ENROLLMENTGUIDE

FOR THE EMPLOYEES OF

Minimum Essential Coverage

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Minimum Essential Coverage (MEC) covers 100% of the CMS listed Preventative and Wellnessbenefitswhenyouvisitanetworkprovider(40%out-of-network).

Anemployeecanpreventbeingtaxedthe“Individual Mandate”coveragepenaltybypurchasing Minimum Essential Coveragethroughhis/heremployer.Beginningin2014,employeeswillfaceataxof thethegreaterof 1%of adjustedhouseholdincomeor$95peradultplus$47.50perchild;in2015,thegreaterof 2%of adjustedhouseholdincomeor$325peradultplus$162.50perchild;thereafter,thegreaterof 2.5%of adjustedhouseholdincomeor$695peradultplus$347.50perchild.

Firstdollarcoveragewithaccesstooneof thelargestnationalprovidernetworksavailable(simplewebportalformember’slocalorout-of-townproviderlookup)withgreatdiscountsavingsforMECbenefits.NetworksavingscanbeusedforservicesnotcoveredbyMEC.

† Rates assume cost is currently and will continue to be remitted in advance of the effective date. Rates include administrative fees for continuation, enrollment and materials.

Minimum Essential Coverage (MEC)Self-Insured by your employer, this coverage is required tosatisfy the individual mandate under Health Care Reform

Monthly Cost† MECEmployeeEmployee Spouse+Employee+Child(ren)Family

$53.48$82.96$144.80$174.28

What are the Covered Servicesin Minimum Essential Coverage

15 Covered Preventive Services for Adults

1.AbdominalAorticAneurysmone-timescreeningformenof specified ageswhohaveeversmoked 2.AlcoholMisusescreeningandcounseling 3.Aspirinuseformenandwomenof certainages 4.BloodPressurescreeningforalladults 5.Cholesterolscreeningforadultsof certainagesorathigherrisk 6.ColorectalCancerscreeningforadultsover50 7.Depressionscreeningforadults 8.Type2Diabetesscreeningforadultswithhighbloodpressure 9.Dietcounselingforadultsathigherriskforchronicdisease 10.HIVscreeningforalladultsathigherrisk 11.Immunizationvaccinesforadults--doses,recommendedages,and recommendedpopulationsvary: oHepatitisA oHepatitisB oHerpesZoster oHumanPapillomavirus oInfluenza(FluShot) oMeasles,Mumps,Rubella o Meningococcal o Pneumococcal oVaricella oTetanus,Diphtheria,Pertussis

12.Obesityscreeningandcounselingforalladults 13.SexuallyTransmittedInfection(STI)preventioncounselingfor adultsathigherrisk 14.TobaccoUsescreeningforalladultsandcessationinterventionsfor tobacco users 15.Syphilisscreeningforalladultsathigherrisk

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Covered Services (continued)

22 Covered Preventive Services for Women, Including Pregnant Women

1.Anemiascreeningonaroutinebasisforpregnantwomen 2.Bacteriuriaurinarytractorotherinfectionscreeningforpregnantwomen 3.BRCAcounselingaboutgenetictestingforwomenathigherrisk 4.BreastCancerMammographyscreeningsevery1to2yearsfor womenover40 5.BreastCancerChemopreventioncounselingforwomenathigherrisk 6.Breastfeedingcomprehensivesupportandcounselingfromtrained providers,aswellasaccesstobreastfeedingsupplies,forpregnantand nursingwomen 7.CervicalCancerscreeningforsexuallyactivewomen 8.ChlamydiaInfectionscreeningforyoungerwomenandotherwomenat higherrisk 9.Contraception:FoodandDrugAdministration-approvedcontraceptive methods,sterilizationprocedures,andpatienteducationandcounseling, not including abortifacient drugs 10.Domesticandinterpersonalviolencescreeningandcounselingfor allwomen 11.FolicAcidsupplementsforwomenwhomaybecomepregnant 12.Gestationaldiabetesscreeningforwomen24to28weekspregnantand thoseathighriskof developinggestationaldiabetes 13.Gonorrheascreeningforallwomenathigherrisk 14.HepatitisBscreeningforpregnantwomenattheirfirstprenatalvisit 15.HumanImmunodeficiencyVirus(HIV)screeningandcounselingfor sexuallyactivewomen 16.HumanPapillomavirus(HPV)DNATest:highriskHPVDNAtesting everythreeyearsforwomenwithnormalcytologyresultswhoare30 or older 17.Osteoporosisscreeningforwomenoverage60dependingonriskfactors

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Covered Services (continued)

18.RhIncompatibilityscreeningforallpregnantwomenandfollow-up testingforwomenathigherrisk 19.TobaccoUsescreeningandinterventionsforallwomen,and expandedcounselingforpregnanttobaccousers 20.SexuallyTransmittedInfections(STI)counselingforsexuallyactivewomen 21.Syphilisscreeningforallpregnantwomenorotherwomenatincreasedrisk 22.Well-womanvisitstoobtainrecommendedpreventiveservices

26 Covered Preventive Services for Children

1.AlcoholandDrugUseassessmentsforadolescents 2.Autismscreeningforchildrenat18and24months 3.Behavioralassessmentsforchildrenof allagesAges:0to11months, 1to4years,5to10years,11to14years,15to17years. 4.BloodPressurescreeningforchildrenAges:0to11months,1to4years, 5to10years,11to14years,15to17years. 5.CervicalDysplasiascreeningforsexuallyactivefemales 6.CongenitalHypothyroidismscreeningfornewborns 7.Depressionscreeningforadolescents 8.Developmentalscreeningforchildrenunderage3,andsurveillance throughout childhood 9.Dyslipidemiascreeningforchildrenathigherriskof lipiddisorders Ages:1to4years,5to10years,11to14years,15to17years. 10.FluorideChemopreventionsupplementsforchildrenwithoutfluoridein theirwatersource 11.Gonorrheapreventivemedicationfortheeyesof allnewborns 12.Hearingscreeningforallnewborns 13.Height,WeightandBodyMassIndexmeasurementsforchildren Ages:0to11months,1to4years,5to10years,11to14years,15to17years.

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Covered Services (continued)

14.HematocritorHemoglobinscreeningforchildren 15.Hemoglobinopathiesorsicklecellscreeningfornewborns 16.HIVscreeningforadolescentsathigherrisk 17.Immunizationvaccinesforchildrenfrombirthtoage18—doses, recommendedages,andrecommendedpopulationsvary: oHepatitisA oDiphtheria,Tetanus,Pertussis oHepatitisB oHaemophilusinfluenzaetypeb oHumanPapillomavirus oInactivatedPoliovirus oInfluenza(FluShot) oMeasles,Mumps,Rubella o Meningococcal o Pneumococcal oRotavirus oVaricella 18.Ironsupplementsforchildrenages6to12monthsatriskforanemia 19.Leadscreeningforchildrenatriskof exposure 20.MedicalHistoryforallchildrenthroughoutdevelopment Ages:0to11months,1to4years,5to10years,11to14years,15to17years. 21.Obesityscreeningandcounseling 22.OralHealthriskassessmentforyoungchildren Ages:0to11months,1to4years,5to10years. 23.Phenylketonuria(PKU)screeningforthisgeneticdisorderinnewborns 24.SexuallyTransmittedInfection(STI)preventioncounselingandscreeningfor adolescentsathigherrisk 25.Tuberculintestingforchildrenathigherriskof tuberculosis Ages:0to11months,1to4years,5to10years,11to14years,15to17years. 26.Visionscreeningforallchildren