Here’s Why More And More People Are Choosing UPMC Health

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Here’s why more and morepeople are choosingUPMC Health PlanCity of Pittsburgh Employees“Highest Member Satisfactionamong Commercial HealthPlans in Pennsylvania”— J.D. Power

What’s insideIntroduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Getting care when and where you need it. . . . . . . . 4Find a doctor near you . . . . . . . . . . . . . . . . . . . . . . . . . 5Preventive care services to help you stay well. . . . 7Taking care of your behavioral health. . . . . . . . . . . . 7Assist America travel coverage. . . . . . . . . . . . . . . . . 8Transition of care for new members. . . . . . . . . . . . . 9Pharmacy benefits you can depend on . . . . . . . . . 10Convenient home deliveryof your medications. . . . . . . . . . . . . . . . . . . . . . . . . . . 11Extra benefits and services. . . . . . . . . . . . . . . . . . . . 12Great care for moms and kids . . . . . . . . . . . . . . . . . 14Privacy and confidentiality. . . . . . . . . . . . . . . . . . . . . 15Utilization management. . . . . . . . . . . . . . . . . . . . . . . 16UPMC Premium Network . . . . . . . . . . . . . . . . . . . . . 19Avoid headaches at the pharmacy. . . . . . . . . . . . . 21Non-discrimination notice. . . . . . . . . . . . . . . . . . . . . 23Translation services. . . . . . . . . . . . . . . . . . . . . . . . . . 24UPMC Health Plan 2016-2017 1

A neighbor committedto making our home a healthierplace to live and workThank you for your interest in UPMC Health Plan. For years we have led the way inthis region with our innovative and affordable health plans. Our success is reflectedin a growing membership that increases every single year. We were founded20 years ago — and we’ve surpassed 3 million members!The key to our growth? It’s simple, really: It’s allabout the focus we place on our members. Ourmembers truly are at the center of everythingwe do.We offer high-quality products and services toour members and our community. And we workhard to deliver outstanding health care benefits,programs, and services so that our members canenjoy the best possible health and quality of life.Need more information?Call the UPMC Health Plan tollfree Open Enrollment Hotlineat 1-844-780-7044 Mondaythrough Friday from 7 a.m. to7 p.m. and Saturday from 8 a.m.to 3 p.m. (TTY users shouldHere’s just some of what our members dependcallon usfor:1-866-407-8762.) Or visitupmchp.us/choose.2 UPMC Health Plan 2016-2017 Better health thanks to comprehensivecoverage and our many health improvementprograms. Convenient access to nationally recognized*doctors and hospitals who will help keepyou healthy. Less hassle and less wasted time thanks toour award-winning** local customer service.All of this adds up to peace of mind, a greatersense of security, and less worry about your health.An innovative health plan should provide thosethings for you — and more. At UPMC Health Plan,that’s exactly what we do.* U.S. News & World Report, America’s BestHospitals, 2016-2017** 2015 Stevie Award winnerProud to bringgood health homeUPMC Health Plan 2016-2017 3

Find a doctornear youIt’s easy to find participating providers in yournetwork. To search our online provider directory,go to upmchealthplan.com/find, then followthese steps: Select Medical. Enter the Provider Last Name/Practice Nameand/or City and ZIP code where youneed care. Under Plan Name choose Premium NetworkPlans – PPO and EPO PlansGetting care whenand where you need itPrimary care physician (PCP): Your PCP is thegateway to all of your health care needs.UPMC MyHealth 24/7 Nurse Line: Running afever at 2 a.m. and not sure what to do? Have ageneral health question or need help with sicknessor a minor injury? Call the UPMC MyHealth 24/7Nurse Line and speak to a registered nurse.UPMC AnywhereCare: Have a virtual visit with aUPMC provider anytime, day or night from yoursmartphone, tablet, or computer. This service isbest for non-serious conditions such as back pain,cold and flu symptoms, pink eye, and allergies.4 UPMC Health Plan 2016-2017Emergency and urgent care: If you believe yourlife or health is in serious danger, go immediatelyto the nearest emergency facility. If you aren’tsure you have an emergency, call your PCP or theUPMC MyHealth 24/7 Nurse Line to explain yoursymptoms. When you need care right away but it’snot an emergency, go to an urgent care facility.Dependent out-of-area coverage: Your kids arecovered up to age 26 no matter where they live.If your covered dependents live outside westernPennsylvania, they have access to great care —whether they’re in college or working.Need more information?Call the UPMC Health Plan tollfree Open Enrollment Hotlineat 1-844-780-7044 Mondaythrough Friday from 7 a.m. to7 p.m. and Saturday from 8 a.m.to 3 p.m. (TTY users shouldcall 1-866-407-8762.) Or visitupmchp.us/choose.UPMC Health Plan 2016-2017 5

Preventive care servicesto help you stay wellWe believe the disease or condition that’s easiestto treat is the one you never get. We cover manyadult and child preventive services at 100 percent,which means you pay nothing. These services fallinto three categories:Common adult screenings include cholesterol,blood pressure, and mammograms. Commonadult immunizations include the tetanus,diphtheria, pertussis, and flu vaccines. Screenings Immunizations Health examsTaking care of yourbehavioral healthUPMC Health Plan takes great pride in thebehavioral health coverage and benefits we offer.We have a strong focus on maintaining mentalhealth and supporting recovery.Whether you want to make small changesto improve your life or are in recovery froma significant behavioral health issue, we canhelp. Most important, we believe that recoveryfrom mental illness and/or substance abuse ispossible, and that you have a voice inyour treatment.6 UPMC Health Plan 2016-2017Our staff includes licensed behavioral healthclinicians who provide you with referrals thatmatch your specific needs. These servicesinclude treatment for: Emotional difficulties.Bereavement issues.Marital or family problems.Mental health disorders.Substance abuse or dependence.UPMC Health Plan 2016-2017 7

Assist Americatravel coverageWhen you travel more than 100 miles from home— even around the world — you still have easy24/7 access to care through our global emergencytravel assistance partner, Assist America.It’s the nation’s largest provider of emergencymedical services for travelers, and it comes freeof charge with your UPMC Health Plan coverage.WorldwideAmong other benefits, you’ll get immediateconnection to medical resources, includingdoctors, hospitals, and pharmacies.For more information about Assist America, call1-800-872-1414 or visit www.assistamerica.com.coverageTransition of carefor new membersIf you join UPMC Health Plan while receivingongoing treatment by a health care provider whois not in the UPMC Health Plan network, you mayrequest transition of care. UPMC Health Plan,in certain situations, may cover your ongoingtreatment with your current health care provider.The transition of care period may last up to 90days, effective from your date of enrollment.UPMC Health Plan will consult with you and theprovider and may extend the transition of careperiod beyond 90 days if clinically appropriate, aswith pregnancies.Please note: Transition of care is not automaticor guaranteed. To apply, you must completeand return a UPMC Health Plan Transition ofCare Request form within 30 days of yourcoverage effective date. For more information,please call 1-844-780-7044.Access to the qualitycare you deserveCall it portable peace of mind.8 UPMC Health Plan 2016-2017UPMC Health Plan 2016-2017 9

Pharmacy benefitsyou can depend onTaking care of your health is simpler when youhave quick and easy access to the prescriptionsyou need. Our pharmacy plan will provide that foryou. It offers a wide variety of high-quality andeffective generic and brand-name drugs.Three key benefits of UPMC Health Plan’spharmacy coverage:1. You get a personal review. Your newprescription coverage with UPMC HealthPlan may be different from your previouscoverage. Some medications may not becovered, others may have a different cost,and so on. That’s why we offer a personalreview of your medications at no charge.One of our pharmacy staff will let you knowif there are any potential issues and helpyou resolve them right away. To completeyour personal pharmacy review, go toupmchealthplan.com/pharmacyreview, orcomplete and return the pharmacy reviewform on page 22 of this booklet.2. You get fast pharmacy service online.Through MyHealth OnLine you can: Search for a drug to see if it’s covered. Find a pharmacy near you. Sign up for and refill mail-orderprescriptions. View and print your prescription historyand more.3. You have low-cost, convenient optionsfor getting your medications. You’ll haveaccess to more than 30,000 pharmaciesnationwide, including CVS, Giant Eagle,Rite Aid, Target, Wegmans (Erie only), andhundreds of independent pharmacies. Also,UPMC Health Plan contracts with ExpressScripts to provide you with convenienthome delivery of certain maintenancemedications. For more on Express Scripts,see the next section.Is your medication covered?To see if your current prescriptionis covered by UPMC Health Plan,check the formulary (drug list) foryour plan option by visitinghttp://upmchp.us/pharmacybenefits.10 UPMC Health Plan 2016-2017Convenient home deliveryof your medicationsUPMC Health Plan and Express Scripts worktogether to provide home delivery of yourprescription medications. With Express Scripts,you get free standard shipping as well.Home delivery works best for “maintenance”medications. These are medications you takelong term for conditions like diabetes, highcholesterol, or high blood pressure. (You wouldn’tuse Express Scripts for cold or sinus infectionmedications, for example.)Getting started: Once you become a UPMCHealth Plan member, it’s easy to transferappropriate prescriptions to Express Scripts.Just go to Express-Scripts.com orcall 1-800-282-2881.Getting refills: You can either opt for auto-refillor contact Express Scripts when you have amonth of medication remaining.Quick tip:Go with a 30-day supply at firstIf you are starting a new medication, it may bebest to start with a 30-day supply from a retailpharmacy before requesting a 90-day supply viamail order. Why? This gives you and your doctora chance to see if the drug is working and thedose is correct as well as make sure there are noserious side effects.UPMC Health Plan 2016-2017 11

Extra benefits and servicesWe believe a health insurance company needs todo a lot more than pay your medical bills. Whichis why we offer all sorts of benefits to help youlive the healthiest life possible. Five of ourfavorites include:MyHealth OnLine: A website you can go to everyday for practical tips, tools, and strategies forbetter health. The site keeps all of your healthinformation, all in one place.Decision-making tools: You have access tosimple tools to help you estimate out-of-pocketcosts of medical procedures you are considering,check on treatment options, find the lowest-costprescription medications, and more.MyHealth Rewards discounts: As a member ofUPMC Health Plan, you are eligible to receivediscounts at participating businesses thatencourage a healthy lifestyle as well as variousothers. These include gyms, spas, salons, healthfood stores, sporting goods stores, and more.UPMC Health Plan mobile app: Stayinghealthy and on top of your health care is soeasy with this powerful app. You can accessyour member ID card, chat with a MemberServices rep, and check the status of your medicalclaims — anytime, anywhere.Health coaching: Need help with a health goalsuch as losing weight, quitting smoking, managingdepression or anxiety, or getting your diabetesunder control? We have what you need. Ourhealth coaches have specialized training to helpyou develop strategies to get and stay healthy.Bringing good healthwithin reach12 UPMC Health Plan 2016-2017UPMC Health Plan 2016-2017 13

Great care for moms and kidsMaternity program:Healthy mom, healthy babyPediatric care program:Keeping kids healthyUPMC Health Plan’s maternity programsupplements the high-quality care that pregnantwomen receive from their providers. The phonebased outreach focuses on enhancing positiveoutcomes for women and their babies. Ourmaternity nurses provide education on overallhealth, identify and eliminate barriers to care, helpmembers establish goals, and help them makeprogress toward those goals during pregnancy.Referrals to lifestyle programs and communityresources are made based upon individual needs.Kids can be challenging at times, and thingscan be even tougher if your child has a complexmedical condition, behavioral health needs, or achronic condition such as asthma, diabetes, orepilepsy. That’s where our pediatric program canhelp. Our care management team can help yourchild stay healthy by coordinating well-child anddental health visits and linking you to communityresources for support. Our pediatric nurses andsocial workers will develop a personalized careplan based on your and your child’s needs.Privacy and confidentialityAt UPMC Health Plan we respect and protect yourpersonal information. Your name, address, SocialSecurity number, and birth date are confidential —along with any other health information that couldidentify you personally and any data we haveabout services you have received or the premiumsyou pay. UPMC Health Plan uses your personalhealth and financial information internally andwith our contracted agents or providers only.We use your personal information for: Your health care treatment. Health care operations that are required toprovide that treatment. Payment of your health care claims.We do not share your personal information withyour employer, except as described in UPMCHealth Plan’s Notice of Privacy Practices. We willnot disclose your information for any purposebeyond the three described above, unless youauthorize us or the law requires us to. You havethe right to access your medical records. YouNeed more information?Call the UPMC Health Plan tollfree Open Enrollment Hotlineat 1-844-780-7044 Mondaythrough Friday from 7 a.m. to7 p.m. and Saturday from 8 a.m.to 3 p.m. (TTY users shouldcall 1-866-407-8762.) Or visitupmchp.us/choose.14 UPMC Health Plan 2016-2017should contact your health care provider directlyfor these files, since UPMC Health Plan does notcreate or maintain medical records.Your privacy rights include the right to access,amend, restrict, and request an alternatecommunication method or alternate location forthe information the Health Plan maintains. Youalso have the right to know any time the HealthPlan discloses your personal health informationbeyond the three reasons described above. UPMCHealth Plan policies and procedures protectpersonal health information for current, former,and prospective members (living or deceased)according to all applicable laws. These policies andprocedures protect your information regardless ofits format: oral, written, or electronic.UPMC Health Plan complies with all aspects ofthe Health Insurance Portability andAccountability Act of 1996 (HIPAA) and monitorsissues related to HIPAA. The Health Plan has aNotice of Privacy Practices document thatdetails our commitment to protecting yourpersonal information. This document can befound at www.upmchealthplan.com.For questions concerning the privacy andconfidentiality of your personal information,call UPMC Health Plan at the number on theback of your member ID card. For questionsconcerning the confidentiality of behavioral healthinformation, please contact UPMC Health PlanBehavioral Health Services at 1-888-251-0083.UPMC Health Plan 2016-2017 15

Utilization management:Making sure you get the medicalservices you needUtilization management (UM) is how we evaluatethe medical necessity, appropriateness, andefficiency of the health care services you receive.UPMC Health Plan affirms that: We are committed to your receiving the bestpossible care, and we do not offer incentivesto providers to restrict your care. UM decisions are based only on theappropriateness of care. No financial incentives are given to our UMadvisers to decide in favor of less medicalcare being used.For more information about our UM program, youcan call a Health Care Concierge in our MemberServices Department. A Health Care Conciergeis your personal contact at UPMC Health Plan.When appropriate, your Concierge can help youcommunicate with the UM staff or have the staffreturn your call. You can also receive a copy of thecriteria we use to make a UM decision.Other informationThis booklet is a summary of plan informationand is not a complete description of the benefitsand limitations under your plan. Plan benefitsand limitations may vary between employers andmay be subject to change from the descriptionsherein. Consult your official plan materials and/or insurance certificate (where applicable) forspecific benefit information.In this document, the term “UPMC Health Plan”refers to benefit plans offered by UPMC HealthPlan Inc., UPMC Health Network Inc., UPMCHealth Options Inc., and UPMC Health CoverageInc. It may also refer to UPMC Health BenefitsInc. and UPMC Benefit Management ServicesInc. This managed care plan may not coverall of your health care expenses. Read yourcontract carefully to determine which healthcare services are covered. It is typically theresponsibility of the medical provider to obtainany preservice approvals.16 UPMC Health Plan 2016-2017Services not coveredYour benefit plan may not cover certain products,services, and procedures. Non-covered itemsmay vary by employer group. If you have questionsabout whether your benefit plan covers aspecific product, service, or procedure, call theUPMC Health Plan Open Enrollment Hotline at1-844-780-7044. Services not covered include,but are not limited to, the following: Acupressure Aromatherapy, ayurvedic medicine,herbal medicine, homeopathy, massagetherapy, naturopathy, relaxation therapy,transcendental meditation, and yoga Comfort or convenience items, such as airconditioners, television rental, or humidifiers Corrective appliances, including, but notlimited to, arch supports, back braces, andorthopedic shoes, unless shoes are specificallyrequired due to diabetes or peripheralvascular disease Cosmetic procedures Custodial care Court-ordered services (when notmedically necessary) Experimental or investigative procedures Food supplements or vitamins (except prenatalvitamins and nutritional supplements requiredto be covered by state or federal mandate) Genetic counseling Hearing aids and routine hearing examinationsand services Military service-connected disabilitiesand conditions Motor vehicle insurance or workers’compensation-covered services Services that are not medically necessary (asdetermined by UPMC Health Plan) Over-the-counter drugs Physical examinations given primarily at therequest of a third party, including, but notlimited to, attorneys, employers, insurers,schools, camps, and driver’s licensing bureaus Surrogate motherhoodUPMC Health Plan 2016-2017 17

UPMC Premium NetworkThe UPMC Premium Networkconsists of UPMC-ownedhospitals, physician practices,and medical facilities as wellas community-based doctors,hospitals, and other medicalproviders located within the29 counties in our service area,shown at right. Members canobtain services as outlinedin their plan documentswhen seeking care fromparticipating providers withinthe Premium YorkChesterPhiladelphiaDelawareAccess to care from doctors and hospitals located in these counties.In-network hospitalsNeed more information?Call the UPMC Health Plan tollfree Open Enrollment Hotlineat 1-844-780-7044 Mondaythrough Friday from 7 a.m. to7 p.m. and Saturday from 8 a.m.to 3 p.m. (TTY users shouldcall 1-866-407-8762.) Or visitupmchp.us/choose.18 UPMC Health Plan 2016-2017AlleghenyChildren’s Hospital of Pittsburghof UPMCHeritage Valley Health SystemHeritage Valley SewickleyJefferson HospitalKindred Hospital – PittsburghMagee-Womens Hospitalof UPMCLifeCare Hospitalsof Pittsburgh – MainLifeCare Hospitalsof Pittsburgh – SuburbanLifeCare Hospitalsof Pittsburgh – MonroevilleOhio Valley General HospitalSelect Specialty Hospital –McKeesportSelect Specialty Hospital –PittsburghSt. Clair HospitalThe Children’s Home ofPittsburghThe Children’s InstituteUPMC EastUPMC McKeesportUPMC MercyUPMC MontefioreUPMC Passavant – McCandlessUPMC PresbyterianUPMC St. MargaretUPMC ShadysideWestern Psychiatric Instituteand Clinic of learfieldSusquehannaArmstrongArmstrong CountyMemorial HospitalBeaverHeritage Valley Health System –Heritage Valley BeaverKindred Hospital –Heritage ValleyBedfordUPMC Bedford MemorialBlairNason HospitalTyrone HospitalUPMC AltoonaUPMC Health Plan 2016-2017 19

ButlerFayetteCambriaGreeneButler Memorial HospitalUPMC Passavant – CranberryConemaugh Memorial MedicalCenterConemaugh MinersMedical CenterSelect Specialty Hospital –JohnstownCentreHighlands HospitalUniontown HospitalWashington Health SystemGreeneHuntingdonJ.C. Blair Memorial HospitalIndianaPotterCole Memorial HospitalSomersetConemaugh MeyersdaleMedical CenterSomerset HospitalWindber Medical CenterVenangoUPMC NorthwestMount Nittany Medical CenterIndiana Regional nceWestmorelandClarion HospitalClearfieldPenn Highlands ClearfieldPenn Highlands DuBoisPenn Highlands BrookvillePunxsutawney Area HospitalCrawfordMeadville Medical CenterTitusville Area HospitalEllwood City HospitalUPMC Jameson –North CampusUPMC Jameson –South CampusElkMcKeanPenn Highlands Elk –St. Marys CampusErieCorry Memorial HospitalMillcreek Community HospitalSaint Vincent HospitalSelect Specialty Hospital –ErieUPMC HamotTo search for a participatingprovider, please visitwww.upmchealthplan.com.20 UPMC Health Plan 2016-2017Bradford Regional MedicalCenterKane Community HospitalWarren General HospitalMonongahela Valley HospitalWashington HospitalExcela Health - Frick HospitalExcela Health - LatrobeArea HospitalSelect Specialty Hospital –Laurel HighlandsExcela Health – WestmorelandRegional Hospital – ExcelaHealthMercerGrove City Medical CenterSharon Regional Health SystemUPMC Horizon – GreenvilleUPMC Horizon – ShenangoValleyFor emergency services, any emergency department visit is covered at thein-network level. This information is subject to change. For the most up-todate information, visit www.upmchealthplan.com/find.Avoid headaches at the pharmacyUPMC Health Plan wants to make your visits tothe pharmacy as fast and simple as possible. Yournew medication coverage with us may be differentfrom your previous coverage. We don’t want youto discover these differences while standing in lineat the pharmacy.If you let us know the medications you’recurrently taking, a member of our pharmacy staffwill personally review your list. If there are anypotential issues, we will let you know and help youaddress them before you go to the pharmacy.Making pharmacy visits as fastand simple as possibleTo notify us of your current medications, completethe online form at www.upmchealthplan.com/pharmacyreview or fill out the form on the back ofthis page and mail or fax to:UPMC Health Plan Pharmacy ServicesU.S. Steel Tower, 600 Grant Street12th FloorPittsburgh, PA 15219Fax: 412-454-5295

You can also find this form on our website at n NoticeUPMC Health Plan1 complies with applicable federal civil rights laws and does not discriminate on thebasis of race, color, national origin, age, disability, or sex. UPMC Health Plan1 does not exclude people ortreat them differently because of race, color, national origin, age, disability, or sex.If this survey is being completed on the member’s behalf, please indicate the individualwho is completing the survey: Spouse Parent OtherUPMC Health Plan1:ABOUT YOU Provides free aids and services to people with disabilities so that they can communicate effectivelywith us, such as:Member NameooAddressMember ID#Qualified sign language interpreters.Written information in other formats (large print, audio, accessible electronic formats, otherformats). Provides free language services to people whose primary language is not English, such as:Employer GroupooDaytime PhoneQualified interpreters.Information written in other languages.If you need these services, contact the Civil Rights Administrator.Evening PhoneIf you believe that UPMC Health Plan1 has failed to provide these services or has discriminated inanother way on the basis of race, color, national origin, age, disability, or sex, you can file a grievancewith:Civil Rights AdministratorUPMC Health Plan600 Grant Street - 55th FloorPittsburgh, PA 15219Date of BirthABOUT YOUR MEDICATIONSPlease list all your current medications, including over-the-counter medications.MedicationPhone: 1-844-755-5611 (TTY: 1-800-361-2629)Fax: 1-412-454-5964Email: HealthPlanCompliance@upmc.eduStrength Quantity/MonthMedicationStrength Quantity/MonthYou can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the CivilRights Administrator is available to help you. You can also file a civil rights complaint with the U.S.Department of Health and Human Services, Office for Civil Rights electronically through the Office forCivil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail orphone at U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F,HHH Building, Washington, DC 20201, 1-800-368-1019. TTY/TDD users should call 1-800-537-7697.MedicationStrength Quantity/MonthMedication the following companies, which are licensedto issue individual and group health insurance products or which provide third party administrationservices for group health plans: UPMC Health Network Inc., UPMC Health Options Inc., UPMC HealthCoverage Inc., UPMC Health Plan Inc., UPMC Health Benefits Inc., UPMC for You Inc., and/or UPMCBenefit Management Services Inc.Strength Quantity/MonthMedicationStrength Quantity/MonthMedication22 UPMC Health Plan 2016-2017 Strength Quantity/MonthUPMC Health Plan 2016-2017 23

Translation ServicesATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al1-855-869-7228 (TTY: 致電 1-855-869-7228(TTY:1800-361-2629)。CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855869-7228 (TTY: 1-800-361-2629).ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.Звоните 1-855-869-7228 (телетайп: 1-800-361-2629).Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebbergricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-855-869-7228 (TTY: 1-800361-2629).주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-855-8697228 (TTY: 1-800-361-2629)번으로 전화해 주십시오.ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguisticagratuiti. Chiamare il numero 1-855-869-7228 (TTY: 1-800-361-2629). )رﻗﻢ ھﺎﺗﻒ 7228-869-855-1 اﺗﺼﻞ ﺑﺮﻗﻢ . ﻓﺈن ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة اﻟﻠﻐﻮﯾﺔ ﺗﺘﻮاﻓﺮ ﻟﻚ ﺑﺎﻟﻤﺠﺎن ، إذا ﻛﻨﺖ ﺗﺘﺤﺪث اذﻛﺮ اﻟﻠﻐﺔ : ﻣﻠﺤﻮظﺔ .(800-361-2629-1 : اﻟﺼﻢ واﻟﺒﻜﻢ ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement.Appelez le 1-855-869-7228 (ATS : 1-800-361-2629).ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zurVerfügung. Rufnummer: 1-855-869-7228 (TTY: 1-800-361-2629).ુ ના: જો તમે જુ રાતી બોલતા હો, તો િન: ુલ્ક ભાષા સહાય સેવાઓ તમારા માટ ઉપલબ્ધ છે . ફોન કરો ચ1-855-869-7228 (TTY: 1-800-361-2629).UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń podnumer 1-855-869-7228 (TTY: 1-800-361-2629).ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-855-8697228 (TTY: 1-800-361-2629).្របយ័ត ៖ េបើសិន អ កនិ យ ែខ រ, េស ជំនួយែផ ក េ យមិនគិតឈ លគឺ ច នសំ ប់បំេ រ អ ក។ ចូ រ ទូ រស័ព 1-855-869-7228 (TTY: 1-800-361-2629)។ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-855869-7228 (TTY: 1-800-361-2629).24 UPMC Health Plan 2016-2017

UPMC Health Plan received the highest numericalscore among commercial health plans inPennsylvania in the J.D. Power 2016 U.S. MemberHealth Plan Study, based on 31,867 responses from9 plans measuring experiences and perceptions ofmembers surveyed October-December 2015. Yourexperiences may vary. Visit jdpower.comU.S. Steel Tower, 600 Grant StreetPittsburgh, PA 15219www.upmchealthplan.comCopyright 2016 UPMC Health Plan, Inc. All rights reserved.OE CITY OF PGH ENRLL BR 16SAM0717 (SHD) 10/3/16

4 UPMC Health Plan 2016-2017 UPMC Health Plan 2016-2017 5 Need more information? Call the UPMC Health Plan toll-free Open Enrollment Hotline at 1-844-780-7044Monday through Friday from 7 a .m . to 7 p .m . and Saturday from 8 a .m . to 3 p .m . (TTY users should call 1-866-407-8762 .) Or visit upmchp.us/choose. Find a doctor near you

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