Prescription Coverage Designed for You

1. Prescription Coverage Designed for You A Medicare-Approved Part D Prescription Drug Plan S7694 18-2415 Broker Prezv2 Accepted 10/12/18

2. Independent insurance agent licensed to sell insurance products in your state. As a licensed EnvisionInsurance agent, I am certified to help you evaluate your prescription drug plan options. May be compensated for the sale of this product. Credentialed, trained and certified by EnvisionInsurance according to Medicare rules to offer you their Part D product.

3. Agenda • EnvisionRxPlus Plan Overview • Review Pre-Enrollment Kit materials • Service Area • Eligibility Requirements • Medicare Basics • Enrollment Periods • Late Enrollment Penalty • Extra Help • Medicare Part D Basics • Understanding our Formulary • EnvisionRxPlus Plan Benefits • Enrollment is Easy! • What Happens After You Enroll • ID Card • Questions

4. EnvisionInsurance is contracted with the Centers for Medicare and Medicaid Services to offer the EnvisionRxPlus Prescription Drug Plan. • Contracted with Medicare to be a Part D plan sponsor. • Started offering Part D plans in 2007. • Has a National Prescription Drug Plan. • Plans available in all 50 states, the District of Columbia, Puerto Rico and Guam. • Prescription Drug Plan (PDP) with a Medicare contract. • Enrollment in EnvisionRxPlus depends on contract renewal between EnvisionInsurance and the Centers for Medicare and Medicaid Services (CMS). • Only sold by Brokers/Agents in 20 States.

5. We provide access to the prescription drugs you need through pharmacies that you know and trust. • Our pharmacy network includes mail order pharmacies, large retail chains and small, independent pharmacies. • Save with a $0 copay on Tier 1 generics through mail order. • Thousands of covered drugs, including brand, generic and specialty. • Choose a preferred pharmacy to get the lowest copays. • Fill your prescriptions from a nationwide network of large chains or independently owned pharmacies. Save Money More Options More Convenience

6. Brokers and agents are authorized to sell EnvisionRxPlus PDP in 20 states. 2019 Service Area California Connecticut Delaware District of Columbia Georgia Maine Maryland Massachusetts Michigan Mississippi New Hampshire New York North Carolina Ohio Oregon Pennsylvania Rhode Island South Carolina Vermont Washington West Virginia • EnvisionRxPlus

7. Your EnvisionRxPlus enrollment guide includes everything you need to understand your Medicare Part D prescription benefits and coverage: • Summary of Benefits • Multi-language Insert • Participating Pharmacy Chain List • Plan Star Rating • Enrollment Application • All Documents also available Online This information is available for free in other languages. Please call our customer service number at 1-866-250-2005 (TTY: 711).  We are available 24 hours a day, 7 days a week. Esta información está disponible gratis en otras lenguajes. Por favor llame nuestro servicio al cliente al número1-866-250-2005 (TTY: 711). Estamos disponible 24 horas al día, 7 días de la semana. 

8. To become an EnvisionRxPlus member, there are certain requirements you need to meet. Your Medicare card looks like this: Member Requirements: • You must be entitled or enrolled into Medicare Part A and/or enrolled in Medicare Part B. • You must live in the EnvisionRxPlus service area. • If you enroll in EnvisionRxPlus, and you are currently enrolled in a Medicare Advantage (MA) private fee-for-service (PFFS) plan that includes Medicare prescription drugs or any MA coordinated care (Health Maintenance Organization - HMO or Preferred Provider Organization - PPO) plan, you will be automatically disenrolled from the HMO, PPO or MA PFFS plan.

9. The Medicare federal health insurance program contains different parts that cover different costs. The right coverage for you depends on your health needs and your budget. ! DECK INSTRUCTIONS DELETE AFTER FINISHED Medicare Part D: Prescription Coverage Medicare Part A: Hospital Care Medicare Part B: Doctors & Medical Care Medicare Part C: Medicare Advantage Plans

10. There are three time periods available to enroll in the Medicare Part D program. !

11. Medicare Part D has a Late Enrollment Penalty that you can avoid if you sign up for coverage on time and keep your coverage active. 1% penalty for every month that you didn’t have creditable coverage . The late enrollment penalty is an amount that’s added to your monthly Part D Premium. 1% PENALTY Medicare adds a 1% penalty to your premium if you did not enroll in a Part D plan when you became eligible or if you don’t have Part D or other creditable (comparable to Medicare) prescription drug coverage for 63 days or more. For example, if you go 14 months without coverage, the penalty will be 14%.

12. If you have limited income and resources, you may qualify for help to pay for some health care and prescription drug costs. CALL VISIT 01 02 • The Social Security website at: socialsecurity.gov. • Your local Social Security office. • Medicare.gov. • 1-800-MEDICARE (1-800-633-4227) (TTY 1-877-486-2048), 24 hours a day, 7 days a week. • Social Security Administration (1-800-772-1213) (TTY 1-800-325-0778) between 8:00 a.m. and 7:00 p.m. EST, Monday through Friday. • Your State Medicaid Office.

13. Your prescription costs, and what your Medicare Part D plan pays, will depend on which coverage phase you're in. DECK INSTRUCTIONS DELETE AFTER FINISHED COVERAGE GAP STAGE INITIAL COVERAGE STAGE CATASTROPHIC DEDUCTIBLE During this stage, you pay the full cost of your Tier 3, 4 or 5 drugs. There is no deductible for Tier 1 and 2 drugs. You pay: Your plan copay or coinsurance. EnvisionRxPlus pays: Remaining Cost until the combined amount reaches $3,820. After your total yearly drug cost reaches $3,820, you pay: 25% of negotiated drug cost for brand and 37% of negotiated drug cost for generics. After your total yearly drug cost reaches $5,100, you pay: $3.40 for generics and $8.50 for brand or 5% (whichever is greater) 2019 True Out-Of-Pocket (TrOOP) is $5,100.

14. EnvisionRxPlus uses a formulary, which is a list of drugs covered by your plan. FORMULARY EXCEPTION TRANSITION PROCESS COST TIERS RESTRICTIONS NETWORK You can ask us to make an exception to our coverage rules. If you recently joined the plan and learned that we don’t cover a drug you are taking, you may be able to receive a one-time fill of that medication. Each drug is categorized by tier, which determines how much you will pay for that drug. Some drugs have prior authorization, quantity limits, and/or step therapy requirements. More than 60,000 pharmacies* nationwide, including mail order. Using a preferred pharmacy will reduce your out-of-pocket expense. The Formulary may change at any time. You will receive a notice when necessary. *Visit enisionrxplus.com for the most up-to-date listing of network pharmacies.

15. In 2019 EnvisionRxPlus provides low monthly premiums, low copays and $0 deductible on Tier 1 and 2 drugs.

16. Order a 90-day supply of medications through mail order and save even more.

17. Cost Share for Tier 3 varies by region. You will save more by using a preferred pharmacy.

18. Cost Share for Tier 4 varies by region.

19. Cost Share for Tier 5 varies by region.

20. Enrolling in EnvisionRxPlus is easy. • Meet with your local Agent • Complete the application in your pre-enrollment kit materials • Call an EnvisionRxPlus service representative at 1-888-377-1439 (TTY: 711) 24 hours daily • or • Complete the application online at envisionrxplus.com

21. After you enroll, you will receive a letter confirming membership in our plan along with a member identification card and a welcome packet. DECK INSTRUCTIONS DELETE AFTER FINISHED EnvisionRxPlus will process your request to enroll with CMS and verify your eligibility. If you enroll with an agent/broker, we will verify your enrollment by sending you a letter within 15 days. Upon CMS enrollment confirmation, we will send your ID card and Welcome Kit within 10 days.

22. After you receive your member identification card, keep it with you to use when filling your prescriptions. Example EnvisionRxPlus Identification Card FRONT BACK

23. It is important that you enroll with prescription drug plans that are contracted with the Centers for Medicare and Medicaid services. EnvisionRxPlus is a Prescription Drug Plan (PDP) plan with a Medicare contract. Enrollment in EnvisionRxPlus depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copays and coinsurance may change January 1 of each year.

24. EnvisionRxPlus provides services to people with disabilities or for individuals who do not understand English. If you need these services, contact Member Services. If you believe that EnvisionRxPlus has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: EnvisionRxPlus, mailing address: 2181 E. Aurora Rd, Ste. 201, Twinsburg, OH, 44087, Member Services: 1-866-250-2005, TTY: 711, fax: 1-877-503-7231, email: clinicalservices@envisionrxplus.com. If you need help filing a grievance, Member Services is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. • EnvisionRxPluscomplies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. EnvisionRxPlus does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. EnvisionRxPlus: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: • Written information in other formats (large print and accessible electronic formats) • Provides free language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages

25. We also provide multi-language interpreter services if English isn't your first language.

26. We also provide multi-language interpreter services if English isn't your first language (continued).

27. Questions

28. Thank you for your time!