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New Year. New Plans. Better Pricing. New Opportunities. 2010 New Consumer-Driven Health Plans Product Rollout.

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Presentation on theme: "New Year. New Plans. Better Pricing. New Opportunities. 2010 New Consumer-Driven Health Plans Product Rollout."— Presentation transcript:

1 New Year. New Plans. Better Pricing. New Opportunities. 2010 New Consumer-Driven Health Plans Product Rollout

2 2 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Welcome Lumenos Overview Product Suite Pricing Improvements Network Overview CDHP Experience Implementation Plan Designs Q&A Agenda

3 3 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Historical Overview Product Evolution 2004200520062007200820092010 & beyond Empire partners with CDH pioneer/ innovator, Lumenos to launch HSA/HRA “Total Blue Products” WellPoint acquires Lumenos Connected Blue Networks to Lumenos Lumenos products launched for local group business: Fully insured & ASO Anthem Lumenos product Anthem’s CDH Membership: 1.3 Million Introduced improved pricing in Georgia for 100+ size groups Improved pricing in Georgia for 2-99 Open Access POS linked to BlueCard ®

4 4 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. CDHP Membership Note: CDHP membership shown above includes all of the Company’s Individual CDHP consumers. Source: Monthly Wellpoint Financial Report Our Lumenos Membership has steadily increased over time 1,600,000 Dec 07 1,200,000 800,000 400,000 Dec 08Dec 09Jan 10 (Projected) Period-End Membership

5 5 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Health Improvement through Consumer Engagement Plan design Web tools/ decision support tools Incentives Wellness programs Disease management Member Education

6 Product Suite

7 7 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos Plans Health Savings Account (HSA) Health Reimbursement Arrangement (HRA) Health Incentive Account (HIA)

8 8 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos HSA Plan *Rewards may be allocations to account or, for fully-insured HSA plans, credit dollars to redeem for gift cards to select health-focused retailers. Consumers can fund their HSA with pre-tax dollars and can use funds for health care expenses Employers can also contribute to employee’s HSAs Additional dollars earned with rewards for healthy behaviors* Preventive services are covered at 100% Includes Traditional PPO or OA POS Health Coverage to cover expenses after the deductible Unused HSA dollars roll over from year to year and can be used for future health care expenses Preventive Care 100% In-Network HSA Funded by annual employee and/or employer contributions Plus Additional funds available through rewards (optional) Traditional PPO or OA POS Health Coverage Out-of-Pocket deductible to Traditional Health Coverage

9 9 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Rewards Allocations to HSA Reward dollars earned are redeemed for gift cards for fully- insured business Reward allocations are taxable to the employee, and amounts do not count toward the annual HSA contribution limit For ASO accounts, reward dollars earned are deposited directly into the consumer’s HSA Rewards may be allocations to account or, for fully-insured HSA plans, credit dollars to redeem for gift cards to select health-focused retailers.

10 10 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. HSA Integration with Mellon Bank Employer product set-up One combined health plan and HSA employer application Consumer enrollment One combined health plan and HSA consumer application Employer funding implementation Plan-based resources and Mellon bank resources that will support employer’s efforts to facilitate payroll-based funding Customer service Customer Service Advocate can assist with all benefit information, level 1 HSA account service, and warm-transfers to Mellon bank for level 2 support Consumer portal Consumers will visit anthem.com for both their benefit and HSA details HSA consumer communications Consumers will receive all of their benefit and banking enrollment materials from Anthem

11 11 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos HRA Plan Consumers use employer-funded HRA dollars to pay for covered expenses Earn more dollars for their HRA through rewards for healthy behaviors Preventive services are covered at 100% Unused HRA dollars may roll over from year to year and can be used for future health care expenses Traditional PPO or OA POS Health Coverage covers expenses after the deductible Preventive Care 100% In-Network HRA Funded by annual employer allocation Plus Additional reward dollars Traditional PPO or OA POS Health Coverage Out-of-Pocket deductible to Traditional Health Coverage

12 12 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos HIA Plan Companion product to introduce elements of consumerism Can replace an existing traditional PPO offering with a similar PPO plan design, or an Open Access POS plan design Has the added benefit of financial rewards for healthy behaviors Includes Traditional PPO or OA POS Health coverage to cover expenses after deductible Also includes all of the tools, services and programs to encourage and reward positive consumer behavior Preventive Care 100% In-Network Out-of-Pocket deductible to Traditional Health Coverage HIA Funded by reward dollars Traditional PPO or OA POS Health Coverage

13 13 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Offerings and Product Approaches Full suite of CDHP options allows for personalized strategies for employers Single Lumenos CDHP offering Multiple CDHP pairings – for example, HRA or HSA paired with HIA to replace (transition from) existing PPO Lumenos CDHP offered alongside a non-CDHP

14 Pricing

15 15 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos PPO to Lumenos Open Access POS Pricing Impact (2-50) Markets/Plan Description Open Access POS HSAPPO HSA Estimated Savings Atlanta$242$323-25% Albany$331$3320% Athens$254$327-22% Augusta$254$331-23% Columbus$254$316-20% Gainesville$266$326-18% Macon$266$336-21% North Georgia$278$319-13% Savannah$266$332-20% Lumenos PPO to Lumenos Open Access POS Pricing Impact (2-50) Sample rates

16 16 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos PPO to Lumenos Open Access POS Pricing Impact (51+) Markets/Plan Description Open Access POS HSAPPO HSA Estimated Savings Atlanta$235$295-20% Albany$331$3320% Athens$254$327-22% Augusta$254$331-23% Columbus$254$316-20% Gainesville$266$326-18% Macon$266$336-21% North Georgia$278$319-13% Savannah$266$332-20% Lumenos PPO to Lumenos Open Access POS Pricing Impact (51+) Sample rates

17 Network Overview

18 18 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Network Composition Traditional/Indemnity 17,868 physicians 193 hospitals Open Access HMO/POS 14,357 physicians 154 hospitals PPO 16,092 physicians 170 hospitals HMO/POS 13,478 physicians 137 hospitals We continue to offer the largest statewide network across Georgia.

19 19 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Open Access POS Participation PhysiciansALBATHATLAUGCOLGNVMACROMSAVNon-ATLGA PCP 87%84%82%88%73%80%68%87%80%82%83% Spec 84% 89%91%85%89%74%88%77%86%88% Total 85%84%87%90%82%87%72%88%78%85%86% ALBATHATLAUGCOLGNVMACROMSAVNon-ATLGA Hospitals 57%100%98%100%78%100%87%100%90%85%88% Georgia PPO Providers/Open Access POS Participation

20 20 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. What’s new to Open Access POS? All Members enrolled in Open Access POS products will be able to utilize “in-network” benefits and network discounts when visiting any BlueCard ® PPO provider outside the state of GA While in the state of GA, in-network benefits will only be provided when using the Open Access POS network Upon renewal, all employees enrolled in Open Access POS plans will receive a new ID card, even if no other benefits are changed Great News!

21 21 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Open Access POS w/PPO Network Member ID Card Open Access POS with PPO network when traveling outside of Georgia Key Product Features Existing GA Open Access POS products will be enhanced to include access to the PPO network for members traveling out of state. The PPO suit case and Alpha Prefix will be included on the member identification card.

22 22 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos Open Access POS Member ID Card Lumenos Open Access POS Key Product Features Lumenos Open Access POS products will now offer options for: Health Savings Accounts (HSA) Health Reimbursement Arrangement (HRA) Health Incentive Accounts (HIA) GA members will have access to PPO networks when traveling out of state

23 CDHP Experience

24 24 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. 360 ° Health: Your Total Health Solution 360º Health surrounds members with the help they need to live healthier lives. Provides meaningful programs for everyone at every stage of health Much more than a disease management program, it’s designed around each member’s total needs Includes everything from online tools and information to complex care management

25 25 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Healthy Lifestyles Healthy Lifestyles for the Lumenos plans includes: Online coaching for the following: Tobacco cessation Weight management Diet & Nutrition Exercise Stress management One-on-One telephonic coaching for: Tobacco Cessation Weight Management

26 26 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos Plan Health Programs 24/7 NurseLine ComplexCare Future Moms MyHealth@Anthem web tools ConditionCare: Asthma, Diabetes, Chronic Obstructive Pulmonary Disease, Coronary Artery Disease, and Heart Failure MyHealth Coach Healthy Lifestyles: Online & Telephonic Coaching Healthy Weight (weight management) Tobacco Free (smoking cessation)

27 27 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Standard Incentive Amounts Incentive amounts for activities that contribute to better health and well-being $50 for completing the MyHealth Assessment online health profile (one per family*/per calendar year) $100 for enrolling in Health Coaching (per qualified family member per calendar year) $200 for Activity Achievement from Health Coaching (per qualified family member per calendar year) $50 for completing the Tobacco Free program (per qualified employee and/or spouse one per lifetime) $50 for completing the Healthy Weight program (per qualified employee and/or spouse one per lifetime) Incentives for fully-insured HSA plans credit dollars to redeem for gift cards to select health-focused retailers.

28 28 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. WebMD Coverage Advisor Coverage Advisor Helps Members Determine Which Health Coverage Is Right for Them (and their Families) Interactively estimates family medical needs & health expenses for coming year Estimates medical & pharmacy costs Reviews tax implications Explores impact of estimated tax savings & out-of-pocket costs of contributing to HSAs or FSAs

29 29 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Lumenos Member Portal An integrated experience, built for the consumer Secure Message Center “MyOptions” integration 360º Health tools from WebMD Health Account Activity Claims analysis And much more

30 30 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. “MyOptions” Tab: Empowering Consumers with Information

31 31 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Member Recommendations and NCQA designations Estimated cost of most common services of this specialty. Physician Cost and Quality

32 32 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Animated Surgery Tool Helping Consumers Prepare for Surgery Online tool to help educate consumers about steps involved, most common complications, and questions to ask

33 Implementation

34 34 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. New Group Lumenos Implementation Timeline Days 1-2Complete package received Days 2-3Package imaged and sent to Underwriting to review Days 4-10The group’s information is entered into the system Days 11-16Membership data is entered into the system Days 17-18The group’s bill is generated and ID cards are ordered Days 18-22ID cards are sent to the vendor to be mailed Days 21-30Account activation is available online after the Member is in Mellon Day 30 The Welcome Kit is ordered and mailed to the member – the Kit may take 6-9 calendar days to arrive Days 1-30 are calendar days

35 35 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Renewal Group Lumenos Implementation Timeline Days 1-2Complete package received Days 2-6Package imaged and sent to Underwriting to review Days 3-11The group’s information is entered into the system Days 6-11Membership data entered into the system Days 11-15The group’s bill is generated and ID cards are ordered Days 15-19ID cards are sent to the vendor to be mailed Days 14-20Account activation is available online after the Member is in Mellon Day 20 Days 1-20 are calendar days The Welcome Kit is ordered and mailed to the member – the Kit may take 6-9 calendar days to arrive

36 36 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Things to remember If a member has medical and dental benefits they will continue to receive two ID cards Multiple ID Cards If an employer group has a Lumenos product alongside a non-Lumenos product, they will receive two invoices Employer groups should send separate payments for each invoice to ensure the premium is properly applied Multiple Bills

37 37 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Employer Access Why a New Employer Portal? Employer Need Saves Time Decreases Errors Provides Convenience and Security

38 38 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Employer Access What will be on the new Employer portal? Consumer Driven Healthcare Products: Online Enrollment Contract Updates Benefits Inquiry Online Billing

39 39 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Employer Access Interactive Demo How does it work? Differences No Dental or Vision Add Dependent No PCPs to select

40 40 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Member Access Member Access – www.anthem.com Same functionality and tools as www.bcbsga.com HSA, HRA & HIA products have different detail levels than traditional PPO & HMO products

41 Plan Designs

42 42 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. What’s new? More affordable rates Expanded product portfolio Improved pricing Product portfolio CDHP experience Tools and resources

43 43 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. What’s Different? Lumenos PPO vs. Lumenos Open Access POS Benefit DescriptionLumenos PPO PlansLumenos Open Access POS plans Preventive Care On 80/60 plan designs: In-network plan pays 100%, Out-of-network-plan pays 70% (GA PPO mandate) On 80/60 plan designs: In- network plan pays 100%, Out-of-network plan pays 60% Chiropractic Care Combined with PT and OT, 20 visits combined Separated from PT and OT, 20 separate visit limits. Available as a standard benefit for all group sizes Non-emergency use of the emergency room Covered based on the coinsurance percentage of the plan design for In- network and Out-of-network Not covered Prescription Drugs Plan pays the same coinsurance percentage for In-network and Out-of- network (80/80) (GA PPO Mandate) Plan pays the appropriate In-network coinsurance percentage and the appropriate Out-of-network coinsurance percentage based on the plan design (80/60) Pre-Existing Waiting Period 12 months In-network-No PE waiting period, Out-of- network-12 months The new Lumenos Open Access POS plan designs will mirror the current Lumenos PPO plan designs except for the following benefit differences:

44 44 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. What’s Different? Lumenos Open Access POS vs. Blue Open Access POS Benefit DescriptionBlue Open Access POSLumenos Open Access POS plans Lifetime Maximum In-network- Unlimited, Out-of network-$5,000,000 In-network & Out-of-network combined- $5,000,000 Chiropractic Care Not covered on Large Group plans Covered on all plan designs Skilled Nursing Facility Plan pays 100% after deductible (if applicable) regardless of the plan design coinsurance Plan pays based on coinsurance of the plan design, subject to the deductible (if applicable) Home Health Care Plan pays 100% after deductible (if applicable) regardless of the plan design coinsurance Plan pays based on coinsurance of the plan design, subject to the deductible (if applicable) Respiratory Therapy Plan pays 100% after deductible (if applicable) regardless of the plan design coinsurance Plan pays based on coinsurance of the plan design, subject to the deductible (if applicable) Radiation Therapy/ Chemotherapy Plan pays 100% after deductible (if applicable) regardless of the plan design coinsurance Plan pays based on coinsurance of the plan design, subject to the deductible (if applicable) The new Lumenos Open Access POS product has been designed to mirror the current Lumenos PPO portfolio where possible, thus making the Lumenos Open Access POS product slightly different than our standard Blue Open Access POS product.

45 45 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. What’s new? Lumenos Rx Copay Plans The new Lumenos Rx Copay plans allow groups to have additional lower cost options when selecting plan designs The Lumenos Rx Copay plans are only available for HSA and HRA These plans are available within the PPO and Open Access POS product portfolios The plan designs that were chosen as the Lumenos Rx Copay plans mirror the benefits of the original plans with the exception of the Rx benefit portion and an increase to the in- network individual and family out of pocket maximums

46 46 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Product Overview: Lumenos Rx Copay Plans continued Product Benefit Details Coinsurance will still apply to medical services while the Rx copays will only apply to the Rx benefits Rx copays apply after the deductible has been met Member pays 100% of Rx cost (no copays) until deductible is met Rx copays apply to the out of pocket accumulators Once the out of pocket limit is met, no further copays are taken and member has no additional cost sharing If the copay is more than the remaining out of pocket limit, the copay will be reduced to meet the remaining out of pocket limit The Lumenos Rx Copay plans will mirror typical group Rx copay designs (3 Tiers - $15/$30/$60) The Lumenos Rx Copay plans will have the mail order option, including Tier 3 mail order (3 Tiers - $15/$60/$180)

47 47 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Product Overview: Lumenos Rx Copay Plans continued Product Benefit Details continued On the Lumenos PPO Rx Copay plans, the Rx copays apply to in-network and out-of-network pharmacies {GA PPO Mandate} (ex. in-network & out-of-network Tier 1 - $15) On the Lumenos Open Access POS Rx Copay plans, the Rx copays only apply to in-network pharmacies, out-of-network pharmacies are paid based on the out of network coinsurance of the plan design (ex. in-network Tier 1 - $15, out-of-network Tier 1 – 60%) Standard plan cross accumulation rules will apply to copays HSA or HRA account funds may be used to pay Rx copays

48 Circle of Excellence

49 49 Blue Cross Blue Shield Healthcare Plan of Georgia, Inc., is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. New Broker Bonus/Circle of Excellence 2010 New Broker Bonus All licensed and appointed brokers are eligible Applies to the fully-insured and ASO local group segments The payout rate is $20 per fully insured contract and $8 per ASO contract New Business Bonuses paid under the 2009 program are excluded from the 2010 Bonus program 2010 Circle of Excellence 3 Tier Levels Elite Champion Advantage Stay tuned for details regarding our 2010 Broker Road Shows!

50 Thank you!


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