HPHC Additional Resources

Harvard Pilgrim: Your Partner in Health Care Understand your benefits DGI Communications January 1, 2024

Organizational Brand Hierarchy Commercial health insurance Medicare and Medicaid will will be branded as: continue to be branded as: This parent name (Point32Health) represents the collective interests of our family of companies who share common goals to transform health care for all customers we serve. We believe we can achieve more when we work together. Toguide and empower healthier lives for everyone. 2

2024 Plan Highlights 3

2024 Plan Highlights NEW wellness reimbursement program Integrated behavioral health program and resources Expanded family-centered care resources 4

HSA-Eligible PPO Plan Overview In-Network Out-of-Network Annual Deductible Individual $3,000 $6,000 Family $6,000 $12,000 HSA-Eligible PPO Annual Out-of-Pocket Maximum Individual $6,000 $12,000 Covers in-network and Family $12,000 $24,000 out-of-network providers Annual Physical (preventive) $0, covered in full Office Visit Deductible Deductible, then 20% coinsurance Specialist Visit Deductible Deductible, then 20% Referral to specialist coinsurance not required Diagnostic X-Ray/Lab Tests Deductible Deductible, then 20% coinsurance Services subject to deductible, Inpatient Hospital (including maternity) Deductible Deductible, then 20% coinsurance then coinsurance Outpatient Hospital Deductible Deductible, then 20% coinsurance Inpatient Mental Health Deductible Deductible, then 20% Eligible to open a Health Savings coinsurance Outpatient Mental Health Deductible Deductible, then 20% Account (HSA) coinsurance Emergency Room Visit Deductible Deductible Physical Therapy (20 visits combined with occupational Deductible Deductible, then 20% therapy per calendar year) coinsurance 5

Provider Network: Finding Care 6

Provider Search: How to Find Doctors and Care https://www.harvardpilgrim.org 7

Easily Find Your Providers Online Visit harvardpilgrim.org Note: Primary Care Providers have a Provider ID number. 8

The Right Quality Care Options for You $ $ $$ $$$ Virtual Care Retail Clinic Urgent Care Emergency Room Clinic (ER) Real-time virtual visit with Walk-in, convenience care or Walk-in clinic for urgent care Part of a local hospital Doctor on Demand providers retail clinic, (CVS Minute Clinic) • Coughs, colds, flu • Bronchitis • Burns, rashes, bites, • Choking • Strep/sore throat • Ear infections cuts and bruises • Convulsions • Pediatric issues • Eye infections • Infections • Heart attack • Sinus and allergies • Skin conditions like • Coughs, cold and flu • Loss of • Nausea/diarrhea poison ivy and • Minor injuries consciousness • Rashes and skin issues ringworm • Respiratory infections • Major blood loss • Women’s health: UTIs, • Strep throat • Sprains and strains • Seizures yeast infections • Sever head trauma • Sports injuries • Shock • Eye issues • Stroke • Behavioral health • Prescription orders at local pharmacy If you think you’re having a medical emergency, call 911 or go to the nearest ER. 9

Behavioral Health: A Whole Person Care Approach 10

Integrated Behavioral Health Overview • At Harvard Pilgrim, we prioritize the overall health and wellness of our members by making high quality behavioral health care accessible and affordable. Our commitment is to provide a best-in-class behavioral health benefit through an integrated care approach that addresses both medical and behavioral health needs, helping to keep total health care costs under control. • Starting November 1, 2023, all Commercial members will be able to access our integrated behavioral health program, a proven model at Tufts Health Plan. The model is focused on providing comprehensive care for medical and behavioral health needs, with condition-based tools, services and care navigation support, as well as access to clinical care, self-service programs and specialty services. • The result will be robust end-to-end network of both medical and behavioral health care providers along with innovative clinical programs, services and resources all managed from within our organization by qualified clinicians working together to help members receive the best possible “whole-person” care. 11

Behavioral Health Overview On November 1, 2023 we will bring our best-in-class, whole person integrated behavioral health approach for Harvard Pilgrim members. This enhanced model is comprised of a broad, innovative provider network, new service navigation program, and access to expanded programs and resources. Service Navigation Provider Network Personalized Support Our enhanced model is Our team of service navigators guide comprised of a broad, insourced members to the right behavioral provider (medical and behavioral health providers to ensure timely health) network in New England Enhanced Network Integrated Physical appointments and streamline access and nationwide Whole Health Planning our behavioral health resources Person Care Innovative Services Optimize Care Coordination Innovative provider partnerships Coordinating Care with our internal provide specialized behavioral licensed Clinicians and peer support health services, including self- specialists will work with members and service digital tools for easy access Care Management Innovative Programs/ their providers to manage their care to virtual therapy and treatments Providers 12

Behavioral Health: Programs & Services We continue to develop unique and innovative partnerships with providers who can enhance service delivery and access to resolve health disparities Autism Substance Use Therapy Access/ NEW Service Digital Tools Navigation - Cortica, AbleTo and Valera Health offer access to 24/7 therapeutic digital tools to support patient treatments. The programs reflected above complement our behavioral health network of providers and facilities. - AbleTo now owns Sanvello, which is in the process of rebranding and will be Self Care moving forward. Please note that Talkspace program will be sunsetting starting November 1. 13

AbleTo program offers 8 weeks of virtual, individualized cognitive-behavioral therapy sessions for motivated 18+ members who are struggling with mild to moderate anxiety, depression, stress, and may be influenced by chronic or recent medical conditions. Additionally, AbleTo and Sanvello are coming together in a single digital experience. Sanvello becomes Self Care by AbleTo, taking the best of Sanvello to create a high quality AbleTo self care digital tool program designed for everyday well-being. From talk therapy to medication1 management, Doctor On Demand licensed providers are here to support members by video or phone visits, with concerns such as anxiety, depression, seasonal affective disorder, or PTSD. A complete set of outpatient clinic services in-person and via telehealth serving children, adolescents, and adults. The network offers outpatient therapy and medication management for children, adolescents, and adults. Comprehensive virtual outpatient behavioral health services for child, adolescent and adults. 14

Behavioral Health Service Navigation Program Launching November 1, 2023 for Harvard Pilgrim Commercial Members GOALS • Strengthen the Member Experience: by helping members navigate the complex healthcare system and care continuum through enhanced Access to Care personalized interactions • Enhance Access to Care: by helping members obtain timely behavioral health appointments and connecting them to internal Vision supports and programs, such as internal care managers Innovative • Connect with Self-service Tools: by educating members about and Programs and Services connecting them with our innovative tools and services to support their Enhanced Personalized Interactions behavioral health needs Behavioral Health • Support Advancement of Health Equity: by providing Behavioral Service Navigation Health Service Navigation to all lines of business 15

Behavioral Health Service Navigation: Member Journey Member calls Integrated 1 Member Services Team for behavioral and physical health 2 Member services representative addresses member’s inquiries – 888-333-4742 behavioral health inquiries and connects member with specialized behavioral health service navigation team 3 Behavioral health service Behavioral health service navigation team connects Member receives follow-up navigation staff works with member to the right service outreach from behavioral member to discuss personalized 4 or resource at the right health team to ensure needs behavioral health support time 5 are met options 16

Behavioral Health: Self-Service Tools & Specialty Care Personalized and effective care, with a focus on improving access to care and overall health outcomes. Virtual Therapy Services Specialty Care Providers Substance Use Treatment Available seven days a week Quick and easy access to care A range of treatment options, to support your mental health for autism spectrum disorder for with support from our internal and well-being, including children, and outpatient care management team after licensed coaching, talk psychiatry and therapy for inpatient treatment: therapy, medication adults, children and adolescents: management and more:  Multiple network providers,  Cortica including Spectrum Health  AbleTo  Transformations Care  Our Addiction Recovery  Doctor On Demand Network Care Management Team  Valera Health If you’re experiencing a crisis or emergency, you should always call 911 or go to the nearest emergency facility right away. 17

Pharmacy Program 18

Understanding Pharmacy Benefits Log in or register for your Plan ahead if you take maintenance medication secure online member account Check your medication expiration date, refill amount and coverage under Harvard Pilgrim. If your medication is not Visit harvardpilgrim.org to get started. covered, talk to your doctor about switching to an alternate . maintenance medication that is covered Look up your prescriptions Save money with mail order service We cover thousands of different medications, Mail order service provides the convenience of home but if your current prescription isn’t on our list delivery instead of going to a retail pharmacy. On some (formulary), talk to your doctor about switching to a plans, your medication may be less expensive if you buy a covered medication. 90-day supply through this service Check if your prescription has special requirements If there is a “PA,” “STPA,” “QL” or “SP” after any of your prescriptions, talk to your provider. Refer to the “Key Terms“ section of this Member Guide for full “special requirements” definitions. 19

Prescription Drug Benefits: Premium 3-Tier Is a prescription covered? How the drug tiers work Find the tier on member ID Card PREMIUM 3-TIER Plan type • Generic drugs, certain over-the-counter Tier 1 $ medications, and selected brand-name drugs Tier 2 $$ • Brand-name drugs without generic equivalents and some high-cost generic drugs Plan tiers Tier 3 $$$ • Drugs not in Tier 1 or Tier 2 (non-preferred Easy to use: brands, and highest cost generics) Online Drug Tier Look-up HarvardPilgrim.org/rx 20

Health Engagement & Wellness Programs 21

Wellness Programs & Services Living Well Online Portal Health Coaching • Holistic well-being program • For members age 18+, one-on-one • Variety of wellbeing activities & support for issues like managing monthly challenges weight, smoking cessation, reducing stress and increasing physical • Syncs to wearable devices activity • Mobile & app accessible • Opportunity to earn rewards Living Well at Home Mindfulness • Free, virtual fitness and wellness • Guided mindfulness sessions led by classes, including Zumba, yoga, barre our team of expert instructors • Wellness webinars • Private Facebook group Reimbursement Programs Discounts & Savings Family Wellness • Wellness • Exclusive savings on a wide • Ovia Health: Family and women’s health range of programs, products and resources services to support your health • Wellthy: Support for caregivers and well-being • Included Health: Support for LGBTQ+ members 22

SM Living Well Health Portal Access the health engagement portal offered through the Living WellSM program. • Available to everyone – at no cost • A holistic program that includes rewards and incentives • Seamless experience and easy to use • Dedicated user support Download the Limeade app to access for on-the-go access from your smartphone, tablet or computer Code Needed: HPHC 23

SM Living Well Health Portal Rewards Designs Enhanced Rewards Core Rewards • Earn up to $120 in gift cards by • Earn entries into monthly participating in the program and gift card drawings by achieving levels participating in the program • $15 gift card at each level, up to 8 and achieving levels levels possible per year (2 per • Available to everyone, quarter) including non-members • Select from over 40 different vendor gift cards 24

SM Living Well at Home Programs Available at no cost to everyone at harvardpilgrim.org/livingwellathome • Live webinars: healthy Yoga Guided Mindfulness eating, mindfulness, fitness M & W T, W, Th and more 5:15 - 6:15 p.m. ET 8:30 - 9 a.m. ET • Live home fitness classes including Zumba, yoga and Zumba Health & Wellness Webinars barre T & Th W & Th • Private Facebook group 5:15 - 6:15 p.m. ET 1 - 1:30 p.m. ET brings community together 25

Mind the Moment Program Our innovative mindfulness program offers the communities we serve a sense of stability with programming designed especially for the public. • Virtual, interactive mindfulness sessions with short bursts of instruction, followed by mini meditations, all featuring our team of instructors • Hundreds of hours of videos produced by our experts • Playlists of guided meditations • Resources for mindfully managing pain – in English and Spanish, available at mindful.org/pain. Visit harvardpilgrim.org/mindfulness 26

Health Coaching Personalized phone support on the path to a new you Health Coaching Get advice and tips on how to: • Control blood pressure • Stop smoking • Manage weight & eat a more balanced diet • Reduce stress and balance a busy lifestyle • Increase physical activity • Cope with back pain Call (877) 594-7177 to get started 27

NEW: Up to $300 Wellness Reimbursement Effective January 1, 2024 Get reimbursed for fees you pay toward wellness activities  Fitness facility monthly fees  Select nutrition programs: PlateJoy, MyPlate  Virtual fitness class subscriptions Calorie Counter, Wondr, Noom, Eat Right  Studios or facilities that offer monthly fees or Now, Weight Watchers, Savory Living, My tuition for dance, gymnastics, swimming or Fitness Pal, Lose It!, EatLove, Stronger U, martial arts The Dinner Daily  Cardiovascular and strength training  Select mindfulness meditation programs: equipment Calm, Ten Percent Happier, Headspace, The  Athletic fees: seasonal town, club or school Mindfulness App, Meditation Studio, Insight Timer 28

How to Get Your Wellness Reimbursement Sign up Getting reimbursed is simple! Pay up to four months of your membership or subscription fees. Or pay for your qualified cardiovascular/strength training equipment. Participate After four month of Harvard Pilgrim membership: • Submit your request online. • Complete the paper form and mail it to the address on the form, along with copies of your receipts. Submit the Reimbursement Form You can submit your request starting May 1 of the current calendar year. Go to harvardpilgrim.org/reimbursement for more details. 29

Perks and Discounts A wide range of healthy savings opportunities for members Fitness, personal training, yoga Healthy Eating virtual programs or products • Savory Living • Daily Burn • The Dinner Daily • Ompractice • Eat Right Now • ProSourceFit Family & Senior Care Mindfulness Programs • Be Safer at Home • Ten Percent Happier • Lively • Unwinding Anxiety • Life Cycle Transitions • Sana Health • Home Instead Senior Care • Vigorous Mind Smoking Cessation Magic Weighted Blanket, • Craving to Quit Mindful Magazine, and more! • QuitSmart 30

Member Experience & Support 31

Member Experience: Services, Tools & Opportunities Our digital tools are designed to educate members, encourage healthy behaviors, maximize plan benefits . and create a seamless transition Communications & support Cost savings tools • Welcome Communications • Cost calculator tool (Estimate My Cost) • Member Portal dashboard • Cost comparison tool (Reduce My Costs) • Text-based Messaging Digital care & well-being tools • Digital Welcome Guide • Virtual wellness platform, education and classes • Quarterly Member Newsletter • Mindfulness • Open Enrollment Materials • Personal health coaching • Dedicated phone support • Behavioral health-focused tools • Secure email, mobile app & Chat • Maternal health-focused tools Bot support • Telehealth for 24/7 support – non-emergency 32

Your Secure Member Account Visit harvardpilgrim.org and select “Member login” In your account, you can: Search for in-network providers Review your claims Learn about lower-cost alternatives to the Emergency Room Look up the costs and tiers of your medications Apply for fitness reimbursement Print a member ID card or add your ID card to your Apple Wallet or Google Pay 33

Your Member ID Card Will arrive in the mail before your plan effective date – and available through your secure member account Sample ID card (front and back) Digital Member • Access through mobile app or secure member account ID Card Access at harvardpilgrim.org • Apple Wallet compatible, Android users save as a PDF • Member ID card is dynamic – updates in real time 34

Digital Tools and Support Get the most out of your Harvard Pilgrim plan with these tools Secure Member Account and Mobile App Reduce My Costs Log in or activate your secure online account at Connect with a nurse at 855-772-8366 when you harvardpilgrim.com/create or download the Harvard shop for a wide range of outpatient tests and Pilgrim mobile app to access your health plan benefits procedures, including lab work and diagnostic information imaging, and earn cash rewards when you select Find a doctor or hospital high-quality, cost-effective providers. Log in to your secure account to find a convenient Telehealth provided by Doctor On Demand location near you. Search for doctors or hospitals by Access a Doctor on Demand provider 24/7, by name or location, find doctors accepting new patients, phone or mobile app worldwide for everyday care and view doctors by specialty and confidential therapy. Set up your account at Estimate My Cost doctorondemand.com/harvard-pilgrim. Log in to your secure account to estimate your out-of- pocket costs and find a provider that will save you money 35

Additional Programs 36

Telehealth options with Doctor On Demand Non-emergency virtual care 24/7 What members are saying • Connect with a U.S. board-certified physician in less than 15 minutes from your smartphone, tablet or computer • Get care for concerns such as bronchitis, sinus issues, pink eye, UTIs, or skin rashes Confidential behavioral health therapy • Licensed providers can help with anxiety, depression, grief, family issues, trauma or PTSD • Choose from a variety of therapists with different backgrounds and specialties, and build a relationship with the provider who best meets your needs Providers can order prescriptions* at the member’s local pharmacy when medically necessary * Doctor On Demand physicians do not prescribe controlled substances and may elect not to treat or prescribe other medications based on what is clinically appropriate. 37

Estimate My Cost: A simple way to estimate your health care costs Our easy online medical cost transparency tool empowers you to: ► Plan ahead for out-of-pocket costs ► Be more engaged in your health plan ► Make informed decisions 38

Reduce My Costs A concierge service that helps members find high-quality, cost-effective providers Eligible Services Quick and easy access • Radiology (e.g., • Experienced nurse helps member compare costs MRI and CT scan) and shop for nearby cost-effective providers. • Lab work • The nurse can assist with appointment scheduling or • Mammogram required paperwork, if needed. • Ultrasound • Bone density study Lower costs and more savings • Colonoscopy • Rewards vary, depending on the service and associated • Other non-emergency cost savings outpatient tests & • Average savings more than $1,000 for services like procedures colonoscopy or MRI • Member can still receive reward if they’re already seeing a cost-effective provider — just for using Reduce My Costs 39 * Ranges are based on Harvard Pilgrim’s data; actual service prices vary by and location.

Family-Centered Care 40

Introducing a new Curated programs offer: approach to o Affirming experiences for LGBTQ+ employees from Included Health supporting families o Personalized support for at-home we care for – no caregivers from Wellthy matter how ‘family’ is o Enhanced resources for family and defined. women’s health from Ovia Health Members will receive opportunities to enroll and engage with these new services and programs – based on program availability. 41 Confidential. Please do not distribute. General Business

Wellthy: Overview Wellthy helps members tackle the logistical and administrative tasks of caring for the ones they love, including themselves – across a wide array of needs.  Aging Care Dashboard  Mental Health  Financial Hardship  Childcare Needs  Health Concerns  Veteran Support Helping families plan and learn Care Concierge Care Dashboard Wellthy Community Helping families get things done Helping families plan and learn Helping families feel less alone Dedicated, hands-on support from Comprehensive care planning tools Peer-to-peer platform where family experts who get to know each family and resources in one centralized, caregivers can find support and and tackle their to-dos accessible place exchange knowledge 42

LGBTQ+ Health: Capabilities Overview Included Health’s LGBTQ+ Health offers whole person care focused on LGBTQ+ members and their needs while working within their health plan ecosystem to ensure members feel safe, understood and supported.  Community Support  Benefits Navigation  Gender Affirming Care Care Dashboard  Provider Matching  Family Building  Mental Well being Helping families plan and learn Provider Matching Benefits Navigation Education & Advocacy Helping members find the best Helping members navigate and plan Supporting and advocating for provider who’s also in-network Concierge support helping members LGBTQ+ with family, social and navigate their benefits ecosystem. workplace questions Concierge support from experts who help pair members with Includes trans-focused complex care Trusted guidance and advocacy vetted providers who are affirming management, supporting trans and provided by concierge care and clinically competent non-binary members with transition, coordinators. gender affirming surgery and benefits navigation. 43 Confidential. Please do not distribute. General Business

LGBTQ+ Health: Approaches to Care & Support In-house experts dedicated to care equality for the specific needs of the LGBTQ+ community Administrative Continuum of Care Complex Member seeking Member trying to Member looking Member trying to find Member seeking guidance on how to change their for a culturally an affirming gender-affirming come out at work legal name competent PCP therapist for their surgery LGBTQ+ child  90% of the Included Health care team is part of the LGBTQ+ community. Care Team  Care team members can support members across a wide spectrum of topics and needs 44 Confidential. Please do not distribute. General Business

Family Health and Wellness Ovia Health features three mobile apps: Ovia, Ovia Pregnancy, and Ovia Parenting • Daily personalized articles and tips to help achieve goals • Unlimited in-app messaging from Ovia Health’s team of experts (registered nurses, nurse practitioners, social workers, mental health counselors, nurse midwives, lactation consultants, and infant and child sleep consultants) • Feedback on health data • Information about fertility/family planning, maternity, parenting for children and adolescence and menopause 45

Questions?