Connecticut State Retiree Health Plan UnitedHealthcare .

2020 Benefit Health FairConnecticut State Retiree Health PlanUnitedHealthcare Group Medicare AdvantagePPOY0066 SPRJ47490 081619 MProprietary information of UnitedHealth Group. Do not distribute or reproducewithout express permission of UnitedHealth Group.

WelcomeOriginal Medicare BasicsPlan Benefits and FeaturesWhat to Expect NextQuestions and Answers2Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

UnitedHealthcare is here for youHelping you make the most of your planConnecting you to the care and coverage you may needProviding programs, resources and toolsDedicated to helping you live a healthier life3Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Original Medicare Basics

Important Information about your Medicare EnrollmentYou’re eligible for the Medicare Advantage plan if:Medicare-eligible members and Medicare-eligible dependents must be entitledto Medicare Part A (if applicable) and enrolled in Medicare Part B to becovered under the UnitedHealthcare Group Medicare Advantage (PPO)plan.ANDYou’re a U.S. citizen or a legal resident who has lived in the United States forat least 5 consecutive yearsIf you are not eligible for both Part A (if applicable) and Part B, you will NOT beenrolled in the UnitedHealthcare Group Medicare Advantage plan and youmay continue on the current medical plan made available to non-Medicareeligible retirees.5Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Your Medicare Advantage planThe advantages of a single planMedicare Advantage (Part C) plans are provided through privateinsurers, like UnitedHealthcare6All the benefits of Part A Hospital stays Skilled nursing Home healthAll the benefits of Part B Doctor visits Outpatient care Screenings and shots Lab testsPrescription drug coverage Included in theUnitedHealthcare GroupMedicare Advantage (PPO)plan for State of ConnecticutAdditional benefits,programs and features SilverSneakers Solutions for Caregivers HouseCalls NurselineProprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Plan Benefits and FeaturesUnitedHealthcare Group Medicare Advantage PPO

Enrolling into the Medicare Advantage PlanYou will be automatically enrolled The Connecticut State Retiree Health Plan has selected theUnitedHealthcare Group Medicare Advantage PPO for their Medicare-eligibleretirees, spouses and their eligible dependents Connecticut State Retiree Health Plan eligible retirees, spouses and theirdependents will be automatically enrolled in the plan and no action is neededYou can opt out You will have the opportunity to opt out of this plan if you don’t want to beenrolled. Connecticut State Retiree Health Plan: you can opt-out by contacting the Stateof Connecticut at 1-860-702-3533, TTY 711, 8 a.m. – 4:30 p.m. ET, Monday –Friday or mail the Opt Out form to the State of Connecticut Retiree HealthInsurance Unit 55 Elm Street Hartford, CT 06106 no later than October 31,2019. However, doing so will interrupt your retiree health benefit coverage for atleast a year and will terminate your Medicare Part B reimbursement.8Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Enrollment RulesYou can only be enrolled in one Medicare Advantage / Medicare Advantagewith Prescription Drug Plan or Prescription Drug Plan. If you enroll in another MA/MAPD or Part D plan you will automatically bedisenrolled from the Connecticut State Retiree Health Plan throughUnitedHealthcare . You will receive a letter from UnitedHealthcare that you have been disenrolledfrom the Connecticut State Retiree Health Plan. If this occurs, the member must call the other health plan and cancelenrollment before it becomes effective. Medicare will then reinstate your coverage in the Connecticut State RetireeHealth Plan. Any Medicare Supplement plan should be terminated when you enroll into aMedicare Advantage plan.9Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Group Medicare Advantage PPO Coverage in and out of network This is NOT an individual Medicare Advantage Plan This is a custom Medicare Advantage with Prescription Drug plan designed at thedirection of the Health Care Cost Containment Committee exclusively for the Stateof CT retirees and eligible dependents. National plan that covers all retirees regardless of where they reside in the U.S., DCand 5 U.S. territories. Emergency and Urgent Care covered out of the country Do not have to select a Primary Care Physician. No referrals needed. Retirees can access care from any provider that has not opted out of Medicare andaccepts the plan. Nationally over 99% of health care providers participate in Medicare. 11UnitedHealthcare10Internal Data, 2019Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

2020 Medical Plan BenefitsRetiredPrior toJuly1999Retired July 1,1999-May2009 or 2009RIPRetired June2009October 1,2011Retired afterOctober 1,2011October 1,2017Retired onor afterOctober 2,2017 2,000 2,000 2,000 2,000 2,000Inpatient Hospital Services 0 0 0 0 0Outpatient Services 0 0 0 0 0Primary Care Services 5 15 15 15 15Specialist (IncludesMH&SA) 5 15 15 15 15Urgent Care 5 15 15 15 15Emergency Room 0 0 0 35 100Podiatry (MedicareCovered) 5 15 15 15 15Eye Exam (MedicareCovered) 5 15 15 15 15 5 15 15 15 15Benefit CoverageOut-of-Pocket MaximumHearing Exam (MedicareCovered)11Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Common Preventive ServicesBenefit CoverageAnnual Routine physicalMammogramCommon Immunizations:PneumoniaFlu (Influenza) ShotHepatitis BShinglesProstate screeningColorectal Cancer Screening(most common options)12Copayment 0 0How Often CoveredOne Per Calendar YearAnnually 0Once to twice (subject to clinicalcircumstances)Once per Flu Season3 Shots, once Per LifetimeOnce Per Lifetime 0Annually 0Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.Once Every 12 months for fecal occultblood testOnce Every 48 Months for flexiblesigmoidoscopyOnce Every 120 months for screeningcolonoscopy

What Medical service is Updating in 2020?Hearing BenefitsThrough the acquisition of EPIC Hearing Healthcare and the transition of hiHealthInnovations from Optum to UnitedHealthcare Specialty Benefits, UnitedHealthcareis offering UnitedHealthcare Hearing to State of CT in 2020.Hearing ExamsMembers will receive hearing exams in-network and out-of-network.The hearing exam network will be supported by UHC Hearing and UHN contractedhearing providers (audiologists, ENT’s, etc.).Hearing AidsMembers must purchase hearing aids through UHC Hearing; there is no out-of-networkcoverage. Members may utilize home delivery through UHC Hearing.UHC Hearing will now manage all claim submissions to UnitedHealthcare; thereforemembers do not have to pay the full cost upfront for hearing aids.13Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

2020 Non-Medicare Covered BenefitsBenefit Coverage: NonMedicare Covered ServicesRetired Priorto July 1999Retired July 1,1999-May2009 or 2009RIPNaturopathic Care (UnlimitedVisits) 5 15Routine Eye Exam/Refraction(1 exam every 12 months) 15Routine Hearing Services (1exam every 12 months)Retired onor afterOctober 2,2017 15 15 15 15 15 15Benefit Coverage: Non Medicare Covered Services 15 15 15 15 15Hearing Aids (1 set within a36 month period) Covered viaUHC Hearing in-network only 0 0 0 0 0Routine Chiropractic 0 0 0 0 0Podiatry (routine foot care 6visits per year) 5 15 15 15 15Acupuncture (20 visits peryear)14 15Retired June2009-October1, 2011Retired afterOctober 1,2011October 1,2017 15Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group. 15 15 15 15

What Pharmacy Part D Services are updating in2020?Preferred Pharmacy Network: in 2019 UnitedHealthcare included a Preferred PharmacyNetwork to include CVS, Stop and Shop and OptumRX our mail-service pharmacy.Utilizing these networks will provide reduced copayments for prescriptions as detailedwithin your plan documentsWe contracted with additional retail pharmacies that will be effective 1/1/2020. To name afew large chains: Big YShop RitePrice ChopperOver 4,000 other pharmaciesA full list of additional pharmacies are available, please see one of the Advocates, SAMsor other staff15Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Your Part D (Prescription Drug)What is changing in 2020?Retired on or after October 2, 2017TierPrescription Drug TypeYour CostsNetwork Retail andMail ServicePharmacy(up to a 90-daysupply)Preferred Retail andMail Service Pharmacy(up to a 90-day supplyof lower cost drugs totreat certainconditions) † Tier 1Generic – Many generic drugs. 5 0Tier 2Preferred Brand – Many common brand namedrugs, called preferred brands and some highercost generic drugs. 25 5Tier 3Non-preferred Drug – Non-preferred genericand non-preferred brand name drugs. Inaddition, Part D eligible compound medicationsare covered in this Tier. 40 12.50Tier 4Specialty Tier – Unique and/or very high-costbrand and generic drugs. 40 12.50† Please see the Additional Drug Coverage for a list of lower cost drugs to treat these conditions: asthma or COPD, heartdisease/heart failure, hypertension and cholesterol. Reduced copay only available at Preferred Retail and Mail Service Pharmacy.16Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.

Your Part D Prescription DrugTierTier 1Tier 2Important DefinitionsPrescription Drug TypePreferred Generic – Lower-cost,commonly used generic drugs.Generic – Many generic drugs.Tier 3Preferred Brand – Many commonbrand name drugs, called preferredbrands and some higher-cost genericdrugs.Tier 4Non-preferred Drug – Non-preferredgeneric and non-preferred brandname drugs. In addition, Part Deligible compound medications arecovered in Tier 4.Tier 5Specialty Tier – Unique and/or veryhigh-cost brand and generic drugs.Maintenance Drugs: Maintenancemedications are those drugs you maytake on a regular basis to treat conditionssuch as high cholesterol, high bloodpressure or diabetesPreferred Network Pharmacy1: Ournetwork includes pharmacies withpreferred cost sharing,which may offer you lower costsharing than the standard costsharing offered by other networkpharmacies for some drugs. You canfind a list of Preferred RetailPharmacies on our website.1Members may use any pharmacy in the network but may not receive preferred retail pharmacy pricing.17Proprietary information of UnitedHealth Group. Do not distribute orreproduce without express permission of UnitedHealth Group.