Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison

Carpenters Health & Welfare Trust Fund for California Retiree Plan Comparison Information Needed: Eligibility, Benefits, COBRA or Disability Claims: Indemnity Medical Plan Indemnity Hearing Aid Benefit Contract Provider Program In California (Indemnity Medical Plan) Contract Provider Program Outside California (Indemnity Medical Plan) Review Organization for Required Pre-Authorizations In or Outside California (Indemnity Medical Plan) Prescription Drug Benefits (Indemnity Medical Plan) Vision Service Plan (Indemnity Medical Plan) QUICK REFERENCE Contact the Following: Fund Office (510) 633-0333 or Toll Free (888) 547-2054 Claims Office - Direct (925) 676-3828 Toll Free - In California (800) 323-6661 Toll Free - Outside California (800) 232-2527 www.carpenterfunds.com Claims Office (925) 676-3828 or Toll Free (800) 323-6661 www.anthem.com/ca BlueCard (800) 810-2583 www.bluecares.com Anthem Blue Cross (800) 274-7767 Prudent Buyer Plan (for physicians only) Medco (800) 939-7093 www.medco.com Fund Office (888) 547-2054 (800) 877-7195 www.vsp.com Kaiser Foundation Health Plan (800) 464-4000 http://my.kp.org/ca/carpenterfunds/index.html Health Net (800) 638-3889 www.healthnet.com Dental Delta Dental (PPO) PMI Customer Relations (800) 765-6003 (800) 422-4234 opeiu 3 afl-cio (125) 4/2008

Please note: This summary is a brief description of Carpenters Health and Welfare Plan benefits. In all cases, the Plan Rules and Regulations, including any amendments, will be the basis for the payment of any benefits. Plan Selections Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare Choice of Physicians A Health Maintenance Organization (HMO) that provides prepaid medical, drug, vision and hearing aid benefits to Participants enrolled in this Plan with a guaranteed payment of these benefits. Participants must live within the Service Area. Members choose a Physician on staff at a Kaiser Permanente facility located in their service area. Routine, preventive, and specialist care are provided at Kaiser Permanente facilities or by Kaiser contract providers. A Health Maintenance Organization (HMO) that provides prepaid medical, drug, and vision benefits to Participants enrolled in this Plan with a guaranteed payment of these benefits. Participants must live within the Service Area. Members choose a primary care physician from Health Net participating medical group (PMG) or an individual practice association (IPA). The primary care physician manages the member s routine and preventive care and refers patients to specialists as needed. The Indemnity Plan is a comprehensive benefit plan with an annual deductible and a limit on your annual out of pocket covered expenses. After the out of pocket limit is reached each year, the Plan will pay 100% of covered expenses for the remainder of the calendar year. Members may use the providers of their choice. To receive maximum benefits, members must use PPO/ contract providers. Annual Deductible None None Calendar Year - Per person PPO: $100 Non-PPO: $200 Calendar Year - Per family PPO: $200 Non-PPO: $400 Annual Out of Pocket Limits Limit on co-payments: Per person - $1,500 Per family - $3,000 Limit on co-payments: Person - $1,500 Per family of 3 or more - $4,500 Out of Pocket Limits Per person - PPO: $1,000 Non-PPO: $2,000 Per family - PPO: $2,000 Non-PPO: $4,000 Co-Payments Shown for each service Shown for each service Once annual deductible has been satisfied and until the out of pocket limit is met, the Plan pays: PPO at 90%, Non-PPO at 70% C&R (Customary and Reasonable) for all benefits unless otherwise indicated. Plan Lifetime Maximum None None $250,000 Hospital Services No Charge No Charge Subject to deductibles and annual out of pocket limits. Benefits reduced by 25% if utilization review is not obtained. PPO: Paid at 90% Non-PPO: Paid at 70% C&R 2 Retiree Plan Comparison

Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare Hospital Emergency Room $50 per visit, waived if admitted to hospital. $50 per visit, waived if admitted to hospital. Subject to deductibles and Physician Office Visits $20 per visit $20 per visit Subject to deductibles and Surgical Services No Charge No Charge Subject to deductibles and X-rays & Lab No Charge No Charge Subject to deductibles and Maternity Co-payments for physician visits, hospital and surgery apply. Co-payments for physician visits, hospital and surgery apply. Subject to deductibles and Sterilization Benefits Co-payment required Co-payment required Subject to deductibles and Ambulance No Charge No Charge Subject to deductibles and Non- C&R Preventive Care Adult Physical Exam $20 per visit $20 per visit for a periodic health evaluation when recommended by the primary care physician. Annual routine physical exams are not covered (for example: examinations required by an employer or for school admission). Well Baby Care $20 per visit $20 per visit Not covered Subject to maximum benefit limits, plan deductible and coinsurance: adult physical limited to $250, plus PSA test or pap smear allowance. Out of pocket limits do not apply to charges in excess of the benefit limits. Female Routine Exam $20 per visit $20 per visit See Adult Physical Exam above. Exam limited to $250 if not provided by Examinetics plus allowance for pap smear. PPO paid at 90%; Non-PPO paid at 70%. Subject to deductibles and out of pocket limits. Immunization (Dependent Children) No Charge No Charge Not covered Retiree Plan Comparison

Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare Allergy Testing and Treatment Inpatient Outpatient Severe Mental Illness Inpatient $20 per visit; $3.00 per injection No Charge, up to 45 days per calendar year. $20 per visit for individual, $10 per visit for group. Limited to 20 visits per year. Mental Health Allergy Testing - No Charge Allergy Injection - No Charge Allergy Serum - Not Covered No Charge; limited to 30 days per calendar year, combined with alcohol and chemical dependency benefit. $30 per visit; Limited to 20 visits per year, combined with alcohol and chemical dependency benefit. The mental health co-payments and visit/day limits shown above do not apply to Severe Mental Illness or Serious Emotional Disturbance of a Child - services for these conditions are covered on the same basis as a medical condition. Exception: Health Net office visit copayment for severe conditions is $15 per visit. Alcohol & Chemical Dependency Treatment No Charge for prescribed residential rehabilitation, up to 30 days per calendar year. $100 per admission for transitional residential recovery services, up to 60 days per year, not to exceed 120 days in any 5 consecutive calendar years. No Charge; limited to 30 days per calendar year, combined with inpatient mental health days. Outpatient $20 per visit $30 per visit; Limited to 20 visits per year, combined with mental health benefit. Subject to deductibles and Subject to deductibles and Not covered Benefits are limited to two treatments per individual. 100% for first treatment, 80% for second treatment. Must use PPO provider or no benefits are payable. Subject to deductibles, but not subject to out of pocket limits. Maximum of $2,500 for treatment received from a Non-Contract Facility if no outpatient program available from a Contract Facility in the Preferred Provider Service Area. Subject to deductibles and out of pocket limits. Included in the above two treatments. Other Medical Services Home Health Care No Charge $20 per visit; Co-payment begins on 31st day of service Skilled Nursing Facilities No Charge; Limited to 100 days per calendar year. No Charge; Limited to 100 days per calendar year. Subject to deductible and annual out of pocket limit. Subject to deductibles and 4 Retiree Plan Comparison

Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare Short Term Therapy (Physical, Speech, Occupational) Chiropractic $20 per visit No Charge; Limited to 60 consecutive days per episode. Self-referral; must use network providers; $10 per visit, up to 30 visits per year Self-referral; must use network providers; $10 per visit, up to 20 visits per year Acupuncture Available with referral Contact Health Net s Well Choices Department 1(888)793-7746 for a listing of providers that offer a discount. (This is not a benefit). Subject to deductibles and Maximum payment of $25 per visit and 20 visits per calendar year. Subject to deductibles. Out of pocket limits do not apply to charges over plan maximums. Benefits are payable for Participant and Spouse only. Maximum payment of $35 per visit and 20 visits per calendar year. Subject to deductibles. Out of pocket limits do not apply to charges over plan maximums. Podiatry $20 per visit $20 per visit Subject to deductibles and Durable Medical Equipment No Charge No Charge Subject to deductibles and Vision Benefits Vision Exam Glasses and Contact Lenses $20 per visit; Must use Kaiser Optical Must use Kaiser Optical. Maximum allowance of $125 for glasses or contact lenses. Benefit renews every 24 months. $20 per visit; Must use contract provider. Lenses and Frames provided every 24 months up to a maximum allowance of $60 for frames. Contact lenses provided every 24 months up to a maximum allowance of $100. Must use contract providers. Vision exam through Vision Service Signature Choice Plan every 12 months after $10 co-payment for exam. Covered through Vision Service Signature Choice Plan after $25 co-payment for materials. Provides one pair of lenses every 12 months and frames every 24 months. Necessary contact lenses paid in full. Retiree Plan Comparison 5

Retail Pharmacy Mail Order Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare Prescription Drugs Hearing Exam & Hearing Aids $10 for generic drug $30 for formulary brand drug Prescriptions from Non- Kaiser providers (other than Dentists) are NOT covered. Maximum 100-day supply $10 for generic drug $30 for formulary brand drug Maximum 100-day supply. Mail orders on reorder prescriptions only. Call your local Kaiser Pharmacy for further details or see Kaiser s website at http:// my.kp.org/ca/carpenter funds/index.html Prescriptions from Non- Kaiser providers (other than Dentists) are NOT covered. $20 per visit; $2,500 maximum for each hearing aid. Hearing aids are provided every 36 months. Retail contract pharmacies only. $10 for generic drug $35 for formulary brand drug $50 for non-formulary brand drug Prescriptions from Dentists are NOT covered. 30-day supply $20 for generic drug $70 for formulary brand drug $100 for non-formulary drug 90-day supply Prescriptions from Dentists are NOT covered. $20 per visit; Hearing aids covered under the Indemnity Plan. Contract pharmacies only. 30-day supply. $10 for formulary generic drug $10 PLUS cost difference between generic and brand for multi-source brand $40 for single source formulary brand. $60 for non-formulary - Certain non-formulary drugs are not covered without prior authorization. Doctors may call 1(800) 797-9791 to receive authorization. $20 for formulary generic drug $20 PLUS cost difference between generic and brand for multi source brand $80 for single source formulary brand $100 for non-formulary - certain non-formulary drugs are not covered without prior authorization. 90-day supply Doctors may call 1(800) 797-9791 to receive authorization for mail order and retail prescriptions. Maximum benefit limits: 100%, up to $800 maximum for each ear, including the exam only if the hearing aid(s) are obtained. Hearing aids provided every 3 years. (Not subject to deductibles or out of pocket limits.) 6 Retiree Plan Comparison

Coverage Areas Benefit Kaiser Health Net Indemnity Plan Not yet eligible for Medicare See attached page for a zip code listing of covered areas. See attached page for a zip code listing of covered areas. PPO/Contract facilities available throughout California and the U.S. Call 1(800) 323-0661(In California) or 1(800) 232-2527 (Outside California) to verify contract facilities. Plan Selections Choice of Physicians Benefit Health Net Indemnity Plan medicare coordinated A Health Maintenance Organization (HMO) that provides prepaid medical, drug, and vision benefits to Participants enrolled in this Plan with guaranteed payment of these benefits. Provider network limited. Participants must live within the Service Area. Members choose a primary care physician from Health Net participating medical group (PMG) or an individual practice association (IPA). The primary care physician manages the member s routine and preventive care and refers patients to specialists as needed. Annual Deductible None $100 per person Plan Lifetime Maximum None None An indemnity plan that provides supplemental benefits to Medicare. Members may utilize the providers of their choice. Co-Payments Shown for each service Inpatient Hospital Benefit: Plan pays the Medicare Part A deductible for the Hospital Services Hospital Emergency Room Physician Office Visits Surgical Services X-rays & Lab Ambulance No Charge $50 per visit, waived if admitted to hospital. $20 per visit No Charge No Charge No Charge Preventive Care Adult Physical Exam $20 per visit Not available first 60 days of each Medicare benefit period. Supplemental Medical Benefits for services for which benefits are provided by Part B of Medicare: After the Plan s $100 deductible, Plan pays 20% of covered customary and reasonable charges if the provider does not accept the Medicare assignment of benefits; or 20% of Medicare s allowable charges if the provider does accept the Medicare assignment of benefits. Retiree Plan Comparison 7

Inpatient Outpatient Severe Mental Illness Benefit Health Net Indemnity Plan medicare coordinated Mental Health No Charge. Limited to 30 days per calendar year, combined benefit for mental health and alcohol & chemical dependency. * $30 per visit * Limited to 20 visits per calendar year. Combined for mental health and alcohol and chemical dependency benefit. *The mental health co-payments and limits shown above do not apply to Severe Mental Illness or Serious Emotional Disturbances of a Child - services for these conditions require the same co-payments as a medical condition. Exception: Health Net office visit copayment for severe conditions is $15 per visit. See Inpatient Hospital Benefit on previous page. See Supplemental Medical Benefits on previous page; covered if covered by Medicare. Inpatient Outpatient Alcohol & Chemical Dependency Treatment No Charge. Limited to 30 days per calendar year, combined benefit for mental health and alcohol & chemical dependency. $30 per visit Limited to 20 visits per calendar year. Combined for mental health and alcohol and chemical dependency benefit. See Inpatient Hospital Benefit on previous page. See Supplemental Medical Benefits on previous page; covered if covered by Medicare. Home Health Care Skilled Nursing Facilities Chiropractic Other Medical Services $20 per visit; Co-payment begins on 31st day of service No Charge. Limited to 100 days per calendar year $10 per visit Self-referral; limited to 20 visits per year. Must use network providers. No supplemental benefits provided for services covered by Part A of Medicare (i.e., the first 100 visits following a qualifying stay in a hospital or skilled nursing facility). See Supplemental Medical Benefits on previous page for services covered by Part B of Medicare. See Inpatient Hospital Benefit on previous page. Plan pays Medicare Part A deductible for first 60 days of each Medicare benefit period. No other supplemental benefits are provided. See Supplemental Medical Benefits. Benefits are only provided for Participant and Spouse only. Durable Medical Equipment No Charge See Supplemental Medical Benefits 8 Retiree Plan Comparison

Benefit Health Net Indemnity Plan medicare coordinated Vision Benefits Vision Exam $20 per visit Vision exam through Vision Service Signature Choice Plan every 12 months after $10 co-payment for exam. Glasses and Contact Lenses Lenses and Frames provided every 24 months up to a maximum allowance of $60 for frames. Contact lenses provided every 24 months up to a maximum allowance of $100. HMO Plan V2. Must use contract providers. Prescription Drugs Retail Pharmacy Mail Order Hearing Exam & Hearing Aids Coverage Areas 30-day supply $10 for generic drug $35 for formulary brand drug $50 for non-formulary brand drug Prescriptions from Dentists are NOT covered. 90-day supply $20 for generic drug $70 for formulary brand drug $100 for non-formulary brand drug Prescriptions from Dentists are NOT covered. $20 per visit Hearing aids covered under the Indemnity Plan. See attached page for zip code listing of covered areas. Covered through Vision Service Signature Choice Plan after $25 co-payment for materials. Provides one pair of lenses every 12 months and frames every 24 months. Necessary contact lenses paid in full. Contract pharmacies only. 30-day supply $10 for formulary generic drug $10 PLUS cost difference between generic and brand for multi-source brand $40 for single source formulary brand. $60 for non-formulary - Certain non-formulary drugs are not covered without prior authorization. Doctors call 1(800) 797-9791 to for authorization. 90-day supply $20 for formulary generic drug $20 PLUS cost difference between generic and brand for multi-source brand $80 for single source formulary brand $100 for non-formulary - certain nonformulary drugs are not covered without prior authorization. Doctors may call 1(800) 797-9791 to receive authorization for mail order and retail prescriptions. 100%, up to $800 maximum for each ear, including the exam only if the hearing aid(s) are obtained. Hearing aids provided every 3 years. (Not subject to deductibles or out of pocket limits.) Providers covered by Medicare. Where to go for more information 1(800) 638-3889 www.healthnet.com Trust Fund Office 1(888) 547-2054 or 1(510) 633-0333 www.carpenterfunds.com Retiree Plan Comparison 9

Plan Selections Choice of Physicians benefit kaiser health net medicare senior advantage A Health Maintenance Organization (HMO) that provides prepaid medical, drug, vision and hearing aid benefits to Participants enrolled in this Plan with a guaranteed payment of these benefits. Participants must live within the Service Area. Members choose a Physician on staff at a Kaiser Permanente facility located in their service area. Routine, preventive, and specialist care are provided at Kaiser Permanente facilities or by Kaiser contract providers. Annual Deductible None None A Health Maintenance Organization (HMO) that provides prepaid medical, drug, and vision benefits to Participants enrolled in this Plan with a guaranteed payment of these benefits. Participants must live within the Service Area. Members choose a primary care physician from a Health Net participating medical group (PMG) or an individual practice association (IPA). The primary care physician manages the member s routine and preventive care and refers patient to specialists as needed. Co-Payments Shown below for each service Shown below for each service Plan Lifetime Maximum None None Hospital Services No Charge No Charge Hospital Emergency Room $50 per visit, waived if admitted to hospital. Physician Office Visits $20 per visit $20 per visit Surgical Services No Charge No Charge X-rays & Lab No Charge No Charge Ambulance No Charge No Charge Preventive Care Adult Physical Exam $20 per visit $20 per visit $50 per visit, waived if admitted to hospital. $20 per visit for Urgent Care Center. Allergy Testing and Treatment $20 per visit $3.00 per injection Allergy Testing - No Charge Allergy Injection - No Charge Allergy Serum - Not Covered Mental Health Inpatient Outpatient No Charge, limited to lifetime maximum of 190 days. $20 per visit for individual or $10 for group therapy. Limited to 20 visits per calendar year. No Charge; limited to lifetime maximum of 190 days. $20 per visit. Severe Mental Illness or Serious Emotional The mental health co-payments and visit/day limits shown above do not apply to Severe Mental Illness or Serious Emotional Disturbance of a Child - services for these Distrubance conditions are covered on the same basis as a medical condition. Exception: Health Net office visit copayment for severe conditions is $15 per visit. Alcohol & Chemical Dependency Treatment Inpatient No Charge for prescribed residential treatment - limited to 30 days per calendar year. $100 per admission for transitional residential recovery services, up to 60 days per year, not to exceed 120 days in any 5 consecutive years. Outpatient $20 per visit $20 per visit No Charge for prescribed residential treatment. 10 Retiree Plan Comparison

benefit kaiser health net medicare senior advantage Other Medical Services Home Health Care No Charge $20 per visit Co-payment begins on 31st day of service. Skilled Nursing Facilities Short Term Therapy (Physical, Speech, Occupational) No Charge Limited to 100 days per calendar year. No Charge $20 per visit No Charge Limited to 60 consecutive days per episode. Chiropractic $10 per visit, up to 30 visits per year. $10 per visit, up to 20 visits per year. Acupuncture Available with referral Contact Health Net s Well Choices Department 1(888)793-7746 for a listing of providers that offer a discount. (This is not a benefit). Durable Medical Equipment No Charge No Charge Vision Benefits Vision Exam $20 per visit Must use Kaiser Optical $20 per visit Glasses and Contact Lenses Retail Pharmacy Mail Order Hearing Exam & Hearing Aids Coverage Areas Must use Kaiser Optical. Maximum allowance of $150 for glasses or contact lenses. Benefit renews every 24 months. Prescription Drugs $10 for generic drug $20 for formulary brand drug Prescriptions from Non-Kaiser providers (other than Dentists) are NOT covered. Maximum 100-day supply $10 for generic drug $20 for formulary brand drug Maximum 100-day supply. Mail orders on reorder prescriptions only. Call your local Kaiser Pharmacy for further details or see Kaiser s website at http://my.kp.org/ca/carpenterfunds/ index.html Prescriptions from Non-Kaiser providers (other than Dentists) are NOT covered. $20 per visit; $2,500 maximum for each hearing aid. Hearing aids are provided every 36 months. See attached page for a zip code listing of covered areas. Where to go for more information 1(800) 464-4000 http://my.kp.org/ca/carpenterfunds/in dex.html Lenses and Frames provided every 24 months up to a maximum allowance of $100 for frames, no charge for lenses. Contact lenses provided every 24 months up to a maximum allowance of $100. Must use contract providers. $10 for generic drug $20 for formulary brand drug $35 for non-formulary brand drug Prescriptions from Non-Health Net providers (other than Dentists) are NOT covered. 30-day supply $20 for generic drug $40 for formulary brand drug $70 for non-formulary drug 90-day supply Prescriptions from Dentists are NOT covered. $20 per visit; Hearing aids covered under the Indemnity Plan. See attached page for a zip code listing of covered areas. 1(800) 638-3889 http://www.healthnet.com Retiree Plan Comparison 11

Dental Benefits Voluntary plan for retirees who choose to purchase coverage. Delta Dental PPO Group #1533 DeltaCare/PMI (Pre-paid dental HMO plan) Group #00907-0001 Retiree Only Retiree & One Dependnet Retiree & More than One Dependent $35.00 $62.00 $103.00 $27.00 $43.00 $59.00 Generic Multi-Source Brand Single Source Formulary Brand Non-Formulary Drug C&R definitions A drug identified by its chemical name - an equivalent version of a brand name drug whose exclusive patent has expired. A brand name drug that has a generic equivalent. A brand name drug that has no generic equivalent and is placed on a list of preferred formulary drugs by the pharmacy benefit manager. A drug that is NOT on a list of preferred formulary drugs. Customary and Reasonable 12 Retiree Plan Comparison

Retiree Plan Comparison 13

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Health Net Commerical HMO Service Areas 90000-90102 91350-91362 92276-92278 93247 94074 95339-95344 95700-95701 96323-96324 90111 91364-91367 92282 93249-93252 94080-94083 95348 95703-95704 96327-96328 90118 91370-91372 92284-92286 93254-93258 94085-94091 95350-95358 95709 96331 90141 91375-91377 92292 93260-93263 94096-94199 95360-95361 95712-95714 96333-96336 90172 91380-91390 92301-92303 93265-93268 94203 95363 95717 96338 90174 91392-91396 92305-92318 93270-93272 94204-94504 95365-95369 95722 96340-96341 90176-90177 91399-91649 92320-92322 93274-93280 94506-94531 95374 95726-95727 96343-96344 90185 91651-91699 92324-92327 93282-93283 94533-94553 95376-95378 95736 96346 90200-90202 91701-91702 92329-92330 93285-93288 94555-94583 95380-95382 95741-95743 96351 90209-90213 91706 92333-92337 93290-93292 94585-94776 95384-95388 95746-95747 96356 90220-90224 91708-91711 92339-92350 93300-93391 94778-94915 95391 95757-95759 96358 90230-90233 91714-91716 92352-92362 93399 94920 95400-95409 95762-95763 96361 90239-90242 91718-91720 92365 93427 94922-94931 95412-95413 95765 96366-96367 90245 91722-91724 92367-92383 93429 94933-94934 95416 95776 96369-96371 90247-90251 91729-91737 92385-92388 93434 94937-94942 95419 95798-95891 96397 90254-90255 91739-91741 92390-92427 93436-93438 94945-94957 95421 95893-95899 96401 90260-90267 91743-91750 92500-92523 93440-93441 94960 95425 95924 96404-96405 90270 91752 92530-92532 93454-93458 94963-94966 95430-95431 95937 96408 90272 91754-91756 92536 93460 94969-94999 95433 95945-95946 96411 90274-90278 91758-91780 92539 93463-93464 95001-95003 95436 95949 96431-96432 90280 91784-91786 92543-92546 93501-93505 95005-95011 95439 95959-95690 96434-96435 90290-90296 91788-91793 92548-92557 93510 95013-95021 95441-95442 95975 96438 90300-90612 91795 92561-92564 93516 95026 95444 96145 96455 90620-90624 91797-91899 92567 93518-93519 95030-95033 95446 96202 96460 90630-90633 91901-91903 92570-92572 93523-93524 95035-95038 95448 96208-96210 96468 90637-90640 91905-91906 92581-92587 93531-93532 95041-95042 95450 96212-96213 96483 90650-90665 91908-91917 92589-92593 93534-93539 95044 95452 96218 96488 90670-90671 91921 92595-92596 93543-93544 95046 95462 96220-96221 96501-96503 90680 91931-93935 92601-92607 93550-93553 95050-95056 95465 96224-96225 96515 90701-90704 91941-91948 92609-92610 93555 95060-95067 95471-95473 96230-96231 96519 90706-90707 91950-91963 92612-92635 93560-93563 95070-95071 95476 96235-96236 96528 90710-90717 91976-91980 92637 93581-93582 95073 95480 96239 96545 90720-90721 91990-91991 92640-92670 93584-93586 95076-95077 95486-95487 96244-96245 96553 90723 91994 92672-92681 93590-93591 95100-95199 95492 96248 96555-96558 90731-90734 92001-92075 92683-92688 93596 95201-95220 95497 96251 96570-96571 90740 92077-92086 92690-92694 93599 95227 95602-95628 96259 96601-96602 90742-91003 92088 92697-92698 93601-93616 95230-95231 95630-95639 96261 96605 91006-91007 92090-92093 92700-92899 93618-93622 95234 95641 96263-96264 96610-96617 91009-91012 92100-92199 93001-93016 93624-93631 95236-95237 95643 96270-96271 96619 91016-91017 92201-92203 93020-93024 93634-93657 95240-95242 95645 96274 96621 91020-91021 92210-92211 93030-93036 93660-93622 95253 95648 96276-96277 96630 91023-91025 92220 93040-93044 93664-93670 95258 95650 96280 96637 91030-91031 92223 93060-93067 93673-93675 95267-95304 95651-95653 96282 96650-96652 91040-91043 92230 93093-93094 93700-93799 95307 95655 96286-96287 96654 91046 92234-92236 93100-93199 94002-94003 95312-95313 95658 96290 96656 91050-91051 92240-92241 93201-93208 94005-94006 95315-95317 95660-95664 96292 96658-96659 91066-91077 92247-92248 93210 94010-94012 95319-95320 95667-95668 96298 96680 91100-91313 92252-92258 93212 94014-94031 95322-95324 95670-95673 96301-96303 96685 91316 92260-92264 93214-93227 94035 95326 95677-95684 96305 96690 91319-91331 92268 93230-93232 94037-94045 95328-95331 95686-95688 96311 96692 91333-91337 92270 93234-93235 94059-94067 95333-95334 95690-95691 96315 96699 91340-91346 92274 93237-93245 94070-94071 95336-95337 95693-95698 96319 96266 Jan-07 Retiree Plan Comparison 15

Health Net EPO Service Areas 93401 95251 95456 95563 95935 96011 96121 93402 95252 95457 95564 95936 96013 96122 93403 95254 95458 95565 95938 96016 96123 93405 95255 95459 95569 95939 96017 96124 93406 95257 95460 95570 95940 96019 96125 93407 95305 95461 95571 95941 96020 96126 93408 95306 95463 95573 95942 96021 96127 93409 95309 95464 95585 95943 96022 96128 93410 95310 95466 95587 95944 96028 96129 93412 95311 95467 95589 95947 96029 96130 93420 95314 95468 95601 95948 96033 96132 93421 95318 95469 95640 95950 96035 96135 93422 95321 95470 95642 95951 96040 96136 93423 95325 95481 95644 95953 96047 96137 93424 95327 95482 95645 95954 96049 93428 95329 95485 95646 95955 96051 93430 95335 95488 95654 95956 96055 93432 95338 95490 95659 95957 96056 93433 95343 95493 95665 95958 96059 93435 95345 95494 95666 95961 96061 93442 95346 95501 95668 95962 96062 93443 95347 95502 95669 95963 96063 93444 95364 95503 95674 95965 96065 93445 95370 95511 95675 95966 96068 93446 95372 95514 95676 95967 96069 93447 95373 95518 95685 95968 96070 93448 95375 95519 95689 95969 96071 93449 95379 95521 95692 95970 96073 93452 95383 95524 95699 95971 96074 93453 95389 95525 95901 95972 96075 93461 95410 95526 95903 95973 96078 93465 95415 95528 95910 95974 96079 93475 95417 95534 95912 95976 96080 93483 95418 95536 95913 95978 96084 93623 95420 95537 95914 95979 96087 95221 95422 95540 95915 95980 96088 95222 95423 95542 95916 95981 96089 95223 95424 95545 95917 95982 96090 95224 95426 95546 95918 95983 96092 95225 95427 95547 95919 95984 96095 95226 95428 95549 95920 95987 96096 95228 95429 95550 95922 95988 96099 95229 95432 95551 95923 95991 96103 95232 95435 95553 95925 95992 96105 95233 95437 95554 95926 95993 96106 95245 95443 95555 95927 96001 96109 95246 95445 95556 95928 96002 96113 95247 95449 95558 95929 96003 96114 95248 95451 95559 95930 96007 96117 95249 95453 95560 95932 96008 96118 95250 95454 95562 95934 96009 96119 Jan-07 16 Retiree Plan Comparison

Health Net Medicare Service Areas 90000-90102 91020-91021 91908-91917 92640-92670 93531-93532 94926 95336-95337 95693-95695 90111 91023-91025 91931-91935 92672-92681 93534-93539 94928 95350-95358 95697-95698 90118 91030-91031 91941-91948 92683-92684 93543-93544 94931 95360-95361 95700-95701 90141 91040-91043 91950-91951 92686-92688 93550-93555 94951-94952 95363 95703 90172 91046 91962-91963 92690-92694 93558 94954 95366-95368 95713-95715 90174 91050-91051 91976-91980 92697-92698 93560-93586 94972 95376-95378 95717 90176-90177 91066 91990-91991 92700-92899 93590-93591 94998-94999 95380-95382 95722 90185 91077 91994 93013-93014 93599 95001-95003 95385-95387 95736 90200-90202 91100-91129 92001-92014 93067 94002 95005-95011 95391 95741-95742 90209-90213 91131 92016-92075 93101-93103 94005 95013-95021 95397 95746-95747 90220-90224 91175 92077-92086 93105-93111 94010 95026 95401 95757-95759 90230-90233 91182 92088 93116-93118 94012 95030-95033 95403-95405 95763 90239-90242 91184-91313 92090-92093 93120-93121 94014-94015 95035-95038 95407 95765 90245 91316 92100-92199 93130 94018-94030 95041-95042 95409 95776 90247-90251 91321-91331 92201-92203 93140 94035 95044 95412 95798-95891 90254-90255 91333-91337 92210-92211 93150 94038-94044 95046 95421 95893-95899 90260-90267 91340-91346 92220 93160 94060-94063 95050-95056 95425 95937 90270 91350-91357 92223 93190 94065-94066 95060-95067 95436 90272 91361-91362 92225-92226 93199 94070 95070-95071 95439 90274-90278 91364-91367 92230 93203 94074 95073 95441-95442 90280 91370-91372 92234-92236 93205-93206 94080 95076-95077 95444 90290-90296 91375-91377 92239-92242 93215 94085-94090 95101-95103 95446 90300-90512 91380-91388 92247 93220 94100-94199 95106 95448 90601-90612 91390 92252-92256 93224-93226 94203-94299 95108-95142 95450 90620-90624 91392-91396 92258 93238 94301-94310 95148 95452 90630-90633 91399-91431 92260-92264 93240-93241 94401-94404 95150-95161 95462 90637-90640 91436 92267-92268 93243 94501-94503 95164 95465 90650-90652 91450 92270 93249-93252 94506-94507 95170-95173 95472 90658-90665 91461-91463 92274-92278 93255 94509-94514 95190-95194 95476 90670-906671 91470 92280 93263 94516-94531 95196 95480 90680 91482 92282 93268 94533-94553 95201-95213 95492 90701-90704 91490-91524 92284-92286 93276 94555-94557 95215 95602-95612 90706-90707 91598-91617 92292 93280 94560-94561 95219-95220 95615-95618 90710-90717 91701-91702 92301-92330 93283 94563-94566 95227 95620-95621 90720-90721 91706 92332-92350 93285 94568-94572 95230-95231 95624 90723 91708-91711 92352-92378 93287 94575 95234 95626-95628 90731-90734 91714-91716 92380-92427 93301-93309 94577-94580 95236-95237 95630-95632 90740 91718-91720 92500-92523 93311-93314 94582-94583 95240-95242 95637-95639 90742-90750 91722-91724 92530-92532 93380-93382 94585-94592 95253 95641 90755 91729-91737 92536 93384-93389 94595-94598 95258 95645 90800-90815 91739-91741 92539 93427 94601-94627 95267 95648 90822 91743-91750 92543-92557 93436-93438 94643 95269 95650 90831-90835 91752 92561-92564 93440-93441 94649 95296-95297 95652-95653 90840 91754-91756 92567 93460 94659-94662 95304 95655 90842 91758-91780 92570-92572 93463-93464 94666 95307 95658 90844-90848 91784-91786 92581-92587 93501-93502 94701-94710 95313 95660-95663 90853 91788-91793 92589-92593 93504-93505 94712 95316 95670-95671 90888 91795 92595-92596 93510 94720 95319-95320 95673 91001-91003 91797 92601-92607 93516 94800-94808 95323 95677-95681 91006-91007 91799-91899 92609-92610 93518-93519 94820 95326 95683 91009-91012 91901-91903 92612-92635 93523 94850 95328-95330 95686-95688 91016-91017 91905-91906 92637 93527-93528 94922-94923 95334 95690-95691 Retiree Plan Comparison Jan-07 17

18 Retiree Plan Comparison

Retiree Plan Comparison 19