A New Approach to Health Insurance

1. A New Approach to Health Insurance “To be a leader in transforming the health of Maine people and positively affecting the Maine economy”

2. Local, Nonprofit, Maine-Based, Statewide Located in the Bates Mill in Lewiston, MCHO is committed to offering local serviceswith a local presence, and at the highest quality. • Member Services Center • Provider Relations • Care Management • Behavioral Health Integration • Members have a voice: Member-led Board • Nonprofit and Transparent

3. Extensive Network and Preferred Provider Organization (PPO) Plan • Maine Community Health Options offers an extensive network of Medical and Behavioral Health Providers. • All Maine Hospitals • Border Facilities and Providers • National network of in-network providers • Providers include doctors, nurse practitioners, specialists, mental health and substance abuse providers, pharmacies, clinics, hospitals, and others. • No referral needed for a specialist.

4. Small Group Plans on & off SHOP

7. MCHO Approach – Benefit Design Attributes • Integrated Behavioral and Medical Health • Member Engagement • PT/ST/OT at primary care level cost sharing • Value Based Insurance Design • Chronic Illness Support Program • Tobacco Cessation

8. Your Wellness Counts Make informed decisions with guidance from skilled coaches and get useful information from our online portal. 24/7 Access to Health Coaches Healthy Options Online Health and Wellness Portal • Registered Nurses, Dieticians, Respiratory Therapists • May call you to talk about your condition • Provide information • Help you make important medical decisions • Get facts on over 6,000 health topics • Use decision support tools and videos • Complete your wellbeing assessment • Join challenges to earn points and get rewards. Create personal goals and track progress

9. Tobacco Cessation Treatment Maine Community Health Options will cover: • Plan Provider prescribed nicotine replacement products or any products approved by the FDA to quit tobacco use • Medications covered at no Out-Of-Pocket cost when prescribed by a Plan Provider • Generic Nicotine Replacement Therapy (NRT): Gum, Patch, Lozenge • Chantix (up to a 90 day supply) • Tobacco cessation education and counseling NOTE: MCHO does not use the new “tobacco rating band” or charge higher premiums for smokers

10. Chronic Illness Support Program MCHO offers additional help to members with certain chronic medical conditions that can be managed for better health: High blood pressure/Hypertension Diabetes Asthma COPD (Chronic Obstructive Pulmonary Disease)/Emphysema. This program can save members money through lower Out-of-Pocket costs when they get medically necessary services from a Plan Provider.

11. Supporting You to Manage Your Chronic ConditionLower out-of-pocket costs for meds and services Diabetes Asthma & COPD Hypertension Medications • $0 costing sharing for Specific medications used to treat diabetes-Generics, 50% cost-sharing for preferred brand Services - $0 cost sharing when done by Plan Provider • Offices Visits to PCP for routine management • Endocrinology consultation • Podiatry Consultation • Nutritional Counseling, diabetes education, modification counseling • Diabetic Eye Exam (1/yr.) • 1 Glucometer/yr., up to 100 test strips every 90 days • Lab services linked to diabetes primary diagnosis code. Medications • $0 costing sharing for Specific medications used to treat asthma & COPD-Generics, 50% cost-sharing for preferred brand Services - $0 cost sharing when done by Plan Provider • Offices Visits to PCP for routine management asthma, COPD, emphysema • Pulmonologist consultation; Pulmonary function test (1/yr.), Home oxygen therapy assessment • Lab services linked to asthma/COPD primary diagnosis code • Inhaler adjuncts; Peak flow meter (1/yr.); Asthma education • Pulmonary rehab., ongoing exercise program for COPD • Home assessment (asthma only) up to $75/yr. Medications • $0 costing sharing for Specific medications used to treat hypertension and hyperlipidemia-Generics, 50% cost-sharing for preferred brand Services - $0 cost sharing when done by Plan Provider • Offices Visits to PCP for routine management • Cardiology or nephrology consultation and management of hypertension • Lab services linked to hypertension primary diagnosis code.

12. Impact of CISP as Seen Through SBC(Silver Plan example)

13. Maine Community Health Options

19. MCHO Website Business Development

20. MCHO Website Business Development

21. Group Plans – easy to access Business Development

22. 1 Step Employer/Employee Contributions Business Development

23. Choices at your finger tips Business Development

24. All the information you need to make a decision Business Development

25. Ongoing administration made easy Business Development

26. Automated process keeps you in the know Business Development

27. Maine Community Health OptionsMission “To partner with Maine people, businesses and health professionals to provide affordable, high quality benefits that promote health and well-being”

28. Thank you for your time and interest in Maine Community Health Options. Toll Free: 1-855-624-6463 www.maineoptions.org Business Development 207-402-3353