Florida Blue has got you covered. Choose your plan. Choose your network.

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1 overed. Choose your plan. Choose your network. When it omes to your health are overage, you an ount on us. attention and extra support are part of every plan. You hoose features that are most important to you. Is out-of-network overage important to you? Do you prefer to pay less premium per month and more for health are at the time of servie? Do you want to know what your opay will be eah time you go to the dotor? Choose from one of our 5 plan ategories4 (Clik on the header for more overage details). No dedutible Three free sik visits per person First ER visit for $75 Presription drug overage with $4 Generis Free wellness visits and preventive generi drugs through mail order Free pediatri dental and vision servies * Essential (HSA) Essential Everyday Health Preditable Cost All Copay * Applies to plans with pediatri dental and/or vision overage. Some limitations may apply. Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and

2 Choose your plan. Choose your network. BlueOptions (PPO/EPO) BlueCare (HMO) BlueSelet (PPO/EPO) Availability Statewide Selet Counties Selet Counties In-Network Size Broad physiian network Broad hospital network Broad physiian network Broad hospital network Broad ommunity-based physiian network Limited hospital network Out-of-Network Coverage Yes, exept for Exlusive Provider Servies No, exept for emergeny servies Yes, exept for Exlusive Provider Servies Exlusive Provider Servies (EPO) Speifi providers or suppliers must be used for these servies or they will not be overed. Presription drugs and/or dental servies when inluded in a health plan Not appliable Presription drugs Durable medial equipment and supplies Home health Lab tests and/or dental servies when inluded in a health plan Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and The provider networks are made up of independently ontrated hospitals, physiians, and anillary providers. Covered servies are based on your speifi health plan benefit.

3 Invest and save with Essential (HSA) Care Knowledge/Resoures le For generally lower monthly premiums, Essential (HSA) provide aess to are for all servies you and your family may need, along with a health savings aount. Whether you use it to simply stay healthy or for emergenies only, you ll have the peae of mind that omes from knowing that your plan offers protetion for both your well-being and your wallet. Health/Eating w ws Help manage your spending, with aess to an optional health savings aount where you an put money away to help over your health are expenses. No ost to you for preventive servies. For all other health are visits, you pay the allowed amount for overed servies until you meet your dedutible and then you pay a perentage alled a oinsurane. One your out-of-poket maximum is met, your plan pays 100% of overed servies for the rest of the year. Use in-network providers to get the most value from your plan. A health savings aount is a tax-advantaged aount that you an fund, up to a maximum set by the government, to pay for urrent or future qualified medial expenses. Triple tax-savings for: Contributions Withdraws for eligible medial expenses Interest earnings It s your money; it goes with you wherever you go. Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and offers only the qualified health plan that an be used in onjuntion with a Health Savings Aount (HSA). An HSA is a personal aount that you may open at a qualified finanial institution or trustee of your hoie. For more information, ontat your legal or tax advisor.

4 Lower your monthly premium with Essential For generally lower monthly premiums, Essential provide aess to quality overage for all the servies you and your family may need. Whether you use it to simply stay healthy, or for emergenies only, you ll have the peae of mind that omes from knowing that your plan offers protetion for your well-being and your wallet. Healthy ideas H On Save money on your health are expenses: No additional ost to you for preventive servies For all other health are visits, you pay the allowed amount for overed servies until you meet your dedutible and then you pay a perentage alled a oinsurane. One your out-of-poket maximum is met, your plan overs 100% of your servies for the rest of the year. To get the most value from your plan, it s important to use in-network providers. I Pe ass Dental Our online provider diretory will show you whih dotors, speialists, and other health providers are in your network. Pha Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and

5 When you need just the basis, Everyday Health provide value If your typial health are needs inlude annual hekups or the oasional sik visit, Everyday Health offer you a real value. The basis like routine visits to your primary are physiian are free for the first 3 visits, and you ll pay a simple flat fee (a opay) for any additional visits. And for unexpeted are, suh as ER or hospital visits, you an hoose the plan benefits that offer the most value for you. Healthy ideas He Antiipating your needs helps you determine what you an afford to pay: On You hoose whih plan fits your needs for presription drugs, ER visits or hospitalization. I Selet a set opay plan; or Choose a ost-share plan with a dedutible and oinsurane To get the most value from your plan, it s important to use in-network providers. Pe ass Dental One your out-of-poket maximum is met, your plan then pays 100% of all overed servies for the rest of the year Our online provider diretory will show you whih dotors, speialists, and other health providers are in your network. Pha Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and

6 Know what you ll pay with Preditable Cost Preditable Cost help make it easy to keep your health are spending under ontrol with preditable osts for the servies that you use most. You ll know exatly what you ll pay for dotor s visits, speialist visits, and onvenient are visits. Even in an emergeny, you only pay a opay for the ER and ambulane servies. In the event that something more serious happens Healthy ideas Care and you re in the hospital, your out-of-poket maximum Knowledge/Resoures also puts a ap on how muh you ll have to pay. Healthy ideas On Preditable osts help you manage your health are expenses: No additional ost to you for preventive servies I Dental For ertain servies, there s a flat dedutible, so you know how muh you ll pay. One your out-of-poket maximum is met, your plan overs 100% of your servies. To get the most value from your plan, it s important to use innetwork providers. Our online provider diretory will show you whih dotors, speialists, and other health providers are in your network. Pe ass Pha Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and

7 All Copay mean just that all opays, no dedutibles If you want a plan that makes it easy to estimate your health are osts, All Copay are designed so you pay a set opay for eah servie, suh as routine dotor visits, speialists, presription drugs, ER visits and hospital are so there s no surprises. Health/Eating Healthy ideas On You ll know what to pay when you need medial are: No dedutible to meet. I No need to alulate what is owed. Dental Copays add up to an out-of-poket maximum. Your plan then pays 100% of all overed servies for the rest of the year. To get the most value from your plan, it s important to use in-network providers. Our online provider diretory will show you whih dotors, speialists, and other health providers are in your network. Pe ass Pha Benefits designed to help you manage any ondition Free money-saving benefits you get with every plan Health insurane is offered by Blue Cross and Blue Shield of Florida, In., D/B/A. HMO overage is offered by Health Options, In., D/B/A HMO, an HMO subsidiary of Blue Cross and Blue Shield of Florida, In. These ompanies are Independent Liensees of the Blue Cross and

8 Presription Drugs Presription drug benefits are inluded in all of our health are plans and are designed to save you money and keep your out-of-poket expenses to a minimum. floridablue.om and hek out our online pharmay tool to: find the lowest drug osts and where to get them. get laim information. view the Mediation Guide to help you determine whih drugs are overed or require a prior authorization. find pharmay information and resoures. Plus, there s no ost for ertain presription drugs when you order them by mail. If you take mediine for diabetes, asthma, high blood pressure or high holesterol, generis are free! Living with an ongoing hroni illness? Diabetes High-blood pressure If you have Asthma Depression* High holesterol Our plans inlude: FREE lab tests* FREE preventive sreenings and wellness exams First three sik visits are FREE FREE 90-day supply of generi maintenane mediations through mail order $4 generi maintenane mediations at your loal pharmay FREE diabeti retinal exam, self-management eduation, and insulin pump* First ER visit at $75 FREE immunizations and vainations *Benefits are subjet to a ost share on Essential (HSA) plans. Refer to your benefits of overage for plan details.

9 Why hoose? Care Consultations for help understanding benefit and treatment options, ost omparisons and ondition-speifi programs hour nurse line for unexpeted and ongoing health are questions Beyond health are overage, personalized programs and servies are available to help you manage your overall health and finanial well-being. With, you an take advantage of a variety of easy-to-use health and wellness resoures. An exlusive national member disount program with savings on gym memberships, vision are, hearing aids, weight management programs, and more. Care oordination and ase management. health assessment and plans for staying healthy. Online health improvement programs for weight loss, exerise, smoking essation and more. Shopping tools for quality and ost estimates on medial servies or presription drugs. A monthly member health statement that shows what was paid, what is owed and ways to save. A member website for 24-hour aess to benefits, laims, ID ards, health information, real-time ost omparisons, wellness programs and more. Centers are loal stores that you an walk in and talk to an expert in person. No other health insurane ompany offers suh personalized fae-to-fae servie! has arrangements with various vendors to provide value-added programs, whih are not part of insurane overage. All medial deisions should be made with the member s dotor. Disounts are available as a ourtesy to all and HMO members through separate business partners. Disounts may be used one overed benefits, if any, are exhausted.