BlueEdge HSASM bcbsok.com Rev 11-2013 EMI team A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Copyright © 2013. All rights reserved.

Discussion Items BlueEdge HSASM High Deductible Health Plan Benefits – What are the benefits? Define the benefits Examples Difference between BlueEdge/BlueOptions Premium Difference Health Savings Account What is it? Advantages Eligibility Contribution Rules Benefit Wallet (Bank) Member Experience Rev 11-2013 EMI team * America’s Health Insurance Plans (AHIP), Center for Policy and Research, 2013 Source: BlueEdge Value Story, 2012

What are the Benefit Differences BLUEOPTIONS BLUEEDGE PPO Provider Network BluePreferred (BP) BlueChoice (BC) BlueChoice Office Visit Copayments $30.00 Primary Care $50.00 Specialist No Office Visit Copayments Deductible $750.00 Individual BP/BC/$2,250 Family Embedded* $1,500 Deductible / $3,000 Family Aggregate* Coinsurance 80% In Network 80% Out of Pocket $4,250 Individual/$12,700 Family Embedded* $4,000 Individual/$8,000 Family Aggregate* Pharmacy Benefits $4.00 Generic $50.00 Preferred $100.00 Non Preferred Subject to Deductible and Out of Pocket Maximum – Member must meet deductible before insurance pays Savings Account with Investment Options No Yes Embedded - For services that are subject to the plan deductible, once the Individual Deductible is met, the member does not have to wait for the entire Family Deductible to be satisfied before benefits are payable. Aggregate - For services that are subject to the plan deductible, the entire Family Deductible must be satisfied before benefits are payable

BlueEdge High Deductible Office Visit Claim In Network OFFICE VISIT Member has an office visit for Bronchitis and seeks services from their PCP BlueEdge High Deductible BlueOptions Total Charge: $300.00 Allowable Charge: $250.00 Deductible: $250.00 Member Responsibility: $250.00 Total Charge: $300.00 Allowable Charge: $250.00 Office Visit Copay: $30.00 Deductible: $0.00 Member Responsibility: $30.00 BlueEdge Plan - The members responsibility is $250.00 because there is no office visit copayment on the plan. EVERYTHING, except preventative care will apply to the benefit period deductible before health insurance is paid.

BlueEdge High Deductible Preventative Claim In Network OFFICE VISIT Member has a routine physical BlueEdge High Deductible BlueOptions Total Charge: $200.00 Allowable Charge: $175.00 Member Responsibility: $0.00 Total Charge: $200.00 Allowable Charge: $175.00 Member Responsibility: $0.00 Both plans cover preventative care at 100% of allowable charge. ***Preventative care is the ONLY type of services that will be covered at 100% of allowable when deductible and out of pocket have not been satisfied.

Taking a look at the Hospitalization Claim – Total Benefit Perspective BlueEdge Vs. BlueOptions INPATIENT Member is inpatient and has employee only coverage. BlueEdge BlueOptions Total Charge: $30,000.00 Allowable Charge: $20,000.00 Deductible: $ 1,500.00 20% after Deductible: $ 2,500.00 BCBSOK Paid: $16,000.00 Member Responsibility: $ 4,000.00 Total Charge: $30,000.00 Allowable Charge: $20,000.00 Deductible: $ 750.00 20% after Deductible: $3,500.00 BCBSOK Paid: $16,000.00 Member Responsibility: $ 4,250.00 In this scenario, the member is out of pocket less money because the member out of pocket is lower on the BlueOptions Plan for Employee Only Coverage.

Hospitalization In-Network OFFICE VISIT Member is inpatient and has Family Coverage. No other member has had any claims process for the current year. BlueOptions BlueEdge High Deductible Total Charge: $30,000.00 Allowable Charge: $20,000.00 Deductible: $ 3,000.00 20% after Deductible: $ 5,000.00 BCBSOK Paid: $12,000.00 Member Responsibility: $ 8,000.00 Total Charge: $30,000.00 Allowable Charge: $20,000.00 Deductible: $ 750.00 20% after Deductible: $ 5,000.00 BCBSOK Paid: $15,750.00 Member Responsibility: $ 4,250.00 BlueEdge Plan – The provider can bill the member $3,000 at the time of service when they verify benefit coverage during the admissions process. Family deductible is aggregate which means the entire deductible must be met prior to any payment by BCBSOK. BlueOptions – The provider can bill $750.00 at the time of service when they verify benefits coverage during the admission process. Family deductible is embedded, unlike the BlueEdge High Deductible plan, the individual only has to meet their individual deductible and out of pocket maximum amounts.

Pharmacy Claim Member fills a brand name prescription at the pharmacy. BlueEdge High Deductible BlueOptions Total Charge: $175.00 Allowable Charge: $125.00 Deductible: $125.00 Member Responsibility: $125.00 Total Charge: $175.00 Allowable Charge: $125.00 Copayment: $50.00 Member Responsibility: $50.00 BlueEdge Plan The member will receive a discount at the time of purchase at the pharmacy. There is no copayment for the BlueEdge plan so the member will be required to pay the entire discounted amount at the time of purchase. The claim is transmitted to BCBSOK to apply to the deductible. When the deductible is satisfied, then the member would only be required to pay 20% at the time of purchase.

What are the 2015 premium differences BENEFIT BLUEOPTIONS BLUEEDGE PPO Premium Difference Annualized Employee Only Coverage $491.40 $390.94 $100.46 $1,205.52 Employee and Spouse $1230.50 $978.96 $251.54 $3,018.48 Employee and Dependent $890.70 $708.66 $182.04 $2,184.48 Family $1618.86 $1287.62 $331.24 $3,974.88

What is an HSA? An HSA must be used in combination with a qualified high-deductible health plan (HDHP) A Health Savings Account (HSA) is a tax-exempt account established exclusively for the purpose of paying qualified medical expenses. A higher annual deductible Out-of-pocket maximum applies only to covered expenses No First dollar coverage (100%) except for preventive care benefits without a deductible Rev 11-2013 EMI team High Deductible Health Plan Design An HSA must be used in conjunction with a qualified high-deductible health plan (HDHP) A qualified high-deductible health plan has: A higher annual deductible than typical health plans The out-of-pocket maximum applies only to covered expenses. Out-of-pocket expenses include copayments, deductible and other amounts, but do not include premiums May provide preventive care benefits without a deductible or with a deductible below the minimum annual deductible Preventive care does not include any service or benefit intended to treat an existing illness, injury, or condition 10

HSA ADVANTAGES FOR EMPLOYERS FOR EMPLOYEES For Employers For Employees Lower health insurance premiums Employees make better health care choices FOR EMPLOYEES Protects against high / unexpected medical bills Members decide how much money to put into the account and whether to use it to pay for current qualified medical expenses or save the money for future needs Triple Tax Savings Portability No “use it or lose it” rules HSA ADVANTAGES Rev 11-2013 EMI team HSA Advantages For Employers Two integrated HSA banking options – one offers auto debit payment Lower health insurance premiums by switching to a health insurance plan with a high deductible A way to assist your employees make better health care choices and spending decisions For Employees High deductible insurance and HSA protect against high or unexpected medical bills Members decide how much money to put into the account and whether to use it to pay for current medical expenses or save the money for future needs Triple Tax Savings Tax deductions when members contribute to account Tax-free earnings through investments Tax-free withdrawals for qualified medical expenses Portability Keep the account even if jobs change or retirement – funds remain in the account from year to year, like an IRA No “use it or lose it” rules for HSAs 11

TO BE ELIGIBLE YOU: Must be enrolled in an HSA-compatible High Deductible Health Plan (HDHP) May not have other first dollar medical coverage If an employee enrolls on the HDHP and uses the HSA option, they could not also be covered under their spouses plan that is NOT HDHP compatible meaning it could not have an office visit copayment, or first dollar coverage under pharmacy. May not be claimed as a dependent on another person's tax return May not be enrolled in Medicare An individual can be Medicare eligible and have an HSA. However, once enrolled in Medicare contributions to the HSA account must stop. The individual can keep any funds in the account prior to enrolling in Medicare and use those funds to pay for qualified medical expenses tax-free. Rev 11-2013 EMI team HSA Eligibility To be an eligible individual and qualify for an HSA you: Must be enrolled in an HSA-compatible High Deductible Health Plan (HDHP) May not have other first dollar medical coverage (other types of insurance, accident, disability, etc.) May not be claimed as a dependent on another person's tax return May not be enrolled in Medicare An individual can be Medicare eligible and have an HSA. However, once enrolled in Medicare contributions to the HSA account must stop. The individual can keep any funds in the account prior to enrolling in Medicare and use those funds to pay for qualified medical expenses tax-free. 12

HSA CONTRIBUTION RULES If made by the individual outside a cafeteria plan, contributions are a tax-free deduction If made by the employer, contributions are not taxable to the employee (excluded from income) Contributions can be made by others on behalf of the individual and deducted by the individual If an individual has more than one HSA, the aggregate annual contributions made to all the HSAs are subject to the limit Rev 11-2013 EMI team HSA Contribution Rules If made by the individual outside a cafeteria plan, contributions are an “above-the line” deduction, which is tax-free. If made by the employer, contributions are not taxable to the employee (excluded from income). Contributions can be made by others on behalf of the individual and deducted by the individual. If an individual has more than one HSA, the aggregate annual contributions made to all the HSAs are subject to the limit. All contributions must be aggregated. All HSA contributions made by or on behalf of an eligible individual are combined for purposes of applying the limit.

U.S. TREASURY GUIDELINES FOR 2015 Annual Contributions Self-Only Family HSA Contributions $3,350 $6,650 Minimum Deductible Amounts $1,300 $2,600 Annual Out-of-Pocket (In-network) $6,450 $12,900 “Catch-up” Contributions (Individuals age 55 and older) $1,000* Amounts are adjusted annually for inflation. * No change from calendar year 2014 Rev 11-2013 EMI team HSA Contributions. The IRS determines the minimum/maximum amounts. The amounts are adjusted annually for inflation. Employee, employer or any other person may make contributions on behalf of an eligible individual. 14

FLEXIBILITY OF THE BlueEdge HSASM USERS have multiple options to leverage HSA $$$s SAVERS use personal funds to cover expenses and invest excess HSA account balance Health Care Transaction Excess Balance Investment Options Rev 11-2013 EMI team Flexibility of the BlueEdgeSM HSA The flexible payment platform of the HSA accommodates both “users” and “savers” HSA account balance > Health Care Transaction > 1. Users: have multiple options to leverage HSA $$$s > 2. Savers: use personal funds to cover expenses and invest excess The excess balance from each can then be used as Investment Option

BANKING PARTNER Rev 11-2013 EMI team

BlueEdge HSASM Custodian Integration Features DIMENSIONS OF INTEGRATION INTEGRATION FEATURES Payment Options Automatic Debit ● Online bill pay Payment via debit card/checkbook Enrollment & Eligibility Integrated Enrollment File to Bank Web Services Access to balance & transactional details on BAM via real-time web feed Can access bank via single sign-on Customer Service Integration BCBS handles all “tier 1” questions Warm transfer to bank for detailed Q’s Communications BlueEdge Plan communications Bank custodian communications Rev 11-2013 EMI team 17

THE VALUE OF BlueEdge Banking 2015 Financials* Account Set Up Fees $0 Monthly Maintenance Fees – Accountholder Paid $2.25 waived for balances of $3,000+ Monthly Maintenance Fees – Employer Invoiced/Paid Investment Options 20+ highly rated mutual funds Balance Threshold prior to investing $1,000 Minimum Investment Amount Varies by Fund Investment Fees $2.90 per month Interest Rate (subject to change at ANY time) Flat, earned on first dollar Miscellaneous Other fees may apply Rev 11-2013 EMI team * All banks may have additional, miscellaneous fees. Refer to each bank’s fee schedule for additional information.

Member Experience Rev 11-2013 EMI team

AUTOMATIC HSA DEBIT FOR MEDICAL (BenefitWallet) Member goes to doctor for broken arm AUTO DEBIT ON* BCBSOK requests HSA balance information If balance available, BCBSOK pays provider directly BCBSOK creates consolidated EOB with HSA dollars used If any remaining patient share, member pays doctor after EOB generated AUTO DEBIT OFF* BCBSOK creates EOB that includes patient share Member receives EOB and pays doctor patient share using bank debit card, bank checkbook, or personal funds Rev 11-2013 EMI team Automatic HSA debit for Medical EXAMPLE: Member goes to doctor for broken arm Doctor submits claim to BCBSOK BCBSOK processes claim, determines out-of-pocket liability for member (copay, coinsurance, deductible) Auto debit ON* BCBSOK requests HSA balance information If balance available, BCBSOK pays provider directly BCBSOK creates consolidated EOB with HSA dollars used If any remaining patient share, member pays doctor after EOB generated Auto debit OFF* BCBSOK creates EOB that includes patient share Member receives EOB and pays doctor patient share using bank debit card, bank checkbook, or personal funds *Assumes PPO network provider. Only available with BenefitWallet Doctor submits claim to BCBSOK BCBSOK processes claim, determines out-of-pocket liability for member (copay, coinsurance, deductible) *Assumes PPO network provider. This feature is only available with BenefitWallet. 20 20

AUTOMATIC HSA DEBIT FOR RX (BenefitWallet/Prime) Member goes to a pharmacy to fill a prescription AUTO DEBIT ON* PBM requests HSA balance information If balance available, PBM pulls HSA dollars to pay pharmacy for claim The pharmacist can see amount due from member (zero if HSA covered RX cost, or partial balance if funds covered only part of Rx cost) AUTO DEBIT OFF* Member pays for the RX at the point of sale with bank debit card, bank checkbook, or his/her own personal funds Rev 11-2013 EMI team Automatic HSA debit for Rx EXAMPLE: Member goes to a pharmacy to fill a prescription Pharmacy sends claims to PBM PBM processes claim and determines out of pocket liability for member (copay, coinsurance, deductible) at the point of sale Auto debit ON* PBM requests HSA balance information If balance available, PBM pulls HSA dollars to pay pharmacy for claim The pharmacist can see amount due from member (zero if HSA covered RX cost, or partial balance if funds covered only part of Rx cost) Auto debit OFF* Member pays for the RX at the point of sale with bank debit card, bank checkbook, or his/her own personal funds *Assumes PPO network provider. Only available with BenefitWallet and Prime Pharmacy sends claims to PBM PBM processes claim and determines the out of pocket liability for member (copay, coinsurance, deductible) at the point of sale *Assumes PPO network provider. This feature is only available with BenefitWallet and Prime. 21 21

Rev 11-2013 EMI team

Rev 11-2013 EMI team

Other Resources

MyPrime.com and MyPrimeMail.com Link from Blue Access for Members to: Locate a pharmacy Find drugs / formulary View prescription claim history Create personal drug list Learn about specific drugs Rx Cost Calculator Health information PrimeMail Refill a mail order prescription Check the status of an order Streamlined order refills Manage payment options Add alternative mailing address

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Blue Access Mobile BCBSOK App Features: Member resources Find Doctors or Hospitals near you Shop for Plans Text BCBSOK APP to 33633 to download* *msg and data rates may apply Or visit store links below:

Online Tools and Resources Benefits and Claims ID Card Management Monthly Health Topics Health Assessment Provider Finder® Be Smart. Be Well.® eCards for HealthSM Health Care School Blue Access for MembersSM Cost Estimator tool Member Care Profile Member Discounts Member Wellness Portal Wellness Points Special Beginnings®´ 28

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Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Health Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. © 012 Health Care Service Corporation. All rights reserved.