1. Caring for Small Business in New York EmblemHealth’s 2014 Portfolio November 2013

2. 1 Today’s Discussion Overview 2014 SG Off Exchange Product Portfolio Select Care Network SA Commissions Portal Renewal Functionality Manual Transactions for EH Conversions

3. “Not Business as Usual” EmblemHealth is transforming to compete in the commercial market  “NY Marketplace” on and off-exchange products  Neighborhood Care – Care Café  SelectCare - AdvantageCare Physician Groups – tailored high performance network  Focused on distribution channel and business relationships 2 “We are committed to the small group market and you our valued partners”

4. Small Group Product Summary 3 ServiceHMO 40/60 (Gold)HMO 35/55 (Silver)HMO HD6300 (Bronze) In Network Only (except for emergency care) Select Care network Coinsurance (member responsibility) 10%30%0% Annual deductible (individual/family)No deductible$2,000/$4,000$6,300/$12,600 Annual out-of-pocket maximum (individual/family) $4,000/$8,000$6,000 /$12,000$6,300/$12,600 Annual/lifetime maximum benefitUnlimited Preventive services (e.g., well-child care including immunizations; annual physical; mammography; prostate exam; bone density screening; colonoscopy and more) Covered in full Office visit copay (primary care/ specialist) $40/$60 copay$35/$55 copayCovered in full after deductible Diagnostic lab and radiology$60 copay$55 copayCovered in full after deductible Inpatient hospital admission $1,500 copay per admission30% coinsurance after deductible Covered in full after deductible Emergency room facility$200 copay Covered in full after deductible Emergency ambulance$100 copay$150 copayCovered in full after deductible Urgent care facility$60 copay Covered in full after deductible Ambulatory surgery facility$150 copay 30% coinsurance after deductible Covered in full after deductible Pediatric vision exams$40 copay$35 copayCovered in full after deductible Pediatric vision lenses and frames10% coinsurance30% coinsuranceCovered in full after deductible Durable medical equipment (DME)10% coinsurance30% coinsuranceCovered in full after deductible Gym Reimbursement Subscriber reimbursed up to $200 per six-month period and 50 exercise facility visits. Covered spouse reimbursed up to $100 per six-month period and 50 exercise facility visits. Prescription Drugs — Retail (30 Day Supply) $100 deductible per person must be met by either Retail or Mail Order, before the following copay applies (Tier 1/Tier 2/Tier 3)*: $15 / $35 / $75 Covered in full after deductible Prescription Drugs — Mail Order (90 Day Supply) $100 deductible per person must be met by either Retail or Mail Order, before the following copay applies (Tier 1/Tier 2/Tier 3)*: $38 / $88 / $188 Covered in full after deductible

5. Small Group Rates 4 Rating RegionRate Tier HMO 40/60 (Gold) HMO 35/55 (Silver) HMO HD6300 (Bronze) Bronx, Kings, New York, Queens, Richmond, Westchester, Rockland and Orange counties. Employee$460.08$392.54$342.74 Employee/spouse$920.16$785.08$685.48 Employee/children$782.14$667.32$582.66 Family$1,311.23$1,118.74$976.81 Nassau and Suffolk counties. Employee$522.86$446.10$389.51 Employee/spouse$1,045.72$892.20$779.02 Employee/children$888.86$758.37$662.17 Family$1,490.15$1,271.39$1,110.10

6. Small Group Underwriting Guidelines - Highlights No Participation Requirement Submission Deadline – 23 rd of the prior month Husband/Wife – Must go to the Exchange Requalification will begin 2Q of 2014 Multiple Plan Offerings -Up to 4 enrolled = 1 plan -5 to 20 enrolled = up to 3 plans -Groups of 21+ enrolled = up to 4 plans 5

7. 2014 Commission Schedule Commissions for Groups covering up to 50 eligible employees Selling Agent General Agent Competitive Commissions for all New Small Group Plans 6

8. 2014 Incentive Opportunity 7 Small Group Individual

9. Select Care Network COUNTY Non-Physician SpecialistPCPSpecialistGrand Total Bronx69881011132621 Kings1873494951031 Nassau37143910721882 New York26859413782240 Orange24 230278 Queens2995727471618 Richmond6486295445 Rockland13216195 Suffolk149160339648 Westchester105269530904 Grand Total21783324626011762 8

10. Select Care Hospital Network 9 Bronx Jacobi Medical Center Lincoln Medical and Mental Health Center Montefiore Medical Center - Henry and Lucy Moses Division Montefiore Medical Center - Jack D. Weiler Hospital of Albert Einstein College Division Montefiore Medical Center - North Division New York Westchester Square Medical Center - (OP Site) North Central Bronx Hospital St Barnabas Hospital Kings Beth Israel Medical Center - Kings Highway Division Brookdale University Hospital Medical Center Coney Island Hospital Kings County Hospital Center Lutheran Medical Center Woodhull Medical and Mental Health Center New York City Bellevue Hospital Center Beth Israel Medical Center - Petrie Campus Coler-Goldwater Specialty Hospital and Nursing Facility Harlem Hospital Center Hospital for Special Surgery Lenox Hill Hospital Metropolitan Hospital Center Mount Sinai Hospital Mount Sinai Hospital - Queens New York Eye and Ear Infirmary New York Presbyterian Hospital St Luke's Roosevelt Hospital Center - Roosevelt Division St Luke's Roosevelt Hospital Center - St. Luke's Division Orange Bon Secours Community Hospital St Anthony's Community Hospital Westchester Lawrence Hospital Center Northern Westchester Hospital Phelps Memorial Hospital Center St Joseph's Hospital Medical Center – Yonkers White Plains Hospital Queens Elmhurst Hospital Flushing Hospital Medical Center Forest Hills Hospital Jamaica Hospital Medical Center Queens Hospital Center Richmond Staten Island University Hospital – North Staten Island University Hospital – South Good Samaritan Hospital of Suffern Nassau Franklin Hospital Glen Cove Hospital Long Island Jewish Medical Center North Shore University Hospital – Manhasset North Shore University Hospital – Syosset Plainview Hospital Suffolk Eastern Long Island Hospital Huntington Hospital Peconic Bay Medical Center Southampton Hospital Southside Hospital

11. AdvantageCare Physician brings together four legacy medical groups: By joining forces, we are better able to cohesively: Improve clinical quality outcomes through a model that enables team- based and coordinated care Improve the patient experience – helping them better navigate the healthcare system to meet their health care needs Make health care more affordable – creating a sustainable future for our physicians and staff, our patients and our communities Introducing AdvantageCare Physicians Manhattan’s Physician Group Preferred Health Partners Queens-Long Island Medical Group Staten Island Physician Practice 10

12. New Product Features 11 Select Care network PCP's/Referral required RX Deductible (retail/mail): $100 per member; Retail: $15/$35/$75; Mail: $38.00/$88.00/$188 with Value Plus Formulary –Gold/Silver Individual deductible can apply towards family deductible Stand Alone PED Dental - DentCare (Dentcare Junior) Pediatric Vision - GVS (exams & material), comprehensive professional Systems (materials only), EyeCare Advantage (materials only) Optional Age 29 Rider

13. New Business Cases 12 Submission process remains the same.

14. HIP/HIPIC/Comprehealth Conversions Performed under Renewal Functionality within EH portal Model Plans (compare all three plans) Make Roster Changes when available Allocate Subs for Multiple Plan Options – Must meet Underwriting guidelines 13 NOTE: Brokers/GA’s obtain letter of instruction, signed rates, and roster changes from the group

15. Small Group Renewal Process 14 HIP/HIPIC/CH Renewals: 1.Renewal Plan pre- populated:  Silver  Except Select EPO/PPO - Gold 2.Model up to 3 Plans – Make Selection – subject to previous rules at this time 3.Submit to EH 4.View/change PCP’s

16. Groups without Member/Roster listing 15 HIP/HIPIC/CH Renewals: 1.Groups without roster/member listings will be unable to make any roster changes and only select one plan 2.Submit paperwork for all other transactions

17. Subgroups – different LOB & Rider options 16 Groups with more than one benefit set, must each be processed individually.

18. EH Product Conversions Manual Process Requirements: 1.New Master App 2.Latest NYS 45 3.New Transaction forms (if needed) 4.No Binder Checks Email/mail documents to your dedicated EH representative Enter as new business on the portal 17

19. Questions? 18