1. PLAN COMPARISON

2. MEDICAL PLAN COMPARISON Medical Plan Comparison PPOSouthern NevadaNorthern Nevada Benefit CategoryCD PPO HDHPHealth Plan of NevadaHometown Health Plan Amount you Pay In- Network Amount You Pay In- Network Medical deductible$1,500 individual $3,000 family *$2,600 individual - when two or more family members covered No Deductible Out-of-pocket maximum$3,900 person $7,800 family (per plan year) $6,800 person (per calendar year) $6,200 person $12,400 family (per plan year) Hospital inpatient20% coinsurance after deductible $300 per admission$500 per admission Outpatient Same Day Surgery 20% coinsurance after deductible $50 per admission$350 per admission Primary care visit20% coinsurance after deductible $15 copayment$25 copayment

3. MEDICAL PLAN COMPARISON Medical Plan Comparison Southern NevadaNorthern Nevada Benefit CategoryCD PPO HDHPHealth Plan of NevadaHometown Health Plan Amount you Pay In- Network Amount You Pay In- Network Specialist visit20% coinsurance after deductible $25 copayment$45 copayment Urgent care visit20% coinsurance after deductible $30 copayment$50 copayment Emergency room visit20% coinsurance after deductible $150 copayment waived if admitted $300 copayment per visit General laboratory services 20% coinsurance after deductible No chargeNo charge for outpatient or hospital Chiropractic services20% coinsurance after deductible $15 copayment per visit$45 copayment per visit $1,000 plan year maximum Wellness/ PreventionNo charge for eligible wellness benefits provided in-network No charge

4. MEDICAL PLAN COMPARISON Medical Plan Comparison Southern NevadaNorthern Nevada Benefit CategoryCD PPO HDHPHealth Plan of NevadaHometown Health Plan Amount you Pay In- Network Amount You Pay In- Network Vision ExamCovered under wellness ( Maximum $120Allowance ) $10.00 co-payment$15 co-payment Hardware (frames, lenses, contacts) No benefit (but can use H.S.A. or H.R.A funds) $10 copayment/ lenses frames – ($100 allowance) contacts $115 in lieu glasses 15% to 20% discount

5. PHARMACY PLAN COMPARISON Pharmacy Plan Comparison Southern NevadaNorthern Nevada Benefit CategoryCD PPO HDHPHealth Plan of NevadaHometown Health Plan Amount you Pay In-Network Amount You Pay In- Network Plan Deductible$1,500 individual $3,000 family - *$2,500 individual - when two or more family members covered No Deductible Out-of-pocket maximum$3,900 person $7,800 family (per plan year) Contact HPN for pharmacy OOP Maximum Contact HHP for pharmacy OOP maximum Retail Pharmacy - 30 Day Supply Preferred Generic (Tier 1)20% after deductible$7 copayment Preferred Brand (Tier 2)20% after deductible$35 copayment$40 copayment Non-Formulary (Tier 3)100% of contracted price - does not apply to deductible or OOP $55 copaymentGreater of $75 copayment per script or 40% Specialty Drugs20% after deductible - available in 30 day supply only through Catamaran Pharmacies Applicable retail pharmacy copayment will apply 30% coinsurance

6. PHARMACY PLAN COMPARISON Pharmacy Plan Comparison Mail Order - 90 Day Supply PPOSouthern NevadaNorthern Nevada Preferred Generic (Tier 1) 20% coinsurance after deductible $14 copayment Preferred Brand (Tier 2)20% coinsurance after deductible $70 copayment$80 copayment Non-Formulary (Tier 3)100% of contracted price - does not apply to deductible or OOP Not available through mail order Greater of $150 copayment per script of 40% Specialty Drugs20% after deductible - available in 30 day supply only through Catamaran Home Delivery Applicable retail pharmacy copayment applies Not available through mail order

7. MEDICAL PLAN INFORMATION Information regarding plan benefits, evidence of coverage certificate, prescription drug formulary, and the provider directory for the health insurance plan of your choice is available for review via the following PEBP web links: CDHD PPO Plan: http://pebp.state.nv.us/all_plan_benefits.htmhttp://pebp.state.nv.us/all_plan_benefits.htm Health Plan of Nevada (South) : http://www.stateofnvhpnbenefits.com/http://www.stateofnvhpnbenefits.com/ Hometown Health Plan (North): http://stateofnv.hometownhealth.com/http://stateofnv.hometownhealth.com/