W H AT BLUE MEANS FOR YOU. BIGGEST. HIGH- QUALITY. EASIEST. HE A LT H CARE. THE COLOR BLUE SURROUNDS US, from the sky above our heads to the ocean waves against our shores. It can mean so many things, from the hard working spirit of blue collar workers to a symbol of excellence and distinction. Here at Highmark, Blue means all of that and more …

We didn’t select the image of the largest mammal on earth on a whim. It’s our way of putting an exclamation point on a crucial fact: When you’re a Highmark member, you’re part of something really big … THE BLUE CROSS BLUE SHIELD NETWORK. You have access to the largest health care network in the nation.

IN-NETWORK ACCESS TO

96%of the nation’s hospitals 93%of the nation’s doctors (According to the Blue Cross Blue Shield Association.)

Travel with assurance In western Pennsylvania Because you’re covered nearly anywhere You have access to more than 50 you go — nationally in every state, and hospitals — including seven Allegheny internationally in 190 countries. Not Health Network (AHN) hospitals, every health plan can offer that. Children’s Hospital of Pittsburgh of Plus, emergency care is always UPMC (until 2022), and many high- covered at the in-network benefit quality community hospitals. level at any hospital, near or far. Many are recognized as Blue Distinction Centers®, a Blue Cross Blue Shield Association program that recognizes excellence for delivering superior outcomes in advanced specialty care.

IN WESTERN PA YOU HAVE ACCESS TO 7,600+ 2,800+ primary care physicians of those physicians are and specialists. within AHN.

YOUR ACCESS TO HIGH- QUALITY CARE Hospitals that have one or more Blue Distinction Center® designations that are in-network: Erie McKean Potter • Allegheny General Hospital • Heritage Valley Sewickley Warren Crawford • Allegheny Valley Hospital • Indiana Regional Medical Center • Armstrong County • Jefferson Hospital Forest Memorial Hospital • Meadville Medical Center Venango Elk Cameron • Bradford Regional Medical Center • Monongahela Valley Hospital Mercer • Canonsburg Hospital • Ohio Valley Hospital • Charles Cole Memorial Hospital • Penn Highlands DuBois Clarion Jeerson • Conemaugh Memorial • Punxsutawney Area Hospital Lawrence Butler Medical Center Clearfield Centre • Saint Vincent Hospital • Conemaugh Nason Medical Center • Sharon Regional Health System Armstrong • Excela Health • St. Clair Hospital Beaver Indiana Westmoreland Hospital • Uniontown Hospital Allegheny • Excela Latrobe Hospital • Warren General Hospital Cambria Blair • Forbes Hospital • West Penn Hospital Huntingdon • Heritage Valley Beaver Westmoreland Bedford Washington Somerset Allegheny Health Fayette Network hospitals Greene Access to Allegheny Health Network (AHN), one of the providers in our network AHN is the highest-rated health system in western PA* for Medical Excellence in Cardiac Care, Stroke Care, and Women’s Health.** Plus, it offers cancer care that’s rated among the top providers nationwide, in addition to its relationship with John Hopkins Sidney Kimmel Cancer Center.

AHN is a leader in women’s health Yo u ’ll receive compassionate, personalized health care through all stages of a woman’s life, whether it’s for preventive or more specialized care, such as fertility issues, cardiac care, or breast cancer. Plus, if you’re expecting, rest assured that you’ll have in-network access to Level III Neonatal Intensive Care Units (NICU) located at West Penn and Saint Vincent hospitals and Level II NICUs at Jefferson and Forbes hospitals.

For more information about other specialties and research at AHN, please visit AHN.ORG.

Map indicates in-network hospitals in western PA. Erie McKean Potter Warren Crawford

Forest Venango Elk Cameron Mercer

Clarion Jeerson Lawrence Butler Clearfield Centre

Armstrong Beaver Indiana Allegheny Cambria Blair

Huntingdon Westmoreland Bedford Washington Somerset Allegheny Health Fayette Network hospitals Greene U.S. News & World Report. Thomson Reuters. Health Grades. CareChex®. We’re proud that the hospitals in our network have … TOP MARKS FOR HIGH-QUALITY. But we’re even prouder to offer access to top-quality care that’s close to home.

Highmark’s network of hospitals in western PA includes some of the best in the nation. Highmark members have in-network coverage at hospitals which are rated in the top 10% in the nation for Medical Excellence* in: Cardiac Surgery (4) Cardiac Care (4) TOP Heart Attack Care (4) Heart Failure (3) Orthopedic Care (1) Orthopedic Major Surgery (1) 10%in the nation for Medical Excellence* and Organ Transplants (1)

(#) numbers of hospitals falling within the top 10%

• Women’s Health (5)** TOP 25% • Stroke Care (9) IN THE NATION FOR • Cancer Care (7) MEDICAL EXCELLENCE*: • Pulmonary Care (8)

IT’S EASY TO FIT CARE INTO YOUR BUSY LIFE When you choose AHN primary and specialty care providers, you also get these added conveniences:

Same-day appointments are available now. Convenient Locations Health+Wellness Pavilions Convenient locations for services that provide one-stop health care at state-of-the art facilities in Wexford, Peters Township, Bethel Park, and Erie West Side, including extended hours for Express Care urgent care services. Same-day Appointments Primary and Specialty Care Call (412) DOCTORS between 7 a.m. and 11 a.m., Monday – Friday, to get same-day appointments for Online Health primary care and over 20 specialties, including heart care, cancer care, Connection and women’s health.† MyChart® Communicate with your doctors, † Some restrictions apply. For more details, visit AHN.ORG/same-day view your medical history and test results, schedule appointments, request prescription renewals, and pay your health bills at any time — online or with the app.

Use the MyChart app! It’s super easy. The human body is an incredibly complex system. But the health care you need to take care of yours shouldn’t be complicated to navigate. HIGHMARK WORKS HARD TO MAKE IT EASY FOR YOU. Highmark services make it easier to fit care into your busy life.

Highmark members have access to dedicated health advocates through My Care Navigator who can help you find in-network providers, make appointments, and transfer medical records.

To get started call 1-844-462-2551 or visit HIGHMARKBCBS.COM.

Highmark Direct Stores Meet Dr. Right Visit with a representative in person. Meet with in-network primary care Go to highmarkdirect.com to find a doctors and specialists from the local store near you. community at our Meet Dr. Right events. If you find the right match, make an appointment before you leave. For a list of upcoming events, There are 5 Highmark Direct go to meet-dr-right.com. Stores in western PA!

A heritage of care, innovation, and community involvement that proves we’re True Blue. OUR HISTORY BEGAN MORE THAN 75 YEARS AGO. Helping to build healthier, stronger communities.

Highmark is committed to improving the quality of life in the communities we serve — to give back, reinvest, and ensure those communities remain as strong and healthy as possible. Our corporate giving benefited hundreds of organizations across our service areas, donating millions of dollars. In addition, Highmark’s signature program — Walk for a Healthy Community — along with Adopt-a-Schools programs initiated by employees in Pittsburgh and Erie, and National Make a Difference Day of volunteering provide significant benefits to individuals and the communities we proudly serve.

In 2016 … Over the past 13 years … MORE THAN MORE THAN 6,000 12,000 BUTTERFLIES WERE DECORATED WOMEN HAVE BEEN EMPOWERED with messages of hope for grieving to take control of their health at our children in conjunction with Children’s Fun, Fit & Fabulous health conference. Grief Awareness DayTM.

Supporting grieving children The Highmark Caring Place is a program of the Highmark Caring Foundation. For over two decades it has been supporting children who have been devastated by the loss of a loved one. It provides support through various programs at their facilities in Erie, Harrisburg, and Pittsburgh. Thousands of community members are helped each year at no cost through peer support programs, education, consultation, and referral services.

Come see why Highmark has been trusted for more than 75 years and insures more than 4.2 million members. Reference

* Market claims are based on CareChex® Composite Quality Scores™ and nationally balanced scorecard criteria for health systems servicing the combined statistical area (CSA) of Pittsburgh-New Castle-Weirton. Source: Quantros Inc., CareChex® National Quality Rating Database: FFY 2013, 2014 and 2015.

** Excludes labor & delivery.

Access for children Highmark currently is in a long-term contract with Children’s Hospital of Pittsburgh of UPMC, which provides in-network access to both Children’s Hospital of Pittsburgh of UPMC and its pediatricians (CHP) until at least 2022. Highmark has every intention to continue to renew this contract. You will have access to the services provided by Children’s Hospital of Pittsburgh of UPMC and the physicians who practice there.

What you need to know about temporary access to UPMC. When UPMC terminated most of its commercial contracts with Highmark, the Governor’s Office facilitated a Consent Decree to allow members limited and temporary access to UPMC in certain circumstances, through June 30, 2019. The specific terms of coverage will be according to the member’s benefit plan and covered claims from UPMC providers may process at a lower level of benefits in certain plans.

Oncology/cancer services Members who have been diagnosed with cancer have in-network access to all UPMC services, facilities, doctors, and joint ventures for oncology covered services through June 2019. (When the member’s physician in consultation with the member has determined that the member should be treated by a UPMC oncology provider.) This also includes care for any illnesses/complications resulting from cancer treatment such as endocrinology, orthopedics, and cardiology.

Highmark members in the Community Blue Flex and Connect Blue products can access UPMC facilities on an in- network basis at the standard level of benefits for cancer services.

ER access Members who seek care at any UPMC emergency room will be covered at in-network rates, at the highest level of benefits, including any inpatient admission through discharge. After discharge, patients may choose to receive any related follow-up care for up to 90 days at UPMC, which will be covered at the lower level of benefits.

Access for seniors Highmark members (excluding Community Blue Medicare Advantage HMO) who are age 65 or older, and covered by or eligible for Medicare, will have access to most UPMC providers on an in-network benefit level through June 2019. This in-network access also applies to CHIP and Medicaid members.

Continuation of care Members who were in a continuing course of treatment for a chronic or persistent condition in 2013, 2014, or 2015 (through 6/30/2016 at UPMC Mercy) with a UPMC provider or an independent provider and received care for that condition at UPMC can continue to receive care from the same provider at the in-network level of benefits through June 2019 if the care is for that chronic or persistent condition. Routine, preventive, and acute care that is received during such a visit for treatment of your chronic or persistent condition will also be at the in-network level of benefits. Otherwise, routine, preventive, and acute care will not be covered on an in-network basis. You cannot be referred to or treated by a new UPMC doctor on an in-network basis for care related to your chronic or persistent condition or other conditions you might have or develop.

When Highmark members in the Community Blue Flex and Connect Blue products access UPMC facilities for continuation of care, such care will be covered at the lower level of benefits.

Balance billing protection Out-of-network UPMC providers can only balance bill Highmark members up to the difference between the plan’s payment and 60 percent of the UPMC provider’s billed charges for covered services. Temporary in-network access to UPMC physicians includes: • All UPMC physicians outside the five-county Greater Pittsburgh area (Allegheny, Beaver, Butler, Washington, Westmoreland) • All UPMC physicians when they are practicing at any of the UPMC hospitals that continue to be in-network or at community hospitals • All UPMC oncology providers • All UPMC pediatricians at in-network facilities • All UPMC behavioral health providers at in-network facilities

Temporary in-network access to UPMC facilities (includes the physicians who practice there)

UPMC Facility Contract Expires Western Psychiatric Institute and Clinic 6/30/2019 Hillman Cancer Center 6/30/2019 UPMC Altoona 6/30/2019 UPMC Bedford 6/30/2019 UPMC Hamot and its affiliate Kane Community Hospital 6/30/2019 UPMC Horizon 6/30/2019 UPMC Northwest 6/30/2019 UPMC Jameson 6/30/2021 In-network access to Children’s Hospital of Pittsburgh of UPMC and their physicians will continue until 6/30/2022.

The specific terms of coverage will be according to your benefit plan.

Highmark Blue Cross Blue Shield and the Highmark Caring Foundation are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross Blue Shield Plans. Blue Whale Big, Blue Skies, True Blue, and Strong BluePrint are service marks of the Blue Cross and Blue Shield Association. Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. A Local Blue Plan may require additional criteria for facilities located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable health care. Each facility’s cost of care is evaluated using data from its Local Blue Plan. Facilities in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on www.bcbs.com. Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers. MyChart is a registered trademark of Epic Systems Corporation.

Discrimination is Against the Law The Claims Administrator/Insurer complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex, including sex stereotypes and gender identity. The Claims Administrator/Insurer does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex assigned at birth, gender identity or recorded gender. Furthermore, the Claims Administrator/Insurer will not deny or limit coverage to any health service based on the fact that an individual’s sex assigned at birth, gender identity, or recorded gender is different from the one to which such health service is ordinarily available. The Claims Administrator/Insurer will not deny or limit coverage for a specific health service related to gender transition if such denial or limitation results in discriminating against a transgender individual. The Claims Administrator/Insurer: • Provides free aids and services to people with disabilities to communicate effectively with us, such as: –– Qualified sign language interpreters –– Written information in other formats (large print, audio, accessible electronic formats, other formats) • Provides free language services to people whose primary language is not English, such as: –– Qualified interpreters –– Information written in other languages If you need these services, contact the Civil Rights Coordinator. If you believe that the Claims Administrator/Insurer has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, including sex stereotypes and gender identity, you can file a grievance with: Civil Rights Coordinator, P.O. Box 22492, Pittsburgh, PA 15222, Phone: 1-866-286-8295, TTY: 711, Fax: 412-544-2475, email: [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/ lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Nation’s largest network • Comprehensive benefits No referrals needed • 24/7 nurse help line And so much more! 27626 10/17 CS209304 27626