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Premera Preferred

Choice

2019

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For fully insured and OptiFlex businesses with 51–99 employees enrolled on the plan

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At Premera, the customer is at the center of all we do—that’s why we offer plans that help you keep control of your expenses while giving your employees access to quality and affordable care.

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Our most popular medical, pharmacy, and dental benefits

Unmatched access and deep discounts

• We offer an extensive provider network built for quality and value. Your employees get broad access to doctors and hospitals not only in Alaska, but also across the country.

• We have the largest contracted nationwide network available, delivering the lowest total cost of care in all markets.*

Well-rounded benefits package

• We make it easy for you to attract and retain the best talent with appealing benefits packages that supports the whole health of your employees.

• Choose from a range of our most popular plans to find the right balance that best fits the needs and budget for both your business and your employees.

Tools and programs for employees

• Our built-in support programs encourage your employees to engage in their healthcare leading to healthier, happier employees.

• Online tools and apps help your employees find doctors, compare costs of services and medications, access pharmacy information, and review claims.

Administrative ease and support

• Integrate dental and pharmacy with your medical plans and simplify your work by dealing with only one health plan for all your healthcare administration.

• Effortlessly manage your health plans and pay bills online with our secure employer dashboard.

• Get ready-to-share resources that makes understanding benefits simple and easy for you and your employees with the Employee Communications resource center. Log in to your secure employer website to gain access.

* Consortium Health Plans, Inc. Network Compare Key Findings as of June 5, 2015. Available at chpmarketquest.com.

PREFERRED CHOICE LETS YOU CHOOSE FROM

• 18 medical plans

• 9 pharmacy plans

• 8 dental plans

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Video chat with a doctor: Video or phone consultations with a Teladoc®* physician are available to your employees any time for a low copay.

Alaska medical transportation benefits: Because some Alaskans live and work far from doctors and hospitals, Premera plans include benefits that support members in traveling to get the medical care they need. Two types of medical transportation benefits are included in all plan designs. Travel is available for serious medical conditions that cannot be treated locally and for certain approved services for elective, non-emergent surgeries.

Low-cost fitness center memberships: Get access to 9,000 fitness centers nationwide for only $25 a month (plus a $25 enrollment fee and applicable taxes).

CareCompass360®: For employees who qualify, this whole-person approach to health offers support services tailored to their unique needs.

24-Hour NurseLine: Free, confidential health advice from a registered nurse, available 24/7.

Wellness programs and rewards: Employees who feel better do better. That’s why we offer rewards to employers for participating in wellness programs aimed at equipping them with information and tools to create a culture of well-being within their workplace.

Pregnancy and newborn support: BestBeginnings Maternity engages parents from pregnancy through newborn care with personalized tools and support that encourages early risk discovery. Additionally, the NICU program is available to help reduce costs associated with high-risk pregnancies or newborns who end up in neonatal intensive care units (NICU).

Premera Pulse: Help your employees stay connected to their health plan benefits by signing up for Premera Pulse. Employees can receive care notifications via text that help them take advantage of their health plan benefits and stay on top of recommended care, instantly book appointments with select primary care doctors, search for doctors nearby and see whether they are in-network, and more.

All medical plans include these great support programs

* Teladoc is an independent company that provides virtual medical care services on behalf of Premera Blue Cross Blue Shield of Alaska. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services.

Teladoc phone consultations are available 24 hours a day, 7 days a week; video consultations are available 7 a.m. to 9 p.m., 7 days a week.

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Choosing your health plan is as easy as 1-2-3

VISION IS INCLUDEDWith each Preferred Choice plan, the vision benefit is included.

You select the medical, pharmacy, and dental plans that work best for your business needs and budget. At the same time, you provide great benefits to your employees and their eligible dependents.

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Medical plans

You can choose from a range of plans to find the right balance between budget and healthcare needs for both your business and your employees.

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1 Choose up to 2 medical plans from 18 options

10 preferred provider organization (PPO) plans

• Access to the Heritage provider network

• Covers a wide range of medical services

• Choosing in-network providers saves your employees more oney

8 health savings account (HSA) qualified PPO plans

• Access to the Heritage provider network

• Lets employees save money to use for medical expenses, even during retirement

• Can be paired with an employee-owned tax advantage HSA

• Option for ConnectYourCare (CYC), an independent company that administers HSA accounts at a federally insured bank for Premera customers

Speak with your producer or Premera representative for more details about these plans.

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Premera Preferred Choice Medical Plans Deductible

CoinsuranceOffice Visit Copay Out-of-Pocket

MaximumEmergency Room

Cost ShareIn-Network (Preferred/Participating)

Out-of-Network

Plus Split Copay $500 $500

20% / 40%

60%

$20 / $60 $3,500

$100 copay, then deductible and preferred coinsurance

Plus Split Copay $1,000 $1,000 $25 / $60$4,500

Plus Split Copay $2,000 $2,000 $25 / $65

Plus Split Copay $3,000 $3,000$30 / $65 $6,000

Plus Split Copay $4,000 $4,000

Plus Split Copay $5,000 $5,00030% / 40% $45 / $80

$7,150

Plus Split Copay $6,000 $6,000 $7,350

Plus HSA Qualified $1,5001 $1,500

20% / 40%60% Deductible /

Coinsurance applies

$3,000

Deductible, then preferred coinsurance

Plus HSA Qualified $2,0002 $2,000$5,000

Plus HSA Qualified $3,0003 $3,000

Plus HSA Qualified $4,0003 $4,000 $6,000

Plus HSA Qualified $5,0003 $5,000$6,550

Plus HSA Qualified $6,0003 $6,000

Plus HSA Qualified $6,5003 $6,500 0% / 0% $6,500

Select $1,000 $1,00020% / 40%

60% Deductible / Coinsurance applies

$4,500 $100 copay, then deductible and preferred coinsurance

Select $3,000 $3,000 $6,000

Select $6,000 $6,000 30% / 40% $7,350

Select HSA Qualified $4,0003 $4,000 20% / 40% 60% Deductible / Coinsurance applies $6,000

Deductible, then preferred coinsurance

1 Aggregate Deductible and Aggregate Out-of-Pocket2 Aggregate Deductible and Embedded Out-of-Pocket3 Embedded Deductible and Embedded Out-of-PocketNOTE: The deductible spread between the two plans cannot exceed $3,000.

Your medical plan options

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Premera’s provider network

Covering customers wherever they go.We believe in working closely with doctors and hospitals to deliver for the customer together. That’s why our provider networks are more than just a collection of contracts—they give members access to quality care and good experiences. For decades, Premera has maintained one of the largest networks of doctors and medical facilities in Alaska. As a result, we offer greater network stability and deep discounts for covered in-network services.

Heritage network

Our contracted providers and hospitals include over 4,000 preferred providers and 21 preferred hospitals across Alaska.

National and worldwide network coverage with BlueCard™

Every Premera health plan has the BlueCard Program. This program provides access to networks of contracted preferred and participating Blue Cross Blue Shield providers across the country. Just like here at home, these networks provide valuable discounts on billed charges and the added advantage of direct billing.

The BlueCard Program includes the added benefit of worldwide coverage with Blue Cross Blue Shield Global Core. This program provides members access to an international network of participating doctors and hospitals for a broad range of medical care services. This access means they can feel safe wherever they go.

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2 Choose a pharmacy plan to pair with each PPO planAll medical plans require a pharmacy plan, except HSA qualified plans, which already include a pharmacy plan. Choose from 9 pharmacy plan options. Each offers:

• Negotiated, discounted rates from preferred providers

• Retail and mail-order coverage

• Drug classification based on the tier of coverage selected

Important: If you choose a non-HSA- qualified medical plan, you are required to have a pharmacy plan. Qualified HSA plans already include a pharmacy plan, and your drug list options are as follows:

• Select plans are paired with Preferred-A1

• Plus plans choose from Preferred-A1 or Essentials-E1

Premera Preferred Choice Pharmacy Plans

Retail Cost Share Mail Cost Share1

Drug ListTier 1 Tier 2 Tier 3 Tier 4 Tier 1 Tier 2 Tier 3 Tier 4

Essentials - $10 / $25 / $45 / 30% $10 $25 $4530%

$25 $62.50 $45 30%

Essential - E4Essentials - $15 / $30 / $50 / 30%$15

$30 $50$37.50

$75 $50

Essentials - $150 - $15 / $60 / $100 / 50%2 $60 $100 50% $150 $100 50%

$10 / $30 / $50 $10 $30 $50 N/A

$25 $75 $125N/A Preferred - B3

$20 / $40 / $60 $20 $40 $60 $50 $100 $150

$10 / $30 / $30 / 30% $10 $30 $30

30%

$25 $75 $75

30% Preferred - B4$15 / $30 / $50 / 30%

$15 $30 $50 $37.50 $75 $125 $150 - $15 / $30 / $50 / 30%2

$20 / $50 / 50% / 30% $20 $50 50% $50 $125 50%1 Specialty drugs are limited to a 30-day supply from Premera’s specialty pharmacy provider.2 Deductible Waived for Tier 1

the Essentials pharmacy plan keeps costs as low as possible by focusing on high-value drugs that are approved by the U.S. Food and Drug Administration (FDA).

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Together, Premera’s medical and dental plans encourage healthy habits and better outcomes, provide a robust network of medical and dental providers, and make it easy and simple so you can take great care of your employees.

3 Choose a dental plan Select from 8 dental plans. Each offers:

• A broad Choice network. We offer access to one of the largest networks of dentists—with hundreds of network dentists in Alaska and nearly 82,000 in-network dentists nationally for your employees who live or travel outside of Alaska.

• An emphasis on prevention. Premera dental customers do not pay a deductible for regular dental visits, and most plans will cover preventive services in full.

• One consistent experience. Customers get a streamlined experience with one ID card, one customer service number, one website, and one customer login.

• Easy online tools. Find in-network care, see how much dental services will cost, or even email a licensed dentist.

• Dental expertise. We’ve been serving dental customers for more than 30 years.

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PremeraPreferred Choice

Dental Plans

Individual Deductible1

FamilyDeductible1

Coinsurance- Diagnostic & Preventive

(INN & OON)

Coinsurance-Basic

(INN & OON)

Coinsurance-Major

(INN & OON)

AnnualMaximum

Class-Endodontic/Periodontic

Services

Waiting Period

Orthodontia (Ortho)

Optima 20% 1000 $50 $150 20% 20% 50% $1,0002 Major No No

Optima 1000 $50 $150 0% 20% 50% $1,0002 Major No No

Optima 1500 $50 $150 0% 20% 50% $1,5002 Major No No

Optima 1500 Enhanced $50 $150 0% 20% 50% $1,5001 Basic No No

Optima 1500 Enhanced, plus Ortho

$50 $150 0% 20% 50% $1,5001 Basic No

0%coinsurance

to $1,500 lifetime

maximum(all ages)

Optima 2000 Enhanced $50 $150 0% 20% 50% $2,0001 Basic No No

Optima 2000 Enhanced, plus Ortho

$50 $150 0% 20% 50% $2,0001 Basic No

0%coinsurance

to $1,500 lifetime

maximum(all ages)

Essentials 1000(Voluntary) $50 $150 0% 20% 50% $1,0002 Major 12

months3 No

1 Applies to Basic and Major only2 Applies to all classes3 Applies to Major only

INN: In-network OON: out-of-network

Your dental plan options

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What our customers say

@premera THANK YOU SO MUCH for helping me get my question answered. Jennifer in Alaska just gave me the info I needed.The gentleman I spoke with was knowledgeable and helpful. Could not have been handled more professionally.Whato remove such a financial hardship. One of the best customer experiences I’ve had over the phone.It’s awesome that they’re actually paying attention, it’s good to know this is a way to reach them. Got the call this morning—issue resolved!We couldn’t have asked for a better person to help us through all we’ve been through with my wife’s strokes.Shout-out to @premera Customer Service rep Carrie in Spokane WA for helping me w/my insurance. #insurance #premera #bestcustomerserviceI felt so helpless, but now I feel like I have help.I have faith that Adrian will have the issue resolved today. He promised me a card and the numbers I need

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FIND OUT MORE

Visit premera.com/ak/employer

Talk with your Premera representative or producer.

042830 (10-15-2018)