Health Net Presentation for SDCERS Presentation by Audrey

Health Net Presentation for SDCERS Presentation by Audrey Mueller Rollins Herminia Escobedo Health Net

SUITE OF OFFERINGS Pam White Health Net NON-MEDICARE (EARLY RETIREES) MEDICARE (RETIREES) Privileged & Confidential

NON-MEDICARE PLANS Pam White Health Net HMO PPO OUT-OF-STATE PPO Privileged & Confidential

HMO Plan (Non-Medicare) Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum (Individual/Family) $1, 500/$3, 000 Physician Office Visit Copay (Primary& Specialist) $20 copay Lab & X-ray CT, MRI or PET No charge Inpatient Hospitalization $100 copay Outpatient Surgery $50 copay Emergency Room Visit (waived if admitted) $75 copay Ambulance No charge Prescription Coverage (30 -day supply) $15 Generic/$30 Brand Prescription by Mail (90 -day supply) $30 Generic/$60 Brand 4

PPO Plan (Non-Medicare) Medical Plan Features In-Network Only Out- of- Network Calendar Year Deductible (Individual/Family) $500 /$1, 500 (PPO/OON combined) Out-of-Pocket Maximum (Individual/Family) $3, 000/$9, 000 $6, 000/$18, 000 Physician Office Visit Copay (Primary/Specialist) $25 copay 40% after deductible Lab & X-ray /CT, MRI or PET 20% after deductible 40% after deductible Inpatient Hospitalization 20% after deductible 40% after deductible Outpatient Surgery 20% after deductible 40% after deductible 20% after deductible (additional $100 if not admitted) $50+20% after deductible $50+40% after deductible Prescription Coverage (30 -day supply) $15 Generic/$30 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Prescription by Mail (90 -day supply) $30 Generic/$60 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Emergency Room Visit (deductible waived if admitted) Ambulance 5

Out-Of-State PPO Plan (Non-Medicare) Medical Plan Features In-Network Only Out- of- Network Calendar Year Deductible (Individual/Family) $500 /$1, 500 (PPO/OON combined) Out-of-Pocket Maximum (Individual/Family) $3, 000/$9, 000 $6, 000/$18, 000 Physician Office Visit Copay (Primary/Specialist) $25 copay 40% after deductible Lab & X-ray /CT, MRI or PET 20% after deductible 40% after deductible Inpatient Hospitalization 20% after deductible 40% after deductible Outpatient Surgery 20% after deductible 40% after deductible 20% after deductible (additional $100 if not admitted) $50+20% after deductible $50+40% after deductible Prescription Coverage (30 -day supply) $15 Generic/$30 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Prescription by Mail (90 -day supply) $30 Generic/$60 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Emergency Room Visit (deductible waived if admitted) Ambulance 6

MEDICARE PLANS Pam White Health Net SENIORITY PLUS HMO COB FLEX NET COB Privileged & Confidential

Seniority Plus (Medicare Advantage Plan) • • • Works like a traditional HMO plan where PCP coordinates care Retirees must have both Medicare Part A and Medicare Part B Retirees “assign” their Medicare to Health Net provides all Medicare covered services Part D prescription drug coverage and benefits administered by Health Net. Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum $3, 400 Physician Office Visit Copay $10 copay Lab & X-ray, CT, MRI or PET No charge Inpatient Hospitalization No charge Outpatient Surgery $50 copay Emergency Room Visit (waived if admitted) $50 copay Prescription Coverage (30 -day supply) $10 Generic/$20 Brand Prescription by Mail (90 -day supply) $30 Generic/$60 Brand 8

Flex Net COB • • • NOT a Medicare Advantage Plan (benefits are NOT assigned to Health Net). An Indemnity Plan No provider network. You can go to any physician who accepts Medicare assignment Retirees must have Medicare Part A and B for benefit coordination Part D prescription drug is administered by Silverscripts so members of this plan will have two cards (medical ID card and pharmacy ID card) Medical Plan Features Calendar Year Deductible Out-of-Pocket Maximum (Indiv/Family) None $6, 350/$12, 700 Physician Office Visit Copay (Primary/Specialist) No charge Lab & X-ray, CT, MRI or PET No charge Inpatient Hospitalization Varies by number of days Outpatient Surgery No charge Emergency Room Visit (in U. S. ; waived if admitted) No charge Prescription Coverage (30 -day supply) $10 Generic/$20 Brand/$35 Non-Formulary/25% Spec Prescription by Mail (90 -day supply) $30 Generic/$60 Brand/$105 Non-Formulary/25% Spec

HMO COB • • • Works like a traditional HMO plan where PCP coordinates care Retirees must have Medicare Part A and B for coordination Retirees do NOT assign their Medicare benefits to Health Net Medicare pays first; Health Net second Part D prescription drug is administered by Silverscripts so members of this plan will have two cards (medical ID card and pharmacy ID card) Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum (Indiv/Family) Physician Office Visit Copay (Primary/Specialist) Lab & X-ray, CT, MRI or PET Inpatient Hospitalization $1, 500 / $3, 000 $15 No charge $100 per admit Outpatient Surgery $50 Emergency Room Visit (waived if admitted) $50 Prescription Coverage (30 -day supply) $15 Generic/$30 Brand/$50 Non-Formulary/25% Spec Prescription by Mail (90 -day supply) $45 Generic/$90 Brand/$150 Non-Formulary/25% Spec 10

MEMBER PERKS Pam White Health Net Privileged & Confidential

Decision Power Nurse 24 (Nurse Advice) Decision Power Nurse 24 - Registered nurses are available 24 hours a day, 7 days a week answer any of your health questions. Benefits of Nurse 24 • Prevent unnecessary office/ER visits • Reinforce treatment plans • Empower participants • Ability to immediately address special needs 12

Discount Programs 13

Health Coaching ! y r a t n e m i l p m Co > > > Weight Loss Nutrition Exercise Stress Smoking Cessation 14

Healthy Living Programs & On-line Seminars Classes on emotional health, exercise, nutrition, smoking cessation, stress management, and weight management. 15

Silver & Fit * – Fitness/Gym * This program is limited to Health Net Seniority Plus members 16

Silver & Fit* - Chiropractic l a r r e f e R P C P No ! d e r i u Req To locate a participating chiropractor near you, go to www. choosehealthy. com * This program is limited to Health Net Seniority Plus members 17

Thank you! 18