KPCA Fall Conference 2017 11

What’s new for 2018 QHPs Open Enrollment started 11/01/2017 and will end on 12/15/2017. All applicants that enroll after 12/15/2017 will be considered as a SEP (Special Enrollment Period) and will need to provide proof of a qualifying event to receive coverage. (QE examples – Loss of coverage, a move, or marriage) All Anthem PPO plans will be discontinued as of 1/1/2018. HMO product will be offered in 59 counties. All QHP applicants will receive a 01/01/2018 effective date for Open Enrollment. Anthem dental and vision plans can be sold on a stand alone basis in all 120 counties.

Individual Plans Only Blue counties represent the 59 counties that Anthem will Participate in for 2018. Grey counties represent the 61 counties that Anthem will not participate in for 2018. 29

Discontinuance and Migration Process Anthem PPO members in the 61 counties we are not participating in will get a discontinuance letter explaining that their plan will end as of 12/31/2017. They will be mapped to a CareSource plan to ensure coverage. Anthem members who are currently on a PPO plan within the 59 counties Anthem will participate will get a letter informing them they will be mapped to a HMO plan with the new premium listed on the letter. HMO members in the 59 counties Anthem is participating in will get a letter informing them they will be able to keep their plan for 2018 and will receive a new renewal rate. Please Note : All on-exchange applicants are still required to confirm their subsidy on the FFM website for 2018. (Healthcare.gov) (income verification)

Individual Product Updates

3D Mammogram Preventive Screening Effective 6/6/2017, Preventive care benefit will include Digital Breast Tomosynthesis (DBT or 3D screening mammography) as HCR preventive for all ACA compliant plans. o 3D mammography for screening purposes will be covered at 100% with no member cost share (copayments, percentage of cost or deductibles) when services are provided by a participating/preferred health care professional.

Urgent Care Changes Urgent care will no longer be covered Out-of-Network. It will be covered Out-of-Area (outside KY) if they go to a BlueCard provider. Where possible, many plans have had their urgent care cost share changed to a copay - deductible not applicable.

Individual Product Portfolio

2018 Gold Plan (ON Exchange) Product Name Network Metal INN Ded Single INN Ded Family INN OOP Single Family Coins Anthem Gold Pathway X HMO 1350 Pathway X HMO Gold $1350 $2700 $5800 $11600 20% Pathway X HMO network plans are available in the following counties only: Adair, Allen, Ballard, Barren, Bell, Breathitt, Breckinridge, Butler, Caldwell, Calloway, Carlisle, Christian, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Fulton, Graves, Grayson, Green, Hancock, Hardin, Harlan, Hart, Henderson, Hickman, Hopkins, Johnson, Knott, Lawrence, Lee, Leslie, Letcher, Lewis, Livingston, Logan, Lyon, Magoffin, Marshall, Martin, McCracken, McCreary, McLean, Meade, Metcalfe, Monroe, Muhlenberg, Ohio, Owsley, Pike, Russell, Simpson, Todd, Trigg, Union, W arren, Wayne, and Webster. Pathway Transition X HMO network plans are available in Hardin county.

2018 Silver Plans (ON Exchange) Product Name Network Metal INN Ded Single INN Ded Family INN OOP Single Family Coins Anthem Silver Pathway X HMO 2000 (2VA1) Pathway X HMO Silver $2000 $4000 $7350 $14700 20% Anthem Silver Pathway X HMO 3000 for HSA (2V9V) $3000 $6000 $5700 $11400 10% Anthem Silver Pathway X HMO 3500 (1GHS) $3500 $7000 $5850 $11700 25% Anthem Silver Pathway X HMO 5300 (2EDB) $5300 $10600 $14000 Anthem Silver Pathway X Transition HMO 6350 (2VAH) Pathway X Transition HMO $6350 $12700 Pathway X HMO network plans are available in the following counties only: Adair, Allen, Ballard, Barren, Bell, Breathitt, Breckinridge, Butler, Caldwell, Calloway, Carlisle, Christian, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Fulton, Graves, Grayson, Green, Hancock, Hardin, Harlan, Hart, Henderson, Hickman, Hopkins, Johnson, Knott, Lawrence, Lee, Leslie, Letcher, Lewis, Livingston, Logan, Lyon, Magoffin, Marshall, Martin, McCracken, McCreary, McLean, Meade, Metcalfe, Monroe, Muhlenberg, Ohio, Owsley, Pike, Russell, Simpson, Todd, Trigg, Union, W arren, Wayne, and Webster. Pathway Transition X HMO network plans are available in Hardin county.

2018 Bronze Plans (ON Exchange) Product Name Network Metal INN DED Single Family INN OOP Coins Anthem Bronze Pathway X HMO 6100 (1GG6) Pathway X HMO Bronze $6100 $12200 $7350 $14700 40% Anthem Bronze Pathway X HMO 6650 for HSA (2V9S) $6650 $13300 0% Anthem Bronze Pathway X Transition HMO 6750 (2VAD) Pathway X Transition HMO $6750 $13500 Pathway X HMO network plans are available in the following counties only: Adair, Allen, Ballard, Barren, Bell, Breathitt, Breckinridge, Butler, Caldwell, Calloway, Carlisle, Christian, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Fulton, Graves, Grayson, Green, Hancock, Hardin, Harlan, Hart, Henderson, Hickman, Hopkins, Johnson, Knott, Lawrence, Lee, Leslie, Letcher, Lewis, Livingston, Logan, Lyon, Magoffin, Marshall, Martin, McCracken, McCreary, McLean, Meade, Metcalfe, Monroe, Muhlenberg, Ohio, Owsley, Pike, Russell, Simpson, Todd, Trigg, Union, W arren, Wayne, and Webster. Pathway Transition X HMO network plans are available in Hardin county.

2018 Catastrophic plan (ON Exchange) Product Name Network Metal INN DED Single Family INN OOP Coins Anthem Catastrophic Pathway X HMO 7350 (2VAG) Pathway X HMO Cat $7350 N/A 0% Pathway X HMO network plans are available in the following counties only: Adair, Allen, Ballard, Barren, Bell, Breathitt, Breckinridge, Butler, Caldwell, Calloway, Carlisle, Christian, Clinton, Crittenden, Cumberland, Daviess, Edmonson, Fulton, Graves, Grayson, Green, Hancock, Hardin, Harlan, Hart, Henderson, Hickman, Hopkins, Johnson, Knott, Lawrence, Lee, Leslie, Letcher, Lewis, Livingston, Logan, Lyon, Magoffin, Marshall, Martin, McCracken, McCreary, McLean, Meade, Metcalfe, Monroe, Muhlenberg, Ohio, Owsley, Pike, Russell, Simpson, Todd, Trigg, Union, W arren, Wayne, and Webster. Pathway Transition X HMO network plans are available in Hardin county.

Questions?