Solutions. Quality Service Plan Choice Value-Added Programs. for small business.

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1 Solutions Quality Service Plan Choice Value-Added Programs for small business.

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3 How does a small business attract and keep talented workers? One of the most important and attractive employee benefits an employer can offer is health care coverage. And, today s educated workforce has come to expect a health care coverage as part of an overall compensation package. An employer who offers quality health care coverage gains a competitive advantage to attract and retain the best personnel. Selecting the right health care plan for your employees plays an important role in your success in the marketplace. What level of benefits should you offer? How much are you willing to pay? And what company can you trust to do the job? Making these decisions can be a challenge for any business. To make the best decision, you need a partner you can trust. A partner with the experience and know-how to deliver a complete package of products and services. A partner who can show you how to make health care coverage work for you That partner is Capital BlueCross.

4 Our team of employees is committed to delivering personal service that connects us to our customers and our Members. All policy decisions are made right here in Central Pennsylvania and the Lehigh Valley, and we are able to adapt to the specialized needs of our customers. Capital BlueCross is a name you can trust, providing an established reputation of service excellence you can depend on. Our strength lies in our commitment to our customers and Members. We are well prepared to provide the quality service you deserve, quality that our Members have come to expect. And we will continue to look for innovative ways to serve our valued customers far into the future. Seamless administration Transitioning from one insurance carrier to another may have created problems for you in the past. Capital BlueCross brings the expertise to provide a seamless transition and easy administration of all your insurance needs. As you move through the challenges of your business day, you can relax and feel secure knowing that Capital BlueCross is taking care of the health insurance needs of your employees. Web tools Interactive, secure Internet-based tools provide access to administrative self-service capabilities any time, day or night, for you and your staff. Send enrollment files electronically without expensive software or dedicated connections. Submit data changes and view enrollment and benefit information for employees online. Employees will have fewer reasons to drop into your office with claim inquiries, name changes, and lost ID card problems. The convenience of using our secure, online services to check the status of a claim, order a replacement ID card, and get benefits or eligibility information is valued by group administrators and Members alike. And they can do it 24-hours a day, when it fits in their schedule, not when it interrupts yours! Quality Service Plan Choice Value-Added Programs

5 It s why so many small businesses choose Capital BlueCross we have been providing area businesses with the best value and selection in health care coverage since Select from our low- and high-deductible PPO plan options, POS, HMO, Comprehensive, and Traditional plan designs. Ask about our Health Savings Accounts and Health Reimbursement Arrangements to coordinate with a high-deductible PPO plan option. According to the U.S. Small Business Administration, HSAs offer small business owners and their employees a new option for affordability, portability, and freedom in health care coverage. HSAs can save small business owners up to 40 percent in health care costs. Some small business owners, who previously couldn t offer health care to their employees, can do so now through HSAs. We offer you a selection of several affordable dental programs with access to the largest dental Provider network in the country. Our choice of dental program administrator is Delta Dental. More than 43 million Americans and their families rely on Delta Dental for their dental coverage. Complement your employee benefits package with vision care coverage. We have chosen National Vision Administrators (NVA) to administer our vision care program. Providing vision benefit services to over four million people throughout the United States, NVA serves virtually every industry in both the private and public sectors. insurance needs. Quality Service Plan Choice Value-Added Programs Offered as part of a complete medical benefit package to all of our small business customers is the Capital BlueCross Prescription Drug Program. We provide a wide selection of programs administered by Express Scripts, Inc. (ESI), one of the largest Pharmacy Benefit Management (PBM) companies in North America. ESI provides PBM services to over 50 million members through facilities in eight states and Canada. Retiree Benefits With a Capital BlueCross Medicare plan, your Medicare-eligible retirees gain access to our broad Provider network and quality customer service. Simply choose a plan for your retirees/employees that is right for your business. Your Capital BlueCross account executive can help you find a program that best fits your needs. Complete your employee benefits package with life and long-term/short-term disability insurance. As a broker for a variety of established insurance carriers, our subsidiary, Consolidated Benefits, Inc. (CBI) provides a comprehensive portfolio of products to provide you with a winning benefit package. Each company is chosen for their financial stability, range of quality products, service, and responsiveness to customers.

6 Plan Design Overview Preferred Provider Organization (PPO) 1 Offering preventive health care benefits and the freedom to choose any physician or hospital, with a low copayment for routine office visits. Preferred Provider Organization Plus (PPO Plus) 1 A PPO plan adding the voluntary choice of a primary care physician (PCP) for a lower copayment for office visits to the selected PCP. Whether or not a PCP is chosen, no referrals are required for specialty care. Point of Service (POS) 1 Emphasizing preventive care and giving Members the freedom to self-refer to any Provider in or out of network. Benefits are maximized when care is delivered or coordinated by a primary care physician. Traditional 2 Featuring comprehensive benefits and complete freedom to choose any physician or hospital. Comprehensive 1 Combining facility and professional Provider services into one, easy-to-use program with freedom to choose any physician or hospital. Quality Service Plan Choice Value-Added Programs HMO 3 Featuring one of the largest managed care networks in Central Pennsylvania and the Lehigh Valley with services delivered and coordinated by a primary care physician. Our HMO programs, offered through Keystone Health Plan Central (Keystone), include preventive care services for children and adults, case management, maternity management, disease management, and discount network programs. SimplySelect sm1 HRA/HSA accounts For a healthier workforce guidance to make better health care choices and long-term management of your health care costs, you may be interested in choosing SimplySelect, our Health Reimbursement Arrangement (HRA) and Health Savings Account (HSA) options. These special tax-advantaged accounts allow your employees to cover their out-of-pocket costs today and plan wisely for their health care needs. With a SimplySelect plan, you provide your employees with health insurance they already understand with tools to help them manage their benefits, treatment options, and costs. 1 Issued by Capital Advantage Insurance Company, a wholly owned subsidiary of Capital BlueCross 2 Basic hospitalization issued by Capital BlueCross and Medical Surgical and Major Medical issued by Capital Advantage Insurance Company 3 Keystone Health Plan Central is a wholly owned subsidiary of Capital BlueCross

7 Retiree Plans Our flexible participation requirements mean that our Medicare Advantage plans are available to group customers with at least two Medicare-eligible enrollees, and are offered with or without prescription drug coverage. And, if you have only one eligible Member, you can still select from our Medicare Complementary program offering. Medicare Advantage Plans SeniorBlue HMO 3 /SeniorBlue PPO 1 Our Medicare Advantage plans are offered under contract with and authorized by the Centers for Medicare and Medicaid Services (CMS), the Federal agency responsible for Medicare. Choose from either HMO or PPO Medicare Advantage plan designs. Our SeniorBlue HMO and SeniorBlue PPO programs provide all of the coverage physician, facility, and prescription drug in one place while eliminating the need to purchase a separate Medicare Part D prescription drug plan. Medicare Complementary Coverage Senior 1 Our Senior programs provide a choice of designs for group Members who are eligible and enrolled in Medicare hospital and physician insurance programs. Senior programs complement Medicare by providing additional benefits in addition to the services covered by Medicare. And, Medicare Part D Options are available for purchase through an arrangement with a local vendor to provide a CMS-approved prescription drug program to employers. under one roof. The health plan choices you want

8 Quality Service Plan Choice Value-Added Programs Healthy Advantage To help your employees stay healthy and productive, we offer an expanded portfolio of wellness programs. Capital BlueCross Healthy Advantage programs provide a solid foundation of health education information and professional clinical management support services. Healthy Advantage resources give employees the tools they need to become wiser consumers of health benefits, and to give them the information they need to get healthy and stay healthy. To you, that means less absenteeism and lower utilization of medical services. Worksite wellness tools to complement or to build your health promotion program The Capital BlueCross Healthy Advantage@Work Tool Kit is available exclusively to Capital BlueCross groups. All resource information and materials come from highly regarded, dependable sources like Health Forums, Capital BlueCross Nurse Line, Wellness Councils of America, and the National Healthy People 2010 Program managed by the U.S. Department of Health and Human Services. Our Web links guide you to the best Web sites for more information on the topics that interest you the most. You can trust the tools in the Healthy Advantage@Work Tool Kit to help you create a quality wellness promotion program. 24-hour Nurse Line Questions about health can come up at any time, day or night. That s why your employees will appreciate easy access to our Nurse Line a trusted source for health information 24 hours a day, 7 days a week. With Nurse Line, simply pick up the phone and speak to a registered nurse or access recorded health information on more than 1,100 health topics in the audio Health Information Library.

9 Precious Baby Prints Healthy moms healthy babies lower complications. Precious Baby Prints is a voluntary maternity program designed to support Members throughout pregnancy, birth, and follow-up care. Self-directed and nurse-assisted disease management programs If you have an employee with a chronic health condition like diabetes, heart disease, or asthma, we provide confidential, personalized assistance to contribute to high-quality health care, better medical outcomes, lower costs, and increased productivity. Care Management The majority of an employer s health care expenses are often attributed to a small number of employees. Staffed by specially trained RNs and experienced professionals, our Care Management program helps to lower the cost of care wherever possible and to improve the quality of service these employees receive. Preauthorization/Utilization Program Our Preauthorization and Utilization Management program is the first step in monitoring and managing the way your benefit plan is used. This program helps to determine the medical necessity of services being delivered to our Members. This ensures that the care provided is the most appropriate and cost effective. Most importantly, we are able to identify high-risk and high-cost patients early on. stay healthy. Helping employees to get healthy and to Smart Surgery sm The Smart Surgery preadmission program and our Discharge Outreach Call program are designed to prevent unnecessary or excessive inpatient utilization by encouraging comprehensive discharge planning for certain surgical procedures. Both programs are an important part of care management delivery, assisting our care management staff in caring for Members before, during, and after a hospital admission.

10 Choose the Plan That Works for You Capital BlueCross plan designs provide virtually all of the key features you are looking for. We are committed to providing our customers with the best value in health care coverage and complementary services. All of the plans offer access to our broad Provider network, health and wellness materials and support, and quality customer service. Simply choose a plan that is right for your business. For more specific information about the options available for a particular product, contact your Capital BlueCross or Keystone account executive. Ask about our group coverage options for retirees and Medicare-eligible workers. Benefit PPO PPO Plus POS* Traditional Comprehensive SimplySelect Keystone Health Plan Central HMO* PCP Coordinated Care No Optional No No No Referrals required No Optional No No No Out-of-network coverage No Health Savings Account option available No No No No No No Prescription drug benefit Adult and pediatric preventive benefits No No Child immunizations Annual mammogram Annual GYN and PAP Preauthorization Copayment for Provider office visits No No ** Deductibles Optional Optional No * These managed care plans may not cover all of your health care expenses. Read your contract carefully to determine which health care services are covered. To contact the plan if you are a Member, please call the number on your ID card. All others should call ** For HSA products, copayments apply after plan year deductible has been met.

11 Capital BlueCross providing long-term solutions health insurance to your needs. Quality Service Plan Choice Value-Added Programs For more information, call your Capital BlueCross account executive or contact our Sales Department at:

12 Serving businesses since 1938 Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company and Keystone Health Plan Central. Independent licensees of the Blue Cross and Blue Shield Association. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies. NF-374 (8/2006)