Health Net SDCERS Audrey Mueller Rollins

Suite of Offerings Non-Medicare (Early Retirees) Medicare (Retirees) Pam White Health Net Privileged & Confidential

Non-Medicare Plans HMO PPO Out-of-State PPO Pam White Health Net Privileged & Confidential

In-Network Only (Primary Care Physician Required) HMO Plan (Non-Medicare) Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum (Individual/Family) $1,500/$3,000 Physician Office Visit Copay (Primary& Specialist) $20 copay Lab & X-ray CT, MRI or PET No charge Inpatient Hospitalization $100 copay Outpatient Surgery $50 copay Emergency Room Visit (waived if admitted) $75 copay Ambulance Prescription Coverage (30-day supply) $15 Generic/$30 Brand Prescription by Mail (90-day supply) $30 Generic/$60 Brand

PPO Plan (Non-Medicare) Medical Plan Features In-Network Only Out- of- Network Calendar Year Deductible (Individual/Family) $500 /$1,500 (PPO/OON combined) Out-of-Pocket Maximum (Individual/Family) $3,000/$9,000 $6,000/$18,000 Physician Office Visit Copay (Primary/Specialist) $25 copay 40% after deductible Lab & X-ray /CT, MRI or PET 20% after deductible Inpatient Hospitalization Outpatient Surgery Emergency Room Visit (deductible waived if admitted) (additional $100 if not admitted) Ambulance $50+20% after deductible $50+40% after deductible Prescription Coverage (30-day supply) $15 Generic/$30 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Prescription by Mail (90-day supply) $30 Generic/$60 Brand

Out-Of-State PPO Plan (Non-Medicare) Medical Plan Features In-Network Only Out- of- Network Calendar Year Deductible (Individual/Family) $500 /$1,500 (PPO/OON combined) Out-of-Pocket Maximum (Individual/Family) $3,000/$9,000 $6,000/$18,000 Physician Office Visit Copay (Primary/Specialist) $25 copay 40% after deductible Lab & X-ray /CT, MRI or PET 20% after deductible Inpatient Hospitalization Outpatient Surgery Emergency Room Visit (deductible waived if admitted) (additional $100 if not admitted) Ambulance $50+20% after deductible $50+40% after deductible Prescription Coverage (30-day supply) $15 Generic/$30 Brand $15+50% AWP/Retail (Generic) $30+50% AWP/Retail (Brand) Prescription by Mail (90-day supply) $30 Generic/$60 Brand

Medicare Plans Seniority Plus HMO COB Flex Net COB Pam White Health Net Privileged & Confidential

In-Network Only (Primary Care Physician Required) Seniority Plus (Medicare Advantage Plan) Works like a traditional HMO plan where PCP coordinates care Retirees must have both Medicare Part A and Medicare Part B Retirees “assign” their Medicare to Health Net. Health Net provides all Medicare covered services Part D prescription drug coverage and benefits administered by Health Net. Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum $3,400 Physician Office Visit Copay $10 copay Lab & X-ray, CT, MRI or PET No charge Inpatient Hospitalization Outpatient Surgery $50 copay Emergency Room Visit (waived if admitted) Prescription Coverage (30-day supply) $10 Generic/$20 Brand Prescription by Mail (90-day supply) $30 Generic/$60 Brand

Flex Net COB NOT a Medicare Advantage Plan (benefits are NOT assigned to Health Net). An Indemnity Plan No provider network. You can go to any physician who accepts Medicare assignment Retirees must have Medicare Part A and B for benefit coordination Part D prescription drug is administered by Silverscripts so members of this plan will have two cards (medical ID card and pharmacy ID card) Medical Plan Features Calendar Year Deductible None Out-of-Pocket Maximum (Indiv/Family) $6,350/$12,700 Physician Office Visit Copay (Primary/Specialist) No charge Lab & X-ray, CT, MRI or PET Inpatient Hospitalization Varies by number of days Outpatient Surgery Emergency Room Visit (in U.S.; waived if admitted) Prescription Coverage (30-day supply) $10 Generic/$20 Brand/$35 Non-Formulary/25% Spec Prescription by Mail (90-day supply) $30 Generic/$60 Brand/$105 Non-Formulary/25% Spec

In-Network Only (Primary Care Physician Required) HMO COB Works like a traditional HMO plan where PCP coordinates care Retirees must have Medicare Part A and B for coordination Retirees do NOT assign their Medicare benefits to Health Net Medicare pays first; Health Net second Part D prescription drug is administered by Silverscripts so members of this plan will have two cards (medical ID card and pharmacy ID card) Medical Plan Features In-Network Only (Primary Care Physician Required) Calendar Year Deductible None Out-of-Pocket Maximum (Indiv/Family) $1,500 / $3,000 Physician Office Visit Copay (Primary/Specialist) $15 Lab & X-ray, CT, MRI or PET No charge Inpatient Hospitalization $100 per admit Outpatient Surgery $50 Emergency Room Visit (waived if admitted) Prescription Coverage (30-day supply) $15 Generic/$30 Brand/$50 Non-Formulary/25% Spec Prescription by Mail (90-day supply) $45 Generic/$90 Brand/$150 Non-Formulary/25% Spec

Privileged & Confidential Member Perks Pam White Health Net Privileged & Confidential

Decision Power Nurse 24 (Nurse Advice) Decision Power Nurse 24 - Registered nurses are available 24 hours a day, 7 days a week answer any of your health questions. Talk to a Registered Nurse - a trained professional, available 24 hours a day, to support you for any and every health question, goal or situation. Ask about our intensive education programs for weight loss and tobacco cessation. Benefits of Nurse 24 Prevent unnecessary office/ER visits Reinforce treatment plans Empower participants Ability to immediately address special needs

Discount Programs All our Health Net members are rewarded with discounts regardless which plan you sign-up on. So look for this flyer in your packets. Some of the discounts that you’ll receive; Receive a 25% discount off the usual and customary fees from contracted acupuncturists, chiropractors and massage therapists. Through the ChooseHealthystore, you can buy vitamins, minerals and herbal supplements at a discount – up to 40% off the suggested retail price. Health Net members receive free standard shipping on most orders. For Gym’s a minimum 10% discount off initiation and/or monthly dues. Last but not least, popular Weight Management programs; with Jenny Craig and Weight Watchers.

Health Coaching Complimentary! > Weight Loss > Nutrition > Exercise > Stress > Smoking Cessation Wellness health coaching Based on your HRQ results, you may be eligible for wellness health coaching, giving you unlimited access to a registered dietitian, respiratory therapist, health educator, or social worker, offering ongoing support in reaching your goals and sustaining positive behavioral changes. Our whole-person approach reduces the risk of preventable diseases, such as coronary artery disease and diabetes and promotes healthy behaviors, including, but not limited to: • Healthy weight maintenance. • Smoking and tobacco cessation (See Quit for Life® below). • Physical activity. • Healthy eating and nutrition. • Managing stress.

Healthy Living Programs & On-line Seminars Classes on emotional health, exercise, nutrition, smoking cessation, stress management, and weight management. 

Silver & Fit * – Fitness/Gym * This program is limited to Health Net Seniority Plus members

Silver & Fit* - Chiropractic No PCP Referral Required! To locate a participating chiropractor near you, go to www.choosehealthy.com * This program is limited to Health Net Seniority Plus members

Thank you!