Step 1: Compare the medical plans available to you – Surest, Blue Cross Blue Shield (BCBS), UnitedHealthcare Choice Plus (UHC) and High Deductible + HSA. Estimate what your out-of-pocket costs may be with each plan.

Health Plan	Plan Highlights
Surest, BCBS & UHC	In-network benefits are available with the Surest plan, national BCBS BlueCard plan, BCBS Select Network plans in designated locations and the UHC Choice Plus plan. Out-of-network benefits are also available but are more expensive since there are no negotiated provider discounts and the out-of-network deductible and out-of-pocket maximum are higher.
UHC High Deductible + HSA	There is no difference in benefits if you use an in-network or out-of-network provider. However, when you receive care from in-network providers, your plan costs are typically lower because UHC has negotiated discounts with in-network providers. NOTE: Fertility and Infertility Medications and Services are not covered under the High Deductible + HSA Plan

Click the box next to each plan to either remove or add them to the plan comparison chart below.

	Surest Plan Provider Directory		BCBS and UHC Choice Plus Plans BCBS Provider Directory UHC Provider Directory		UHC High Deductible + HSA Plan Provider Directory
	In-Network	Out-of-Network	In-Network	Out-of-Network	UHC High Deductible + HSA Plan
Deductible	N/A	N/A	$1,000 per person, $2,000 per family	$2,000 per person, $4,000 per family	$1,900 for single coverage, $3,800 for family coverage*
Out-of-Pocket Maximum	$3,900 per person, $7,800 per family	$7,800 per person, $15,600 per family	$4,400 per person, $8,800 per family	$8,800 per person, $17,600 per family	$5,000 for single coverage, $10,000 for family coverage** (combined medical and prescription drug out-of-pocket maximum)
Lifetime Maximum	Unlimited	Unlimited	Unlimited	Unlimited	Unlimited
Retail Medical Clinic	$15 copay	No coverage	$15 copay	30% coinsurance after the deductible	20% coinsurance after the deductible
Medical Virtual Visit (using preferred virtual provider network)	Covered at 100%	No coverage	$10 copay	No Coverage	20% coinsurance
Primary Care Office Visit	$20-$135 copay	$220 copay	$50 copay	30% coinsurance after the deductible	20% coinsurance after the deductible
Specialist Office Visit	$20-$135 copay	$220 copay	$60 copay	30% coinsurance after the deductible	20% coinsurance after the deductible
Maternity Office Visits (prenatal and postnatal)	Covered at 100%	Not Covered	$60 copay for initial visit, $0 copay thereafter	30% coinsurance after the deductible	20% coinsurance after the deductible
Childbirth / Delivery	$550-$3,000 copay per stay	$6,600 copay per stay	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Urgent Care Facility	$100 copay	$180 copay	$60 copay	30% coinsurance after the deductible	20% coinsurance after the deductible
Emergency Room	$275 copay	$275 copay	$300 per visit; waived if admitted to a hospital	$300 per visit; waived if admitted to a hospital	20% coinsurance after the deductible
MRI/CT Scans	$100-$1,400 copay	Up to $4,200 copay	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Home Health Care	$60 copay	$180 copay	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Durable Medical Equipment (DME)	$0-$1,000 copay/based on tier	Up to $2,000 copay/based on tier	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Inpatient Hospital and Physician Services	$150-$3,000 copay per stay	Up to $6,600 copay per stay	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Outpatient Surgical Services	$150-$3,000 copay	Up to $6,600 copay	10% coinsurance after the deductible	30% coinsurance after the deductible	20% coinsurance after the deductible
Well Baby	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%
Physical Examinations and Immunizations	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%
Mammography	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%
Colonoscopy	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%
Vision screening (routine exam)	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%
Hearing screening (routine exam)	Covered at 100%	No coverage	Covered at 100%	No coverage	Covered at 100%

When you enroll in a Travelers medical plan you automatically receive prescription drug coverage through CarelonRx. Review the out-of-pocket costs associated with the prescription drug coverage using the chart below.

Prescription Drug Overview

	Surest Plan		BCBS and UHC Choice Plus Plans		UHC High Deductible + HSA Plan
	Network Pharmacy	Non-network Pharmacy	Network Pharmacy	Non-network Pharmacy	Network Pharmacy	Network Pharmacy
Prescriptions					Preventive Medications***	Non-Preventive & Specialty Medications
Tier 1	You pay:	If you fill a prescription at a non-participating pharmacy but had access to a participating pharmacy, you will be reimbursed for the negotiated pharmacy cost minus the applicable in-network coinsurance. If you did not have access to a participating pharmacy, the in-network coinsurance will apply.	You pay:	If you fill a prescription at a non-participating pharmacy but had access to a participating pharmacy, you will be reimbursed for the negotiated pharmacy cost minus the applicable in-network coinsurance. If you did not have access to a participating pharmacy, the in-network coinsurance will apply.	You pay:	You pay 20% coinsurance after meeting the deductible
- 30-day supply at retail	$15 copay		$15 copay		$15 copay
- 90-day supply at eligible retail 90 pharmacies or through CarelonRx mail order	$30 copay		$30 copay		$30 copay
Tier 2	You pay 20% coinsurance:		You pay 20% coinsurance:		You pay 20% coinsurance:
- 30-day supply at retail	$65 minimum, $210 maximum		$65 minimum, $210 maximum		$65 minimum, $210 maximum
- 90-day supply at eligible retail 90 pharmacies or through CarelonRx mail order	$130 minimum, $420 maximum		$130 minimum, $420 maximum		$130 minimum, $420 maximum
Tier 3	You pay 40% coinsurance:		You pay 40% coinsurance:		You pay 40% coinsurance:
- 30-day supply at retail	$65 minimum, $210 maximum		$65 minimum, $210 maximum		$65 minimum, $210 maximum
- 90-day supply at eligible retail 90 pharmacies or through CarelonRx mail order	$130 minimum, $420 maximum		$130 minimum, $420 maximum		$130 minimum, $420 maximum
GLP-1 Medications prescribed for Weight Loss (limited to a 30-day supply)					N/A
Tier 2	$200 copay, when prescribed by a Form Health provider		$200 copay, when prescribed by a Form Health provider			$200 copay after the deductible, when prescribed by a Form Health provider
Tier 3	50% coinsurance, when prescribed by a Form Health Provider		50% coinsurance, when prescribed by a Form Health Provider			50% coinsurance after the deductible, when prescribed by a Form Health Provider
Infertility Medications	Covered at Tier 1-3 benefit levels shown above, as applicable		Covered at Tier 1-3 benefit levels shown above, as applicable		Infertility medications are not covered by this plan.	Infertility medications are not covered by this plan.
Specialty Drugs - available exclusively through BioPlus Specialty Pharmacy (limited to a 30-day supply)	$0 copay if participating in Cost Relief program; 30% coinsurance if not participating in Cost Relief Program	Specialty medications not sourced though BioPlus Specialty Pharmacy are not covered.	$0 copay if participating in Cost Relief program; 30% coinsurance if not participating in Cost Relief Program	Specialty medications not sourced though BioPlus Specialty Pharmacy are not covered.	Preventive Specialty medications are covered at the generic/formulary/non-formulary benefit levels shown above, as applicable	You pay 20% coinsurance after meeting the deductible
Annual Prescription Out-of-Pocket Maximum	$3,100 per person / $6,200 per family		$3,100 per person / $6,200 per family		There is no separate OOPM for prescriptions. Prescription drug cost sharing accumulates to the OOPM listed in the general section.

*For family coverage in the High Deductible + HSA Plan, the plan does not begin to cost share until the full family deductible is met.

**There is a $8,000 out-of-pocket maximum per individual with family coverage in the High Deductible + HSA Plan.

***Copays and coinsurance for preventive medications in the High Deductible + HSA Plan do not count towards the plan deductible, but do count towards the out-of-pocket maximum.

Step 2: Check to see which doctors, hospitals and specialists are available in each plan.

Included Health is a free service for Travelers medical plan members that matches you with doctors based on their quality and expertise. Included Health can help you find a high-quality doctor in your area and a second opinion from a leading specialist. Go to https://includedhealth.com/microsite/travelers/.

Health Plan	Instructions	Referrals Required
Surest	Surest uses the UnitedHealthcare Choice Plus Network. Visit Surest provider directory and click "Start your search".	Enrollees do not have to select a primary care physician and referrals are not required to see a specialist.
BCBS	Use the BCBS provider directory and click on your network.
UHC	Use the UHC provider directory. Click "Open the directory" for the Choice Plus Network.
UHC High Deductible + HSA Plan	UHC High Deductible + HSA Plan enrollees have a passive network arrangement. There is no difference in benefits if you use an in-network or out-of-network provider; however, when you receive care from in-network providers, your plan costs are typically lower because UHC has negotiated discounts with in-network providers. Use the UHC provider directory. Click "Open the directory" for the Options PPO Network.

Step 3: Compare the medical plan premiums.

You share the cost of your medical coverage with Travelers. Your share of the premium is based on:

• The medical plan that you choose
• The coverage level you select
• Your annual base salary (or full-time equivalent salary if you are part-time)
• Your smoker status and your spouse or domestic partner's smoker status if you elect coverage for them
• Your spouse or domestic partner's eligibility for subsidized medical coverage through their employer

You pay for your share of the premium with pretax dollars from your salary.

You can use the Rate Calculator to estimate your premiums.

Step 4: Decide which medical plan is best for you.

After you've compared the plan benefits, network and medical plan premiums you may be ready to enroll.

Note: If you have questions regarding your medical plan options or benefits, please contact the Employee Services Unit (ESU) at 4-ESU@travelers.com or 800-441-4378.

Step 5: Consider making contributions to a Health Care Spending Account.

Through pretax payroll deductions, the Health Care Spending Account provides an opportunity to fund qualifying health care expenses not covered by insurance, including deductibles, copays and coinsurance. Additional information can be found on the Health Care Spending Account page.*

Participants who elect to enroll in the UHC High Deductible + HSA Plan are not eligible to participate in a Health Care Spending Account (HCSA).

*This link is accessible only to employees logged into Travelers secure network.

Step 6. If you enroll in the UHC High Deductible + HSA Plan, you may be eligible for a Health Savings Account (HSA).

If you enroll in the UHC High Deductible + HSA Plan, you may be eligible to make pretax contributions into a Health Savings Account (HSA). For additional information on the HSA, visit the High Deductible + HSA overview page.*

*This link is accessible only to employees logged into Travelers secure network.

The Company, as Plan sponsor, selects the coverage options made available to you under the Plan. The decisions to establish and maintain the Plan, to determine the coverage options offered, and to set the employee contribution levels and cost-sharing features (including deductibles, copayments, coinsurance rates, and out-of-pocket maximums) applicable to each option (collectively, the "Financial Terms"), are plan design decisions made by the Company in its settlor capacity (that is, its capacity as Plan sponsor rather than as a Plan fiduciary). These decisions do not constitute fiduciary acts under ERISA and are not subject to ERISA's fiduciary standards.

The different coverage options may differ in their Financial Terms. Neither the Company nor the Administrator makes any representation, warranty, or guarantee regarding the relative value, cost-effectiveness, or financial advantage of any option as compared to any other, nor recommends or endorses any particular option as more suitable or advantageous for any participant.

You are solely responsible for evaluating the coverage options and selecting the option that best meets your individual and family needs. The coverage options have different Financial Terms, so one may meet your individual and family needs better than another depending on your circumstances, including, for example, how much and when you expect to utilize the Plan, the types of services you expect to need and the frequency with which you expect to need them, whether you expect to reach the deductible or out-of-pocket maximum, your preference for paying a higher monthly contribution amount as compared to potentially higher out-of-pocket payments in the event you receive certain health services, and your need for greater predictability in your monthly financial obligations for health-care related costs. In making your decision, you should carefully evaluate each option's Financial Terms in light of these considerations. Neither the Company nor the Administrator assumes any responsibility or liability for your enrollment decision, for the suitability of any coverage option to your individual or family needs, or for any difference in total cost resulting from your selection. The Company is under no obligation to offer any particular combination of options or to structure the available options so that one is financially preferable to another under all circumstances.