Understanding Your HealthSync Network

Your HealthSync network Questions and answers to help you save on healthcare costs HealthSync is a network of carefully chosen, high-quality care providers who offer their services at the lowest rates available. That means you can see a doctor who is truly invested in your health. HealthSync also offers: • Access to high-performing care providers who are driven by quality. • Lower costs when you use a care provider in your plan’s network. • Access to nearly 10,000 care providers and 45 hospitals across Indiana. • Easy-to-use access to care if you’re out of state or away from home through BlueCard. Below is information to help answer any questions you may have. What are the benefits of HealthSync? Anthem and your employer want you and your covered family members to have strong relationships with top-performing doctors to keep you at your healthiest. That’s why HealthSync offers: • Care providers with a proven track record of success for high-quality, personalized care and keeping costs low. • Access to telehealth visits for minor or routine covered services. • Lower costs. What are tiers of coverage? Your health plan has three tiers of coverage. The least-expensive options are when you receive care from providers in the HealthSync network (tier 1). You may still access care from providers in the Anthem preferred provider organization network (tier 2), and those expenses will be considered in your plan’s network. Care providers in tier 3 are considered out of network and will have higher out-of-pocket costs. Here’s a breakdown: Tier 1 – HealthSync network (lowest costs for you) Care providers in this network have agreed to become even stronger partners by giving enhanced care to patients, meeting best-practice quality standards, and charging the lowest fees for their services. A great deal of research goes into creating this network to benefit our members. Tier 2 – Your health plan’s network but not HealthSync (lower costs for you) Care providers in your plan’s network are not part of the HealthSync network, but they are still considered to be in network. That means your costs will still be lower than using care providers who are out of your plan’s network. Tier 3 – Outside of your plan’s network (higher costs for you) These care providers do not have contracted arrangements with Anthem, so there are no set limits for what they can charge. That can leave you with more out-of-pocket expenses for services. How do HealthSync medical expenses work? Your medical expenses will count toward your HealthSync and in-network deductible. This includes charges from HealthSync care providers, care providers in your plan’s network, and prescriptions. • Once you reach your HealthSync out-of-pocket maximum, HealthSync care providers will be covered 100%. • Care providers in your plan’s network will continue to apply toward your in-network deductible and in-network out-of-pocket maximum. 1052288INMENABS 04/23

How will my health plan pay between the different tiers? This chart below shows you an example of how benefits are paid. As you can see, the deductible, coinsurance, and out-of-pocket maximum is lower when you use HealthSync care providers. Benefit Tier 1 HealthSync care providers (in your plan’s network — lowest costs for you) Tier 2 care providers (in your plan’s network) Tier 3 care providers (not in your plan’s network) Deductible $1,500 $4,500 $13,500 Out-of-pocket maximum $8,500 $8,500 $19,500 Primary care doctor visit $15 copay $40 copay Deductible + 50% coinsurance Specialist visit $30 copay $80 copay Deductible + 50% coinsurance Urgent care $50 copay Deductible + 30% coinsurance Deductible + 50% coinsurance Inpatient Deductible + 10% coinsurance Deductible + 30% coinsurance Deductible + 50% coinsurance Outpatient Deductible + 10% coinsurance Deductible + 30% coinsurance Deductible + 50% coinsurance Emergency $400 + 10% coinsurance Same as preferred Same as preferred Ambulance Deductible + 10% coinsurance Same as preferred Same as preferred What care providers are in the HealthSync network? The HealthSync network includes more than 10,000 care providers and 45 top hospitals throughout Indiana. These include: • Ascension St. Vincent hospitals • Bluffton Regional Medical Center • Dukes Memorial Hospital • Dupont Hospital • Elkhart General Hospital • Franciscan Health • Good Samaritan Hospital • Lutheran Hospital of Indiana • Memorial Hospital of Logansport • Memorial Hospital of South Bend • OrthoIndy • Perry County Memorial Hospital • Schneck Medical Center • Lutheran Downtown Hospital Do I have to use only HealthSync care providers? No, you can use care providers in any of the three tiers. When you use HealthSync providers, you will have the lowest costs. Do I need to get a referral from my primary care provider to see a specialist in the HealthSync network? No, HealthSync plans are open access, which means referrals are not required. What is care provider matching? This service matches you and your dependents with a primary care provider (PCP) and records that PCP in the Anthem system as your assigned PCP. Care providers who participate in HealthSync have agreed to provide a higher level of service to their patients. This includes matching patients with care providers who are: • Best suited to fit their needs. • Able to provide quick access to appointments. • Able to help with referrals and links to specialists and other care providers when needed. • Able to provide top-quality care. • In general practice, family practice, internal medicine, and pediatrics. • Reid Hospital • Lutheran Kosciusko Hospital • The Orthopedic Hospital

Why is care provider matching so important? This matching is done so you get the most out of this new network arrangement. Anthem will send you a letter to let you know the care provider has been recorded for you and your covered dependents. If you want to change your PCP, you can log in to anthem.com and select Update Primary Care Physician or call the Member Services number on the back of your health plan ID card. What if I already have a doctor or want to make a change? If you or your covered dependent already have a PCP in the HealthSync network, Anthem will use your current claims to put them on record as your match. If you have a HealthSync nurse practitioner, it will be listed under the supervising doctor of the practice. If at any time you want to make a change, you can: • Log in or register at anthem.com or the SydneySM Health app. • Hover over the Care tab and select Update Primary Care Physician. • Select the member whose PCP you’d like to change. • Search for and then select a PCP to update. If you need help updating your HealthSync care provider information, call the Member Services number on the back of your ID card. Please note that any changes made to your PCP will not update automatically; they update at the first of each month. We are here to help If you have questions or need more information, please call the Member Services number on the back of your ID card. Sydney Health is offered through an arrangement with Carelon Digital Platforms, a separate company offering mobile application services on behalf of your health plan. ©2023 In addition to using a telehealth service, you can receive in-person or virtual care from your own doctor or another healthcare provider in your plan’s network. If you receive care from a doctor or healthcare provider not in your plan’s network, your share of the costs may be higher. You also may receive a bill for any charges not covered by your health plan. Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc. Independent licensee of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.