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1 Anthem Blue Cross Advantage PPO Blue Cross PPO (Prudent Buyer)-Large Group Blue Cross PPO (Prudent Buyer)-Small Group Bronze 60 D EPO (Pathway-Tiered EPO/ Bronze 60 D Health Savings Account EPO (Pathway - Tiered EPO/ Bronze 60 D Health Savings Account PPO (Pathway - PPO/ Bronze 60 D PPO (Pathway- PPO/ Bronze 60 Health Savings Account EPO (Pathway - Tiered EPO/ Bronze EPO (Prudent Buyer PPO/ Bronze EPO Plus (Prudent Buyer PPO/ Small Bronze Pathway EPO (Pathway - Tiered EPO/ Bronze Pathway PPO (Pathway - PPO/ Individual Bronze PPO (Prudent Buyer PPO/ Bronze Select PPO (Select PPO/ Bronze Select PPO Plus (Select PPO/ Small Core DirectAccess (Select PPO/ Small Group) Core DirectAccess Plus (Prudent Buyer PPO/ Small Group) Core DirectAccess Plus (Select PPO/ Small Group) Core DirectAccess Plus w/dental (Prudent Buyer PPO/ Small Group) Core DirectAccess Plus w/dental (Select PPO/ Small Group) Core DirectAccess w/hsa (Prudent Buyer PPO / Core DirectAccess w/hsa (Select PPO / Dignity Health EPO / PPO EPO Essential DirectAccess (Prudent Buyer PPO / Employer, Individual, and Family Health Plans Accepted Essential DirectAccess (Select PPO/ Essential DirectAccess Plus (Prudent Buyer PPO / Essential DirectAccess Plus (Select PPO / Essential DirectAccess w/ HRA (Prudent Buyer PPO / Essential DirectAccess w/hsa (Prudent Buyer PPO / Essential DirectAccess w/hsa (Select PPO / Gold 80 D EPO (Pathway - Tiered EPO/ Gold 80 D PPO (Pathway - PPO/ Gold Advantage PPO Plus (Advantage PPO Network/ Gold EPO (Prudent Buyer PPO/ Gold PPO (Prudent Buyer PPO/ Gold Select PPO (Select PPO/ Gold Select PPO Plus (Select PPO/ Lumenos Plans MemorialCare Custom PPO Minimum Coverage D EPO (Pathway - Tiered EPO/ Minimum Coverage D PPO (Pathway - PPO/ National PPO (BlueCard PPO Basic) National PPO (BlueCard PPO) PERS Select HMO PERS Traditional HMO Platinum 90 D EPO (Pathway - Tiered EPO/ Platinum Select PPO Plus (Select PPO/ Small Preferred DirectAccess (Prudent Buyer PPO / Preferred DirectAccess (Select PPO/Small Preferred DirectAccess Plus (Advantage PPO Network / Preferred DirectAccess Plus (Select PPO /

2 Employer, Individual, and Family Health Plans (Continued 2) Anthem Blue Cross (continued) Preferred DirectAccess w/hra (Prudent Buyer PPO/ Small Group) Preferred DirectAccess w/hra (Select PPO/ Small Group) Premier DirectAccess Plus (Select PPO/ Select PPO (Alternate Network) Select PPO (PERS Select Providers) Select PPO Silver 70 D EPO (Pathway - Tiered EPO/ Silver 70 D PPO (Pathway - PPO/ Silver Advantage PPO Plus (Advantage PPO Network/ Silver EPO Plus (Prudent Buyer PPO/ Silver Pathway EPO (Pathway - Tiered EPO/ Silver Pathway PPO (Pathway-PPO/ Silver PPO (Prudent Buyer PPO/ Silver Select PPO (Select PPO/ Silver Select PPO Plus (Select PPO/ Traditional UCSHIP anthem.com Blue Shield Access +HMO Access +HMO Enhanced (15,25,35,40,45) Access +HMO Premier (15,25,35,45) Active Choice Base PPO (30,40,50) Basic Full PPO for HSA for Small Business (3500, 5500) Basic Full PPO for Small Business 4500 Blue Shield of California PPO Network Bronze 60 PPO Mirror Bronze 60 PPO SHOP Bronze Full PPO 4500 Bronze Full PPO HSA (3500,5500) CalPERS Access + HMO Blue Shield (continued) Enhanced Full PPO for HSA for Small Business 2000 Enhanced Full PPO for Small Business (1250, 1700) Enhanced PPO (15,25,30,35,40,45) Federal Employee Health Benefit Program Access + HMO Gold Full PPO (0, 750) Platinum Full PPO (0, 150) Point of Service (POS) PPO PPO HSA Preferred Full PPO for Small Business (0, 750) Premier PPO (5,15,20,25,35,45) Shield PPO Shield PPO Savings Plus Aggregate 1250/2500 Shield PPO Savings Plus Individual Member Deductible (2600,3000,3500) Shield Saver Shield Savings Plus (2400, 4000) Shield Savings Plus 4000 Shield Secure Shield Spectrum PPO (1500,1800) - 80/50 Shield Spectrum PPO 2500 Value Shield Spectrum PPO Plan (750,1000,1500,2500) Value Shield Wise Silver Full PPO (1250,1700) Silver Full PPO HSA 2000 Simple Savings Small Business Enhanced PPO UC Care Plan (UC Select) UC High Option Supplement to Medicare Plan-retiree plan UC Medicare PPO Plan with Rx-retiree plan UC Medicare PPO Plan without RX-retirees plan Ultimate Full PPO for Small Business (0,150) blueshieldca.com

3 Employer, Individual, and Family Health Plans (Continued 3) Cigna HMO/Network - Cigna HealthCare of CA - Southern CA Open Access Network HMO/Network - CIGNA HealthCare of CA, Inc. - So. CA HMO/Network Indemnity LocalPlus Open Access Plus, OA plus, Choice Fund OA Plus Open Access Plus, OA plus, Choice Fund OA Plus WITH CareLink PPO, Choice Fund PPO cigna.com Health Net Blue & Gold HMO Elect Elect - Medicare COB Elect Open Access Elect Open Access - ExcelCare Network Elect Open Access - Medicare COB HMO - Employer Group Plans HMO - ExcelCare Network HMO - ExcelCare Network (with walk-in clinics) HMO - ExcelCare Network Medicare COB HMO - ExcelCare Network Medicare COB (with walk-in clinics) HMO - Medicare COB HMO - WholeCare Network National PPO - First Health POS - Medicare COB PPO PPO - Individual & Family Select POS Select POS Medicare COB healthnet.com Humana ChoicePOS COT National POS Open Access EPO PPO Open Access GE Health Care Preferred Humana ChoiceCare Network PPO Humana ChoiceCare+ Network PPO National POS OpenAccess National POS OpenAccess Plus P&G National POS US Bank humana.com UnitedHealthcare CalPERs Medicare Advantage PPO Charter HMO / Charter Balanced HMO / Charter Plus HMO Charter Plus Charter/Charter Balanced Choice Choice HMO/Choice Plus HMO Choice Plus CS VEBA Performance HMO - Network 3 Medica Choice with UnitedHealthcare Choice Plus Options PPO Passport Connect Choice Passport Connect Choice Plus Passport Connect Options PPO Select Select Plus SignatureValue HMO uhc.com

4 Covered California Health Benefit Exchange Plans Anthem Blue Cross $0 Cost Share AI-AN EPO (Pathway X - Tiered EPO/ $0 Cost Share AI-AN PPO (Pathway X - PPO/ Bronze 60 EPO (Pathway X - Tiered EPO/ Bronze 60 Health Savings Account PPO (Pathway X - Bronze 60 PPO (Pathway X - PPO/ Individual via Exchange) Gold 80 EPO, a Multi-State Plan (Pathway X - Gold 80 PPO, a Multi-State Plan (Pathway X - Minimum Coverage EPO (Pathway X - Tiered EPO/ Minimum Coverage PPO (Pathway X - PPO/ Pathway X - PPO Network Pathway X - Tiered (EPO) Network Platinum 90 EPO (Pathway X - Tiered EPO/ Platinum 90 PPO (Pathway X - PPO/ Individual via Exchange) Silver 70 EPO, a Multi-State Plan (Pathway X - Silver 70 PPO, a Multi-State Plan (Pathway X - Silver 73 EPO, a Multi-State Plan (Pathway X - Silver 73 PPO, a Multi-State Plan (Pathway X - Silver 87 EPO, a Multi-State Plan (Pathway X - Silver 87 PPO, a Multi-State Plan (Pathway X - Silver 94 EPO, a Multi-State Plan (Pathway X - Silver 94 PPO, a Multi-State Plan (Pathway X - anthem.com

5 Covered California Health Benefit Exchange Plans (Continued) Blue Shield 0 Cost Share EPO AI-AN 0 Cost Share PPO AI-AN Bronze 60 EPO Bronze 60 EPO AI-AN Bronze 60 HSA EPO Bronze 60 HSA EPO AI-AN Bronze 60 HSA PPO Bronze 60 HSA PPO AI-AN Bronze 60 PPO Bronze 60 PPO AI-AN Gold 80 EPO Gold 80 EPO AI-AN Gold 80 PPO Gold 80 PPO AI-AN Minimum Coverage EPO Minimum Coverage PPO Platinum 90 EPO Platinum 90 EPO AI-AN Platinum 90 PPO Platinum 90 PPO AI-AN Silver 70 EPO Silver 70 EPO AI-AN Silver 70 PPO Silver 70 PPO AI-AN Silver 73 EPO Silver 73 PPO Silver 87 EPO Silver 87 PPO Silver 94 EPO Silver 94 PPO blueshieldca.com Health Net PPO - Small Business healthnet.com

6 Medicare/Medicare Advantage Health Plans We accept TriCare for Life, traditonal Medicare, all Medicare Supplemental/Gap policies, Medicare Advantage plans and all Medicare PPO plans. Anthem Blue Cross Medicare Supplement Policies (Medi-Gap Policies) Medicare PPO- Orange County only Blue Shield Medicare Supplement Policies (Medi-Gap Policies) Blue Shield 65 Plus HMO (We DO NOT accept: Blue Shield 65 Plus Choice) Employer Retiree Plans UC Care Plan UC High Option Supplement to Medicare Plan-retiree plan UC Medicare PPO Plan with Rx-retiree plan UC Medicare PPO Plan without RX-retirees plan blueshieldca.com/medicare Health Net Seniority Plus Amber I Seniority Plus Amber II Seniority Plus Green(LA County Only) Healthy Heart Seniority Plus Sapphire Seniority Plus Sapphire Premier (Medi-Medi) (We Do Not accept Gold Select & Jade) healthnet.com/medicare Humana Humana Gold Plus HMO Humana Gold Plus Enhanced HMO Humana Gold Plus Dual (Medi-Medi) humana.com/medicare SCAN SCAN Balance SCAN Classic SCAN Connections (LA County Only) SCAN Heart First (Orange County Only) SCAN Plus Plan (Medi/Medi) scanhealthplan.com UnitedHealthcare Medicare Supplement Policies (Medi-Gap Policies) AARP Medicare Complete- Orange County SecureHorizons Plan 2 SecureHorizons Premier Plan SecureHorizons Plan 3 (Medi/Medi) SecureHorizons Essential AARP Medicare Complete- Los Angeles County SecureHorizons Plan 1 SecureHorizons Plan 3 (Medi/Medi) SecureHorizons Essential Employer Retiree Plans CalPERs Medicare Advantage PPO Medicare Advantage PPO uhcmedicaresolutions.com

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