A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

How to Find a PPO Provider 2 Call Customer Service on the back of your ID card From your computer OR mobile phone, log on to bcbstx.com and click on “Doctors and Hospitals” For Worldwide Assistance, call BLUE ( 2583)

Plan Overview Benefits (In-Network) A&M Care In-Network* You Pay 65+ Plan You Pay Medical Deductible (per plan year) $700 person $2,100 family $500 person – Out-of-Pocket Maximum (per plan year) $5,000 person + $700 deductible $10,000 family + $2,100 deductible $1,400 person + $500 deductible – Office Visit (per visit) Primary Care and Mental Health Providers Specialists $30 copay** $45 copay** 20% coinsurance after deductible Preventive Services (covered at 100%) 0% 3 *Out-of-network benefits are also available. When using out-of-network providers, you pay 50 percent after the out-of-network deductible. **Retirees age 65 and older enrolled in the 65+ Plan are not eligible for copays. Your 65+ Plan benefits are secondary to Medicare. Please refer to your Benefits Booklet for more detailed information. What’s NewBeginning 9/1/2015 Out-of-Pocket Maximum Prescription drug deductible and copays apply to the out-of- pocket maximum along with medical copays and coinsurance

Preventive Coverage What’s covered? Recommended routine gender- and age-specific preventive care, such as annual physical, OB/GYN exams, mammograms and other cancer screenings, well-child care and immunizations – both facility and professional services Preventive coverage provided in-network at 100% with no copay, no deductible Get an annual physical to be sure you get the lowest premium! Remember: Lab tests related to an illness or condition are not considered preventive and may pay differently 4 Inform your doctor’s office that you are scheduling your “annual wellness checkup”

Retiree Information 5 Retirees under age 65 Are considered Network and can use the Network providers Remember: Enroll in BOTH Medicare parts A & B. When you receive your Medicare Card, notify BCBSTX and your Human Resource Office of your Medicare number which includes an alpha character. If you use a Provider that accepts Medicare or is a BCBSTX provider, you cannot be balance billed. Retirees age 65 and older Choose from: A&M Care Plan 65 Plus – you must be: –Age 65 and enrolled in Medicare Parts A&B or disabled under 65 and enrolled in Medicare Parts A&B –Working for the A&M System, if at all, less than 50% time or for less than 4.5 months during the plan year –If covering dependents, spouse must be age 65 or older (or disabled) and enrolled in Medicare Parts A&B

Retiree Coordination of Benefits Example A&M CARE PLAN (deductible not met) A&M CARE PLAN (deductible is met) Charge $500 Medicare Paid 80% $400 Patient Share 20% $100 A&M Care Plan Deductible $700MET Applied to Deductible $500Zero BCBSTX Would Have Paid Zero$400 A&M Care Plan Payment Zero$100 Patient’s Responsibility $100Zero Plans calculate the normal plan benefits, then pay that amount, or the difference after Medicare has paid, whichever is less. Your coinsurance will continue until you meet the out-of-pocket maximum, then plan pays at 100%. A&M Care 65 Plus = $1,400 + $500 Individual A&M Care Plan = $5,000 + $700 Per Person / $10,000 + $2,100 Family 6

Preventive Care Immunizations — Covered at 100% Option 1: Go To Personal PhysicianOption 2: Go to Walgreens or HEB Present your ID cardPay the full cost File the claim with Medicare File claim along with the Medicare explanation of benefits with BCBSTX 7 Option 1: Go To Personal PhysicianOption 2: Go to Walgreens or HEB Present your ID card Present your ID card (Pharmacy files claim under BCBSTX Medical Provider Number) If you are an active employee and you want to get a shingles vaccine: If you are 65 or older, or Medicare-eligible and you want to get a shingles vaccine:

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Other Programs & Services

The BVA Benefits Value Advisor EDUCATION GUIDANCE SUPPORT 9 ONE CALL SOLUTION Help you understand your benefits Cost comparison on X-rays, MRIs, CT Scans, maternity services, surgeries Appointment scheduling Find in-network providers Help you access online educational tools

Well onTarget ® Health Assessment Biometrics Preventive care Member Portal and online tools 24/7 Nurseline Behavioral Health Lifestyle management Utilization management Special Beginnings ®’ maternity program Care Coordination and Early Intervention Blue Care Advisors nurse coaching Condition management Case management - complex and catastrophic HEALTHY AT-RISK CHRONIC CONDITION COMPLEX CONDITION BLUE CARE CONNECTION ® An active approach to integrated health management

Save time with self-service support tools and health and wellness resources on a convenient and secure online site. 11 BLUE ACCESS FOR MEMBERS SM

A FULL SUITE OF SELF-DIRECTED AND INTERACTIVE WELLNESS TOOLS Health Assessment Self-paced courses Food and exercise diary Life Points Health and wellness content Fitness Program Complementary and alternative medicine MEMBER PORTAL 12

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14 BCBSTX App Mobile App Overview Centered Healthy Family 5 AlwaysOn Well onTarget® 14 BCBSTX APP Text BCBSTXAPP to Centered Text CENTERED to Healthy Family Text FAMILY to Well onTarget (AlwaysOn) --Download from App Store

Medical benefit coverage questions Help with finding network providers Help from a Benefits Value Advisor ID card requests Help with navigating online tools Health education and transfer to other health programs Claim questions or status Call your BCBSTX customer service team am to 8 pm / CST Monday -Friday Service that Takes You Out of the Middle 15

ID Cards Will Not Be Reissued for 9/1/15 16 Need Assistance? See the back of your ID card for important phone numbers

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association Questions?