Plan Comparison Guide

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1 2016 Health Insurance Plan Comparison Guide Available through the Health Insurance Marketplace for Individuals and Families BENEFIT PERIOD: JANUARY 1, 2016 TO DECEMBER 31, A

2 FIND HIGHMARK ON THE HEALTH INSURANCE MARKETPLACE At Highmark Blue Shield, we believe that change is a good thing. Because health care can, and should, be a better experience. With plans and services that put you first. And easy access to health and wellness tools and services that help you make more informed health care decisions. For more than 75 years, Highmark has been helping people like you in our area find the right health insurance plan that fits their needs and budget. This dedication has helped make Highmark the preferred health insurance company in the areas we serve. 1 If you don t have health insurance through your employer, Highmark can help you find an affordable 2016 qualified health plan option that is right for you. Listed in this brochure are Highmark plans that are available through the Health Insurance Marketplace at HealthCare.gov. Most people are eligible to use the Marketplace, if they: Live in the United States Are a U.S. citizen or national (or lawfully present) Are not incarcerated Do not have benefits under Medicare Part A, or are enrolled in Medicare Part B, Medical Assistance or CHIP Plus, most people who buy a plan through the Marketplace qualify for financial help. 2 Did you know that you can buy a Marketplace plan even if you don t qualify for financial help? To learn more or to see if you qualify for financial help go to page 3 or visit HealthCare.gov. THE HIGHMARK DIFFERENCE Highmark is dedicated to making health insurance easier for you when and where you need it. Our goal is to transform health care, because you deserve a better health care experience: Lower Costs Get the most out of your health care dollars with the best quality care at the most competitive price Higher Quality Standards Hospitals and doctors close to where you live and work for the best access to care Better Health Outcomes Get better access to doctors and specialists who meet the highest benchmarks for delivering quality, cost-effective care My Care Navigator SM BlueCard Find a Doctor or RX A built-in guide for Wherever you go Now Highmark gives navigating the health nationwide as a you more ways than care system. Whether Highmark member, ever to find a health care it s help with a care you re in a Blue network. provider that s right for claim or assistance with Just show your BlueCard you. Our easy-to-use provider billing, My Care to the thousands of online directory can Navigator helps members participating physicians help you find doctors, understand and manage and hospitals across dentists, pharmacies, their care costs. the country, and you ll and even search for receive in-network access away from home. covered medications. To Find a Doctor, visit: HighmarkBlueShield.com. And when you become a Highmark member, you have access to exclusive health and wellness tools and services for when you need care, to check health care costs before a procedure is done and most importantly, to help you make good decisions that keep you healthy. If you are already a Highmark member, visit HighmarkBlueShield.com and Log In to your secure member website to see more. Blues On Call SM Health & Wellness Tools Care Cost Estimator Your medical questions Members get access to When you re planning don t just come up during today s leading-edge, a medical treatment, offce hours. That s why online health and Highmark s Care Cost Blues On Call gives you a wellness tools. With Estimator online tool lets 24/7 hotline to a team of Highmark you get what you find and compare registered nurses to help you need to launch your costs just like you do you with personal health journey toward better for other big purchases questions. health and wellness. It s for more than 1,600 convenient, easy to use, kinds of care visits. and best of all, it s free. 1 Highmark Brand Perception Study Conducted by Lynx Research Consulting. 2 86% of National members are receiving an APTC (subsidy); Source is Data.Healthcare.gov as of 2/2015: https://data.healthcare.gov/dataset/2015-qualifying-health-plan-selections-by-aptc-and/f7yt-nc7m 1 Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll.

3 QUALITY, AFFORDABLE COVERAGE FROM HIGHMARK Highmark offers a variety of affordable plan options through the Health Insurance Marketplace. All of our plans: Cover Essential Health Benefits (See a list of EHB s to the right.) Have pediatric dental and vision care services Cover preventive services like annual physicals, immunizations and screenings at no cost to you, when delivered by a doctor in the Highmark network Include coverage for dependents up to age 26 Cover you even if you have a pre-existing health or medical condition ALL HIGHMARK PLANS HAVE THESE ESSENTIAL HEALTH BENEFITS: Ambulatory services, such as primary care and specialist visits Maternity and newborn care Emergency services Prescription drugs, including retail and mail order Pediatric services, including oral and vision care Mental health and substance abuse services Rehabilitative services and devices Hospitalization Laboratory services No-cost preventive and wellness services, and chronic disease management No Referrals Emergency Coverage National Coverage All Highmark plans let you see a No matter which Highmark Highmark is a Blue plan, so you specialist without needing plan you choose, emergency care have access to over 92% of all a referral from your primary is covered at in-network rates at physicians and more than 97% of care doctor, so you can get the any emergency room. all hospitals across the country. care that you need when you need it. THINGS YOU NEED TO KNOW Choosing a health plan can be complicated. There are a lot Out-of-Pocket Maximum The highest amount you of things to take into account. It s important that you have all will need to pay each benefit period (usually a year) for the information you need to make the best possible health covered in-network care before your insurance company pays 100% of covered in-network services. insurance decision. To help you get a better understanding of the basics of health insurance, here are some of the most Coinsurance The part of a medical bill that you pay after reaching your. common health insurance terms that are important to know: Copayment (Copay) Fixed, upfront dollar amounts that Premium The amount you pay each month for your you pay each time you receive certain health care services; health insurance. can be before or after. Deductible The dollar amount you must pay each Formulary A formulary is a list of prescription drugs that benefit period (usually a year) for your health care are covered by your health insurance plan; out-of-pocket expenses before your plan begins to pay. costs may apply. Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll. 2

4 IMPORTANT 2016 OPEN ENROLLMENT DATES The Open Enrollment Period for 2016 health insurance coverage starts November 1, This is the first day you can enroll in a 2016 plan through the Health Insurance Marketplace (HealthCare.gov). Coverage may begin as soon as January 1, 2016 depending on when you enroll. Enroll in a 2016 plan any time between November 1, 2015 and January 31, If you don t enroll before Open Enrollment ends on January 31, 2016 you may pay a fee on your federal income tax return for To learn more about fee exceptions visit HealthCare.gov. There is a Special Enrollment Period if you have a qualifying life event.* Examples include, but are not limited to, certain permanent moves, certain changes in your income, and changes in your family size (such as marriage, childbirth or adoption). *A special enrollment period may occur during or outside of Open Enrollment. NOVEMBER 1, 2015 Open Enrollment Begins DECEMBER 15, 2015 Enroll by this date for coverage to begin January 1, 2016 JANUARY 15, 2016 Enroll by this date for coverage to begin February 1, 2016 JANUARY 31, 2016 Open Enrollment Ends Enroll by this date for coverage to begin March 1, 2016 HOW TO ENROLL Highmark is here to be your health insurance partner, every step of the way. Together, we ll help you find the coverage you need Compare and shop for health insurance plans in your area for you and your family on the Marketplace. We ve included the Plan ID number for the 2016 Highmark Plans on pages 4-6 to help you find us online at the Marketplace. Gather the documents you ll need to see if you re eligible for financial help and to complete online enrollment for yourself and every family member you want to enroll in your 2016 plan, including: Social Security Numbers (or documents for legal immigrants) Birth dates Pay stubs, W-2 forms or wage and tax statements Policy numbers for any current health insurance Information about any health insurance you or your family could get from your jobs Have a valid address to create an account on the Marketplace (HealthCare.gov) to see if you are eligible for financial help. To create that account: You will be asked to enter your address on the Marketplace A Marketplace will be sent to you to validate You must open your Marketplace to validate account creation 4 Complete the online Marketplace application to see if you are eligible for financial help. You ll answer detailed questions about your 2015 household income and size. This process may take about 30 minutes; more if you have a large household. The Marketplace will do the calculations and tell you what programs and savings you qualify for, which may include one or both of the following: Advanced Premium Tax Credits (APTC) may be applied (in advance) to lower what you pay in monthly premiums on any Marketplace plan. Cost-Sharing Reductions (CSR) will lower out-ofpocket costs that you may pay at the time of service for doctor s visits, lab tests, drugs and other covered services. You can only get these savings if you enroll in a Marketplace Silver Metal Level plan.* 5 Enroll in 2016 Marketplace health coverage directly online through the Marketplace (HealthCare.gov) or by calling (TTY: ). Or, call or visit a Highmark representative. *American Indian and Alaska Native cost-sharing reductions apply to individual plans at any Metal Level through the Marketplace. 3 Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll.

5 2016 HIGHMARK PLANS Plans are available in these counties: Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Miffin, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Union and York Shared Cost plans have s with coverage for some services right from the start. For other services, you first need to meet your. Specialty pharmacy drugs treat complex, chronic conditions like multiple sclerosis or cancer. They often are more expensive and may require special handling, administering and monitoring, and are distributed by an approved specialty pharmacy. HCR Progressive Formulary a list of prescription drugs that your health insurance plan covers. A generic drug will be dispensed regardless of whether or not the prescription order specifies a brand drug. Members who cannot or will not accept a generic substitution will be required to pay more for the brand drug. HCR Comprehensive Formulary a list of prescription drugs that your health insurance plan covers. A generic drug will be dispensed unless the prescription order specifies that a brand drug is required. Plan Name Shared Cost Blue PPO 6000 Blue Shield Shared Cost Blue PPO 3200, a Multi-State Plan Blue Shield Shared Cost 1500, a Multi-State Plan Plan ID 70194PA PA PA Metal Level BRONZE SILVER GOLD Deductible (Individual) $6,000 $3,200 $1,500 Deductible (Family) 1,2 $12,000 $6,400 $3,000 Out-of-Pocket Maximum (Individual) 3 $6,850 $6,350 $4,000 Out-of-Pocket Maximum (Family) $13,700 $12,700 $8,000 Coinsurance (Plan Pays) Primary Care Visit Specialist or Urgent Care Visit 60% after 80% after 90% after 100% after $80, no 100% after $125, no 100% after $30, no 100% after $70, no 100% after $20, no 100% after $40, no Emergency Room Visit 60% after 80% after 90% after Inpatient Hospital Services Diagnostic Lab 7 60% after 80% after 90% after 100% after $75, no 100% after $40, no 100% after $20, no Prescription Formulary HCR Comprehensive 6 HCR Progressive* 4 HCR Progressive* 4 Prescription Drug Coverage Retail Generic/Brand/ Non-Formulary (Member Pays) Specialty Pharmacy Retail Brand/ Non-Formulary (Member Pays) Pediatric Vision Services Pediatric Dental Services (Diagnostic & Preventive) 40% after 40% after no or no or $10 ; $50 ; $100 50% with $600 max per prescription; 50% up to $1,000 max per prescription no or no or *HCR Progressive Formulary offers $3 low-cost generic drugs. $10 ; $50 ; $100 50% with $600 max per prescription; 50% up to $1,000 max per prescription no or no or Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll. 4

6 2016 HIGHMARK PLANS Plans are available in these counties: Adams, Berks, Centre, Columbia, Cumberland, Dauphin, Franklin, Fulton, Juniata, Lancaster, Lebanon, Lehigh, Miffin, Montour, Northampton, Northumberland, Perry, Schuylkill, Snyder, Union and York Health Savings plans offer the tax and savings advantages of a Health Savings Account (HSA). You pay all costs until your is met. Then you pay a percentage of costs until you meet your out-ofpocket maximum. Embedded plans have s that have two components, an individual and a family. This allows for each family member to have medical bills covered before the family is met. The individual s add up to meet the family. Specialty pharmacy drugs treat complex, chronic conditions like multiple sclerosis or cancer. They often are more expensive and may require special handling, administering and monitoring, and are distributed by an approved specialty pharmacy. HCR Comprehensive Formulary a list of prescription drugs that your health insurance plan covers. A generic drug will be dispensed unless the prescription order specifies that a brand drug is required. Plan Name Health Savings Blue PPO Embedded 4500 Health Savings Blue PPO Embedded 2700 Health Savings Blue PPO 1400 Plan ID 70194PA PA PA Metal Level BRONZE SILVER GOLD Deductible (Individual) $4,500 $2,700 $1,400 Deductible (Family) 1,2 $9,000 $5,400 $2,800 Out-of-Pocket Maximum (Individual) 3 $6,450 $5,400 $2,800 Out-of-Pocket Maximum (Family) $12,900 $10,800 $5,600 Coinsurance (Plan Pays) 70% after 90% after 90% after Primary Care Visit 70% after 90% after 90% after Specialist or Urgent Care Visit 70% after 90% after 90% after Emergency Room Visit 70% after 90% after 90% after Inpatient Hospital Services 70% after 90% after 90% after Diagnostic Lab 7 70% after 90% after 90% after Prescription Formulary HCR Comprehensive 6 HCR Comprehensive 6 HCR Comprehensive 6 Prescription Drug Coverage Retail Generic/Brand/ Non-Formulary (Member Pays) Specialty Pharmacy Retail Brand/ Non-Formulary (Member Pays) Pediatric Vision Services Pediatric Dental Services (Diagnostic & Preventive) 30% after 10% after 10% after 30% after 10% after 10% after no or no or no or no or no or no or 5 Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll.

7 2016 ALLIANCE FLEX BLUE PLANS Alliance Flex Blue plans are only available in these counties: Berks, Cumberland, Dauphin, Lebanon and Perry Alliance Flex Blue covers services from in-network health providers participating at two different levels of benefits: 1 Enhanced Value Level of Benefits When you choose health care providers participating at this level of benefits, you generally pay the least in out of-pocket costs 2 Standard Value Level of Benefits You generally pay more out-of-pocket at this level Your out-of-pocket savings on your, coinsurance or ment will depend on the provider s level of participation. You save the most by using providers who participate at the Enhanced Value Level of Benefits. (See partial provider list on the next page.) Emergency care services are covered at Enhanced Value Level of Benefits no matter where care is provided. Out-of-network hospitals and providers that do not participate in the PremierBlue Shield Preferred Professional Provider Network, the Highmark Blue Shield Participating Facility Provider Network, a local Blue plan or BlueCard networks, will generally have the highest cost sharing. From the full network of providers, at all levels of benefits, you will receive high quality care and easy access to every kind of service. HCR Progressive Formulary a list of prescription drugs that your health insurance plan covers. A generic drug will be dispensed regardless of whether or not the prescription order specifies a brand drug. Members who cannot or will not accept a generic substitution will be required to pay more for the brand drug. Specialty pharmacy drugs treat complex, chronic conditions like multiple sclerosis or cancer. They often are more expensive and may require special handling, administering and monitoring, and are distributed by an approved specialty pharmacy. Plan Name Alliance FLEX Blue PPO 2100 Alliance FLEX Blue PPO 1000 Plan ID 36247PA PA Metal Level SILVER GOLD Deductible (Individual) Deductible (Family) 1,2 Out-of-Pocket Maximum (Individual) 3 Out-of-Pocket Maximum (Family) Coinsurance (Plan Pays) Primary Care Visit Specialist or Urgent Care Visit Emergency Room Visit Inpatient Hospital Services Diagnostic Lab 7 $2,100 (enhanced); $4,200 (standard) $4,200 (enhanced); $8,400 (standard) $6,850 Enhanced and Standard Combined $13,700 Enhanced and Standard Combined 70% after (enhanced); 50% after (standard) 100% after $30, no (enhanced); 100% after $90, 100% after $60, no (enhanced); 100% after $120, 70% after enhanced 70% after $950 admission, no (enhanced); 50% after $2,000 admission, 100% after $30, no (enhanced); 100% after $120, $1,000 (enhanced); $2,000 (standard) $2,000 (enhanced); $4,000 (standard) $5,000 Enhanced and Standard Combined $10,000 Enhanced and Standard Combined 80% after (enhanced); 60% after (standard) 100% after $10, no (enhanced); 100% after $55, 100% after $20, no (enhanced); 100% after $70, 100% after $150, no (waived if admitted) 80% after $500 admission, no (enhanced); 60% after $1,000 admission, 100% after $20, no (enhanced); 100% after $70, Prescription Formulary HCR Progressive* 4 HCR Progressive* 4 Prescription Drug Coverage Retail Generic/Brand/Non- Formulary (Member Pays) Specialty Pharmacy Retail Brand/Non-Formulary (Member Pays) Pediatric Vision Services Pediatric Dental Services (Diagnostic & Preventive) $10 ; $50 ; $100 50% with $600 max per prescription; 50% up to $1,000 max per prescription no or no or *HCR Progressive Formulary offers $3 low-cost generic drugs. $10 ; $50 ; $100 50% with $600 max per prescription; 50% up to $1,000 max per prescription no or no or Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll. 6

8 ALLIANCE FLEX BLUE You decide how much to save on your out-of-pocket costs because you decide which provider to use with our Alliance Flex Blue health plan options. Alliance Flex Blue covers services from health providers participating at two levels of in-network benefits: Enhanced Value Level of Benefits or Standard Value Level of Benefits. Participating at the Enhanced Value Level of Benefits are Penn State Milton S. Hershey Medical Center and PinnacleHealth System Hospitals. They were rated as must have hospitals based on reputation and members personal experience. They were ranked first and second for quality. 1 Alliance Flex Blue is only available in five Pennsylvania counties, Berks, Cumberland, Dauphin, Lebanon and Perry. Outside of these counties, services received from providers participating in the PremierBlue Shield Preferred Professional Provider Network, the Highmark Blue Shield Participating Facility Provider Network, or a local Blue plan s BlueCard PPO Network will be covered at the Standard Value Level of Benefits. This gives you access to 97 percent of all U.S. hospitals and more than 92 percent of all U.S. physicians nearly 720,000 providers across the country. ALLIANCE FLEX BLUE is only available to individuals that reside in these counties Berks, Cumberland, Dauphin, Lebanon and Perry. Members have access to any of these hospitals and affliated physicians at the in-network levels of benefits.* Plus, access to other in-network hospitals and physicians in the participating networks listed below or BlueCard program at the Standard Value Level of Benefits. ENHANCED Value Level of Benefits Penn State Milton S. Hershey Medical Center Penn State Health St. Joseph PinnacleHealth System Hospitals: - Community General Osteopathic Hospital - Harrisburg Hospital - Polyclinic Hospital - West Shore Hospital STANDARD Value Level of Benefits Carlisle Regional Medical Center Good Samaritan Hospital Holy Spirit Hospital Reading Hospital Surgical Institute of Reading All other providers in the PremierBlue Shield Preferred Professional Provider Network, the Highmark Blue Shield Participating Facility Provider Network, Highmark Managed Care Network, or BlueCard networks *Provider designation within Levels of Benefits and participating hospitals/doctors is subject to change. List current as of 10/15. OUT-OF-NETWORK Hospitals that do not participate in the PremierBlue Shield Preferred Professional Provider Network, the Highmark Blue Shield Participating Facility Provider Network, Highmark Managed Care Network or BlueCard networks To Find a Doctor and check that provider s level of participation visit HighmarkBlueShield.com. The Level of Benefits will be listed under the provider s name. 1 SMART survey, Booz & Company analysis 7 Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll.

9 DISCLOSURE Important Benefit Details 1 Alliance Flex Blue, Shared Cost and Health Savings Embedded Family Deductible: For an Agreement covering more than one (1) family member, as each Member satisfies their individual Deductible, the Plan will begin to pay benefits for Covered Services for that Member for the remainder of the Benefit Period (January 1, 2016 December 31, 2016), whether or not the entire family Deductible has been satisfied. When the family Deductible has been satisfied, the family Deductible will be considered to have been satisfied for all remaining covered family members. No individual Member may satisfy the entire family Deductible. 2 Health Savings Family Deductible: For an Agreement covering more than one (1) family member, the ENTIRE family must be met [within a benefit period (January 1, 2016 December 31, 2016)] before Highmark will pay for covered services for ANY family member. The family can be satisfied by an individual family member or a combination of one or more family members. 3 You are responsible for out-of-pocket costs each Benefit Period up to a maximum amount shown. Thereafter, the Plan pays 100% of the Provider s Allowable Charge during the remainder of the Benefit Period. This amount does not include amounts in excess of the Provider s Allowable Charge. 4 HCR Progressive Formulary prescription drug s for a 31-day supply (Retail): $3 low-cost generic; $10 generic; $50 brand; $100 non-formulary brand and nonformulary generic; specialty drug s vary. The plan has a six-tier structure and utilizes the HCR Progressive Formulary on the National network. Mail order available. If a generic substitution is available but not accepted by the Member they are responsible for paying the difference between the price for a Brand Drug and any available generic equivalent, for each separate Prescription Order or refill plus the drug. 5 Vision benefits utilize the Davis National Network. Pediatric Dental benefits utilize United Concordia s Advantage Network 6 The plan utilizes the HCR Comprehensive Formulary on the National network. Specialty drug s may vary. Mail order available. 7 Basic Diagnostic Services include four types of service: Standard Imaging Services, Laboratory and Pathology, Diagnostic Medical and Allergy Testing. Basic Diagnostic Services require one per date of service and type of service. Additional Basic Diagnostic Services are subject to and coinsurance. Advanced Diagnostic Services include but are not limited to CAT Scan, CTA, MRI, MRA, PET Scan and PET/CT Scan. Health Savings Plans are Qualified High Deductible Health Plans that may be coupled with a Health Savings Account (HSA). However, certain Cost-Sharing Reductions (CSR) or plan variations of this plan that are offered through the Health Insurance Marketplace are not intended to be used with an HSA. If you have questions, please check with your financial advisor. Multi-State Plans are only available for enrollment through the Health Insurance Marketplace. Insurance may be provided by Highmark Health Insurance Company or Highmark Select Resources. Highmark Blue Shield, Highmark Health Insurance Company and Highmark Select Resources are independent licensee of the Blue Cross and Blue Shield Association. Blue Shield and the Shield symbol are registered service marks of the Blue Cross and Blue Shield Association. Highmark is a registered mark of Highmark Inc. Information regarding the Patient Protection and Affordable Care Act of 2010 (a.k.a. PPACA, Affordable Care Act, ACA, and/or Health Care Reform ), as amended, and/or any other law, does not constitute legal or tax advice and is subject to change based upon the issuance of new guidance and/or change in laws. State laws may be applicable. Any review of materials, request for information, or application does not obligate you to enroll for coverage. The benefits listed are a summary. Please request the Outline of Coverage for details on benefits, conditions and exclusions. Federal and state laws and regulations govern health insurance and health plans may vary from state to state. Highmark does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations. We are committed to providing outstanding services for our applicants and members. If you require special assistance, including accommodations for disabilities or limited English proficiency, please call us at to request these free services (TTY/TDD users may call 711). To find more information about Highmark s benefits and operating procedures, such as accessing the drug formulary or using network providers, please go to DiscoverHighmark. com/qualityassurance; or for a paper copy, call Highmark Health Insurance Company and Highmark Select Resources are Qualified Health Plan issuers in the Health Insurance Marketplace. Blues On Call and My Care Navigator are service marks and BlueCard is a registered mark of the Blue Cross and Blue Shield Association. If you are looking for additional plan details, each plan s Summary of Benefits and Coverage is available online at HighmarkBlueShield.com/sbc/bs.html. With this information, you ll be able to shop and compare with confidence. If you do not have online access, you can get a paper copy of any Summary of Benefits free of charge by calling toll-free Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll. 8

10 ا COMMITTED TO PROVIDING OUTSTANDING SERVICE We are committed to providing outstanding services for our applicants and members. If you require special assistance, including accommodations for disabilities or limited English proficiency, please call us at to request these free services. (TTY/TDD: 711) Estamos comprometidos a ofrecer servicios excepcionales a nuestros solicitantes y miembros. Si usted necesita ayuda especial, incluyendo acomodaciones para discapacidades o dominio limitado del inglés, por favor llámenos al para solicitar estos servicios gratuitos. (TTY/TDD: 711) Wir haben uns verpflichtet, unseren Bewerbern und Mitgliedern außerordentliche Dienstleistungen anzubieten. Falls Sie beispielsweise Unterkünfte für Menschen mit Behinderungen oder aufgrund eingeschränkter Englischkenntnisse besondere Unterstützung benötigen, kontaktieren Sie uns unter der Rufnummer , um unsere kostenlosen Dienstleistungen in Anspruch zu nehmen. (TTY/TDD: 711) Ci impegniamo a fornire sempre servizi all avanguardia per i nostri candidati e membri. In caso necessitiate di assistenza speciale, compresi alloggi per disabili o supporto per la scarsa padronanza della lingua inglese, contattateci allo per richiedere gratuitamente tali servizi. (TTY/TDD: 711) 我 們 致 力 於 為 我 們 的 申 請 人 和 會 員 們 提 供 卓 越 的 服 務 如 果 您 需 要 特 殊 協 助, 包 括 殘 障 或 英 語 能 力 有 限, 請 致 電 來 要 求 這 些 免 費 服 務 (TTY/TDD: 711) Nous nous engageons à fournir des services exceptionnels pour nos candidats et membres. Si vous avez besoin d'une assistance particulière, y compris pour handicapés ou compétences limitées en anglais, s'il vous plaît appelez-nous au pour demander ces services gratuits. (TTY/TDD: 711) Мы стремимся оказывать первоклассные услуги для наших кандидатов и членов. Если вы нуждаетесь в специальной помощи, включая принятие мер в связи с инвалидностью или ограниченным владением английским языком, пожалуйста, позвоните нам по телефону и попросите об оказании этих бесплатных услуг. (TTY/TDD: 711) Chúng tôi quyết tâm cung cấp dịch vụ xuất sắc cho các đương đơn và hội viên của mình. Nếu quý vị cần được trợ giúp đặc biệt, bao gồm các thích nghi cho người bị khuyết tật hoặc có khả năng Anh Ngữ hạn hẹp, xin gọi chúng tôi tại số để yêu cầu các dịch vụ miễn phí này. (TTY/TDD: 711) Zależy nam, aby usługi, które świadczymy dla naszych kandydatów i członków charakteryzowały się zawsze najwyższą jakością. Jeżeli potrzebna jest specjalna pomoc, np. w przypadku osób niepełnosprawnych lub osób z ograniczoną znajomością języka angielskiego, oferujemy bezpłatne usługi w tym zakresie prosimy o telefon pod numer (TTY/TDD: 711) 저희들은 신청자들과 회원들에게 탁월한 서비스를 제공하고자 노력하고 있습니다. 신체장애인들이나 비영어권 참석자들을 위해 특별한 도움이 필요하시면 전화 로 알려주시기 바랍니다. 이러한 서비스는 무료입니다. (TTY/TDD: 711) نلتزم بتوفير خدمة متميزة للمتقدمين واألعضاء. إذا كنت تتطلب مساعدة خاصة شام ل التجهيزات ال لزمة ل لحتياجات الخاصة أو إجادة محدودة لإلنجليزية برجاء االتصال ع ىل لط بل هذه الخدمات المجانية. (711 (TTY/TDD: हम अपन आव दक और सदस य क ल ए उत क ष ट स व ए प द न करन क प त वचनबद ह यदद आपक ववश ष सह य च दहए ह, ज सम अक म अथव स लम अ ग तनपण ह सम य न भ श लम ह, क पय इन तनश ल क स व ओ ह अन र ध क ल ए हम पर क कर (TTY/TDD: 711) 9 Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll.

11 COMMITTED TO PROVIDING OUTSTANDING SERVICE અમ અમ ર અરજ કર ઓ અન સભ ય મ ટ ઉમદ સવ ઓ પર પ ડવ કટટબદ છ એ. જ ર મન વવકલ ગર ક અ ગ જ મ મય ટદર વનપણર ધર વન ર ઓ મ ટ સગવડભર ગ ઠવણ સટ ર ન વવશષ સ યર જ ઈર ય, ર આ મફર સવ ઓન વવનર કરવ કપ કર અમન નબર પર ફ ન કર. (TTY/TDD: 711) May pananagutan kaming magbigay ng bukod-tanging mga serbisyo para sa aming mga aplikante at mga miyembro. Kung kailangan mo ng espesyal na tulong, kabilang ang mga akomodasyon para sa mga kapansanan o limitadong kahusayan sa wikang Ingles, mangyaring tawagan kami sa para hilingin ang mga libreng serbisyong ito. (TTY/TDD: 711) Είμαστε δεσμευμένοι να παρέχουμε εξαιρετικές υπηρεσίες για τους αιτούντες και τα μέλη μας. Εάν χρειάζεστε ειδική βοήθεια, συμπεριλαμβανομένων διευκολύνσεων για ειδικές ανάγκες ή περιορισμένη ευχέρεια στα Αγγλικά, παρακαλούμε επικοινωνήστε μαζί μας στο να ζητήσετε τις δωρεάν αυτές παροχές. (TTY/TDD: 711) 私 たちは 入 会 志 願 者 とメンバーのために 卓 越 したサービスを 提 供 することに 全 力 を 注 いでいます あなたが 障 害 者 のための 便 宜 または 制 限 英 語 能 力 を 含 む 特 別 な 支 援 が 必 要 な 場 合 は これらの 無 料 サービスを 受 けるため に までお 電 話 ください (TTY/TDD: 711) ہم اپنے درخواست دہندگان اور ممبران کے لیے عمدہ خدمات فراہم کرنے کے لیے عہد بستہ ہیں اگر آپ کو خصوصی اعانت کی ضرورت ہے جس میں معذوریوں یا انگریزی کی محدود لیاقت کے لیے سہولیات شامل ہیں ان مفت خدمات کی درخواست کرنے کے لیے براہ کرم ہمیں پر کال کریں (711 (TTY/TDD: Estamos empenhados em fornecer serviços especiais para os nossos candidatos e membros. Caso necessite de assistência especial, incluindo alojamento por motivos de deficiência ou conhecimentos limitados de língua inglesa, ligue para o n.º para solicitar estes serviços gratuitos. (TTY/TDD: 711) Ebe fun awon alaabo ara tabi oore ofe lati le so ede geesi to se gbo seti. Ejowo e pe wa fun eyikeyi ohun ti e ba nfe ki a se fun yin lofe. (TTY/TDD: 711) Sisi ni nia ya kutoa huduma bora kwa waombaji wetu na wanachama. Kama unahitaji msaada maalum, ikiwa ni pamoja na malazi kwa ulemavu au mdogo Kiingereza duni, tafadhali wito wetu katika idadi ya kuomba huduma hizi bure. (TTY/TDD: 711) Nihinaanish niizhóni go bee nihiká adiilwołi gi i binahji ts i dá ye ego bidiilkaal, nihi naaltsoos nidahoni łi gi i dóó Bee Atah i dli ni gi i nihił hada di t e hi gi i nihá. Hait e ego da anáhóót i go, bilagáana bizaad t áá nił nanitł ago, áká a ayeed holo, koji be e sh beehane e bee hodi i lnih , e i t áá ji i k eh áká a ayeed biniiye. (TTY/TDD: 711) เราม งม นท จะมอบบร การท โดดเด นให แก ผ สม ครและสมาช กของเรา หากค ณต องการความช วยเหล อเป นพ เศษ รวมถ งการอานวยความสะดวกให แก บ คคลท พพลภาพหร อผ ท ม ความสามารถทางภาษาอ งกฤษในระด บอ อน โปรดต ดต อเราได ท เพ อร องขอบร การด งกล าวได โดยไม ม ค าใช จ าย (TTY/TDD: 711) Visit HealthCare.gov or call Highmark at (TTY/TDD 711) to learn more and enroll. 10

12 There are many ways for you to enroll. Call (TTY/TDD 711) and talk directly to a Highmark representative who can answer your questions. Or, call the Health Insurance Marketplace 24/7 at (TTY: ). Enroll on the Marketplace day or night at HealthCare.gov for a Highmark plan. Visit a local Highmark Direct store. Talk to your local Highmark insurance agent (11/15)

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