Educational Service Center of Cuyahoga County Effective July 1, 2013 Your Cigna Plans - Open Access Plus (OAP) and Health Savings Account (HSA) Educational Service Center of Cuyahoga County Effective July 1, 2013

Cigna Open Access Plus (OAP) balancing choice and convenience Cigna Open Access Plus (OAP) Good oral health can do more than brighten your smile! Regular dental care often catches minor problems before they become major and expensive to treat. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Open Access Plus Plan Medical Plan Choice and Convenience Your option to select a Primary Care Physician; however we encourage you to have a relationship with a doctor Save the most when you visit in-network doctors and facilities Freedom to visit any licensed provider with no referrals Access to a nationwide network of doctors and hospitals CHOICE CONVENIENCE a perfect balance The CIGNA DPPO plan offers a perfect balance of savings and choice. You and your covered family members have convenient access to quality dental care through our nationwide network of dentists — dentists who have agreed to offer their services to our members at reduced contracted fees. Or, you have the option to visit any licensed dentist and receive out-of-network benefits. You also have the freedom to choose any specialist without a referral. Whether you choose a dentist in the CIGNA Dental Core Network or outside the network, your coverage includes a wide range of eligible services after you satisfy any waiting period and meet your deductible. Your plan will pay part of your costs (shown by the coinsurance amount on your Benefit Summary) until your plan’s annual maximum is reached. [Review the items listed on the slide] Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Open Access Plus Copay Medical Plan In Network Out-of-Pocket Costs TYPE OF SERVICE Copayment/Coinsurance In-Network Deductible: $300 Single / $600 Family Out of Pocket Maximum: $1,000 Single / $2,000 Family (plan deductible does count towards OOP maximum – copays do not count) Primary Care Physician visit: $25 copay Specialist visit: $25 copay Preventive Care Visits No charge In-patient hospital care: 10% charges after deductible Out-patient hospital care: 10% charges after deductible Emergency Room Copay: $100 copay, then no charge (waived if admitted) Urgent Care Copay: $25 copay, then no charge Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

WHAT IS A HEALTH SAVINGS ACCOUNT (HSA) PLAN? Qualified Medical Plan Health Savings Account Tax-advantaged HSA Plan + = A tax-advantaged health plan that provides coverage for current medical/pharmacy expenses with the option to save for future health expenses Combines a Qualified Medical Plan (medical/pharmacy coverage) with a Health Savings Account You, your employer or both can contribute to the Health Savings Account Money put in the Health Savings Account is generally not taxable* You have investment options A.T. I added the HSA disclaimer related to taxability status. We need to include this if we describe anything related to the taxability of earnings or contributions to HSA accounts. * HSA contributions and earnings are not subject to Federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

HOW IS THIS DIFFERENT FROM A TRADITIONAL PLAN? Same Wide choice of doctors/hospitals Preventive care covered at 100% Plan begins to pay after deductible is met Covers routine, emergency and catastrophic care Plan pays percentage of bill for covered out-of-network care Plan pays higher percentage for covered in-network care Cigna receives bills, sends payment to doctors/hospitals Different Lower premium but higher deductible Plan begins to pay after deductible is met; however, funds in your Health Savings Account can be used to cover eligible health expenses Amount can be used to pay the deductible Unused money rolls over to next year Cigna HSA HSA (Employer contribution) $1,000 Your Share $1,000 Health Plan 100% in-network 100% Preventive Care (in-network) Deductible $2,000 Out-of-pocket Max $2,000 Unused $ rolls over to next year Employee Only Example Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

$440 HSA Balance – carried over to next year Meet Karen Single, in her 50s Heart disease; controlling health through medication Out-of-pocket Max $2000 Deductible $2,000 Plan pays 100% 100% Preventive Care (in-network) HSA Deposits $ 1,000 by Karen $ 1,000 by Employer $ 2,000 Total HSA Contribution Preventive Care $398 (covered 100% by Plan) No cost to Karen $ 1,000 ER Visit $ 320 4 PCP Visits $ 240 Generic RX (12) $ 1,560 medical expenses Total = $1, 560 How Expenses Are Paid $1,560 applied to deductible $ 398 preventive care (covered by Plan) $1,958 paid by Plan and Deductible $1,560 What Karen Paid from HSA $2,000 in HSA $1,560 Paid $ 440 Rollover $440 HSA Balance – carried over to next year Contribution: $1000 Employer + Employee $1000 = $2,000 Case example for illustrative purposes only, in-network. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

WHAT IS THE MAXIMUM I CAN CONTRIBUTE ANNUALLY TO THE HSA? The IRS has set the following limits for 2013: Under age 55 and not enrolled in Medicare (based on a 12-month period): 2013 Up to $3,250 individual coverage* Up to $6,450 family coverage* Age 55 or older: Maximum contribution increases by $1,000 (considered a “catch-up” contribution) Up to $4,250 individual coverage* Up to $7,450 family coverage* To make the maximum contribution in a calendar year, you must: Meet all requirements to be eligible for HSA contributions on January 1 Remain qualified through December 1 If these criteria are not met, maximum contribution is prorated = if 1/12 maximum contribution for each month then individual is qualified *Contributions to your HSA that you receive from your employer and incentives count toward your maximum. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

HOW ARE MY MEDICAL CLAIMS PAID? Medical claim payment process Cigna updates quarterly Health Statement; sends email alert or mails to your home, based on preference setting. Sick visit to an in-network doctor/hospital/facility. Show Cigna Choice Fund ID card to obtain Cigna discounted rates. Cigna provides an Explanation of Benefits or EOB (“receipt”) showing: Doctor’s fee, Cigna discount, amount billed, amount deducted from the HSA, amount paid to doctor, remaining HSA balance, and what you saved. Doctor bills Cigna. If Auto Claim Forwarding was elected, Cigna automatically subtracts the amount owed to the doctor from your HSA and pays the doctor. If no Auto Claim Forwarding in place, you have the option to pay the doctor bill using your HSA (debit card/ checkbook) or pay out of pocket. Cigna receives the claim and processes it based on the HSA- qualified plan deductible, covered expenses and Cigna-negotiated discounts. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

AM I ELIGIBLE TO PARTICIPATE IN AN HSA PLAN? Because HSA plans have special tax advantages, the IRS defines specific rules for participation. To be eligible, you: Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plans sold with Cigna’s Choice Fund HSA meet IRS requirements) Cannot have any other health coverage Not covered by spouse’s medical or pharmacy plan Not covered through Medicare Part A or Part B Not covered through a general-purpose Flexible Spending Account (FSA) plan (either employer’s or spouse’s) Cannot be claimed as a dependent on another person’s tax return Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

JP Morgan Chase enrollment information You will need to go to the intranet to open an account Before opening the account, JPMorgan Chase will: Verify your identity (required by the Federal government) using information provided in the HSA application and enrollment form Notify you if additional documentation is needed to verify your name, social security number or address You can get a letter or a phone call from JP Morgan Chase JPMorgan Chase will send your HSA information and a debit card within 7–10 days of the start of the plan year or the verification of identity (whichever is later) ID cards are mailed from Cigna Debit cards are mailed separately from JPMorgan Chase JPMorgan Chase cannot open an HSA until it is able to satisfy the requirements of the Federal government. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

WHAT ARE MY HSA SAVING AND INVESTMENT FEATURES? $2,000 minimum in HSA to invest Once the investment account is open, no minimum balance applies Several mutual funds to choose from Investments can be put into one fund or multiple funds No minimum deposit for any fund Tax-free growth of interest or investment earnings* Monthly fees apply Online trading – no fees apply Track your balance online or with convenient monthly statements Another advantage of the Health Savings Account – the opportunity to invest your balance once it reaches $2,000 Go through bullets Note that once HSA dollars are invested they aren’t accessible to pay claims. Employee will need to transfer back to their regular Health Savings Account if they want used for auto claims forwarding. *HSA contributions and earnings are not subject to Federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna 12

CAN YOU HELP ME UNDERSTAND AND TRACK MY HEALTH CARE EXPENSES? 24/7 online health account management Review personalized plan coverage Check available balances Track claims and payments Get HSA bank account information Manage investment accounts via link to JPMorgan Chase At-A-Glance Account Summary Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Let’s do a comparison Good oral health can do more than brighten your smile! Regular dental care often catches minor problems before they become major and expensive to treat. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Health Savings Account (HSA) Medical plan highlights In-network Open Access Plus (OAP) Health Savings Account (HSA) Single Family Preventative Care No charge Deductible $300 $600 $2,000 $4,000 Out-of-pocket maximum  $1,000 Health Savings Account contribution from employer n/a Lifetime maximum Unlimited Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Pharmacy plan highlights In-network Open Access Plus (OAP) Health Savings Account (HSA) Retail (30 day supply) Mail Order (90 day supply) Generic You pay $15 You pay $30 You pay 100% of drug cost until the deductible is met – after the deductible is met then plan pays 100% Cigna-preferred brand You pay $35 You pay $70 Non-preferred brand You pay $55 You pay $110 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

helpful resources the information you need Good oral health can do more than brighten your smile! Regular dental care often catches minor problems before they become major and expensive to treat. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

CAN YOU HELP ME UNDERSTAND AND TRACK MY HEALTH CARE EXPENSES? Explanation of Benefits (EOB) Clearly shows how and when claims were paid, and by which plan and/or account(s) Available in print or online at myCigna.com Choose if you would like EOBs mailed to your home, or go paperless and receive email alerts after each claim is processed and posted to myCigna.com Quarterly Health Statement Available online at myCigna.com You will be alerted by email after each statement is posted to myCigna.com Shows year-to-date deductibles, all claim activity and out-of-pocket expenses for that quarter Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

CAN YOU HELP ME UNDERSTAND AND TRACK MY HEALTH CARE EXPENSES? 24/7 customer phone assistance One toll-free number – on the back of the ID card and debit card Specially trained Customer Service Representatives answer questions about: Medical and pharmacy benefits and claims HSA IRS requirements HSA transaction activity and balance Live transfer to JPMorgan Chase for specialized activity (investments, lost debit card, debit card transaction questions) Help with the tools and resources available on myCigna.com Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

WHENEVER. WHEREVER. SO MANY WAYS TO CONNECT WITH CIGNA. Cigna.com • Simple to navigate • Find what you’re looking for, quickly and easily WHENEVER. WHEREVER. myCigna.com • Personalized • Easy access to doctor and facility searches, cost and quality of care and more Interactive Voice Response (IVR) • New “natural language” system recognizes over 150 languages and dialects At Cigna, we understand that people are busy. And, they want to connect with us on their terms. And, on their time. That’s why we continue to offer more ways for people to get in touch. Cigna.com – offers an easy way for people to learn more about our products and services. Site visitors also have instant access to an array of health and wellness information, and can easily link to our social sites and more. New tablet technology – we use tablets to capture biometric results at onsite health screening events. This allows us to instantly capture the info and have an engaging dialogue with people about their health risks and potential ways they may improve their health. myCigna.com – offers Cigna customers access to all their personalized health information in one convenient location. Here customers can locate a doctor and find cost-of-care estimates and physician quality ratings before they receive treatment. They can also access their personal health assessment, account balance information, view and pay claims, research and order prescriptions and much, much more. Interactive Voice Response (IVR) – Cigna’s “natural language” IVR lets callers easily get the information they’re requesting. They can simply tell us why their calling – in their own words – to get routed to the right place. No long menus or hassle to deal with. 24/7/365 live phone service – we continue to be the only carrier to offer around-the-clock live customer service. Expanded Cigna mobile – people can use their mobile devices to access Cigna’s websites. Whenever, wherever. 24/7/365 live phone service • Around-the-clock customer service Expanded Cigna mobile • All Cigna sites available via any web-enabled mobile device Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna 20

FIND DOCTORS AND SERVICES Search for a health care professional in Cigna’s national network Valuable quality-of-care ratings Easily navigate using consumer-friendly language, not jargon Access maps for driving directions right from your smartphone The doctor prescribes a moderate painkiller and recommends that Elizabeth see an orthopedic specialist. Sara looks up orthopedic specialists on her myCigna app and discusses which specialist is the best one for Elizabeth (they both agree on one closer to home and part of the Cigna Care Designation). Sara can even see exactly where this specialist performs ankle fracture surgeries. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna 21

Programs for you Good oral health can do more than brighten your smile! Regular dental care often catches minor problems before they become major and expensive to treat. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Your Health First Resources for members with chronic conditions Educational materials, self-care tools, support and information for the following conditions: Asthma Heart Disease Coronary Artery Disease Angina Congestive Heart Failure Acute Myocardial Infarction COPD (Emphysema and Chronic Bronchitis) Type I & II Diabetes Metabolic Syndrome Peripheral Arterial Disease Low Back Pain Osteoarthritis Depression Anxiety Bipolar Disorder Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Lifestyle Management Programs CIGNA Healthy Steps to Weight Loss, CIGNA Quit Today and Stress & Resilience Call 1.866.417.7848 or visit www.mycigna.com to enroll Designed to help you set and manage your goals Scheduled one-on-one calls for ongoing support and goal-setting Online program participation available Set Personal Healthy Living Plan Dedicated Health Coach Workbook and Toolkit Weekly educational emails with key learning themes and tips* * - If participate online Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Helping you stay healthy. Cigna Healthy Rewards® Discounts on a full range of health and wellness programs and services* Eye care – exams, frames and lenses, laser vision correction Jenny Craig® Smoking cessation programs Hearing care Fitness club memberships Alternative medicine – acupuncture, chiropractic care, massage therapy Mind/body – Yoga Journal and SpaFinderTM and much more Through CIGNA Healthy Rewards, CIGNA Dental members have access to discounts on a full range of health and wellness programs and services often not covered by traditional insurance plans. *Healthy Rewards is a discount program. Some Healthy Rewards programs are not available in all states. A discount program is NOT insurance, and the customer must pay the entire discounted charge. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna 25

CIGNA HealthCare Healthy Babies Voluntary prenatal education Helpful informational materials from the March of Dimes® Toll free, round-the-clock access to information and support from registered nurses Post-delivery support and service Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna

Q & A Good oral health can do more than brighten your smile! Regular dental care often catches minor problems before they become major and expensive to treat. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna