Employee 2010-11 Benefit Info Meeting

1. Employee 2010-11 Benefit Info Meeting

2. Deductible/ Coinsurance/ Copay Examples Reflects New Co-Insurance Liability for Employee in 2010-11 Reflects New 2010-11 Deductible of $200 (as compared to $100 in 09-10)

3. 1. Office Visit with provider ordering an MRI Dr. Doe office visit charge - $ 110.00 BCBSM approved amount - 85.00 Minus member copay - 20.00 BCBSM process and pays - 65.00 Savings because provider pars + 25.00 (charge vs. approved) Total covered - $ 110.00 Member Balance $ 20.00 Holland Hospital MRI charge - $1100.00 BCBSM approved amount - 850.00 Minus member deductible - 200.00 Minus member coinsurance - 65.00 ($850 – $200 x 10%) BCBSM process and pays - 585.00 Savings because provider pars + 250.00 (charge vs. approved) Total covered - $1100.00 Member Balance $ 265.00 Dr Doe MRI reading charge - $ 150.00 BCBSM approved amount - 125.00 Minus member coinsurance - 12.50 ($125 x 10%) BCBSM process and pays - 112.50 Savings because provider pars + 25.00 (charge vs. approved) Total covered - $ 150.00 Member Balance $ 12.50 TOTAL MEMBER LIABILITY $297.50

4. 2. Facility and provider charge for an open heart surgery. BCBSM receives provider charge first. Dr Doe Surgical Charge - $2,600.00 BCBSM approved amount - 2,100.00 Minus member deductible - 200.00 Minus member coinsurance - 190.00 ($2100 - $200 x 10%) BCBSM process and pays - 1,710.00 Savings because provider pars + 500.00 (charge vs. approved) Total covered - $2,600.00 Member Balance $ 390.00 Holland Hospital charge - $21,500.00 BCBSM approved amount - 19,250.00 Minus member coinsurance - 810.00 ($1000 – $190 above) BCBSM process and pays - 18,440.00 Savings because provider pars + 2,250.00 (charge vs. approved) Total covered - $21,500.00 Member Balance $ 810.00 TOTAL MEMBER LIABILITY $1200.00

5. ER visit due to broken nose, charge for x-rays included in Hospital charge. Holland Hospital ER charge - $1,100.00 BCBSM approved amount - 1,080.00 Minus member copay - 100.00 BCBSM process and pays - 1,030.00 Savings because provider pars + 20.00 (charge vs. approved) Total covered - $1,100.00 Member Balance $ 100.00 Dr Doe ER Physician charge - $ 175.00 BCBSM approved amount - 125.00 Minus member deductible - 125.00 BCBSM process and pays - 0.00 Savings because provider pars + 50.00 (charge vs. approved) Total covered - $ 175.00 Member Balance $ 125.00 Dr. Joe Xray reading charge - $ 200.00 BCBSM approved amount - 175.00 Minus member deductible - 75.00 ($200 – $125 above) Minus member coinsurance - 10.00 ($175 – $75 x 10%) BCBSM process and pays - 90.00 Savings because provider pars + 25.00 (charge vs. approved) Total covered - $ 200.00 Member Balance $ 85.00 TOTAL MEMBER LIABILITY $310.00

6. 4. Office visit to allergist with allergy testing Dr. Doe office visit charge - $ 110.00 BCBSM approved amount - 85.00 Minus member copay - 20.00 BCBSM process and pays - 65.00 Savings because provider pars + 25.00 (charge vs. approved) Total covered - $ 110.00 Member Balance $ 20.00 Dr. Doe allergy testing charge - $ 750.00 BCBSM approved amount - 540.00 BCBSM process and pays - 540.00 Savings because provider pars + 210.00 (charge vs. approved) Total covered - $ 750.00 Member Balance $ 0.00 TOTAL MEMBER LIABILITY $20.00