Individual & Family Medical, Dental & Life Plans

1. Individual & Family Medical, Dental & Life Plans

2. Great News!!! Our Individual Plan Portfolio is now complete! New Plans to fit all your clients needs.

3. New PPACA compliant plans !!!! Anthem Blue Cross Plans PPO Share HMOs Anthem Blue Cross Life & Health Insurance Policies • SmartSense Plus • ClearProtection Plus • CoreGuard Plus • Lumenos HSA Plus • Premier Plus • Tonik 5000

4. Quick Review of PPACA Mandates • Unlimited Lifetime Maximum • Dependents to Age 26 • Rescission Reform • Removal of Dollar limits on Essential Health Benefits • In Network Preventive Covered at 100% • No Pre-existing for children under age 19

5. Grandfathered vs Non-Grandfathered • Grandfathered members enrolled with an effective date on or before 03/23/10 • Non-Grandfathered members enrolled with an effective date between 03/24/10 and 09/22/10

6. Preventive Care Summary Adult Preventive Care Office Visits Screening Tests including the following: • Vision screening • Hearing screening • Cholesterol and Lipid level screening • Blood Glucose test to screen for Type II Diabetes • Prostate Cancer screenings including Digital Rectal Exam and PSA test • Breast exam and Mammography screening • Pelvic exam, Pap test and contraceptive management for females • Screening for sexually transmitted diseases • HIV test • Bone Density test to screen for osteoporosis • Colorectal Cancer screening including Fecal Occult Blood test, Barium Enema, • Flexible Sigmoidoscopy and screening Colonoscopy • Routine blood and urine screenings Immunizations • Hepatitis A • Hepatitis B • Tetanus, Diphtheria (Td) • Varicella (chicken pox) • Influenza (flu shot) • Pneumococcal Conjugate (pneumonia) • Human Papilloma Virus (HPV) • Measles, Mumps, Rubella (MMR) • Meningococcal Polysaccharide • Herpes Zoster (shingles)

7. Preventive Care Summary Cont. Well Baby and Well Child Preventive Care Office Visits • Screening Tests including the following: • Vision screening • Hearing screening • Screening for lead exposure • Pelvic exam, Pap test and contraceptive management for females Immunizations • Hepatitis A • Hepatitis B • Diphtheria, Tetanus, Pertussis (DtaP) • Varicella (chicken pox) • Influenza (flu shot) • Pneumococcal Conjugate (pneumonia) • Human Papilloma Virus (HPV) • H. Influenza type b • Polio • Measles, Mumps, Rubella (MMR) • Meningococcal Polysaccharide • Rotavirus

8. Deductible Options Three options! • 2- member maximum • Once 2 members each reach the deductible, the deductible is satisfied for the entire family. (Share PPO, HMO Plans) • Aggregate • When one or more family members’ eligible covered expenses (combined) meet the aggregate amount, the requirement is satisfied for all covered family members. (Lumenos HSA) • Embedded deductible • The family deductible can be satisfied by 2 or more family members. (Premier Plus, SmartSense Plus, CoreGuard Plus, ClearProtection Plus)

9. Policy/Plan Terms • Network Discounts- Negotiated costs between Anthem Blue Cross and our participating providers. • Coinsurance- The percentage of the cost of covered services that the member is responsible for, after the annual deductible has been met. • Deductible- The amount you have to pay each calendar year for covered services before your health plan starts paying. • Out-Of-Pocket Maximum- The most that you would have to pay in a calendar year for deductible and coinsurance for in-network covered services. • Formulary-a list of prescription drugs our health plans cover. • Specialty Drugs- typically high in cost, scientifically engineered drugs used to treat complex, chronic conditions. • Health Savings Account (HSA) – is a special bank account that can be set up by a member enrolled in a qualified HSA-compatible high-deductible health plan if they choose. Contributions to this account can be made with certain tax advantages if used for qualified health care expenses.

10. Find a plan that meets your clients needs You can achieve this by simply asking the following questions to your client: • PPO or HMO? • Are you looking for maternity coverage? • What type of prescription coverage are you looking for? Generic? Name brand? • What does your budget look like? • Are you looking for coverage that is comparable to group?

11. Things to keep in mind • Maternity and Pharmacy are the main cost drivers on each plan. • The higher the deductible option, the lower the premium. • If coming off of group coverage, enrollment under Individual is medically underwritten. • To increase client retention always include a quote for dental and life products. • Social security numbers are not needed to apply, only California residency for at least 3 months. • The earliest effective date available would be 15 calendar days after receipt of the application. • Writeable Applications can now be emailed to ApplicationExpress@Anthem.com

12. “What are the plans that Anthem Blue Cross has to offer?”

13. PPO Policies/Plans • Premier Plus • SmartSense Plus • ClearProtection Plus • CoreGuard Plus • Lumenos HSA • Lumenos HSA Plus • Tonik 5000 • PPO Share

14. Premier Plus • Six deductible options from a $1000-$6000 • Unlimited - First dollar (no deductible) office visits with separate office visit copays for family practice and specialist ($30 & $50) • Routine vision exam • 100% Preventive Care Coverage • Comprehensive drug coverage from generics to specialty drugs • “Embedded” family deductible and out-of-pocket maximum • No maternity coverage Benefits shown are in-network

15. Premier Plus Benefits shown are in-network

16. SmartSense Plus • Choice of 4 new deductibles • Choice of standard or upgrade drug coverage • “Embedded” family deductible and out-of-pocket maximum • 3 office visits before deductible • No maternity coverage • 100% Preventive care Benefits shown are in-network

17. SmartSense Plus Benefits shown are in-network

18. Lumenos HSA Plus Consumer-Driven Health Plans (CDHPs) • HSA-compatible • 100% coverage after deductible • Preventive care benefits • Various deductible options • Special programs for Smoking Cessation and Weight Management • Powerful online health management tools • Access to our 24-Hour nurse Line Benefits shown are in-network

19. Lumenos HSA Plus Benefits shown are in-network

20. Lumenos HSA Plus Examples – 2 members on policy • Lumenos HSA Plus $3500 (aggregate) • Husband meets $1750 • After wife meets other $1750, they both are covered at 100% • Family deductible can also be met by just one family member (example once husband meets $3500 both him and his wife will be covered 100%) • Lumenos HSA Plus $7500 (embedded) • Husband meets $3750 (half of the family deductible) then he is covered 100% • After wife meets the additional $3750, she gets covered 100% • ***Please note examples given are based on In-Network benefits

21. Lumenos Health Savings Account (HSA)-Compatible Benefits shown are in-network

22. Lumenos Health Savings Account (HSA)-Compatible With Maternity Benefits shown are in-network

23. CoreGuard Plus • Higher percentage of member cost sharing in exchange for lower premiums • Choice of 7 deductibles • Full drug coverage • “Embedded” family deductible and out-of-pocket maximum • No maternity coverage • Inpatient/outpatient facility copays for 3 lowest deductibles • Separate in-network and out-of-network deductibles and out-of-pocket maximums Benefits shown are in-network

24. CoreGuard Plus Benefits shown are in-network

25. ClearProtection Plus • Two deductible levels (negotiated rates apply before and after meeting deductible) • Lower deductible for Inpatient/Outpatient Surgical and Emergency Room • Higher deductible for Outpatient/Professional/Diagnostic (this deductible is equal to the plan out-of-pocket maximum) • Two deductibles work together to meet out-of-pocket maximum • 2 office visits before deductible • Full drug coverage • “Embedded” family deductible and out-of-pocket maximum • No maternity coverage • Coverage for generic and brand name prescription drugs Benefits shown are in-network

26. ClearProtection Plus Benefits shown are in-network

27. Tonik • Lowest out of pocket maximum • 100% coverage after deductible/ out of pocket have been met • Built in dental and vision benefits • 100% preventive care coverage • Non maternity coverage • Generic prescription coverage $15 copay Benefits shown are in-network

28. Tonik 5000 Benefits shown are in-network

29. PPO Plans PPO Share (7500/5000/3500) Comprehensive PPO plans • Once deductible is met, member pays 0% or 30% co-insurance (depending on plan) for most covered services • Deductible waived for office visits, annual physical exam and preventive care • Maternity coverage • Generic and Brand name prescription coverage Benefits shown are in-network

30. PPO Share (7500/5000/3500) Benefits shown are in-network

31. HMO Plans • HMO Saver • Individual HMO • Select HMO

32. HMO Plans HMO Saver, Individual HMO, Select HMO • First dollar coverage on: • Office visits • Generic drugs • Preventive care • Unlimited office visits with set copays • Coverage for services from doctors and hospitals in HMO network • Comprehensive drug plan • Maternity coverage Benefits shown are in-network

33. HMO Plans Benefits shown are in-network

34. Plan Options Based on Prospect’s Needs Benefits shown are in-network

35. Short-Term Plans • Coverage from 30 to 180 days • Choice of deductible level • Easy application process • Streamlined underwriting • No maternity • Member-level-rated

36. Short-Term Plans Benefits shown are in-network

37. Dental Plans Three Individual dental options: • Dental Blue Basic* • Dental Blue Enhanced* • Dental SelectHMO** • *Anthem Blue Cross Life & Health Insurance Company • **Anthem Blue Cross

38. Dental Plans

39. Dental SelectHMO

40. Individual Life Insurance Term Life Insurance • Anyone who qualifies for one of medical plans can purchase: • $15,000, $30,000, $50,000, $75,000 or $100,000 (if over age 19) • $15,000 or $30,000 (ages 1-19)

41. Health • Dental • Life Thank You for Selling Anthem Blue Cross!