SecurityChoice A Medicare Advantage Private Fee For Service Plan PFFS

1. SecurityChoiceA Medicare Advantage Private Fee For Service Plan (PFFS)

2. Agenda SecurityChoice Overview Eligibility Requirements Plan Options Member Guidelines ID Cards Provider Guidelines Provider Disclosure Geriatric Care Management Contacts Participation Benefits

3. SecurityChoice - PFFS SecurityChoice is a Medicare Advantage (MA) Private Fee For Service (PFFS) health plan offered by UniCare UniCare contracts on an annual basis with The Center for Medicare and Medicaid Services (CMS) to offer MA health plans Benefits may increase during the annual contract period but cannot be decreased SecurityChoice provides coverage for all healthcare services offered by Original Medicare, plus some extras Original Medicare does not offer

4. SecurityChoice - PFFS Extra benefits offered by SecurityChoice include: Annual physical Vision � including coverage for eyewear Routine hearing exam Prescription drugs SecurityChoice members pay: Monthly plan premium Co-payment for services received Known cost share amount Part B premium Member cost with SecurityChoice plan is considerably lower than Original Medicare and a Medicare Supplemental plan

5. SecurityChoice - PFFSEligibility Requirements Member eligibility requirements: Must be enrolled in Part A & Part B of Medicare Must continue to pay Part B premium Must not be diagnosed with ESRD prior to enrollment Enrollment exception is made for applicants transitioning from a UniCare commercial product to a Medicare Advantage product Enrollment exception is made for members affected by a Medicare Advantage plan exiting the MA market Must live within the plan service area - See summary of Benefits for Service area

6. Service Area Service Area A:� Aitkin, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carlton, Carver, Cass, Chippewa, Clay, Clearwater, Cook, Cottonwood, Dodge, Douglas, Faribault, Fillmore, Freeborn, Goodhue, Grant, Houston, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Kittson, Koochiching, Lac qui Parle, Lake, Lake of the Woods, Le Sueur, Lincoln, Lyon, Mahnomen, Marshall, Martin, McLeod, Meeker, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Red Lake, Redwood, Renville, Rice, Rock, Roseau, Scott, Sherburne, Sibley, St. Louis, Stearns, Steele, Swift, Todd, Traverse, Wabasha, Wadena, Waseca, Washington, Watonwan, Wilkin, Winona, Wright and Yellow Medicine counties� Service Area B:� Hubbard county� Essential and Essential Plus plans available in the following counties:� Crow Wing, Dakota, Olmsted and Ramsey counties�

7. SecurityChoice - PFFSPlans Plan options with and without integrated Part D prescription drug benefits: SecurityChoice Classic � no pharmacy benefit SecurityChoice Plus � pharmacy benefit included SecurityChoice Enhanced � with and without pharmacy Security Choice Essential � with and without pharmacy benefit (Sold only where Classic, Plus & Enhanced are not available)

8. SecurityChoice - PFFSMember Guidelines SecurityChoice members are not restricted to a network of providers Members must seek care from a provider that accepts the plans terms and conditions No PCP required No referrals required to see specialist Pre-Certification required for : Transplants Gastric Bypass Carotid Endarterectomies Pre-notification required for scheduled Hospital inpatient stay, SNF stay and DME over $750.00

9. SecurityChoice - PFFSMember Guidelines / ID Cards Members must inform providers they are enrolled in a Medicare Advantage plan and present the UniCare SecurityChoice ID card Plan ID without pharmacy

10. SecurityChoice - PFFS ID Cards

11. SecurityChoice - PFFSProvider Guidelines Must be eligible to receive Medicare payment Must agree to reimbursement equivalent to 100% of the current Medicare allowable amount Must notify member prior to rendering services of participation status Must not collect from the member, no more than the applicable co-payment or cost share for services Must not balance bill members Must agree to all other plan terms and conditions as noted on the provider disclosure document

12. SecurityChoice - PFFSPrimary Care Payment Example Original Medicare SecurityChoice Primary Care w/procedure Primary Care w/procedure (office visit 99212+ procedures) (office visit 99212+ procedures) _________________________ _________________________ Billed Charges $532.00 Billed Charges $532.00 Medicare Allowable $332.12 Medicare Allowable $332.12 Patient coinsurance (20%) $ 66.42 Patient co pay $ 10.00 Medicare pays (80%) $265.70 SecurityChoice pays $322.12 Total to provider $ 332.12 Total to provider $332.12

13. SecurityChoiceProvider Disclosure

14. SecurityChoice - PFFSProvider Guidelines When an enrollee in a PFFS plan obtains services from a provider, the provider is classified as: A deemed-contracting provider if: The provider is *aware in advance of furnishing services, that the person is enrolled in a PFFS plan The provider has **reasonable access to the plan�s terms and conditions of payment The service provided is covered by the plan Deeming is specific to a date of service, providers have the option to opt-out at any time *A provider is considered aware in advance of enrollment if notice of enrollment for the enrollee was obtained from: The enrollee (e.g., presentation of an enrollment card); CMS; A Medicare intermediary, A carrier; or The MA Organization itself. **A provider has reasonable access to the plan�s terms and conditions of payment if the plan makes accessible it terms and conditions of payment through: postal service; electronic mail; fax; telephone; or a plan web site

15. SecurityChoice - PFFSDeemed Provider Example An enrollee walks into a physician�s office, advises the physician he or she is a member of the PFFS plan and presents his or her plan enrollment card. Since the provider has the opportunity to call the plan phone number on the enrollee�s card, the provider is considered deemed contracting as soon as s/he provides services, even though the provider did not actually check the terms and conditions of payments. 2. An enrollee enters a hospital for non-emergency care, advises the hospital that he or she is a member of the PFFS plan and presents his or her enrollment card. All providers that contract with this hospital, or are employed by this hospital, are considered deemed contracting as soon as they provide services even though hospital providers typically do not themselves verify plan enrollment. Resource:CMS Medicare Managed Care Manual; Chapter 4 Benefits and Beneficiary Protection (Rev.87, 06-08-07)

16. SecurityChoice Secure - PFFSGeriatric Care Management (GCM) The Senior Business Geriatric Care Management (GCM) Program is a comprehensive facilitator of integrated care management to improve the lives of the Medicare members we serve The Program serves the entire MA population across the health continuum integrating 360 degrees of health and wellness management Dedicated Case managers on staff to provide assistance 1-866-797-9884 Monday � Friday 8:00 a.m. � 5:00 p.m.

17. SecurityChoice - PFFSContacts For customer service and claims status: 1-888-445-8916 8:00 a.m. to 8:00 p.m. 7 days a week Dedicated Provider Service line: 1-866-364-2374 Geriatric Care Management: 1-866-797-9884 8:00 a.m. to 5:00 p.m. M-F File claims and mail to: UniCare � P.O. Box 795180 San Antonio TX, 78279 Electronic claims accepted Additional plan information available at: www.unicare.com/medicare

18. SecurityChoice � PFFSParticipation Benefits Ability to collect co-pays up front, improving on-hand revenue No secondary claims to file or seeking the balance from the patient Same coverage guidelines as Original Medicare Same billing requirements as Original Medicare Increase access to healthcare plan options for Medicare beneficiaries by partnering with UniCare

19. SecurityChoiceMedicare AdvantagePrivate Fee For Service Plan Thank You!