Regional Rate and Plan Information

Helping Customers Better Understand Their Enrollment Options

September, 2014

Regional Data Sheets (9-3-14) Helping Customers Better Understand Their Enrollment Options

As new and current Covered California enrollees engage in the fall 2014 enrollment process (for coverage effective in 2015), you will be receiving questions in a number of areas.

This document will help you address common questions so you can provide high levels of service as quickly and accurately as possible. This package include two sections:

1) Help in Making the Most of Your Coverage

This offers several helpful hints you should share with new or renewing enrollees to make using their chosen plan easier. It covers points on how to prepare for a visit, what ID to bring, and what general information to know about their plan and the benefits. A brief review of this narrative is important to share with all exchange enrollees. It will be available separately from this package to provide directly to enrollees.

2) Quick Fact Sheets – One Per Region

These quick reference guides are designed to provide you with rapid insight into the dynamics of each region including rates, subsidies, alternative plans and relative cost positions, and helpful regional observations. We encourage you to understand this regional information as you and the customer determine what may be best for their specific situation.

On pages 3 and 4 of this package is a sample Quick Fact Sheet that highlights key information available and how to explain it to the enrollee.

Regional Data Sheets (9-3-14) 1 1) Help in Making the Most of Your Coverage* Help in making the most of your Coverage

Being informed and educated about your benefits with some back-up supporting information will go a long way. All health insurance benefit plans now share some common characteristics. The Affordable Care Act requires When you are sick, one of the last things you want to have happen is confusion at the doctor's office about what that all health insurance plans offered to individuals must provide a comprehensive package of items and you have to pay. The two most common areas for helping your visit go smoother are: 1) knowing the plan you services, known as essential health benefits. These benefits fit into the following 10 categories: are on; 2) confirming your provider is part of the plan you have chosen, and; 3) having a good understanding of · Ambulatory patient services your plans covered benefits. · Emergency services. · Hospitalization. · Maternity and newborn care. Keep your Health Plan ID card with you at all times · Mental health and substance use disorder services, including behavioral health treatment. As a minimum, when both making an appointment or when at the doctor seeking care, make sure you have your · Prescription drugs. health plan benefit card with you and proper photo ID. This will help remind you of important coverage · Rehabilitative and habilitative services and devices. information when making an appointment, while at the provider's location, informing office staff of the plan you · Laboratory services. are on, and confirming for office staff you are the right person who should receive the insurance coverage · Preventive and wellness services and chronic disease management. benefits. · Pediatric services, including dental and vision care.

Another big advantage of keeping a summary of benefits handy is Verify the provider is available under your selected coverage Tip: If there is a question about services while you are at the doctor's office, have to better understand services available when you aren't sick. This First, it is good practice to understand a bit about the provider network you have available with your coverage. the office staff call your insurance carrier is because you can better be in position to make use of services This can help you and your doctor better know and ensure services you may need are covered at the right then and there to both verify the such as preventative check-ups that have no added cost to you appropriate benefit level. The provider network you have with your plan is identified on your health plan ID provider participation in the plan you have and more importantly, can help you stay healthy. card. This is typically called out as an HMO, PPO, or EPO plan. Each of these corresponds to a list of providers and to verify service coverage level. Doing offered by your health plan that are available to you as part of this may take more time while at the As we move into coverage requirements that are part of the ACA, Tip: If you see the doctor on the website the benefits of your plan. Knowing this is something to learn office and for your appointment, but many people still do not know about what is covered under their remember even the doctors and hospitals but when you get to the doctor's office about at the time you sign-up for your plan and can be of help plan. Additional information about the essential health benefits, are adjusting to the new rules under the the doctor says he/she is not in the when you need to make financial decisions about treatment. including preventive services, can be found on the ACA. So there may just be an honest network, it is best to have office staff call CoveredCalifornia web site at: misunderstanding. https://www.coveredca.com/coverage-basics/ the carrier while you are still at the Prior to making an appointment, go to your carrier's web site and

doctor's office to verify what is actually look up your provider (doctor, hospital, etc.). Doing this can help

correct. provide you with verification at that point in time your provider participates in your chosen plan's provider network. Some comments about planning ahead for your coverage renewal In choosing a plan it's important to consider how often and what types of health care needs you may have. It's

also worthwhile to consider if you have an on-going relationship with a provider and how important (or not) it Understand your coverage benefits may be for you to maintain the doctor as being available. Knowing more about how you actually utilized the It is important to review and understand the benefits of the Tip: Keeping a folded up copy of your plan coverage in the previous year can help you decide if plan changes make sense. Generally speaking, a person plan you have selected. A good way to do this is to keep a benefits may not be entirely practical - although it who utilizes their benefits a lot may find it advantageous to pay more in monthly premium for plans that come copy of your benefits summary handy as you seek services. is a good idea to keep a copy in your car glove with higher benefit levels. While the monthly premium payments may be higher, costs for services may be This information can be found online at coveredca.gov or from box. This said, at least know the website address lower than with other benefit plans and thus over the course of a year will be the most cost effective. your health plan directly. This information will not only help to access what your benefits are is on your plan ID determine the correct level of benefit for the most immediate card. While both CoveredCA and the health plans services you seek, but in the event of continuing treatment, it work to make information more quickly found, the can also work to help ensure the next steps for services are truth is there is a very large amount of covered to the full extent of your plan. Having this information information on these websites. As such, it is a with you can help ensure you are only charged for what you good idea for you to have gone into the website * Available as separate handout for distribution to enrollees should be. And making sure services are rendered fairly is ahead of time and do a "test run" of its navigation important to both you and the provider. so you can find information easier when needed.

Regional Data Sheets (9-3-14) 2 You will note the majority of enrollees in all 2) Quick Fact Sheet: Sample Region regions receive a subsidy. Thus, considering This can help indicate what plans post subsidy cost is usually important. may generate the most rate Region Generalizations (Individual circumstance will vary) complaints. Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases

3.8% 85% Silver – Blue Shield Coin PPO: 6%

In this example, the rates and the subsidies increased with a net effect that the post subsidy cost is going up. Regions will vary on this dynamic. Knowing what is happening in general for a region can help set context for discussions/decisions.

Rate increases by carrier combined with percentage of enrollment the carrier has can help you Rate Change For Consumers Who Stay With Current Plan know where most questions may come from and help indicate where to look for coverage options. % of Enrollment in Weighted Average Rate Increase Carriers Range of % Rate Change from 2014 Region Before Subsidy Carrier A PPO Look for carriers who have 7.6% 6.6% 6% to 9% Range will help the largest enrollments in indicate rate changes across Carrier B PPO the region. This can help 38.8% 6.0% 6% identify where you may all metal tiers. Carrier C EPO receive the most questions. 2.0% 7.2% 6% to 9%

Sample of Contracted Hospitals ** Carrier A PPO Carrier B PPO Carrier C EPO Inland Medical Center X X X Jackson Medical Center X X X Doctors Medical Center X X X Area Medical Center X X Designed to provide a quick overview of which carriers are associated with regional hospitals. A sample (not necessarily all) of hospitals in the region is provided with carrier network affiliation. The hospitals shown are generally selected based on those with the largest bed count and listed in alphabetical order. Note Kaiser hospitals are not listed as they are exclusive to Kaiser. ** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selectio n.Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or v isit the carrier website.

Regional Data Sheets (9-3-14) 3 Shows, for the Silver tier, Carrier A is less 2) Quick Fact Sheet: Sample Region expensive than Carrier C. This can help to This chart will show how carriers at each tier are priced in relation to each other. highlight shopping options. Also, noted as nd Some examples of what this can show you and your client are demonstrated below. the 2 lowest cost silver, Carrier A is the Relative Carrier Rate Positions Note these are examples and circumstances will change by region. base plan for determining subsidy amount. Metal Level Lowest 2nd 3rd Many people may be attracted to the lower monthly premium of a Bronze Carrier A Carrier B Carrier C plan. Depending on needs, Bronze Copay PPO Coin PPO Coin EPO Bronze may or may not be the best option for them. Be sure Carrier B Carrier A Carrier C to discuss the option of the Silver Coin PPO Copay PPO Coin EPO Silver or other tiers to help best meet needs. This is Carrier B Carrier A Carrier C especially true if the person is Gold Coin PPO Copay PPO Coin EPO eligible for Enhanced Silver coverage. Carrier A Carrier B Carrier C Platinum Copay PPO Coin PPO Coin EPO Carrier A’s network is likely different than Carrier B’s. Thus, Be aware of the difference between an EPO and PPO customers may have to switch doctors if they switch carriers. plan – specifically for out-of-network benefits. Rate and Plan Observations • Enrollees in Carrier B EPO will now have access to Carrier B PPO network. • Individuals who are currently enrolled in Carrier C should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits. • Carrier D is no longer available in the Market Place. Enrollees previously in this plan will need to make a new selection.

In these two sections are noted any plan changes or pricing differences with suggestions for options to consider. It’s important to note all usage of these comments should be considered in relation Additional Rate Observations for those receiving subsidies to the individual’s circumstance.

• Subsidies in 2015 will be about the same as 2014. • Carrier A and Carrier B will generally be the lowest option after subsidies are applied.

Regional Data Sheets (9-3-14) 4 2) Quick Fact Sheets - Index

Region Region Region Name Page # Region Name Page # # # San Joaquin, Merced, State State-wide Overview 6 10 26 Tulare 1 Northern California 8 11 Fresno, Kings, Madera 28 Napa, Sonoma, Marin, 2 10 Solano 12 Santa Barbara 30 Sacramento, Yolo, Placer, 3 12 13 Imperial, Mono, Inyo 32 El Dorado

4 San Francisco 14 14 Kern 34

5 Contra Costa 16 15 Los Angeles - E 36

6 Alameda 18 16 Los Angeles - W 40

7 Santa Clara 20 17 San Bernardino, Riverside 44

8 San Mateo 22 18 Orange 47

9 Santa Cruz, Monterey 24 19 San Diego 50

Regional Data Sheets (9-3-14) 5 Quick Fact Sheet: California Statewide Statewide Generalizations (Regional and individual circumstance will vary) Rate Change Change in APTC Post-Subsidy Cost Percent of Enrollees Additional Consideration: Rates go up each year based on age. Across State * Subsidy Amount to Enrollee Receiving APTC Subsidy In general, rates will go up by the following amounts:

88% People under 40: $5-10/month 4.2% Slightly Unchanged People over 40: $10-25/month

Rate Change For Consumers Who Stay With Current Plan

Carriers Average Rate Change Range of % Rate (All plans are not available in all areas) Before Subsidy * Change from 2014 Percent of All Enrollees and their Rate Change Anthem Blue Cross of California 4.6% -3.3% to 19.2% Blue Shield of California 6.0% 6.0% 13% Chinese Community Health Plan 8.9% 8.5% to 9.8% Increase of >8% Health Net 5.0% -0.2% to 9.6% 36% Kaiser Permanente -1.5% -13.7% to 2.2% 16% Increase of L.A. Care Health Plan 11.4% 3.7% to 15.6% Decrease 5%-8% to 0% Molina Healthcare 2.9% -2.0% to 4.0% Sharp Health Plan 4.4% 2.7% to 7.2% Valley Health Plan 0.4% -0.3% to 3.4% 35% Western Health Advantage 1.1% -7.0% to 4.1% Increase of <5% * Averages are weighted based on enrollment.

Note: Provider and hospital availability may vary by carrier and carrier plan type. It is advised to confirm provider and h ospital availability with carrier prior to enrollment selection. For more detailed network information, please contact carrier or visit the carrier website.

Regional Data Sheets (9-3-14) 6 Quick Fact Sheet: California Statewide

Regional Data Sheets (9-3-14) 7 Quick Fact Sheet: Region 1 - Northern California Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Anthem Coin PPO: 5% 4.8% Slightly 91% Silver – Blue Shield Coin EPO: 6%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Increase Carriers Range of % Rate Change from 2014 Region Before Subsidy Anthem PPO 90.8% 4.6% 4% to 8% Blue Shield * EPO 8.6% 6.0% 6% Kaiser Permanente * HMO 0.6% 1.6% -4% to 2% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield EPO Enloe Medical Center Esplanade X X Mercy Medical Center Redding X X Oroville Hospital X X Rideout Memorial Hospital X Shasta Regional Medical Center X Sierra Nevada Memorial Hospital X X Sonora Regional Medical Center X X St. Joseph Hospital - Eureka X X Ukiah Valley Medical Center X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selectio n. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or v isit the carrier website.

Regional Data Sheets (9-3-14) 8 Quick Fact Sheet: Region 1 - Northern California Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd

Anthem Kaiser Blue Shield Bronze Coin PPO Copay HMO Coin EPO Anthem Blue Shield Kaiser Silver Coin PPO Coin EPO Copay HMO

Anthem Blue Shield Kaiser Gold Coin PPO Coin EPO Copay HMO

Blue Shield Kaiser Anthem Platinum Coin EPO Copay HMO Coin PPO

Rate and Plan Observations • Anthem generally has the lowest rates – except in the Platinum Tier, where Blue Shield is lowest. • Depending on area, Kaiser may have limited coverage. As such, it may not be an alternative for some. • Not much of an opportunity to shop for lower rates, as Anthem has both the majority of the enrollees and the lowest rates.

Additional Rate Observations for those receiving subsidies

• Post-subsidy monthly premium for most renewals will be less in 2015 than it was in 2014 • A few Blue Shield enrollees will see small increases – a few dollars per month • Blue Shield and Kaiser members can move to Anthem and generally save a few premium dollars

Regional Data Sheets (9-3-14) 9 Quick Fact Sheet: Region 2 – North Bay Counties Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze - Anthem Coin PPO: 11% 5.4% 87% Silver - Anthem Coin PPO: 10%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Increase Carriers Range of % Rate Change from 2014 Region Before Subsidy Anthem PPO 33.3% 10.2% 10% to 13% Blue Shield* EPO 16.7% 6.0% 6% Health Net EPO 3.4% 7.2% 6% to 9% Kaiser* HMO 41.8% 1.7% -4% to 2% Western Health Advantage* HMO 4.9% 2.8% -3% to 4% *Plan not available in all areas.

Western Health Advantage Sample of Contracted Hospitals ** Anthem PPO Blue Shield EPO Health Net EPO HMO

Healdsburg District Hospital X X X X Marin General Hospital X X X X NorthBay Medical Center X X X Petaluma Valley Hospital X X X X Santa Rosa Memorial Hospital X X X X Sutter Medical Center of Santa Rosa X ** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact ca rrier or visit the carrier website.

Regional Data Sheets (9-3-14) 10 Quick Fact Sheet: Region 2- North Bay Counties Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th 5th

Western Kaiser Anthem Blue Shield Health Net Bronze Copay HMO Copay HMO Coin PPO Coin EPO Coin EPO Western Blue Shield Kaiser Anthem Health Net Silver Copay HMO Coin EPO Copay HMO Coin PPO Coin EPO Blue Shield Western Kaiser Anthem Health Net Gold Coin EPO Copay HMO Copay HMO Coin PPO Coin EPO

Western Kaiser Blue Shield Anthem Health Net Platinum Copay EPO Copay HMO Coin EPO Coin PPO Coin EPO

Rate and Plan Observations • About one-third of the consumers in this region will increases of around 5%. Should these enrollees want to look at other carrier options, typically the ones to look at will be Kaiser Permanente, Blue Shield, or Western Health Advantage. • Blue Shield EPO consumers will now have access to providers in Blue Shield PPO. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• Almost all enrollees who receive APTC will see price reductions in their current plan. • Post-subsidy monthly premium for most renewals will be less in 2015 than it was in 2014. This said, about a third of people will see an increase.

Regional Data Sheets (9-3-14) 11 Quick Fact Sheet: Region 3 – Sacramento, El Dorado, Placer, Yolo

Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Anthem Coin PPO: 5% 3.7 % 90% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan

Carriers % of Enrollment in Region Weighted Average Rate Increase Before Subsidy Range of % Rate Change from 2014 Anthem PPO 35.8% 4.3% 4% to 7% Anthem* HMO 0.1% 16.7% 15% to 19% Blue Shield * PPO 25.1% 6.0% 6% Kaiser Permanente * HMO 36.9% 1.7% -4% to 2% Western Health Advantage* HMO 2.1% -1.8% 0.7% to 4% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Anthem HMO Blue Shield PPO Western Health Advantage Mercy General Hospital X X X X Mercy Hospital of Folsom X X X X Mercy San Juan Medical Center X X X X Methodist Hospital of Sacramento X X X X Sutter Medical Center Sacramento – Sutter Memorial X X Sutter Roseville Medical Center X UC Davis Medical Center X X X Woodland Healthcare X X

Regional Data Sheets (9-3-14) 12 Quick Fact Sheet: Region 3 – Sacramento, El Dorado, Placer, Yolo Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th 5th Western Health Anthem Kaiser Blue Shield Advantage Bronze Coin PPO HMO Coin PPO HMO Western Health Anthem Kaiser Blue Shield Anthem Advantage Silver Coin PPO HMO Coin PPO Copay HMO HMO Western Health Blue Shield Anthem Kaiser Anthem Advantage Gold Coin PPO Coin PPO Copay HMO Copay HMO HMO Western Health Kaiser Blue Shield Anthem Anthem Advantage Platinum HMO Coin PPO Coin PPO Copay HMO HMO Rate and Plan Observations • The majority of enrollees will experience a 2-6% rate increase. Opportunity to shop is somewhat limited given premiums for the plans most of the enrollment is in are relatively close in cost.

Additional Rate Observations for those receiving subsidies

• Subsidy amounts are increased compared to 2014. • Those in Anthem PPO, Kaiser, or with Western Health Advantage will generally see their post subsidy costs go down.

Regional Data Sheets (9-3-14) 13 Quick Fact Sheet: Region 4 – San Francisco

Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Anthem Coin EPO: 11% 6.6% 82% Silver – Chinese Copay HMO: 8% Silver- Anthem Coin EPO: 10%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy Anthem* EPO 17.7% 10.9% 10% to 14% Blue Shield EPO 22.4% 6.0% 6% Chinese Community Health Plan 28.4% 8.9% 8% to 10% Health Net EPO 5.6% 7.4% 6% to 9% Kaiser Permanente HMO 25.9% 1.6% -4% to 2% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem EPO Blue Shield PPO Health Net EPO Chinese Community California Pacific Medical Center - California Campus X California Pacific Medical Center – Pacific Campus X Chinese Hospital X X X St. Francis Memorial Hospital X X St. Mary’s Medical Center – San Francisco X X X UCSF Medical Center – Moffitt/Long X X X UCSF Medical Center - Mt. Zion X

Regional Data Sheets (9-3-14) 14 Quick Fact Sheet: Region 4 – San Francisco Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th 5th

Chinese Community Kaiser Anthem Health Net Blue Shield Bronze Copay HMO Copay HMO Coin EPO Coin EPO Coin PPO Chinese Community Kaiser Blue Shield Anthem Health Net Silver Copay HMO Copay HMO Coin PPO Coin EPO Coin EPO

Blue Shield Chinese Community Kaiser Anthem Health Net Gold Coin PPO Copay HMO Copay HMO Coin EPO Coin EPO

Kaiser Chinese Community Blue Shield Anthem Health Net Platinum Copay HMO Copay HMO Coin PPO Coin EPO Coin EPO

Rate and Plan Observations • Chinese Community has the lowest cost Bronze in 2015. • Kaiser has had a rate reduction for 2015. • With changes to rates and a relatively large number of plan offerings. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• In general, federal subsidy available to consumers in the region will increase in 2015.

Regional Data Sheets (9-3-14) 15 Quick Fact Sheet: Region 5 – Contra Costa

3.8% 85% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Increase Carriers Range of % Rate Change from 2014 Region Before Subsidy Anthem PPO 7.6% 6.6% 6% to 9% Blue Shield PPO 38.8% 6.0% 6% Health Net EPO 2.0% 7.2% 6% to 9% Kaiser Permanente HMO 51.7% 1.7% -4% to 2%

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO Health Net EPO Doctors Medical Center – San Pablo X X X John Muir Medical Center – Concord Campus X X X John Muir Medical Center – Walnut Creek Campus X X X San Ramon Regional Medical Center X X X Sutter Delta Medical Center X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selectio n.Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or visit the carrier website.

Regional Data Sheets (9-3-14) 16 Quick Fact Sheet: Region 5 – Contra Costa Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th

Kaiser Blue Shield Anthem Health Net Bronze Copay HMO Coin PPO Coin PPO Coin EPO Blue Shield Kaiser Anthem Health Net Silver Coin PPO Copay HMO Coin PPO Coin EPO

Blue Shield Kaiser Anthem Health Net Gold Coin PPO Copay HMO Coin PPO Coin EPO

Kaiser Blue Shield Anthem Health Net Platinum Copay HMO Coin PPO Coin PPO Coin EPO

Rate and Plan Observations • Enrollees in Blue Shield EPO will now have access to Blue Shields PPO network. • Kaiser has over 50% of the enrollment. • In general, the federal subsidy available to consumers in the region will increase for 2015. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits. • Contra Costa has withdrawn from the Market Place. Enrollees previously in this plan will need to make a new selection.

Additional Rate Observations for those receiving subsidies

• Subsidies in 2015 will be about the same as 2014. • Blue Shield and Kaiser will generally be the lowest option after subsidies are applied.

Regional Data Sheets (9-3-14) 17 Quick Fact Sheet: Region 6 – Alameda County

Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Anthem Coin PPO: 5% 2.8% 85% Silver – Blue Shield Coin EPO: 6%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Increase Carriers Range of % Rate Change from 2014 Region Before Subsidy Anthem PPO 29.9% 5.2% 4% to 8% Blue Shield * EPO 29.2% 6.0% 6% Kaiser Permanente HMO 40.9% -0.9% -7% to -1% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield EPO Alameda Hospital X X Alta Bates Summit Medical Center – Alta Bates Campus X Alta Bates Summit Medical Center – Summit Campus (Hawthorne) X Children's Hospital and Research Center at Oakland X Eden Medical Center X St. Rose Hospital X ValleyCare Health System X X Washington Hospital Healthcare System X

Regional Data Sheets (9-3-14) 18 Quick Fact Sheet: Region 6 – Alameda County Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd

Kaiser Blue Shield Anthem Bronze Copay HMO Coin EPO Coin PPO Blue Shield Kaiser Anthem Silver Coin EPO Copay HMO Coin PPO

Blue Shield Kaiser Anthem Gold Coin EPO Copay HMO Coin PPO

Blue Shield Kaiser Anthem Platinum Coin EPO Copay HMO Coin PPO

Rate and Plan Observations • Blue Shield generally has the lowest rates – except in the Bronze Tier, where Kaiser is lowest. • Depending on area, Blue Shield may have limited coverage. As such, it may not be an alternative for some. • There is an opportunity to shop for lower rates, as Kaiser has the majority of the enrollees but Blue Shield has the lower rates. • Blue Shield EPO will now have access to the Blue Shield PPO Networks.

Additional Rate Observations for those receiving subsidies • APTC will go up slightly or stay close to same as in 2014. • After subsidy is applied, Blue Shield generally will be the lowest cost plan.

Regional Data Sheets (9-3-14) 19 Quick Fact Sheet: Region 7 – Santa Clara Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Silver – Anthem Copay HMO: 6% 1.0% 82% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy Anthem PPO 56.1% 1.5% 1% to 4% Anthem HMO* 4.7% 6.4% 6% to 10% Blue Shield PPO 10.7% 6.0% 6% Health Net EPO 4.5% 7.5% 6% to 9% Kaiser Permanente HMO* 21.0% -5.6% -11% to -5% Valley Health HMO 2.9% 0.4% 0% to 3% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Anthem HMO Blue Shield PPO Health Net EPO Valley Health HMO El Camino Hospital (and El Camino Los Gatos) X X X X Good Samaritan Hospital - San Jose X X X X Lucile Packard Children’s Hospital X X X O'Connor Hospital X X X X Regional Medical Center of San Jose X X X X Santa Clara Valley Medical Center X X X X X St. Louise Regional Hospital X X X X X Stanford Hospital and Clinics X X X X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or visit the carrier website.

Regional Data Sheets (9-3-14) 20 Quick Fact Sheet: Region 7 – Santa Clara Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd 4th 5th 6th Anthem Valley Kaiser HealthNet Blue Shield Bronze Coin PPO Copay HMO Copay HMO Coin EPO Coin PPO

Anthem Valley Kaiser Anthem Blue Shield HealthNet Silver Coin PPO Copay HMO Copay HMO Copay HMO Coin PPO Coin EPO

Valley Anthem Kaiser Blue Shield Anthem HealthNet Gold Copay HMO Coin PPO Copay HMO Coin PPO Copay HMO Coin EPO Anthem HealthNet Kaiser Valley Anthem Blue Shield Copay HMO Coin EPO Platinum Copay HMO Copay HMO Coin PPO Coin PPO

Rate and Plan Observations • Kaiser enrollees will see an actual decrease in rates in this region. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• Post-subsidy monthly premium for most renewals will be less in 2015 than it was in 2014. Most consumers who receive subsidies will have lower total costs for next year. • Blue Shield and Health Net enrollees may benefit from shopping other offerings in their tier.

Regional Data Sheets (9-3-14) 21 Quick Fact Sheet: Region 8 – San Mateo Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Silver – Chinese C. Copay HMO: 8% 3.7% 82% Slightly Silver – Blue Shield- Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy Anthem PPO 16.2% 1.5% 1% to 4% Blue Shield PPO 22.8% 6.0% 6% Chinese Community Health Plan HMO 10.3% 8.9% 8% to 10% Health Net EPO 4.6% 7.5% 6% to 9% Kaiser Permanente HMO* 46.1% 1.7% -4% to 2% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO Health Net EPO Chinese Community Health Plan HMO Menlo Park Surgical Hospital X Mills-Peninsula Health Services X X Sequoia Hospital X X X Seton Medical Center X X X X

Regional Data Sheets (9-3-14) 22 Quick Fact Sheet: Region 8 – San Mateo Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd 4th 5th

Chinese C. Kaiser Anthem HealthNet Blue Shield Bronze Copay HMO Copay HMO Coin PPO Coin EPO Coin PPO

Chinese C. Kaiser Anthem Blue Shield HealthNet Silver Copay HMO Copay HMO Coin PPO Coin PPO Coin EPO

Kaiser Anthem Blue Shield Chinese C. HealthNet Gold Copay HMO Coin PPO Coin PPO Copay HMO Coin EPO

Kaiser Blue Shield Chinese C. Anthem HealthNet Platinum Copay HMO Coin PPO Copay HMO Coin PPO Coin EPO

Rate and Plan Observations • Consumers in Blue Shield, HealthNet, and Anthem may have opportunity to shop. • Consumers in Chinese Community Health Plan will see increases, however are still in the lowest cost plan offered. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• After subsidy is applied, those in Blue Shield and HealthNet may benefit from shopping other plans

Regional Data Sheets (9-3-14) 23 Quick Fact Sheet: Region 9 – Monterey, San Benito and Santa Cruz Counties Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Blue Shield- Coin EPO: 6% 2.9 % 87% Bronze – HealthNet- Coin EPO: 9% Silver – Blue Shield- Coin EPO: 6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy Anthem PPO 62.1% 0.9% 0% to 4% Blue Shield EPO* 29.7% 6.0% 6% Health Net EPO* 8.2% 7.1% 6% to 9% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield EPO Health Net EPO Community Hospital of the Monterey Peninsula X Dominican Santa Cruz Hospital X X X George L. Mee Memorial Hospital(Southern Monterey County Hosp) X Hazel Hawkins Memorial Hospital X X Natividad Medical Center X Salinas Valley Memorial Healthcare System X Sutter Maternity and Surgery Center of Santa Cruz X Watsonville Community Hospital X X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or visit the carrier website.

Regional Data Sheets (9-3-14) 24 Quick Fact Sheet: Region 9 – Monterey, San Benito and Santa Cruz Counties Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd Anthem Blue Shield HealthNet Coin EPO Bronze Coin PPO Coin EPO

Blue Shield Anthem HealthNet Coin EPO Silver Coin EPO Coin PPO

Blue Shield Anthem HealthNet Coin EPO Gold Coin EPO Coin PPO

Blue Shield Anthem HealthNet Coin EPO Platinum Coin EPO Coin PPO

Rate and Plan Observations

• Rates for most Anthem enrollees will be close to flat. • Blue Shield and HealthNet may not be available to some in this region. Thus Anthem will be the only option available. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• In general, the federal subsidies available to consumers in 2015 in this region will be very similar to the amount in 2014. • Anthem and will see minimal change in cost. HealthNet enrollees have option to buy down. Blue Shield enrollees in silver tier will already be at the lowest cost.

Regional Data Sheets (9-3-14) 25 Quick Fact Sheet: Region 10 - Central California (Stanislaus, Merced, San Joaquin and Tulare Counties) Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Blue Shield Coin PPO: 6% -1.9% 93% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Weighted Average Rate Increase Plan % of Enrollment in Region Range of % Rate Change from 2014 Carriers Before Subsidy Anthem PPO 69.5% -2.9% -3% to 0% Blue Shield PPO 11.3% 6.0% 6% Health Net* EPO 1.5% 7.3% 6% to 9% Kaiser Permanente* 17.6% -4.0% -10% to -4% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO Health Net EPO Dameron Hospital X X Doctors Medical Center of Modesto X X Emanuel Medical Center X X X Kaweah Delta Health Care District X X X Lodi Memorial Hospital X X X Memorial Medical Center Modesto X X Mercy Medical Center Merced X X X San Joaquin General Hospital X St. Joseph's Medical Center of Stockton X X X ** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selectio n. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact ca rrier or visit the carrier website.

Regional Data Sheets (9-3-14) 26 Quick Fact Sheet: Region 10 - Central California (Stanislaus, Merced, San Joaquin and Tulare Counties) Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th

Anthem Kaiser Blue Shield HealthNet Bronze Coin PPO Copay HMO Coin PPO Coin EPO Anthem Kaiser Blue Shield HealthNet Silver Coin PPO Copay HMO Coin PPO Coin EPO Anthem Kaiser Blue Shield HealthNet Gold Coin PPO Copay HMO Coin PPO Coin EPO

Kaiser Anthem Blue Shield HealthNet Platinum Copay HMO Coin PPO Coin PPO Coin EPO

Rate and Plan Observations • Overall, Blue Shield and Health Net enrollment will see their costs go up compared to 2014. • Generally, Anthem and Kaiser enrollees will see their costs go down compared to 2014. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• For those looking to shop for a lower rate within their Tier, Anthem is often the plan to look at. Those currently in Anthem are usually already in the lowest cost option.

Regional Data Sheets (9-3-14) 27 Quick Fact Sheet: Region 11 - Fresno, Kings, Madera County Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Anthem Coin PPO: 4% 3.0% 92% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan

Weighted Average Rate Increase % of Enrollment in Region Range of % Rate Change from 2014 Carriers Before Subsidy Anthem PPO 45.7% 3.7% 3% to 8% Anthem HMO* 1.0% 6.5% 6% to 9% Blue Shield PPO 39.9% 6.0% 6% to 9% Kaiser Permanente HMO* 13.4% -8.5% -14% to -8% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Anthem HMO Blue Shield PPO Adventist Medical Center - Hanford X X Adventist Medical Center - Selma X X X Children’s Hospital Central California X Clovis Community Medical Center X Community Regional Medical Center X Madera Community Hospital X X St. Agnes Medical Center X X X

Regional Data Sheets (9-3-14) 28 Quick Fact Sheet: Region 11 – Fresno, Kings, Madera County Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th

Kaiser Anthem Blue Shield Bronze Copay HMO Coin PPO Coin PPO Anthem Kaiser Blue Shield Anthem Silver Coin PPO Copay HMO Coin PPO Copay HMO

Blue Shield Anthem Kaiser Anthem Gold Coin PPO Coin PPO Copay HMO Copay HMO

Kaiser Blue Shield Anthem Anthem Platinum Copay HMO Coin PPO Coin PPO Copay HMO

Rate and Plan Observations • Anthem will generally be the lowest cost option. • Kaiser Permanente has rate reductions in all metal tiers compared to 2014. However, they have partial coverage in the region with only one hospital offer in Fresno.

Additional Rate Observations for those receiving subsidies

• For those looking to shop for a lower rate within their tier, Anthem is likely the plan to consider. Those currently in Anthem are usually already in the lowest cost option.

Regional Data Sheets (9-3-14) 29 Quick Fact Sheet: Region 12 – San Luis Obispo, Santa Barbara, Ventura Counties

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase % of Enrollment in Region Range of % Rate Change from 2014 Carriers Before Subsidy Anthem PPO 49.1% 4.9% 4% to 8% Blue Shield PPO 43.2% 6.0% 6.0% Kaiser Permanente HMO* 7.6% 1.7% -4% to 2% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO Community Memorial Hospital X French Hospital Medical Center X X Los Robles Hospital & Medical Center X Marian Medical Center X X Santa Barbara Cottage Hospital X X Sierra Vista Regional Medical Center X X Simi Valley Hospital X X St. John's Regional Medical Center - Oxnard X X Twin Cities Community Hospital X X Ventura County Medical Center X X

Regional Data Sheets (9-3-14) 30 Quick Fact Sheet: Region 12 - San Luis Obispo, Santa Barbara, Ventura Counties

Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd

Kaiser Anthem Blue Shield Bronze Copay HMO Coin PPO Coin PPO Blue Shield Kaiser Anthem Silver Coin PPO Copay HMO Coin PPO Blue Shield Kaiser Anthem Gold Coin PPO Copay HMO Coin PPO

Kaiser Blue Shield Anthem Platinum Copay HMO Coin PPO Coin PPO

Rate and Plan Observations • Kaiser Permanente has partial coverage in the region. Thus they may not be reasonable option to some.

Additional Rate Observations for those receiving subsidies

• APTC federal subsidy is going up in this region in 2015. • Post subsidy costs generally do not vary a significant amount.

Regional Data Sheets (9-3-14) 31 Quick Fact Sheet: Region 13 – Mono, Inyo and Imperial counties Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases

3.8 % 95% Silver – Blue Shield- Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan

Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy

Anthem PPO 47.6% 1.3% 1% to 4%

Blue Shield PPO 51.5% 6.0% 6.0%

Kaiser Permanente HMO* 1.0% 1.6% -4% to 2%

* Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO El Centro Regional Medical Center X X Mammoth Hospital X X Northern Inyo Hospital X X Pioneers Memorial Hospital X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact carrier or visit the carrier website.

Regional Data Sheets (9-3-14) 32 Quick Fact Sheet: Region 13 – Mono, Inyo and Imperial counties Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd Kaiser Copay Anthem Coin Blue Shield Coin Bronze HMO PPO PPO

Kaiser Copay Anthem Coin Blue Shield Coin Silver HMO PPO PPO

Kaiser Copay Blue Shield Coin Anthem Coin Gold HMO PPO PPO

Kaiser Copay Blue Shield Coin Anthem Coin Platinum HMO PPO PPO

Rate and Plan Observations • Modest rate increase in this region. • Generally, Anthem will be slightly lower cost than Blue Shield. • Kaiser has only partial coverage in this region. Thus, while they are generally the lost cost option, they may not be available.

Additional Rate Observations for those receiving subsidies

• Those in a Blue Shield plan have opportunity to shop for a lower rate.

Regional Data Sheets (9-3-14) 33 Quick Fact Sheet: Region 14 – Kern County

Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – Health Net Coin EPO: 9% 4.5% Slightly 90% Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase % of Enrollment in Region Range of % Rate Change from 2014 Carriers Before Subsidy Anthem PPO 37.8% 3.0% 2% to 6% Blue Shield PPO 46.4% 6.0% 6.0% Health Net EPO* 4.7% 7.7% 6% to 9% Kaiser Permanente HMO* 11% 1.6% -4% to 2% * Plan not available in all areas.

Sample of Contracted Hospitals ** Anthem PPO Blue Shield PPO Health Net EPO Bakersfield Memorial Hospital X X X Delano Regional Medical Center X X X Good Samaritan Hospital - Bakersfield X X Kern Medical Center X X X Mercy Healthcare Bakersfield – Bakersfield X X X Mercy Healthcare Bakersfield - Southwest X Ridgecrest Regional Hospital X X X San Joaquin Community Hospital X X

Regional Data Sheets (9-3-14) 34 Quick Fact Sheet: Region 14 – Kern County Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th

Anthem Health Net Kaiser Permanente Blue Shield Bronze Coin PPO Coin EPO Copay HMO Coin PPO Anthem Blue Shield Kaiser Permanente Health Net Silver Coin PPO Coin PPO Copay HMO Coin EPO Blue Shield Anthem Kaiser Permanente Health Net Gold Coin PPO Coin PPO Copay HMO Coin EPO

Blue Shield Anthem Kaiser Permanente Health Net Platinum Coin PPO Coin PPO Copay HMO Coin EPO

Rate and Plan Observations • Kaiser Permanente has partial coverage in the region, with no hospitals in this county. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• APTC federal subsidies are going up in this region in 2015. • Anthem will generally be the lowest cost option for those looking to shop pricing.

Regional Data Sheets (9-3-14) 35 Quick Fact Sheet: Region 15 - Los Angeles (partial)

Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases No Change Bronze – L.A. Care Coin HMO: 12% Bronze – Anthem Coin EPO: 8% 4.4% 89% Silver – Blue Shield Coin PPO: 6% Bronze – Blue Shield Coin PPO:6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase % of Enrollment in Region Range of % Rate Change from 2014 Carriers Before Subsidy Anthem* EPO 7.9% 8.0% 7% to 11% Anthem* HMO 3.8% 0.3% 0% to 3% Blue Shield PPO 37.6% 6.0% 6% Health Net HMO 32.7% 2.8% 2% to 3% Health Net EPO 1.6% 7.9% 7% to 9% Kaiser Permanente* HMO 8.9% -3.4% -9% to -3% L.A. Care HMO 7.2% 11.0% 4% to 15% Molina Health Care* HMO 0.3% 2.7% -1% to 4% *Plan not available in all areas.

Regional Data Sheets (9-3-14) 36 Quick Fact Sheet: Region 15 – Los Angeles (partial) Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th 5th 6th 7th

L.A. Care Molina Kaiser Blue Shield Anthem Health Net Bronze Coin HMO Coin HMO Copay HMO Coin PPO Coin EPO Coin EPO Health Net Anthem Molina L.A. Care Blue Shield Kaiser Anthem Silver Copay HMO Copay HMO Coin HMO Copay HMO Coin PPO Copay HMO Coin EPO Health Net Molina L.A. Care Blue Shield Anthem Kaiser Anthem Gold Copay HMO Coin HMO Copay HMO Coin PPO Copay HMO Copay HMO Coin EPO

Health Net Molina L.A. Care Blue Shield Kaiser Anthem Anthem Platinum Copay HMO Coin HMO Copay HMO Coin PPO Copay HMO Copay HMO Coin EPO

Rate and Plan Observations

• Most plan rates in this region have increased, however, Kaiser Permanente rates have decreased. • Health Net and Blue Shield had the most enrollment in 2014. Most consumers in these plans will see a modest increase in monthly premium of less than $20. • Health Net generally has the lowest rates, except in the Bronze Tier, where L.A. Care is lowest. • Blue Shield offers the only PPO in this region. Blue Shield PPO consumers will see a rate increase, but may consider purchasing Anthem or Health Net HMOs to avoid the increase. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• APTC subsidy amounts have generally remained the same. Post-subsidy costs to consumers have increased. • With 7 plans to choose from, consumers may benefit from shopping around. They may be able to find a better deal and see minimal cost increases, depending on their personal circumstances.

Regional Data Sheets (9-3-14) 37 Quick Fact Sheet: Region 15 – Los Angeles (partial)

Anthem Anthem Blue Health Health L.A. Care Molina Sample of Contracted Hospitals ** EPO HMO Shield Net EPO Net HMO HMO HMO PPO Antelope Valley Hospital X X X X X Beverly Hospital X X X X X Citrus Valley Medical Center – Queen of the X X X X X X Valley Campus Community Hospital of Long Beach X X X Foothill Presbyterian Hospital X X X X X X Garfield Medical Center X X X X X X X Glendale Adventist Medical Center X X X X

Glendale Memorial Hospital and Health Center X X X X X Huntington Memorial Hospital X X X X Long Beach Memorial Center X X X X X Methodist Hospital of Southern California X X X X X X X Miller Children’s Hospital X X X X Pomona Valley Hospital Medical Center X X X X X Presbyterian Intercommunity Hospital X X

Providence Saint Joseph Medical Center X X X X X

St. Mary Medical Center – Long Beach X X X X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact ca rrier or visit the carrier website.

Regional Data Sheets (9-3-14) 38 Quick Fact Sheet: Region 15 – Los Angeles (partial) Region 15 Service Area Zip Codes* 90601 90670 90746 90835 91023 91115 91208 91706 91750 91792 93560 90602 90671 90747 90840 91024 91116 91209 91709 91754 91793 93563 90603 90701 90748 90842 91025 91117 91210 91710 91755 91795 93584 90604 90702 90749 90844 91030 91118 91214 91711 91756 91801 93586 90605 90703 90755 90846 91031 91121 91221 91714 91759 91802 93590 90606 90704 90801 90847 91040 91123 91222 91715 91765 91803 93591 90607 90706 90802 90848 91041 91124 91224 91716 91766 91804 93599 90608 90707 90803 90853 91042 91125 91225 91722 91767 91896 90609 90710 90804 90895 91043 91126 91226 91723 91768 91899 90610 90711 90805 90899 91046 91129 91501 91724 91769 93063 90623 90712 90806 91001 91066 91182 91502 91731 91770 93243 90630 90713 90807 91003 91077 91184 91503 91732 91771 93510 90631 90714 90808 91006 91101 91185 91504 91733 91772 93532 90637 90715 90809 91007 91102 91188 91505 91734 91773 93534 90638 90716 90810 91008 91103 91189 91506 91735 91775 93535 90639 90717 90813 91009 91104 91199 91507 91740 91776 93536 90640 90723 90814 91010 91105 91201 91508 91741 91778 93539 90650 90731 90815 91011 91106 91202 91510 91744 91780 93543 90651 90732 90822 91012 91107 91203 91521 91745 91786 93544 90652 90733 90831 91016 91108 91204 91522 91746 91788 93550 90660 90734 90832 91017 91109 91205 91523 91747 91789 93551 90661 90744 90833 91020 91110 91206 91526 91748 91790 93552 90662 90745 90834 91021 91114 91207 91702 91749 91791 93553

*Certain products may not be available in every zip code.

Regional Data Sheets (9-3-14) 39 Quick Fact Sheet: Region 16 - Los Angeles (partial)

Region Generalizations (Individual circumstance will vary) Rate Change in Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Region Subsidy Amount Enrollee Receiving Subsidy Above Average Increases Bronze – L.A. Care Coin HMO: 12% 4.3% 80% Bronze – Anthem Coin EPO: 13% Silver – Anthem Coin EPO: 11%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Carriers Range of % Rate Change from 2014 Region Increase Before Subsidy Anthem* EPO 13.0% 12.5% 11% to 16% Anthem* HMO 10.4% 3.4% 3% to 6% Blue Shield PPO 22.6% 6.0% 6% Health Net HMO 29.2% 0.9% 0% to 1% Health Net EPO 2.6% 8.4% 7% to 9% Kaiser Permanente* HMO 9.7% -8.5% -14% to -8% L.A. Care HMO 11.4% 11.5% 4% to 15% Molina Health Care* HMO 1.2% 3.0% -1% to 4% *Plan not available in all areas.

Regional Data Sheets (9-3-14) 40 Quick Fact Sheet: Region 16 – Los Angeles (partial)

Relative Carrier Rate Positions

Metal Level Lowest 2nd 3rd 4th 5th 6th 7th

Molina LA Care Kaiser Blue Shield Anthem Health Net Bronze Coin HMO Coin HMO Copay HMO Coin PPO Coin EPO Coin EPO Health Net Molina Anthem L.A. Care Kaiser Blue Shield Anthem Silver Copay HMO Coin HMO Copay HMO Copay HMO Copay HMO Coin PPO Coin EPO Health Net Molina L.A. Care Anthem Blue Shield Kaiser Anthem Gold Copay HMO Coin HMO Copay HMO Copay HMO Coin PPO Copay HMO Coin EPO

Health Net Molina L.A. Care Kaiser Anthem Blue Shield Anthem Platinum Copay HMO Coin HMO Copay HMO Copay HMO Copay HMO Coin HMO Coin EPO

Rate and Plan Observations • Blue Shield offers the only PPO in this region. Consumers in the Blue Shield PPO will face an increase but could go to Anthem or Health Net HMOs if price sensitivity is an issue. • Kaiser Permanente rates in the region have decreased. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies • APTC subsidy amounts have generally decreased. Post-subsidy costs to consumers have increased. • With seven plans to choose from, consumers may benefit from shopping around. They may be able to find a better deal and see minimal cost increases, depending on their personal circumstances.

Regional Data Sheets (9-3-14) 41 Quick Fact Sheet: Region 16 – Los Angeles (partial)

Blue Anthem Anthem Health Net Health Net L.A. Care Molina Sample of Contracted Hospitals ** Shield EPO HMO EPO HMO HMO HMO PPO

California Hospital Medical Center X X X X X Cedars-Sinai Medical Center X Centinela Hospital Medical Center X X X X X Children’s Hospital Los Angeles X X X Good Samaritan Hospital – Los Angeles X X X X X X Hollywood Presbyterian Medical Center X X LA County/ USC Medical Center LA County – Olive View – UCLA Medical Center X Northridge Hospital Medical Center X X X X Providence Holy Cross – Mission Hills X X X X X Providence Mary Hospital – Torrance X X X X Providence Tarzana Medical Center X X X Ronald Regan UCLA Medical Center X X X X X Santa Monica UCLA Medical Center X X X St. Francis Medical Center X X X X X X St. John’s Health Center X X X X

Regional Data Sheets (9-3-14) 42 Quick Fact Sheet: Region 16 – Los Angeles (partial)

Region 16 Service Area Zip Codes* 90601 90671 90748 90844 91031 91123 91224 91722 91768 93243 90602 90701 90749 90846 91040 91124 91225 91723 91769 93510 90603 90702 90755 90847 91041 91125 91226 91724 91770 93532 90604 90703 90801 90848 91042 91126 91501 91731 91771 93534 90605 90704 90802 90853 91043 91129 91502 91732 91772 93535 90606 90706 90803 90895 91046 91182 91503 91733 91773 93536 90607 90707 90804 90899 91066 91184 91504 91734 91775 93539 90608 90710 90805 91001 91077 91185 91505 91735 91776 93543 90609 90711 90806 91003 91101 91188 91506 91740 91778 93544 90610 90712 90807 91006 91102 91189 91507 91741 91780 93550 90623 90713 90808 91007 91103 91199 91508 91744 91786 93551 90630 90714 90809 91008 91104 91201 91510 91745 91788 93552 90631 90715 90810 91009 91105 91202 91521 91746 91789 93553 90637 90716 90813 91010 91106 91203 91522 91747 91790 93560 90638 90717 90814 91011 91107 91204 91523 91748 91791 93563 90639 90723 90815 91012 91108 91205 91526 91749 91792 93584 90640 90731 90822 91016 91109 91206 91702 91750 91793 93586 90650 90732 90831 91017 91110 91207 91706 91754 91795 93590 90651 90733 90832 91020 91114 91208 91709 91755 91801 93591 90652 90734 90833 91021 91115 91209 91710 91756 91802 93599 90660 90744 90834 91023 91116 91210 91711 91759 91803 93063 90661 90745 90835 91024 91117 91214 91714 91765 91804 90662 90746 90840 91025 91118 91221 91715 91766 91896 90670 90747 90842 91030 91121 91222 91716 91767 91899

*Certain products may not be available in every zip code.

Regional Data Sheets (9-3-14) 43 Quick Fact Sheet: Region 17 – San Bernardino and Riverside Region Generalizations (Individual circumstance will vary) Rate Change in Change in Subsidy Post-Subsidy Cost Percent of Enrollees High Enrollment Plans with Region Amount to Enrollee Receiving Subsidy Above Average Increases

Bronze – Anthem Coin PPO: 8% 4.5% 89% Silver – Blue Shield Coin PPO: 6% Slightly

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Carriers % of Enrollment in Region Range of % Rate Change from 2014 Increase Before Subsidy Anthem PPO 13.1% 8.0% 7% to 11%

Anthem HMO* 4.4% 5.3% 5% to 8%

Blue Shield PPO 31.1% 6.0% 6%

Health Net HMO 29.0% 4.8% 4% to 9%

Health Net EPO 0.8% 8.0% 7% to 9%

Kaiser Permanente HMO* 15.2% -1.0% -7% to -1%

Molina Healthcare HMO* 6.4% 3.1% -1% to 4%

* Plan not available in all areas.

Regional Data Sheets (9-3-14) 44 Quick Fact Sheet: Region 17 – San Bernardino and Riverside Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd 4th 5th 6th

Molina Kaiser Blue Shield Anthem HealthNet Bronze Coin HMO Copay HMO Coin PPO Coin PPO Coin EPO

Molina HealthNet Anthem Blue Shield Kaiser Anthem Silver Coin HMO Copay HMO Copay HMO Coin PPO Copay HMO Coin PPO

Molina HealthNet Blue Shield Anthem Kaiser Anthem Gold Coin HMO Copay HMO Coin PPO Copay HMO Copay HMO Coin PPO

HealthNet Molina Blue Shield Kaiser Anthem Anthem Platinum Copay HMO Coin HMO Coin PPO Copay HMO Copay HMO Coin PPO

Rate and Plan Observations • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits. • Blue Shield and Anthem enrollees who are considering cost options can maintain a rate similar to their 2014 rate by moving to Health Net.

Additional Rate Observations for those receiving APTC subsidies • The majority of enrollees will see cost after subsidy increase. • Post subsidy, Health Net will typically be the lowest cost option.

Regional Data Sheets (9-3-14) 45 Quick Fact Sheet: Region 17 – San Bernardino and Riverside

Sample of Contracted Hospitals ** Anthem PPO Anthem HMO Blue Shield PPO Health Net EPO Health Net HMO Molina Arrowhead Regional Medical Center X Barstow Community Hospital X X X X Chino Valley Medical Center X X Community Hospital of San Bernardino X X X X X Corona Regional Medical Center X X X X X X Desert Regional Medical Center X X X X Desert Valley Hospital X X X X X X Eisenhower Medical Center X X X Hemet Valley Medical Center X X X X X X Hi-Desert Medical Center X X X John F. Kennedy Memorial Hospital X X X X X Loma Linda University Medical Center X X X Loma Linda University Medical Center - Murrieta X X X Menifee Valley Medical Center X X X X X Montclair Hospital Medical Center X X Palo Verde Hospital X X X Parkview Community Hospital Medical Center X X X X X X Redlands Community Hospital X X X X Riverside Community Hospital X X X Riverside County Regional Medical Center X San Antonio Community Hospital X X X X X X San Gorgonio Memorial Hospital X X X X X Southwest Healthcare - Rancho Springs/Murrieta Campus X X X X X Southwest Healthcare System - Inland Valley/Wildomar X X X X X St. Bernardine Medical Center X X X X X St. Mary Medical Center - Apple Valley X X X X X Victor Valley Community Hospital X X X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact ca rrier or visit the carrier website.

Regional Data Sheets (9-3-14) 46 Quick Fact Sheet: Region 18 – Orange County

Region Generalizations (Individual circumstance will vary) Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Rate Change in Region Subsidy Amount Enrollee Receiving Subsidy Notable Increases Bronze – Anthem Coin EPO: 6% 6.3% 85% Silver – HealthNet Copay HMO: 9% Slightly Silver – Blue Shield Coin PPO: 6%

Rate Change For Consumers Who Stay With Current Plan Weighted Average Rate Increase Carriers % of Enrollment in Region Range of % Rate Change from 2014 Before Subsidy Anthem EPO 20% 5.7% 5% to 9%

Anthem HMO 3.3% 6.7% 6% to 9%

Blue Shield PPO 36.6% 6.0% 6%

Health Net HMO 28.4% 9.3% 8% to 9%

Health Net EPO 3.6% 8.4% 7% to 9%

Kaiser Permanente HMO* 8.2% -3.3% -9% to -3% * Plan not available in all areas.

Regional Data Sheets (9-3-14) 47 Quick Fact Sheet: Region 18 – Orange County

Sample of Contracted Hospitals ** Anthem EPO Anthem HMO Blue Shield PPO Health Net EPO Health Net HMO

AHMC Anaheim Regional Medical Center X X X X Chapman Medical Center X X X Children’s Hospital of Orange County X X X Childrens Hospital at Mission X X X Coastal Communities Hospital X X X College Hospital Costa Mesa X X X X Fountain Valley Regional Hospital & Medical Center X X X Garden Grove Hospital and Medical Center X X X Hoag Memorial Hospital Presbyterian-Irvine X X Hoag Memorial Hospital Presbyterian-Newport Beach X X X Huntington Beach Hospital X X X X La Palma Intercommunity Hospital X X X Los Alamitos Medical Center X X X Mission Hospital - Laguna Beach X X X Mission Hospital - Mission Viejo X X Orange Coast Memorial Medical Center X X X X Placentia-Linda Hospital X X X Saddleback Memorial Medical Center - Laguna Hills Campus X X X X Saddleback Memorial Medical Center - San Clemente Campus X X X X St. Joseph Hospital - Orange X X X St. Jude Medical Center X X X UC Irvine Medical Center X X X West Anaheim Medical Center X X X Western Medical Center - Anaheim X X X Western Medical Center - Santa Ana X X X

Regional Data Sheets (9-3-14) 48 Quick Fact Sheet: Region 18 – Orange County

Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd 4th 5th

Anthem Kaiser HealthNet Blue Shield Bronze Coin EPO Copay HMO Coin EPO Coin PPO

HealthNet Anthem Anthem Blue Shield Kaiser Silver Copay HMO Coin EPO Copay HMO Coin PPO Copay HMO

HealthNet Blue Shield Anthem Anthem Kaiser Gold Copay HMO Coin PPO Coin EPO Copay HMO Copay HMO

HealthNet Blue Shield Kaiser Anthem Anthem Platinum Copay HMO Coin PPO Copay HMO Coin EPO Copay HMO

Rate and Plan Observations • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits. • Health Net Silver enrollees will see above average increases but Health Net is still the lowest cost silver plan. • Changing to Health Net could provide a silver plan enrollee with lower costs than other 2014 silver plans.

Additional Rate Observations for those receiving subsidies

• Most enrollees will pay about the same post-subsidy as they did the previous year. • Post-subsidy, Kaiser enrollees will pay less in 2015 than 2014.

Regional Data Sheets (9-3-14) 49 Quick Fact Sheet: Region 19 – San Diego Region Generalizations (Individual circumstance will vary) Change in Rate Change in Post-Subsidy Cost to Percent of Enrollees High Enrollment Plans with Subsidy Region Enrollee Receiving Subsidy Above Average Increases Amount Bronze – Anthem Coin EPO: 8% Silver – Health Net Copay HMO: 9% 5.8% 85% Silver – Anthem Coin EPO: 7% Silver – Anthem Coin EPO:7%

Rate Change For Consumers Who Stay With Current Plan % of Enrollment in Weighted Average Rate Increase Range of % Rate Change from 2014 Carriers Region Before Subsidy Anthem EPO 18.7% 7.8% 7% to 11% Anthem* HMO 0.6% 7.3% 7% to 10% Blue Shield PPO 20.9% 6.0% 6% Health Net HMO 28.0% 8.7% 7% to 9% Health Net EPO 4.3% 8.5% 7% to 9% Kaiser Permanente* HMO 16.5% -1.6% -7% to -1% Molina Healthcare HMO 0.6% 0.6% -2% to 3.7% Sharp Health Plan 7.3% 4.8% 3% to 7% HMO Network 2 (Coinsurance) Sharp Health Plan* 3.1% 3.5% 3% to 6% HMO Network 1 (Copay) * Plan not available in all areas.

Regional Data Sheets (9-3-14) 50 Quick Fact Sheet: Region 19 – San Diego Relative Carrier Rate Positions Metal Level Lowest 2nd 3rd 4th 5th 6th 7th 8th Kaiser Sharp Anthem Molina Health Net Blue Shield Bronze Copay HMO Coin HMO Coin EPO Coin HMO Coin EPO Coin PPO Health Net Kaiser Molina Sharp Anthem Sharp Blue Shield Anthem Silver Copay HMO Copay HMO Coin HMO Copay HMO Coin EPO Coin HMO Coin PPO Copay HMO Health Net Molina Sharp Kaiser Sharp Blue Shield Anthem Anthem Gold Copay HMO Coin HMO Copay HMO Copay HMO Coin HMO Coin PPO Coin EPO Copay HMO Health Net Kaiser Sharp Molina Sharp Blue Shield Anthem Anthem Platinum Copay HMO Copay HMO Copay HMO Coin HMO Coin HMO Coin PPO Coin EPO Copay HMO

Rate and Plan Observations

• Kaiser is the only plan that decreased their rates in this region. Other plans moderately increased their rates. • Anthem and Blue Shield consumers in the Silver tier who are price sensitive may benefit from shopping rates. • Individuals who are currently enrolled in Health Net’s PPO should note this plan has changed to an EPO plan in 2015. The EPO plan has limited to no out-of-network benefits.

Additional Rate Observations for those receiving subsidies

• Subsidy amounts have generally decreased. Post subsidy costs to consumers have generally increased.

Regional Data Sheets (9-3-14) 51 Quick Fact Sheet: Region 19 – San Diego

Sharp Sharp Sample of Contracted Anthem Anthem Blue Health Net Health Net Molina HMO HMO Hospitals ** EPO HMO Shield PPO HMO EPO HMO Network 2 Network 1

Alvarado Hospital Med Center X X X X X X Fallbrook Hospital X X X X X Palomar Medical Center X X X X X X X Paradise Valley Hospital X X X X Pomerado Hospital X X X X X X Rady Childrens Hospital X X X X X X Scripps Green Hospital X X X X X Scripps Memorial – Encinitas X X X X Scripps Memorial - La Jolla X X X X Scripps Mercy - Chula Vista X X X X Scripps Mercy - San Diego X X X X Sharp Chula Vista Med Center X X X X X Sharp Coronado Hospital X X X X X Sharp Grossmont Hospital X X X X X Sharp Mary Birch Hospital X X X X X UC San Diego Med Cntr Hillcrest X X X X

** Hospital availability may vary by carrier plan type. It is advised to confirm availability with carrier prior to selection. Kaiser Permanente hospitals are not listed. For more detailed network information such as medical group or individual physician availability, please contact ca rrier or visit the carrier website.

Regional Data Sheets (9-3-14) 52 Quick Fact Sheet: Region 19 – San Diego Region 19 Service Area Zip Codes* 91901 91943 92011 92049 92079 92111 92135 92165 92194 91902 91944 92013 92051 92081 92112 92136 92166 92195 91903 91945 92014 92052 92082 92113 92137 92167 92196 91905 91946 92018 92054 92083 92114 92138 92168 92197 91906 91947 92019 92055 92084 92115 92139 92169 92198 91908 91948 92020 92056 92085 92116 92140 92170 92199 91909 91950 92021 92057 92086 92117 92142 92171 91910 91951 92022 92058 92088 92118 92143 92172 91911 91962 92023 92059 92090 92119 92145 92173 91912 91963 92024 92060 92091 92120 92147 92174 91913 91976 92025 92061 92092 92121 92149 92175 91914 91977 92026 92064 92093 92122 92150 92176 91915 91978 92027 92065 92096 92123 92152 92177 91916 91979 92028 92066 92101 92124 92153 92178 91917 91980 92029 92067 92102 92126 92154 92179 91921 91987 92030 92068 92103 92127 92155 92182 91931 91990 92033 92069 92104 92128 92158 92184 91932 92003 92036 92070 92105 92129 92159 92186 91933 92004 92037 92071 92106 92130 92160 92187 91934 92007 92038 92072 92107 92131 92161 92190 91935 92008 92039 92074 92108 92132 92162 92191 91941 92009 92040 92075 92109 92133 92163 92192 91942 92010 92046 92078 92110 92134 92164 92193

*Certain products may not be available in every zip code.

Regional Data Sheets (9-3-14) 53