2015 HEALTH INSURANCE OPTIONS

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INSURANCE PLUS Rose Gagliardi 15 West Main Street President Oyster Bay, NY 11771 516-922-1200 / 212-268-4473 516-922-2801 fax rose@insuranceplusny.com www.insuranceplusny.com September 16, 2015 2015 HEALTH INSURANCE OPTIONS Health Republic (www.healthrepublicny.org) Primary Select Gold (Magnacare Extra network) InNetwork Only, No Referrals $0 to Selected PCP, otherwise $25 / Specialist $75 Single $500 Deductible / Coinsurance $250/$500(Family) Deductible / 20% Coinsurance Couple $1,001 Maximum Out of Pocket $3,500 / $7,000 (Family) Parent/Child $851 Prescription Plan $10/$35/$70 Deductible waived for Tier1 Generics Family $1,426 Essential Care Silver (Magnacare Extra network) InNetwork Only, No Referrals $30 after deductible / Specialist $50 after Deductible Single $429 Deductible / Coinsurance $2,000/$4,000(Family) Deductible / 30% Coinsurance Couple $857 Maximum Out of Pocket $5,500 / $11,000(Family) Parent/Child $729 Prescription Plan $10/$35/$70 Family $1,222 Essential Care Bronze HSA (Magnacare Extra network) InNetwork Only, No Referrals 50% after Deductible Single $351 Deductible / Coinsurance $3,000/$6,000(Family) Deductible / 50% Coinsurance Couple $701 Maximum Out of Pocket $6,350 / $12,700(Family) Parent/Child $596 Prescription Plan $10/$35/$70 after Deductible Family $999

CareConnect - North Shore LIJ (www.nslijcareconnect.com) Platinum (NSLIJ CareConnectNetwork) InNetwork Only, No Referrals PCP $15/ Specialist $35 Single $547 Deductible / Coinsurance N/A Couple $1,094 Maximum Out of Pocket $2,000 / $4,000(Family) Parent/Child $930 Prescription Plan $10/$30/$60 Family $1,559 Gold (NSLIJ CareConnectNetwork) InNetwork Only, No Referrals $25 after deductible / Specialist $40 after Deductible Single $476 Deductible / Coinsurance $600/$1,200(Family) Deductible / 20% Coinsurance Couple $952 Maximum Out of Pocket $4,000 / $8,000(Family) Parent/Child $809 Prescription Plan $10/$35/$70 Family $1,357 Silver (NSLIJ CareConnectNetwork) InNetwork Only, No Referrals $30 after deductible / Specialist $50 after Deductible Single $420 Deductible / Coinsurance $2,000/$4,000(Family) Deductible / 30% Coinsurance Couple $840 Maximum Out of Pocket $5,500 / $11,000(Family) Parent/Child $714 Prescription Plan $10/$35/$70 Family $1,197 Bronze (NSLIJ CareConnectNetwork) InNetwork Only, No Referrals 50% after Deductible Single $334 Deductible / Coinsurance $3,000/$6,000(Family) Deductible / 50% Coinsurance Couple $668 Maximum Out of Pocket $6,350/ $12,700(Family) Parent/Child $568 Prescription Plan $10/$35/$70 After Deductible Family $952 Empire Blue Cross Blue Shield (www.empireblue.com) Platinum HMO Standard (Pathway Enhanced Network) In-network Only, Referrals Required Deductible / Coinsurance Maximum Out of Pocket Prescription Plan PCP $15 / Specialist $35 N/A $2,000 / $4,000 (Family) $10/$30/$60 Gold HMO 600 Standard (Pathway Enhanced Network) In-network Only, Referrals Required Deductible/Coinsurance Maximum Out of Pocket Prescription Plan PCP $25 after Deductible / Specialist $40 after Deductible $600/$1,200 (Family) Deductible / 0% Coinsurance $4,000 / $8,000 (Family) $10/$35/$70 Single Couple Parent/Child Family Single Couple Parent/Child Family Silver HMO 2250 Non-Standard (Pathway Enhanced Network) In-network Only, Referrals Required Deductible / Coinsurance Maximum Out of Pocket Prescription Plan PCP $30 / Specialist Deductible + Coinsurance $2,250/$4,500 (Family) Deductible / 25% Coinsurance $5,800 / $11,600 (Family) Deductible & Coinsurance Single Couple Parent/Child Family Bronze HMO 3000 Standard HSA (Pathway Enhanced Network) In-network Only, Referrals Required Deductible / Coinsurance Maximum Out of Pocket Prescription Plan Deductible & Coinsurance $3,000/$6,000 (Family) Deductible / 50% Coinsurance $6,350 / $12,700 (Family) Deductible & Coinsurance Single Couple Parent/Child Family $666 $1,332 $1,132 $1,898 $562 $1,124 $955 $1,602 $459 $918 $780 $1,308 $405 $809 $688 $1,153

Oscar (www.hioscar.com) Platinum Standard (Oscar Network) InNetwork Only, No Referrals $15 / Specialist $35 Single $591 Deductible / Coinsurance N/A Couple $1,183 Maximum Out of Pocket $2,000/$4,000(family) Parent/Child $1,005 Prescription Plan $10/$30/$60 Family $1,685 Gold Standard (Oscar Network) InNetwork Only, No Referrals $25 after Deductible / Specialist $40 after Deductible Single $512 Deductible / Coinsurance $600/$1,200(Family) Deductible / 0% Couple $1,024 Maximum Out of Pocket $4,000 / $8,000(Family) Parent/Child $870 Prescription Plan $10/$35/$70 Family $1,459 Silver Edge Plus (Oscar Network) InNetwork Only, No Referrals 2 Free then $30 after Deductible / Specialist $50 after Deductible Single $428 Deductible / Coinsurance $2,500/$5,000(Family) Deductible / 0% Couple $857 Maximum Out of Pocket $5,600 / $11,200 (Family) Parent/Child $728 Prescription Plan $0/$35/$150 Family $1,221 Bronze Standard HSA (Oscar Network) InNetwork Only, No Referrals 50% after Deductible / Specialist 50% after Deductible Single $352 Deductible / Coinsurance $3,000/$6,000(Family) Deductible / 50% Coinsurance Couple $705 Maximum Out of Pocket $6,350 / $12,700(family) Parent/Child $599 Prescription Plan $10/$35/$70 after Plan Deductible Family $1,004 Simple 1000 (Oscar Network) InNetwork Only, No Referrals 2 Free then $0 after Deductible / Specialist $0 after Deductible Single $572 Deductible / Coinsurance $1,000 / $2,000(Family) Deductible / 0% Couple $1,144 Maximum Out of Pocket $1,000 / $2,000(Family) Parent/Child $972 Prescription Plan $0 for Generics/ $0 after Plan Deductible for T2&T3 Family $1,630 Simple 2500 (Oscar Network) InNetwork Only, No Referrals 2 Free then $0 after Deductible / Specialist $0 after Deductible Single $476 Deductible / Coinsurance $2,500 / $5,000(Family) Deductible / 0% Couple $952 Maximum Out of Pocket $2,500 / $5,000(Family) Parent/Child $809 Prescription Plan $0 for Generics/ $0 after Plan Deductible for T2&T3 Family $1,356 Simple 4000 (Oscar Network) InNetwork Only, No Referrals 2 Free then $0 after Deductible / Specialist $0 after Deductible Single $406 Deductible / Coinsurance $4,000 / $8,000(Family) Deductible / 0% Couple $812 Maximum Out of Pocket $4,000 / $8,000(Family) Parent/Child $690 Prescription Plan $0 for Generics/ $0 after Plan Deductible for T2&T3 Family $1,157 Simple 6600 (Oscar Network) InNetwork Only, No Referrals 2 Free then $0 after Deductible / Specialist $0 after Deductible Single $341 Deductible / Coinsurance $6,600 / $13,200(Family) Deductible / 0% Couple $683 Maximum Out of Pocket $6,600 / $13,200(Family) Parent/Child $580 Prescription Plan $0 for Generics/ $0 after Plan Deductible for T2&T3 Family $973

Emblem Health (www.emblemhealth.com) Platinum (Select Care Network) InNetwork Only, Referrals Required PCP $15/ Specialist $35 Single $601 Deductible / Coinsurance N/A Couple $1,202 Maximum Out of Pocket $2,000 / $4,000(Family) Parent/Child $1,022 Prescription Plan $10/$30/$60 Family $1,713 Gold (Select Care Network) InNetwork Only, Referrals Required $25 after deductible / Specialist $40 after Deductible Single $493 Deductible / Coinsurance $600/$1,200(Family) Deductible / 20% Coinsurance Couple $986 Maximum Out of Pocket $4,000 / $8,000(Family) Parent/Child $838 Prescription Plan $10/$35/$70 Family $1,405 Silver (Select Care Network) InNetwork Only, Referrals Required $30 after deductible / Specialist $50 after Deductible Single $407 Deductible / Coinsurance $2,000/$4,000(Family) Deductible / 30% Coinsurance Couple $815 Maximum Out of Pocket $5,500 / $11,000(Family) Parent/Child $692 Prescription Plan $10/$35/$70 Family $1,161 Bronze (Select Care Network) InNetwork Only, Referrals Required 50% after Deductible Single $354 Deductible / Coinsurance $3,000/$6,000(Family) Deductible / 50% Coinsurance Couple $709 Maximum Out of Pocket $6,350/ $12,700(Family) Parent/Child $602 Prescription Plan $10/$35/$70 After Deductible Family $1010

HEALTH INSURANCE OPTIONS For CORPORATION / LLC OXFORD Platinum FREEDOM PPO: NO REFERRALS REQUIRED When using FREEDOM providers, you have a: Office Visit - $10 Primary Copay / $20 Specialist Copay No Plan Deductible Emergency Room - $100 Outpatient Facility - $100 copay Hospital Admission - $150 When using YOUR OWN providers, you have a: Deductible - $2,000/$4,000 Individual/Family Coinsurance - 30 % Emergency Room - $100 Outpatient Facility 30% after Deductible Hospital Admission 30% after Deductible Prescription Drug Card - $10/$30/$60 $100 Deductible Tier 2/3 *MONTHLY RATE: $998 Single/ $1,995 Couple**/ $1,696 Single Parent / $2,843 Family PHYSICIAN DIRECTORY: WWW.OXHP.COM OXFORD Platinum FREEDOM EPO: NO REFERRALS REQUIRED When using FREEDOM providers, you have a: Office Visit - $20 Primary Copay / $30 Specialist Copay No Plan Deductible Emergency Room - $150 Outpatient Facility - $300 copay Hospital Admission - $500 Prescription Drug Card - $10/$30/$60 $100 Deductible Tier 2/3 *MONTHLY RATE: $903 Single / $1,806 Couple / $1,535 Single Parent / $2,573 Family PHYSICIAN DIRECTORY: WWW.OXHP.COM

OXFORD Gold FREEDOM EPO: NO REFERRALS REQUIRED When using FREEDOM providers, you have a: Deductible - $1,250/$2,500 Individual/Family Coinsurance - 10 % Office Visit - $20 Primary Copay / $40 Specialist Copay Emergency Room - $200 copay Outpatient Facility - $250 copay after Deductible Hospital Admission 10% after Deductible Prescription Drug Card - $15/$35/$75 $100 Deductible Tier 2/3 *MONTHLY RATE: $770 Single / $1,539 Couple / $1,308 Single Parent / $2,193 Family PHYSICIAN DIRECTORY: WWW.OXHP.COM OXFORD Silver LIBERTY EPO: NO REFERRALS REQUIRED When using LIBERTY providers, you have a: Deductible - $2,000/$4,000 Individual/Family Coinsurance - 30 % Office Visit - $40 Primary Copay / $70 Specialist Copay Emergency Room 30% after Deductible Outpatient Facility - $250 copay after Deductible Hospital Admission 30% after Deductible Prescription Drug Card - $15/$35/$75 $100 Deductible Tier 2/3 *MONTHLY RATE: $651 Single / $1,302 Couple / $1,107 Single Parent / $1,856 Family PHYSICIAN DIRECTORY: WWW.OXHP.COM

AETNA NYC Community Plan $30: REFERRALS REQUIRED When using AETNA NYC Community Plan providers, you have a: No Plan Deductible Office Visit - $30 Primary Copay /$50 Specialist Copay Emergency Room - $150 Outpatient Facility - $150 copay Hospital Admission - $1,000 Urgent Care - $35 Prescription Drug Card - $10/$50/50% to $750 *MONTHLY RATE: $592 Single / $1,183 Couple / $1,006 Single Parent/ $1,686 Family PHYSICIAN DIRECTORY: WWW.AETNA.COM EMBLEM GOLD Select Care HMO: REFERRALS REQUIRED When using Select Care providers, you have a: No Plan Deductible Office Visit - $40 Primary Copay /$60 Specialist Copay Emergency Room - $200 Outpatient Facility - $150 copay Hospital Admission - $1,500 Urgent Care - $60 Prescription Drug Card - $15/$35/$75 ($100 Deductible Tier 2/3) *MONTHLY RATE: $526 Single/ $1,051 Couple/ $894 Single Parent / $1,498 Family PHYSICIAN DIRECTORY: WWW.EMBLEMHEALTH.COM

LARGE GROUP / PEO PLANS Eligibility Required HIP OXFORD EMPIRE CIGNA Not subject to open enrollment

DENTAL INSURANCE OPTIONS For CORPORATION/LLC **OXFORD (OBM) DENTAL / VISION PLAN: ELITE SPECIALTY PLAN OPTION DENTAL BENEFIT Can use Oxford provider or provider of choice. No Waiting Period on Basic and Major Services (optional) $50/$100 Annual Deductible $1,500 Annual Maximum ($1,000 optional) Discounts include Wellness, Alternative Medicine, and Infertility When using an Oxf ord PROVIDER, you have a: 100% Coverage for Preventative 80% Coverage after Deductible for Basic Restorative 50% Coverage after Deductible for Major Care When using YOUR OWN DOCTOR**, you have a: 100% Coverage for Preventative 80% Coverage after Deductible for Basic Restorative 50% Coverage after Deductible for Major Care **Out-of-network benefits are paid based on UHC Dental s Maximum Allowable Charge. VISION BENEFIT Can use Oxford provider or provider of choice. Benefits include eye exams, frames, lenses, contact lenses. Benefits are subject to copays and reimbursement schedule. *MONTHLY RATES: $50 Single / $91 Couple / $95 Single Parent / $141 Family *Rates are subject to change and to final underwriting. **ADDITIONAL PROGRAMS ARE AVAILABLE. PROVIDERS DIRECTORY: WWW.OXHP.COM

DENTAL INSURANCE OPTIONS For INDEPENDENT CONTRACTORS GUARDIAN Managed Choice DMO DENTAL PLAN When using a GUARDIAN Managed DentalGuard Network dentist, you have a: *RATES VALID UNTIL 10/31/2015 Deductible - $0 No Annual Maximum No Waiting Period Office Visit - $5 copay Preventive Exam, Cleanings, X-rays No charge Fee Schedule applies for: Diagnostic / Basic Restorative/ Periodontal / Endodontic / Oral Surgery Prosthetics Repairs / Crown and Bridges / Dentures /Orthodontic *MONTHLY RATES: $50 Single / $76 Emp + 1 / $102 Family PROVIDERS DIRECTORY: WWW.GUARDIANLIFE.COM (MANAGED DENTALGUARD NETWORK) UNITED CONCORDIA DENTAL PLAN: DENTAL BENEFIT Can use UnitedConcordia provider or provider of choice. Deductible - $50 single/$150 family No Waiting Period on Basic and Major Services No Pre-Existing Condition Limitations $1,500 Annual Maximum When using a UNITED CONCORDIA provider, you have a: Preventive Exam, Cleanings, X-rays No charge (deductible waived) Basic Restorative 90% after Deductible Major Care 60% after Deductible When using YOUR OWN DOCTOR, you have a: Preventive Exam, Cleanings, X-rays No charge after Deductible Basic Restorative 80% after Deductible Major Care 50% after Deductible *MONTHLY RATES: $61 Single / $129 Couple / $122 Single Parent / $162 Family *RATES VALID UNTIL 12/31/2015 PROVIDERS DIRECTORY: WWW.UNITEDCONCORDIA.COM (ADVANTAGE PLUS NETWORK)

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