MEDICAL MUTUAL OF OHIO® MEDICARE ADVANTAGE BROKER AND SALES AGENT TRAINING

Part 2: Selling Medical Mutual Advantage Plans Lesson 1: Medical Mutual Plan: Key Advantages Lesson 2: Medical Mutual Advantage Plan Comparisons Lesson 3: Consumer and Employer Benefits Lesson 4: The Enrollment Process

This Advantage Plans from Medical Mutual of Ohio Producer Training Program is available in both electronic and print editions, and is © 2009 Medical Mutual of Ohio, 2060 E. 9th Street, Cleveland, OH 44115. Reproduction and/or distribution of this training program and its associated materials without the prior written consent of an authorized Medical Mutual of Ohio representative are strictly prohibited. For additional assistance, contact Medical Mutual at (216) 687-7000.

Table of Contents

* Items must be completed and returned to your Medical Mutual representative.

PART 2: Selling Medical Mutual Advantage Plans Lesson 1: Medical Mutual Plan: Key Advantages Lesson 2: Medical Mutual Advantage Plan Comparisons Lesson 3: Consumer and Employer Benefits Lesson 4: The Enrollment Process

Lesson One: Medical Mutual Plan: Key Advantages

Your Sales Potential

With nearly two million eligible Medicare beneficiaries in the State of Ohio, you have an excellent opportunity to generate revenue while providing elderly, disabled and underinsured people health coverage that meets their individual needs. Of those eligible for benefits, only about 27% are actually covered by a Medicare Advantage plan, according to monthly statistics released by the Centers for Medicare and Medicaid Services (CMS). For example, in the Cleveland service area, only 75,000 people out of nearly 400,000 eligible Medicare recipients were enrolled in a Medicare Advantage plan. That means only 19% of eligible Cleveland residents have been enrolled. In the nearby similar market of Western Pennsylvania, greater than 30% of Medicare beneficiaries have enrolled in Medicare Advantage plans. More importantly, as each year passes, fewer and fewer companies are willing to offer health benefits to retirees, and many that still offer retiree benefits are looking for more cost-effective ways to provide ongoing coverage for their retirees. The Advantage Plans from Medical Mutual of Ohio are cost effective for individuals, as well as employer groups, to receive a more substantial benefit package than through the traditional Medicare program. As you may know, Medicare Advantage plans also offer accounting advantages to employers that fund retirement health benefits for employees. For more information about group sales, contact your Medical Mutual service representative.

Why should you offer your clients and prospects Medical Mutual Advantage Plans?

Medical Mutual is a trusted household name having served Ohioans for more than 75 years. As a mutually held company, we operate for the benefit of our members. We have superior customer service, have won many awards and conduct our business with the utmost professionalism and respect for our customers. In this session of the Medicare Advantage Broker and Sales Agent Training Program, we’ll give you a few more good reasons to choose Medical Mutual, and provide:

1. Detailed Medical Mutual Advantage Plan descriptions to help you compare the benefits of our options with your customers

2. Our program’s benefits for consumers and employers 3. Enrollment processing information to ensure your sales

experience is a positive one that satisfies your customers’ needs

Why Medical Mutual?

There are many Medicare options you could offer your customers. What makes Medical Mutual products appealing is that we:

1. Offer continuity of coverage for those Medicare beneficiaries that have previously received coverage through the Medical Mutual family of products. Medical Mutual is one of the oldest and most trusted insurers in Ohio.

2. Offer low total out-of-pocket costs for beneficiaries.

3. Offer one of the broadest provider networks in the service areas we cover.

4. Offer competitive coverage and expanded benefits with the flexibility to seek care from in-network and out-of-network providers, and drug options that include generic drug availability in the coverage gap.

5. Offer covered services with no referral requirements for Primary Care Physician and Specialty Care Providers.

6. Offer programs that are easy for you to administer, using the same registration process as other Medical Mutual products.

Our Provider Network

Medical Mutual Advantage Plans provide members with access to more than 15,000 physicians, a broad network of hospitals, and thousands of retail and mail-order pharmacies. By using our network providers, we guarantee members won’t be balance-billed for services outside of their normal copayments and/or coinsurance. That means no hidden charges or confusing forms to file with Medicare or providers.

Expanded Benefits

In 2010, Medical Mutual will offer two Medicare Advantage plan options. Both options offer benefits that extend the coverage of their Medicare Parts A and B policies, some of which include:

1. Coverage for routine hearing and vision exams with the Optimumx plan 2. Coverage for prescription glasses with the Optimumx plan 3. Generic prescription drugs in the “coverage gap” with the Optimumx plan 4. Lower deductible, coinsurance and copayment amounts for regularly used services such as

doctor and hospital visits and prescription drug purchases 5. Coverage for preventive care and access to health and wellness programs

Disease Management and Wellness Benefits

Our Advantage Plan members also receive access to Medical Mutual’s Disease Management and Wellness programs, designed to keep them healthy and reduce their risk of complications related to many conditions. Disease Management programs to help them gain control of their conditions include:

• Congestive Heart Failure • Chronic Obstructive Pulmonary Disease (COPD) • Asthma • Diabetes • Coronary Artery Disease • Chronic Pain

Medical Mutual extends the following Wellness programs to our Advantage Plan members:

• QuitLine • Weight Watchers • Global Fit • Walking for Wellness

No Referrals Required

Medical Mutual’s Advantage Plan product options provide additional freedom than traditional HMO plans. The Advantage Plan Primary Care Physician (PCP) is not granting “permission” to seek care; rather he or she will assist Advantage Plan members in the management of their health status. While the PCP is available to assist the customer in managing their health care, members are not required to obtain a PCP referral for specialists as they do in traditional HMOs. That means, Medical Mutual Advantage Plan customers receive benefits for services rendered by any Medical Mutual network specialist without a referral.

Easy Administration

When you sell one of the new Medical Mutual Advantage Plans or the Medicare Supplement plan, you’ll follow the same enrollment process you followed last year with your Royal Advantage Broker. We’d rather you spend your time helping customers select the plan that’s right for them, not filling out and submitting mounds of paperwork to Medical Mutual! So, we’ve made this process as easy and hassle-free as possible, keeping paperwork to a minimum.

Why sell Medical Mutual Advantage Plans?

Because we offer a vast network of providers, expanded plan benefits, no PCP referrals and easier administration. Your decision to sell Medical Mutual products, in turn, provides your customers with ease of use and additional benefits. In addition, our Advantage Plan members can take full advantage of our other member benefits, such as our online consumer health tool, MyHealthPlan to view claims, order ID cards and more. For more information about these member programs and benefits, visit us online at www.advantage-plan.com or www.MyBrokerLink.com.

Lesson Two: Medical Mutual Advantage Plan Comparisons Throughout this learning, you’ve been provided a brief introduction to the Medicare Advantage plan options offered by Medical Mutual. In this lesson, we’re going to review these plan options by comparing their features and benefits. At the end of this training, you should be able to engage your customers in the same type of product comparison to select the plan that best meets their needs and budget. Now, let’s compare the MA-PD plans offered by Medical Mutual.

MA-PD Options

Medical Mutual now offers two Medicare Advantage plan options featuring medical and prescription drug benefits:

1. Advantage Plan Optimumx with Rx coverage – for Metro (MSA) or non-Metro (Non-MSA) areas 2. Advantage Plan Securex with Rx coverage

MSA means Metropolitan Statistical Area. The only difference between MSA and Non-MSA plans is the premium rate, which is determined by the county in which the member resides. This only applies to the Optimumx plan. All benefits are the same regardless of county. Please note that MMO will have no Medicare Advantage plans available in Muskingum, Coshocton and Guernsey counties in 2010.

Discontinued Plans

Members previously enrolled in Medical Mutual’s Premiumx plan will automatically be moved to the Securex plan effective January 1, 2010. Members previously enrolled in other discontinued Advantage Plans will be cancelled effective January 1, 2010. So it is important they make a decision on another product during the Annual Enrollment Period. These discontinued plans include Freedom and Freedomx, Standardx, Secure and Value (without prescription drug coverage). Medical Mutual and Medco will not be offering a co-logo Part D plan in 2010. Members currently enrolled in the Medco/MMO co-logo product will be transitioned to Medco's Part D plan effective 1/1/2010 and will be advised by Medco directly of any benefit and rate changes via the Annual Notice of Change/Evidence of Coverage mailing in October. Information on another Part D option for your Medicare Supplement customers is forthcoming.

Plan Similarities

The annual benefit period for each of these options is January 1st through December 31st. Although they do provide some choice, these plans require members to obtain service from in-network providers and specialists to receive their plan’s maximum benefits. However, neither requires a PCP referral for primary and specialty physician care. Each of these plans provide coverage, at different benefit levels, for outpatient services and surgery, emergency care,

prescription drug coverage with no deductible, hearing services and vision services. Advantage Plan

Securex does not cover routine physical exams.

At Medical Mutual, we understand that the cost to cover preventive services is often lower than the cost to treat chronic conditions and diseases. This is why we include the benefit of many preventive services in our Advantage Plan options, all with no copayment. These services include colorectal screening exams, pap smears, pelvic exams, prostate cancer exams, mammograms and immunizations, including pneumonia and flu vaccines. When discussing these added benefits with your customers, ensure you point out that some of these preventive services are covered on an annual basis, which means the customer may receive only one exam or screening during each benefit period. The MA-PD plans come with a core set of prescription drug benefits that exceed the Medicare requirements. Members have no deductible to meet, and copayment for a 30-day supply of generic drugs is $4, for non-preferred generic drugs is $15, and, for preferred-brand drugs, $50 at in-network retail pharmacies. For non-preferred brand drugs, the member pays $90; and for specialty drugs, their contribution is 33% coinsurance. In addition, members can receive 90-day supplies of maintenance prescriptions from either their local pharmacy or through a mail-order pharmacy, although they will receive greater discounts through the mail-order pharmacy.

Plan Premiums

Plan options that include more coverage for more services typically have higher premiums. For example, plans with lower deductibles, copayments or coinsurance often have higher premiums. Which one is right for your customer depends on their health status and budget, whether they can afford to pay more upfront or later when they receive service.

Benefit Coverage

Our plan options also include benefits for inpatient hospital care, outpatient services, emergency care, professional services (such as chiropractic, podiatry and rehab), ambulance, skilled nursing facility care and home health care. Benefits for vision and hearing are also offered.

Emergency and Urgent Care Benefits

Accidents happen. On occasion, your customer may have to visit an emergency room or an urgent care facility, so all of our options offer benefits with a $50 copayment for emergency room visits and range from a $25 to $30 copayment for urgent care visits. Emergency Care is covered without regard to network affiliation. Out-of-area urgent care is also covered without regard to network affiliation.

Coordination of Benefits

Medical Mutual makes it easy for its members to obtain care without worrying about the coordination of benefits. When members select the Medical Mutual Advantage Plan options, Medical Mutual replaces Medicare in the coordination of benefits process. If the Medicare Supplement option is selected, Medical Mutual handles coordination with Medicare. The member is not required to complete any additional paperwork. For an overview of the MMO Advantage Plan product options, please refer to the Plan Information brochure. Click the button above for a short cut to the brochure. The next lesson discusses the non-medical benefits our Advantage Plans offer consumers and employers who purchase them.

Lesson Three: Consumer and Employer Benefits We’ve already discussed the many benefits our Advantage Plans offer Medicare beneficiaries. But, these plans offer more than coverage for emergency room care or routine physical exams. The real benefit to these programs is the amount of money the right option can save customers, as well as employers.

Consumer Benefits

Many Medicare beneficiaries live on fixed incomes and the total cost of coverage is very important. The MA-PD offerings from Medical Mutual offer not only expanded benefit sets when compared to the Traditional Medicare environment, they also provide the opportunity for Medicare beneficiaries to save money on their annual healthcare expenses. The savings increase as beneficiaries age. The MA-PD offerings from Medical Mutual include the same premium for all members regardless of age and health status. Supplement policies often adjust premiums as beneficiaries age. Additional coverage benefits and a great potential for savings on health care expenses – that’s what makes these Medicare Advantage plans attractive to Medicare Parts A and B beneficiaries. However, they’re not your only potential market. Take a moment to consider how you might sell these plans to employers as a benefit to their workforce.

Employer Benefits

Fewer companies offer retiree health care benefits than ever before, which means employees are retiring without adequate coverage. In fact, according to CNN Money, retiree health costs are up 5.3%, and “An average couple retiring [in 2006] will need $200,000 to cover their health care costs for 20 years in retirement.” Knowing that, retiree benefits are a great incentive employers can use to hire and retain quality employees. However, the cost of such benefits has caused many employers to abandon their programs for future retirees. Our Medicare Advantage plans offer them an affordable alternative that allows them to continue offering retiree benefits.

When you’re talking to your customers, remember what sets our plans apart from other Medicare Advantage plans:

1. Low out-of-pocket costs for beneficiaries 2. One of the broadest provider networks in the service areas we cover 3. Out-of-network benefits with no referral required 4. More coverage and expanded benefits 5. Covered services with no referral requirements for Primary Care Physician and Specialty Care

Providers 6. No balance-billing, with the exception of copayments and coinsurance 7. No pharmacy deductibles, and options that provide gap coverage for prescription benefits 8. Access to health and wellness programs offered by Medical Mutual 9. Coverage consistency from Medical Mutual 10. A customer service team that has historically resolved 96% of customer calls before the

member hangs up

So, after selling a Medical Mutual Advantage Plan, what do you do next? To answer this question, the next lesson reviews the enrollment process.

Lesson Four: Enrollment Process Enrolling a new customer in a Medical Mutual Advantage Plan is just as easy as enrolling customers in any other Medical Mutual product. In this lesson, we’ll review the process and provide additional resources you and your customers can use to obtain more information.

Scope of Appointment Forms

First things first! CMS requires that a Scope of Appointment (SOA) form be completed by the beneficiary prior to any appointments. Please keep these forms on file and have them available at the request of MMO. Upon request, the forms must be delivered to MMO within 48 hours.. Medical Mutual has prepared collateral material to assist with the selling process. Medical Mutual will make pre-enrollment kits

available for you to use when calling on Medicare beneficiaries. Materials required within these kits before being given to any beneficiary are:

1. Enrollment Application (Please include your unique MMO identification number to ensure appropriate credit)

2. Product Information Brochure 3. Summary of Benefits 4. Provider Directory 5. Formulary 6. Pharmacy Listing 7. Cover Letter

These materials can be ordered through MyBrokerLink.com or from your Royal Advantage Broker. They should be inserted into the available Advantage Plan folder, which includes a place for you to insert your business card. In addition, prospective members can access provider directories and formularies through the Medical Mutual web site: www.advantage-plan.com. Medical Mutual’s pharmacy benefit management (PBM) firm for the Advantage Plans is Medco, the same firm that provides pharmacy management for Medical Mutual’s commercial lines. Medco’s website will also include a Medical Mutual Formulary, as well as Pharmacy Provider Directory, available at: www.advantage-plan.com. For brokers, we’ve attempted to make the process of submitting applications as similar as possible to the process currently used for SuperMed One, our individual coverage product. In brief, the enrollment process is:

1. Obtain applications from Medical Mutual. 2. Include your unique Medical Mutual identifier on the application (to ensure you receive

appropriate credit for your work) and make sure your address is on the return envelope. 3. Talk to the customer about their options and program requirements. 4. The customer, or their representative, completes an application. 5. You review the application for completeness (remember, all requested information is not

required); if it’s incomplete, return it to the customer for completion and appropriate dating. 6. Submit the application to your Royal Advantage Broker the same day you receive it from your

customer. 7. Medical Mutual will verify the customer’s eligibility with Medicare.

8. Coverage begins January 1, 2010 or the first of the following month, whichever is later.

Customer Options and Requirements

Talk to your customers about their eligibility, the Medical Mutual Advantage Plan products and the program’s limitations, requirements and responsibilities. For example, ensure they know the Annual Open Enrollment and limited enrollment periods, along with these other important points:

1. Out-of-network services may be covered, but at a lower benefit level. 2. They must already be enrolled in Medicare Parts A and B, paying a premium to Part B, in order

to enroll in a Medicare Advantage plan. 3. They can only enroll in one Medicare Advantage medical and/or one prescription plan at a time.

If the member is already enrolled in a Medicare Advantage plan prescription or medical plan, they will be automatically disenrolled from that plan if they elect a new one.

4. They can enroll in a MA-PD that includes both medical and prescription drug benefits. 5. They will have to pay a premium for Advantage Plan coverage. Once enrolled in any Medicare

Advantage product, Medicare beneficiaries must continue to pay their monthly Part B premium along with any premium associated with the Medicare Advantage product.

Plus, don’t forget to tell them their enrollment entitles them to benefits found in other Medical Mutual products, such as online consumer health tools, Disease Management and Wellness programs.

Complete the Application

After helping your customer select an Advantage Plan that meets their health care needs and budget, they will complete an application for coverage. Medical Mutual will verify a prospect’s eligibility to enroll in an Advantage Plan directly with Medicare. Please make sure all required information is provided. Don’t forget to include your unique Medical Mutual identifier on the application.

Submit the Application

After the customer submits the application you must check it for completeness. If complete, forward the application to your Royal Advantage broker that day. If incomplete, return it to the customer for completion.

Medical Mutual Covers the Customer

Medical Mutual will contact Medicare to verify the customer’s eligibility for an Advantage Plan. If the customer is eligible, coverage begins on the first of the following month and Medical Mutual will forward all membership material directly to the new member. Contact your Royal Advantage Broker for enrollment status.

Customer Resources

In the event your customer needs additional financial support or to enroll in a Part D prescription drug plan, they should contact Social Security at 1-800-772-1213 or www.socialsecurity.gov. Through Social Security, they may qualify for relief from premiums and deductibles, called a Low Income Subsidy or (LIS). Once enrolled, they can access their Medical Mutual member benefits and tools online at www.advantage-plan.com

Additional Resources

You and your customers can find additional information about Medicare programs through the Medicare web site at www.medicare.gov. This site not only includes a history of Medicare and information about

Medicare programs, but compares options, offers a prescription drug formulary look-up tool and benefit management tools. You can also click one of the buttons above to download the various resources that have been made available through this training program, including the Medical Mutual Advantage Plan Plan Information Brochure, an Enrollment Guide and an enrollment application.

PART 2 CONCLUSION At this point, you should feel comfortable offering, selling and administering Medical Mutual Advantage Plans to your customers. After all, Medical Mutual is a respected insurance provider that gives superior service to our members. Our Advantage Plans offer Medicare beneficiaries more variety, expanded benefits and the broadest provider network in our service area. Why would you offer your customers anything else?

The next steps of the process are to agree to the Broker and Sales Agent Acknowledgement, and complete a Producer Agreement if you haven’t yet done so.

Each of these is a required step in the process, and, if incomplete, could result in you not being considered certified with MMO. You must be certified in order to receive commissions. If all steps are completed, you will see your Certificate of Completion at the end of the training. If you cannot see your certificate, you have missed a step. Please complete the Broker and Sales Agent Acknowledgement on the page that follows, and

then return it to your Medical Mutual representative.

Thank you for participating in the Medicare Advantage Broker and Sales Agent Training.

Broker and Sales Agent Acknowledgement I acknowledge that I have completed the entire Medical Mutual Broker and Sales Agent training for Advantage Plans from Medical Mutual, which are Medicare Advantage plans and Medicare Prescription Drug Plans. I understand that Medical Mutual is ultimately responsible to CMS for maintaining compliance with all rules and regulations associated with the above described products for which Medical Mutual has contracts with the Federal Government. I understand that federal funds are used to pay Medical Mutual and I understand that it is my responsibility to follow and I agree to follow all Medical Mutual and CMS rules and regulations, whether presented in this program or otherwise published. I further acknowledge that I am not now nor have I ever been excluded from participation in Medicare under any section of the SSA. Please check your response.

I AGREE

I DISAGREE (If you select this, please explain below). ____________________________________________________________________________________

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APPENDIX A: SUMMARY OF BENEFITS

APPENDIX B – LIS APPLICATION

APPENDIX C – REQUIRED ENROLLMENT INFORMATION

APPENDIX D: ADDITIONAL DOCUMENTS The following pages reference other resources provided during this training.

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ContentsMedicare Advantage Plans from Medical Mutual®

Introduction to Medical Mutual Advantage Plans 2

What are my Medicare Advantage options? 3

What is MSA/Non-MSA? 3

Medicare Advantage Plan Benefits 4

Am I eligible? 6

How do I sign up? 6

Enrollment Schedule 7

My Health Plan 7

Condition Management Programs 8

Wellness Programs 8

For More Information 8

Advantage Plans

What are my Medicare Advantage options?At Medical Mutual we offer two Medicare Advantage plans: Securex (HMO/POS) and Optimumx (HMO/POS), which are compared on pages 4 and 5. With an HMO/POS plan you get the following features:

In-network physicians to handle any of your pre-certification needs

No pharmacy deductibles

Never required to get a referral to see a specialist

Primary Care Physicians required to help coordinate care for chronic conditions

What is MSA/Non-MSA?Through guidance from Medicare, we set our premiums based on the county in which an applicant lives. All Ohio counties are considered MSA except for the following, which are Non-MSA counties:

Adams, Ashland, Athens, Auglaize, Champaign, Clinton, Crawford, Darke, Fayette, Gallia, Hancock, Hardin, Harrison, Henry, Highland, Hocking, Huron, Jackson, Logan, Marion, Meigs, Mercer, Monroe, Morgan, Noble, Paulding, Perry, Pike, Putnam, Ross, Sandusky, Scioto, Seneca, Shelby, Van Wert, Vinton, Williams and Wyandot.

Medical Mutual is happy to schedule an appointment

with you to answer questions or explain the application

process in person. Please call 800/613-2583.

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Thank you for your interest in a Medicare Advantage plan from Medical Mutual. We hope this guide allows you to learn more about what Medical Mutual has to offer and helps you select a plan that’s right for you.

We offer two Medicare Advantage plans. Both are considered Health Maintenance Organization/Point of Service (HMO/POS) plans and include medical and prescription drug coverage with access to our comprehensive network of doctors and hospitals. This booklet will help you understand our plans, our networks, your eligibility options, many tools and programs available to all our members — and how to sign up.

Medical Mutual is a health plan with a Medicare contract

Medicare Advantage PlansFrom Medical Mutual of Ohio®

Securex OptimumxPremium $58 (Medical w/Rx) $170/$210 (MSA/Non-MSA)Deductible (Network/Non-Network) $500/$500 $0/$0

Out-of-Pocket Max. (Network/Non-Network) $3,400/$3,400 $3,400/$3,400

Inpatient ServicesInpatient Hospital $250 Copay per admission

(Unlimited days)$250 Copay per admission (Unlimited days)

Inpatient Mental Health $250 Copay per admission (Limited days)

$250 Copay per admission (Limited days)

Skilled Nursing $100 Copay per stay (60 day renewal)

$100 Copay per stay (60 day renewal)

Home Health $0 Copay per visit $0 Copay per visitOutpatient Services

Emergency Room $50 Copay per visit $50 Copay per visitUrgent Care $25 Copay per visit $30 Copay per visitSurgeries - Ambulatory Surgical Center - Outpatient Hospital

$100 Copay per visit $100 Copay per visit

$75 Copay per visit $100Copay per visit

Diagnostic Tests - Lab - Radiation Therapy - X-Ray

$0 Copay per visit $20 Copay per visit $20 Copay per visit

$0 Copay per visit $0 Copay per visit $0 Copay per visit

Cardiovascular $20 Copay per visit $20 Copay per visitTherapy (Physical/Occupational/Speech)

$20 Copay per visit $20 Copay per visit

Other Services $0 Copay per visit $0 Copay per visitProfessional Services

Inpatient Visits/Services $0 Copay per visit $0 Copay per visitOutpatient Visits/Services $0 Copay per visit $0 Copay per visitPrimary Care Physician (PCP) Office Visits

$15 Copay per visit $10 Copay per visit

Specialist Office Visits $20 Copay per visit $20 Copay per visitChiropractor $20 Copay per visit $20 Copay per visitRoutine Chiropractic Not covered $20 Copay per visit

(6 visits per year)

Securex OptimumxPodiatry $20 Copay per visit $20 Copay per visitRoutine Podiatry Not covered $20 Copay per visit

(6 visits per year)Outpatient Rehab $20 Copay per visit $20 Copay per visitOutpatient Mental Health $20 Copay per visit $20 Copay per visitOutpatient Substance Abuse

$20 Copay per visit $20 Copay per visit

Vision & HearingDiagnostic Hearing Exams $20 Copay per visit $20 Copay per visitHearing Tests Not covered $20 Copay per visitHearing Aids Not covered $250 Allowance every 3 yearsDiagnostic Eye Exams $20 Copay per visit $20 Copay per visitRoutine Eye Exams Not covered $20 Copay per visitEyewear Not covered $40 Allowance per year

Other ServicesAmbulance $50 Copay per trip $50 Copay per tripDME/Prosthetics 20% Coinsurance 20% CoinsuranceRoutine Physical One per lifetime $0 Copay per visit

Pharmacy$0 DeductibleCopays (up to $2,830 Initial Coverage Limit): - $4 Preferred Generic - $15 Non-preferred Generic - $50 Preferred brand - $90 Non-preferred brand - 33% Specialty drugsNo coverage in GapMax 5% ($2 50G/$6 30B) after $4,550 True Out-of-Pocket reachedMail order copays: - 2 x retail (generic) - 3 x retail (brand)

$0 DeductibleCopays (up to $2,830 Initial Coverage Limit): - $4 Preferred Generic - $15 Non-preferred Generic - $50 Preferred brand - $90 Non-preferred brand - 33% Specialty drugsGeneric coverage in GapMax 5% ($2 50G/$6 30B) after $4,550 True Out-of-Pocket reachedMail order copays: - 2 x retail (generic) - 3 x retail (brand)

Out-of-Network 20% Coinsurance 20% Coinsurance

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Medicare Advantage Plan Benefits*

* The benefit information provided is not comprehensive. Additional information should be requested before making a decision about your coverage.

Advantage

Advantage Plan Enrollment ScheduleSign-up Period Coverage BeginsNovember 15 to December 31, 2009 January 1, 2010January 1 to January 31, 2010 February 1, 2010February 1 to February 28, 2010 March 1, 2010March 1 to March 31, 2010 April 1, 2010Limited Options after March 31, 2010 1st of following month if qualified

Eligibility

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Am I eligible?In order to qualify for Medicare Advantage coverage, you must be entitled to Medicare Part A benefits and enrolled in Medicare Part B – while continuing to pay your Part B premium. You can only be enrolled in one Medicare Advantage program at a time, so if you enroll into a Medical Mutual Medicare Advantage Plan, you will be disenrolled from your current Medicare plan.

Medicare has residency requirements and, as a result, you must reside in the coverage area defined by Medical Mutual. Our only requirement is that you live in the state of Ohio. We do not offer plans in Coshocton, Guernsey or Muskingum Counties.

In addition to the residency requirement, individuals with end-stage renal disease (kidney failure) are not eligible to enroll in our plans.

How do I sign up?The open-enrollment period begins November 15, 2009, and ends December 31, 2009. During this time you are free to sign up for any of our plans. All you have to do is fill out an application and give it to your broker, sales representative or send it to Medical Mutual directly. Applications are available through Medical Mutual by calling 800/613-2583 or visiting Advantage-Plan.com. Once we receive your application, we will confirm your eligibility and your coverage will start on January 1, 2010.

In addition to the open-enrollment period, there is another sign-up period from January 1, 2010, to March 31, 2010. During this period you must keep the same type of plan, but you may switch carriers. The same enrollment process is followed, with coverage beginning the first of the following month.

If you age into Medicare outside of the open-enrollment period, you can sign up for a Medicare Advantage Plan, three months prior to your birth month and up to three months past your birth month (seven full months). Your coverage starts on the first of the following month.

Medicare beneficiaries can also enroll in Medical Mutual’s Advantage Plan through the Centers for Medicare and Medicaid Services Online Enrollment Center, located at Medicare.gov. For more information, contact Medical Mutual at 800/613-2583.

People with limited incomes may qualify for Extra Help to pay for their prescription drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gapor a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 800/MEDICARE (800/633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2408.

My Health PlanOur member Web site, My Health Plan, is your one-stop resource for managing your benefits, plus you have access to the following:

Quicken Health – From the makers of Turbo Tax, Quicken Health explains and simplifies your medical claims and expenses.

Health Record – Track your personal health history and information by creating a unique health journal.

Wellness Programs – Whether you want to start walking more, quit smoking, or manage your diabetes better, we’ve got a program just for you.

Condition Management Programs – Access information about, and receive counseling for more than 50 different medical conditions.

To access these tools and more on My Health Plan, visit MedMutual.com.

Now that you’ve reviewed the plans, let’s go over the eligibility rules, and other important information.

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Condition Management ProgramsMedical Mutual has programs to help our members who are diagnosed with the following conditions and much more:

Diabetes

Congestive heart failure

Chronic obstructive pulmonary disease

Asthma

Coronary artery disease

Chronic pain conditions

Depression

More information is available on My Health Plan.

Wellness ProgramsIn addition to the Condition Management programs, you’ll also be eligible for the following wellness benefits:

QuitLine – We provide an eight-week supply of nicotine replacement patches for free.

Weight Watchers – Get up to $150 in registration fees reimbursed.

Global Fit – Receive reduced rates on fitness club memberships at more than 2,000 clubs nationwide.

Walking for Wellness – An innovative walking program with helpful materials and pedometers.

For More InformationFor more information, please contact your broker or Medical Mutual directly at 800/613-2583 (TTY/TDD 800/982-8109) seven days a week, from 8 a.m. to 8 p.m., during open enrollment. After March 1, 2010, we are available five days a week, Monday through Friday from 8 a.m. to 8 p.m.

You can also get more information on our Web site, Advantage-Plan.com. In addition, you can call Medicare at 800/633-4227 or visit Medicare.gov. TTY/TDD users should call 877/486-2048. Medicare customer service representatives are available 24 hours a day, seven days a week.

Medical Mutual of Ohio®

2060 East Ninth StreetCleveland, OH 44115-1355

Visit MedMutual.com.© 2009 Medical Mutual of Ohio00000 00/00