Horizon Vision Products Available in All Markets

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1 December 9, 2015 Applies to: All Markets Vision Products Available in All Markets Vision, which announced an expansion in September, has introduced new products across all markets Individual, Small Group and Large Group for a January 1, 2016, effective date. Quoting and submission are available now. ye exams are important for everyone, not just the 81 percent of Americans who wear eyeglasses or contact lenses. 1 An eye exam can uncover conditions such as glaucoma, age-related macular degeneration and cataract, as well as conditions not usually associated with eye health, such as diabetes and hypertension. Retaining a vision policy is also important because many who have been diagnosed with a vision condition have changing prescription needs and require regular care. Our Vision plans are administered through Davis Vision, a national leader in the eye health industry, and are available in three categories, depending on market: Vista: Budget friendly options, ideal for those new to a vision plan Panorama: Mid-range offerings with more generous allowances and reduced copayments xpanse: Premium plans that minimize out-of-pocket costs combined with the highest allowances and lowest copayments available All Vision plans use the /Davis Vision Select network, Davis Vision s core nationwide network of independent retailers and Visionworks locations. Many of our plans, however, also leverage the expanded /Davis Vision View network, which combines the /Davis Vision Select network with an additional 20,000 eye care professionals throughout the country. You can view the new 2016 products and pricing here, as well as a chart that explains which products are available in each market and which network they use. While open enrollment is an ideal time for companies to add vision benefits to their packages, vision coverage can be purchased at any time. Vision is part of our enhanced ancillary product line, which also includes the expanded Dental program. If you have questions, please contact your BCBSNJ sales executive or account manager. 1 Had Your yes Checked Lately?, Atlanta Journal Constitution, June 6, 2009 Davis Vision, Inc., is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies may be provided by Insurance Company and services and products may be provided by Blue Cross Blue Shield of New Jersey or Healthcare of New Jersey, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (0215)

2 Vista I Vision Product Overview Market Individual Small Group Large Group Vista II Vista III Vista IV Vista V Panorama IIIA Panorama IIIB Panorama IVA Panorama IVB Panorama V xpanse V xpanse VI xpanse VIIA xpanse VIIB xpanse VIII Network access depends on product and market. Purple-shaded boxes represent access to the /Davis Vision Select network. All other product/market variations use the /Davis Vision View network. Davis Vision, Inc. supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc. is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies are provided by Insurance Company, and services are provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215)

3 Individual Plans Overview Vista V Panorama V Network /Davis Vision View In-Network Benefits Frequency Once every: ye examination inclusive of dilation (when professionally indicated) Frame Contact lens evaluation, fitting and follow-up care Contact lenses (in lieu of eyeglasses) Copayments ye examination $10 $10 Contact lens evaluation, fitting and follow-up care $0 $0 1 yeglass Benefit Frame Member Charges Non-collection frame allowance (retail): Up to $100 or $150 2 Up to $130 or $180 2 Plus a 20% discount on any overage 3 Davis Vision Frame Collection 4 (in lieu of allowance): Fashion level Designer level $15 copayment Premier level $40 copayment $25 copayment yeglass Benefit Spectacle Lenses Clear plastic single-vision, lined bifocal, trifocal or lenticular lenses (any size or Rx) Tinting of plastic lenses $15 Scratch-resistant coating Polycarbonate lenses (children 5 / adults) $0 / $35 $0 / $30 Ultraviolet coating $15 $12 Anti-reflective (AR) coating (standard / premium / ultra) $40 / $55 / $69 $35 / $48 / $60 Progressive lenses (standard / premium / ultra) $65 / $105 / $140 $50 / $90 / $140 High-index lenses $60 $55 Polarized lenses $75 Plastic photochromic lenses $70 $65 Scratch Protection Plan: Single vision / Multifocal lenses $20 / $40 Contact Lens Benefit (in lieu of eyeglasses): Non-collection contact lenses: Materials allowance Up to $100 Up to $130 Plus a 15% discount on any overage 3 valuation, fitting and follow-up care standard and specialty lens types 15% discount 3 Collection Contact Lenses 4 (in lieu of allowance): Disposable N/A Up to 4 boxes/multi-packs Planned replacement N/A Up to 2 boxes/multi-packs valuation, fitting and follow-up care N/A Visually required contact lenses (with prior approval) Materials, evaluation, fitting and follow-up care Out-of-Network Reimbursement Schedule Up to: ye examination: $40 Single-vision lenses: $40 Trifocal lenses: $80 lective contact lenses: Fashion Value: $80 Designer: $105 Frame: $50 Bifocal/progressive lenses: $60 Lenticular lenses: $100 Visually required contact lenses: $225 1 Copayment applies to Davis Vision Collection contact lenses only. 2 Members receive an additional $50 allowance at Visionworks retail locations. 3 Additional discounts not applicable at Walmart, Sam s Club or Costco locations. 4 Davis Vision Collection is available at most participating independent provider offices. Collection is subject to change. Contact lens collection (Option II) is inclusive of select torics and multifocals. 5 Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions +/ diopters or greater. Davis Vision, Inc., supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc., is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association.Products and policies provided by Insurance Company and services provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215) shop.blue.com

4 Vision Individual Plans Price Chart (effective 1/1/16) Vision: Powered by an industry leader Blue Cross Blue Shield of New Jersey s Vision plans are administered by Davis Vision, a national leader in eye care. Our relationship with Davis Vision means our members are able to save even more when they receive services through Davis Vision s retail arm, Visionworks. Here are just a few of the benefits Davis Vision offers in all of our Vision plans. A higher frame allowance when purchased through Visionworks Savings on additional eyeglasses, sunglasses and disposable contact lenses One-year breakage warranty Mail-order contact lenses Laser-vision-correction discounts Low-vision services ye health and wellness education Learn more about Vision at shop.blue.com. Vista V Premium Rates Subscriber Only $10.88 Subscriber + Spouse $21.77 Subscriber + Child(ren) $29.39 Subscriber + Family $42.45 Panorama V Premium Rates Subscriber Only $11.91 Subscriber + Spouse $23.83 Subscriber + Child(ren) $32.17 Subscriber + Family $46.46 Davis Vision, Inc. supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc. is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies are provided by Insurance Company, and services are provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey shop.blue.com (1215)

5 Vista Plans Overview Vista III Vista IV Network /Davis Vision Select In-Network Benefits Frequency Once every: ye examination inclusive of dilation (when professionally indicated) Frame 24 months Contact lens evaluation, fitting and follow-up care Contact lenses (in lieu of eyeglasses) Copayments ye examination $0 $10 $10 $25 yeglass Benefit Frame Member Charges Non-collection frame allowance (retail): Up to $100 Plus a 20% discount on any overage Davis Vision Frame Collection 1 (in lieu of allowance): Fashion level Designer level $15 copayment Premier level $40 copayment yeglass Benefit Spectacle Lenses Clear plastic single-vision, lined bifocal, trifocal or lenticular lenses (any size or Rx) Tinting of plastic lenses $15 Scratch-resistant coating Polycarbonate lenses (children 2 / adults) $0 / $35 Ultraviolet coating $15 Anti-reflective (AR) coating (standard / premium / ultra) $40 / $55 / $69 Progressive lenses (standard / premium / ultra) $65 / $105 / $140 High-index lenses $60 Intermediate-vision lenses $30 Polarized lenses $75 Plastic photochromic lenses $70 Scratch Protection Plan: Single vision / Multifocal lenses $20 / $40 Contact Lens Benefit (in lieu of eyeglasses): Up to $100 Non-collection contact lenses: Materials allowance Plus a 15% discount on any overage valuation, fitting and follow-up care standard and specialty lens types 15% discount Visually required contact lenses (with prior approval) Materials, evaluation, fitting and follow-up care Out-of-Network Reimbursement Schedule Up to: ye examination: $40 Single-vision lenses: $40 Trifocal lenses: $80 lective contact lenses: $80 Frame: $50 Bifocal/progressive lenses: $60 Lenticular lenses: $100 Visually required contact lenses: $225 1 Davis Vision Collection is available at most participating independent provider offices. Collection is subject to change. Contact lens collection (Option II) is inclusive of select torics and multifocals. 2 Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions +/ diopters or greater. Davis Vision, Inc., supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc., is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies provided by Insurance Company and services provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215)

6 xpanse VIIA and VIIB Overview xpanse VIIA xpanse VIIB Network /Davis Vision Select In-Network Benefits Frequency Once every: ye examination inclusive of dilation (when professionally indicated) Frame 24 months Contact lens evaluation, fitting and follow-up care Contact lenses (in lieu of eyeglasses) Copayments ye examination $0 $10 $10 $25 Contact lens evaluation, fitting and follow-up care $0 $0 yeglass Benefit Frame Member Charges Non-collection frame allowance (retail): Up to $150 Plus a 20% discount on any overage Davis Vision Frame Collection 1 (in lieu of allowance): Fashion level Designer level Premier level yeglass Benefit Spectacle Lenses Clear plastic single-vision, lined bifocal, trifocal or lenticular lenses (any size or Rx) Tinting of plastic lenses Scratch-resistant coating Polycarbonate lenses (children 2 / adults) Ultraviolet coating Anti-reflective (AR) coating (standard / premium / ultra) $35 / $48 / $60 Progressive lenses (standard / premium / ultra) $0 / $40 / $90 High-index lenses $55 Intermediate-vision lenses Polarized lenses $75 Plastic photochromic lenses $65 Scratch Protection Plan: Single vision / Multifocal lenses $20 / $40 Contact Lens Benefit (in lieu of eyeglasses): Up to $150 Non-collection contact lenses: Materials allowance Plus a 15% discount on any overage valuation, fitting and follow-up care standard and specialty lens types 15% discount Collection Contact Lenses 2 (in lieu of allowance) materials Disposable Up to 8 boxes/multi-packs Planned replacement Up to 4 boxes/multi-packs valuation, fitting and follow-up care Visually required contact lenses (with prior approval) Materials, evaluation, fitting and follow-up care Out-of-Network Reimbursement Schedule Up to: ye examination: $40 Single-vision lenses: $40 Trifocal lenses: $80 lective contact lenses: $105 Frame: $50 Bifocal/progressive lenses: $60 Lenticular lenses: $100 Visually required contact lenses: $225 1 Davis Vision Collection is available at most participating independent provider offices. Collection is subject to change. Contact lens collection (Option II) is inclusive of select torics and multifocals. 2 Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions +/ diopters or greater. Davis Vision, Inc., supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc., is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies provided by Insurance Company and services provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215)

7 xpanse VIII Overview xpanse VIII Network /Davis Vision Select In-Network Benefits Frequency Once every: ye examination inclusive of dilation (when professionally indicated) Frame 24 months Contact lens evaluation, fitting and follow-up care Contact lenses (in lieu of eyeglasses) Copayments ye examination $10 $25 Contact lens evaluation, fitting and follow-up care $0 1 yeglass Benefit Frame Member Charges Non-collection frame allowance (retail): Up to $150 Plus a 20% discount on any overage Davis Vision Frame Collection 2 (in lieu of allowance): Fashion level Designer level Premier level yeglass Benefit Spectacle Lenses Clear plastic single-vision, lined bifocal, trifocal or lenticular lenses (any size or Rx) Tinting of plastic lenses Scratch-resistant coating Polycarbonate lenses (children 3 / adults) Ultraviolet coating Anti-reflective (AR) coating (standard / premium / ultra) Progressive lenses (standard / premium / ultra) High-index lenses Intermediate-vision lenses Polarized lenses Plastic photochromic lenses Scratch Protection Plan: Single vision / Multifocal lenses $20 / $40 Contact Lens Benefit (in lieu of eyeglasses) Up to $150 Non-collection contact lenses: Materials allowance Plus a 15% discount on any overage valuation, fitting and follow-up care standard and specialty lens types 15% discount Collection Contact Lenses 2 (in lieu of allowance): Disposable Up to 8 boxes/multi-packs Planned replacement Up to 4 boxes/multi-packs valuation, fitting and follow-up care Visually required contact lenses (with prior approval) Materials, evaluation, fitting and follow-up care Out-of-Network Reimbursement Schedule Up to: ye examination: $40 Single-vision lenses: $40 Trifocal lenses: $80 lective contact lenses: $105 Frame: $50 Bifocal/progressive lenses: $60 Lenticular lenses: $100 Visually required contact lenses: $225 1 Davis Vision Collection is available at most participating independent provider offices. Collection is subject to change. Contact lens collection (Option II) is inclusive of select torics and multifocals. 2 Polycarbonate lenses are covered in full for dependent children, monocular patients and patients with prescriptions +/ diopters or greater. Davis Vision, Inc., supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc., is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies provided by Insurance Company and services provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215)

8 /Davis Vision Select Network Plans Pricing (effective 1/1/16) Vista III mployee Only $6.16 mployee + Spouse $12.33 mployee + Child(ren) $16.64 mployee + Family $24.04 mployee Only $4.12 mployee + Spouse $8.23 mployee + Child(ren) $11.12 mployee + Family $16.06 Vista IV mployee Only $4.57 mployee + Spouse $9.14 mployee + Child(ren) $12.33 mployee + Family $17.82 mployee Only $2.98 mployee + Spouse $5.97 mployee + Child(ren) $8.05 mployee + Family $11.63 xpanse VIIA mployee Only $8.76 mployee + Spouse $17.51 mployee + Child(ren) $23.64 mployee + Family $34.15 mployee Only $5.75 mployee + Spouse $11.50 mployee + Child(ren) $15.52 mployee + Family $22.42 xpanse VIIB mployee Only $6.79 mployee + Spouse $13.58 mployee + Child(ren) $18.33 mployee + Family $26.48 mployee Only $4.30 mployee + Spouse $8.60 mployee + Child(ren) $11.62 mployee + Family $16.78 xpanse VIII mployee Only $9.19 mployee + Spouse $18.39 mployee + Child(ren) $24.83 mployee + Family $35.86 mployee Only $5.72 mployee + Spouse $11.45 mployee + Child(ren) $15.46 mployee + Family $22.33 Davis Vision, Inc. supports Blue Cross Blue Shield of New Jersey in the administration of vision benefits. Davis Vision, Inc. is independent from and not affiliated with Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association. Products and policies are provided by Insurance Company and services are provided by Blue Cross Blue Shield of New Jersey, each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The name and symbols are registered marks of Blue Cross Blue Shield of New Jersey Blue Cross Blue Shield of New Jersey. Three Penn Plaza ast, Newark, New Jersey (1215)