOption Standard Option & Basic Option BasicOption • No deductibles • Copayment based • Preferred Providers only • Retail Rx • Deductible • Copayments and Coinsurance • Ability to Choose Provider (Preferred and Non-preferred) • Retail and Mail Rx • No Pre-Existing Conditions • No Referrals Required • No Lifetime Maximums • Unlimited I/P Hospital Days

4. Preventive Care • Free Preventive Care (Preferred Providers) • Free annual physicals for adults • Free well child care from birth up to the age of 22 • Free cancer screenings • Free immunizations

5. Health Club Membership Healthways Fitness Your Way • Online enrollment payment • $25 one time initiation fee • $25/month (3 monthsminimum) • Unlimited access to >8000 fitness centers • Web tools, trackers and online health tracking • Ongoing engagement through social networking and gaming

6. 2014 Benefits Changes

7. 2014 Benefit Changes • BRCA Testing • Vitamin D Supplements • Catastrophic Maximums • Prescription Drugs • Basic Option Copayments • Wellness Incentives • Other Changes

8. Preventive BRCA Testing • Current Benefit: • Benefits are not available for BRCA testing when no condition is present • 2014 Benefit: • Benefits are available for BRCA testing, limited to one per lifetime, for: • Female members without personal diagnosis of breast or ovarian cancer who meet specific family history criteria; no member-cost share when provider is Preferred • Male or Female members with a cancer diagnosis when test is medically necessary to manage treatment of cancer; regular medical benefits apply Standard Option and Basic Option

9. Vitamin D Supplements • Current Benefit: • Benefits are not available for Vitamin D supplements • 2014 Benefit: • Benefits are available with no member cost-share for Vitamin D supplements for adults, age 65 and over: • When prescribed by a physician; • When obtained from a Preferred retail pharmacy; and • Limited to 600-800 international units (I.U.s) daily Standard Option and Basic Option

10. Catastrophic Out-of-Pocket Maximums

11. Catastrophic Maximum – Standard Option • Current Benefit: • The calendar year deductible does not count toward the catastrophic protection out-of-pocket maximum • 2014 Benefit: • Include the calendar year deductible in calculation of the catastrophic maximum

12. Standard Option: CatastrophicOut-of-Pocket Maximums *Basic Option limited to Preferred providers

13. Catastrophic Maximum – Basic Option • Current Benefit: • The member cost-share for Tier 3 (non-preferred brand-name) drugs does not apply toward the catastrophic maximum • 2014 Benefit: • Apply the member cost-share for Tier 3 (non-preferred brand-name) drugs toward the catastrophic maximum

14. Basic Option: CatastrophicOut-of-Pocket Maximums *Basic Option limited to Preferred providers

15. Basic Option Surgical Copayment • Current Benefit: • Member copayment = $150 per surgeon, regardless of place of service (Special exceptions exist for some minor procedures to be treated as office visit with copayment). • 2014 Benefit: • Member copayment = $150 per surgeon for surgical procedures performed in an office setting • All other settings, a $200 copayment per surgeon will apply

16. Basic Option Inpatient Admission Copayment • Current Benefit: • Member copayment = $150 per day for inpatient admission (maximum of $750 per admission) • 2014 Benefit: • Member copayment = $175 per day for inpatient admission (maximum of $875 per admission)

17. Basic Option Diagnostic Test Copayments • Current Benefit: • No cost-share for neurological testing • $25 copayment for low-cost diagnostic tests • $75 copayment for professionally-billed high-cost diagnostic tests • $100 copayment for facility-billed high-cost diagnostic tests • 2014 Benefit: • $40 copayment for neurological tests and other low-cost diagnostic tests • $100 copayment for professionally-billed high-cost diagnostic tests • $150 copayment for facility-billed high-cost diagnostic tests

18. Wellness Incentives

19. Health Assessment Incentive • Current Benefit: • Members receive up to $50 on a wellness incentive card for completing the Blue Health Assessment ($35) and up to 3 online coaching modules ($5 each) during the calendar year • 2014 Benefit: • Members receive up to $75 on a wellness incentive card for completing the Health Assessment ($40) and achieving up to 3 of 5 lifestyle goals ($15 for first goal; $10 each for two additional goals) during the calendar year. Lifestyle goals include exercise, nutrition, stress, weight management, and emotional health

20. Other Changes

21. Insulin and Diabetic Supplies • Current Benefit: • Members can obtain insulin and diabetic supplies from professional providers or through the pharmacy program(s) • 2014 Benefit: • Limit benefits for insulin and diabetic supplies to be dispensed exclusively through the pharmacy program(s) • Except for members with primary coverage under Medicare Part B, exclude coverage for insulin and diabetic supplies dispensed by professional providers

22. Wigs • Current Benefit: • Benefits are available for one wig per lifetime, up to a $350 maximum, for hair loss due to chemotherapy for the treatment of cancer • 2014 Benefit: • Benefits are available for one wig per lifetime, up to a $350 maximum, for hair loss due to the treatment of cancer

23. Home Nursing Care Visits (Standard Option only) • Current Benefit: • 25 home nursing care visits, limited to 2 hours per visit, per calendar year • 2014 Benefit: • 50 home nursing care visits, limited to 2 hours per visit, per calendar year

24. Acupuncture Limitations (Basic Option only) • Current Benefit: • For Basic Option, current acupuncture benefit includes an unlimited number of visits, but limited to physicians only • 2014 Benefit: • Limits Basic Option acupuncture visits to 10 per calendar year (with all licensed providers now allowed to bill)

25. 2014 RatesStandard OptionBasic Option

26. Enrollment Codes Standard Option • 104 Self Only • 105 Self and Family Basic Option • 111 Self Only • 112 Self and Family

27. 2014 Rates – Standard Option (Non-Postal Rates) Bi Weekly Monthly • Self 104 87.82 (+1.91) 190.28 (+4.14) • Family 105 204.98 (+4.84) 444.12 (+10.49) Source

28. 2014 Rates – Basic Option (Non-Postal Rates) • Bi Weekly Monthly • Self 11160.96 (+1.89)132.08 (+4.10) • Family 112142.75 (+4.43)309.29(+9.60)

29. Pharmacy Programs Blue Cross and Blue Shield Service Benefit Plan 2013 HBO Open Season Seminar

30. Pharmacy Programs Overview • 2014 Tier Structure • 2014 Benefits • Member Resources Agenda

31. Pharmacy Program Overview for 2014 • Continuation of… • CVS/Caremark Administration • Generic Incentive Program • Medicare Part B member savings • Added Tier 5 in Specialty Program • Enhanced Diabetic Benefit • Affordable Care Act Impact • Basic Option non-Preferred Brand cost share now applies to Catastrophic Benefit • Vitamin D supplements with a prescription for members over 65

32. 2014 Tier Structure • Tier 1 – Generics (least out-of-pocket) • Tier 2 – Preferred Brands (moderate out-of-pocket) • Tier 3 – non-Preferred Brands (most out-of-pocket) • Tier 4 – Specialty Preferred • *Tier 5 – Specialty non-Preferred • *New for 2014 • Letter mailing to impacted members

33. 2014 Standard Option Benefits

34. 2014 Basic Option Benefits

35. Enhanced Diabetic Benefit • Insulin and supplies available through pharmacy benefit • Medical Benefit available to Medicare Part B members • Free Diabetic Meter Program  • $0 cost share for selected meters ACCU-CHEK or OneTouch • Preferred strips – Tier 2 • Alcohol Swabs covered with a prescription • Toll free number 855.582.2024 • Delivered 7-10 business days after the request   • Letters will be sent to diabetic members

36. Generic Incentive Program • Program will continue in 2014 • Started in 2010 • Increase generic alternative awareness • Generics contain same active ingredient as brands • Save member out-of-pocket costs • Change from brand to generic in specific categories • Copay and Coinsurance waiver • List of drugs on brochure page _ _ _

37. Member Resources • Retail Pharmacy Program • (800) 624-5060 • Available 24/7 • Mail Pharmacy Program • (800) 262-7890 • Available 24/7 • Specialty Pharmacy Program • (888) 346-3731 • M-F 7am- 9pm • S/S 8am-6:30pm

38. Questions Contact Information

39. FEP BlueDentalEasy to do Business With! HBO Seminar -- 2013

40. Agenda

41. 2014 Premiums (monthly rate)

42. It’s More Than You Expect • All FEP BlueDental members receive 2 paid-in-fullexams and cleanings when they see an in-network provider • With FEP BlueDental, members have in-network preventive and diagnostic treatments available at no cost • There are no calendar year deductibles applied to services performed by an in-network provider • Orthodontic benefits available (covering 50% of allowed amount) for both children and adults following a 12 month waiting period

43. A Benefit for All Your Dental Needs • FEP BlueDental has four types of covered services: • Class A (Basic) – Preventive and Diagnostic • Class B (Intermediate) – Fillings, minor endodontic, minor periodontal

44. A Benefit for All Your Dental Needs • FEP BlueDental has four types of covered services: • Class C (Major) – major restorative, endodontic, periodontal and prosthodontic services • Class D -- Orthodontic Services - 50% for High & Standard for both in and out of the network 44

45. A Benefit for All Your Dental Needs • High Option annual benefit maximum for non-orthodontic services is $10,000 for in-network services and $3,000 for out-of-network services • Standard Option annual benefit maximum for non-orthodontic services is $1,500 for in-network services and $750 for out-of-network services • Lifetime maximum for High Option orthodontic services is $3,500 for both in-network and out-of-network services • Lifetime maximum for Standard Option orthodontic services rendered by an in-network provider is $2,000 and services rendered by an out-of-network provider are subject to a $1,000 limitation.

46. Provider Network • Providers in all 50 states and includes more than 85,000 unique dentists and 199,000 access points • If you have Service Benefit Plan (SBP) your in-network provider will file directly with the local BCBS Plan for primary coverage and then the claim will be sent to FEP BlueDental • Dental network may be different from medical network • Specialties included in the network are: Endodontics, General Dentistry, Oral Maxilofacial Surgery, Orthodontics, Pediatric Dentistry, and Periodontics • Provider nominations are welcome • To find a provider visit our web site (www.fepblue.org) or call us at 855.504.BLUE (2583)

47. International Benefits • The International Dental Program includes English-speaking dentists in approximately 100 countries worldwide • You will only receive in-network benefits levels if you use a dentist in our International Dental Program • You are responsible for paying the dentist (we will reimburse you in US $’s) and for submitting claims to the following address: FEP BlueDental Claims PO Box 75 Minneapolis, MN 55440-0075 • Claims are available on our website at www.fepblue.org. You may use this website to get other benefit related information or call us at: 855-504-BLUE(2583), TTY number 1-888-853-7570

48. Contact us today to get the FEP BlueDental coverage you deserve 1.855.504.BLUE (2583) TTY 1-888-853-7570 Call Center Hours (EST): • Monday through Friday: 8:00 a.m. – 8:00 p.m. Or visit www.fepblue.organy time! To enroll: Visit www.benefeds.com or call 1.877.888.FEDS

49. FEP BlueVision:Take a new look at eyecare Health Benefits Officer Seminar Fall 2013

50. FEP BlueVision - It’s More Than You Expect • You receive an annual eye exam with no copay when you see a participating provider • Eyeglass wearers have many lens options available at no cost or at discounted copays • You can receive a generous frame allowance toward ANY frame you choose or you may select a frame from our Exclusive Collection that is covered-in-full with no copay