2017 Plan Preview

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HealthTeam Advantage 2017

• Who is HealthTeam Advantage – A Quick Refresher• Goal for Benefit Changes• Network Additions• What’s New for 2017• HealthTeam Advantage Plan I Changes• HealthTeam Advantage Plan II Changes• HealthTeam Advantage Plan I Overview• HealthTeam Advantage Plan II Overview

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Who is HealthTeam Advantage?• Medicare Option for consumers in the Piedmont Triad area

• Alamance, Guilford, Randolph and Rockingham Counties

• Partnership between Cone Health and Care N’ Care Insurance Company, Inc.

• Care N’ Care Health Insurance Company, Inc.• Started in 2009 by local doctors to fill a need in the market for a better health

plan option

Goals for Benefit Changes

Network Additions

• Now over 2,800 contracted physicians and facilities• New Additions

• Morehead Hospital and Physician Group• Cornerstone Imaging• Asheboro Family Physicians• Alliance Urology Specialists• Carolina Cardiology• Triangle Orthopaedic Associates• Eden Internal Medicine• White Oak Family Physicians

• Annual Physical Exam at $0 copay in-network

• Annual Hearing Exam at $0 copay in-network

• Annual Eye Exam at $0 copay in-network

• 90-Day Prescription Copays reduced to only 2 times the 30 day copay

• Reimbursement Schedule for Out-Of-Network Dental Rider Benefits

Changes to Plan I

• Inpatient Hospital Coverage: • 2016: Days 1-7 - $275 per day; Inpatient stay covered to 90 days• 2017: Days 1-6 - $225 per day; Unlimited number of days covered

• Skilled Nursing Facility Coverage:• 2016: Unlimited number of days covered• 2017: Coverage limited to 100 days

• Doctor Visits:• 2016: Primary Care Physician - $15 Specialist - $30 • 2017: Primary Care Physician - $10 Specialist - $20

• X-Rays:• 2016: $10• 2017: $5

Changes to Plan II

• Premium:• 2016: $57 per month• 2017: $49 per month

• Inpatient Hospital Coverage: • 2016: Inpatient stay covered to 90 days• 2017: Unlimited number of days covered

• Skilled Nursing Facility Coverage:• 2016: Unlimited number of days covered• 2017: Coverage limited to 100 days

• Doctor Visits:• 2016: Primary Care Physician - $10 Specialist - $20 • 2017: Primary Care Physician - $5 Specialist - $15

HealthTeam Advantage Plan IBenefit In-Network Out-of-Network

Maximum Out-of-Pocket $3,400 $5,100

Primary Care Physician $10 $40

Specialist Visit $20 $50

Inpatient Hospital $225 (days 1-6) $400 (days 1-7)

X-Rays $5 $10-$25

Laboratory Tests $0-$5 $10-$25

Outpatient Surgery- Ambulatory Surgical Center- Hospital Facility

$150$170

$200$250

Skilled Nursing Facility $0 (days 1-20) $150 (days 21-100)

$40 (days 1-20) $160 (days 21-100)

HealthTeam Advantage Plan I - ContinuedBenefit In-Network Out-of-Network

Urgently Needed Care $30 $30

Outpatient Rehab Services $15 $40

Prescription Drugs – 30 day supply- Tier One (Preferred Generics)- Tier Two (Generics)- Tier Three (Preferred Brands)- Tier Four (Non-Preferred Drugs)- Tier Five (Specialty)

$4$15$45$8533%

Prescription Drugs – 90 day supply- Tier One (Preferred Generics)- Tier Two (Generics)- Tier Three (Preferred Brands)- Tier Four (Non-Preferred Drugs)- Tier Five (Specialty)

$8$30$90

$17033%

HealthTeam Advantage Plan IIBenefit In-Network Out-of-Network

Maximum Out-of-Pocket $3,100 $5,100

Primary Care Physician $5 $30

Specialist Visit $15 $50

Inpatient Hospital $225 (day 1) $75 (days 2-5) $425 (days 1-6)

X-Rays $0 $10-$25

Laboratory Tests $0-$5 $10-$25

Outpatient Surgery- Ambulatory Surgical Center- Hospital Facility

$100$125

$175$225

Skilled Nursing Facility $0 (days 1-20) $140(days 21-100)

$40 (days 1-20) $160 (days 21-100)

HealthTeam Advantage Plan II - ContinuedBenefit In-Network Out-of-Network

Urgently Needed Care $30 $30

Outpatient Rehab Services $10 $30

Prescription Drugs – 30 day supply- Tier One (Preferred Generics)- Tier Two (Generics)- Tier Three (Preferred Brands)- Tier Four (Non-Preferred Drugs)- Tier Five (Specialty)

$0$12$40$7533%

Prescription Drugs – 90 day supply- Tier One (Preferred Generics)- Tier Two (Generics)- Tier Three (Preferred Brands)- Tier Four (Non-Preferred Drugs)- Tier Five (Specialty)

$0$24$80

$15033%