WPS Illinois Small Group Insurance –2019

Illinois employers

HONEST. INDEPENDENT. MIDWESTERN.

WPS Health Insurance offers high-quality coverage, local and national networks, affordable plans, and a wide range of benefit choices that you and your employees need. WPS, a leading not-for-profit health insurer based in Wisconsin, has been serving the people of the Midwest since 1946.

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Comprehensive provider access. Freedom of choice.The Alliance NetworkAccess to major hospitals, health systems, and physicians in northern Illinois and southern Wisconsin.

90 hospitals

18,000service providers

More than

» Ascension Health System » Beloit Health System » Centegra Health » Cadence Health » CGH Medical Center » Dean Clinics/SSM Healthcare » Finley Hospital » Freeport Health Network » Illinois Valley Community Hospital » KishHealth » KSB Hospital

Find a complete list of providers in The Alliance Network online at wpshealth.com; click on Find a Doctor. Providers can leave or enter the network at any time. It is recommended that you check the network status of your provider on a regular basis.

9,500medical doctors, including:

» Mercy Health System » Mercy Medical Center-Dubuque » Midwest Medical Center » Monroe Clinic » OSF Healthcare » Rochelle Community Hospital » Rockford Health System » Swedish American Health System » University of Wisconsin Hospital

and Clinics

Clinton

IAMN

ILWI

MI

WI

PeoriaKnox

McLean

Warren

Livingston

Henry

Milwaukee

Kane

DuPage

Gogebic

Cook

Bureau

Ozaukee

LincolnLanglade

ShawanoMarathon

Clark

Taylor

Wood Portage Waupaca Outagamie

Waushara

MarquetteGreenLake Fond du Lac

Washing

ton

Waukesha

DeKalb

McHenry

LaSalle

Clayton

Chippewa

Eau Claire

PepinBuffalo

Houston

Winona

Trem

peal

eau

La CrosseMonroe

Jackson

Fayette

Winn

eshie

k

Allamakee

Adams

Juneau

SaukRichland ColumbiaDodge

JeffersonDaneIowa

Grant

LafayetteGreen

RockWalworth

DubuqueWinnebago BooneStephenson

Jo Daviess

OgleCarroll

Whiteside

Lee

Vernon

Crawford

Winnebago

Vilas

Sawyer

Rusk

Racine

Price

Ontonagon

Oneida

IronIron

Houghton

Dunn

Barron

Jackson

Scott

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Specialty Hospital LocationsOffer specialty care for children, rehabilitation, surgery, or other services

S

Hospital LocationsH

Primary Service Area

1WPS Customer Service data, 2017.

HONEST. INDEPENDENT. MIDWESTERN.

99%of customer calls are connected to a live Customer Service Representative right here in the Midwest.1

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HONEST. INDEPENDENT. MIDWESTERN.

Comprehensive provider access. Freedom of choice.First Health Network In-network benefits—in all 50 states outside specific counties in Illinois and Wisconsin—for customers covered under The Alliance Network.

Visit wpshealth.com and click on the Find a Doctor tool.or for First Health, visit myfirsthealth.comProviders can leave or enter the network at any time. It is recommended that you check the network status of your provider on a regular basis.

1 millionhealth care service locations

More than

Ideal for: » Customers who travel » Customers whose children attend school out of state » Out-of-state employees receiving in-network care

90,000ancillary facilities

5,000hospitals

Find a complete list of in-network providers

Call: 800-332-1398

Online: wpshealth.com—click Find a Doctor

First Health

51%of Illinois residents are covered by employer-sponsored insurance.2

2Kaiser Family Foundation estimate based on Census Bureau, 2017. Retrieved from kff.org/other/state-indicator/total-population/ on Aug. 3, 2018.

HONEST. INDEPENDENT. MIDWESTERN.

You Pay

Metal TierIndividual

Deductible1Coinsurance

Individual Annual Max

Out of Pocket1

At Preferred Providers2

In NetworkOut of

NetworkIn

NetworkOut of

NetworkIn

NetworkOut of

NetworkTeladoc

Visit

Retail Clinic Visit

PCP Visit

Specialty Visit

Emergency Room

Outpatient Lab/X-ray

Outpatient Surgery

Hospitalization

Platinum $500 $1,000 20% 50% $1,650 $11,000 No charge $10 $35 $55 $375 20% after deductible*

Gold $1,000 $2,000 20% 50% $5,000 $12,000 No charge $10 $35 $55 $375 20% after deductible*

Gold $1,500 $3,000 10% 40% $6,000 $11,000 No charge $10 $35 $55 $375 10% after deductible*

Gold $2,000 $4,000 20% 50% $7,900 $14,000 No charge $10 $35 $55 $375 20% after deductible*

Gold $2,500 $5,000 20% 50% $7,900 $15,000 No charge $10 $35 $55 $375 20% after deductible*

Silver $3,000 $6,000 20% 50% $7,900 $16,000 No charge $10 $45 $90 $500 20% after deductible*

Silver $3,500 $7,000 10% 40% $7,900 $15,000 No charge $10 $45 $90 $500 10% after deductible*

Silver $4,500 $9,000 0% 30% $7,900 $15,000 No charge $10 $45 $90 $500 No charge after deductible*

Silver $4,500 $9,000 20% 50% $7,900 $19,000 No charge $10 $45 $90 $500 20% after deductible*

Silver $5,500 $11,000 20% 50% $7,900 $21,000 No charge $10 $45 $90 $500 20% after deductible*

Silver $6,500 $13,000 20% 50% $7,900 $23,000 No charge $10 $45 $90 $500 20% after deductible*

Platinum and Gold Prescription Drugs: Preventive and Preferred Generics: $0; Non-Preferred Generics: $15; Preferred Brand: $40; Non-Preferred Brand: $70; Specialty Drugs: 30% coinsurance

Silver Prescription Drugs: Preventive and Preferred Generics: $0; Non-Preferred Generics: $25; Preferred Brand: $60; Non-Preferred Brand: $100; Specialty Drugs: $500 deductible, then 40% coinsurance

*Until maximum out-of-pocket is met

HONEST. INDEPENDENT. MIDWESTERN.

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AYWPS Small Group Copay Plan Summary

» Copays help reduce out-of-pocket costs » Affordable plan designs » No referral needed: Choose providers in-network and out-of-network » Plan covers greater share of costs when care provided is in-network

1Family deductibles and out-of-pocket limits are 2x the individual amounts.

²Preferred providers are in this plan’s network. All other providers are out of network. Ser-vices performed out of network are subject to the out-of-network deductible and coinsur-ance. See policy for details.

All plans feature embedded deductibles and out-of-pocket maximums unless otherwise noted.Preventive drugs include specific supplements, contraceptives, immunizations, and other preventive drugs ranked A or B by the U.S. Preventive Services Task Force.

84%of both employers and employees agree that health care benefits are important for attracting and retaining employees.3

3Transamerica Center for Health Studies® Survey: Employer Attitudes Toward the Employer Mandate and the ACA, December 2016

HONEST. INDEPENDENT. MIDWESTERN.

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HONEST. INDEPENDENT. MIDWESTERN.

WPS Group High-Deductible Health Plan (HDHP) Summary

» Gives employees more control over their medical expenses » Significantly lower premiums » Wide range of plan options and benefits

» Offer employees up to four benefit plan design options

¹Family deductibles and out-of-pocket limits are 2x the individual amounts.

²Preferred providers are in this plan’s network. All other providers are out of network. Services performed out of network are subject to the out-of-network deductible and coinsurance. See policy for details.³Non-Embedded Deductible and Out-of-Pocket Limit: This plan features a non-embedded deductible and out-of-pocket limit. If an employee has family coverage, the family deductible must be satisfied before this plan will pay benefits. One person can satisfy the family deductible. If an employee has family coverage, the family out-of-pocket limit must be satisfied before this plan will pay 100% of covered benefits. One person can satisfy the family out-of-pocket limit. Deductibles and out-of-pocket maximums apply annually.

4Non-Embedded Deductible and Embedded Out-of-Pocket Limit: This plan features a non-em-bedded deductible. If an employee has family coverage, the family deductible must be satisfied before this plan will pay benefits. One person can satisfy the family deductible. This plan features an embedded out-of-pocket limit. The individual out-of-pocket limit must be satisfied before this plan will pay 100% of covered benefits. Deductibles and out-of-pocket maximums apply annually.Unless otherwise noted, plans have an Embedded Deductible and Embedded Out-of-Pocket Limit: These plans feature an embedded deductible where an individual deductible must be satisfied before this plan will pay benefits. These plans feature an embedded out-of-pocket limit where the out-of-pocket limit must be satisfied before this plan will pay 100% of covered benefits. Deductibles and out-of-pocket maximums apply annually.Preventive drugs include specific supplements, contraceptives, immunizations, and other preventive drugs ranked A or B by the U.S. Preventive Services Task Force.

HSA-Qualified HDHPOur HSA-qualified HDHPs combine the cost savings of a HDHP with the ability to add a Health Savings Account (HSA) that you own and control. Employee-owned, tax-favored personal savings accounts help your employees pay for current medical expenses sand save for future medical needs.

You Pay

Metal Tier Individual Deductible1 Coinsurance

Individual Annual Max

Out of Pocket1At Preferred Providers2

In Network

Out of Network

In Network

Out of Network

In Network

Out of Network

Teladoc Visit

Retail Clinic Visit

PCP Visit

Specialty Visit

Emergency Room

Outpatient Lab/X-ray

Outpatient Surgery

Hospitalization

Gold3 $2,000 $4,000 0% 30% $2,000 $10,000 No charge after deductible

Gold $2,800 $5,600 0% 30% $2,800 $11,600 No charge after deductible

Silver4 $1,550 $3,100 30% 50% $6,750 $13,100 30% after deductible*

Silver4 $2,500 $5,000 30% 50% $6,750 $15,000 30% after deductible*

Silver $2,700 $5,400 20% 50% $6,750 $15,400 20% after deductible*

Silver $3,500 $7,000 20% 50% $6,750 $17,000 20% after deductible*

Silver $3,850 $7,700 0% 30% $3,850 $13,700 No charge after deductible

Bronze $5,500 $11,000 30% 50% $6,750 $21,000 30% after deductible*

Bronze $6,750 $13,500 0% 30% $6,750 $19,500 No charge after deductible

Prescription Drugs: Preventive: $0; All others: deductible and coinsurance

*Until maximum out-of-pocket is met

HONEST. INDEPENDENT. MIDWESTERN.

of health plans using Express Scripts spent less per person on prescription drugs in 2017 compared to 2016.4

44%

4Express Scripts 2017 Drug Trend Report.

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HPreventive Care 100% covered by WPS when care given by preferred provider:

» Routine immunizations » Routine medical exams » Well-child care » Mammograms

The preventive services listed are covered subject to the terms and conditions set forth in your WPS certificate. Age-appropriate screenings are set by the United States Preventive Services Task Force and are subject to change.

EyeMed Vision Care Discount » No-cost access for WPS customers » Save on eye care and eyewear with discount No. 9238049 » Thousands of locations nationwide

Hear in America Hearing Program » Includes an annual hearing screening at no cost » Discounts on nine top hearing aid brands » Three-year warranties covering repairs, loss, and damage are

included with all purchases » Three years of office service included (clean, check, adjust) » Three years of hearing aid batteries included » To take advantage of this offer, call 800-286-6149 and tell

them you are a WPS customer

Prescription Drug Coverage » $0 copay on select preventive drugs for common

conditions (e.g., high blood pressure, cholesterol, heart conditions, and asthma)

» Keep costs down: Lower-cost generic drugs and monitoring of specialty drug use

» Home delivery service available

$0 Copay Drugs

Amlodipine besylate

Atenolol

Atenolol/chlorthalidone

Atorvastatin calcium

Benazepril hcl

Bisoprolol fumarate/hctz

Carvedilol

Chlorthalidone

Clonidine hcl

Diltiazem 24hr cd

Enalapril maleate

Enalapril/hydrochlorothiazide

Gemfibrozil

Glimepiride

Glipizide

Glyburide

Glyburide, micronized

Hydrochlorothiazide

Indapamide

$0 Copay Drugs

Irbesartan

Lisinopril

Lisinopril/hydrochlorothiazide

Losartan potassium

Losartan/hydrochlorothiazide

Lovastatin

Metformin hcl

Metolazone

Metoprolol tartrate

Montelukast sodium

Pravastatin sodium

Propranolol hcl

Quinapril hcl

Ramipril

Simvastatin

Spironolactone

Triamterene/ hydrochlorothiazide

Verapamil hclWarfarin sodium

» Preventive screenings » Preventive drugs » And more

Preventive drugs include specific supplements, contraceptives, immunizations, and other preventive drugs ranked A or B by the U.S. Preventive Services Task Force.

5Kaiser Family Foundation 2017 Employer Health Benefits Survey. Retrieved from kff.org/report-section/ehbs-2017-section-12-health-and-wellness-programs/ on Aug. 1, 2018.

Small firms that offer wellness and health promotion programs.5

58%

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1The Active&Fit Direct and ExerciseRewards programs are provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Incorporated (ASH). Active&Fit Direct and ExerciseRewards are trademarks of ASH and used with permission herein. If you think an employee might be unable to meet a standard for a reward under this wellness program, the employee might qualify for an opportunity to earn the same reward by different means.

Teladoc® Telehealth Services » Connect with a licensed physician over the phone or via video consult

» Cost: No added cost for a copay plan or $45 fee for an HDHP plan

ExerciseRewards™ Program1

» Encourages employees to stay active

» $30 reward each month for visiting a fitness club 10 or more times that month

» Includes large fitness chains, independently owned clubs, and YMCA/YWCA

» Three ways to track: Automated reporting via 5,700 partner centers, smartphone app, or paper log

Active&Fit™ Direct Program1

» Choose from 9,000+ participating fitness centers nationwide for only $25 a month (plus a $25 enrollment fee and applicable taxes)

» A guest pass to try out a fitness center before enrolling (where available)

» The option to switch fitness centers to make sure you find the right fit

Delta Dental InsuranceThe most in-network providers:

» Delta Dental PPO Network: Lowest agreed-upon fees; more locations than any other PPO network

» Delta Dental Premier: More than 80% of the country’s dentists are in this network

» More options available: orthodontic services; coverage and treatment for endodontic and nonsurgical periodontic services; and maximum allowable charge reimbursement plan

Visit wpshealth.com and click Customers to get started.

Customer ResourcesConvenient access to tools and resources for your best health.

» Access health and wellness information » Locate in-network doctors and facilities » Order prescriptions through Express Scripts » Manage your account » Learn about your benefits

6U.S. Small Business Administration Office of Advocacy, Illinois 2018 Small Business Profile

In Illinois:6

1.2 million small businesses2.5 million small business employees

HONEST. INDEPENDENT. MIDWESTERN.

Choose the Right Plan to Support the Best Health of Your Employees

About WPSWisconsin Physicians Service Insurance Corporation, doing business as WPS Health Solutions, has a strong legacy of serving the people of the Midwest since 1946. WPS, a leading not-for-profit health insurer based in Wisconsin, offers flexible and affordable group health plans and cost-effective benefit plan administration for businesses.

Searching for the right fit?Comprehensive plans give you options with affordable, high-quality coverage across Illinois.

Ready to choose?You can apply online or over the phone in just a few minutes.

See your local agent

CALL 800-332-1398

Visit wpshealth.com

Contact us today!WPS Health Insurance is ready to help you find the plan that meet your needs!HONEST. INDEPENDENT. MIDWESTERN.

In accordance with 215 ILCS 97/35 Sec.35. Disclosure of Information. Upon request, Small employers have the right

to information concerning WPS’: (a) right to change premium rates and the factors that may affect changes in premium

rates; (b) renewability of coverage provisions; (c) pre-existing conditions exclusion, if any; and (d) the benefits and

premiums available under all health insurance cover for which the employer is qualified.

©2018 Wisconsin Physicians Service Insurance Corporation. All rights reserved. JO9483 31179-100-1808

1717 W. BroadwayP.O. Box 8190Madison, WI 53708-8190

See your local agent

Request a

Quote Call 800-332-1398 Visit wpshealth.com

HONEST. In 2018, WPS was named one of the World’s Most Ethical Companies® for the ninth straight year.*

INDEPENDENT. Independent for more than 70 years.

MIDWESTERN. Covering northern Illinois and all of Wisconsin.

* 2010–2018 World’s Most Ethical Companies, Ethisphere® Institute, worldsmostethicalcompanies.ethisphere.com/honorees/.