Eff. date 01/01/10 and beyond

• Benefit Options for Preferred Plans (Except Asuris Advance)
• Benefit Options for Asuris Advance Preferred Plan
• Benefit Options for HSA Healthplan

Exclusions and Limitations

Eff. date 10/15/2009 to 12/31/09

• Benefit Options for Preferred Plans (Except Asuris Advance)
• Benefit Options for Asuris Advance Preferred Plan

Exclusions and Limitations

Eff. date 01/01/09

• Asuris Embark Plan Highlights
• Asuris Vantage Plan Highlights
• Asuris Motivate Plan Highlights

Eff. date 01/01/09

• Traditional HSA Benefit Summary
• HSA 100 Benefit Summary
• Embedded HSA Benefit Summary

Eff. date 01/01/10 and beyond

100+ employees

• HSA Healthplan
• Preferred Plan 80/80/50
• Preferred Plan 100/80/60/15
• Preferred Plan 100/80/60/20
• Preferred Plan 100/80/60/25

Eff. date 10/15/09 to 12/31/09

51+ employees

• HSA Healthplan
• Preferred Plan 80/80/50
• Preferred Plan 100/80/60/15
• Preferred Plan 100/80/60/20
• Preferred Plan 100/80/60/25

2-50 employees

• HSA Healthplan
• Preferred Plan 80/80/50
• Preferred Plan 100/80/60/15
• Preferred Plan 100/80/60/20
• Preferred Plan 100/80/60/25

Eff. date 01/01/10 and beyond

100+ employees

• Asuris Advance 70/70/50/20
• Asuris Advance 70/70/50/25
• Asuris Advance 70/70/50/30
• Asuris Advance 80/80/50/20
• Asuris Advance 80/80/50/25
• Asuris Advance 80/80/50/30

Eff. date 10/15/09 to 12/31/09

51+ employees

• Asuris Advance 70/70/50/20
• Asuris Advance 70/70/50/25
• Asuris Advance 70/70/50/30
• Asuris Advance 80/80/50/20
• Asuris Advance 80/80/50/25
• Asuris Advance 80/80/50/30

2-50 employees

• Asuris Advance 70/70/20
• Asuris Advance 70/70/25
• Asuris Advance 70/70/30
• Asuris Advance 80/80/20
• Asuris Advance 80/80/25
• Asuris Advance 80/80/30

• Preferred Medication List (PML)/Formulary (located on the RegenceRx site)

Eff. date 01/01/10 and beyond

• Rx Medications $15 Closed Formulary
• Rx Medications $20 Closed Formulary
• Rx Medications $7/30%/50%
• Rx Medications $12/30%/50%
• Rx Medications $10/$20/$40
• Rx Medications $500 Deductible
• Rx Medications 50% Note: Available only for renewing groups that already have the 50% Rx benefit.

Eff. date 10/15/09 to 12/31/09

• Rx Medications $15 Closed Formulary
• Rx Medications $20 Closed Formulary
• Rx Medications $7/30%/50%
• Rx Medications $12/30%/50%
• Rx Medications $10/$20/$40
• Rx Medications $500 Deductible
• Rx Medications 50% Note: Available only for renewing groups that already have the 50% Rx benefit.

• Creditable Coverage Status for Facets Pharmacy Products (PDF)

• Traditional Dental Plan 100/80/50
• Traditional Dental Plan 100/80/50/25
• Traditional Dental Plan 100/80/50/50
• Traditional Dental Plan 80/80/50/25
• Orthodontic Option Traditional Dental Plan (for groups of 26 or more employees only)

• Columbia Dental Plan CD-10
• Columbia Dental Plan CD-15A
• Orthodontic Option Columbia Dental Plan