High-level overview of the plan types Anthem Link HealthSync HMO HealthSync POS HealthSync Options POS (3 Tier) Think of these plans as HMO and PPO “hybrids.” An HMO plan that combines a network with Tier 1 high performing providers with comprehensive Anthem HealthSync/Cooperative Care Indiana High medical and digital capabilities. The integration Providers: o昀昀ers the lowest out-of-pocket of these components strengthens the costs and a network of high-performing value proposition for our members through A Point of Service plan (POS) o昀昀ers lower practices providing value-based care. costs if doctors, health care providers, and consumer empowerment and a di昀昀erentiated hospitals in the plan‘s network are used. Tier 2 Description digital experience, driving a昀昀ordability and improved member experience as a whole. Other Blue Access PPO providers: may result Bene昀椀ts are covered in the HealthSync in higher out-of-pocket costs. To maximize Performance network as well as out of network. savings, consider using a Tier 1 doctor. $0 member out of pocket cost for primary Tier 3 care, virtual care, mental/behavioral health Out of network: will result in higher out- and retail health care on non-HSA plan. of-pocket costs. To maximize savings, Networks consider using a Tier 1 doctor. Members receive in-network coverage when they visit any participating HPN provider Out-of-network care is allowed, but staying Out-of-network care is allowed, but staying Access to care in our HPN markets across the U.S. Non- in the plan’s network is far less expensive. in the plan’s network is far less expensive. network and out of country coverage is At A Glance limited to urgent and emergency care. O昀昀ers the freedom to use HealthSync and other PPO providers, as well as out-of-network doctors and providers, O昀昀ers the freedom to use out-of- but the out-of-pocket cost is higher than network doctors and providers, but an in-network doctor or provider. the out-of-pocket cost is higher than Typically o昀昀ers lower monthly payments Members have access to most providers De昀椀nitions The bottom line and out-of-pocket costs. an in-network doctor or provider. Anthem has contracts with, including BlueCard, Blue HPN: The Blue HPN is available in over 55+ markets Gives members access to BlueCard without compromising access. While pricing and related out-of-network care. is not as lean as an HMO or POS, tier plans (MSAs) across the country, of which nine are service-area provide value-based bene昀椀t design, which incentivizes the use of the HealthSync network wide, high-performance-networks that cover 56% of the US when compared to Blue Access PPO. population. Blue HPN is the only high-performance network Small Group Large Group (2-50) Large Group (100+) o昀昀ered by a national carrier that is available in all 10 of the Segment size(s) (51+) largest cities in the U.S. Members in Blue HPN will be able Large Group (requires a 30% spread in bene昀椀t cost (51+) shares between the two network tiers) to access in-network care across all 55+ markets, enjoying Small Group FI ACA: 1/1/2021 seamless access when they and covered dependents travel.* Small Group ChamberCare Health 1/1/2018 7/1/19 E昀昀ective date Alliance - MEWA: 10/1/21 Large Group: 1/1/2021 BlueCard: Seamless access for employees who live/travel Small Group: Fully Insured (FI) FI and ASO FI (100 covered and up) and ASO outside of the state. Funding Large Group: FI and Administrative Services Only (ASO) Cooperative Care: A subset of HealthSync PCPs also Only includes OON coverage for emergency or Out-of-network (OON) authorized services. Includes OON coverage with higher participate in Cooperative Care, Anthem’s next-generation cost shares (including deductible, Includes OON coverage with higher cost shares Members are responsible for 100% of non-ER (including deductible, coinsurance, and copays). coverage payment innovation model. Cooperative Care is made up of a related costs. coinsurance, and copays). select group of providers within the HealthSync network. BlueCard   Blue HPN  Digital capabilities Yes Yes Yes PCP selection required Yes Yes Yes No – but encouraged No – but encouraged No – but encouraged Required referrals Cooperative Care Yes Yes Yes *MSA number and coverage are subject to change