Advocate Health Partners

CONTRACT SUMMARY (Chicago PHOs) Risk Contract PLAN NAME/PRODUCT NAME/PLAN TYPE Managed by KEY OPERATIONAL ITEMS APP* Advocate Meridian Health Plan of Illinois Referrals and Claims managed/paid by Medicaid HMO Meridian Aetna Referrals and Claims managed/paid by Aetna Aetna HMO/POS/EPO/PPO Aetna Open Choice PPO Aetna Whole Health will no longer be offering Aetna Choice POS the Individual Market Place Product as of Aetna Choice POS II 1/1/2017. Aetna Whole Health products will Aetna HMO continue to be offered to Employers Groups Aetna QPOS (Self and Fully Insured) until 12/31/2018. Aetna Select Open Access Aetna Select State of Illinois = SOI Aetna Open Access HMO Aetna Elect Choice HMO (includes Aetna Health Funds) Aetna Open Access Elect Choice (includes Aetna Health Funds) Aetna Health Network Only Aetna Health Network Option Aetna Open Choice PPO – State of Illinois-SOI Aetna HMO (Formerly Coventry HMO) - SOI Aetna Choice POS II (Formerly Coventry OAP)-SOI Managed Choice POS Managed Choice Open Access PPO National Advantage Program (NAP) PPO Signature Authority (ASA or SRC) PPO Aetna Whole Health Beech Street / PPO Next PPO Only PPO products included in this agreement *Risk Managed by APP indicates when claims are paid by Advocate Physician Partners and when referrals are submitted through ERMA 1 Updated 1/1/2018 CONTRACT SUMMARY (Chicago PHOs) Risk Contract PLAN NAME/PRODUCT NAME/PLAN TYPE Managed by KEY OPERATIONAL ITEMS APP* Blue Cross Blue Shield Illinois Claims and Referrals are paid/managed by BlueCare Direct HMO APP Blue Precision HMO Must use ACL Labs for services Blue Advantage HMO X HMO Illinois Blue Medicare Advantage Basic HMO Blue Medicare Advantage Basic Plus HMO-POS Blue Medicare Advantage Premier Plus HMO-POS Blue Cross Medicare Advantage PPO Choice Plus PPO Claims are paid by BCBS Illinois Choice Premier PPO Blue Cross Community MMAI HMO (Medicare-Medicaid) Claims are paid by BCBS Illinois Referrals and Claims managed/paid by Cigna Advocate Physician Partners does not Cigna participate in the Cigna Local Plus Network or Cigna HMO / Network Cigna Connect Cigna PPO Cigna Choice Fund PPO/EPO Open Access Plus/Choice Fund OA Plus POS Cigna C5 PPO Claims are paid by Coventry Health Plans First Health EPO & PPO Cofinity PPO Coventry HMO & PPO *Risk Managed by APP indicates when claims are paid by Advocate Physician Partners and when referrals are submitted through ERMA 2 Updated 1/1/2018 CONTRACT SUMMARY (Chicago PHOs) Risk Contract PLAN NAME/PRODUCT NAME/PLAN TYPE Managed by KEY OPERATIONAL ITEMS APP* HealthLink / Unicare PPO HFN HFN Total Care PPO HFN PPO & EPO HFN Platinum EPO HST Care Connect Humana Claims and Referrals are paid/managed by Humana Select HMO APP Humana Platinum HMO X Must use ACL Labs for services Humana Advocate Centered HMO Plan Humana Claims are paid by Humana Humana PPO Humana Preferred PPO POS-Open Access Humana ICCN HMO is Advocate Only Humana Advocate Centered EPO Plan Network Humana Choice POS Humana ChoiceCare/National PPO Humana National EPO/HMO/POS-Open Access Humana Premier HMO Humana Illinois CCN HMO Humana Medicare Advantage Plans Humana Gold Plus – HMO Humana Medicare Advantage plans are not HumanaChoice – PPO an Advocate only network Humana Gold Choice – Private Fee-for-service (PFFS) 3 *Risk Managed by APP indicates when claims are paid by Advocate Physician Partners and when referrals are submitted through ERMA Updated 1/1/2018 CONTRACT SUMMARY (Chicago PHOs) Risk Contract PLAN NAME/PRODUCT NAME/PLAN TYPE Managed by KEY OPERATIONAL ITEMS APP* PHCS & MultiPlan Inc. PPO Private Healthcare Systems (PHCS) PPO PHCS Savility PPO MultiPlan Inc. PPO SEIU – Local 4 HMO & PPO Union Medical (Local 1546) HMO Union Medical Referrals are managed by the Union Medical Primary Care Clinic All APP Specialists can receive referrals from Union Medical Primary Care Clinic United Healthcare Claims are paid by United Healthcare United Healthcare/Choice Plus/Select Plus POS United Healthcare Choice Select HMO United Healthcare Charter HMO is Advocate United Healthcare Core PPO only network United Healthcare Options PPO Railroad Employees Plan is a UHC Choice United Healthcare Navigate HMO & POS Plus Product Network/Claims are paid by United Healthcare HDHP Definity Basics PPO United Healthcare United Healthcare Medicare Advantage Medicare Solutions PPO/Group Retirees United Healthcare Charter HMO United Healthcare NexusACO R and NexusACO OA Railroad Employees National Health & Welfare Plan In-Network for United Healthcare Affiliate: Harken Health ChoicePlus *Risk Managed by APP indicates when claims are paid by Advocate Physician Partners and when referrals are submitted through ERMA 4 Updated 1/1/2018 CONTRACT SUMMARY (Chicago PHOs) Risk Contract PLAN NAME/PRODUCT NAME/PLAN TYPE Managed by KEY OPERATIONAL ITEMS APP* United Healthcare Claims and referrals are paid/managed by AARP Medicare Complete HMO APP AARP Medicare Complete ACCESS HMO Must use ACL Labs for services AARP Medicare Complete Plan 1 HMO X AARP Medicare Complete Plan 2 HMO EXCEPTION: If ID card does not include the Advocate Health logo then claims are billed to UHC address on the ID card *Risk Managed by APP indicates when claims are paid by Advocate Physician Partners and when referrals are submitted through ERMA 5 Updated 1/1/2018 .

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