NJ Direct 10/Aetna Freedom 10 v. Horizon Direct Access 10 Brown - - PowerPoint PPT Presentation

NJ Direct 10/Aetna Freedom 10 v. Horizon Direct Access 10

Brown & Brown Benefit Advisors 1

In-Network Non-Network In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $100 $0 $100 Family $0 $250 $0 $250 Coinsurance 100%; 90% on select services 80% of R&C 1 100%; 90% on select services 80% of R&C 1 Office Visit Copay2 $10 Primary or Specialist Not applicable $10 Primary or Specialist Not applicable Annual Out of Pocket Maximum3 Individual $400 $2,000 $400 $2,000 Family $1,000 $5,000 $800 $5,000 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 80% after deductible 100% 80% after deductible Emergency Room 100% after $25 copay waived if admitted 100% after $25 copay waived if admitted 100% after $25 copay waived if admitted 100% after $25 copay waived if admitted Ambulance 90% 80% after deductible 90% 80% after deductible Radiation/Chemotherapy Outpatient 100% 80% after deductible 100% 80% after deductible X-Ray and Lab Tests 100% 80% after deductible 100% 80% after deductible 100% 80% after deductible 100% 80% after deductible 100% 80% after deductible 100% 80% after deductible Up 120 days/calendar year Up 60 days/calendar year Up 120 days/calendar year Up 60 days/calendar year 100% 80% after deductible 100% 80% after deductible Hospice Unlimited Unlimited

Montgomery Township Board of Education

SEHBP NJ Direct 10/Aetna Freedom 10 vs Horizon Direct Access 10

NJ Direct 10/Aetna Freedom 10 Horizon Direct Access Design 7 Education 10 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network NO NO Unlimited Unlimited Skilled Nursing Facility Home Health Care Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network

Brown & Brown Benefit Advisors 2

In-Network Non-Network In-Network Non-Network Surgery/Anesthesia 100% 80% after deductible 100% 80% after deductible Physician Office Visits Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Annual Physical Exams 100% No coverage 100% 80% (No deductible) Annual Well Child Care 100% No coverage 100% 80% (No deductible) Immunizations (except if travel or job related) 100% No coverage 100% 80% (No deductible) Annual OB-Gyn Exam 100% 80% (No deductible) 100% 80% (No deductible) Annual Mammogram (baseline; women over 40) 100% 80% (No deductible) 100% 80% (No deductible) Annual Prostate screening (men over 50) 100% No coverage 100% 80% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 80% after deductible Office Visit copay for 1st prenatal visit, then 100% 80% after deductible Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Allergy Testing and Treatment Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Acupuncture Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Office Visit Copay 80% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100% 80% after deductible

100% per hearing aid per 24 months, for children to age 15

80% after deductible per hearing aid per 24 months, for children to age 15 Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) Unlimited Unlimited NJ Direct 10/Aetna Freedom 10 Horizon Direct Access Design 7 Education 10 $500 maximum every 2 years Infertility services Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates Chiropractic Care 30 visits per calendar year combined in and out-of-network 30 visits per calendar year combined in and out-of-network Maternity (including pre-natal) Includes coverage for child dependents Includes coverage for child dependents Hearing Aids $1,000 per hearing aid/24 months, for children to age 15

Brown & Brown Benefit Advisors 3

In-Network Non-Network In-Network Non-Network Durable Medical equipment/Medical Supplies 90% 80% after deductible 90% 80% after deductible Specialized Non-Standard Infant Formula 90% 80% after deductible 90% 80% after deductible Inherited Metabolic Disease 90% 80% after deductible 90% 80% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Routine Vision Exam 100% No coverage Office Visit copay 80% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization Children covered to end of year age 26 NJ Direct 10/Aetna Freedom 10 Horizon Direct Access Design 7 Education 10

4Mental health/substance abuse, must be coordinated through the mental health administrator.

Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 3Out-of-Pocket maximum includes deductible, coinsurance and copayments.

Charges in excess of Reasonable and Customary do not count toward out-of-pocket maximum.

2 Copayments apply to in-network primary care and specialist office visit services unless otherwise indicated.

No coverage $50 reimbursement eligible every 24 months Children covered to end of year age 26

Brown & Brown Benefit Advisors 4

NJ Direct 15/Aetna Freedom 15 v. Horizon Direct Access 15

Brown & Brown Benefit Advisors 5

In-Network Non-Network In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $100 $0 $100 Family $0 $250 $0 $250 Coinsurance 100%; 90% on select services 70% of R&C 1 100%; 90% on select services 70% of R&C 1 Coinsurance Maximum $400/$10002 Office Visit Copay $15 Primary or Specialist Not applicable $15 Primary or Specialist Not applicable Annual Out of Pocket Maximum3 Individual $5,720 $2,000 $400 $2,000 Family $11,440 $5,000 $800 $5,000 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 70% after deductible 100% 70% after deductible Emergency Room 100% after $50 copay waived if admitted 100% after $50 copay waived if admitted 100% after $50 copay waived if admitted 100% after $50 copay waived if admitted Ambulance 90% 70% after deductible 90% 70% after deductible Radiation/Chemotherapy Outpatient 100% 70% after deductible 100% 70% after deductible X-Ray and Lab Tests 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible Up 120 days/calendar year Up 60 days/calendar year Up 120 days/calendar year Up 60 days/calendar year 100% 70% after deductible 100% 70% after deductible

SEHBP NJ Direct 15/Aetna Freedom 15 vs Horizon Direct Access 15

Unlimited

Montgomery Township Board of Education

NO NO Horizon Direct Access Design 7 Education 15 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network NJ Direct 15/Aetna Freedom 15 Unlimited Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Unlimited Skilled Nursing Facility Unlimited Home Health Care Hospice

Brown & Brown Benefit Advisors 6

In-Network Non-Network In-Network Non-Network Surgery/Anesthesia 100% 70% after deductible 100% 70% after deductible Physician Office Visits Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Annual Physical Exams 100% No coverage 100% 70% (No deductible) Annual Well Child Care 100% No coverage 100% 70% (No deductible) Immunizations (except if travel or job related) 100% No coverage 100% 70% (No deductible) Annual OB-Gyn Exam 100% 70% (No deductible) 100% 70% (No deductible) Annual Mammogram (baseline; women over 40) 100% 70% (No deductible) 100% 70% (No deductible) Annual Prostate screening (men over 50) 100% No coverage 100% 70% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Allergy Testing and Treatment Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Acupuncture Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100% 70% after deductible

100% per hearing aid per 24 months, for children to age 15 70% after deductible per hearing aid per 24 months, for children to age 15

$1,000 per hearing aid/24 months, for children to age 15 Unlimited Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) $500 maximum every 2 years Subject to limitations set by NJ Mandates Infertility services Subject to limitations set by NJ Mandates Includes coverage for child dependents Chiropractic Care Maternity (including pre-natal) Includes coverage for child dependents 30 visits per calendar year combined in and out-of-network 30 visits per calendar year combined in and out-of-network NJ Direct 15/Aetna Freedom 15 Horizon Direct Access Design 7 Education 15 Unlimited Hearing Aids

Brown & Brown Benefit Advisors 7

In-Network Non-Network In-Network Non-Network Durable Medical equipment/Medical Supplies 90% 70% after deductible 90% 70% after deductible Specialized Non-Standard Infant Formula 90% 70% after deductible 90% 70% after deductible Inherited Metabolic Disease 90% 70% after deductible 90% 70% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Routine Vision Exam 100% No coverage Office Visit copay 70% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization

4Mental health/substance abuse, must be coordinated through the mental health administrator.

No coverage Required for certain services $50 reimbursement eligible ever 24 months Children covered to end of year age 26 Required for certain services

3Out-of-Pocket maximum includes deductible, coinsurance and copayments. Charges in excess

Customary do not count toward out-of-pocket maximum. Horizon Direct Access Design 7 Education 15 Children covered to end of year age 26

2The $400 Individual/$1,000 Family in-network out-of-pocket maximum includes only coinsurance. The in-network coinsurance out-of-pocket amounts met, apply towards out-of-

network out-of-pocket maximum. In addition to the in-network coinsurance out-of-pocket maximum, a maximum out-of-pocket limit of $5,720 individual/$11,440 family, applies to the plan. In-network coinsurance and copays apply toward this overall in-network maximum out-of-pocket amount. Out-of-Network out-of-pocket includes deductibles and

• coinsurance. Charges in excess of Reasonable and Customary do not count toward out of pocket maximum.

*Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances.

NJ Direct 15/Aetna Freedom 15

Brown & Brown Benefit Advisors 8

NJ Direct 1525/Aetna Freedom 1525 v. Horizon Direct Access 1525

Brown & Brown Benefit Advisors 9

In-Network Non-Network In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $100 $0 $100 Family $0 $250 $0 $250 Coinsurance 100%; 90% on select services 70% of R&C 1 100%; 90% on select services 70% of R&C 1 Coinsurance Maximum $400/$10002 Office Visit Copay $15 Primary/ $25 Specialist Not applicable $15 Primary/ $25 Specialist Not applicable Annual Out of Pocket Maximum3 Individual $5,720 $2,000 $400 $2,000 Family $11,440 $5,000 $800 $5,000 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 70% after deductible; subject to $200 copay 100% 70% after deductible; subject to $200 copay Emergency Room 100% after $75 copay waived if admitted 100% after $75 copay waived if admitted 100% after $75 copay waived if admitted 100% after $75 copay waived if admitted Ambulance 90% 70% after deductible 90% 70% after deductible Radiation/Chemotherapy Outpatient 100% 70% after deductible 100% 70% after deductible X-Ray and Lab Tests 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible Up 120 days/calendar year Up 60 days/calendar year Up 120 days/calendar year Up 60 days/calendar year 100% 70% after deductible 100% 70% after deductible NJ Direct 1525/Aetna Freedom 1525 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network

Montgomery Township Board of Education

SEHBP NJ Direct 1525/Aetna Freedom 1525 vs Horizon Direct Access 15/25

NO Horizon Direct Access Design 7 $15/$25 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network NO Home Health Care Unlimited Unlimited Unlimited Skilled Nursing Facility Hospice Unlimited

Brown & Brown Benefit Advisors 10

In-Network Non-Network In-Network Non-Network Surgery/Anesthesia 100% 70% after deductible 100% 70% after deductible Physician Office Visits Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Annual Physical Exams 100% No coverage 100% 70% (No deductible) Annual Well Child Care 100% No coverage 100% 70% (No deductible) Immunizations (except if travel or job related) 100% No coverage 100% 70% (No deductible) Annual OB-Gyn Exam 100% 70% (No deductible) 100% 70% (No deductible) Annual Mammogram (baseline; women over 40) 100% 70% (No deductible) 100% 70% (No deductible) Annual Prostate screening (men over 50) 100% No coverage 100% 70% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Allergy Testing and Treatment Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Acupuncture Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100% 70% after deductible

100% per hearing aid per 24 months, for children to age 15 70% after deductible per hearing aid per 24 months, for children to age 15

30 visits per calendar year combined in and out-of-network Infertility services Subject to limitations set by NJ Mandates Maternity (including pre-natal) Includes coverage for child dependents Hearing Aids $1,000 per hearing aid/24 months, for children to age 15 $500 maximum every 2 years Subject to limitations set by NJ Mandates Unlimited Includes coverage for child dependents 30 visits per calendar year combined in and out-of-network NJ Direct 1525/Aetna Freedom 1525 Horizon Direct Access Design 7 $15/$25 Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) Unlimited Chiropractic Care

Brown & Brown Benefit Advisors 11

In-Network Non-Network In-Network Non-Network Durable Medical equipment/Medical Supplies 90% 70% after deductible 90% 70% after deductible Specialized Non-Standard Infant Formula 90% 70% after deductible 90% 70% after deductible Inherited Metabolic Disease 90% 70% after deductible 90% 70% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Routine Vision Exam 100% No coverage Office Visit copay 70% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 2The $400 Individual/$1,000 Family in-network out-of-pocket maximum includes only coinsurance. The in-network coinsurance out-of-pocket amounts met, apply towards out-of-

network out-of-pocket maximum. In addition to the in-network coinsurance out-of-pocket maximum, a maximum out-of-pocket limit of $5,720 individual/$11,440 family, applies to the plan. In-network coinsurance and copays apply toward this overall in-network maximum out-of-pocket amount. Out-of-Network out-of-pocket includes deductibles and

• coinsurance. Charges in excess of Reasonable and Customary do not count toward out of pocket maximum.

4Mental health/substance abuse, must be coordinated through the mental health administrator. 3Out-of-Pocket maximum includes deductible, coinsurance and copayments. Charges in excess of Reasonable and Customary do not count toward out-of-pocket

No coverage Children covered to end of year age 26 $50 reimbursement eligible ever 24 months Children covered to end of year age 26 Required for certain services NJ Direct 1525/Aetna Freedom 1525 Horizon Direct Access Design 7 $15/$25 Required for certain services

Brown & Brown Benefit Advisors 12

NJ Direct 2030/Aetna Freedom 2030 v. Horizon Direct Access 2030

Brown & Brown Benefit Advisors 13

In-Network Non-Network In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $200 $0 $200 Family $0 $500 $0 $500 Coinsurance 100%; 90% on select services 70% of R&C 1 100%; 90% on select services 70% of R&C 1 Coinsurance Maximum $800/$20002 Office Visit Copay $20 Primary/ $30 Specialist Not applicable $20 Primary/ $30 Specialist Not applicable Annual Out of Pocket Maximum3 Individual $5,720 $5,000 $800 $5,000 Family $11,440 $12,500 $1,600 $12,500 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 70% after deductible; subject to $500 copay 100% 70% after deductible; subject to $500 copay Emergency Room 100% after $125 copay waived if admitted 100% after $125 copay waived if admitted 100% after $100 copay waived if admitted 100% after $100 copay waived if admitted Ambulance 90% 70% after deductible 90% 70% after deductible Radiation/Chemotherapy Outpatient 100% 70% after deductible 100% 70% after deductible X-Ray and Lab Tests 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible 100% 70% after deductible Up 120 days/calendar year Up 60 days/calendar year Up 120 days/calendar year Up 60 days/calendar year 100% 70% after deductible 100% 70% after deductible

Montgomery Township Board of Education

SEHBP NJ Direct 2030/Aetna Freedom 2030 vs Horizon Direct Access 20/30

NJ Direct 2030/Aetna Freedom 2030 Horizon Direct Access Design 7 $20/$30 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network NO NO Unlimited Unlimited Skilled Nursing Facility Hospice Unlimited Unlimited Home Health Care

Brown & Brown Benefit Advisors 14

In-Network Non-Network In-Network Non-Network Surgery/Anesthesia 100% 70% after deductible 100% 70% after deductible Physician Office Visits Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Annual Physical Exams 100% No coverage 100% 70% (No deductible) Annual Well Child Care 100% No coverage 100% 70% (No deductible) Immunizations (except if travel or job related) 100% No coverage 100% 70% (No deductible) Annual OB-Gyn Exam 100% 70% (No deductible) 100% 70% (No deductible) Annual Mammogram (baseline; women over 40) 100% 70% (No deductible) 100% 70% (No deductible) Annual Prostate screening (men over 50) 100% No coverage 100% 70% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit copay for 1st prenatal visit, then 100% 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Allergy Testing and Treatment Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Acupuncture Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Office Visit Copay 70% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100% 70% after deductible

100% per hearing aid per 24 months, for children to age 15 70% after deductible per hearing aid per 24 months, for children to age 15

Maternity (including pre-natal) Includes coverage for child dependents Includes coverage for child dependents NJ Direct 2030/Aetna Freedom 2030 Horizon Direct Access Design 7 $20/$30 Infertility services Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates Chiropractic Care 30 visits per calendar year combined in and out-of-network 30 visits per calendar year combined in and out-of-network Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) Unlimited Unlimited $500 maximum every 2 years Hearing Aids $1,000 per hearing aid/24 months, for children to age 15

Brown & Brown Benefit Advisors 15

In-Network Non-Network In-Network Non-Network Durable Medical equipment/Medical Supplies 90% 70% after deductible 90% 70% after deductible Specialized Non-Standard Infant Formula 90% 70% after deductible 90% 70% after deductible Inherited Metabolic Disease 90% 70% after deductible 90% 70% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Routine Vision Exam 100% No coverage Office Visit copay 70% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization Children covered to end of year age 26 Children covered to end of year age 26 NJ Direct 2030/Aetna Freedom 2030 Horizon Direct Access Design 7 $20/$30 No coverage $50 reimbursement eligible ever 24 months

4Mental health/substance abuse, must be coordinated through the mental health administrator.

Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 2The $800 Individual/$2,000 Family in-network out-of-pocket maximum includes only coinsurance. The in-network coinsurance out-of-pocket amounts met, apply towards out-of-

network out-of-pocket maximum. In addition to the in-network coinsurance out-of-pocket maximum, a maximum out-of-pocket limit of $5,720 individual/$11,440 family, applies to the plan. In-network coinsurance and copays apply toward this overall in-network maximum out-of-pocket amount. Out-of-Network out-of-pocket includes deductibles and

• coinsurance. Charges in excess of Reasonable and Customary do not count toward out of pocket maximum.

3Out-of-Pocket maximum includes deductible, coinsurance and copayments. Charges in excess of Reasonable and Customary do not count toward out-of-pocket Brown & Brown Benefit Advisors 16

NJ Direct 2035/Aetna Freedom 2035 v. Horizon Direct Access 2035

Brown & Brown Benefit Advisors 17

In-Network Non-Network In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $200 $800 $200 $800 Family $500 $2,000 $400 $1,600 Coinsurance 80% 60% of R&C 1 80% 60% of R&C 1 Coinsurance Maximum 20% after deductible2 Office Visit Copay $20 Primary/ $35 Specialist Not applicable $20 Primary/ $35 Specialist Not applicable Annual Out of Pocket Maximum3 Individual $5,720 $6,500 $2,500 $5,000 Family $11,440 $13,000 $5,000 $10,000 Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 80% 60% after deductible; subject to $500 copay 80% 60% after deductible; subject to $500 copay Emergency Room 100% after $300 copay waived if admitted 100% after $300 copay waived if admitted 100% after $100 copay waived if admitted 100% after $100 copay waived if admitted Ambulance 80% 60% after deductible 80% 60% after deductible Radiation/Chemotherapy Outpatient 80% 60% after deductible 80% 60% after deductible X-Ray and Lab Tests 80% 60% after deductible 80% 60% after deductible 80% 60% after deductible 80% 60% after deductible 80% 60% after deductible 80% 60% after deductible Up 120 days/calendar year Up 60 days/calendar year Up 120 days/calendar year Up 60 days/calendar year 80% 60% after deductible 80% 60% after deductible Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network NJ Direct 2035/Aetna Freedom 2035 Direct Access 20/35

Montgomery Township Board of Education

SEHBP NJ Direct 2035/Aetna Freedom 2035 vs Horizon Direct Access 20/35

NO NO Unlimited Unlimited Skilled Nursing Facility Home Health Care Hospice Unlimited Unlimited

Brown & Brown Benefit Advisors 18

In-Network Non-Network In-Network Non-Network Surgery/Anesthesia 80% 60% after deductible 80% 60% after deductible Physician Office Visits Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Annual Physical Exams 100% No coverage 100% 60% (No deductible) Annual Well Child Care 100% No coverage 100% 60% (No deductible) Immunizations (except if travel or job related) 100% No coverage 100% 60% (No deductible) Annual OB-Gyn Exam 100% 60% (No deductible) 100% 60% (No deductible) Annual Mammogram (baseline; women over 40) 100% 60% (No deductible) 100% 60% (No deductible) Annual Prostate screening (men over 50) 100% No coverage 100% 60% (No deductible) Office Visit copay for 1st prenatal visit, then 80% 60% after deductible Office Visit copay for 1st prenatal visit, then 80% 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Allergy Testing and Treatment Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Acupuncture Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100% 60% after deductible

100% per hearing aid per 24 months, for children to age 15 60% after deductible per hearing aid per 24 months, for children to age 15

Infertility services Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates Maternity (including pre-natal) Includes coverage for child dependents Includes coverage for child dependents NJ Direct 2035/Aetna Freedom 2035 Direct Access 20/35 Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) Unlimited Unlimited Chiropractic Care 30 visits per calendar year combined in and out-of-network 30 visits per calendar year combined in and out-of-network $500 maximum every 2 years Hearing Aids $1,000 per hearing aid/24 months, for children to age 15

Brown & Brown Benefit Advisors 19

In-Network Non-Network In-Network Non-Network Durable Medical equipment/Medical Supplies 80% 60% after deductible 80% 60% after deductible Specialized Non-Standard Infant Formula 80% 60% after deductible 80% 60% after deductible Inherited Metabolic Disease 80% 60% after deductible 80% 60% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness4 Same as any other illness4 Same as any other illness4 Same as any other illness4 Routine Vision Exam 100% No coverage Office Visit copay 60% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization NJ Direct 2035/Aetna Freedom 2035 Direct Access 20/35 No coverage $50 reimbursement eligible ever 24 months Children covered to end of year age 26 Children covered to end of year age 26 Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 3 Copayments apply to in-network primary care and specialist office visit services unless otherwise indicated. 2The in-network coinsurance out-of-pocket amounts met, apply towards out-of-network out-of-pocket maximum. In addition to the in-network coinsurance out-of-pocket maximum,

a maximum out-of-pocket limit of $5,720 individual/$11,440 family, applies to the plan. Out-of-Network out-of-pocket includes deductibles and coinsurance. Charges in excess of Reasonable and Customary do not count toward out of pocket maximum.

4Mental health/substance abuse, must be coordinated through the mental health administrator. Brown & Brown Benefit Advisors 20

Horizon/Aetna HMO v. Horizon POS 10

Brown & Brown Benefit Advisors 21

In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $500 Family $0 $1,000 Coinsurance 100% 60% of R&C 1 Office Visit Copay $10 Primary or Specialist Not applicable Annual Out of Pocket Maximum2 Individual Family Lifetime Maximum Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 60% after deductible Emergency Room 100% after $35 copay waived if admitted 100% after $35 copay waived if admitted Ambulance 100% 60% after deductible X-Ray and Lab Tests 100% 60% after deductible 100% 60% after deductible 100% 60% after deductible Up 120 days/calendar year Up 60 days/calendar year 100% 60% after deductible Unlimited Unlimited

Montgomery Township Board of Education

SEHBP Horizon/Aetna HMO vs Horizon POS Design 10

Horizon HMO/Aetna HMO Horizon POS Design 10 Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; No Coverage Outside NJ In-Network $100 on select services $100 per person on select services 100% $10 Primary or Specialist YES 100% YES Unlimited Unlimited Skilled Nursing Facility $5,720 $11,440 Unlimited 100% 100% after $35 copay waived if admitted 100% 100% 100% 100% Up 120 days/calendar year $3,000 combined INN/OON $6,000 combined INN/OON Home Health Care Hospice

Brown & Brown Benefit Advisors 22

In-Network Non-Network Surgery/Anesthesia 100% 60% after deductible Physician Office Visits Office Visit Copay 60% after deductible Annual Physical Exams 100% 60% (No deductible) Annual Well Child Care 100% 60% (No deductible) Immunizations (except if travel or job related) 100% 60% (No deductible) Annual OB-Gyn Exam 100% 60% (No deductible) Annual Mammogram (baseline; women over 40) 100% 60% (No deductible) Annual Prostate screening (men over 50) 100% 60% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 60% after deductible Office Visit Copay 60% after deductible Allergy Testing and Treatment Office Visit Copay 60% after deductible Acupuncture Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100%

60% after deductible

100% 60% after deductible 100% Excluded 100% 100% 100% (no copayment) 100% (no copayment) 100% (no copayment) 100% (no copayment) Office Visit copay for 1st prenatal visit, then 100% 100% Office Visit Copay 100% (no copayment) 100% (no copayment) Horizon HMO/Aetna HMO Chiropractic Care 20 visits max per calendar year 25 visits per calendar year combined in and out-of-network Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) 60 visits combined for physical, occupational, and speech therapies per calendar year. Subject to office visit copay. 60 visits per therapy, subject to office visit copay. Horizon POS Design 10 $500 max every 2 years; subject to $100 deductible In-Network Hearing Aids $1,000 per hearing aid/24 months, for children to age 15 Maternity (including pre-natal) Includes coverage for child dependents Includes coverage for child dependents Infertility services Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates Office Visit Copay

Brown & Brown Benefit Advisors 23

In-Network Non-Network Durable Medical equipment/Medical Supplies 100% 60% after deductible Specialized Non-Standard Infant Formula 100% 60% after deductible Inherited Metabolic Disease 100% 60% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Routine Vision Exam Office Visit copay 60% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization 100% after $100 annual deductible Horizon HMO/Aetna HMO No coverage $50 reimbursement eligible ever 24 months 100% after $100 annual deductible 100% Same as any other illness3 Same as any other illness3 100%

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 2Out-of-Pocket maximum includes deductible, coinsurance and copayments. In-Network coinsurance applies towards out-of-network coinsurance. Charges in excess of

Reasonable and Customary do not count toward out-of-pocket maximum.

3Mental health/substance abuse, must be coordinated through the mental health administrator.

Children covered to end of year age 26 Children covered to end of year age 26 Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration. In-Network Horizon POS Design 10

Brown & Brown Benefit Advisors 24

Horizon/Aetna HMO 1525 v. Horizon POS 1525

Brown & Brown Benefit Advisors 25

In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $500 Family $0 $1,000 Coinsurance 100% 60% of R&C 1 Office Visit Copay $15 Primary/ $25 Specialist Not applicable Annual Out of Pocket Maximum2 Individual Family Lifetime Maximum Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 60% after deductible Emergency Room 100% after $75 copay waived if admitted 100% after $75 copay waived if admitted Ambulance 100% 60% after deductible X-Ray and Lab Tests 100% 60% after deductible 100% 60% after deductible 100% 60% after deductible Up 120 days/calendar year Up 60 days/calendar year 100% 60% after deductible Skilled Nursing Facility 100% Up 120 days/calendar year Hospice 100% Unlimited Unlimited $5,720 $11,440 Unlimited 100% Unlimited 100% after $75 copay waived if admitted 100% 100% 100% Unlimited $3,000 combined INN/OON $6,000 combined INN/OON Home Health Care $15 Primary/ $25 Specialist 100%

Montgomery Township Board of Education

SEHBP Horizon/Aetna HMO 1525 vs Horizon POS Design 10 1525

Horizon/Aetna HMO $15/$25 Horizon POS Design 10 $15/$25 In-Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network YES YES $100 on select services $100 per person on select services

Brown & Brown Benefit Advisors 26

In-Network Non-Network Surgery/Anesthesia 100% 60% after deductible Physician Office Visits Office Visit Copay 60% after deductible Annual Physical Exams 100% 60% (No deductible) Annual Well Child Care 100% 60% (No deductible) Immunizations (except if travel or job related) 100% 60% (No deductible) Annual OB-Gyn Exam 100% 60% (No deductible) Annual Mammogram (baseline; women over 40) 100% 60% (No deductible) Annual Prostate screening (men over 50) 100% 60% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 60% after deductible Office Visit Copay 60% after deductible Allergy Testing and Treatment Office Visit Copay 60% after deductible Acupuncture Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100%

60% after deductible

100% 60% after deductible Hearing Aids $1,000 per hearing aid/24 months, for children to age 15 20 visits max per calendar year Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) 100% 60 visits combined for physical, occupational, and speech therapies per calendar year. Subject to office visit copay. 60 visits per therapy, subject to office visit copay. 30 visits per calendar year combined in and out-of-network Maternity (including pre-natal) Office Visit copay for 1st prenatal visit, then 100% Includes coverage for child dependents Includes coverage for child dependents Infertility services Office Visit Copay Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates 100% Excluded Chiropractic Care 100% 100% (no copayment) 100% Office Visit Copay 100% (no copayment) 100% (no copayment) 100% (no copayment) 100% (no copayment) 100% (no copayment) Horizon/Aetna HMO $15/$25 Horizon POS Design 10 $15/$25 In-Network $500 max every 2 years; subject to $100 deductible

Brown & Brown Benefit Advisors 27

In-Network Non-Network Durable Medical equipment/Medical Supplies 100% 60% after deductible Specialized Non-Standard Infant Formula 100% 60% after deductible Inherited Metabolic Disease 100% 60% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Routine Vision Exam Office Visit copay 60% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization

3Mental health/substance abuse, must be coordinated through the mental health administrator.

Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances. 2Out-of-Pocket maximum includes deductible, coinsurance and copayments. In-Network coinsurance applies towards out-of-network coinsurance. Charges in excess of

Reasonable and Customary do not count toward out-of-pocket maximum. Horizon/Aetna HMO $15/$25 Horizon POS Design 10 $15/$25 Children covered to end of year age 26 Children covered to end of year age 26 100% after $100 annual deductible 100% after $100 annual deductible 100% Same as any other illness3 Same as any other illness3 100% No coverage $50 reimbursement eligible ever 24 months In-Network

Brown & Brown Benefit Advisors 28

Horizon/Aetna HMO 2030 v. Horizon POS 2030

Brown & Brown Benefit Advisors 29

In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $0 $500 Family $0 $1,000 Coinsurance 100% 60% of R&C 1 Office Visit Copay $20 Primary/ $30 Specialist Not applicable Annual Out of Pocket Maximum2 Individual Family Lifetime Maximum Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 100% 60% after deductible Emergency Room 100% after $100 copay waived if admitted 100% after $100 copay waived if admitted Ambulance 100% 60% after deductible X-Ray and Lab Tests 100% 60% after deductible 100% 60% after deductible 100% 60% after deductible Up 120 days/calendar year Up 60 days/calendar year 100% 60% after deductible Home Health Care Skilled Nursing Facility 100% Up 120 days/calendar year Hospice 100% Unlimited Unlimited $11,440 Unlimited 100% Unlimited 100% after $125 copay waived if admitted 100% 100% 100% Unlimited $6,000 combined INN/OON $5,720 $20 Primary/ $30 ($20 children) Specialist 100%

Montgomery Township Board of Education

SEHBP Horizon/Aetna HMO 2030 vs Horizon POS Design 10 2030

Horizon/Aetna HMO $20/$30 Horizon POS Design 10 $20/$30 In-Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network YES YES $100 on select services $100 per person on select services $3,000 combined INN/OON

Brown & Brown Benefit Advisors 30

In-Network Non-Network Surgery/Anesthesia 100% 60% after deductible Physician Office Visits Office Visit Copay 60% after deductible Annual Physical Exams 100% 60% (No deductible) Annual Well Child Care 100% 60% (No deductible) Immunizations (except if travel or job related) 100% 60% (No deductible) Annual OB-Gyn Exam 100% 60% (No deductible) Annual Mammogram (baseline; women over 40) 100% 60% (No deductible) Annual Prostate screening (men over 50) 100% 60% (No deductible) Office Visit copay for 1st prenatal visit, then 100% 60% after deductible Office Visit Copay 60% after deductible Allergy Testing and Treatment Office Visit Copay 60% after deductible Acupuncture Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100%

60% after deductible

100% 60% after deductible Hearing Aids 20 visits max per calendar year Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) 100% 60 visits combined for physical, occupational, and speech therapies per calendar year. Subject to office visit copay. 60 visits subject to office visit copay. $1,000 per hearing aid/24 months, for children to age 15 $500 max every 2 years; subject to $100 deductible 30 visits per calendar year combined in and out-of-network Maternity (including pre-natal) Office Visit copay for 1st prenatal visit, then 100% Includes coverage for child dependents Includes coverage for child dependents Infertility services Office Visit Copay Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates 100% Excluded Chiropractic Care 100% 100% (no copayment) 100% Office Visit Copay 100% (no copayment) 100% (no copayment) 100% (no copayment) 100% (no copayment) 100% (no copayment) Horizon/Aetna HMO $20/$30 Horizon POS Design 10 $20/$30 In-Network

Brown & Brown Benefit Advisors 31

In-Network Non-Network Durable Medical equipment/Medical Supplies 100% 60% after deductible Specialized Non-Standard Infant Formula 100% 60% after deductible Inherited Metabolic Disease 100% 60% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Routine Vision Exam Office Visit copay 60% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration.

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances.

Same as any other illness3 Same as any other illness3 100% No coverage $50 reimbursement eligible ever 24 months Children covered to end of year age 26 Children covered to end of year age 26 100% after $100 annual deductible In-Network 100%

4Mental health/substance abuse, must be coordinated through the mental health administrator. 2Out-of-Pocket maximum includes deductible, coinsurance and copayments. In-Network coinsurance applies towards out-of-network coinsurance. Charges in excess of

Reasonable and Customary do not count toward out-of-pocket maximum. Horizon/Aetna HMO $20/$30 Horizon POS Design 10 $20/$30 100% after $100 annual deductible

Brown & Brown Benefit Advisors 32

Horizon/Aetna HMO 2035 v. Horizon POS 2035

Brown & Brown Benefit Advisors 33

In-Network Non-Network Service Areas Primary Care Physician Referral Required? Annual Deductible Individual $100 $500 Family $250 $1,000 Coinsurance 80% 60% of R&C 1 Coinsurance Maximum $2,000/$5,000 Office Visit Copay $20 Primary/ $35 Specialist Not applicable Annual Out of Pocket Maximum2 Individual $2,000 $4,000 Family $4,000 $8,000 Lifetime Maximum Unlimited Unlimited Hospital Inpatient Services (room and board; physician visits) 80% 60% after deductible Emergency Room 100% after $100 copay waived if admitted 100% after $100 copay waived if admitted Ambulance 80% 60% after deductible X-Ray and Lab Tests 80% 60% after deductible 80% 60% after deductible 80% 60% after deductible Up 120 days/calendar year Up 60 days/calendar year 80% 60% after deductible Unlimited Home Health Care 80% Unlimited Skilled Nursing Facility 80% Up 120 days/calendar year Hospice 80% Unlimited Unlimited $5,720 $11,440 Unlimited 80% 100% after $300 copay waived if admitted 80% 80% $20 Primary/ $35 Specialist 80% after deductible

Montgomery Township Board of Education

SEHBP Horizon/Aetna HMO 2035 vs Horizon POS Design 6 2035

Horizon/Aetna HMO $20/$35 Horizon POS Design 6 $20/$35 In-Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network Inside NJ- Managed Care Network, including contiguous counties; Outside NJ-Blue Card Network YES YES $200 $500

Brown & Brown Benefit Advisors 34

In-Network Non-Network Surgery/Anesthesia 80% 60% after deductible Physician Office Visits Office Visit Copay 60% after deductible Annual Physical Exams 100% 60% (No deductible) Annual Well Child Care 100% 60% (No deductible) Immunizations (except if travel or job related) 100% 60% (No deductible) Annual OB-Gyn Exam 100% 60% (No deductible) Annual Mammogram (baseline; women over 40) 100% 60% (No deductible) Annual Prostate screening (men over 50) 100% 60% (No deductible) Office Visit copay for 1st prenatal visit, then 80% 60% after deductible Office Visit Copay 60% after deductible Allergy Testing and Treatment Office Visit Copay 60% after deductible Acupuncture Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Office Visit Copay 60% after deductible Wigs (if needed due to specific diagnosis like Chemo) 100%

60% after deductible

100% 60% after deductible Hearing Aids $1,000 per hearing aid/24 months, for children to age 15 Excluded Chiropractic Care 100% 20 visits max per calendar year $500 max every 2 years; subject to deductible 30 visits per calendar year combined in and out-of-network Short Term Therapies (Physical, Cognitive, Occupational, Respiratory, Speech) 80% 60 visits combined for physical, occupational, and speech therapies per calendar year. Subject to office visit copay. 60 visits subject to office visit copay. Includes coverage for child dependents Infertility services Office Visit Copay Subject to limitations set by NJ Mandates Subject to limitations set by NJ Mandates 100% 100% (no copayment) 100% (no copayment) 100% (no copayment) Maternity (including pre-natal) Office Visit copay for 1st prenatal visit, then 80% Includes coverage for child dependents 80% Office Visit Copay 100% (no copayment) 100% (no copayment) Horizon POS Design 6 $20/$35 100% (no copayment) Horizon/Aetna HMO $20/$35 In-Network

Brown & Brown Benefit Advisors 35

In-Network Non-Network Durable Medical equipment/Medical Supplies 80% 60% after deductible Specialized Non-Standard Infant Formula 80% 60% after deductible Inherited Metabolic Disease 80% 60% after deductible Inpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Outpatient Mental Illness/Substance Abuse/Alcohol Treatment Same as any other illness3 Same as any other illness3 Routine Vision Exam Office Visit copay 60% after deductible Vision Hardware Child Dependent Termination age Prior-Authorization

2Out-of-Pocket maximum includes deductible, coinsurance and copayments. Charges in excess of Reasonable and Customary do not count toward out-of-pocket maximum. 3Mental health/substance abuse, must be coordinated through the mental health administrator.

$50 reimbursement eligible ever 24 months Children covered to end of year age 26 Children covered to end of year age 26 Required for certain services Required for certain services *Comparison is for illustrative purposes only. Written plan documents supersede any errors on this illustration. No coverage 80% Same as any other illness3 Same as any other illness3 100%

1Reasonable and Customary fee schedule based at the 90th percentile of FAIR Health. You are responsible for any charges in excess of Reasonable and Customary allowances.

Horizon POS Design 6 $20/$35 80% 80% Horizon/Aetna HMO $20/$35 In-Network

Brown & Brown Benefit Advisors 36