Championing Retiree Health Insurance Solutions

California

Medicare

Andre Hamil,Health Net

We partner with you to promote

workforce health.

Health Net Seniority Plus (Employer HMO) Plans

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Health Net is your one-stop health coverage resource for

your retirees. Working with one company is always easier, and we

have you covered with our portfolio of Seniority Plus plans. Beyond

comprehensive benefits and predictable copayments, Seniority Plus plans

include extra health-boosting resources that match the interests and

goals of today’s retirees.

Health Net is one of the country’s leading health care companies,

providing a variety of health care services and benefit programs to

over 5.4 million people nationwide. Supporting individuals and families

through all stages of life is what we’ve been doing for over 30 years –

And we’re just getting started.

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Championing solutions that meet the varied coverage needs of workforces like yours isn’t just our business – It’s our passion.

There are numerous reasons why so many California companies count on Health Net to cover their retirees.

Reasons to choose Health Net Seniority Plus (Employer HMO) coverage include:

1 One-stop shopping for cost-saving

Medicare plans and competitive Coordination of Benefits plans. Plus the ongoing convenience of having employee and retiree coverage coordinated by one company.

2 Choice of Medicare HMO plan

designs, the majority of which combine medical and prescription drug coverage in one plan. Easy to choose and easy to use, the Seniority Plus portfolio is the simple, flexible way to meet budgets and exceed expectations.

3 Custom fit for your retirees with

the choice to add dental, vision and/or chiropractic care benefits to your Seniority Plus plan.

4 Broad networks for more

choice. Retirees have access to the thousands of doctors, specialists and hospitals that comprise Health Net’s statewide networks.

5 Health-boosting extras,

including Health Net’s exclusive Decision Power® program, discounts on health-related products, and the Silver&Fit® exercise and education program.

6 Strength. Health Net, Inc. is

one of the nation’s largest publicly traded managed health care companies, and ranked #221 on the 2012 list of Fortune 500 companies. This means we have the strength and stability to focus on care delivery and the resources to innovate.

The Health Net Difference

Christian Aparicio, Health Net

We deliver performance as promised.

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Seniority Plus Plans at a Glance

Seniority Plus is a portfolio of Medicare Group HMO plans that are easy to understand, compare and select. Our HMO networks leverage the trusted relationship between doctor and patient, which is key to maximizing and improving health. Better health translates into lower health care costs in the long run.

What’s more, Medicare Part D prescription drug coverage is included in many Seniority

Plus plans, so your retirees don’t need to buy a standalone Medicare Part D plan. With Seniority Plus pharmacy benefits, there is no Medicare Part D coverage gap – another plus for your retirees.

Find the Seniority Plus plan that works for you and your retirees with our quick comparison chart of benefits used most often.

Medical benefits comparison of popular Seniority Plus plans

Plan code1 2WW 2XF 2WV 2WM 2VZOffice visits $0 $5 $5 $10 $15

Urgent care $20 $20 $20 $20 $20

Hospital (per admission) $0 $0 $0 $0 $0

Emergency room $20 $20 $20 $20 $20

Hearing aids Not covered $0 Not covered Not covered Not covered

LaRae Littlefield,Health NetWe help build businesses, one healthy employee at a time.

1 Plan codes, benefits and rates may change after January 1 of each year. Please contact your Health Net account manager for current plan benefit information.

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For prescription drug coverage, Health Net offers a variety of options. Five of our most popular pharmacy packages offer affordable coverage for 30-day supplies of generic, brand and non-preferred brand drugs. In addition

to Medicare Part D drugs, Health Net’s Employer Group Medicare formulary also provides coverage of additional drugs not covered under Medicare Part D.

Prescription Drug Coverage

Seniority Plus

Pharmacy Advantage

• The convenience of

having one Seniority

Plus ID card for both

pharmacy and

medical coverage.

• Choice of filling

prescriptions at a

national network of

more than 65,000

retail and specialty

pharmacies.

• Savings on

prescriptions with

our mail-order

pharmacy option.

Benefits comparison of popular pharmacy packages2

Plan code3 Preferred generic drugs copayment

Preferred brand drugs copayment

Non-preferred brand drugs copayment

PW6 $10 $20 $20

PXG $5 $15 $30

PXH $10 $15 $35

PXK $5 $15 $35

PXR $10 $20 $35

Coverage for retirees outside the Health Net Seniority Plus area

If you have retirees living outside of the Health Net Seniority Plus service area, you can choose one of our Coordination of Benefits (COB) plans. Please check with your account manager for additional information or options.

The COB plans work like our Seniority Plus plans with one difference. With COB, Medicare is the primary plan and Health Net is the secondary plan. This means that we pay the difference between the amount Medicare pays and the Health Net allowed amount for the covered service.

With a COB plan, Health Net covers benefits as a supplemental payer only when services are coordinated by the member’s physician and authorized either by the medical group or by us.

Retirees must be enrolled in both Medicare Part A and Part B to enroll in a Health Net Medicare COB plan. Individuals over the age of 65 and actively employed are not eligible.

2 Health Net uses a formulary (drug list) which is subject to change. Drug copays in this document are based on a 30-day supply. Plan drugs obtained at out-of-network pharmacies may be covered in special circumstances, for instance, illness while traveling outside of the plan’s service area where there is no network pharmacy. Members may pay more than the copay if they get drugs at an out-of-network pharmacy. Please refer to the Summary of Benefits and/or Employer Group Formulary for complete coverage details.

3 Pharmacy plan codes, benefits and rates may change after January 1 of each year. Please contact your Health Net account manager for current plan benefit information.

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Dental. Vision. Chiropractic care. Designing a well-rounded benefits package is easy with Health Net. Enhance your Seniority Plus plan with value-added benefits such as vision, dental and/or chiropractic care – all delivered seamlessly to your retirees.

Dental coverage that makes them smileThe Health Net Dental Plan provides convenient coverage for preventive, basic and major dental care, and diagnostic services. Members choose a primary care general dentist who coordinates all their dental services.

Our dental plan includes additional services at varying copayments. Members receive an Evidence of Coverage with a complete schedule of covered services and copayments.

Our vision plans have a clear advantageHealth Net Vision HMO connects members to affordable eye care services from a vast network of ophthalmologists, optometrists and opticians. In addition to annual exams, our vision plans cover frames and contact lenses once every 12 months from retailers such as LensCrafters, Pearle Vision, Sears Optical, and Target Optical.

Our plan also offers discounts on LASIK and PRK, laser vision corrections from U.S. Laser Network.

Chiropractic care Health Net works with American Specialty Health Plans of California, Inc. (ASH Plans) to offer affordable chiropractic coverage. Covered services include up to 20 office visits per calendar year and a $50 annual chiropractic appliance allowance. If you choose to add chiropractic coverage, retirees can select one of ASH Plans’ participating chiropractors located in California. A referral from their primary care physician is not required to use this benefit.

Ancillary Products

Experts by the numbers

• More than 2,000

dental HMO providers

in California

• More than 5,500 vision

providers in California

and 45,000 vision

providers nationwide

• More than 3,300

chiropractors in

California

Benefits comparison of popular dental packages

Type of service What you payOffice visits to a Health Net participating dentist/ dental facility after regularly scheduled hours

$40 copay

Teeth cleaning• 1st cleaning per calendar year• 2nd cleaning per

calendar year

No charge$25 copay

X-rays• (bitewings, 2 or 4 films)• (full mouth)

No chargeNo charge

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Exclusive to Health Net, Decision Power helps people build healthy habits, make decisions with their doctors and manage complex health issues. Decision Power offers a combination of wellness coaching, online resources and self-guided programs spanning the full spectrum of health. Members use Decision Power to:

• Get help with a specific health goal.

• Learn about treatment options for conditions like back pain and arthritis.

• Try an online health improvement program on nutrition, weight management, tobacco cessation, and more.

• Assess health risks and get practical steps for making healthy lifestyle changes.

• Track diet, exercise or cholesterol levels.

• Adapt to living with chronic illness.

Get discounts on health-related products and services Decision Power Healthy Discounts complements our Decision Power resources by supporting each member’s good health with

discounts on popular products and services. With this program, Health Net Seniority Plus members can save with discounts for:

• Acupuncture

• Chiropractic services

• Massage therapy

• Eye exams, frames and lenses

• LASIK or PRK surgery

• Fitness club memberships

• Vitamins, minerals and herbal supplements

• In-home care services

• Weight Watchers

• Jenny Craig

Once members, your retirees can log on to www.healthnet.com/medicare and click on Decision Power Health & Wellness > Member Discounts to learn more about the discounts and how to use them.

Healthy Lifestyle Extras

Silver&Fit Basic Program

We make it easy for retirees to get fit and have fun with the Silver&Fit Basic Program. The program is designed specifically for Medicare beneficiaries and includes membership in a participating fitness facility or the Silver&Fit Home Fitness Program. Silver&Fit memberships include standard fitness facility services but do not include nonstandard services that typically require an additional fee. Silver&Fit is a federally registered trademark of ASH.

®

Christine Varner,Health NetWe facilitate strong patient-doctor relationships.

The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year.

The Silver&Fit program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). All programs and services are not available in all areas.

Enrolless have access to Decision Power through current enrollment with any of the following Health Net companies: Health Net of California, Inc. and Health Net Life Insurance Company.

Decision Power is not part of Health Net’s commercial medical benefit plans. Also, it is not affiliated with Health Net’s provider network and it may be revised or withdrawn without notice. Decision Power is part of Health Net’s Medicare Advantage benefit plans. But it is not affiliated with Health Net’s provider network. Decision Power services, including clinicians, are additional resources that Health Net makes available to enrollees of the above listed Health Net companies.

6028177 CA81174 (3/13) Health Net of California, Inc. is a Medicare Advantage organization with a Medicare contract. Anyone with Medicare Parts A and B may apply. Health Net of California, Inc. and Health Net Life Insurance Company are subsidiaries of Health Net, Inc. Health Net, Decision Power and Seniority Plus are registered service marks of Health Net, Inc. All other identified trademarks/service marks remain the property of their respective companies. All rights reserved.

Seniority Plus is an affordable, flexible way to offer group retiree health

coverage. But it’s more than that.

Retiree health coverage that works smarter for your businessAt Health Net, we’re focused on making things easier for you! That’s why we connect you with an expert account management team who is devoted to ensuring you and your employees and retirees get maximum value from your health benefits package. It’s another way we’re working hard to make health care work for you!

Contact your Health Net account executive today to learn more about Health Net Seniority Plus (Employer HMO) options.

www.healthnet.com/medicare

Health Net Seniority Plus