1. Plan Year January 1 through December 31, 2012 2012 Benefit Options Presentation 1

2. The Employee Benefit Options Guide 2 How to access the Guide: View the Guide on the OSEEGIB website at www.sib.ok.gov or www.healthchoiceok.com Complete the online request Contact your Insurance Coordinator Contact OSEEGIB Member Services

3. 2012 Plan Changes Health Plans Dental Plans Vision Plans HealthChoice Life Insurance Plan Eligibility Topics 3

4. 2012 Employee Benefit Options Guide Frequently Asked Questions at www.sib.ok.gov or www.healthchoiceok.com Your Insurance Coordinator OSEEGIB Member Services Plan websites and customer service representatives For More Information 4

5. Index 5 2012 Plan Changes HealthChoice Health Plans Dental Plans Vision Plans HealthChoice Life Insurance Plan Eligibility End Click the link below to access a particular section of this presentation.

6. 2012 PLAN CHANGES 6

7. Eligibility Changes 7 There are no eligibility changes for plan year 2012.

8. High and Basic Plans Must submit the HealthChoice High and Basic Plans Tobacco-Free Attestation for Plan Year 2012 by November 15, 2011, or enroll in the High or Basic Alternative Plan The Attestation is available online, by calling HealthChoice Member Services, or from your Insurance Coordinator HealthChoice Plan Changes 8

9. Two new plans: High Alternative and Basic Alternative Plans Plan costs for tobacco use are approximately $52 million annually High Alternative has a $750 individual/ $2,250 family deductible $3050 ind/yearly maximum Basic Alternative has a $750 individual/$1,500 family deductible $5750 ind/yearly maximum HealthChoice Plan Changes 9

10. High and Basic Plans You may still be eligible without the Attestation if you provide a letter: Showing you/your dependent has enrolled in the quit tobacco program Showing you/your dependent has completed the quit tobacco program From your doctor indicating it is not medically advisable for you/your dependent to quit using tobacco HealthChoice Plan Changes 10

11. All HealthChoice Plans Specific preventive procedures covered at 100% when using a Network Provider; refer to your Employee Benefit Options Guide Non-Network emergency room services will be paid as Network; deductibles and balance billing may apply Speech therapy no longer requires certification for patients 18 and older HealthChoice Plan Changes 11

12. High Plan Family out-of-pocket limit of $8,400 for Network and $9,900 for non- Network Basic Plan Well child care visits covered at 100% when using a Network Provider HealthChoice Plan Changes 12

13. S-Account Plan Out-of-pocket limits are being lowered to $3,000 for an individual and $6,000 for a family Well child care visits have no copay and do not apply to the deductible Proof of enrollment in an HSA is no longer required HealthChoice Plan Changes 13

14. S-Account Plan To make enrollment easier and more convenient, HealthChoice has contracted with American Fidelity Health Services Administration to provide an HSA or you can enroll in an HSA through the financial institution of your choice HealthChoice Plan Changes 14

15. Prescription Plan Benefits Prescriptions can be filled at a retail pharmacy or through the mail-order pharmacy Retail pharmacy fills are limited to a 30-day supply or less for one copay Mail-order pharmacy fills are limited to a 90-day supply for one copay Prescription tobacco cessation products covered at 100% HealthChoice Plan Changes 15

16. Dental Plan Changes There are no changes to the dental plan benefits for 2012. 16

17. Vision Plan Changes Superior Vision With a network provider, there is a $25 fitting copay for standard and specialty fitting for contact lenses, then plan pays 100% for standard fitting and up to $50 for specialty fitting Plan offers savings of 20-50% on LASIK surgery Fitting fee not covered with a non- network provider 17

18. Vision Plan Changes UnitedHealthcare Vision With network provider, the UV coating and tint lens options are covered in full Vision Service Plan (VSP) With network provider, the contact lens exam is covered in full after up to $60 copay 18

19. HealthChoice Life Insurance Plan You can now purchase up to $500,000 of supplemental life insurance coverage with an approved Life Insurance Application, regardless of salary You can no longer purchase $20,000 of life insurance coverage without a Life Insurance Application during Option Period 19 Return to Index

20. HEALTHCHOICE HEALTH PLANS 20

21. Available Plans HealthChoice High HealthChoice High Alternative HealthChoice Basic HealthChoice Basic Alternative HealthChoice S-Account HealthChoice USA Using a HealthChoice Network Provider will lower your out-of-pocket costs. 21 View plan changes for 2012

22. When using a Network Provider: $30 copay for PCP office visits $50 copay for specialist office visits Annual deductible $500/individual or $1,500/family Plan pays 80%/member pays 20% of Allowed Charges up to the out-of- pocket limit of $2,800/individual or $8,400/family High 22

23. 23 High Alternative When using a Network Provider: Benefits same as High Option except deductibles and out-of-pocket limit Annual deductible $750/individual or $2,250/family Plan pays 80%/member pays 20% of Allowed Charges up to the out-of- pocket limit of $3,050/individual or $9,150/family

24. When using a Network Provider: Office visit copays do not apply Plan pays first $500 then member pays next $500 as deductible; $1,000 deductible for a family of two or more Plan then pays 50% until $5,500/ individual or $11,000/family out-of- pocket limit is met Plan then pays 100% of Allowed Charges Basic 24

25. 25 When using a Network Provider: Office visit copays do not apply Plan pays first $250 then member pays next $750 as deductible; $1,500 deductible for family of two or more Plan then pays 50% until $5,750/individual or $11,500/family out-of-pocket limit is met Plan then pays 100% of Allowed Charges Basic Alternative

26. Designed for a Health Savings Account (HSA) When using a Network Provider: Combined $1,500 deductible/individual and $3,000/family Entire deductible must be met before claims are paid (including prescriptions) $50 copay for office visits The calendar year out-of-pocket limit is $3,000/individual or $6,000/family American Fidelity Health Service Administration S-Account 26

27. For members who live and work outside of Oklahoma and Arkansas for more than 90 consecutive days Benefits are the same as the HealthChoice High Plan Members have access to the USA Plan’s nationwide provider network USA 27

28. Network Pharmacy Benefits 28 Prescriptions can be filled at retail pharmacies or through mail-order Benefits are the same for all plans; S- Account members must meet the plan deductible before benefits are paid You are responsible for the cost difference when choosing a brand- name if a generic is available

29. Network Pharmacy Benefits 29 When using a retail pharmacy: Up to 30-day supply For generics, maximum copay of $10 For Preferred brand-name, maximum copay of $30 For non-Preferred brand-name, maximum copay of $60

30. Network Pharmacy Benefits 30 When using the mail-order pharmacy: Up to 90-day supply For generics, maximum copay of $25 For Preferred brand-name, maximum copay of $60 For non-Preferred brand-name, maximum copay of $120 90-day supply does not apply to drugs with quantity or dosage limits

31. Network Pharmacy Benefits 31 Certain prescription tobacco cessation medications for a $0 copay A calendar year pharmacy out-of- pocket limit of $2,500 (does not apply to S-Account Plan) Specialty medications must be filled through Accredo Health, the HealthChoice specialty care, delivery service pharmacy Return to Index

32. DENTAL PLANS 32

33. Dental Plans Available 33 Assurant Heritage Plus with SBA Prepaid Assurant Heritage Secure Prepaid Assurant Freedom Preferred CIGNA Dental Care Plan Prepaid Delta Dental PPO – Choice Delta Dental PPO Delta Dental Premier HealthChoice Dental There are no changes to the dental plan benefits for 2012.

34. Dental Benefits 34 All the dental plans have the same core benefits which are divided into four different classes: Preventive Care includes cleanings, bitewing x-rays, and routine oral exams Basic Care includes fillings, extractions, root canals, endodontics, and periodontics

35. *HealthChoice and Assurant Freedom Preferred have a 12-month waiting period for orthodontic care unless you provide proof of prior group dental coverage. Major Care includes dentures, bridgework, crowns, and implants Orthodontic Care* is covered for members under age 19 and members age 19 or older with temporomandibular joint dysfunction (unless otherwise noted) Dental Benefits 35

36. No deductibles or maximum annual benefit You must select a Primary Care Dentist for each covered person Preventive Care is covered at 100% Copay schedule applies to other services The SBA (Special Benefit Amendment) provides an additional discount for network specialists Heritage Plus Dental Plan with SBA 36

37. No deductibles or maximum annual benefit You must select a Primary Care Dentist for each covered person Preventive Care is covered at 100% A copay schedule applies to other services, including specialist care Heritage Secure Dental Plan 37

38. Preventive Care is covered at 100% A $25 deductible applies to Basic and Major Care. After the deductible: Basic Care is covered at 85% Major Care is covered at 60% Orthodontic Care is covered at 60%; maximum lifetime benefit of $2,000 All other services have a combined $2,000 maximum annual benefit Freedom Preferred Dental Plan 38

39. No deductible or maximum annual benefit You must select a Primary Care Dentist for each covered person After routine cleanings, x-rays, and evaluations are covered at 100%; a $5 copay applies A copay schedule applies to other services, including specialist care Orthodontia benefits for adults Prepaid Dental Plan 39

40. You must select a Primary Care Dentist for each covered person No deductible for Preventive or Basic Care A $100 deductible for Major Care A copay schedule for all other services A $2,000 maximum annual benefit for Preventive, Basic, and Major Care Orthodontic Care has a maximum lifetime benefit of $1,800 Delta Dental PPO - Choice 40

41. A $50 combined deductible applies to Preventive, Basic, and Major Care Preventive Care is covered at 100% Basic Care is covered at 70% Major Care is covered at 50% Orthodontic Care is covered at 60% with a lifetime maximum of $2,000 $3,000 maximum annual benefit Delta Dental Premier 41

42. Preventive Care is covered at 100% $25 annual deductible for Basic and Major Care After deductible: Basic Care is covered at 85% Major Care is covered at 60% Orthodontic Care is covered at 60%  $2,000 maximum $2,500 maximum annual benefit for other services Delta Dental PPO 42

43. When using a Network Provider: Preventive Care is covered at 100% A $25 deductible applies to Basic and Major Care Basic Care is covered at 85% Major Care is covered at 60% Orthodontic Care is covered at 50% — no lifetime maximum A $2,000 calendar year maximum applies to all other services Dental 43 Return to Index

44. VISION PLANS 44

45. Vision Plans Available 45 Humana/CompBenefits Vision Care Plan Primary Vision Care Services (PVCS) Superior Vision Plan United Healthcare Vision Vision Service Plan (VSP)

46. Each vision plan has its own provider network The toll-free number and website address of each plan is listed in the Employee Benefit Options Guide Contact each vision plan for specific benefit questions Vision Plans Overview 46

47. A $10 copay for an annual eye exam A $25 copay for lenses and frames — one pair per year Discounts are available for other vision services and lens options Contact lenses are available instead of glasses Humana/CompBenefits 47

48. There is no copay or limit on the number of eye exams Lenses and frames are sold at wholesale cost There is no limit on the number of pairs of glasses Benefits available for contact lenses Primary Vision Care Services 48

49. A $10 copay applies to eye exams — one per year A $25 copay for lenses and frames — one pair per year Contact lenses – available instead of glasses; $25 copay/standard fitting then plan pays 100% or $25 copay/specialty fitting then plan pays up to $50 Discounts available for other vision services and lens options Superior Vision 49

50. A $10 copay for eye exams — one exam per year A $25 copay for lenses and frames — one pair per year Discounts are available for other vision services and lens options Lens UV coating and tints are covered in full Contact lenses are available instead of glasses UnitedHealthcare Vision 50

51. A $10 copay for eye exams — one exam per year A $25 copay for lenses and frames — one pair per year Discounts are available for glasses and other vision benefits Up to $60 copay for contact lens exam with network provider Contact lenses are available instead of glasses VSP 51 Return to Index

52. Life Insurance Plan 52

53. Basic and Supplemental Life for You First $20,000 of life coverage (Basic Life) All additional coverage is known as Supplemental Life Basic Life and the first $20,000 of Supplemental Life include Accidental Death and Dismemberment (AD&D) benefits Employee Life 53

54. During initial enrollment: Guaranteed Issue (two times your annual salary) can be elected without completing a Life Insurance Application Amounts above Guaranteed Issue require an approved Life Insurance Application Employee Life 54

55. During Option Period: You can purchase up to $500,000 of supplemental life insurance coverage with an approved Life Insurance Application, regardless of your annual salary HealthChoice no longer offers the $20,000 of life insurance annually without an approved Life Insurance Application Employee Life 55

56. Keep your beneficiary designation up-to- date Beneficiaries can be changed at any time Review your beneficiaries if you have a change such as a marriage, divorce, death of a family member, or birth of a child Beneficiary Designation Forms are available online, from your Insurance Coordinator, or by calling OSEEGIB Member Services Beneficiary Designation 56

57. All three options offer $1,000 of coverage for dependents under six months of age. Premier Option Spouse$20,000 Child$10,000 Premier Option Spouse$20,000 Child$10,000 Standard Option Spouse$10,000 Child $5,000 Standard Option Spouse$10,000 Child $5,000 Low Option Spouse$6,000 Child$3,000 Low Option Spouse$6,000 Child$3,000 Dependent Life 57 You must be enrolled in Basic Life coverage in order to enroll your eligible dependents in Dependent Life. Return to Index

58. ELIGIBILITY 58

59. An education employee must be: Currently employed, eligible for TRS, and working at least four hours a day/20 hours a week A local government employee must be: Currently employed, regularly scheduled to work 1,000 hours or more per year, and cannot be listed as a temporary or seasonal employee Eligible Employees 59

60. If you insure one dependent under any benefit, you must insure all eligible dependents Eligible dependents can be excluded if on group insurance of the same type You can exclude dependents that do not reside with you, are married, or are not financially dependent on you for support A spouse can be excluded by signing the Spouse Exclusion Certification statement on the back of the form Dependent Eligibility 60

61. Eligible dependents include: Your legal spouse (including common- law) Your daughter, son, stepdaughter, stepson, eligible foster child, adopted child or child legally placed with you for adoption up to age 26, whether married or unmarried Disabled dependents over age 26 with approved documentation Eligible Dependents 61

62. Other Dependent Children 62 Other unmarried dependent children up to age 26, upon completion of an Application for Coverage for Other Dependent Children Guardianship papers or a tax return showing dependency may be provided in lieu of the application

63. Certain qualifying events may allow you to make a midyear change, examples include: Marriage Divorce Adoption Death Childbirth Gain or loss of other group insurance Notify your Insurance Coordinator within 30 days of the event or wait until the next annual Option Period. Midyear Qualifying Events 63

64. Option Period Enrollment/Change Form: Your Insurance Coordinator will provide the deadline Insurance Enrollment Form: Return your form to your Insurance Coordinator within 30 days Insurance Change Form: Return your form to your Insurance Coordinator within 30 days of a qualifying event Deadlines for Forms 64

65. Attestation: Must be completed online or returned to your Insurance Coordinator by November 15 HRA for HMO Wellness Alternative Plus Plans: Must be completed online and confirmation of your completion provided to your Insurance Coordinator New employees enroll in the HMO Alternative Plan and have 30 days to complete the HRA Deadlines for Forms 65

66. OSEEGIB mails you a Confirmation Statement when your form is received If your Confirmation Statement is incorrect, contact your Insurance Coordinator immediately If you do not make changes during the annual Option Period, no Confirmation Statement will be sent; keep your enrollment form as verification of coverage Confirmation Statements 66

67. You cannot enroll in dental or life coverage unless you have group health insurance If excluding or adding common-law spouse, your spouse must sign your form You must sign and date your form Return your form to your Insurance Coordinator by the set deadline Notify your Insurance Coordinator if you have a change of address Reminders 67

68. The 2012 Employee Benefit Options Guide Plan websites and toll-free numbers available in your Option Period packet The FAQ section of the OSEEGIB website OSEEGIB Member Services at 1-405- 717-8780 or toll-free 1-800-752-9475 TDD users call 1-405-949-2281 or toll- free 1-866-447-0436 Your Insurance Coordinator Questions ? 68 Return to Index