Teradyne ESI Advantage Blue. Plan details: (click to view documents)

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1 Welcome Teradyne Advantage Blue Contents Plan details: (click to view documents) PPO Summary Get more details on your plan (click to view documents) Teradyne ESI Advantage Blue View Document Teradyne Care Concierge View Document Fitness Benefit Fact Sheet View Document ahealthyme Wellness Brochure View Document Weight Loss Benefit Fact Sheet View Document Blue Care Line Fact Sheet View Document Registered Marks and Service Marks of the Blue Cross and Blue Shield Association. and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc Blue Cross and Blue Shield of Massachusetts, Inc.

2 SUMMARY OF BENEFITS Advantage Blue EPO Teradyne, Inc. An Association of Independent Blue Cross and Blue Shield Plans

3 Your Care Advantage Blue is an exclusive provider health care plan, commonly referred to as an EPO. You receive benefits only when you use preferred providers, except for covered emergency care. When You Choose Preferred Providers. After a $300 per admission copayment, you have full coverage for inpatient hospital, physician, and other provider covered services. The $300 inpatient copayment does not apply to admissions to a skilled nursing facility or rehabilitation facility. For outpatient services, there are two levels of copayment. You pay a $20 copayment for each visit when care is received from the following types of providers: Family or general practitioner Geriatric specialist Internist OB/GYN physician Physician assistant Nurse midwife Nurse practitioner Audiologist Optometrist Pediatrician Multi-specialty provider group You pay a $40 copayment per visit for services by other types of providers (usually specialists), community health centers and hospital outpatient services. The copayments do not apply to preventive care services. For these services, you pay nothing. Please note: If a preferred provider refers you for covered services to another provider (such as a lab or specialist), make sure the provider you have been referred to is also a preferred provider. If the provider you use is not a preferred provider, you pay all costs even if you are referred by a preferred provider. How to Find a Preferred Provider. There are several ways to find a preferred provider: Look up a provider in the Provider Directory. If you need a copy of your directory, call Member Service at the number on your ID card. Visit the Blue Cross Blue Shield of Massachusetts website at Call our Physician Selection Service at When You Choose Non-Preferred Providers. You are covered for emergency care only. To receive coverage, any necessary follow-up care must be received from a preferred provider. Your Out-of-Pocket Maximum. Your out-of-pocket maximum is the most that you could pay during a calendar year for copayments and coinsurance for covered services. Your medical out-of-pocket maximum is $2,000 per member (or $4,000 per family). Emergency Room Services. In an emergency, such as a suspected heart attack, stroke, or poisoning, you should go directly to the nearest medical facility or call 911 (or the local emergency phone number). You pay a $100 copayment per visit for emergency room services. This copayment is waived if you are admitted to the hospital or for an observation stay. Utilization Review Requirements. You must follow the requirements of Utilization Review, which are Pre-Admission Review, Pre-Service Approval for Certain Outpatient Services, Concurrent Review and Discharge Planning, and Individual Case Management. If you need non-emergency or non-maternity hospitalization, you or someone on your behalf must call the number on your ID card for pre-approval. Information concerning Utilization Review is detailed in your benefit description and riders. If you do not notify Blue Cross Blue Shield and receive pre-approval, your benefits may be reduced or denied. Dependent Benefits. This plan covers dependents until the end of the calendar month in which they turn age 26, regardless of their financial dependency, student status, or employment status. Please see your benefit description (and riders, if any) for exact coverage details. Domestic Partner Coverage. Domestic partner coverage may be available for eligible dependents. Contact your plan sponsor for more information.

4 Your Medical Benefits Plan Specifics Calendar-year out-of-pocket maximum Covered Services Preventive Care Well-child care exams, including related tests, according to age-based schedule as follows: 10 visits during the first year of life Three visits during the second year of life (age 1 to age 2) Two visits for age 2 One visit per calendar year from age 3 through age18 Routine adult physical exams, including related tests for members age 19 or older (one per calendar year) Routine GYN exams, including related lab tests (one per calendar year) Routine hearing exams, including related tests Routine vision exams (one every 24 months) Family planning services office visits Routine PSA test for a member age 40 and older (one per calendar year) Other Outpatient Care Emergency room visits Allergy injections Office visits Family or general practitioner, geriatric specialist, internist, licensed dietitian nutritionist, OB/GYN or pediatrician, physician assistant, nurse midwife, nurse practitioner, audiologist, optometrist Other covered providers Mental health or substance abuse treatment Chiropractors office visits Infertility services office visits (up to a $25,000 lifetime benefit maximum per member) Short-term rehabilitation therapy physical and occupational (up to 100 visits per calendar year*) Speech, hearing, and language disorder treatment speech therapy Diagnostic X-rays, lab tests, and other tests, excluding CT scans, MRIs PET scans, and nuclear cardiac imaging tests CT scans, MRIs, PET scans, and nuclear cardiac imaging tests Oxygen and equipment for its administration Home health care and hospice services Prosthetic devices Durable medical equipment and repairs such as wheelchairs, crutches, hospital beds Surgery and related anesthesia Office and health center services Hospital and other day surgical facility services Your Cost $2,000 per member $4,000 per family $100 per visit (waived if admitted or for observation stay) $20 per visit, no deductible $40 per visit, no deductible $20 per visit $40 per visit $40 per visit and all charges beyond the benefit maximum $20 per visit $20 per visit $50 per category per date of service (no cost for interpretation) $150 per admission (no cost for medically necessary colonoscopies) * No visit limit applies when short-term rehabilitation therapy is furnished as part of covered home health care or for the treatment of autism spectrum disorders.

5 Covered Services Inpatient Care (including maternity care) General or chronic disease hospital care (as many days as medically necessary) Mental hospital or substance abuse facility care (as many days as medically necessary) Rehabilitation hospital care (up to 60 days per calendar year) Skilled nursing facility care (up to 100 days per calendar year) Your Cost $300 per admission $300 per admission Get the Most from Your Plan. Visit us at or call to learn about discounts, savings, resources, and special programs like those listed below that are available to you. Wellness Participation Program Reimbursement for a membership at a health club or for fitness classes This fitness program applies for fees paid to: privately owned or privately sponsored health clubs or fitness facilities, including individual health clubs and fitness centers; YMCAs; YWCAs; Jewish Community Centers; and municipal fitness centers. (See your benefit description for details.) Reimbursement for participation in a qualified weight loss program This weight loss program applies for fees paid to: a qualified hospital-based weight loss program or a Blue Cross Blue Shield of Massachusetts designated weight loss program. (See your benefit description for details.) Blue Care Line SM A 24-hour nurse line to answer your health care questions call BLUE (2583) $150 per calendar year per policy $150 per calendar year per policy No additional charge Healthy You Concierge Care Center For answers to claims, benefits as well as any health or wellness-related questions call Member Services at The nurses in the Care Center are available to support your health care needs, whether that means choosing a doctor or hospital, understanding a diagnosis, medication, or upcoming surgery or procedure, or taking advantage of benefits available through your plan to help you lead a healthier life. No additional charge Questions? Call For questions about Blue Cross Blue Shield of Massachusetts, visit the website at Interested in receiving information from Blue Cross Blue Shield of Massachusetts via ? Go to to sign up. Limitations and Exclusions. These pages summarize the benefits of your health care plan. The benefit description and riders define the full terms and conditions in greater detail. Should any questions arise concerning benefits, the benefit descriptions and riders will govern. Some of the services not covered are: cosmetic surgery; prescription drugs for use outside the hospital; custodial care; hearing aids for members over age 21; most dental care; and any services covered by workers compensation. For a complete list of limitations and exclusions, refer to your benefit description and riders. Please note: Blue Cross and Blue Shield of Massachusetts, Inc. administers claims payment only and does not assume financial risk for claims. Registered Marks of the Blue Cross and Blue Shield Association. SM Service Marks of the Blue Cross and Blue Shield Association. SM Service Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield HMO Blue, Inc Blue Cross and Blue Shield of Massachusetts, Inc. Printed at Blue Cross and Blue Shield of Massachusetts, Inc BS (9/15) PDF LE

6 Fitness Benefit Your Blue Cross Blue Shield of Massachusetts health plan can save you money annually in qualified health club membership fees or up to 10 fitness classes taken at a qualified health club. 3 Easy Steps to Getting Reimbursed Choose Start by picking a qualified health club. Complete Once you pay for the program, fill out the attached form. Mail Send the completed form to the address listed at the bottom. Important Information The reimbursement is for each individual (or family) health plan and can only be submitted once each calendar year. Keep copies of all your paperwork and proof of payment in case you are denied reimbursement. Proof of payment includes the following: Itemized, dated, paid receipts from your health club Bank or credit card statements Paycheck stubs if your club fees are automatically deducted from that account Receipts or statements should include the name of the family member enrolled and the individual charges for a full reimbursement of health club fees or fitness classes. The dollar amount you receive may be considered taxable income. Consult your tax advisor about how to treat this reimbursement on your taxes. What s covered: 2 Your benefit will reimburse you for three consecutive months of membership fees from a qualified health club or for up to 10 fitness classes taken at a qualified health club. A qualified health club is: A full-service health club with a variety of exercise equipment, including: Cardiovascular equipment like treadmills and bikes Strength-training equipment like free weights and weight machines To receive the fitness reimbursement for a qualified pay-as-you-go health club, get paid receipts from the club for your records. What doesn t qualify? You can t receive the fitness reimbursement for expenses for personal training, lessons, coaching, equipment, clothing, or any of the clubs below: Martial arts or yoga centers Gymnastics, tennis, aerobic, or pool-only facilities Country clubs or social clubs Sports teams or leagues Be sure to talk with your doctor before starting an exercise program. 1. Before starting, check to see if your plan includes the Fitness Benefit. 2. Most plans offer a reimbursement for three months of membership or up to 10 fitness classes, but your employer may have offered a different benefit. Please refer to your benefits information to confirm. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association

7 Fitness Reimbursement Form 3 To verify this reimbursement is within your plan, log in to Member Central at or call Member Service at the number on your ID card. Submit this form once per calendar year, no later than March 31 of the following year. PLEASE PRINT ALL INFORMATION CLEARLY Subscriber Information (Policyholder) Identification Number (including first 3 letters) Subscriber s Last Name First Name Middle Initial Address Number and Street City State Zip Code Employer s Name Member and Claim Information Member s Last Name First Name Middle Initial Date of Birth: Mo. Day Yr. Mailing Address Number and Street (if different from subscriber s) City State Zip Code Gender Male Female Claim is for (check one): Subscriber (policyholder) Ex-Spouse Other (specify) Spouse (of policyholder) Dependent (up to age 26) Name, Address, and Phone Number of Qualified Health Club I am due $ for the following reimbursement (check one): Membership at a qualified health club. My monthly fee is $. Fitness classes at a qualified health club. My fee per class is $. Health Plan Year Certification and Authorization (This form must be signed and dated below.) I authorize the release of any information to Blue Cross Blue Shield of Massachusetts about my health club membership. I certify that the information provided in support of this submission is complete and correct and that I have not previously submitted for these services. I understand that Blue Cross may require additional evidence of health club membership and proof of payment for my membership before reimbursement is provided. Subscriber s or Member s Signature: Date: Questions? To verify this reimbursement is within your plan or for further information, please log in to the Member Central website at or call Member Service at the number on the front of your ID card. Please complete and mail this form to: Blue Cross Blue Shield of Massachusetts Local Claims Department PO Box Boston, MA Blue Cross will make a reimbursement decision within 30 calendar days of receiving a completed request for coverage or payment. Registered Marks of the Blue Cross and Blue Shield Association Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc M (4/15)

8 Programs, discounts, and tools to help you stay healthy Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association

9 Everything You Need to Live a Healthier Life All in One Place Whatever your health goals are from losing weight to managing stress ahealthyme can help you get there. Access & Convenience Discounts & Deals Pregnancy & Parenthood Alternative Medicine & Services Español Encuentra estos programas, herramientas y recursos disponibles en español que te ayudarán a mantenerte saludable.

10 Live Healthy ahealthyme Your personal wellness planner Create your own action plan with A health assessment that gives you a personal wellness score Self-paced workshops on topics like healthy eating and quitting smoking Nutrition and exercise trackers to keep you motivated Healthy resources Learn about health your way Read articles, tips, and our Healthy Times newsletter Watch videos and listen to podcasts Take quizzes, risk assessments, and more Español Recursos saludables para conocer el camino hacia una buena salud. Visita

11 Access & Convenience Connected Always on the go? No problem. Access our collection of mobile applications anywhere, anytime. Web, Apps, Texts & Social There s so much you can do on the go Find a doctor or hospital Manage your prescriptions Get weekly health tips via text throughout pregnancy and motherhood Follow us on Facebook, Twitter, and YouTube Track your progress toward your fitness and nutrition goals Go to

12 Discounts & Deals Deals From gym memberships and diet programs to family activities, we have just the deal for you. Blue365 Get special savings, 365 days a year Healthy Choices: fitness, weight management, food and nutrition, and stress management Health Care Resources: financial services and assessments, information about prescription drugs, hearing and vision care, and insurance tips Recreation and Travel: arts and entertainment, outdoor recreation, and travel tips Go to

13 Pregnancy & Parenthood Family Have questions about pregnancy, labor, and what to expect during your baby s first year? We can help answer your questions. Living Healthy Babies A trusted, online resource for new parents Pregnancy Prep: understand your body and plan ahead with ovulation calculators Pregnancy: know what to expect in each trimester and download a birth plan New Parents: learn more about your baby s first year Go to Español Tienes preguntas sobre el embarazo, el parto y qué esperar durante el primer año de tu bebé? Visita

14 Alternative Medicine & Services Alternative Save on alternative services nationwide like massage therapy and acupuncture. Living Healthy Naturally SM A complementary approach to health Services: massage therapy, acupuncture, pilates, yoga, and much more Discounts: save up to 30 percent on select services or medicine Peace of Mind: relax knowing all practitioners meet requirements for education, training, and facilities Go to www. bluecrossma.com/alternative-care

15 We are here to help Member Service For questions about your health coverage, claims, and benefits. Call the number on your Blue Cross ID card, Monday through Friday, 8:00 a.m. to 6:00 p.m. ET. Español Estamos para responder a tus preguntas sobre tu plan médico. Llama al número que se encuentra en tu tarjeta de identificación de Blue Cross. Member Central Review your claims and benefits information, order a new ID card, change your primary care provider, and do so much more. Blue Care Line SM For questions about your health if you re hurt or sick and not sure where to get care. Call us 24/7 to speak directly to a nurse who can help guide your care. Español Si tienes preguntas sobre tu salud, puedes comunicarte con un enfermero disponible las 24 horas del día, los 7 días de la semana BLUE (2583), SM Registered Marks and Service Marks of the Blue Cross and Blue Shield Association., SM Registered Marks and Service Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc Blue Cross and Blue Shield of Massachusetts, Inc M (3/15)

16 Weight Loss Benefit 3 Easy Steps to Getting Reimbursed 2 Your Blue Cross Blue Shield of Massachusetts health plan can save you money annually in qualified Weight Watchers and hospital-based weight-loss programs. 3 Easy Steps to Getting Reimbursed Choose Start by picking a qualified weight-loss program. Complete Once you pay for the program, fill out the attached form. Mail Send the completed form and proof of payment to the address listed at the bottom. Important Information The reimbursement is for each individual (or family) health plan and can only be submitted once each calendar year. Keep copies of all your paperwork and proof of payment in case you are denied reimbursement. Proof of payment includes the following: Paid receipts from qualified program Weight Watchers Membership Book Receipts, statements, or Weight Watchers Membership Book should include the name of the family member enrolled in the program, the amount paid per session(s), and date(s) paid. The dollar amount you receive may be considered taxable income. Consult your tax advisor about how to treat this reimbursement on your taxes. Be sure to check with your doctor before starting any weight-loss program. What's covered: 2 Your benefit will reimburse you for up to three months of participation in a qualified weight-loss program. A qualified weight-loss program is: Weight Watchers meetings Weight Watchers At Work A hospital-based weight-loss program What doesn t qualify? Weight Watchers Online Weight Watchers At Home Fees paid for individual nutrition-counseling sessions, food, books, videos, or scales 1. Before starting, check to see if your plan includes the Weight Loss Benefit. 2. Most plans offer a three-month reimbursement, but your employer may have offered a different benefit. Please refer to your benefits information to confirm. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association

17 Weight-Loss Reimbursement Form 3 To verify this reimbursement is within your plan, log in to Member Central at or call Member Service at the number on your ID card. Submit this form when you have paid receipts from a qualified weight-loss program, once per calendar year, no later than March 31 of the following year. PLEASE PRINT ALL INFORMATION CLEARLY Subscriber Information (Policyholder) Identification Number (including first 3 letters) Subscriber s Last Name First Name Middle Initial Address Number and Street City State Zip Code Employer s Name Member and Claim Information Member s Last Name First Name Middle Initial Date of Birth: Mo. Day Yr. Mailing Address Number and Street (if different from subscriber s) City State Zip Code Gender Male Female Claim is for (check one): Subscriber (policyholder) Ex-Spouse Other (specify) Spouse (of policyholder) Dependent (up to age 26) Class or Program Information Required: Attach 8.5" x 11" photocopies of paid receipts from your qualified weight-loss program. Receipts must show Blue Cross Blue Shield of Massachusetts member s name, name or logo of program, amount paid per session(s), and date(s) paid. For qualified Weight Watchers programs, a photocopy of your program Membership Book showing this information is required. Name and Address of Class or Program Health Plan Year Total Amount Submitted: $ Certification and Authorization (This form must be signed and dated below.) I authorize the release of any information to Blue Cross and Blue Shield of Massachusetts about my weight-loss program. I certify that the information provided in support of this submission is complete and correct and that I have not previously submitted for these services. Subscriber s or Member s Signature: Date: Questions? To verify this reimbursement is within your plan or for further information, please log in to the Member Central website at or call Member Service at the number on the front of your ID card. Please complete and mail this form (including copies of paid receipts) to: Blue Cross Blue Shield of Massachusetts Local Claims Department PO Box Boston, MA Blue Cross will make a reimbursement decision within 30 calendar days of receiving a completed request for coverage or payment. Registered Marks of the Blue Cross and Blue Shield Association. Registered Marks are the property of their respective owners Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc M

18 Blue Care line SM We re here for you 24/7 Call BLUE (2583) for the Blue Care Line. We re here for you 24/7 Have a question about your health? You can talk to a professionally trained, registered nurse 24 hours a day, seven days a week. They re ready when you are even at 4 a.m. Know your options Calling the Blue Care Line is a quick way to find out if you need to see a doctor, go to an emergency room, or if you re able to treat it yourself at home. We ll call you Depending on your type of illness or injury, the registered nurse will call and follow up to see how you re responding to the self-treatment. Confidentiality Your information is kept in accordance with our policy on confidentiality. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Registered Marks of the Blue Cross and Blue Shield Association Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc (3/15)

19 Advantage Blue EPO Plan Your prescription co-payments at a glance Co-Payment Phase You pay the co-payment amounts listed in the chart below until you reach your out-of-pocket maximum of $2,000/single and $4,000/family*. *Out-of-Pocket Maximum is Medical and Prescription Drug Combined At a retail pharmacy Through home delivery Generic drugs Preferred brand-name drugs Nonpreferred brand-name drugs $10, up to a 30-day supply $30, up to a 30-day supply $50 up to a 30-day supply $20, up to a 90-day supply $75, up to a 90-day supply $125, up to a 90-day supply Cost of standard shipping is part of your plan 100 Percent Coverage Phase Once you ve reached your out-of-pocket maximum, your plan pays 100 percent of eligible medical and prescription drug expenses for the remainder of the benefit year. Home Delivery Pharmacy Services If you need a long-term medication, you may pay less over time by using home delivery pharmacy services from Express Scripts. We'll deliver up to a 90-day supply right to you-and standard shipping is free. Take a home delivery form to your doctor and ask if a 90-day prescription would be right for you. Home Delivery forms can be obtained on the Express Scripts web site. Your doctor can also fax your prescription to Express Scripts by calling for faxing instructions. To learn more about your benefit, log in to Express-Scripts.com and select "Benefit highlights" from the menu under Health & Benefits Information. Affordable Care Act - Preventative Medications Certain preventative medications in the following categories are covered at $0 copay for eligible members: Aspirin, Fluoride, Folic Acid, Iron Supplements, Smoking Cessation, Women s Contraceptives, Vaccines, Vitamin D, Colonoscopy Preps, and Breast Cancer Treatment. Express Scripts may contact your doctor about your prescriptions If you are prescribed a drug that is not on your health plan's preferred list, yet an alternative plan-preferred drug exists, we may contact your doctor to ask whether that drug would be appropriate for you. If your doctor agrees to use a plan-preferred drug, you will usually pay less. Use generics and preferred medications If you are taking a medication that s not on the preferred list, ask your doctor to consider prescribing a lower-cost generic or preferred brand-name drug. To find out which drugs are preferred, log in to Express-Scripts.com and select Learn about Formularies from the Health & Benefits Information menu. KEEP THIS INFORMATION For more information about your benefit, log in to Express-Scripts.com, or call Member Services toll-free at

20 For short-term prescriptions, such as antibiotics, use a participating retail pharmacy As a member, you can go to any of nearly 60,000 retail pharmacies, including most major drugstores. Just ask your retail pharmacy if it's in our network. You can also log in to Express-Scripts.com and select "Locate a pharmacy" from the menu under "Manage Prescriptions." Prior authorization: When is a coverage review necessary? Some medications are not covered unless you first receive approval through a coverage review (prior authorization). This review uses plan rules based on FDA-approved prescribing and safety information, clinical guidelines and uses that are considered reasonable, safe and effective. There are other medications that may be covered, but with limits (for example, only for a certain amount or for certain uses), unless you receive approval through a coverage review. During this review, Express Scripts asks your doctor for more information than what is on the prescription before the medication may be covered under your plan. To find out whether a medication requires a coverage review, log in to Express-Scripts.com, select "Price a medication" from the menu under Manage Prescriptions, and search for your medication. On the pricing results page, select "View coverage notes" to see coverage details. My Rx Choices : An easy way to lower your out-of-pocket prescription costs Your My Rx Choices prescription savings program is designed to help you find potential savings on prescription medications that you or your covered family members take on an ongoing basis. Your doctor knows which medications are right for you but may not know their cost. My Rx Choices provides you with available lower-cost options so that you and your doctor can make the most informed decisions based on health and cost. No prescription is ever changed without your doctor's approval. Specialty medications: Get individualized service through Accredo Specialty medications are drugs that are used to treat complex conditions, such as cancer, growth hormone deficiency, hemophilia, hepatitis C, immune deficiency, multiple sclerosis and rheumatoid arthritis. Accredo Health Group, Inc., Express Scripts specialty pharmacy, is composed of therapy-specific teams that provide an enhanced level of individual service to patients with special therapy needs. Whether they're administered by a healthcare professional, self-injected, or taken by mouth, specialty medications require an enhanced level of service. By ordering your specialty medications through Accredo, you can receive: Toll-free access to specialty-trained pharmacists and nurses 24 hours a day, 7 days a week Delivery of your medications within the United States, on a scheduled day, Monday through Friday, at no additional charge Most supplies, such as needles and syringes, provided with your medications Safety checks to help prevent potential drug interactions Refill reminders Up to a 90 -day supply of your specialty medication for just one copayment Automatic refills: A convenient, automatic refill program for your long-term medications When you refill certain home delivery prescriptions, you'll be asked whether you want to enroll. Once you enroll and are ready for a refill or renewal, your medications will automatically be shipped to you. Find out more about how automatic refills work by logging in to Express-Scripts.com. Stretch your home delivery payments with the Extended Payment Program Instead of paying in full up front, you'll be billed for the cost of your medications over three installments. You can enroll online. Express Scripts manages your prescription benefit for your employer. EME31362 LT46210K CRP15_1491

21 Care Concierge Personalized, One-on-One Health Guidance You re an employee with Blue Cross Blue Shield of Massachusetts coverage. That means you and your family have access to an exclusive health service, Care Concierge. Best of all, it s available at no additional cost to you. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Call Care Concierge at the number on your Blue Cross ID card, , Monday through Friday, 8:00 a.m. to 8:00 p.m. ET.

22 The Care Concierge team is ready to: Help you make better-informed health decisions Support you with a diagnosis you received Guide you through our available wellness programs and resources 101 Huntington Avenue Suite 1300 Boston, MA presort STANDARD MAIL U.S. Postage Paid BCBSMA Boston, MA Permit No Call Care Concierge at the number on your Blue Cross ID card, , Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. Your Privacy Is Important to Us Any information you share is treated in accordance with the Blue Cross Blue Shield of Massachusetts policy on confidentiality. Registered Marks of the Blue Cross and Blue Shield Association Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc M (7/15)