1. Health Care Cabinet March 10, 2015 1

2. 2 Agenda A.Open Enrollment Update B.Benefits available for individuals using Methadone or other opioids C.Anticipated costs and subsidies available to the individuals at 138% of poverty who are anticipated to move from Medicaid to AHCT

3. 3 Open Enrollment Update

4. 4 Operating Metrics

5. 5

6. 6 Open Enrollment Activity Update (2/13/15) Current enrollment volume across all plans and programs stands at 536,436 individuals Since the start of this open enrollment, we have processed more than 103k QHP enrollments and 235k Medicaid enrollments. – Of these 35,887 were new QHP customers, and 153,828 were new Medicaid applicants. – Net new enrollment for the OE period thus far stands at 189,715 (81% Medicaid/19% QHP) Total Enrollment New Enrollment Repeat Enrollment 103,007 35,887 67,120 Total Enrollment New Enrollment Repeat Enrollment 433,429 153,828 81,170 Existing Membership 198,431 QHP MembershipMedicaid Volume

7. 7 Additional Membership Information (2/13/15) To date, ConnectiCare continues to see the majority of new enrollments (42%) Anthem is currently taking 1 out of every 3 new enrollments (30%) Healthy CT has seen a dramatic uptick in selection, with nearly a quarter of individuals selecting their plans. Newly offered dental plans and our SHOP program continue to show solid gains Dental = 1,565 SHOP: Groups = 173 Members = 1,148 173 groups with 1148

8. 8 Post Open Enrollment Another round of our new member census research will be conducted to gather information on key demographic and attitudinal variables. This will include questioning in the areas of : – Prior uninsured status – Race and ethnicity – Enrollment channel use – Reasons for sign up – Post enrollment expectations – Expected plan use

9. 9 Benefits available for individuals using Methadone or other opioids

10. 10 Benefits available for individuals using Methadone or other opioids CarrierCoverage Anthem Methadone maintenance is covered on all policies/products. Opioid treatment such as ambulatory detox, with the use of suboxone, is also covered as well as other levels of care such as inpatient, PHP, IOP and Residential when it meets medical necessity. Anthem formulary includes the Methadone and the generic form of Soboxon. Connecticare Methadone treatment is not specified within CBI’s EOC. Based on the definition for coverage for Behavioral Health, Inpatient, Outpatient regarding Substance Abuse, Methadone may get covered under the umbrella outlining the coverage. HealthyCT Methadone Treatment is covered. Prior Authorization is required for Inpatient services but is not required for Outpatient services. HealthyCT formulary includes Methadone. Soboxon as well as the generic form is available. This drug is used for opioids. United Healthcare Methadone is not covered.

11. 11 Anticipated costs and subsidies available to the individuals at 138% of poverty who are anticipated to move from Medicaid to AHCT

12. 12 2015 Silver and 2015 Silver Cost-sharing Reduction Alternatives – Qualified Health Plans - Single Individual, age 30, Hartford County Income Band (FPL) FPL Level used for premiu m examplePlan Monthly Premiums (cheapest silver plan) Medical Deductible Pharmacy Deductible Inpatient Co- Pays Emergency Departmen t Co-Pay Primary Care Co-Pays Speci alists Co- Pay Pharmacy Co-Pays Out-of- Pocket Max Per Day Max per Stay Preven tative Non- Preven tative Tier 1 Generic Tier 2 Preferred Brand Tier 3 Non- Preferred Brand Tier 4 Specialt y 138- 150%*139% 94% CSR$49.74$0 $100$400$75$0$20$35$5$20$35$50 $600 150- 200%185% 87% CSR$102.56$400$25$200$800$100$0$20$35$5$20$35$50 $1,750 200- 250%201% 73% CSR$125.66$1,900$25$500$2,000$150$0$30$50 $5$30$55$60$5,200 >250%263% 70% Silver$218.07$2,600$25$500$2,000$150$0$30$50 $5$30$55$60$6,600 Subject to the Medical deductible before listed cost-sharing benefit will apply Subject to the Pharmacy deductible before listed cost-sharing benefit will apply * 94% CSR plan is available to those who are eligible for APTCs and whose household MAGI is between 138% and 150% of the federal poverty level. The threshold drops to 0-150% for those HHs who do not qualify for HUSKY due to immigration prohibitions such as the 5 year bar.

13. 13 2015 Silver and 2015 Silver Cost-sharing Reduction Alternatives - Qualified Health Plans - Single Parent age 30, child age 20, Hartford County Income Band (FPL) FPL Level used for premium examplePlan Monthly Premiums (cheapest silver plan) Medical Deductible Pharmacy Deductible Inpatient Co-Pays Emergency Depart- ment Co- Pay Primary Care Co-Pays Specialis ts Co-Pay Pharmacy Co-Pays Out-of- Pocket Max Per Day Max per Stay Preven tative Visit Non- Prevent ative Tier 1 Generic Tier 2 Preferre d Brand Tier 3 Non- Preferr ed Brand Tier 4 Specialty 138- 150%*141% 94% CSR$67.83$0 $100$400$75$0$20$35$5$20$35$50$1,200 150- 200%185% 87% CSR$138.82$800$50$200$800$100$0$20$35$5$20$35$50$3,500 200- 250%201% 73% CSR$174.36$3,800$50$500$2,000$150$0$30$50$5$30$55$60$10,400 >250%263% 70% Silver$293.48$5,200$50$500$2,000$150$0$30$50$5$30$55$60$13,200 Subject to the Medical deductible before listed cost-sharing benefit will apply Subject to the Pharmacy deductible before listed cost-sharing benefit will apply * 94% CSR plan is available to those who are eligible for APTCs and whose household MAGI is between 138% and 150% of the federal poverty level. The threshold drops to 0-150% for those HHs who do not qualify for HUSKY due to immigration prohibitions such as the 5 year bar.