experience. wellness. everywhere

OUTHE UNIVERSITY OF OKLAHOMA EMPLOYEE BENEFITS

2012

Experience. Wellness. Everywhere.

TABLE OF CONTENTS

2012 Benefit Highlights & Changes . . . . . Welcome

Benefit Enrollment & Making Changes During the Year . . . . . . . . . . . .1

Medical Plan Options . . . . . . . . . . . . . . . . . . 1-3

BlueLincs® HMO . . . . . . . . . . . . . . . . . . . . . . .4

BlueOptions® PPO . . . . . . . . . . . . . . . . . . . . . .5

BlueEdgeSM HCA . . . . . . . . . . . . . . . . . . . . . 6-7

Plan Comparison Chart . . . . . . . . . . . . . . . . 8-13

What’s Not Covered . . . . . . . . . . . . . . . . . . .14

ID Cards . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Wellness Guide . . . . . . . . . . . . . . . . . . . . 15-17

Resource Guide & Contacts . . . . . . . . . . . . . . .18

For more than 70 years, Blue Cross and Blue Shield of Oklahoma (BCBSOK) has delivered high value products and unrivaled customer service to more Oklahomans than any other health insurance plan. And our nationwide network of physicians and hospitals, coupled with local resources and friendly service, keeps you connected to your health care coverage no matter where you are.

Through the University of Oklahoma, we are pleased to offer benefits that give you and your family the best care possible and services that allow you to put your health care decisions and health education closer to your fingertips. Please take a few minutes to look through this summary guide and review the options that are available to you. You may also visit bcbsok.com/OU for more information. It is our desire during the enrollment period that you gain a clear understanding of each option and to help you decide what is best for your health care needs.

BCBSOK members don’t just have access to traditional insurance coverage; you also have a complete suite of health and wellness resources and tools at your fingertips, to encourage healthier living and smarter health decisions. Blue Cross and Blue Shield of Oklahoma is a health care industry leader in creating and promoting wellness programs that you and your family can conveniently integrate into your daily life. Merging technology and medical management with online resources, education, one-on-one coaching, rewards and multiple touch points, BCBSOK’s Blue Care Connection® program aims to ultimately improve you and your family’s health and wellness.

Our goal at Blue Cross and Blue Shield of Oklahoma is to provide you with first class service, and to do the job right the first time, every time. We appreciate the opportunity to serve you.

Sincerely,

Linza JonesVice President, Marketing and SalesBlue Cross and Blue Shield of Oklahoma

Welcome to Blue Cross and Blue Shield of Oklahoma, and to your benefit enrollment period. This is your opportunity to select health benefits for you and your family for the coming year.

WELCOME

2012 Benefit Highlights & ChangesOU is committed to providing a healthy environment for you and your family. Our health care program with Blue Cross and Blue Shield of Oklahoma offers health insurance coverage and wellness programs that offer flexible and affordable options for you and your family - as well as help us all achieve and maintain a healthier lifestyle.

OU has made modifications to the 2012 health benefit package, including:

Introducing BlueOptions® PPO n The BlueOptions PPO plan replaces the BlueChoice®

plan - providing greater flexibility and freedom to choose your provider and network, and ultimately determine your copayment and deductible amounts. The flexibility of BlueOptions PPO allows you to make smarter health care decisions for you and your family.

Preventive Care Services Fully Covered Under BlueOptions PPO n Most preventive care services for members with BlueOptions

PPO are fully covered if using in-network providers, which means you will pay no copayment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests.

BlueLincs HMO Deductible and Copayment Amounts n The addition of a calendar year deductible for certain

services, including but not limited to inpatient/outpatient hospital services, skilled nursing facilities, durable medical equipment, and certain imaging services such as MRI, PET and CT scans.

n Adjustment of the copayment amount for certain imaging services such as MRI, PET and CT scans.

01

Benef i t En ro l lmen t & Making Changes Dur ing the Year

During the open and new member enrollment period, you can add or delete dependents from your health care coverage without a “qualifying event”. The enrollment period is the time to make sure all of your eligible dependents are enrolled and that Human Resources has all the correct information about your dependents on file.

The health care plan options you select during the enrollment period will remain in effect during the calendar year.

In order to change benefit elections outside of the enrollment period, the employee must have:

1) Experienced an Applicable Qualifying Event, as defined by the Internal Revenue Service (IRS). Changes based on financial reasons alone are not allowed under the current IRS regulations. AND 2) The request for a change of benefits must be made within 31 days of the Applicable Qualifying Event.

Within the context of changing benefits, “Applicable” refers to a change that is directly related to the individual experiencing the qualifying event.

A qualifying event includes:

n A birth or adoption

n Marriage, divorce or legal separation

n Death

n Child loses eligibility because of age

n Employee’s spouse gains or loses coverage through employment

n Significant change in the financial terms of health benefits provided through a spouse’s employer or another carrier

Except for coverage of a newborn or adopted child, all other changes in coverage begin the first day of the month following the qualifying event. Coverage for the newborn is effective on the child’s date of birth. Coverage for an adopted child is effective on the date of placement. In both instances, the employee must initiate and complete the appropriate paperwork.

Changes in provider networks (for example, your doctor leaving the network) are not considered acceptable reasons for you to be able to change your product election outside of the enrollment period.

Please visit the “Benefits” section of the OU Human Resources website for more information at hr.ou.edu.

E l ig ib i l i t y

Please visit the “Benefits” section of the OU Human Resources website for information at hr.ou.edu.

Medica l P lan Opt ions

The following pages (1 – 14) provide an overview of the health benefits of each of the program options. These are only summaries – not the actual plan descriptions. If you have questions that aren’t answered in the summary information in this booklet, please contact customer service at 1-888-881-4648 or review the detailed Summary Plan Descriptions. Dental care benefits are offered separately, and are not highlighted in this benefit guide.

The medical plan you select during the enrollment period will apply for the calendar year. You will not be able to make changes to your medical plan during the year UNLESS YOU HAVE A QUALIFYING EVENT. In no event will you be able to switch from one plan to another during the year, unless you are on the HMO plan and move outside the service area. A brief description of the various aspects of each program follows on the next pages.

02

Medica l P lan Compar i sons

Available Health Care Plans There are three notably different benefit plans to choose from: BlueLincs HMO, BlueOptions PPO or BlueEdge HCA.

The BlueLincs HMO is a health maintenance organization type of plan, otherwise known as a “managed care” plan. It requires selection and use of a primary care physician (PCP), and referrals are usually needed for specialty care.

BlueOptions PPO and BlueEdge HCA are preferred provider organization (PPO) types of plans. Blue Cross and Blue Shield of Oklahoma has negotiated discounts with medical providers (doctors, hospitals etc) to reduce the cost of health care. The discount is applied before there is any payment for services from you or BCBSOK.

When you see a provider that is in-network, you will have the lowest out-of-pocket expense because the cost of services is usually lower and the benefits you receive are higher.

n BlueEdge HCA uses the BlueChoice network, which is BCBSOK’s largest PPO network.

n BlueOptions PPO offers a unique tiered structure that allows you the flexibility to see providers in the BlueChoice or BluePreferred® networks. However, you will have the lowest out-of-pocket expense when you see providers in the BluePreferred network (see pages 2-3 and 5 for additional information) because the discounts are greater. The BluePreferred network has fewer providers than the BlueChoice network.

BlueOptions PPO and BlueEdge HCA also give you the flexibility to choose an out-of-network provider, with whom BCBSOK does not have a contract, and still receive health care benefits. However, you may have more out-of-pocket expense when you choose an out-of-network provider.

The BlueEdge HCA pairs a high deductible and the BlueChoice network with a health care account (HCA). The HCA can be used to pay for certain out-of-pocket medical expenses.

Key Areas to Consider When Choosing a Health Plan You should choose the plan best suited for you and your family. There are important differences between the plans that should be considered. Details and benefits of each plan are listed on the following pages for easy comparison. Here are some additional factors to keep in mind:

1) Benefit design – Each of the three plans promotes wellness, offers preventive care and has unlimited lifetime maximums. However, there are notable differences among the plans, which impact the coverage and out-of-pocket costs you’ll have when you utilize your benefits.

The BlueLincs HMO has very low out-of-pocket costs with only applicable copayments and a low calendar year deductible that is applicable to some services. There is no calendar year deductible to satisfy except for certain services such as inpatient/outpatient hospital services, skilled nursing facilities, durable medical equipment, and certain imaging services such as MRI, PET and CT scans.

BlueOptions PPO has a calendar year deductible to satisfy before coverage begins. However, like the HMO plan, many services are covered with just a copayment, so depending on the type of services you need, you may not even need to meet your deductible during the year. Most preventive care services are fully covered under BlueOptions PPO if using in-network providers, which means you will pay no copayment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests. When you see providers in the BluePreferred network, you will have the lowest out-of-pocket expense because the discounts are greater.

The BlueEdge HCA has a notably higher deductible to satisfy each year, and some services, except for some of your preventive care benefits, are subject to that deductible before your coverage begins. (If you have family coverage, the full family deductible must be satisfied before coinsurance begins.) To help offset the higher deductible, money is put into a health care account each year on your behalf, which can be applied to your deductible or other eligible out-of-pocket medical expenses. Blue Edge HCA uses the BlueChoice network, so you will have the lowest out-of-pocket costs when you use providers in the BlueChoice network.

2) Rates – It’s important to compare the rates of each plan, while keeping in mind the benefits that come with each plan. The rates for BlueLincs HMO are slightly higher than the other plans, but BlueLincs HMO also has the most predictable out-of-pocket costs when you need to utilize your benefits. Keep in mind, however, that as an HMO, BlueLincs HMO has less flexibility than the other two plans, and it has a smaller network of providers to choose from. BlueOptions PPO is the middle cost plan, and unlike BlueLincs HMO, it provides a high level of flexibility when choosing your providers and out-of-pocket costs. BlueEdge HCA has the lowest premiums. It provides a high level of flexibility, but it has higher out-of-pocket costs than the other two plans.

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3) Provider access – The BlueChoice network is BCBSOK’s largest network. BlueEdge HCA utilizes the BlueChoice network, which means you will have the lowest out-of-pocket costs when you see providers in the BlueChoice network. The BluePreferred network is BCBSOK’s second largest network, including providers in the Tulsa and Oklahoma City metro areas as well as many providers in the rest of the state. BlueOptions PPO offers a unique tiered structure that allows you the flexibility to see providers in the BlueChoice or BluePreferred networks. However, you will have the lowest out-of-pocket costs when you see providers in the BluePreferred network (see pages 2-3 and 5 for additional information) because the discounts are greater.

BlueOptions PPO and BlueEdge HCA also give you the flexibility to choose an out-of-network provider, with whom BCBSOK does not have a contract, and still receive health care benefits. However, you may have more out-of-pocket expense when you choose an out-of-network provider.

There are fewer providers in the BlueLincs HMO network than there are in the BlueChoice or BluePreferred network. Be sure to verify that your current physicians are in the network for the plan you are considering. If you are joining the HMO and want to choose a new primary care physician (PCP), make sure that physician is accepting new patients.

With BlueLincs HMO, out-of-state coverage is generally limited to emergency treatment. If you have a dependent living out-of-state (for example, a college student), or if you are moving out-of-state during the year, you may be eligible to enroll in the Away From Home Care Program, which connects BlueLincs HMO members to a participating out-of-state HMO.

The Away From Home Care Program does not cover the entire United States. If you are considering the HMO, and you have an out-of-state dependent or plans to move out-of-state, please contact BCBSOK at 1-888-881-4648 to discuss your options.

BlueOptions PPO and BlueEdge HCA members have nationwide access to contracting providers through the BlueCard® Program when you or your covered family members live, work, or travel anywhere in the country.

Additionally, when you travel outside the United States, PPO members have access to contracting providers in more than 200 countries through BlueCard Worldwide®.

You can verify that your current physicians are in the network for the plan you are considering by checking the online provider directory at bcbsok.com/OU.

4) Flexibility – BlueOptions PPO and BlueEdge HCA give you the most flexibility since you have coverage for both in-network (PPO) and out-of-network providers. Keep in mind that you will always receive your highest level of benefits and lowest out-of-pocket costs when choosing an in-network provider. BlueOptions PPO gives you additional freedom of choice and flexibility because you can see providers in the BlueChoice or BluePreferred networks and still receive benefits. (For BlueOptions members, you will have the lowest out-of-pocket costs when you see providers in the BluePreferred network.) The BlueLincs HMO plan is a managed care plan that requires the use of BlueLincs HMO contracted providers. You also are required to select a primary care physician (PCP) to provide or coordinate most of your care. Referrals are generally required from your PCP for most specialty care. BlueOptions PPO and BlueEdge HCA do not have these requirements; you “manage” your own care.

5) Pre-existing conditions - The BlueLincs HMO has no pre-existing condition restrictions. In some instances where individuals have had no prior group insurance coverage immediately before enrolling, the BlueOptions PPO and the BlueEdge HCA may have pre-existing condition limitations. Refer to the Summary Plan Descriptions available on the OU Human Resources website for details.

Nourish to flourish.People sometimes turn to popular diets to achieve quick weight loss. For lasting changes and healthy eating, balance what you eat to meet your need for nutrition and enjoyment. Enjoy a variety of foods while keeping key food groups in mind and use moderation when choosing less nutritious foods.

04Enjoy a state of balance.

BlueL incs HMO

If you are enrolling in BlueLincs HMO, you must specify a Primary Care Physician (PCP) during your enrollment. During your online enrollment process, you will be asked to provide your PCP’s National Provider Identification (NPI) number.

n You must select your own PCP from the HMO provider network, and you must see him or her to coordinate care for most services in order to receive benefits.

n You may choose a different PCP for each family member, or you may select the same one for the entire family.

n If you receive non-emergency care outside the HMO network or from a provider without a referral from your PCP (except as noted in the following bullet), you receive no benefits.

n To visit a specialist, a referral is usually required from your PCP for most care. Referrals are not required when you receive an annual exam from a network OB/GYN or from a network ophthalmologist or optometrist for routine exams.

Besides the BlueLincs HMO plan, an additional HMO plan is available for Tulsa employees. Please visit the “Benefits” section of the OU Human Resources website for more information at hr.ou.edu.

BlueLincs HMO Frequently Asked Questions

Where do I get my PCP’s NPI number? Visit bcbsok.com/OU and click on “Search for Doctors and Hospitals in your area” to find a provider directory. There you can search for a PCP you currently use or locate a new PCP that is available through the BlueLincs HMO network. You must enter the PCP’s NPI (as shown on the website) during the online enrollment process.

I want to change my current PCP. Can I do that during the enrollment period? Yes, and you are able to do that up to four times a year as well. Consult the provider directory on bcbsok.com/OU to choose a PCP in the BlueLincs HMO network. During the enrollment period, include the PCP’s NPI. During the year, simply call BCBSOK customer service to make this change.

My dependents live out-of-state. Can I choose BlueLincs HMO? With BlueLincs HMO, out-of-state coverage is generally limited to emergency treatment only. If you have a dependent living out-of-state (for example, a college student), or if you are moving out-of-state during the year, you or your dependent may be eligible to enroll in the Away From Home Care Program, which connects BlueLincs HMO members to a participating out-of-state HMO. The program is designed for members who:

n have a child attending school out-of-state

n have family members living in different service areas

n have a long-term work assignment in another state

n are retired with dual residence

The Away From Home Care Program does not cover every area in the entire United States. If you are considering BlueLincs HMO, and you have an out-of-state dependent or plans to move out-of-state, please contact BlueLincs HMO at 1-800-580-6202 to discuss your options.

05BlueOpt ions PPO

BlueOptions PPO is a preferred provider organization (PPO) plan, which gives you the flexibility to choose your provider and network at the time of service. BlueOptions PPO gives you the freedom to select any health care provider (whether they are in-network or not). You do not need to select a primary care physician. Your choice of health care providers can affect the level of health care benefits (including copayment and deductible amounts) – based on the network your provider is in. With the BlueOptions PPO plan, you can choose from two different networks each time you need health care. Or, you may choose to see providers that are not in a network (out-of-network).

n The BluePreferred network provides the biggest discount and pays your benefits at the highest level, which means you will have the lowest out-of-pocket costs when you use providers in the BluePreferred network.

n The BlueChoice network will pay your benefits at the second highest level, although some aspects of coverage are the same with the BluePreferred and BlueChoice networks.

n If you see out-of-network providers, you will receive no discounts and your benefits will be paid at the lowest level.

Finding out which network your providers are located in is easy! Simply visit bcbsok.com/OU and click on “Search for Doctors and Hospitals in your area.” You can search for a doctor by name, location, network, or specialty, such as dermatology or cardiology.

The office copayments and deductible are lower for the BluePreferred network than the BlueChoice network. The coinsurance paid by BCBSOK and the out-of-pocket maximums are the same for the BluePreferred and BlueChoice network.

Most preventive care services for in-network providers are fully covered under the BlueOptions PPO plan, which means you will pay no copayment or coinsurance for services such as well child and adult immunizations, routine exams, gynecological exams, mammograms and prostate specific antigen (PSA) tests.

In some instances where individuals have had no prior group insurance coverage immediately before enrolling, the BlueOptions PPO may have pre-existing condition limitations. Refer to the Summary Plan Descriptions available on the OU Human Resources website for details.

BlueOptions PPO Frequently Asked Questions

How do I find a doctor in the BluePreferred or BlueChoice network? Go to bcbsok.com/OU and use the provider directory, or call BCBSOK customer service.

How do my benefits work when I am out-of-state? BlueOptions PPO members have nationwide access to contracting providers through the BlueCard® Program when you or your covered family members live, work, or travel anywhere in the country. Your benefits will generally be paid at the BlueChoice benefit level, since BluePreferred providers are mostly located in Oklahoma. You can search for BlueCard providers in the online provider directory at bcbsok.com/OU.

Do I need a referral from my doctor to see a specialist? No. With the BlueOptions PPO plan you can see any doctor at any time without a referral. If you see a specialist who is part of the BluePreferred network, your benefits will be paid at the highest level and your out-of-pocket costs will be lowest. You can also see a specialist who is in the BlueChoice network or not part of the network, but your benefits will be paid at a lower level.

Can I see providers in both the BluePreferred and BlueChoice networks? Yes, with BlueOptions PPO, you have the freedom to see any doctor you choose at any time. You can choose different networks for different health care services and/or for different members of your family. For example, you can see a physician in the BluePreferred network while your spouse and children see a physician in the BlueChoice network. Your benefits are determined at the point of service, which means that your copayment and deductible amounts depend on which network you choose. Your choice can affect the amount of benefits you receive. You will have the lowest out-of-pocket expense when you see providers in the BluePreferred network. Keep in mind that deductibles vary depending on the network you choose. The deductibles update each other, which means that at one point during the year, you may have satisfied your BluePreferred deductible but still have more to satisfy for the BlueChoice network. If you were to continue to see BluePreferred providers, then your deductible is met. If you visit a BlueChoice (or out-of-network) provider, you will first have to satisfy the difference between the deductible for that network and the BluePreferred deductible before coinsurance applies again.

Can my doctor be a part of both networks? What happens if this is the case? Be sure to ask your provider which network(s) they are in. They may be in more than one network. If that is the case, your benefits will be applied at the highest network level. For example, your doctor is in the BluePreferred and BlueChoice network. If you visit your doctor, your benefits will be applied for the BluePreferred network, which means that you will have the lowest out-of-pocket expense.

06Live a life of commitment.

BlueEdge HCA

What is it?

With the BlueEdge HCA plan, a specific amount of money is deposited each benefit year in a health care account (HCA). In 2012 for example, $500 is deposited for an individual employee, or $1,000 is deposited for an employee with enrolled dependents. In both cases, that amount is pro-rated if you are enrolling in the middle of the year. This includes new employees starting after the beginning of the calendar year (see the pro-ration schedule on page 7). When you need any covered medical care, the first out-of-pocket costs you have are paid from available funds in this account. The money paid from your health care account is applied toward meeting your annual plan deductible or other copayment or coinsurance amounts you may be responsible for. Any unused health care account funds roll over year to year, as long as you remain in the BlueEdge HCA.

Benefits

The HCA plan that Blue Cross and Blue Shield of Oklahoma offers is called BlueEdge HCA. However, the network of providers that are covered under the BlueEdge HCA is the BlueChoice network.

n As a HCA member, you have access to an extensive network of providers and hospitals throughout the country. You can select any provider for care within the BlueChoice network or outside the network. When you receive care from a BlueChoice network provider, you receive the highest level of benefits and lowest out-of-pocket costs. When you receive care from an out-of-network provider, you receive a lower level of benefits.

n You do not have to select a primary care physician, and you never need a referral to see a specialist.

n Under BlueEdge HCA, some of your well child and adult preventive care services are covered in full, including routine OB/GYN exams and mammograms, and well child immunizations. Many other well child and adult preventive care services are fully covered up to the first $250 each year. (Additional preventive services are covered under your regular benefits.)

In some instances where individuals have had no prior group insurance coverage immediately before enrolling, the BlueEdge HCA may have pre-existing condition limitations. Refer to the Summary Plan Descriptions available on the OU Human Resources website for details.

How does it work?

1) At the beginning of each year, funds are deposited into your HCA account. In 2012, $500 is deposited for an individual employee, or $1,000 for an employee with enrolled dependents. Available funds in the HCA are used to pay for your initial health care deductible expenses each year.

n The $1,000 credit for employees with dependents can be used in any combination by the covered members of one family for covered expenses, including the entire $1,000 being used by one family member.

2) Once your available HCA funds are depleted, you are responsible for any remaining deductible and coinsurance.

3) Once the deductible is met, benefits for covered services begin. You need to use an in-network provider to receive the highest level of benefits.

n When providers submit their claims to BCBSOK, out-of-pocket expenses for covered services are automatically paid from available funds in your HCA. There is no special paperwork to be submitted for reimbursement, and you will receive an Explanation of Benefits (EOB) showing what benefits are payable under your plan, noting the amount paid from your HCA. You can also keep track of your HCA and deductible balance online.

07

4) Once your out-of-pocket maximum is reached, eligible health care services will be covered at 100 percent of the allowable amount for the remainder of the calendar year.

n If you don’t spend all of your HCA funds in one year, the balance rolls over to the next year and is added to the annual amount contributed to your account. There is no maximum on the amount you can accumulate in your HCA. The higher your HCA balance is, the less you’ll have to pay out-of-pocket when you do need to utilize your health benefits.

n Any funds accumulated in excess of your deductible will be used to pay for any coinsurance you incur. If you switch to a different product option at a future enrollment, you will forfeit any balance in your HCA. The HCA will not be paid out in cash under any circumstance.

Addi t iona l in fo rmat ion abou t the B lueEdge HCA

Pro-ration HCA funds are pro-rated for employees starting work after the beginning of the calendar year, following this pro-ration schedule:

Jan. 1 – March 31 100% contribution $500 individual /$1,000 family

April 1 – June 30 75% contribution $375 individual /$750 family

July 1 – Sept. 30 50% contribution $250 individual /$500 family

Oct. 1 – Dec. 31 25% contribution $125 individual /$250 family

Wellness Services Many wellness services are paid at 100% and are not subject to your annual deductible. Additionally, the preventive care services that are covered at 100% are not paid with any of the funds in your HCA.

Eligible expenses that can be paid from available HCA funds

Deductible, coinsurance and copayment amounts you are responsible for under your benefit plan for covered services.

Annual Enrollment Enrollment in BlueEdge HCA automatically continues from year to year unless you make a plan change.

BlueEdgeSM

When you need any covered medical care, the first dollars spent come from your HCA. The money paid from your HCA is applied toward meeting your annual plan deductible. 1 2 3Health Care

Account Deductible PPO

Coverage (Benefit period is one calendar year) BlueLincs HMO BlueOptions PPO

HMO Network Only BluePreferred Network BlueChoice Network Out-of-Network

Calendar Year Deductible Individual/Family $300 per individual $400/$800 $500/$1,000 $1,000/$2,000

Out-of-Pocket Maximum Individual/Family $2,000/$4,000

Does not include copays for prescription drugs

$3,000/$6,000 $3,000/$6,000 $4,000/$8,000

Health Care Account Fund Not applicable Not applicable

Lifetime Health Care maximum (per person) Unlimited Unlimited

PHYSICIAN SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Office visit & related routine services / consultation / second opinion

$25 copay per visit ($35 copay for specialist)

$20 copay per visit ($30 copay for specialist)

$25 copay per visit ($35 copay for specialist) 30% after deductible

Physical, Occupational, Speech, and Chiropractic Therapies (60 visit maximum combined for all therapies) $35 copay $30 copay $35 copay 30% after deductible

Allergy Injections $25 copay $30 copay $35 copay 30% after deductible

Allergy Testing $35 copay $30 copay $35 copay 30% after deductible

Allergy Serum Covered in full $30 copay $35 copay 30% after deductible

Inpatient Physician Services Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

Outpatient Physician Services / non-routine office services Subject to deductible and applicable copay 20% after deductible 20% after deductible 30% after deductible

Lab & X-ray (Physician Office) Covered in full Covered in full Covered in full 30% after deductible

PREVENTIVE CARE SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Routine Exam Covered in full Covered in full Covered in full Covered in full

Adult Immunizations Covered in full Covered in full Covered in full Covered in full

Well Child Exams Covered in full Covered in Full Covered in Full 30% after deductible

Routine Eye Exam* (does not include hardware) $25 copay $30 copay $35 copay 30% after deductible

Routine Hearing Exam* (does not include hardware/hearing aids) $25 copay $30 copay $35 copay 30% after deductible

Routine Ob/Gyn Exam Covered in full Covered in full Covered in full Covered in full

Routine Mammograms** Covered in full Covered in full Covered in full Covered in full

Routine Prostate Specific Antigen (PSA)*** Covered in full Covered in full Covered in full Covered in full

Routine Colonoscopy (age 50 and above) Covered in full Covered in Full Covered in Full 30% after deductible

Well Child Immunizations Covered in full Covered in full Covered in full Covered in full

P lan Compar i son Char t

*Routine vision and hearing exams limited to once every 24 months.**One baseline screening between ages 35-39. One annual screening age 40 and over.***Age 40 and older one exam every calendar year. 08

*Routine vision and hearing exams limited to once every 24 months.**One baseline screening between ages 35-39. One annual screening age 40 and over.***Age 40 and older one exam every calendar year.

** Medicare Part A and Part B coverage is required.

Coverage (Benefit period is one calendar year) BlueEdge HCA Traditional Indemnity**(over 65 Retirees Only)

BlueChoice Network Out-of-Network No Network

Calendar Year Deductible Individual/Family $1,500/$3,000 $2,500/$5,000 Your deductible is reduced by your HCA fund amount None

Out-of-Pocket Maximum Individual/Family $3,000/$6,000 Includes deductible amounts

$6,000/$12,000 Includes deductible amounts

$3,000/ $6,000

Health Care Account Fund $500 Individual $1,000 Family (see BlueEdge HCA section)

Not Applicable

Lifetime Health Care maximum (per person) Unlimited Unlimited

PHYSICIAN SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Office visit & related routine services / consultation / second opinion 15% after deductible 35% after deductible 20%

Physical, Occupational, Speech, and Chiropractic Therapies (60 visit maximum combined for all therapies) 15% after deductible 35% after deductible 20%

Allergy Injections 15% after deductible 35% after deductible 20%

Allergy Testing 15% after deductible 35% after deductible 20%

Allergy Serum 15% after deductible 35% after deductible 20%

Inpatient Physician Services 15% after deductible 35% after deductible 20%

Outpatient Physician Services / non-routine office services 15% after deductible 35% after deductible 20%

Lab & X-ray (Physician Office) 15% after deductible 35% after deductible 20%

PREVENTIVE CARE SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Routine Exam

Covered in full for the first $250, then subject to deductible and coinsurance.

The first $250 (covered in full) is not counted against the HCA Fund.

100%

Adult Immunizations 100%

Well Child Exams 100%

Routine Eye Exam* (does not include hardware) 100%

Routine Hearing Exam* (does not include hardware/hearing aids) 100%

Routine Ob/Gyn Exam 100%

Routine Mammograms** Covered in full Covered in full 100%

Routine Prostate Specific Antigen (PSA)*** 15%, no deductible 35%, no deductible 100%

Routine Colonoscopy (age 50 and above) 15% after deductible 35% after deductible 80%

Well Child Immunizations Covered in full Covered in full 100%

09



HOSPITAL SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Inpatient Hospital Subject to deductible and $250 copay per admission 20% after deductible 20% after deductible 30% after deductible

Outpatient Surgery Subject to deductible and $100 copay per surgery 20% after deductible 20% after deductible 30% after deductible

Emergency Room Subject to deductible and $100 copay per visit – copay waived if admitted 20% after $100 copay and deductible

Urgent Care Facility $50 copay 20% after deductible 20% after deductible 30% after deductible

ExTENDED CARE INPATIENT/HOME

Skilled Nursing Facility Subject to deductible and $250 copay per admission 20% after deductible 20% after deductible 30% after deductible

Skilled Nursing Facility Maximum No limit 90 visits per calendar year, combined in- and out-of-network

Home Health Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

Home Health Maximum No limit 120 days per calendar year, combined in- and out-of-network

Private Duty Nursing Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

Private Duty Nursing Maximum No limit 70 visits per calendar year, combined in- and out-of-network

Hospice - Inpatient (no benefit limit) Subject to deductible plus $250 copay 20% after deductible 20% after deductible 30% after deductible

Hospice - Outpatient (no benefit limit) Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

MATERNITY & FAMILY PLANNING The amounts shown below are what you are responsible for paying for each type of service or treatment.

Prenatal & Postnatal visits $35 copay for initial visit then no charge

$20 copay/$30 copayfor specialist for initial

visit;all other services

20% after deductible

$25 copay/$35 copayfor specialist for initial

visit;all other services



Inpatient Hospital Subject to deductible and $250 per admission 20% after deductible 20% after deductible 30% after deductible

Infertility Testing & Treatment (Infertility coverage provided for diagnosis and treatment of underlying cause only.) Covered with applicable copay $20 copay per visit

($30 copay for specialist)$25 copay per visit ($35 for specialist) 30% after deductible

Voluntary Sterilization (Reversal of sterilization is not covered.) Subject to deductible and applicable copay 20% after deductible 20% after deductible 30% after deductible

Pregnancy Termination (therapeutic & non-therapeutic) Subject to deductible and applicable copay 20% after deductible 20% after deductible 30% after deductible

Contraceptive Devices Covered with applicable copay Covered with applicable copay

Covered with applicable copay 30% after deductible

10



HOSPITAL SERVICES The amounts shown below are what you are responsible for paying for each type of service or treatment.

Inpatient Hospital 15% after deductible 35% after deductible 20%

Outpatient Surgery 15% after deductible 35% after deductible 20%

Emergency Room 15% after deductible 20%

Urgent Care Facility 15% after deductible 35% after deductible 20%

ExTENDED CARE INPATIENT/HOME

Skilled Nursing Facility 15% after deductible 35% after deductible 20%

Skilled Nursing Facility Maximum 90 visits per calendar year, combined in- and out-of-network 90 visits per calendar year

Home Health 15% after deductible 35% after deductible 20%

Home Health Maximum 120 days per calendar year, combined in- and out-of-network 120 visits per calendar year

Private Duty Nursing 15% after deductible 35% after deductible 20%

Private Duty Nursing Maximum 70 visits per calendar year, combined in- and out-of-network 70 visits per calendar year

Hospice - Inpatient (no benefit limit) 15% after deductible 35% after deductible 20%

Hospice - Outpatient (no benefit limit) 15% after deductible 35% after deductible 20%

MATERNITY & FAMILY PLANNING The amounts shown below are what you are responsible for paying for each type of service or treatment.

Prenatal & Postnatal visits 15% after deductible 35% after deductible 20%

Inpatient Hospital 15% after deductible 35% after deductible 20%

Infertility Testing & Treatment (Infertility coverage provided for diagnosis and treatment of underlying cause only.) 15% after deductible 35% after deductible 20%

Voluntary Sterilization (Reversal of sterilization is not covered.) 15% after deductible 35% after deductible 20%

Pregnancy Termination (therapeutic & non-therapeutic) 15% after deductible 35% after deductible 20%

Contraceptive Devices 15% after deductible 35% after deductible 20%

** Medicare Part A and Part B coverage is required.

11



MENTAL HEALTH The amounts shown below are what you are responsible for paying for each type of service or treatment.

Inpatient Hospital/Facility Subject to deductible and $250 copay per admission 20% after deductible 20% after deductible 30% after deductible

Outpatient Charges $35 copay $30 copay $35 copay 30% after deductible

SUBSTANCE ABUSE The amounts shown below are what you are responsible for paying for each type of service or treatment.



PRESCRIPTIONS The amounts shown below are what you are responsible for paying for each type of service or treatment.

Retail Pharmacy Care Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (30 day supply with one copay or 31-90 day supply with two copays) $10/$30/$60 $10/$30/$60 $10/$30/$60 30% after

$10/$30/$60

Mail Order RX Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (90 day supply) $20/$60/$120 $20/$60/$120 $20/$60/$120 Not covered

Specialty Pharmacy Medications (limited to 30 day supply) Covered Covered

Prescription Tobacco Cessation Products Covered Covered

Oral Contraceptives Covered Covered

Sexual Dysfunction Drugs (limited to eight doses per 30 days - no mail order) Not covered Covered

Diabetic Supplies – Most Diabetic Supplies can be covered under medical benefits (applicable deductible and coinsurance would apply) or under pharmacy benefit (ap-plicable copays will apply).

Covered Covered

Step Therapy – For listing of drugs that apply to Step Therapy, please see Formulary at bcbsok.com/OU. Applies Applies

Pre-Authorization – For listing of drugs that require Pre-Authorization, please see Formulary at bcbsok.com/OU. Applies Applies

OTHER SERVICES & SUPPLIES The amounts shown below are what you are responsible for paying for each type of service or treatment.

MRI, CT, PET, EEG, and other similar imaging testsSubject to deductible and $100

copay per occurrence

20% after deductible 20% after deductible 30% after deductible

Diagnostic Lab & X-ray Covered in full Covered in full Covered in full 30% after deductible

Tobacco Cessation Benefit (non-RX) – 100% member reimbursement for over-the-counter medications, acupuncture, hypnosis, stop smoking aids, etc., to a maximum of 20 visits/services per calendar year (per person)

Applies Applies

Bariatric/Weight Loss Surgery Covered (subject to BCBSOK medical policy criteria) Not covered

Durable Medical Equipment Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

Ambulance (Ground/Air) Covered in full Covered in full

Routine Audiological Exam $25 copay $30 copay $35 copay 30% after deductible

Routine Audiological Exam for children up to age 18 including routine diagnostic audiological exam/evaluation and hearing aids, limited to 2 every 24 months. For children up to age 2, coverage includes 4 additional molds per years. 12










Retail Pharmacy Care Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (30 day supply with one copay or 31-90 day supply with two copays) $10/$30/$60 $10/$30/$60 $10/$30/$60 30% after

$10/$30/$60

Mail Order RX Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (90 day supply) $20/$60/$120 $20/$60/$120 $20/$60/$120 Not covered




Sexual Dysfunction Drugs (limited to eight doses per 30 days - no mail order) Not covered Covered

Diabetic Supplies – Most Diabetic Supplies can be covered under medical benefits (applicable deductible and coinsurance would apply) or under pharmacy benefit (ap-plicable copays will apply).

Covered Covered




MRI, CT, PET, EEG, and other similar imaging testsSubject to deductible and $100

copay per occurrence

20% after deductible 20% after deductible 30% after deductible

Diagnostic Lab & X-ray Covered in full Covered in full Covered in full 30% after deductible


Applies Applies

Bariatric/Weight Loss Surgery Covered (subject to BCBSOK medical policy criteria) Not covered

Durable Medical Equipment Subject to deductible then covered in full 20% after deductible 20% after deductible 30% after deductible

Ambulance (Ground/Air) Covered in full Covered in full

Routine Audiological Exam $25 copay $30 copay $35 copay 30% after deductible

Routine Audiological Exam for children up to age 18 including routine diagnostic audiological exam/evaluation and hearing aids, limited to 2 every 24 months. For children up to age 2, coverage includes 4 additional molds per years.




Inpatient Hospital/Facility 15% after deductible 35% after deductible 20%

Outpatient Charges 15% after deductible 35% after deductible 20%


Inpatient Hospital/Facility 15% after deductible 35% after deductible 20%

Outpatient Charges 15% after deductible 35% after deductible 20%


Retail Pharmacy Care Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (30 day supply with one copay or 31-90 day supply with two copays)

$15/$25/$40 after deductible

$30/$50/$80 after deductible

$8/$35/50% ($100 minimum; $200 maximum)

Mail Order RX Generic (Tier I)/Preferred Brand (Tier II)/Non-Preferred Band (Tier III) (90 day supply)

$30/$50/$80 after deductible Not covered $16/$70/50% ($100 minimum; $200 maximum)

out-of-network not covered




Sexual Dysfunction Drugs (limited to eight doses per 30 days - no mail order) Covered Not covered

Diabetic Supplies – Most Diabetic Supplies can be covered under medical benefits (applicable deductible and coinsurance would apply) or under pharmacy benefit (applicable copays will apply).

Covered Covered*




MRI, CT, PET, EEG, and other similar imaging tests 15% after deductible 35% after deductible 20%

Diagnostic Lab & X-ray 15% after deductible 35% after deductible 20%


Applies Applies Applies

Bariatric/Weight Loss Surgery Not covered Not covered Not covered

Durable Medical Equipment 15% after deductible 35% after deductible 20%

Ambulance (Ground/Air) 15% after deductible 20%

Routine Audiological Exam 15% after deductible 35% after deductible 20%

* Covered (syringes, needles, alcohol swabs). Diabetic management supplies (insulin, insulin pump, etc.) must be covered by Medicare Part B

13

What ’ s Not Covered

Your plan options do not cover all health care expenses, and include exclusions and limitations. You should refer to plan-specific documents to determine which health care services are covered and to what extent. The following is a partial list of services and supplies that are generally not covered. However, your plan documents may contain exceptions to this list based on state mandates, the plan design or rider(s) purchased. Visit the “Benefits” section of the OU HR website for plan-specific information at hr.ou.edu

n Services that BCBSOK determines are experimental/investigational in nature

n Any condition to the extent payment would have been made under Medicare if the member had applied for Medicare and claimed Medicare benefits

n Diagnosis, treatment or medications for infertility and fertilization procedures, including artificial insemination; ovulation induction procedures; in vitro fertilization; embryo transfer. (Coverage for infertility is limited to diagnosis and treatment of underlying cause.)

n Cosmetic surgery or complications resulting there from, including surgery to improve or restore your appearance

n Reverse sterilization

n Treatment of sexual problems not caused by organic disease

n Foot care only to improve comfort or appearance, such as care for flat feet, subluxation, corns, bunions (except capsular and bone surgery), calluses, toenails, etc.

n Acupuncture, whether for medical or anesthesia purposes except for services in relation to tobacco cessation.

n Massage Therapy

ID Cards

You should present your ID card when visiting a physician’s office or hospital, and verify that they have the correct insurance information on file for you. Your card will resemble the card below, and will be customized with your name and plan information. Additional cards can be ordered through BCBSOK customer service or by logging in to the Blue Access for MembersSM (BAM) website at bcbsok.com/OU.

14

Group NumberEffective DateBenefit Network

The University of Oklahoma

Office Visit Copay:

Specialist Copay:

Rx Copay:

PlanName

Subscriber:John Q. SampleIdentification Number:ABC12345678

www.bcbsok.com/OU

L13

Customer ServicePreauthorizationProvider Locator24/7 NurselineRX Tech SupportRX Cust Svc*

1-800-XXX-XXXX1-800-XXX-XXXX1-800-XXX-XXXX1-800-XXX-XXXX1-877-XXX-XXXX1-877-XXX-XXXX

Group NumberEffective DateBenefit Network

The University of Oklahoma

Office Visit Copay:

Specialist Copay:

Rx Copay:

PlanName

Subscriber:John Q. SampleIdentification Number:ABC12345678

www.bcbsok.com/OU

L13

Customer ServicePreauthorizationProvider Locator24/7 NurselineRX Tech SupportRX Cust Svc*

1-800-XXX-XXXX1-800-XXX-XXXX1-800-XXX-XXXX1-800-XXX-XXXX1-877-XXX-XXXX1-877-XXX-XXXX

If you ever lose or misplace your ID card, you can print a temporary ID card

and order a replacement card by logging in to Blue Access for Members (BAM)

at bcbsok.com/OU.

15

† Please review the Blue Points Program Rules listed on the Personal Health Manager for complete information on the program. Program rules are subject to change without prior notice.

Exper ience. Wel lness . Everywhere.

Biometric screenings will continue to be available to all OU employees in 2012. Please watch your email and employee bulletin boards for more information on dates and locations. In addition to the confidential Health Risk Assessment on the Personal Health Manager (located on Blue Access for Members at bcbsok.com/OU), a biometric screening provides a detailed assessment of your basic health indicators, including blood pressure, body mass index (calculated from height and weight), cholesterol (HDL and LDL) and blood glucose. This screening will give you an awareness of potential health conditions.

Blue Care Connec t ion®

Personal Health Manager & Online Resources

Through the Blue Care Connection program, you’ll find tools and services that inform, support and motivate you on your journey to wellness.

Our online health resources are available through Blue Access for Members (BAM) at bcbsok.com/OU, then select Personal Health Manager. Set goals toward a healthier lifestyle, understand and manage a health condition, and keep track of your health care. Interactive tools and extensive information cover all aspects of health and wellness, including nutrition, fitness, work-life balance, medical conditions and more.

Use the Personal Health Manager to:

n Assess Your Health: Learn about your health status and possible health risks by completing the confidential Health Risk Assessment. After you complete and submit your Health Risk Assessment, you will immediately receive information on your overall health status and recommendations for making healthy changes. You may also receive online messages or outreach phone calls from Blue Care Advisors to help you take action to reduce your health risks and improve your health. Before starting the Health Risk Assessment, it’s helpful—but not essential—to know your most recent:

n Height and weight n Blood pressure n Total cholesterol level n HDL cholesterol level n Blood glucose level

n Ask A Professional: Get health and wellness questions answered by Blue Care Advisor nurses and other health care professionals via secure e-mail.

n Ask registered nurses (Blue Care Advisors) your health-related questions with the Ask A Nurse feature.

n Request fitness and weight loss advice from a team of personal trainers with Ask A Trainer.

n Ask registered dietitians for nutrition advice with Ask A Dietitian.

n Receive help on managing stress, workplace conflicts and other similar issues with Ask A Life Coach.

n Track & Motivate Healthy Behaviors: Adopt healthier behaviors and stay motivated using the interactive Get Fit, Eat Right and Live Well tools in the For Your Health section. Find information on fitness, nutrition and lifestyle issues that can be customized to meet your needs. Plus, you can keep track of your activities and results online to keep you motivated.

n Educate: Learn more about health conditions and medical procedures to help you manage your care or prepare for diagnostic testing or treatments by searching the health encyclopedia.

n Manage Health Information: Set up a personal health record to keep track of and manage your family’s health information – within one secure location. Using tracking tools, you can also track your progress by entering values such as cholesterol, blood pressure and blood glucose levels, and view a graph showing how you are doing over a time period.

Reward Yourself with Blue PointsSM †

At Blue Cross and Blue Shield of Oklahoma, we understand how hard it can be to change habits and maintain a healthy lifestyle. That’s why Blue Care Connection builds in a reward program to keep you motivated and support you along the way. Every time you use the Personal Health Manager to track a fitness workout, report a meal, and participate in For Your Health interactive programs, you automatically earn Blue Points. Redeem your Blue Points for health-related products at the Blue Points Redemption Center, accessed through the Personal Health Manager.

16

Weight Management Support for a slimmer, healthier you

The program offers guidance and support through behavioral and motivational coaching, personalized goal setting with an action plan, online tools and discounts to wellness-related products and services. To get started, go to the Personal Health Manager available through Blue Access for Members at bcbsok.com/OU and click the Weight Loss button—or call BCBSOK customer service.

Fitness ProgramJoin a network of gyms

Take advantage of a gym membership to a nationwide network of fitness centers. To get started, go to the Personal Health Manager available through Blue Access for Members at bcbsok.com/OU and click on Fitness Program—or call BCBSOK customer service.

Tobacco Cessation Support for tobacco users who want to quit

The program provides personal coaching, online tools and discounts for wellness-related products and services. To participate, go to the Personal Health Manager and click the Stop Smoking button – or call BCBSOK customer service. There is also a tobacco cessation benefit described on the plan comparison chart.

24/7 Nurseline

Health concerns don’t always follow a 9-to-5 schedule. Fortunately, you can call the toll-free 24/7 Nurseline 24 hours a day, seven days a week to get the information you need…when you need it.

The 24/7 Nurseline is staffed by registered nurses who can answer your general health questions, direct you to your doctor or encourage you to seek emergency services if necessary. A nurse can help identify options and provide information to help you choose the appropriate care for your concerns. Plus, when you call, you also have the option to access an audio library of more than 1,000 health topics.

Call the 24/7 Nurseline toll free at (800) 581-0407.

Special Beginnings – Maternity Program

If you are expecting, this prenatal program can help guide you through your pregnancy and postpartum care. The program provides support and education, pregnancy risk assessment and ongoing attention/monitoring.

Enrolled members receive frequent, personal contact from obstetrical nurses who can help them better understand and manage their pregnancies. Educational materials promote healthy behaviors, preventive care, and identify warning signs of complications. Topics also include nutrition, fetal development and newborn care. Additionally, members can call a 24-hour toll-free BabyLine staffed by maternity nurses.

For more information or to enroll in Special Beginnings, call (877) 904-2229.

Blue Care Advisors

If you have certain chronic health conditions or are at risk for medical complications, a Blue Care Advisor may contact you to offer health counseling, coaching and support. Working with you through regularly scheduled telephone calls, these registered nurses and other health care professionals can help you learn to manage your condition more successfully, identify behaviors that may be barriers to better health, set goals for improving your health and help you adopt healthier habits.

Case Managers

In the event that you or a covered family member experiences multiple or complex medical problems, our case management nurses – registered nurses with specialized training and clinical experience – can work with you.

At a time that’s usually stressful, case managers can be your advocate by:

n Helping to explain your medical problem(s) and treatment plan(s)

n Facilitating communication among your many health care providers

n Coordinating a treatment plan(s)

n Explaining your health care benefits and how to get the most out of them

n Helping you access the right resources and services

n Assisting with transitions from one health care setting to another

17

BlueEx t ras SM Discoun t P rogram†

With BlueExtras, you can take advantage of discounts on health-related products and services that help support a healthy lifestyle. These discounts apply to health care products and services not usually covered by your health care benefits plan. Plus, there are no claims to file, no referrals or pre-authorizations and no additional fees to participate. To find out more, visit bcbsok.com/OU, then select the MyHealth tab.

BlueExtras provides discounts to:

n Jenny Craig weight management program

n Seattle Sutton’s Healthy Eating

n Complementary Alternative Medicine items, such as vitamins, health and wellness magazines, gym memberships, massages, spas, acupuncture, yoga, tai chi and more

n Vision care and hearing aid products

n GHS auto insurance

Other Resources to He lp You

Blue Cross and Blue Shield of Oklahoma also provides other health and wellness information.

Preventive Health Care Guidelines are published each year and made available via bcbsok.com/OU. This is a good source of information on preventive care guidelines, which are based on recommendations set by national health agencies and medical associations. You can learn about recommended screenings, and immunizations and doctor visits for all ages, from prenatal care and infancy through the senior years.

Be Smart. Be Well.TM is our website dedicated to raising awareness of largely preventable health and safety issues. You’ll find in-depth information on a variety of issues, including traumatic brain injuries, drug interactions and mental health at besmartbewell.com.

Glucose Meters help members with diabetes manage their condition and can be ordered at no charge. For information on available meters and how to place an order, call customer service.

Start your journey to wellness today!

It’s easy to use the Personal Health Manager! Simply log in to our secure Blue Access for Members website at bcbsok.com/OU. Access the Personal Health Manager from the My Health tab on Blue Access for Members or click on the Personal Health Manager icon.

† BlueExtras is a discount program available to BCBSOK members. This is NOT insurance. Some of the services offered through BlueExtras may be covered under your health plan. Please refer to your benefit booklet or call the customer service number on the back of your ID card for specific benefit information under your health plan. Use of BlueExtras does not affect your premium, nor do costs of BlueExtras’ services or products count toward your plan deductible, calendar year or lifetime maximums. Discounts are only available through participating vendors.

BCBSOK does not guarantee or make any claims or recommendations regarding the services or products offered under BlueExtras. You may want to consult with your physician prior to use of these services and products. Services and products are subject to availability by location. BCBSOK reserves the right to discontinue or change this discount program at any time without notice.

RESOURCE PURPOSE HOW TO ACCESS

BCBSOK website for OU

• Log in to Blue Access for Members to access the Personal Health Manager or view claims

• View/print benefit brochures • Locate a doctor or hospital

Go to bcbsok.com/OU

Blue Access for Members (BAM)

Website provides:• Ability to print a temporary member ID card and

order a new card• Claim Status• Provider Finder tool• BlueEdge HCA account balances• Personal Health Manager• Explanation of Benefits (EOB)

Go to bcbsok.com/OU• Enter Blue Access for Members user ID

and password • If you do not have a user ID and password,

click on “Register Now”

Blue Points Earn points for completing healthy activities; redeem points for health and wellness services and merchandise

Go to bcbsok.com/OU• Log in to Blue Access for Members• Click on Personal Health Manager• Click on any of the For Your Health links

(Get Fit, Eat Right, Live Well)• Click on the Blue Points tab to see how many

points you’ve earned or to redeem points for rewards

Locate a Health Care Provider

Find a doctor, specialist, or hospital in your area

Go to bcbsok.com/OU • Click on Search for Doctors and Hospitals

in your area

OU Benefits website

Find benefit related information Go to hr.ou.edu

ONLINE BENEFIT RESOURCES

CONTACTS This enrollment guide highlights OU’s Benefits Program. A complete description of each benefit can be found in the legal documents governing the plans. Every effort has been made to provide an accurate summary of the plans in this guide. However, if there is a conflict between this material and the legal documents, the legal documents will govern. If you have any questions after reviewing your enrollment materials, please contact BCBSOK customer service at the phone number below.

SUBJECT CONTACT

BCBSOK Customer Service 1-888-881-4648

Pharmacy 1-800-423-1973

BlueCard 1-800-810-BLUE (2583)

24/7 Nurseline 1-800-581-0407

Special Beginnings 1-877-904-2229

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Blue Cross and Blue Shield of Oklahoma is a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 70450.1011 Web

experience. wellness. everywhere

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