New York Highlights: Northeast Downstate Benefit Highlights $0 - - PowerPoint PPT Presentation

New York Highlights: Northeast Downstate

• $0 Premium Plan
• Part B Giveback Plan
• Full Product Continuum
• DSNP in NYC
• ED Rx Covered on High Option Plan
• Plans with premium covered by LIS and SPAP (EPIC)
• Plans include Dental / Vision / Hearing / OTC (up to $100 CARD on DSNP), Acupuncture and Transportation

Benefit Highlights

• Northwell
• Advantage Care
• Mt. Sinai
• One Medical
• Lutheran
• NYU
• Flushing Hospital

Network Highlights

• Strong National Brand Recognition In Market
• Local Market office and Support Team
• Year Round Selling opportunities: Dual Eligible Plans and EPIC Opportunity creating a SEP

Competitive Advantages

• Jamaica Hospital
• Brooklyn Hospital
• Wyckoff Hospital
• Kingsbrook Jewish Hospital
• Lenox Hill
• Staten Island North Hospital
• Staten Island South Hospital

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

New York Highlights: Northeast Downstate

H3533-021

Premium: $27.40 MOOP: $6,500 PCP /SPEC: $0 / $15 Inpatient: $225 1-5 Rx Included or No Rx: Included Contract/PBP: H3533-021 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bronx Kings New York Queens Richmond

H3533-023

Premium: $ 69 MOOP: $3,400 PCP /SPEC: $0 / $15 Inpatient: $190 1-5 Rx Included or No Rx: Included Contract/PBP: H3533-023 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bronx Kings New York Queens Richmond Nassau Suffolk (Partial)

H3533-027

Premium: $0 with $50 Part B Giveback MOOP: $6,700 PCP / SPEC: $10 / $50 Inpatient: $1,000 Plan Ded excluding office visits Rx Included or No Rx: Included Contract/PBP: H3533-027 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bronx Kings New York Queens Richmond Nassau Suffolk (Partial)

H3533-010

Premium: $28.80 MOOP: $6,700 PCP / SPEC: $0 / $35 Inpatient: $295 1-6 Rx Included or No Rx: Included Contract/PBP: H3533-010 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Nassau Suffolk (Partial) HMO HMO HMO HMO

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

New York Highlights: Northeast Downstate

Dual SNP NYC

Premium: $0 MOOP: $0 PCP /SPEC: $0 / $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H3533-004 OTC: $100 CARD Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bronx Kings New York Queens Richmond HMO

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New York Highlights: Northeast Upstate

• $0 Premium Plan in total footprint
• Part B Giveback Plan
• Full Product Continuum
• DSNP – full year sales opportunity
• Plans with premium covered by LIS and SPAP (EPIC)
• Plans include Dental / Vision / Hearing / OTC (up to $100 CARD on DSNP), and Transportation

Benefit Highlights

• Lourdes
• UHS
• St James
• Mercy
• Arnot
• Saratoga Hospital
• Endwell Family Group

Network Highlights

• Strong National and local Brand Recognition In Market
• Local Market offices and Support Team
• Year Round Selling opportunities: Dual Eligible Plans and EPIC Opportunity creating a SEP

Competitive Advantages

• Guthrie
• Robert Packer
• JAMA
• WCA
• UMPC
• St. Peter’s Hospital
• Ellis Hospital
• Community Care

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

H3533-020 Premium: $0 MOOP: $6,700 PCP /SPEC: $5 / $45 Inpatient: $350 1-5 Rx Included or No Rx: Included Contract/PBP: H3533-020 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Broome Chemung Steuben Tioga H3533-002 Dual SNP Central NY Expanding to Southern Tier Premium: $0 MOOP: $0 PCP /SPEC: $0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H3533-002 OTC: $100 CARD Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Albany, Oneida, Onondaga, Oswego, Rensselaer, Saratoga, Schenectady, Warren, Broome, Chemung, Steuben, Tioga, Washington H3533-006 Premium: $0 MOOP: $6,700 PCP /SPEC: $5 / $40 Inpatient: $345 1-5 Rx Included or No Rx: Included Contract/PBP: H3533-006 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Albany, Rensselaer, Saratoga, Schenectady, Warren, Washington H3533-013 Premium: $26.40 MOOP: $5,900 PCP /SPEC: $0 / $25 Inpatient: $260 1-7 Rx Included or No Rx: Included Contract/PBP: H3533-013 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Albany, Oneida, Onondaga, Oswego, Rensselaer, Saratoga, Schenectady, Warren, Washington HMO HMO HMO HMO

New York Highlights: Northeast Upstate

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

New York Highlights: Northeast Upstate

H5970-001 Premium: $39 MOOP: $6,700 / $10,000 PCP /SPEC: $5/$30 $40/$60 Inpatient: $295 1-6 / $395 1-7 Rx Included or No Rx: Included Contract/PBP: H5970-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Allegany, Cattaraugus, Chautauqua, Chenango, Cortland, Schuyler, Yates, Broome, Chemung, Steuben, Tioga H5970 – 017 (757) Premium: $0 MOOP: $6,700 / $10,000 PCP / SPEC: $10/$50 $40 / $70 Inpatient: $395 1-4 / $700 1-14 Rx Included or No Rx: Included Contract/PBP: H5970 – 017 (757) Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Allegany Cattaraugus, Chautauqua Chenango, Cortland, Schuyler, Yates, Broome, Chemung Steuben, Tioga H5970 – 018 (763) Premium: $0 with $40 Part B Giveback MOOP: $6,700 $10,000 PCP / SPEC: $15 / $50 50% / 50% Inpatient: $1000 IN and OON $650 /stay IN, 50% OON Rx Included or No Rx: Included Contract/PBP: H5970 – 018 (763) Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Allegany, Broome, Cattaraugus, Chautauqua, Chemung, Chenango, Cortland Schuyler, Steuben, Tioga, Yates, Cayuga, Herkimer, Jefferson Lewis, Madison, Oneida, Onondaga, Oswego, Albany Greene, Montgomery, Rensselaer, Saratoga, Schenectady LPPO LPPO LPPO H5970-016 MA Only (VA Plan) Premium: $0 with $40 Part B Giveback MOOP: $4,500 / $10,000 PCP /SPEC: $0 / $40 30% OON Inpatient: $350 1-5 / 30% OON Rx Included or No Rx: NOT Included Contract/PBP: H5970-016 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Allegany, Broome, Cattaraugus, Chautauqua, Chemung, Chenango, Cortland Schuyler, Steuben, Tioga, Yates, Cayuga, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego, Albany, Greene, Montgomery, Rensselaer Saratoga, Schenectady LPPO

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New Hampshire / Maine Highlights

• $0 Premium Plan in total footprint
• Part B Giveback Plan
• Full Product Continuum
• DSNP (or Look-a-Like) – full year sales opportunity
• Plans include Dental / Vision / Hearing / OTC (up to $100 CARD on DSNP), and Transportation

Benefit Highlights Network Highlights

• Strong National and local Brand Recognition In Market
• Local Market offices and Support Team
• Year Round Selling opportunities: Dual Eligible Plans

Competitive Advantages

New Hampshire

 Lakes Region General Hospital  Huggins Hospital  Memorial Hospital  Catholic Medical Center  Elliott Hospital  Monadnock Hospital  Southern New Hampshire Medical Center 

• St. Joseph Hospital

 Concord Hospital  Franklin Regional Hospital  Exeter Hospital  Parkland Medical Center  Portsmouth Regional Hospital  Frisbie Memorial Hospital  Wentworth Douglas Hospital

Maine

• Maine Medical Center
• Bridgton Hospital
• Mercy Hospital
• Mid Coast Hospital
• Parkview Adventist Medical Center
• Henrietta D Goodall Hospital
• Southern Maine Health Care
• York Hospital
• St. Mary’s Regional Hospital
• Inland Hospital

 Maine General Medical Center  Penobscot Bay Medical Center  Rumford Hospital  Stephens Memorial Hospital  Eastern Maine Medical Center  Millinocket Regional Hospital  Penobscot Valley Hospital 

• St. Joseph Hospital

 Waldo County General Hospital

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

New Hampshire / Maine Highlights

H5619-040 001 ME / NH HMO Premium: $29 MOOP: $6,700 PCP /SPEC: $0/$40 Inpatient: $360 1-5 Rx Included or No Rx: Included Contract/PBP: H5619-004 001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: ME: Knox, Oxford, Waldo NH: Belknap, Hillsborough, Merrimack, Strafford H5619-040 002 ME / NH HMO Premium: $39 MOOP: $6,700 PCP / SPEC: $0/$40 Inpatient: $360 1-5 Rx Included or No Rx: NOT Included Contract/PBP: H5619-040 002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: ME: Penobscot NH: Carroll, Rockingham H5619-065 DSNP Look a Like Premium: $24 MOOP: $6,700 PCP / SPEC: $0 / 20% OON 20% Inpatient: $500 1-3 Rx Included or No Rx: Included Contract/PBP: H5619-065 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Belknap, Carroll, Hillsborough, Merrimack, Rockingham, Strafford HMO HMO HMO

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

New Hampshire / Maine Highlights

H5216-057 Premium: $59 MOOP: $4,900 / $10,000 PCP /SPEC: $10/$40 $20/$60 Inpatient: $360 1-6 / $495 1-7 Rx Included or No Rx: Included Contract/PBP: H5216-057 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Belknap, Carroll, Hillsborough, Merrimack, Rockingham, Strafford H5216-059 MA Only (VA Plan) Premium: $0 with $40 Part B Giveback MOOP: $4,500 / $10,000 PCP / SPEC: $0/$40 30% OON Inpatient: $350 1-5 / 30% OON Rx Included or No Rx: NOT Included Contract/PBP: H5216-059 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Belknap, Carroll, Hillsborough, Merrimack, Rockingham, Strafford H5216-138 (764) Premium: $0 with $40 Part B Giveback MOOP: $6,700 / $10,000 PCP / SPEC: $15 / $50 50% / 50% Inpatient: $1000 IN and OON $650 /stay IN, 50% OON Rx Included or No Rx: Included Contract/PBP: H5216-138 (764) Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Belknap, Carroll, Hillsborough, Merrimack, Rockingham, Strafford HMO LPPO LPPO LPPO H5216-058 Premium: $0 Giveback MOOP: $6,700 / $10,000 PCP /SPEC: $15/$50 $20/$65 OON Inpatient: $500 1-3 / $495 1-7 OON Rx Included or No Rx: Included Contract/PBP: H5216-058 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Belknap, Carroll, Hillsborough, Merrimack, Rockingham, Strafford LPPO

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Maine Highlights: Northeast Market- EXCLUDES New Hampshire

H5619-040 003 Premium: $ 0 MOOP: $6,700 PCP /SPEC: $0/$40 Inpatient: $360 1-5 Rx Included or No Rx: Included Contract/PBP: H5619-004 003 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Kennebec H5619-001 Premium: $0 MOOP: $6,700 PCP / SPEC: $5/$45 Inpatient: $360 1-5 Rx Included or No Rx: Included Contract/PBP: H5619-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Androscoggin, Cumberland, Sagadahoc, York H5619-003 DSNP Premium: $10.50 MOOP: $6,700 PCP / SPEC: $0 / 0 Inpatient: $0 Rx Included or No Rx: Included Contract/PBP: H5619-003 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Androscoggin, Cumberland, Knox, Oxford, York HMO HMO H5619-066 Premium: $0 with $40 Part B Giveback MOOP: $6,700 PCP / SPEC: $10/50 Inpatient: $1000 Plan Ded excluding office visits Rx Included or No Rx: Included Contract/PBP: H5619-066 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Androscoggin, Cumberland, Sagadahoc, York, Kennebec, Knox, Oxford, Penobscot, Waldo HMO HMO

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Pennsylvania Highlights: Greater Philadelphia

Philadelphia, Doylestown, Levittown, Abington, Upper Darby, Downingtown

• Four $0 Premium plans (HMO and PPO)
• Most Plans include Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits on our HMO & LPPO products
• Enhanced Transportation benefits for our DE-SNP HMO plan
• Meal Benefit
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply

Benefit Highlights

• Thomas Jefferson University Hospitals: Abington, Aria, Methodist, Rothman Institute and TJUH; Einstein Medical

Center – Montgomery and Philadelphia and Doylestown Health

• National PPO network

Network Highlights

• Year Round Selling opportunities with the Dual Eligible SNP Plan
• Rich benefits with low, fixed copay and no deductibles
• The High Value LPPO plan covered services can be obtained from either in-network or out-of-network providers at

the same cost-share (Passive network design with no deductibles)

• No Referrals needed on HMO plans
• A Part B Giveback HMO Plan in the Greater Philadelphia area

Competitive Advantages

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Pennsylvania Highlights: Greater Philadelphia

Philadelphia, Doylestown, Levittown, Abington, Upper Darby, Downingtown

Greater Philadelphia

$0 Premium MOOP: $6,700 OON Cost Share: N/A PCP/SPEC: $5/$45 Referrals: Not required Inpatient: $225 days 1 - 7 Rx Included or No Rx: Included Rx Deductible: $0 Contract/PBP: H6622-037 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties

DE-SNP HMO

$34.90 Premium* MOOP: $6,700 OON Cost Share: N/A Part B Deductible: $183 PCP/SPEC: 20%/20% Referrals: Not required Inpatient: $600 days 1 - 3 Rx Included or No Rx: Included Rx Deductible: $230 Tiers 2-5 Contract/PBP: H6622-038 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties

*Medicaid Eligibility: Full Benefit Dual Eligible (FBDE), Qualified Medicare Beneficiary (QMB), Qualified Medicare Beneficiary Plus (QMB+), Specified Low-Income Beneficiary Plus (SLMB+) for $0 premium and lower or no cost share (cost share protected)

Pennsylvania Humana Choice MA Only LPPO (Select Counties)

$0 Premium MOOP: $4,500 OON Cost Share: 30% PCP/SPEC: $10/$35 Inpatient: $295 days 1 - 6 Rx Included or No Rx: No Contract/PBP: H5216-116 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties HMO HMO Local PPO MA Only

Greater Philadelphia Part B Give Back Plan

$0 Premium MOOP: $6,700 OON Cost Share: N/A Part B Reduction: $40 Part B Deductible: $183 PCP/SPEC: 20%/20% Referrals: Not required Inpatient: $600 days 1 - 3 Rx Included or No Rx: Included Rx Deductible: $350 Tiers 2-5 Contract/PBP: 6622-039 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties HMO

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Pennsylvania Highlights: Greater Philadelphia

Philadelphia, Doylestown, Levittown, Abington, Upper Darby, Downingtown

Greater Philadelphia Platinum

$149 Premium MOOP: $6,700 OON Cost Share: Passive same cost share as in-network PCP/SPEC: $5/$30 Inpatient: $350 stay Rx Included or No Rx: Included Rx Deductible: $0 Contract/PBP: H5216-122 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties

Gold Choice MAPD

$65 Premium MOOP: $6,700 OON Cost Share: Passive same cost share as in-network PCP/SPEC: $15/$45 Inpatient: $295 days 1 - 6 Rx Included or No Rx: Included Rx Deductible: $360 Tiers 4&5 Contract/PBP: H8145-052 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Chester County

Gold Choice MA Only

$29 Premium MOOP: $6,700 OON Cost Share: Passive same cost share as in-network PCP/SPEC: $15/$45 Inpatient: $350 days 1-5 Rx Included or No Rx: No Contract/PBP: H8145-055 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Chester County Local PPO PFFS MAPD PFFS MA Only

Greater Philadelphia Classic

$79 Premium MOOP: $6,700 OON Deductible: $1,000 OON Cost Share: 30% PCP/SPEC: $15/$45 Inpatient: $350 days 1-5 Rx Included or No Rx: Included Rx Deductible: $0 Contract/PBP: H5525-005 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bucks, Chester, Delaware, Montgomery, & Philadelphia Counties Local LPPO

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Michigan Highlights: Detroit

• Premium as low as $0 for MA and MAPD plans
• Most Plans includes Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits on Most products
• Transportation benefits on some plans
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply

Benefit Highlights

• Tenet back in network on all plans as well as St. John Ascension
• 5 Oak Street Clinics around market
• Strong Relationships with Providers

Network Highlights

• 5 Oak Street clinics exclusive to Humana Plans
• Local Market office and Support Team
• Year Round Selling opportunities: for LIS

Competitive Advantages

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Michigan Highlights: Detroit

Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPC: $10/$50 Inpatient: $285/days 1-6 Rx Included Contract/PBP: H8908-004 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Macomb, Oakland, and Wayne

Humana Gold Plus

$49.00 Premium MOOP: $4,500 PCP/SPEC: $0/$40 Inpatient: $250/days 1-7 Rx Included Contract/PBP: HH8908-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Ingham, Macomb, Oakland, Washtenaw, and Wayne

Humana Value Plus

$23.30 Premium MOOP: $6,700/$10,000 PCP/SPEC: 20%/20% Inpatient: $600/days 1-3 Rx Included Contract/PBP: H5216-133 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Macomb, Oakland, and Wayne

Humana Choice

$108.00 Premium MOOP: $6,700/$10,000 PCP/SPEC: $5/$50 Inpatient: $279/days 1-7 Rx Included Contract/PBP: H5216-011 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Macomb, Oakland, and Wayne HMO HMO LPPO LPPO

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Michigan Highlights: Detroit

Humana Choice

$0 Premium MOOP: $6,700/$10,000 PCP/SPEC: $15/$45 Inpatient: $295/days 1-6 No Rx Contract/PBP: H5216-012 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Macomb, Oakland, and Wayne

Humana Choice

$135.00 Premium MOOP: $6,700/$10,000 PCP/SPEC: $15/$50 Inpatient: $295/days 1-6 Rx Included Contract/PBP: R5826-006 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: ALL

Humana Choice

$0 Premium MOOP: $6,700/$10,000 PCP/SPEC: $15/$45 Inpatient: $295/days 1-6 No Rx Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: ALL LPPO Regional PPO Regional PPO

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Illinois Highlights: Northern Illinois

Greater Chicago

• $0 Premium plans
• $0 Premium C-SNP plan
• LPPO plans
• Plans includes Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits
• Transportation benefit
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply

Benefit Highlights

• Robust provider network that includes all the key hospital and provider systems throughout the Chicagoland and

Rockford area: Advocate Hospitals, Advocate Medical Group, Adventist, Dupage Medical Group, Edward Medical Group, OSF, Rockford Memorial Hospital, Advocate Condell, Centegra, Vista Medical Center, North Shore University Health System, Northwest Community Hospital, Alexian Brothers/Amita, Edward, Silver Cross, Resurrection/Presence, Mercy, Provena, Palos, Little Company of Mary, Ingalls, Gottlieb, Loyola, Delnor, JenCare, and Oak Street Health.

• Strong Relationships with Providers

Network Highlights

• 73,000 Members with sustained year over year growth
• Strong Brand Recognition in Market
• Local Market office and Support Team
• Year Round Selling opportunities: C-SNP plan available in Cook, Dupage, and Will

Competitive Advantages

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This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Illinois Highlights: Northern Illinois

Greater Chicago

Chicago HMO

$0 Premium MOOP: $3,200 PCP: $0 SPEC: $30 Inpatient: $200 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1468-013 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cook, Will, and Lake

Chicago C-SNP

$0 Premium MOOP: $3,200 PCP: $0 SPEC: $20 Inpatient: $200 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1468-017 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cook, Will, and Dupage

IL-LPPO

$89 Premium MOOP: $6,700 PCP: $10 SPEC: $45 Inpatient: $295 days 1-6 Rx Included or No Rx: Included Contract/PBP: H5216-013 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Greater Chicago Serving Counties: Cook, Lake, Dupage, McHenry, Will, Kane, Kankakee, Kendall, DeKalb

MA Only LPPO

$0 Premium MOOP: $6,700 PCP: $15 SPEC: $45 Inpatient: $295 days 1-7 Rx Included or No Rx: Not Included Contract/PBP: H5216-012 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Greater Chicago Serving Counties: Cook, Lake, Dupage, Will, McHenry, Kane, Kendall, Winnebago HMO Chicago C-SNP HMO LPPO MA Only LPPO

18

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Illinois Highlights: Northern Illinois

Greater Chicago

Dupage HMO

$0 Premium MOOP: $2,950 PCP: $0 SPEC: $35 Inpatient: $200 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1468-016 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Dupage

Chicago Collar HMO

$21 Premium MOOP: $6,700 PCP: $5 SPEC: $35 Inpatient: $225 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1468-014 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Kane, Kendall, McHenry

Rockford HMO

$21 Premium MOOP: $5,500 PCP: $0 SPEC: $40 Inpatient: $250 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1468-015 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Winnebago, Boone, Stephenson

Peoria LPPO

$105 Premium MOOP: $6,700 PCP: $10 SPEC: $45 Inpatient: $295 days 1-7 Rx Included or No Rx: Included Contract/PBP: H5525-004 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Greater Chicago Counties: Stephenson, Winnebago, Boone HMO HMO HMO Local PPO

19

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Illinois Highlights: Central & Southern

Major Cities: Peoria, East St. Louis, Bloomington

Humana Gold Plus

$32 Premium MOOP: $5,500 PCP/SPECIALIST: $0 / $40 Inpatient: $250/Day (1-7) Rx Included: Yes Deductible & Applicable Tiers: $200 on Tiers 4,5 Contract/PBP: H1468-007-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Knox, Livingston, Marshall, McLean, Peoria, Stark, Tazewell, Woodford

Humana Choice

$105 Premium MOOP IN-NETWORK: $6,700 MOOP OUT-NETWORK: $10,000 PCP/SPECIALIST: $10/$45 Inpatient: $295/Day (1-6) RX Included: Yes Deductible & Applicable Tiers: $250 on Tiers 4,5 Contract/PBP: H5525-004-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Boone, Brown,

Cass, Fulton, Hancock, Henderson, Knox, LaSalle, Lee, Livingston, Marshall, McDonough, McLean, Ogle, Peoria, Putnam, Schuyler, Stark, Stephenson, Tazewell, Warren, Winnebago, Woodford

Humana Choice

$0 Premium MOOP IN-NETWORK: $3,400 PCP/SPECIALIST: $0/$45 Inpatient: $295/Day (1-8) Rx Included: Yes Deductible & Applicable Tiers: $195 on Tiers 3,4,5 Contract/PBP: H2649-023 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Madison and St. Clair

Humana Choice

$0 Premium MOOP IN-NETWORK: $4,500 PCP/SPECIALIST: $15/$45 Inpatient: $245/Day (1-8) Rx Included or No Rx: Yes Deductible & Applicable Tiers: $195 on Tiers 3,4,5 Contract/PBP: H5216-033 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Madison, Monroe, St. Clair HMO Local PPO Local PPO HMO

20

Wisconsin Highlights: Statewide

• $0 Premium HMO Plans
• Plans include Dental, Hearing, & Vision benefits
• 4 star plans
• Over the Counter (OTC) Benefits on our HMO, PPO and PFFS products
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply
• No referrals required for providers in network

Benefit Highlights

• All Major hospitals in the Milwaukee and Green Bay area-
• Large provider participation in the our HMO and PPO Plans
• Strong Relationships with Providers

Network Highlights

• 62,000 Members Strong and Growing
• Strong Brand Recognition In Market
• Local Market office and Support Team
• Year Round Selling opportunities for Age-ins, LIS and SPAP members

Competitive Advantages

21

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Wisconsin Highlights: Madison, Milwaukee, Green Bay

Milwaukee

$0 Premium MOOP: $5,900 PCP/SPEC: $10/$50 Inpatient: $350 (1-5) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha

Milwaukee

$37 Premium MOOP: $5,900 PCP/SPEC: $0/$40 Inpatient: $295 (1-7) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha

Milwaukee

$0 Premium MOOP: $6,700 PART B Give back: $40 PCP/SPEC: $20/$50 Inpatient: $600 (1-3) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Washington, Waukesha

Green Bay

$0 Premium MOOP: $6,700 PCP/SPEC: $15/$50 Inpatient: $395 (1-4) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Brown, Calumet, Fond Du Lac, Green Lake, Marathon, Manitowoc, Marquette, Oconto, Outagamie, Shawano, Waupaca, Waushara, Winnebago HMO HMO HMO HMO

22

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Wisconsin Highlights: Madison, Milwaukee, Green Bay

Madison

$53 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $279 (1-7) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Columbia, Crawford, Dane, Green, Iowa, Jefferson, Lafayette, Richland, Rock, Sauk

Milwaukee Eastern

$89 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $295 (1-6) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Dodge, Kenosha, Milwaukee, Ozaukee, Racine, Washington, Waukesha

Green Bay Eastern

$89 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $295 (1-6) Rx Included Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1

Serving Counties: Brown, Calumet, Door, Fond Du Lac, Forest, Green Lake, Kewaunee, Marathon, Manitowoc,

Marinette, Marquette, Menominee, Oconto, Outagamie, Portage, Sheboygan, Waupaca, Waushara, Winnebago

Green Bay

$0 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $295 (1-6) No Rx Contract/PBP: H0000-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late Sept. & 10/1 Serving Counties: Door, Marinette, Brown, Marathon, Oconto, Outagamie

LPPO LPPO LPPO LPPO

23

Minnesota Highlights: Twin Cities

• $0, $29, $49, $109 Premium Plan Options
• Plans includes Dental, Hearing and Vision benefits
• Over-the-Counter (OTC) Benefits on most plans
• Silver Sneakers – fitness and gym membership on all plans
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail Order Pharmacy for 90 day supply

Benefit Highlights

• Network providers include: HCMC, Allina, Park Nicollet, Fairview, Health East, North Memorial, Ridgeview
• Statewide provider coverage
• Strong relationships with providers

Network Highlights

• Four competitive plan options
• Strong statewide and national provider network
• Local market office and support team

Competitive Advantages

24

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Minnesota Highlights: Twin Cities

PPO High

$109 Premium MOOP: $3,000 PCP/SPEC: $0/$25 Inpatient: $100 per admittance Rx Included or No Rx: Rx Included Contract/PBP: H5216-063-000

Group ID: To be provided Sept. – 10/1 BSN: To be provided Sept. – 10/1

Serving Counties: Aitkin, Anoka,

Becker, Beltrami, Benton, Big Stone, Carlton, Carver, Cass, Chippewa, Chisago, Clay, Clearwater, Crow Wing, Dakota, Douglas, Grant, Hennepin, Hubbard, Isanti, Itasca, Kanabec, Kandiyohi, Kittson, Lac Qui Parle, Lake, Lake of the Woods, Lincoln, Lyon, Mahnomen, Marshall, McLeod, Meeker, Mille Lacs, Morrison, Murray, Nobles, Norman, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Ramsey, Red Lake, Redwood, Renville, Rock, Roseau, Scott, Sherburne, St. Louis, Stearns, Swift, Todd, Wadena, Washington, Wilkin, Wright

See Twin Cities map to right in both blue and yellow shaded areas

Twin Cities PPO

$49 Premium MOOP: $5,900 PCP/SPEC: $10/$45 Inpatient: $360/day 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H5216-080-001

Group ID: To be provided Sept. – 10/1 BSN: To be provided Sept. – 10/1 Serving Counties: Anoka, Benton, Carver, Chisago, Dakota, Hennepin, Isanti, Ramsey, Scott, Sherburne, Stearns, Washington, Wright

Yellow shaded area ONLY

PPO Low

$29 Premium MOOP: $6,700 PCP/SPEC: $20/$50 Inpatient: $454/day 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H5216-092-000

Group ID: To be provided Sept. – 10/1 BSN: To be provided Sept. – 10/1

Serving Counties: All counties except Cook, Koochiching, Stevens, Traverse and Yellow Medicine Local PPO Local PPO Local PPO

Veterans MA Only

$0 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295/day 1-6 Rx Included or No Rx: No Rx Contract/PBP: H5216-086-000

Group ID: To be provided Sept. – 10/1 BSN: To be provided Sept. – 10/1

Serving Counties: All counties except Cook, Koochiching, Stevens, Traverse and Yellow Medicine Local PPO

25

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Minnesota Highlights: Northern

PPO High

$109 Premium MOOP: $3,000 PCP/SPEC: $0/$25 Inpatient: $100 per admittance Rx Included or No Rx: Rx Included Contract/PBP: H5216-063-000 Group ID: To be provided Sept. – 10/1 BSN: To be provided Sept. – 10/1 Serving Counties: All counties listed for

Northern PPO plus: Anoka, Benton, Big Stone, Carver, Chisago, Chippewa, Dakota, Grant, Hennepin, Isanti, Kandiyohi, Kittson, Lac Qui Parle, Lincoln, Lyon, Murray, Nobles, Pipestone, Pope, Ramsey, Redwood, Renville, Rock, Scott, Sherburne, Stearns, Swift, Washington, Wright

See both blue and yellow shaded areas below:

Veterans MA Only

$0 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295/day 1-6 Rx Included or No Rx: No Rx Contract/PBP: H5216-086-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties : All counties except Cook, Koochiching, Stevens, Traverse and Yellow Medicine

Northern PPO

$89 Premium MOOP: $6,700 PCP/SPEC: $15/$50 Inpatient: $454/day 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H5216-080-003 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties : Aitkin, Becker, Beltrami, Carlton, Cass, Clay, Clearwater, Crow Wing, Douglas, Hubbard, Itasca, Kanabec, Lake, Lake

• f the Woods, Mahnomen, Marshall,

McLeod, Meeker, Mille Lacs, Morrison, Norman, Otter Tail, Pennington, Pine, Polk, Red Lake, Roseau, St. Louis, Todd, Wadena, Wilkin

Blue shaded area only on map to the left

Local PPO Local PPO Local PPO

PPO Low

$29 Premium MOOP: $6,700 PCP/SPEC: $20/$50 Inpatient: $454/day 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H5216-092-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties : All counties except Cook, Koochiching, Stevens, Traverse and Yellow Medicine

See map to the right for coverage area – Same coverage area as MA only plan

Local PPO

26

North Dakota Highlights: Midwest North

• $0, $29, $73, $97 and $109 Premium plan options
• Plans includes Dental, Hearing and Vision benefits
• Over-the-Counter (OTC) Benefits on most plans
• Silver Sneakers – fitness and gym membership on all plans
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail Order Pharmacy for 90 day supply

Benefit Highlights

• Network providers include: Sanford, Altru
• Strong relationships with providers

Network Highlights

• Five competitive plan options
• Strong statewide and national provider network
• Market office and support team

Competitive Advantages

27

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

North Dakota Highlights: Midwest North

PPO High

$109 Premium MOOP: $3,000 PCP/SPEC: $0/$25 Inpatient: $100 per admittance Rx Included or No Rx: Rx Included Contract/PBP: H5216-103-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Burleigh, Cass, Grand Forks, Morton, Richland, Stutsman

PPO Low

$29 Premium MOOP: $6,700 PCP/SPEC: $20/$50 Inpatient: $454/day 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H5216-092-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Burleigh, Cass, Grand Forks, Morton, Richland, Stutsman

Veterans MA Only

$0 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295/day 1-6 Rx Included or No Rx: No Rx Contract/PBP: H5216-086-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Burleigh, Cass, Grand Forks, Morton, Richland, Stutsman

Local PPO Local PPO Local PPO

28

South Dakota Highlights: East River and West River

• New 2018 $0 HMO in Minnehaha County
• New LPPO for 2018 with rich benefits ($100/day Hospital Stay) with RX included
• Plans includes Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits on our HMO products
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply

Benefit Highlights

• Sanford, Avera, Black Hills Surgical and Rapid City Regional
• All Hospitals participate in our HMO Plans

Network Highlights

• Strong Brand Recognition In Market
• $0 PCP Copay
• Year Round Selling opportunities: Humana Value HMO in Minnehaha County
• $29 LIS LPPO in Minnehaha and Pennington County

Competitive Advantages

29

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

South Dakota Highlights: East River

Major Cities: Sioux Falls, Brookings, Watertown, Yankton

Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPECIALIST: $0/$45 Inpatient: $350/Day (1-5) Rx Included: Yes Deductible & Applicable Tiers: $150 on Tiers 3,4,5 Contract/PBP: H0028-008-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Minnehaha, Lincoln, Union

Humana Choice

$59 Premium MOOP IN-NETWORK: $5,900 MOOP IN-NETWORK: $8,850 PCP/SPECIALIST: $10/$45 Inpatient: $363/Day (1-5) RX Included: Yes Deductible & Applicable Tiers: $350 on Tiers 3,4,5 Contract/PBP: H5216-088-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bon Homme,

Brookings, Clark, Clay, Codington, Davison, Day, Deuel, Grant, Hamlin, Hanson, Hutchinson, Kingsbury, Lake, Lincoln, Marshall, McCook, Miner, Minnehaha, Moody, Roberts, Sanborn, Spink, Turner, Union, and Yankton

Humana Choice

$109 Premium MOOP IN-NETWORK: $3,000 MOOP OUT-NETWORK: $4,500 PCP/SPECIALIST: $0/$25 Inpatient: $100/Stay Rx Included: Yes Deductible & Applicable Tiers: $250 on Tiers 3,4,5 Contract/PBP: H5216-103-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bon Homme,

Brookings, Clark, Clay, Codington, Davison, Day, Deuel, Grant, Hamlin, Hanson, Hutchinson, Kingsbury, Lake, Lincoln, Marshall, McCook, Miner, Minnehaha, Moody, Roberts, Sanborn, Spink, Turner, Union, and Yankton

Humana Choice

$0 Premium MOOP IN-NETWORK: $6,700 MOOP OUT-NETWORK: $10,000 PCP/SPECIALIST: $10/$45 Inpatient: $295/Day (1-6) Rx Included or No Rx: No RX Contract/PBP: H5216-086-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bon Homme, Brookings, Clark, Clay, Codington, Davison, Day, Deuel, Grant, Hamlin, Hanson, Hutchinson, Kingsbury, Lake, Lincoln, Marshall, McCook, Miner, Minnehaha, Moody, Roberts, Sanborn, Spink, Turner, Union, and Yankton HMO Local PPO Local PPO Local PPO

30

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Montana Highlights: Midwest North

Rocky Mountain HMO

$27 Premium MOOP: $4,900 PCP/SPEC: $10/$45 Inpatient: $295/day 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H6622-007-000 Group ID: To be provided late Sept. - 10/1 BSN: To be provided late Sept. - 10/1 Serving Counties: Big Horn, Broadwater, Carbon, Cascade, Chouteau, Custer, Deer Lodge, Fergus, Flathead, Golden Valley, Jefferson, Lake, Lewis & Clark, Lincoln, Mineral, Missoula, Musselshell, Pondera, Powell, Ravalli, Rosebud, Sanders, Silver Bow, Stillwater, Sweet Grass, Teton, Treasure, Wheatland, Yellowstone

MT DE SNP

$0 Premium MOOP: $6,700 PCP/SPEC: $0/$0 Inpatient: $0 Rx Included or No Rx: Rx Included Contract/PBP: H6622-008-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cascade, Flathead, Lewis & Clark, Missoula, Ravalli, Yellowstone

MT PPO

$75 Premium MOOP: $5,900 PCP/SPEC: $15/$45 Inpatient: $360/day 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H5216-089-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Carbon, Cascade, Flathead, Ravalli, Stillwater, Yellowstone

MT Western PPO

$67 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $360/day 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H5525-027-000 Group ID: To be provided late Sept. - 10/1 BSN: To be provided late Sept. - 10/1 Serving Counties: Beaverhead, Broadwater, Chouteau, Deer Lodge, Fergus, Granite, Jefferson, Judith Basin, Lake, Lewis & Clark, Liberty, Lincoln, Madison, Meagher, Mineral, Missoula, Pondera, Powell, Sanders, Silver Bow, Teton

HMO HMO Local PPO Local PPO

31

Iowa Highlights: Statewide

• $0 Premium
• $0 PCP CO-PAY
• Plans includes Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail order for 90 day supply

Benefit Highlights

• UnityPoint, Mercy, Iowa Clinic, University of Iowa Hospital System
• All Hospitals participate in our HMO Plans
• No Referrals Required on HMO

Network Highlights

• HMO in 59 counties (56 Counties have $0 Premium)
• Strong Brand Recognition In Market
• Local Market office and Support Team
• Year Round Selling opportunities: Humana Value Plan NEW for 2018
• (Counties: Black Hawk, Johnson, Linn, Polk, Pottawattamie, Scott, Story, Woodbury)

Competitive Advantages

32

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Iowa Highlights: Central & Western

Major Cities: Sioux City, Council Bluffs, Des Moines, Fort Dodge

Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPECIALIST: $0 / $45 Inpatient: $350/Day (1-5) Rx Included: Yes Deductible & Applicable Tiers: $150 on Tiers 3,4,5 Contract/PBP: H0028-008-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Boone, Dallas,

Jasper, Madison, Marion, Marshall, Polk, Story, Warren, Webster, Hamilton, Hardin, Grundy, Pottawattamie, Mills, Montgomery, Lyon, Osceola, Dickinson, Sioux, O’Brien, Clay, Plymouth, Cherokee, Buena Vista, Woodbury

Humana Value Plus

$0-$34 Premium

(QMB,QMB +, SLMB+, FBDE)

MOOP IN-NETWORK: $6,700 PCP/SPECIALIST: $0/$0 (up to 20%) Inpatient: $0 ($605/Day 1-3) RX Included: Yes Deductible & Applicable Tiers: $360 on Tiers 2,3,4 Contract/PBP: H0028-009-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Black Hawk, Johnson, Linn, Polk, Pottawattamie, Scott, Story, Woodbury COPAYS & COST SHARE DEPENDS ON ASSISTANCE LEVEL

Humana Choice

$51 Premium MOOP IN-NETWORK: $5,900 MOOP OUT-NETWORK: $8,850 PCP/SPECIALIST: $15/$45 Inpatient: $360/Day (1-5) Rx Included: Yes Deductible & Applicable Tiers: $399 on Tiers 3,4,5 Contract/PBP: H5216-090-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Benton, Black Hawk, Boone, Buchanan, Cedar, Dallas, Delaware, Iowa, Jasper, Johnson, Jones, Linn, Madison, Marion, Marshall, Muscatine, Polk, Story, Warren, Washington

Humana Choice

$89 Premium MOOP IN-NETWORK: $6,700 MOOP OUT-NETWORK: $10,000 PCP/SPECIALIST: $0/$20 Inpatient: $100/Day (1-7) Rx Included: Yes Deductible & Applicable Tiers: $299 on Tiers 3,4,5 Contract/PBP: H5216-104-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Dallas, Polk HMO HMO Local PPO Local PPO

33

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Nebraska Highlights: Omaha & Surrounding Area

Major Cities: Omaha, Lincoln, South Sioux City, Council Bluffs (IA)

Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPECIALIST: $0/$45 Inpatient: $350/Day (1-5) Rx Included: Yes Deductible & Applicable Tiers: $150 on Tiers 3,4,5 Contract/PBP: H0028-008-001 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Douglas, Sarpy, Saunders, Dodge, Cass, Lancaster, Washington

Humana Choice

$0-$34 Premium

(QMB,QMB +, SLMB+, FBDE)

MOOP IN-NETWORK: $6,700 PCP/SPECIALIST: $0/$0 (up to 20%) Inpatient: $0 ($605/Day 1-3) RX Included: Yes Deductible & Applicable Tiers: $115 on Tiers 2,3,4,5 Contract/PBP: H0028-007-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Douglas COPAYS & COST SHARE DEPENDS ON ASSISTANCE LEVEL

Humana Choice

$110 Premium MOOP IN-NETWORK: $6,700 MOOP OUT-NETWORK: $10,000 PCP/SPECIALIST: $15/$50 Inpatient: $454/Day (1-4) Rx Included: Yes Deductible & Applicable Tiers: $399 on Tiers 3,4,5 Contract/PBP: H5216-085-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cass, Dodge, Douglas, Lancaster, Sarpy, Saunders, Washington

Humana Choice

$0 Premium MOOP IN-NETWORK: $6,700 MOOP OUT-NETWORK: $10,000 PCP/SPECIALIST: $10/$45 Inpatient: $295/Day (1-6) Rx Included or No Rx: No RX Contract/PBP: H5216-086-000 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cass, Dodge, Douglas, Lancaster, Sarpy, Saunders, Washington HMO HMO DE-SNP Local PPO Local PPO

34

Indiana Highlights: Central Indiana/Indianapolis

• $0 HMO premium with no referrals, $0 PCP co-pay, and $0 Rx deductible
• New $25 LPPO; No OON deductibles on LPPO plans
• Dental, hearing, & vision benefits available on most plans
• Over the Counter (OTC) benefits on all products
• Silver Sneakers – fitness and gym membership included
• Transportation benefits available on some HMOs
• 4 Star plan
• Enhanced formulary covers additional drugs in Tier 1

Benefit Highlights

• Large PCP network including PCP’s with all major hospital systems along with Oak Street Health (3 locations)
• IU, St. Vincent, St. Francis, and Community Hospitals are all in network.
• All hospitals participate in our HMO and PPO network except for Eskinazi
• Strong Relationships with providers and hospitals
• Humana Pharmacy

Network Highlights

• 24,000+ Members strong and growing in Central Indiana
• Strong brand recognition In market
• Local market office and support team with local offices on the north and west sides of Indianapolis
• Year-round selling opportunities: Dual-Eligible plan with improved supplemental benefits and Chronic Care Plan

Competitive Advantages

35

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Indiana Highlights: Central Indiana/Indianapolis

Humana Gold Plus HMO

$0 Premium MOOP: $4,900 PCP/SPEC: $0/$45 Inpatient: $295 days 1-6 Rx: $0 deductible 2/8/47/100/33% Contract/PBP: H5619-049 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Boone, Delaware, Hamilton, Hancock, Hendricks, Howard, Johnson, Madison, Marion, Monroe, Montgomery, Morgan, Tippecanoe

NEW Humana Choice LPPO

$25 Premium (+LIS Pricing) MOOP: $6,700 PCP/SPEC: $10/45 Inpatient: $360 days 1-5 Rx: $185 (T 3-5) 2/8/47/100/29% Contract/PBP: H5216-114 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Boone, Delaware, Hamilton, Hancock, Hendricks, Johnson, Madison, Marion, Morgan

NEW Humana Choice LPPO

$25 Premium (+ LIS Pricing) MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $360 days 1-5 Rx: $220 (T 3-5) 2/8/47/100/28% Contract/PBP: H5216-111 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Blackford, Carroll,

Cass, Clay, Clinton, Elkhart, Fountain, Fulton, Grant, Howard, Jasper, Lagrange, Lake, LaPorte, Marshall, Miami, Monroe, Montgomery, Newton, Owen, Porter, Putnam, Randolph, St. Joseph, Shelby, Steuben, Tippecanoe, Tipton, Vermillion, Vigo, Wabash, Warren, White

HMO Local PPO Local PPO

36

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Indiana Highlights: Central Indiana/Indianapolis Special Needs Plans

Humana C-SNP

$17 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295 days 1-6 Rx: $405 (T 4-5) 7/17/47/97/25%/$7 Contract/PBP: H5619-055 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, Boone, DeKalb, Gibson, Hamilton, Hancock, Hendricks, Huntington, Johnson, Kosciusko, Lake, Madison, Marion, Morgan, Posey, Vanderburgh, Wells, Whitley

Humana Dual Eligible SNP

$0 Premium MOOP: $6,700 PCP/SPEC: $0/$0 Inpatient: $0 Rx: $0 (level of assistance) 0/19/47/100/29% Contract/PBP: H5619-054 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, Boone, DeKalb, Gibson, Hamilton, Hancock, Hendricks, Huntington, Johnson, Kosciusko, Lake, Madison, Marion, Morgan, Posey, Vanderburgh, Wells, Whitley HMO HMO

37

Indiana Highlights: Ft. Wayne

• $0 HMO premium with no referrals, $0 PCP co-pay, and $0 Rx deductible
• New $25 LPPO; No OON deductibles on LPPO plans
• Dental, hearing, & vision benefits available on most plans
• Over the Counter (OTC) benefits on all products
• Transportation benefits available on some HMOs
• Silver Sneakers – fitness and gym membership included
• 4 Star plan
• Enhanced formulary covers additional drugs in Tier 1

Benefit Highlights

• Oak Street Health- downtown Ft. Wayne location, transportation provided up to 10 mile radius
• Network Includes Parkview and Lutheran Hospitals
• All hospitals participate in our HMO Plans
• Strong relationships with providers
• Humana Pharmacy

Network Highlights

• 15,000+ Members in NE IN
• Strong brand recognition in market
• Local market office and support team
• Year-round selling opportunities: Dual-Eligible plan with improved supplemental benefits and Chronic Care Plan

Competitive Advantages

38

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Indiana Highlights: Ft. Wayne

Humana Gold Plus HMO

$0 Premium MOOP: $4,500 PCP/SPEC: $0/$40 Inpatient: $275 days 1-7 Rx: No deductible 2/5/47/100/33% Contract/PBP: H5619-051 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, DeKalb, Huntington, Kosciusko, Noble, Wells, Whitley

New Humana Choice LPPO

$25 Premium (+ LIS pricing) MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $360 days 1-5 Rx: $220 (T 3-5) 2/8/47/100/28% Contract/PBP: H5216-112 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, DeKalb, Huntington, Kosciusko, Noble, Wells, Whitley

New Humana Choice LPPO

$25 Premium (+ LIS Pricing) MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $360 days 1-5 Rx: $220 (T 3-5) 2/8/47/100/28% Contract/PBP: H5216-111 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Blackford, Carroll,

Cass, Clay, Clinton, Elkhart, Fountain, Fulton, Grant, Howard, Jasper, Lagrange, Lake, LaPorte, Marshall, Miami, Monroe, Montgomery, Newton, Owen, Porter, Putnam, Randolph, St. Joseph, Shelby, Steuben, Tippecanoe, Tipton, Vermillion, Vigo, Wabash, Warren, White

Humana Choice LPPO

$42 Premium MOOP: $4,900 PCP/SPEC: $10/$45 Inpatient: $325 days 1-5 Rx: $160 (T 3-5) 7/17/47/100/30% Contract/PBP: H5216-055 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, Cass, DeKalb, Elkhart, Fulton, Grant, Huntington, Kosciusko, LaGrange, LaPorte, Marshall, Miami, Noble, St. Joseph, Steuben, Wabash, Wells, Whitley HMO Local PPO Local PPO Local PPO

39

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Indiana Highlights: Ft. Wayne Special Needs Plans

Humana Dual Eligible SNP

$0 Premium MOOP: $6,700 PCP/SPEC: $0/$0 Inpatient: $0 Rx: $0 (level of assistance) 0/19/47/100/29% Contract/PBP: H5619-054 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, Boone, DeKalb, Gibson, Hamilton, Hancock, Hendricks, Huntington, Johnson, Kosciusko, Lake, Madison, Marion, Morgan, Posey, Vanderburgh, Wells, Whitley HMO

Humana C-SNP

$17 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295 days 1-6 Rx: $405 (T 4-5) 7/17/47/97/25%/$7 Contract/PBP: H5619-055 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adams, Allen, Boone, DeKalb, Gibson, Hamilton, Hancock, Hendricks, Huntington, Johnson, Kosciusko, Lake, Madison, Marion, Morgan, Posey, Vanderburgh, Wells, Whitley HMO

40

Ohio Highlights: Cleveland

• New $0 HMO & DE SNP plans in partnership with the Cleveland Clinic
• Expanding existing $0 HMO (H6622-011) beyond Cuyahoga county
• No Referrals on HMO Plans
• Enhanced formulary covers additional drugs in Tier 1
• 4 star plans
• Plans includes Dental, Hearing, Vision, & Over the Counter (OTC) benefits
• DE SNP includes strong hearing, vision, OTC, and transportation benefits
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy for 90 day supply

Benefit Highlights

• New Humana Cleveland Clinic Preferred plans in Cuyahoga County centered around Cleveland Clinic providers
• $0 Premium HMO (H6622-022) includes both University Hospitals and the Cleveland Clinic

Network Highlights

• Local Market Office and Support Team
• Year Round Selling opportunity: Humana Cleveland Clinic Preferred Dual Eligible plan in Cuyahoga county
• Removed Out of Network Deductible on LPPO plans

Competitive Advantages

41

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Ohio Highlights: Cleveland

NEW Humana Cleveland Clinic Preferred HMO

$0 Premium MOOP: $3,900 PCP/SPEC: $0 PCP / $45 SPEC Inpatient: $350 Days 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H6622-023 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cuyahoga

Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPEC: $10 PCP / $50 SPEC Inpatient: $425 Days 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H6622-022 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cuyahoga, Erie, Geauga, Lake, Lorain, Medina

Humana Gold Plus

$48 Premium MOOP: $6,700 PCP/SPEC: $15 PCP / $50 SPEC Inpatient: $360 Days 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H6622-011 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cuyahoga, Erie, Geauga, Lake, Lorain, Medina

NEW Humana Cleveland Clinic Preferred DE SNP

$0 Premium MOOP: $0 PCP/SPEC: $0 PCP / $0 SPEC Inpatient: $0 Rx Included or No Rx: Rx Included Contract/PBP: H5216-024 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Cuyahoga HMO HMO SNP HMO

42

Ohio Highlights: Cincinnati

• $0 Premium HMO with $0 PCP copay and improved Rx deductible and Rx copays
• No referrals on HMO plans
• New $25 LPPO with no OON deductible
• Enhanced formulary covers additional drugs in Tier 1
• 4 star plans
• Plans includes Dental, Hearing, & Vision benefits
• Over the Counter (OTC) Benefits on all products
• DE SNP includes strong hearing, vision, otc and transportation benefits
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Pharmacy for 90 day supply

Benefit Highlights

• Strong provider network on all plans
• University of Cincinnati, Mercy Health, The Christ Hospital, and TriHealth in HMO and PPO networks

Network Highlights

• Strong Brand Recognition In Market
• Local Market Office and Support Team
• Year Round Selling Opportunities with Dual Eligible Plan and Chronic Care Plan
• Introduction of New LPPO in market (LIS Eligible)
• Removed Out of Network Deductible on LPPO plans

Competitive Advantages

43

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Ohio Highlights: Cincinnati

Humana Gold Plus

$0 Premium MOOP: $4,900 PCP/SPEC: $0 PCP / $45 SPEC Inpatient: $350 Days 1-5 Rx Included or No Rx: Rx Included Contract/PBP: H6622-021-002 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Butler Clermont, Hamilton, Warren

Humana Gold Plus Diabetes and Heart

$0 Premium MOOP: $6,700 PCP/SPEC: $10 PCP / $45 SPEC Inpatient: $395 Days 1-4 Rx Included or No Rx: RX Included Contract/PBP: H6622-017 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Butler, Clark, Clermont, Delaware, Fairfield, Franklin, Hamilton, Licking, Warren,

Humana Gold Plus SNP-DE

$0 Premium MOOP: $0 PCP/SPEC: $0 PCP / $0 SPEC Inpatient: $0 Rx Included or No Rx: Rx Included Contract/PBP: H6622-015 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Butler, Clark, Clermont, Hamilton, Warren, Franklin, Fairfield, Licking, Delaware, Mahoning, Carroll, Stark, Summit, Portage, Trumbull, Wayne

NEW Humana Choice

$25 Premium MOOP/OON Ded: $6,700 / $0 PCP/SPEC: $15 PCP / $45 SPEC Inpatient: $415 Days 1-4 Rx Included or No Rx: Rx Included Contract/PBP: H5216-109 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Darke, Fayette, Preble, Madison, Butler, Union, Hamilton, Marion, Clermont, Morrow, Warren, Delaware, Montgomery, Franklin, Miami, Pickaway, Shelby, Ross, Logan, Pike, Champaign, Scioto, Clark, Licking, Greene, Fairfield, Clinton, Brown, Adams, Highland, KY: Boone, Bracken, Campbell, Kenton HMO SNP Local PPO SNP

44

Kentucky Highlights: Greater Louisville (Louisville)

• $0 Premium, Plans includes Dental, Hearing & Vision benefits
• $0 Rx deductible
• Over The Counter (OTC) Benefits
• Silver Sneakers – free fitness and gym membership
• $0 Tier 1 & 2 Rx Benefits if member uses Humana Mail-Order for 90-day supply
• $0 regardless of your Medicaid level

Benefit Highlights

• All Hospitals participate in at least one Humana Advantage Plan,
• Norton accepts the Community HMO, GOLD PLUS HMO, and PPOs
• Baptist and KY/ONE accept the GOLP PLUS and PPOs
• JENCARE is accepting new patients at all 3 facilities

Network Highlights

• 70,000 Members Strong and Growing
• *NO REFERRAL HMO*
• Face-to-Face Customer Service at the (Humana in your community) previously know as the GUIDANCE CENTERS in

the center of Jefferson County

• Strong Brand Recognition Company HQ Market
• Local Market office and Support Team
• Year-Round Selling opportunities: 2 Dual Eligible Plans and Chronic Care Plan

Competitive Advantages

45

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Kentucky Highlights: Greater Louisville (Louisville)

Community HMO Diabetes & Heart (HMO-SNP)

$0 Premium MOOP: $6,700 PCP Pref/ SPEC: $0/$45 Inpatient: $260 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1036-234 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Jefferson

Community HMO SNP-DE

$18.20 Premium MOOP: $6,700 PCP Pref/ SPEC: 20%/20% Inpatient: $500 days 1-3 Rx Included or No Rx: Included Contract/PBP: H1036-235 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Jefferson

Community HMO

$0 Premium MOOP: $5,900 PCP Pref/ SPEC: $0/$40 Inpatient: $250 days 1-7 Rx Included or No Rx: Included Contract/PBP: H1036-236 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Jefferson

Louisville Gold Plus HMO

$19 Premium MOOP: $6,700 PCP Pref/ SPEC: $10/$45 Inpatient: $275 days 1-7 Rx Included or No Rx: Included Contract/PBP: H5619-073 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: KY: Bullitt, Hardin, Jefferson, Oldham; IN: Clark, Floyd SNP SNP HMO HMO

46

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Kentucky Highlights: Eastern Kentucky

Lexington, Richmond, Paintsville, Harlan, Hazard, Pikeville, Winchester, Paris, Frankfort

KY MA Only

$0 Premium MOOP: $4,500 PCP/SPEC: $10/$35 Inpatient: $295 (Days 1-6) Rx Included or No Rx: N/A Contract/PBP: H5216-105 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO

KY Rich LPPO

$119 Premium MOOP: $6,700 PCP/SPEC: $5/$30 Inpatient:$350 per stay Rx Included or No Rx: $0 Deductible Contract/PBP: H5216-601 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO

Bluegrass HumanaChoice

$59 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $350 (Days 1-5) Rx Included or No Rx: $0 Deductible Contract/PBP: H5525-022 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adair, Allen, Boyd,

Butler, Carroll, Carter, Casey, Clay, Clinton, Crittenden, Cumberland, Edmonson, Floyd, Fulton, Gallatin, Grant, Green, Greenup, Hickman, Harlan, Johnson, Leslie, Letcher, Livingston, Logan, Knott, Magoffin, Martin, Meade, Monroe, Morgan, Owen, Owsley, Pendleton, Perry, Pike, Simpson, Trimble, Union, Whitley

HumanaChoice

$69 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $350 (Days 1-5) Rx Included or No Rx: $195 (Tier 4-5) Contract/PBP: R5826-008 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All KY and IN Counties Local PPO Local PPO Local PPO Regional PPO

47

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Kentucky Highlights: Eastern Kentucky

Lexington, Richmond, Paintsville, Harlan, Hazard, Pikeville, Winchester, Paris, Frankfort

Lexington Humana Gold Plus

$0 Premium MOOP: $6,700 PCP/SPEC: $10/$45 Inpatient: $295 (Days 1-6) Rx Included or No Rx: Rx Contract/PBP: H5619-071 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bourbon, Clark, Fayette, Jessamine, Madison, Montgomery, Scott, Woodford

Central KY Humana Gold Plus SNP-DE (HMO SNP)

$0 Premium MOOP: $6,700 PCP/SPEC: 20%/20% Inpatient:$300 (Days 1-3) Rx Included or No Rx: Included Contract/PBP: H5619-075 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bourbon, Clark, Fayette, Jessamine, Madison, Montgomery, Scott, Woodford, Bullitt, Hardin, Jefferson, Oldham

KY LPPO with LIS

$0 - $32 Premium Depending on LIS Qualifications MOOP: $6,700 PCP/SPEC: 20% Inpatient: $600 (Days 1-2) Rx Included or No Rx: $110 (T2-5) Contract/PBP: H5216-115 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO

Lexington Humana Choice

$49 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $350 (Days 1-5) Rx Included or No Rx: $0 Deductible Contract/PBP: H5216-019 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Bath, Bourbon, Boyle, Clark, Fayette, Franklin, Jackson, Jessamine, Lincoln, Madison, Menifee, Montgomery, Powell, Scott, Woodford HMO SNP Local PPO Local PPO

48

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

Kentucky Highlights: Eastern Kentucky

Lexington, Richmond, Paintsville, Harlan, Hazard, Pikeville, Winchester, Paris, Frankfort

KY MA Only

$0 Premium MOOP: $4,500 PCP/SPEC: $10/$35 Inpatient: $295 (Days 1-6) Rx Included or No Rx: N/A Contract/PBP: H5216-105 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO

KY Rich LPPO

$119 Premium MOOP: $6,700 PCP/SPEC: $5/$30 Inpatient:$350 per stay Rx Included or No Rx: $0 Deductible Contract/PBP: H5216-601 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO

Bluegrass HumanaChoice

$59 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $350 (Days 1-5) Rx Included or No Rx: $0 Deductible Contract/PBP: H5525-022 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: Adair, Allen, Boyd,

Butler, Carroll, Carter, Casey, Clay, Clinton, Crittenden, Cumberland, Edmonson, Floyd, Fulton, Gallatin, Grant, Green, Greenup, Hickman, Harlan, Johnson, Leslie, Letcher, Livingston, Logan, Knott, Magoffin, Martin, Meade, Monroe, Morgan, Owen, Owsley, Pendleton, Perry, Pike, Simpson, Trimble, Union, Whitley

HumanaChoice

$69 Premium MOOP: $6,700 PCP/SPEC: $15/$45 Inpatient: $350 (Days 1-5) Rx Included or No Rx: $195 (Tier 4-5) Contract/PBP: R5826-008 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All KY and IN Counties Local PPO Local PPO Local PPO Regional PPO

49

This material is confidential and for contracted, licensed, and appointed agent use only. This material, including any subpart(s), is not to be used as marketing and is not to be provided to a prospect, an applicant, member, group, or the general public. Benefits are subject to CMS approval and may

• change. For proposed benchmark and ensured accuracy of plan benefit data please refer to the 2018 Summary of Benefits.

West Virginia Highlights: Central Appalachian

Huntington, Charleston, Beckley, Lewisburg, Princeton, Ashland KY, Maysville KY, Grayson KY, Morehead KY

Charleston-Huntington HumanaChoice

$45 Premium MOOP: $6,700 PCP Pref/SPEC: $10/$45 Inpatient: $295 days 1-6 Rx Included or No Rx: Included Contract/PBP: H5216-021 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: WV: Boone, Braxton, Cabell, Clay, Fayette, Kanawha, Lewis, Lincoln, Mercer, Monroe, Nicholas, Putnam, Roane, Upshur, Wayne, Webster

WV Rich LPPO

$125 Premium MOOP: $6,700 PCP Pref/SPEC: $5/$30 Inpatient: $350 per stay Rx Included or No Rx: Included Contract/PBP: H5216-124 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO Local PPO Local PPO

WV LPPO with LIS

$0 - $32 Premium Depending on LIS Qualifications MOOP: $6,700 PCP Pref/SPEC: 20%/20% Inpatient: $600 days 1-3 Rx Included or No Rx: Included Contract/PBP: H5216-125 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO Local PPO

WV MA Only LPPO

$0 Premium MOOP: $4,500 PCP Pref/ SPEC: $10/$35 Inpatient: $295 days 1-6 Rx Included or No Rx: Not Included Contract/PBP: H5216-123 Group ID: To be provided between late Sept. & 10/1 BSN: To be provided between late

• Sept. & 10/1

Serving Counties: All Counties with an LPPO Local PPO

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