We all know Health Care Became more As Your Employee Benefit Solu(ons - PowerPoint PPT Presentation

Presenta(on prepared for: PEO & ASO Brokers

We all know Health Care Became more… More Expensive… More Complicated… And Limited in Op(ons

We all know Health Care Became more… As Your Employee Benefit Solu(ons Partner • We simplify what has become so complex • Help brokers and their clients meet ACA Regula(ons • Our MEC plans sa(sfy Employer Penalty A and the Individual Mandate Penalty • Provide Comprehensive Benefit Plans • Choice of MEC Op(ons • Four (4) Year “Rate Lock”

Four (4) Year Rate Lock All MEC Plans feature a 4-Year Rate Lock Not to exceed 3% increase in years 2 through 4 All MEC Plans exceed the requirements of the Affordable Care Act sa(sfying Employer Penalty A and the Individual Mandate Penalty

Health Care Utilization by Frequency… Is Not: Expensive Big-Ticket Items • Hospital Stays • Chronic Disease or Illness • Specialty Drugs

Health Care Utilization by Frequency… What it is: Everyday Health Care Needs � Preven(ve Care � Primary Care � Specialists � Urgent Care � Telemedicine � Rx Advocacy By frequency this accounts for 90% of healthcare services delivered

Plan Comparison Preventive Preventive Advanced Preventive Premier Catastrophic Reimbursement No No No PHCS/Mul(Plan PHCS/Mul(Plan PHCS/Mul(Plan Network with RBP Wrap with RBP Wrap with RBP Wrap Preven(ve Care Services 100% (no deduc(ble) 100% (no deduc(ble) 100% (no deduc(ble) $0 Co-pay $0 Co-pay $0 Co-pay Doctor Access Telemedicine Telemedicine Telemedicine $20 Copay $20 Copay (max 3 visits per year) (max 3 visits per year) Primary Care Physician Office Visit Not covered $50 Copay $50 Copay (max 3 visits per year) (max 3 visits per year) Specialist Office Visit Not Covered $50 Copay $50 Copay (max 3 visits per year) (max 3 visits per year) Urgent Care Not Covered $50 Copay $50 Copay (In office, max 5 services) (In office, max 5 services) Diagnos(c X-ray and Lab Not Covered $200 Copay $200 Copay (1 per year) (1 per year) Cat-Scan or MRI Not Covered $200 Copay $200 Copay (1 per year) (1 per year) Outpa(ent Tes(ng Not Covered $0 Deduc(ble, 50% coinsurance. Max Hospital, Surgical, Ambulance N/A Not Covered benefit of $5,000 TPA Services HMA HMA HMA

Plan Comparison Preventive Preventive Advanced Preventive Premier Prescription Benefits $1 co-pay $1 co-pay $1 co-pay Tier 1 – Low Cost Tier 2 – Generics 10% Co-Insurance 10% Co-Insurance 10% Co-Insurance Tier 3 – Preferred Brand 20% Co-Insurance 20% Co-Insurance 20% Co-Insurance Tier 4 – Non-Preferred 1 40% Co-Insurance 40% Co-Insurance 40% Co-Insurance Benefit Max No max aher co-insurance No max aher co-insurance No max aher co-insurance Tier 5 – Specialty SHARx Advocacy Program SHARx Advocacy Program SHARx Advocacy Program Tier 6 – Non-Preferred 2 SHARx Advocacy Program SHARx Advocacy Program SHARx Advocacy Program Monthly Rate Schedule Employee 127.00 194.31 163.75 Employee + Spouse 178.00 316.48 267.24 Employee + Child(ren) 178.00 298.08 251.24 Employee + Family 214.00 422.80 352.30

Additional Benefit Information • Guaranteed issue product • Minimum Employee Enrollment, 5 • Employer can contribute 0% to 100% • MEC plans can be stand side-by-side with most major carriers • COBRA services are included • Employee contribu(ons can be pre-taxed with Sec(on 125 plan • Benefits are subject to copayments, then 100% coverage

Enrollment • First step: Complete Employer Adop(on Agreement – 20-30 days in advance • Step Two: Enrollment Kit and Form will be prepared • Step Three: All Enrollment Forms should be completed and returned to HR 10 days in advance of Effec(ve Date • Step Four: Data from Enrollment Forms will need to be entered into Enrollment File/Spreadsheet to be uploaded • Step Five: ID Cards will be generated in 10 to 14 business days aher Enrollment File has been uploaded