Choice Offerings from Humana

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Northside ISD Effective 1/1/07
GN-32138-HH 9/04
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2007 Northside ISD Benefits

• Humana SmartSuite Plans
• - CoverageFirst 1000
• - PPO 500
• - PPO 300
• - HMO
• Spectrum Athletic Club membership of your choice
  Upgrades available
• Virgin Life Care Wellness initiative

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SmartSuite

• SmartSuite from Humana offers you a choice of
  several medical plans. Your choices will include
• HMO Higher up-front costs. You select an
  in-network PCP to oversee your routine care.
• PPO Combines cost savings with freedom to choose
  providers. You pay less when seeing participating
  providers.
• CoverageFirst PPO Lower up-front costs.
  Includes a 500-per-member up-front benefit
  allowance.

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Choosing a plan just right for you andyour family

• Think about it
• How do you and your family use health care?
• What types of services?
• How often?
• How much do you pay in out-of-pocket costs?
• Then decide
• Compare the SmartSuite plans
• Use the online tools for guidance
• Choose the plan that meets your health care
  needs and budget

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CoverageFirst PPO

• CoverageFirst 1000 PPO, an innovative concept in
  health plans
• Costs less than other health plan options
• Provides the convenience of low copayments for
  office visits, allergy shots, ER visits and
  prescription drugs
• Provides an up-front 500 allowance to help pay
  for medical care after any copayments and before
  the patient has to meet a deductible
• If you typically spend less than 500 a year on
  health care, take a close look at CoverageFirst

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500 Benefit Allowance

• A 500 up-front benefit allowance for each
  person covered
• For services from in-network (participating)
  providers only
• Excludes office visit and prescription
  copayments, behavioral health services and
  preventive visits
• The 500 benefit pays the first 500 of the
  following in-network medical expenses
• Doctor office visits
• Allergy shots
• Outpatient surgery
• Emergency room care
• Inpatient hospital charges

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How CoverageFirst works

• Chris has a CoverageFirst plan
• He goes to the doctor for an illness office visit
• Total cost is 50
• After Chris pays the 20 copayment, the benefit
  allowance covers the remaining 30
• The 500 allowance is reduced by 30
• Chris has minor surgery at the hospital
• Cost is 400 for the facility
• After Chris pays the 50 copayment, the benefit
  allowance covers the remaining 350
• Chris out-of-pocket costs total 70 (2
  copayments 20 50)
• Chris benefit allowance paid 380 (30 plus
  350)
• Chris still has 120 left in his benefit
  allowance

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Humana Preferred PPO

• The PPO and CoverageFirst PPO plans use the new
  high performance network known as Humana
  Preferred PPO
• To check the participating status of your
  physician visit www.humana.com and select Find a
  physician. When asked to select your plan,
  choose Humana Preferred.
• PPO allows access to providers without needing
  any referrals

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Your prescription benefit Rx 4

• Rx4 A new concept in prescription drug benefits
• Brand-name and generic drugs are in four
  copayment levels
• Rx4 puts drugs in four levels according to price
• First three levels include 99 of all drugs
  prescribed
• Drugs in fourth level are the most expensive
• 10/25/45/25
• Mail order 2 times retail cost for a 90 day
  supply
• 90 day at Retail program is available at CVS,
  Sams Club, Target, Walgreens and Wal-Mart

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MyHumana

• MyHumana helps you find information you need 24
  hours a day, 7 days a week
• Easy access through www.humana.com
• Password-protected security
• Links to
• Medical and Rx claims
• Benefit information
• Physician Finder Plus
• Pharmacy Locator
• Drug Library
• Condition Centers

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Helpful resources

• Disease Management
• Humana has developed an array of programs
  addressing asthma, cancer, congestive heart
  failure, coronary artery disease, diabetes,
  kidney disease, cystic fibrosis, Parkinsons and
  more than 10 other conditions.
• Humana First
• Registered nurses are available 24 hours a day to
  answer health-related questions and to assist
  with the decision of where to best seek
  treatment.
• Case Management
• Assistance in navigating the health care system
  for those facing major procedures and traumatic
  events.

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More helpful resources available year-round

• HumanaBeginnings Prenatal education and guidance
  
• PlanProfessorSM Help in navigating the health
  care system
• Automated Information Line Quick and easy way to
  get answers to general questions call Humana
  Customer Service
• Personal Nurse One-on-one guidance for certain
  members to help manage conditions or find health
  care resources

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Humana Enrollment Kit

• 2007 Enrollment Guide
• CoverageFirst 1000 PPO plan highlights
• Spectrum Athletic Club membership

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Humana Enrollment Wizard

• The Wizard makes it easy to compare plans,
  calculate your expenses and select a plan that
  works best for you.
• Begin at humana.com and choose the enrollment
  center.
• Fill out basic information your social security
  number, date of birth and home zip code.
• Select an action Open enrollment
• View by cost or by medical plan. Look through
  all available plans and sort them based on whats
  important to you.
• Use the Rx Calculator

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Wizard Screen Shot
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Special Situations

• Out of area dependents
• Your out of area dependent may be eligible to
  receive participating provider benefits
• In order for your dependent who resides outside
  of the Humana Preferred PPO service area to
  receive participating level of benefits you must
  enroll in the CoverageFirst plan.
• The Out of Area request form is available on the
  NISD website or you can call 1-888-393-6765.
• Transition of Care
• If you or a family member is in a course of
  treatment with a provider who is not
  participating in your network, we offer an
  exception process through which we may
  temporarily authorize care to be paid at the
  in-network level. Form can be obtained at the
  same places listed above.

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Open Enrollment Hotline

• 1-888-393-6765
• Hours Monday Friday 7 a.m. until 7 p.m. CST
• You can also reach us by e-mail by sending your
  questions to oe_at_humana.com

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Humana Plans are offered by the Family of
Insurance and Health Plan Companies including
Humana Medical Plan, Inc., Humana Employers
Health Plan of Georgia, Inc., Humana Health Plan,
Inc., Humana Health Benefit Plan of Louisiana,
Inc., Humana Health Plan of Ohio, Inc., Humana
Health Plans of Puerto Rico, Inc., Humana
Wisconsin Health Organization Insurance
Corporation, or Humana Health Plan of Texas, Inc.
A Health Maintenance Organization or insured by
Humana Health Insurance Company of Florida, Inc.,
Humana Health Plan, Inc., Humana Health Benefit
Plan of Louisiana, Inc., Humana Insurance
Company, Humana Insurance Company of Kentucky, or
Humana Insurance of Puerto Rico, Inc. or
administered by Humana Insurance Company For
Arizona Residents Offered by Humana Health Plan,
Inc. or insured or administered by Humana
Insurance Company Please refer to your
Certificate of Coverage/Insurance or Summary Plan
Description for more information on the company
providing your benefits. Our plans have
limitations and exclusions.
GN-32138-HH