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1 Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. > GETTING INFORMED. Medical Plan Options > GETTING HEALTHY. Medical Plan Tools > PARTICIPATING. Eligibility Prescription Drug Coverage Enrolling for Coverage Vision Coverage Medicare Dental Plan Options This guide works like a website. To get started, click one of the buttons at the top to go to each section. To navigate within a section, use the links in the navigation bar on the left. The underlined text throughout this guide will also link to more information. Enter 1. Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. GET INFORMED GET HEALTHY PARTICIPATING. > GETTING INFORMED. Medical Plan Options Medical Plan Options In Brief Plan Options Description Things to Consider For retirees and The Aetna HMO and Kaiser Permanente HMO (Kaiser HMO) offer all- When Choosing a Plan.

2 Spouses who are: inclusive, efficient medical care, often with an emphasis on prevention, for Considerations for Under age 65 those who don't have Medicare coverage. Retirees with Medicare Age 65 or The Aetna Open Access Managed Choice (OAMC) Plan gives you the Aetna High Option over but not flexibility to use any licensed medical provider you choose, as a typical Medicare eligible OAMC PPO/Aetna PPO plan does. OAMC PPO After 65 or over The Aetna High Option OAMC Plan is available for those who prefer to with Medicare pay a lower monthly contribution for coverage in exchange for a higher HMOs Part A and/or Part B annual deductible. Aetna Medicare PPO/ESA Aetna Medicare HMO Plan, Kaiser Senior Advantage, and Medicare Advantage- For retirees and UnitedHealthcare Medicare HMO are HMOs for those with Medicare Prescription Drug spouses who coverage.

3 You assign your Medicare benefits to the HMO and the HMO. HMOs are: coordinates with Medicare Parts A and B. The Aetna Medicare PPO/ESA Plan is available for retirees with Medicare Age 65 or over Prescription Drug with Medicare Parts A and B. You'll assign these Medicare benefits to the plan, and you'll Coverage Part A and B receive the highest level of benefits when you receive care from a provider in the plan's network. Vision Coverage If you're enrolled for Medicare A or B and wish to remain on the Aetna Dental Plan Options Prescription HMO or OAMC medical plans, please remember that you can lower your Drug Plan premium costs by enrolling in the Medicare D Prescription Drug Plan. Reminder You'll need to complete a separate enrollment form to start paying lower premiums. See Prescription Drug Coverage for more information.

4 Print Search Back | Next 2. Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. GET INFORMED GET HEALTHY PARTICIPATING. > GETTING INFORMED. Medical Plan Options Medical Plan Options All City retirees may choose from several medical plans for coverage. Your plan choices Important! Retiree and spouse will have to review Things to Consider depend on your age, state of residence and Medicare status. See below for the plans the Retiree Medical When Choosing a Plan available to you. For a general description about the plans available to you, click the name Benefits Decision Tree Considerations for of the plan(s) you're interested in. separately to determine Retirees with Medicare Refer to the 2020 Retiree Benefits Summary Comparison Chart for more information appropriate coverage. Aetna High Option about the cost of key services.

5 Keep in mind that each plan has special rules regarding Spouse is required to OAMC PPO/Aetna coverage outside the service area. Call your plan for information before you travel. enroll in a like plan OAMC PPO similar to the retiree. HMOs Under age 65 with no Medicare coverage For example, if the Reside in California Reside outside of California retiree enrolls in a PPO, Aetna Medicare the spouse must also. PPO/ESA Aetna High Option OAMC PPO Aetna High Option OAMC PPO. If unsure about Medicare Medicare Advantage- Aetna OAMC PPO Aetna OAMC PPO. eligibility, please contact Prescription Drug Kaiser HMO Kaiser HMO (GA, HI, CO, and your local Social Security HMOs Aetna HMO Northwest Limited). office. UnitedHealthcare HMO. Prescription Drug Coverage Age 65 or older with no Medicare coverage Vision Coverage Reside in California Reside outside of California Aetna High Option OAMC PPO Aetna High Option OAMC PPO.

6 Dental Plan Options Aetna OAMC PPO Aetna OAMC PPO. Kaiser HMO Kaiser HMO (GA, HI, CO, and Aetna HMO Northwest Limited). UnitedHealthcare HMO. CONTINUED. Print Search Back | Next 3. Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. GET INFORMED GET HEALTHY PARTICIPATING. > GETTING INFORMED. Medical Plan Options Age 65 or older with Medicare coverage Reside in California Reside outside of California Medicare Part A Medicare Part A Medicare Part A Medicare Part A. Things to Consider OR AND OR AND. When Choosing a Plan Part B (not both) Part B Part B (not both) Part B. Considerations for Aetna High Option Aetna Medicare Aetna High Option Aetna Medicare Retirees with Medicare . OAMC PPO with PPO/ESA 2 OAMC PPO with PPO/ESA3. Aetna High Option PDP1 Aetna High Option PDP1 Aetna High Option OAMC PPO/Aetna Aetna OAMC PPO OAMC PPO with Aetna OAMC PPO OAMC PPO with OAMC PPO with PDP1 PDP1 with PDP1 PDP1.

7 HMOs Kaiser Senior Aetna OAMC PPO Aetna OAMC PPO. Advantage HMO2 with PDP1 with PDP1. Aetna Medicare Aetna HMO with Kaiser Senior Kaiser Senior PPO/ESA PDP1 Advantage HMO Advantage HMO. Medicare Advantage- Aetna Medicare (GA, HI, CO, and Northwest Prescription Drug HMO. Limited). HMOs UnitedHealthcare Medicare HMO. Aetna HMO with PDP1. Prescription Drug Aetna HMO with Coverage PDP1. Vision Coverage 1 . P DP stands for Medicare Part D prescription drug plan. Although these plans provide Medicare Part Dental Plan Options D coverage for prescription drugs, CMS requires that you complete a separate enrollment form to have the plan's Medicare Part D prescription drug coverage. 2. Y ou may enroll in the plan if you have Medicare Part A or B, but you will have to pay a penalty if you don't have both Parts A and B. 3. n Extended Service Area may be available if you do not reside in an Aetna PPO Medicare service A.

8 Area. Higher premiums will apply. Print Search Back | Next 4. Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. GET INFORMED GET HEALTHY PARTICIPATING. > GETTING INFORMED. Medical Plan Options Things to Consider When Choosing a Medical Plan When considering your medical plan options, it's important to compare the contributions you'll Things to Consider pay for coverage. The spectrum below shows how much you pay for the medical plans. The When Choosing a Plan plans in the dark orange boxes on the left have less retiree premium responsibility meaning Considerations for that it doesn't cost most retirees anything to enroll in these plans. If you enroll in the plans in Retirees with Medicare the light orange boxes, you'll pay contributions, with the plans furthest on the right having the highest contributions. Aetna High Option OAMC PPO/Aetna Medical Plan Cost Spectrum OAMC PPO.

9 Kaiser Aetna Aetna Aetna High HMOs Senior Medicare UnitedHealthcare Medicare Kaiser Aetna Option Aetna Medicare HMO HMO HMO OAMC. Aetna Medicare Advantage HMO Plan PPO Plan OAMC. PPO/ESA. Lowest Retiree Contributions Highest Retiree Contributions Medicare Advantage- Prescription Drug Depending on your needs, you may find that the levels of benefits between different plans HMOs are similar and that you could save a significant amount of money by enrolling in a plan with lower contributions. Prescription Drug Coverage In addition to contributions, you should also consider: Vision Coverage Your lifestyle: Do you travel a lot or have a residence in another area or state? Are preventive services important to you? Dental Plan Options Health care providers: Is it important for you to continue seeing a doctor who may not be in one of the HMO networks?

10 Are the doctors and hospitals convenient? Does your current provider participate in another plan's network that has lower contributions? Medicare eligibility: If you're enrolled in Medicare Parts A and B, you can assign your Medicare benefits to certain HMOs. See the Medicare section for additional information. Benefit Cost: Costs for services are different under each plan. Consider the differences in services, conveniences, etc., and determine what is best for you. Print Search Back | Next 5. Contacts Legal Notices YOUR 2020 RETIREE BENEFITS GUIDE. GET INFORMED GET HEALTHY PARTICIPATING. > GETTING INFORMED. Medical Plan Options Additional Considerations for Retirees with Medicare Coverage Things to Consider If You Currently Assign Your Medicare Benefits When Choosing a Plan Government regulations allow you to assign your Medicare benefits to only one plan Considerations for at a time.