Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue Shield of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross

Sample Member CommunicationsLast updated: December 14, 2017

Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Georgia: Blue Cross and Blue Shield of Georgia, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross

Table of Contents

Debit Card Carrier and Welcome Communication.....................................................................................................

Text Message Alerts.....................................................................................................................................................

System Generated Alerts.............................................................................................................................................

Account Balance Alert (HSA, FSA, FSL, HRA, HIP).................................................................................6

Manual Claim Entered Alert (ALL PLANS)................................................................................................7

Card Lost or Stolen Alert (HSA)................................................................................................................8

Direct Deposit Change Alert (ALL PLANS)...............................................................................................9

Account Balance Statement Alert (ALL PLANS).....................................................................................10

Reimbursement Processed Alert (ALL PLANS)......................................................................................11

Deposit Received Alert (HSA)................................................................................................................. 12

IRS Grace Period Reminder Alert (FSA, DCA)........................................................................................13

Run Out Date Reminder Alert (FSA, FSL, HRA, DCA, HIP)....................................................................14

Year End Reminder Alert (FSA, FSL, DCA)............................................................................................15

HSA Online Statement Alert (HSA).........................................................................................................16

Claim Letters...............................................................................................................................................................

Denial Claim Notification.........................................................................................................................17

Ineligible.................................................................................................................................................. 18

Pending Claim (Auto Denied).................................................................................................................. 19

Pending Transaction............................................................................................................................... 20

PNC Bank HSA Statement..........................................................................................................................................

HSA Overview Flier.....................................................................................................................................................

FSA Overview Flier.....................................................................................................................................................

2

Debit Card Carrier and Welcome CommunicationFRONT

3

Debit Card Carrier and Welcome CommunicationBACK

4

Text Message Alerts

5

System Generated Alerts

Account Balance Alert (HSA, FSA, FSL, HRA, HIP)SUBJECT: IMPORTANT INFORMATION ABOUT YOUR HEALTH ACCOUNT

EMAIL PORTAL MESSAGE

6

Manual Claim Entered Alert (ALL PLANS)SUBJECT: WE GOT YOUR REQUEST

EMAIL PORTAL MESSAGE

7

Card Lost or Stolen Alert (HSA)SUBJECT: WE’VE CANCELED YOUR CARD

EMAIL PORTAL MESSAGE

8

Direct Deposit Change Alert (ALL PLANS)SUBJECT: YOUR DIRECT DEPOSIT INFORMATION HAS CHANGED

EMAIL PORTAL MESSAGE

9

Account Balance Statement Alert (ALL PLANS)SUBJECT: YOUR HEALTH SPENDING ACCOUNT STATEMENT IS AVAILABLE

EMAIL PORTAL MESSAGE

10

Reimbursement Processed Alert (ALL PLANS)SUBJECT: YOUR REIMBURSEMENT REQUEST IS APPROVED

EMAIL PORTAL MESSAGE

11

Deposit Received Alert (HSA)SUBJECT: A DEPOSIT HAS BEEN MADE INTO YOUR HEALTH SAVINGS ACCOUNT

EMAIL PORTAL MESSAGE

12

IRS Grace Period Reminder Alert (FSA, DCA)SUBJECT: USE YOUR MONEY BEFORE THE DEADLINE

EMAIL PORTAL MESSAGE

13

Run Out Date Reminder Alert (FSA, FSL, HRA, DCA, HIP)SUBJECT: USE YOUR MONEY BEFORE THE DEADLINE

EMAIL PORTAL MESSAGE

14

Year End Reminder Alert (FSA, FSL, DCA)SUBJECT: USE YOUR MONEY BEFORE THE PLAN YEAR ENDS

EMAIL PORTAL MESSAGE

15

HSA Online Statement Alert (HSA)SUBJECT: YOUR HEALTH SAVINGS ACCOUNT (HSA) STATEMENT IS AVAILABLE

EMAIL PORTAL MESSAGENo portal alert.

16

Claim LettersDenial Claim Notification

17

Claim LettersIneligible

18

Claim Letters Pending Claim (Auto Denied)

19

Claim LettersPending Transaction

20

PNC Bank HSA StatementPAGE 1

21

PNC Bank HSA StatementPAGE 2

22

HSA Overview Flier

23

FSA Overview Flier

24