Berkshire County ARC Open Enrollment - October 24, 2019

1. Open Enrollment 2020 For the Employees of Berkshire County ARC October 24, 2019

2. What is Annual Open Enrollment? What is Annual Open Enrollment? Annual open enrollment is the opportunity for eligible employees to enroll and make changes to your benefits. Changes to benefits at any time other than annual enrollment are restricted to qualified life status changes which must be reported within 31 days of the event. Examples of qualified life status changes are: marriage, divorce, death of a dependent, birth or adoption of a child and gain or loss of other coverage for which you are a family member. Am I eligible? If you are classified as a regular, full time employee working at least 30 hours per week, you are eligible to enroll in the benefits. If you are a new hire, your benefits will be effective 90 days from your date of hire. Who are my eligible dependents? • Your legal spouse • Any child up to age 26 regardless of student, marital, disability or dependent status • Any non-dependent child not living with you for whom you are required to provide medical coverage under a Qualified Medical Child Support Order • A disabled child regardless of age. A disabled child over age 26 must have been disabled on or before the day he/she reached age 26 and is subject to annual medical certification

3. Health New England Fully Funded HMO Service and Eligibility Area Service Area Enrollment Eligibility Area *Health New England serves Connecticut, New York, New Hampshire and Vermont residents (and their dependents) who are employed by Massachusetts companies, but is not licensed in those states.

4. HMO Hospital Map

5. HMO Plan Choices

6. HMO Plan Choices – Employee Contributions

7. PPO Essential 1500 National (PHCS) *** Only available to employees that live OUTSIDE HNE’s service area***

8. Here to There Care Program Need specialty services outside the area? • Call us, we’ll help • If your specialist agrees you need covered services outside of the area, Health New England will approve the care. • We will guide you to the right care in the right place. *Available to qualified employer groups. Contact HNE Sales Department for qualification details.

9. Here to There Care Program – How it Works Member sees in-plan HNE physician Member and specialist agree services are required outside HMO network Physician submits notification form to HNE HNE codes payment authorization for specific time frame or number of visits to out of area provider Member is coded for coverage in HNE system Claim paid at in-network level of benefits

10. Here To There – Notification Form A simple notification form is all you need.

11. PPO Plan: MultiPlan/PHCS NetworkPrivate Health Care Systems • Coverage at the in-network level of benefits for Health New England PPO plans • Access to over 700,000 providers nationally through MultiPlan/PHCS Network

12. MultiPlan/PHCS – the best hospitals in the USA

13. Streamlined search path to PHCS/MultiPlan providers • Easy to find provider search tools • Search for MultiPlan/PHCS providers on HNE website

14. Worldwide Emergency Coverage We go where you go: • Medical emergencies • Urgent care • Prescription drugs • Ambulance transportation

15. Teladoc Access to U.S. Board-Certified Physicians 24/7/365 $30 copay

16. Student Out of Area Coverage: HMO Plans • Follow-up visits after ER or Urgent Care • Non-routine medical office visits • Allergy injections • Outpatient behavioral health visits • Short term rehabilitation • 24 hour Nurse Advice Line • Teladoc phone and video consults *Prior Authorization required except when using Teladoc and Nurse Advice Line.

17. Wellness Reimbursement Program Newly expanded coverage! • Fitness clubs • Weight Watchers (WW) • Personal Trainer fees • Wellness Classes • School and town sports registration fees • Registration fees for athletic events (5K, half marathons etc.) Health New England wants to reward and support members who take action to better understand, improve, and maintain their health and wellbeing. • Golf • Ski lift tickets and trail passes • Fitness equipment (i.e. treadmill, workout videos, Fitbit, etc.) • Nutrition Classes • Mindfulness Classes • Community Supported Agriculture (farm shares) $200 per Individual and $400 per Family

18. Healthcare Management Tools • Improved HNE Member Portal • Quick access to claims history • Personalized preferences and alerts • Benefit details and EOBs • Provider search • On-line wellness reimbursements • Cost of Care Calculator • Compare cost estimates for services in your area my.healthnewengland.org

19. Thank you, we value your relationship!!