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Highmark Lifestyle ReturnsSM

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Highmark Lifestyle ReturnsSMEnjoy the many rewards of a healthy lifestyle!Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 1 of 11

Take charge of your health and enjoy the benefits!We know that the way we live has a real impact on the way we feel. When we take care ofourselves, we have more drive and energy. Good habits promote positive attitudes and healthierlives.Unhealthy lifestyles, on the other hand, can lower the quality of our lives. Often the impact isprofound. Many serious health problems are directly attributed to lifestyle-related behaviors.Being overweight can lead to diabetes and heart disease. Stress weakens the immune system,opening the way for all kinds of illnesses. And there is no longer any question on the dangers ofsmoking; it’s the single largest cause of preventable death in our country today.The costs of a less-than-healthy lifestyle can also be measured in dollars and cents. People withlifestyle-related illnesses spend significantly more on their medical bills. Companies also pay, inboth higher health coverage costs and lower employee productivity.So how do we deal with the enormous tolls caused by unhealthy lifestyles? If you’re like mostpeople, you know you should have healthier habits, but there doesn’t seem to be enough time todo everything you should. And you have other obligations, including your job.Now your employer is making it easier for you and your family to lead healthier lives. Yourcompany is offering you a convenient way to enhance your lifestyle and improve your health.And you will actually be rewarded for your efforts!Highmark Blue Cross Blue Shield Lifestyle Returns gives you everything you need to takecharge of your health. You start by logging onto your member Web site atwww.highmarkbcbs.com and taking the online pledge. Then you complete your PersonalWellness Profile. The Profile provides you with a comprehensive health analysis along withrecommendations for a healthier approach to life. Then you will be given the tools, programs andinformation you need to eat more sensibly, exercise more often, reduce your stress, to even makemore informed and appropriate health care decisions.Unlike other wellness programs that provide one approach for all members, Lifestyle Returns istailored to your specific health needs. No matter what your health status, your age or gender,Lifestyle Returns has the programs and tools you need to enhance your “healthstyle.” AndLifestyle Returns works for all family members, even children, as it provides educational supportfor such problems as childhood obesity, diabetes and asthma. That’s why Highmark encouragesyou and all your Highmark-covered family members to participate in the program.And what is the best thing about participating in Highmark’s Lifestyle Returns? The rewardsyou enjoy will last a lifetime!Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 2 of 11

Program Requirements:Five steps to a healthier lifestyleHighmark Lifestyle Returns is an innovative program that helps change your role with yourhealth. By following program requirements, you take an important step toward a healthierlifestyle.Lifestyle Returns is an easy-to-follow program that identifies health and lifestyle areas in need ofimprovement, then helps you develop (and keep!) new, healthier habits.You have nine months from the program’s effective date to complete the Lifestyle Returnsprogram requirements. Your deadline date is included in your pledge and after you acceptyour pledge you will receive periodic reminders on where you stand with meeting yourrequirements.While all family members would benefit from program offerings, only the plan subscriber isrequired to complete all requirements.Lifestyle Returns begins when your health coverage takes effect and you receive yourHighmark member ID card.STEP 1: Take the PledgeIt’s easy to become a program participant. If you are not yet registered on theHighmark member Web site, you mustestablish a logon ID and a password. Justfollow the steps indicated on the homepage at www.highmarkbcbs.com and keepyour ID and password in a convenientplace so you have them handy. Once you are registered on the Highmark member Web site, simply log ontowww.highmarkbcbs.com, connect to My BlueLinkSM home page and click on“Highmark Lifestyle Returns.”Your pledge is your commitment to improving your health. You pledge to: Make an effort to live a healthy lifestyle. Support family members to take part in healthy activities. Be an educated health care consumer by using Highmark’s health education tools andmaterials. Take the online Personal Wellness Profile (PWP).Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 3 of 11

Have routine physical exams and health screenings based on your age and gender.Participate in two lifestyle improvement or condition management programs or oneprogram plus Blues On CallSM.Use an online Self-Care Guide and complete a follow-up online survey.By accepting the pledge, you acknowledge your commitment to meeting these programrequirements. (Please note that, while your covered dependents can, and should, take part in theprogram, only the plan subscriber is required to accept the pledge and meet the programrequirements.)As a Lifestyle Returns participant, you will receive monthly emails directing you to themember message center where you can learn which requirements you’ve met and stillneed to meet. These helpful updates assure that you’re always aware of your programstatus.STEP 2: Complete Your ProfileYou complete the online health assessment, the Personal Wellness Profile, or PWP. It will takeyou approximately 20-30 minutes to complete this assessment and you will get your resultsonline within minutes. While not required, for the most accurate results, it’s a good idea to knowyour cholesterol and blood pressure scores before completing the Profile.The Personal Wellness Profile is a self-health analysis that covers all aspects of your health,including personal fitness and exercise, nutrition, stress, safety, substance use, heart health,cancer risk, etc. The Profile assesses family history, current health status and lifestyle-relatedinformation to generate an individual action plan to better health.STEP 3: Get Your Preventive CareLifestyle Returns requires you to receive, or to schedule within your health care benefits year,preventive exams/screenings applicable to your age and gender. For instance, women over theage of 40 should receive an annual mammogram and men should receive prostate exams asappropriate.For your convenience, and to help you track your exam results, as well as cholesterol, bloodpressure and BMI (body mass index) readings, please take the “My Wellness Scorecard”(included with this information) with you to your physician. Ask your physician to complete theappropriate information.After you receive your exams and screenings, document your visit and screening results on yourLifestyle Returns link at your member Web site, www.highmarkbcbs.com.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 4 of 11

Please keep in mind that while Lifestyle Returns allows you to schedule your exam for anytimewithin your 12-month benefit coverage period, you must document your visit date on themember Web site within nine months of the program’s effective date in order to get programcredit. Also, please remember that it makes sense for you to schedule your physician visit assoon as possible. Remember, this preventive care is covered under your Highmark healthcoverage.* And getting your results early will give you a clearer picture of your health status soyou can take advantage of the most appropriate health-enhancement programs and tools.*Services may be subject to cost-sharing provisions. Your ID card will indicate your office visitcopayments.STEP 4: Participate in Lifestyle Improvement and/orCondition Management ProgramsYou receive your Personal Wellness Profile report. Depending on your health status andlifestyle, Profile recommendations may include Lifestyle Improvement Programs and/orCondition Management Programs.You will be required to do one of the following: Participate in two Lifestyle Improvementand/or Condition Management Programs. Take one Lifestyle Improvement orCondition Management Program and starta dialogue with your Blues On CallHealth Coach.Health Coaches are available online or toll-free at 1-888-BLUE-428. Coaches arespecially trained registered nurses, dietitians and respiratory therapists who can assist youin making the most informed health decisions for yourself and your family. They can alsoassist with a health symptom assessment, provide health information, and confidentiallydiscuss treatment options, including self-care when appropriate. Take one Lifestyle Improvement or Condition Management Program and receive a flushot, regardless of your risk category. Just indicate the date and location of the service onyour Lifestyle Returns link at your member Web site.Of course, you are encouraged to take all the programs that are recommended based on yourProfile and to participate in additional Lifestyle Improvement and Condition ManagementPrograms.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 5 of 11

Health Media Lifestyle Improvement Programs on the member Web site,www.highmarkbcbs.com: BreatheTM Smoking Cessation Program is personalized to meet your individual quittingneeds and increase confidence and motivation while giving you the tools you need to quitfor good. Program length: 23 days from your quit date.NourishTM Nutrition Program is designed to improve your eating habits over the longterm through smart, simple and creative strategies. Program length: eight weeks.BalanceTM Weight Management Program offers techniques and strategies for makinghealthy food choices and increasing physical activity; also helps you identify and avoidtriggers that lead to overeating. Program length: six weeks.RelaxTM Stress Management Program helps you effectively cope with stress, reduce yourstress levels, and better manage the physical and psychological consequences of chronicstress. Program length: five weeks.Care for Your HealthTM Self-Management Program is designed to help individuals withcertain chronic conditions such as diabetes, asthma, migraines, high blood pressure andhigh cholesterol, better manage their condition. Program covers medication complianceas well as emotional issues such as stress and depression, symptom management andlifestyle behaviors. Program length: monthly newsletters for one year followingcompletion of initial questionnaire.Lifestyle Improvement Programs at the Worksite:In addition to the previous online programs, your employer may offer the following programs atyour worksite. Eat Well for Life - promotes wellness and long-term weight management through goodnutrition, exercise and stress management. Eat Well for Life encourages a healthy attitudetoward food and emphasizes a non-diet approach to weight management, focusing on therelationship between nutrition and health. Program length: eight weekly one-hoursessions.Osteoporosis Prevention: Build Strong Bones for Life - focuses on the prevention ofosteoporosis through lifestyle management. Program provides an overview ofosteoporosis, including risk factors, signs and symptoms, and emphasizes lifestyle factorsto help prevent the disease. Program length: three weekly one-hour sessions.Strides for Health - encourages participants to begin or maintain an active lifestylethrough walking for fitness. This self-paced program helps to enhance overall health andhelps participants develop a regular commitment to walking for fitness and experiencethe benefits of an active lifestyle.HeartBEATS - focuses on education related to cardiovascular health and covers lifestylefactors that impact cardiovascular health, including overall wellness, nutrition, physicalactivity, stress management and social support. Program length: five weekly one-hoursessions.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 6 of 11

Relaxation for Mind & Body - helps individuals identify and reduce stressors throughlearned relaxation techniques. Participants learn coping skills and stress managementtechniques, including deep breathing, visualization and progressive muscle relaxation.Program length: six weekly one-hour sessions.10,000 Step Challenge - helps individuals become more physically active by using apedometer to track the number of steps they take each day. Goal is to increase dailybaseline activity every day. Program length: 12 weeks.Lifestyle Improvement Programs at Community/Hospital Locations:In addition to the worksite, these programs are offered in community and hospital locations. Youcan locate the programs nearest you on the Highmark Web site at www.highmark.comand clicking on “Community Wellness Programs” in the search box. Eat Well for Life - promotes wellnessand long-term weight managementthrough balanced nutrition.Participants learn how to make healthyfood choices and adopt nutritionpractices that result in long-termweight management. Program length:four weekly 90-minute sessions.HOPE (Highmark OsteoporosisPrevention and Education) - focuseson healthy choices to prevent ormanage osteoporosis. Program coversnutrition education, strength training, medication options and stress management.Program length: six weekly two-hour sessions.Personal Nutrition Coaching - available through physician recommendation, forindividuals seeking nutrition counseling related to weight management, heart health anddiabetes. Includes individual nutrition plan and enrollment in a group or Web-basedprogram.Discover Relaxation Within - identifies and reduces individual stressors through learnedrelaxation techniques. Program length: four weekly 90-minute sessions.Ornish Advantage - helps to prevent heart disease and improve overall health. Theclinically proven Dean Ornish Program for Reversing Heart Disease includes stressmanagement, exercise, social support and nutrition. Program length: six weekly two-hoursessions.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 7 of 11

Condition Management Programs through Blues On CallFor those with certain chronic conditions, Personal Wellness Profile recommendations mayinclude Condition Management Programs that provide more in-depth information on theircondition, including educational materials.Condition Management Programs cover all aspects of these chronic conditions, includingmedication compliance, emotional issues, symptom management and lifestyle behaviors thatimpact health. All involve working with Blues On Call Health Coaches. Coronary Artery Disease - participants work with Health Coach to address all aspectsof this chronic illness and to work more effectively with their physician and receiveappropriate tests and treatment. Program requires participants to receive their Lipid Panelto measure cholesterol level.Diabetes - participants work with Health Coach to address all aspects of this chronicillness and to work more effectively with their physicians and receive appropriate testsand treatment. Program requires individuals to enter date and reading of the followingtests: Hemoglobin A1c (measures blood glucose level); Dilated Retinal exam (detectsdiabetic retinopathy to prevent vision loss); Microalbumin Test (measures protein inurine) and Lipid Panel (measures cholesterol level).Asthma - participants work with a Health Coach to address all aspects of this chronicillness and to work more effectively with their physicians and receive appropriate testsand treatment.Back Pain Management - participants complete an online quiz and, depending onresults, may be referred to the Health Coach for further information.Maternity - participants complete an online questionnaire, then phone a Health Coach todiscuss any current or pending medical tests. Health Coach helps individuals ask the rightquestions of their OB/GYN. Participants also receive a complimentary PregnancyBooklet outlining key issues throughout pregnancy.Depression - program may be recommended from results of Personal Wellness Profile.Participants complete a confidential online questionnaire, print out, then review offlinewith their physician, who determines appropriate follow-up.STEP 5: Log onto Your Member Web Site for a HealthyEducationSince Highmark offers you an exceptional range of online health-education reference tools, youwill want to take full advantage of these resources.Lifestyle Returns requires you to access at least one online Self-Care Guide, then to complete anonline follow-up survey about the Guide that you used.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 8 of 11

Online Self-Care Guides include, but are not limited to, the following: Healthwise Knowledgebase comprehensive database with prevention and home careinformation on every kind of medical condition. The Knowledgebase also contains indepth information on thousands of medications.Health Encyclopedia, an extensive illustrated, educational full-color health informationresource that contains thousands of articles on diseases, symptoms, injuries, surgeries andmore.Women’s, Men’s, Children’s, Senior’s and Pregnancy special health sections that addressage- and gender-specific health issues.Health Crossroads modules that provide alternative care choices for a wide range ofhealth conditions, providing a more complete and unbiased picture of your care options.Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 9 of 11

Your Role As Program ParticipantBy following Lifestyle Returns requirements, you can take an important step toward a healthierlifestyle for both yourself and your family. And you also enjoy the reward that your employeroffers exclusively to program participants.With a customized healthy action plan, a wide selection of Lifestyle Improvement and ConditionManagement Programs and a variety of Web-based health education offerings, HighmarkLifestyle Returns represents an innovative, results-driven approach to health coverage. LifestyleReturns is the one program that can actually make you and your family healthier!Take this Wellness Scorecard with you to your physician’s office so he/she can document yourapplicable test results. After you receive your exams and screenings, document your visit andscreening results online on your Lifestyle Returns link at the Highmark member Web site,www.highmarkbcbs.com.My Wellness ScorecardIndicate date of service/screening and results when applicable:ServiceAnnual PhysicalDateScreeningBlood Pressure Reading(systolic/diastolic)DateResultsAnnual GynExam/PapCholesterol Reading(Lipid Panel)TotalHDLLDLMammogramBody Mass Index (BMI)ScoreProstate CancerScreening-- PSA-- Digital Rectal ExamPositiveNegativemgmgHighmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 10 of 11

Fifth Avenue Place120 Fifth AvenuePittsburgh, PA 15222-3099Blue Cross, Blue Shield and the Cross and Shield symbols are registered service marks of the Blue Cross and BlueShield Association, an association of independent Blue Cross and Blue Shield Plans.Blues On Call and My BlueLink are service marks of the Blue Cross and Blue Shield Association.Highmark is a registered mark of Highmark Inc.Highmark Lifestyle Returns is a service mark of Highmark Inc.Healthwise Knowledgebase is a registered trademark of Healthwise, Incorporated.(4/05)Highmark Lifestyle ReturnsHighmark Blue Cross Blue ShieldPage 11 of 11

Lifestyle Returns is an easy-to-follow program that identifies health and lifestyle areas in need of improvement, then helps you develop (and keep!) new, healthier habits. You have nine months from the program’s effective date to complete the Lifestyle Returns program requirements. Your d