Blue Solutions Specialty Services

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1 Blue Solutions Specialty Services For small employers Offer your employees the most comprehensive benefits package Adult Dental Plans Accident & Critical Illness Insurance Global Travel Insurance ibx.com/bluesolutions

2 Add additional specialty products to your Blue Solutions health plans Specialty products can help improve your employees overall wellness and provide financial stability in case of unexpected injury or illness. Independence Blue Cross (Independence) has teamed up with industryleading companies to give you affordable, flexible options to pair specialty products and services with your Blue Solutions health plans adult dental, accident and critical illness insurance, and global travel insurance plans. These products complement the specialty services that are included as part of our Blue Solutions health plans, such as prescription drug and vision benefits. Making specialty products part of your total employee benefits package is an investment in the future of your business, helping you attract and retain the best employees and protect their health and well-being. Pairing certain specialty products with medical benefits may also help lower your overall costs Holistic view of the member Early disease detection and intervention Lower health care costs Healthy members 1

3 Adult dental plans Adult Dental PPO HEALTHY MOUTH HEALTHIER LIFE Studies show that treating gum disease through regular dental visits can reduce hospitalizations, stroke, heart disease, and diabetes, which can help you save thousands of dollars on overall medical costs for your employees. 1 Good oral health can have a direct impact on your employees overall health and wellness. All of our Blue Solutions health plans include pediatric dental coverage for your employees enrolled dependents up to age 19. For adults age 19 and older, we offer a choice of four cost-effective, stand-alone adult dental plan options to add to your Blue Solutions health plans. We ve updated our adult dental portfolio to help you provide your employees and their families with the most comprehensive dental benefits. Two new plans Adult Preferred PPO and Adult Premier PPO with Preventive Incentive give you even more flexibility to offer high-quality dental benefits at a price that fits your budget. Administered by United Concordia, an independent company, all of our adult dental plans are designed to encourage prevention, early diagnosis, and treatment and give members access to a large network of providers nationwide. Adult PPO plans Preventive, Preferred, and Premier You can add one of the following stand-alone adult dental PPO plans to any Blue Solutions health plan: Adult Preventive PPO offers basic coverage for diagnostic and preventive services, like exams, cleanings, and X-rays. Adult Preferred PPO covers diagnostic and preventive services and covers additional services, like filings, root canals, and more. Adult Premier PPO with Preventive Incentive offers the most comprehensive coverage and benefits. Certain services, including exams, cleanings, and X-rays, do not count toward the annual out-of-pocket maximum, giving employees even more value. The chart below shows a sample of what s covered for many adult dental services. BENEFIT ADULT PREVENTIVE PPO* ADULT PREFERRED PPO* ADULT PREMIER PPO* WITH PREVENTIVE INCENTIVE Diagnostic and Preventive Services Exams ** 100% covered 100% covered 100% covered Cleanings ** 100% covered 100% covered 100% covered X-rays ** 100% covered 100% covered 100% covered Palliative (emergency) services Basic Services Not covered 100% covered 100% covered Fillings Not covered Plan pays 50% Plan pays 80% Major Services Endodontics Not covered Plan pays 50% Plan pays 80% (root canals) * Discounts are available from participating network dentists for non-covered services and services over the annual maximum. ** Frequency of covered services varies by plan. Please see the plan benefit grids for more information. Waiting periods apply. Adult DHMO The chart below shows a sample of what s covered for many dental services in-network. BENEFIT DHMO Adult Premier PPO with Preventive Incentive Our new Adult Premier PPO plan includes a Preventive Incentive to help your employees get the most value from their dental benefits. With this plan, certain services, such as exams, cleanings, and X-rays, do not count toward the plan s annual out-of-pocket maximum. Your employees can find Concordia Advantage and Keystone network dentists at ibx.com by going to the Find a Doctor link on the Individuals tab and choosing Dental Providers. Your employees have the freedom to visit any dentist, but they will pay less out of pocket by choosing from more than 60,000 providers in the Concordia Advantage national network. Discounts are available from participating providers for any services that are not covered by the plan. Plus, they never need a referral to visit a provider. Diagnostic and Preventive Services Exams Cleanings X-rays 100% covered, 1 visit per 6 months 100% covered, 1 visit per 6 months 100% covered, subject to limitations Independence Blue Cross dental plans are administered by United Concordia, an independent company. 1. Source: Jeffcoat MK, Jeffcoat RL, Gladkowski PA, Bramson JB, Blum JJ. Impact of Periodontal Therapy on General Health: Evidence from Insurance Data for Five Systemic Conditions, American Journal of Preventive Medicine, 47 (2014) pp DOI: /j.amepre Keystone Adult DHMO If you offer your employees a Blue Solutions HMO or POS plan, you can add the Keystone Adult DHMO rider. Diagnostic and preventive services, like exams and cleanings, are covered in full once every six months. Your employees will be required to select a Primary Dental Office in the Keystone network to coordinate their care and help keep costs lower. Each covered family member can select a different Primary Dental Office. Referrals are required for treatment from specialists. Palliative (emergency) services Basic Services Fillings Major Services Endodontics (root canals) Copayment schedule Copayment schedule Copayment schedule 2 3

4 1. The child must be insured by the plan on the date the accident occurred and must be 18 years of age or younger. Ratings current as of June 2015 and are subject to change. The products listed are offered by The Guardian Life Insurance Company of America, an independent company. These are not Blue Cross or Blue Shield products. Guardian is solely responsible. Guardian s Accident Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/ or features may incur additional costs. Plan documents are the final arbiter of coverage. This policy provides Accident insurance only. It does not provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services. IMPORTANT NOTICE THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS. Policy Form #GP-1-AC-IC-12. Guardian s Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. This policy provides limited benefits health insurance only. It does not provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of Financial Services. Policy Form #GC-C1-11, et al Exp. 6/17 Guardian accident and critical illness insurance If your employees and their families are faced with an unexpected injury or an illness such as cancer, heart attack, or stroke, additional out-of-pocket expenses can cause financial hardship during an already difficult time. We offer accident and critical illness insurance through the Guardian Life Insurance Company of America (Guardian), one of the most respected and highly rated companies in the industry. All of Guardian s accident and critical illness plans offer your employees a lump sum benefit payment that can be used for out-of-pocket medical and non-medical expenses including treatments not covered by medical insurance as well as up-front payouts and unrestricted use of funds. Helping your employees focus on health, not finances Benefit payments from Guardian accident and/or critical illness plans can be used for: Travel for treatment in another city Child care while recovering Household expenses while an employee can t work Modifications to an employee s home or automobile With Guardian accident insurance, covered benefit payments will increase by 20 percent for an insured child who has an accident while playing an organized sport. 1 Your broker or Independence account executive can provide you with rate sheets for details and pricing for Guardian accident and critical illness plans that is exclusive to Independence medical customers. Additional Guardian products can be quoted, including life, disability, and cancer insurance. GeoBlue travel insurance GeoBlue group health plans help make it easy and convenient for your employees who travel internationally to access health care outside of the United States. These plans combine high-quality service with stateof-the-art mobile technology to cover the health needs of expatriates, their families, and business travelers around the globe. There are two GeoBlue group health plans to choose from: GeoBlue Expat for long-term travel and GeoBlue Traveler for short-term travel. Each product has standard and custom plan options. Both are designed to provide your employees and their families with coverage when and where they need it from trusted doctors and hospitals. Compare GeoBlue plan options GEOBLUE TRAVELER For 2+ employees traveling for up to 180 days GeoBlue Traveler provides group supplemental medical benefits and services for international business travelers. The plan also provides: Blanket coverage so that members won t have to submit and maintain member rosters Rich benefits covering everything from medical evacuation and hospitalization to treatment for minor illness or injury Coverage for employees when they are outside their home country for up to 180 days GEOBLUE EXPAT For 2+ employees traveling for six months or more Combining comprehensive global benefits with a new generation of medical assistance services, GeoBlue Expat is designed for employees and their families when they live internationally for six months or more. Features include: Robust, international-focused wellness program Global coverage with no restrictions on the time a member can spend in the United States GeoBlue network outside the U.S. and BlueCard program in the U.S., Puerto Rico, and U.S. Virgin Islands Benefits covering everything from medical evacuation and hospitalization to chronic and maternity care Flexible coverage available for U.S. outbound or third country nationals Optional life and long-term disability insurance Safety and savings Without an insurance program in place, the cost of repatriation or evacuation can range from $10,000 for a last-minute commercial plane ticket and travel preparations to $100,000 for a full evacuation with on-board medical assistance. 2 GeoBlue is the trade name of Worldwide Insurance Services, LLC, an independent licensee of the Blue Cross and Blue Shield Association. GeoBlue products are underwritten by 4 Ever Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. 2. Source: Travel Medicine and Travel Vaccines: An Investment with a Healthy Return, Passport Health Institute. Published June 3,

5 Take care of your employees around the world Learn about GeoBlue health insurance and support services. Contact your broker or Independence Blue Cross account executive or visit ibx.com/geoblue GeoBlue helps your employees travel with confidence GeoBlue Expat and GeoBlue Traveler offer your employees access to a worldwide community of English-speaking physicians and 24/7 concierge-level assistance. They can travel with confidence, knowing an experienced GeoBlue global health coordinator will: Help locate a doctor and schedule appointments Guarantee payments for cashless access to care Arrange for any necessary follow-up treatment Provide reliable expertise and rapid response to deliver these services worldwide With Personal Services from GeoBlue, your employees receive assistance with: Chronic care and maternity support Arranging consultations to help understand international medical treatment options Translating medications and medical terms Daily alerts detailing the latest security and health risks in your employees destination Free GeoBlue app helps your employees find care quickly Help finding the best local doctors, hospitals, and resources is available anywhere in the world. Your employees can download the free GeoBlue mobile app to their Apple or Android device at geo-blue.com to: Search for a provider using GPS technology and request an appointment Arrange direct billing to secure cashless access to care Find generic and brand medications Translate medical terms and phrases for symptoms and situations Display an ID card or fax a copy directly to a provider s office Help your employees find a balanced approach to well-being With GeoBlue Expat plans, there is a global Employee Assistance Program (EAP) to help your employees who are away from home get resources to help them manage various work-life issues. They can contact an EAP counselor, who is ready to assist with issues, such as: Managing life changes Parenting and couples support Handling stress and managing workplace pressure Substance abuse Referrals to local resources, including attorneys and financial professionals Global Wellness Coaches help your employees make healthier lifestyle choices GeoBlue Expat plans also offer GeoBlue Wellness Coaches, trained by the Mayo Clinic, to help your employees assess their current levels of wellness and set achievable health goals. A Wellness Coach can help your employees with challenging areas like: Weight loss Healthy eating Exercise and physical activity Quitting smoking Stress management Adopting a healthier lifestyle The Wellness Coaching program, available only with GeoBlue Expat plans, includes up to five phone sessions, and participants and family members can access this service any time, day or night. 6 7

6 Notes 8 Blue Solutions

7 Contact your broker or Independence account executive for more information about adding specialty products to your Blue Solutions medical benefits. Independence Blue Cross offers products through its subsidiaries Independence Hospital Indemnity Plan, Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield independent licensees of the Blue Cross and Blue Shield Association /15