1. Northern CA, LA & Orange County, Southern CA
California
Northern CA, LA & Orange County, Southern CA
Amerilife Agent Value Prop Overview
9/9/13
AGENT TRAINING ONLY

2. 2014 Anticipated MA Plan Footprint
2014 MA Territory
County
Medicare Eligible
Existing HMO
Fresno
101,125
Kings
12,887
Madera
18,350
Alameda
181,414
Contra Costa
151,655
San Joaquin
76,591
San Francisco
117,309
Tulare
46,775
 Existing MA Counties Total
Total
740,435
2014 Expansion HMO Counties
Santa Barbara
66,854
Santa Clara
223,786
Santa Cruz
33,728
Stanislaus
63,215
Ventura
116,618
504,201
All MA Counties Total
1,244,636

3. Bay Area HMO Counties

4. 2014 MA Plan Summaries Current HMOs
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $10
Hospital: $250 per days 1-5
PDP Benefit: $3/$10/$45/$95/25%
Plan Type: HMO
Premium: $19
MOOP: $5,000
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $5/$10/$45/$95/33%
Premium: $ 49
MOOP: $3,400
PCP: $0 Specialist: $0
Hospital: $0 per days 1-3, $300 per days 4-7
PDP Benefit: $0/$10/$45/$95/33%; Full Tier Gap Cvg: Tier 1 - $0, Tier 2: $10
Alameda I

5. 2014 MA Plan Summaries Current HMOs
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $10
Hospital: $395 per days 1-4
PDP Benefit: $3/$10/$45/$95/25%
Plan Type: HMO
Premium: $19
MOOP: $5,000
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $5/$10/$45/$95/33%
Premium: $ 49
MOOP: $3,400
PCP: $0 Specialist: $5
Hospital: $0 per days 1-3, $300 per days 4-7
PDP Benefit: $0/$10/$45/$95/33%; Full Tier Gap Cvg: Tier 1 - $0, Tier 2: $10
Contra Costa

6. 2014 MA Plan Summaries Current HMOs
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $10
Hospital: $395 per days 1-4
PDP Benefit: $4/$9/$45/$95/25%
Plan Type: HMO
Premium: $19
MOOP: $5,000
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $5/$10/$45/$95/33%
Premium: $ 49
MOOP: $3,400
PCP: $0 Specialist: $5
Hospital: $0 per days 1-3, $300 per days 4-7
PDP Benefit: $0/$10/$45/$95/33%; Full Tier Gap Cvg: Tier 1 - $0, Tier 2: $10
San Francisco

7. 2014 MA Plan Summaries Current HMOs
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $10
Hospital: $395 per days 1-4
PDP Benefit: $3/$8/$45/$95/25%
Plan Type: HMO
Premium: $19
MOOP: $5,000
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $5/$10/$45/$95/33%
Premium: $ 39
MOOP: $3,400
PCP: $0 Specialist: $0
Hospital: $0 per days 1-3, $300 per days 4-7
PDP Benefit: $0/$10/$45/$95/33%; Full Tier Gap Cvg: Tier 1 - $0, Tier 2: $10
San Joaquin I

8. 2014 MA Plan Summaries Current HMOs
Santa Clara
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $10
Hospital: $395 per days 1-4
PDP Benefit: $5/$10/$40/$95/25%
Plan Type: HMO
Premium: $19
MOOP: $5,000
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $5/$10/$45/$95/33%
Premium: $ 49
MOOP: $3,400
PCP: $0 Specialist: $5
Hospital: $0 per days 1-3, $300 per days 4-7
PDP Benefit: $0/$10/$45/$95/33%; Full Tier Gap Cvg: Tier 1 - $0, Tier 2: $10 I

9. 2014 MA Plan Summaries Expansion HMOs
Stanislaus
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $0 Specialist: $10
Hospital: $0 per days 1-2, $325 per days 3-7
PDP Benefit: $3/$10/$45/$95/26%
Premium: $39
MOOP: $3,400
PCP: $0 Specialist: $5
Hospital: $0 per days 1-3, $300 per days 4-7
PDP: $0/$10/$45/$95/33% I

10. Central HMO Counties

11. 2014 MA Plan Summaries Current HMOs
Fresno, Kings, & Madera
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $0 Specialist: $5
Hospital: $335 per days 1-5
PDP Benefit: $5/$10/$45/$95/33%
Premium: $42
MOOP: $5,900
PCP: $0 Specialist: $5
Hospital: $335 per day 1-5(in)
PDP Benefit: $0/$10/$45/$95/33% ; Full Tier Gap Covg: Tier 1 - $0, Tier 2 - $10

12. 2014 MA Plan Summaries Current HMOs
Tulare
Plan Type: HMO
Premium: $0
MOOP: $6,700
PCP: $5 Specialist: $35
Hospital: $295 per days 1-5
PDP Benefit: $5/$10/$45/$95/33%

13. Coastal
HMO Counties

14. 2014 MA Plan Summaries Expansion HMOs
Santa Barbara & Ventura
Plan Type: HMO
Premium: $0
MOOP: $5,900
PCP: $0 Specialist: $5
Hospital: $335 per days 1-5
PDP Benefit: $5/$10/$45/$95/33%

15. 2014 MA Plan Summaries Expansion HMOs
Santa Cruz
Plan Type: HMO
Premium: $52
MOOP: $6,700
PCP: $5 Specialist: $5
Hospital: $419 per days 1-4
PDP: $5/$10/$45/$95/33%
AGENT TRAINING ONLY

16. 2014 Los Angeles & Orange County Market

17. 2014 MA Plan Summaries Orange County Los Angeles County H0108-011
Plan Type: HMO
Premium: $0
MOOP: $3,400
PCP: $0 Specialist: $0
Hospital: $0 per days
PDP Benefit: $0/$10/$45/$95/33%
Orange County H
Premium: $0
PCP: $0 Specialist: $0
Hospital: $0
PDP: $0/$10/$45/$95/33%

18. 2014 San Diego/Riverside/ San Bernardino Market
Russ Barbour
Director of Sales
August 2013

19. 2014 MA Plan Summaries $0 HMO $32 HMO enhanced benefits $0 HMO
$0 HMO-MA only
$42 HMO-POS
PDP only

20. 2014 MA Plan Summaries San Diego County Plan Type: HMO Premium: $0
MOOP: $3,400
PCP: $10 Specialist: $25
Hospital: $150 per days 1-8
PDP Benefit: $0/$10/$45/$95/33%
Plan Type: HMO-POS
Premium: $42
MOOP: $5,000 (in)/$5,000 (out) combined
PCP: $10 (in)/$35 (out) Specialist: $25 (in)/$50 (out)
Hospital: $150 per days (in)/$300 per days 1-8(out)
PDP: Same as HMO $0 prem.

21. 2014 MA Plan Summaries San Diego County $30 Part B giveback
Plan Type: HMO-MA only
Premium: $0
MOOP: $6,700
PCP: $0 Specialist: $0
Hospital: $250 per days 1-5
PDP Benefit: not included
$30 Part B giveback
Silver Sneakers Gym Membership
Vision and dental benefits
OTC Drug benefit
Transportation benefit
Well-Dine benefit

22. San Diego County IPA’s Greater Tri-Cities IPA
Mercy Physicians Medical Group
Primary Care Associates Medical Group
Vantage Medical Group
San Diego Physician’s Medical Group

23. 2014 MA Plan Summaries Riverside/San Bernardino Counties
Plan Type: HMO
Premium: $0
MOOP: $3,400
PCP: $0 Specialist: $0
Hospital: $0/admit
PDP Benefit: $0/$10/$41/$92/33%
Plan Type: HMO enhanced benefits
Premium: $ 32
PCP: $ Specialist: $0
PDP: $0/$5/$24/$68/33%

24. Riverside/San Bernardino IPA’s
Empire Physician’s Medical Group (Coachella Valley)
Prime Care Medical Group
Anchor Medical Group
Choice Medical Group
Employee Health Systems
Hemet Community Medical Group
Riverside Medical Clinic
Riverside Physician’s Network
Vantage Medical Group
San Bernardino Medical Group
Prime Care Associates of California
Epic (including Beaver Medical Group, Redlands Yucaipa Medical Group, Pinnacle Medical Group and Alliance Desert Physicians Group)
Alpha Care