2023 AtlantiCare Benefits Booklet

What’s New for 2023

TABLE OF CONTENTS WELCOME.................2 WHAT’S NEW. ...........3 SERVICE CENTERS AND WEBSITES..........4 HOW TO ENROLL....5-6 MEDICAL..............7-14 PRESCRIPTION DRUG. ................15-17 ADDITIONAL MEDICAL PLAN RESOURCES........18-22 DENTAL...............23-24 VISION.....................25 LIFECENTER..............26 LIFE INSURANCE. .....27 DISABILITY...............28 VOLUNTARY OFFERINGS. ........29-32 SPENDING ACCOUNTS. ............33 RETIREMENT BENEFITS..................34 WELLNESS. .........35-38 LEGAL NOTICES...39-41 GLOSSARY..........42-43 FAQs...................44-46 CONTACTS.........47-48 FORMS................49-58

WHATS NEW FOR 2023 • Horizon Medical - Employee contribution rates increases (pg.10)

Discount Shopping • Check out hundreds on deals and savings plus some deals from local businesses, exclusively for AtlantiCare! Click on the “Discount Shopping” tab on the Starfish to learn more. Health & Wellbeing Resources • See a listing of resources available at AtlantiCare and in the community (pg. 52) 2023 Wellness Activity Checklist • The Wellness Activities and credit amounts have changed. Please review on page 49. • Now earn credits for attending: - Health Engagement Wellness Seminars - Attending the LifeCenter - Enrollment in the Patient Portal

- Tier 2 copays and coinsurance - see table below (pg.13) - In keeping with ACA IRS limits, out-of-pocket maximums change to $7,350 for single coverage and $14,700 for family coverage (pg.13) - Mental Health Office Visits continue to be covered at 100% after a $10 copay for Inner Circle and Tier 2 levels of coverage. These visits are not subject to the deductible. • Employee Assistance Program (EAP) - Employees and eligible family members have access to this confidential wellness benefit (pg. 18) • Prescription - Non-Specialty - Brand preferred prescriptions at Non-AtlantiCare (retail) Pharmacies copay increase from $35 to $50 (pg. 15) • Telehealth - Additional Telehealth program features - still only a $5 copay! (pg.19) • Spending Accounts - Health Flexible Spending Account (FSA) maximum change to $2,850 (pg. 33)

Engaged Plan

PPO Plan

Tier 2 Copay Changes

2022

2023

2022 $750 $750 $500

2023

Room & Board

$1,250 $1,000

$1,500 $1,250 $1,000

$1,000 $1,000

Outpatient Surgery (hospital based) Outpatient Surgery (surgical based)

$750

$700

3