OVERVIEW

New West offers a wide variety of group plans for employers to choose from:

• Managed Care Options
• New West Select - High-deductible indemnity plan
• New West Select - HSA Eligible Plans
• Guardian (First Dollar Coverage + No Balance Billing)
• Innovations (PPO Like Plans - alternatives to HMO)
• Health Connections
• Prescription Drugs
• Vision
• Dental

MANAGED CARE OPTIONS

New West Health Plan, A division of New West Health Services offers 6 HMO plans:

2008 Benefits Booklet (Group Evidence of Coverage)
2008 Amendment to Group Evidence of Coverage

• Valcare -$500 Individual Deductible
• Westcare -$1,000 Individual Deductible
• Valcare Plus -$250 Individual Deductible
• Westcare Plus -$500 Individual Deductible
• Uniform -$1,000 Individual Deductible
• Basic -$750 Individual Deductible

These plans provide the predictability of:

• Flat dollar copayments for office visits on the Westcare, Westcare Plus, Valcare and Valcare Plus Plans.
• Coinsurance on all other health care services and procedures
• In-Network individual and family deductibles.
• Optional Out of Network benefits on the Westcare, Westcare Plus, Valcare and Valcare Plus Plans.*

In many cases, your cost for an office visit copayment is just $20 for adult preventive care, well child care, routine pre-natal care, chiropractic care and other provider office visits (procedures and other services are not covered by the copayment). The plan also features a lifetime benefit maximum of $2 million, and pays 100% of the first $600 of allowed charges for accident-related health care services per contract year. Generally your coverage includes benefits for emergency care, urgent care, provider office visits, hospital care (inpatient and outpatient), durable medical equipment, prosthetics, therapies and preventive, screening and diagnostic medical testing. Participation is limited to members who live or work in an approved HMO service area. Members must select a Primary Care Provider (PCP) and utilize participating providers.

There is no out-of-network coverage unless a Point of Service Endorsement is purchased, which is available with most plans*. If you purchase a Valcare plan, you can select out-of network benefits with either a $1000 Deductible, 70% Coinsurance or $1000 Deductible, 60% coinsurance for out-of network services. Westcare, Westcare Plus, and Valcare Plus plans have an optional Point of Service Endorsement for out-of-network services that offers a $1000 Deductible with 60% coinsurance.

*NOTE - The HMO Options are not available in all areas. New West is permitted to enroll members in a managed care plan provided they live or work within a 30-mile radius of one of the following cities: Anaconda • Big Sandy • Big Timber • Billings • Bozeman• Columbus • Deer Lodge • Dillon • Forsyth • Great Falls • Hamilton • Hardin • Havre • Helena • Jordan • Kalispell • Libby • Livingston • Malta • Miles City • Missoula • Philipsburg • Plains • Polson • Red Lodge • Ronan • Roundup • Shelby • Superior • Townsend • Whitefish.

NEW WEST SELECT - HIGH DEDUCTIBLE PLAN

The New West Select high-deductible indemnity plan has benefits for emergency care, urgent care, provider office visits, hospital care (inpatient and outpatient), durable medical equipment, prosthetics, therapies and preventive, screening and diagnostic medical testing.

This high-deductible plan gives members the freedom to select any provider but extends a higher level of benefit when participating providers are used. The $5,000 deductible is waived for the first $750 of eligible charges for office visits to physicians or other mid-level providers, chiropractors, urgent care, plus basic lab and x-ray associated with preventive office visits, and/or covered services to treat an accidental injury, up to $600 of eligible charges. This plan uses the 2008 Benefit Booklet (Group Member Certificate). 2008 Amendment to Group Member Certificate.

NEW WEST SELECT - HSA ELIGIBLE PLANS

New West Health Services offers 3 plans:

• 2,000 /4,000 Deductible
• 3,000/6,000 Deductible
• 5,000/10,000 Deductible

All three plans pay 100% of the coinsurance on the allowed charge after the deductible is met. Benefits include emergency care, urgent care, provider office visits, hospital care (inpatient and outpatient),prescription drug coverage, durable medical equipment, prosthetics, therapies, preventive, screening and diagnostic medical testing as part of the major medical coverage. For 2007, a $500 first dollar preventive benefit has been added to the plans. These plans uses the 2008 Benefit Booklet (Group Member Certificate).  2008 Amendment to Group Member Certificate.

By purchasing one of these HSA Eligible high-deductible health plans, you can offer your employees the option of opening an account-based savings vehicle which allows your employees to pay for eligible health care expenses tax-free. Unlike a flex spending account, your employee can have:

• Long-term savings.
• Savings for future medical needs.
• Immediate access to their money.
• A variety of investment options to choose from .
• Their unused HSA balance rolls over tax-free from year to year.
• Employees control how their money in the HSA account is spent and can use it for eligible expenses today or save it for the future.
• Savings which can stay in the account even with a change in health care coverage. (Must participate in an HDHP to contribute.)
• An account that travels with them even if they change employers.

New West Health Services has partnered with Wells Fargo to offer you HSA account options for your employees.

GUARDIAN

This plan provides first dollar coverage for in-network (New West Provider Network) office visits. There is a separate in-network deductible and an out-of-network deductible under this plan. There is no balance billing when utilizing the second tier provider network (Classic Health Connections Network, InterWest & BeechStreet Networks).

This plan offers two different options:

• Guardian $500 in-network deductible with 80/20 coinsurance & $1,000 out-of-network deductible with 60/40 coinsurance
• Guardian $1,000 in-network deductible with 60/40 coinsurance & $3,000 out-of-network deductible with 50/50 coinsurance

INNOVATIONS

The Innovations plans include benefits for emergency care, urgent care, provider office visits, hospital care (inpatient and outpatient), durable medical equipment, prosthetics, therapies and preventive, screening and diagnostic medical testing. Members have the freedom to select any provider, but a higher level of benefit is available when in-network providers are utilized. For example, the deductible is $1,000 for in-network services and $2,000 for out-of-network services. These plans uses the 2008 Benefit Booklet (Group Member Certificate).  2008 Amendment to Group Member Certificate.

New West offers three plans for employer groups to choose from:

• In-Network: $500 Deductible with 80% Coinsurance - Out-of-Network: $1,000 Deductible with 70% Coinsurance

• In-Network: $1,000 Deductible with 70% Coinsurance - Out-of-Network: $2,000 Deductible with 60% Coinsurance

• In-Network: $1,500 Deductible with 60% Coinsurance - Out-of-Network: $3,000 Deductible with 50% Coinsurance

Each contract year this unique product covers the first $500 of provider office visits for primary, specialty, preventive or urgent care at a $20 copayment for in-network and $40 copayment for out-of-network office visits. This plan also pays 100% of the first $600 of allowed charges for accident-related health care services per contract year, as well as 100% of the first $76 of allowed charges for in- or out-of-network mammograms, subject to some limitations.

HEALTH CONNECTIONS

The Health Connections indemnity plans offer a wide variety of deductible and coinsurance amounts:

Generally, the Health Connections plans include benefits for emergency care, urgent care, provider office visits, hospital care (inpatient and outpatient), durable medical equipment, prosthetics, therapies and preventive, screening and diagnostic medical testing. The Health Connections plans give members the freedom to select any provider, but extend a higher level of benefit when participating providers are used. (The HC$5000 option is not eligible to be used with health savings accounts.) These plans uses the 2008 Benefit Booklet (Group Member Certificate).  2008 Amendment to Group Member Certificate

PRESCRIPTION DRUGS

All products have four optional prescription drug benefits that can be selected to compliment the group plan, which are:

• 10/20/40 - $10 generic drug copayment - $20 brand name, formulary drugs copayment - $40 brand name, non-formulary drugs copayment
• 15/25/50 - $15 generic drug copayment - $25 brand name, formulary drugs copayment - $50 brand name, non-formulary drugs copayment
• 20/40/60 - $20 generic drug copayment - $40 brand name, formulary drugs copayment - $60 brand name, non-formulary drugs copayment
• 20/40/60, $200 Deductible - $20 generic drug copayment - $40 brand name, formulary drugs copayment - $60 brand name, non-formulary drugs copayment
• Generic Only - $10 generic drug copayment

VISION

New West also offers a Vision Endorsement. The vision benefits are:

DENTAL

This affordable Dental coverage offers $1,000 of Dental Benefits each year to provide coverage for 100% of preventive services, 80% of basic services, 50% of your major services and 50% of orthodontia after a $50 deductible.

WANT MORE INFORMATION?

Please contact the New West Marketing Department or an appointed independent agent for additional information on the these plans available through New West. To request a quote call toll-free 1-888-500-3355 or 406-457-2200 in Helena.

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