Playbook

THE ALLIANTHEALTH PLANS2018 BROKER PLAYBOOK

Blank Page

LET’S GO! TURNER, WOOD & SMITH!Open Enrollment is a busy time and we are here to help. Allianthas a team of professionals prepared to answer questions, offerguidance and assist you. Meet Your Team General Questions Alliant Customer Service 9am to 5pm, Monday through Friday • Eligibility • Benefits, claims and billing questions • Basic sales inquiries Phone: (800) 811-4793 Email: [email protected] Broker/Client Relations Representative Lisa Johnson • Broker Portal • Health plans • Sales questions or issues Phone: (706) 671-2830 Email: [email protected] Provider Relations Representative Angie Fussell serves the Northeast Georgia network and works closely with Lisa to ensure your network needs are met. AlliantPlans.com | (706) 629-8848 | 1503 N. Tibbs Road Dalton, GA 30720

IMPORTANT CONTACT INFORMATIONFinding Medical Providers and Facilities: (800) 811-4793 AlliantPlans.com Customer Service (claims & benefit information) Web-access Other Important Contacts:Navitus Health Solutions (prescription assistance until 12/31/17)Customer Service (866) 333-2757Web-access Navitus.comMagellan Rx (prescription assistance as of 1/1/18) (800) 424-1799Customer Service MagellanHealth.comWeb-access PHRAnywhere℠ (member portal) (800) 811-4793Customer Service PHRAnywhere.comWeb-access Dominion National (optional dental benefit) (800) 811-4793Customer Service (group dental) TeethKeepers.comWeb-access Billing Inquiries (800) 811-4793 [email protected] Health Plans Corporate Office (800) 664-8480Eligibility:Please submit enrollment applications, terminations and changes via fax, email or mail:Fax: (866) 634-8917Mail: Alliant Health Plans 1503 N. Tibbs Rd Dalton, GA 30720Email: [email protected]: (800) 811-4793Note: Enrollments, terminations and changes are processed within 3 – 5 business days. Most changeswill be reflected on your next invoice, depending on the date the information was submitted to Alliant.Identification cards will be mailed directly to the member unless otherwise specified and should bereceived within three weeks of the request.

MARKETING AREAS79 10 13 COUNTY RATE AREA Banks 10 Catoosa 7 Chattooga 13 Dade 7 Dawson 10 Fannin 9 Floyd 13 Franklin 10 Gilmer 13 Gordon 13 Habersham 10 Hall 10 Hart 10 Lumpkin 10 Murray 9 Pickens 13 Polk 13 Rabun 10 Stephens 10 Towns 10 Union 10 Walker 7 White 10 Whitfield 9

BROKER PORTAL LOGIN INFORMATION User Name: _________________________ Password: _________________________ THE BROKER PORTAL: Your Account Your Clients• View your individual broker information • Manage your groups• View commission payments/payment schedule • Manage your members• View book of business • Change member account information• Search/view all pending and completed individual • Create and send a SoloCare quote • Create and send a SimpleCare quote applications • Submit member applications• Search/view all requests awaiting QLE confirmation • View invoices• Search/view all rejected requests • Print ID cards USEFUL LINKSBroker Portal: Enrollment.AlliantPlans.com/EnrollmentBroker/Session/LoginTraining: AlliantPlans.com/wp-content/uploads/2016/11/Broker-Portal-Training-Document-2016.pdf For assistance using the broker portal, contact your Broker/Client Relations Representative

BROKER WEB PAGE The Broker Section of the Alliant Health Plans website is your go-to resource for information about Alliant Health Plans and PY2018.Home page: Find the Broker Section by clicking on the link in the menu bar.Broker Section Page: Find access to documents, forms, Plan information and the broker portal.Highlighted below: • Find A Provider search function • 2017 SoloCare and SimpleCare Plans and Benefits Grids • 2018 SoloCare and Simplecare Brochures (2018 Plans and Benefits Grids will be added) • Forms and Documents for you – as an Alliant broker – and for your clients • Broker Portal with access to information about and to help you manage your book of business and clients covered by Alliant, as well as allows you to quote new business • Welcome, Brokers – Need-to-know messages to keep you in the know with changes and updates • Featured Services Menu – Pertinent plan documents such as the Formulary List, Formulary & Network Announcements, rates for SoloCare and SimpleCare small group and SBCs for SoloCare, SimpleCare and Large Group Plans.

2018 INDIVIDUAL/FAMILY PLANS SoloCare6 plans available for sale both ON/OFF The Health Insurance Marketplace (HealthCare.gov) • Alliant Network Only • Formulary options may vary by plan. Contact your Broker/Client Relations Representative for more information.1 Silver plan will be available OFF exchange ONLY • Alliant Network Only • Formulary options may vary by Plan. Contact your Broker/Client Relations Representative for more information.The naming convention follows CMS guidelines of unique HIOS ID# • Each plan has a suffix of either 00 or 01; (e.g. 0040021-00 or 0040021-01) • -00 = sold OFF The Marketplace • -01 = sold ON The Marketplace • -03-07 = sold ON The Marketplace and indicate a cost share reduction variant per CMSIndividual/Family Plans 50% 2018ON & OFF The Health Insurance Marketplace Alliant Network ONLY In-Network Out-of-Network Plan Coinsurance Deductible Out-of-Pocket Urgent PCP Specialist Mental Health/ (You Pay) Coinsurance Deductible Out-of-Pocket Marketing Plan Pays After Individual/ Maximum ER Care Visit Visit Substance Rx Generic/Preferred/ Plan Pays Individual/ Maximum Individual/ Abuse Visit Brand/Specialty After Deductible Name Deductible Family Family Family Individual/FamilySoloCare 80% $275/ $4,750 / 80% $10 $10 $25 $10 $10/$50/ 60% $20,000/ NoPlatinum PPO 80% $550 $9,500 $100/50% $40,000 Maximum40023 70% $2,300 / $7,350 /SoloCare 70% $4,600 $14,700 80% $75 $20 $40 $20 $15/$50/ 60% $20,000/ NoGold PPO 100% $5,750 / $7,350 / $150/50% $40,000 Maximum40002 100% $11,500 $14,700SoloCare $7,000 / $7,350 / 70% $75 $30 $60 $30 $15/$50/ 50% $20,000/ NoSilver PPO $14,000 $14,700 $150/50% $40,000 Maximum40010 $7,350 / $7,350 /SoloCare $14,700 $14,700 70% $75 $85 $120 $85 $20/$65/ 50% $20,000/ NoSilver PPO $6,650 / $6,650 / $165/50% $40,000 Maximum40017 $13,300 $13,300SoloCare 100% 50% $20,000/ NoBronze PPO $40,000 Maximum40021SoloCare 100% 50% $20,000/ NoBronze HDHP $40,000 Maximum40031 *Individual/Family Plans 2018OFF The Health Insurance Marketplace Alliant Network ONLYSoloCare 70% $3,850 / $7,350 / 70% $75 $30 $60 $30 $15/$50/ 50% $20,000/ NoSilver PPO $7,700 $14,700 $150/50% $40,000 Maximum40007Where coinsurance is displayed, it is first subject to deductible.* PTloanthiseHSbAeesltigoibfleour knowledge, the information contained herein is accurate and reliable as of the date of publication; however, it is the consumer’s responsibility to check the relevant plan information at AlliantPlans.com in order to follow any possible changes.

INTRODUCING A NEW PLAYER TO THE SoloCare LINEUPAlliant Health Plans now offers dental plans for individuals! Alliant has partnered with Dominion National tobring you another highly requested benefit.Choose between three popular, high-value dental plan options and give you and your family a reason to smile.The benefits of the Choice PPO plan include: • Maximum access, convenience and flexibility • Members may use any licensed dentist or choose from over 290,000 participating dentist listings nationwide (over 9,000 in Georgia)1 • Significant out-of-pocket savings if using an in-network dentist • Simple online enrollment and administration. • Rates starting at $15.87 a month • For more information and to enroll today, please visit Teethkeepers.com CHOICE PPO CHOICE PPO CHOICE PPO BASIC PLUS PREMIUM In-Network Out-of-Network In- Out-of- In- Out-of- YEAR 1 YEAR 2 YEAR 3 YEAR 1 YEAR 2 YEAR 3 Network Network Network NetworkDiagnostic & Preventive Care 100% 100% 100% 90% 90% 90% 100% 90% 100% 90%Basic Care Major Restorative Care 50% 60% 80% 30% 50% 70% 50% 40% 80% 70%Endodontics, Oral SurgeryPeriodontics 15% 25% 50% 30% 20% 40% 0% 0% 50% 40%Orthodontics 15% 25% 50% 10% 20% 40% 0% 0% 50% 40%Deductible per adultAnnual Maximum 15% 25% 50% 10% 20% 40% 50% 40% 50% 40%Lifetime Ortho MaximumWaiting Periods 0% 0% 0% 0% 0% 0% 0% 0% 0% 0%Provider NetworkDependent Age/ Student Age BENEFIT FEATURES(up to) $50 (applies to all services) $50 (applies to all $50 (applies to services) basic and major) $1,000 $750 N/A N/A $1,500 None None N/A Yes2 Choice PPO or Any Dentist Choice PPO or Any Dentist Choice PPO or Any Dentist 26/26 26/26 26/26 1. Dominion National Internal Performance Report, July 2017. Participating providers are subject to change. 2. There are no waiting periods for diagnostic and preventive care. To be eligible for basic care, you must have completed 6 (six) months of continuous coverage. To be eligible for major restorative care, you must have completed 12 (twelve) months of continuous coverage. Waiting period credit will be given for the length of time an insured was covered under each benefit classification under the current employer’s prior dental coverage.Dental plans are underwritten by Dominion National Insurance Company.This policy includes limitations, exclusions and terms under which the policy may be continued in force or discontinued. For costs and complete coverage, pleaseobtain the plan document online at Teethkeepers.com.

NOTES

PLAN SPOTLIGHTSWhile 24 small group plan options are offered for 2018, you will find details for sevenspotlighted plans enclosed.Please contact your Broker/Client Relations Representatives for information regardingadditional plans. 24 SimpleCare plans offered in 2018 for small group clients • Alliant Network only (50000 series) • Alliant Network plus the PHCS network wrap (80000 & 90000 series) • Formulary options may vary by Plan. Contact your Broker/Client Relations Representative for more information All 24 plans are ONLY available OFF The Health Insurance Marketplace (SHOP) 8 copay plans that have the $10/$35/$70/25% Rx benefit design 8 copay plans that have the $15/$50/$100/25% Rx benefit design 1 plan with a 70%/30% coinsurance benefit design. 1 plan with a 100%/0% coinsurance benefit design 6 HDHP Options are available. These are strictly deductible and coinsurance plans.

2018 SMALL GROUP SPOTLIGHT PLANS SimpleCare 7 Spotlighted Plans • 2 with AHP Network • 5 with AHP Network and PHCS Wrap Network 3 HDHP Plans 4 Copay PlansAlliant Network ONLY In-Network Out-of-NetworkPlan Marketing Coinsurance Deductible Out-of-Pocket Urgent PCP Specialist Mental Health/ (You Pay) Coinsurance Deductible Out-of-PocketName Plan Pays After Individual/ Maximum ER Care Visit Visit Substance Rx Generic/Preferred/ Plan Pays Individual/ Maximum Deductible Family Abuse Visit After Deductible Family Individual/Family Individual/Family Brand/SpecialtySimpleCare 70% $3,650 / $7,350 / 70% $75 $35 $70 $35 $15/$50/ 60% $20,000/ NoSilver PPO $7,300 $14,700 $100/25% $40,000 Maximum50156SimpleCare 100% $7,350 / $7,350 / 100% $75 100% 60% $20,000/ NoBronze PPO $14,700 $14,700 $40,000 Maximum50172Alliant Network PLUS PHCS Wrap NetworkSimpleCare 100% $500 / $1,750 / $100 $75 $15 $30 $15 $10/$35/ 60% $20,000/ NoPlatinum PPO $1,000 $3,500 $55 $25 $70/25% $40,000 Maximum80140 90% $75 $25 $10/$35/ $70/25%SimpleCare 90% $1,500 / $5,000 / HSA Eligible 60% $20,000/ NoGold PPO $3,000 $10,000 $40,000 Maximum80148WAHraPpNNeetwtwoorkrkPLUS PHCS Wrap NetworkSimpleCare 100% $2,000 / $2,000 / 100% 60% $20,000/ NoGold HDHP $4,000 $4,000 100% $40,000 Maximum90176 100%SimpleCare 100% $4,000 / $4,000 / 60% $20,000/ NoSilver HDHP $8,000 $8,000 $40,000 Maximum90178SimpleCare 100% *$6,650 / $6,650 / 60% $20,000/ NoBronze HDHP $13,300 $13,300 $40,000 Maximum90180*HDHP Plans with 2+ INSURED: Any 1 (one) person will not be responsible for more than $6,550Where coinsurance is displayed, it is first subject to deductible.To the best of our knowledge, the information contained herein is accurate and reliable as of the date of publication; however, it is the consumer’s responsibility to check the relevant plan information at AlliantPlans.com in order to follow any possible changes.

INTRODUCING A NEW PLAYER TO THE SimpleCareLINEUPAlliant Health Plans now offers dental plans for employers!Choose between four popular, high-value dental plan options and give your employees a reason to smile.The benefits of the Choice PPO plan include: • Maximum access, convenience and flexibility • Members may use any licensed dentist or choose from over 290,000 participating dentist listings nationwide (over 9,000 in Georgia)1 • Significant out-of-pocket savings if using an in-network dentist • Diagnostic and Preventive Care services do not count toward the annual maximum • Extra cleaning for diabetics and expectant mothers • No waiting periods • For more information or questions, please visit Teethkeepers.com CHOICE PPO 1000P CHOICE PPO 1500P CHOICE PPO 1000A CHOICE PPO 1500ABENEFIT FEATURES In- Out-of- In- Out-of- In- Out-of- In- Out-of- Network Network Network Network Network Network Network NetworkOffice Visit CopaymentDeductible (x3 Family Max) None None None None– Waived on D&PAnnual Maximum $50 $50 $50 $50– Does not apply to D&PWaiting Periods $1,000 $1,500 $1,000 $1,500Provider Network None None None None Choice PPO or Choice PPO or Choice PPO or Choice PPO orDependent Age/Student Age (up to) Any Dentist Any Dentist Any Dentist Any DentistDiagnostic & PreventiveCare (D&P) 26/26 26/26 26/26 26/26Basic Care Major Restorative Care 100% 100% 100% 100% 100% 80% 100% 80%Endodontics, Periodontics, 80% 80% 80% 80% 80% 60% 80% 60%Oral Surgery 50% 50% 50% 50% 50% 40% 50% 40%Orthodontics 50% 50% 50% 50% 50% 40% 50% 40% 0% 0% 0% 0% 0% 0% 0% 0% 1. Dominion National Internal Performance Report, July 2017. Participating providers are subject to change.Dental plans are underwritten by Dominion National Insurance Company and administered by Alliant Health Plans.This policy includes limitations, exclusions and terms under which the policy may be continued in force or discontinued. For costs and complete coverage, call (800) 811-4793..

MOBILE ID CARD APP FOR MEMBERS Access information on the Alliant Health Plans App Health insurance information at your fingertips! Download the Alliant Health Plans app on a smartphone for one-touch access to a digital Alliant ID card. Email or fax an ID card directly to a provider. Or, find a new Alliant Health Plans’ physician through the app. Find the free, member mobile ID card app at the Apple or Google app store.

NOTES