you might be surprised at how much your health plan … might be surprised at how much your health...

You might be surprised at how muchyour health plan can do for you.

World-class

customer serviceFind a great

doctor or

hospital online

Chiropractic care

Discounts on

magazine

subscriptions1

Nutrition

counseling

Childhood

immunizations

Better Breathing®

program

Allergists

Day in. Day out. Week in. Week out. Year in. Year out. You can now make

the most of your health plan anytime. Your health plan – and all the

health-related programs that go with it – is designed for your well being.

For one thing, we like our Members. And for another, we want you to

think of us as the company that always promotes good health. Your

health. Your kid’s health. Your neighbor’s health.

To see what we mean, check out what’s available under our health-related

programs. Diverse programs that give you access to services you’ll

actually want to use – like yoga classes and massage therapy. We also

have acupuncturists, nutritionists and weight loss & smoking cessation

programs. Even discounts on cool stuff like karate classes, sports

equipment and organic food.1

And just to prove we’re not taking your health insurance coverage lightly,

you’ll find that practically every doctor and specialist in our network is

either board certified or board eligible.2 We also provide 24/7 access to

our healthcare guidance line, where you can speak with live nurses. But

in order to take full advantage of your health plan, you’ll have to make

the first move and turn the page.

Not just when you’re all stuffy, but every day of the year.

1 Offers are valid through December 31, 2007. These discounts are offered in addition to, and separate from, the Member’s benefitcoverage through Oxford. These arrangements have been made for the benefit of Members, and do not represent an endorsementor guarantee on the part of Oxford. Discounts may change from time to time and without notice and are applicable to the items referenced only. Oxford cannot assume any responsibility for the products or services provided by vendors or the failure of vendors referenced to make available discounts negotiated with Oxford; however, Members should report any failure to receive discounts to Oxford Customer Service by calling the number on their Oxford ID card.

2 As of 1/1/07, this data represents all the participating providers except ancillary providers and hospitals. Dental and complementaryand alternative medicine providers are included. Providers who are board certified in more than one specialty are counted for each specialty. Therefore, providers who are board certified in more than one specialty are counted multiple times.

With over 72,000 doctors,

you can feel good

about your choices2

Doctor Network

Annual checkups

at no charge3

Review a list of questions

to ask your doctor

Select an OB/GYN

in addition to a

primary care physician

Board certified

podiatrists

1

Need

ag

reatd

octo

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3 Some plans may require Member cost shares or have annual dollar limits. 4 Based on a survey by Ingenix, Q4/2006. Tri-state is defined as NY, NJ and CT.

Never underestimate the value of a good doctor.

A broad choice of doctors can help you feel at ease. That’s why you’ll find literally thousands of primary care

physicians and specialists in our network. This greatly increases the chance that you’ll get in-network access

to the doctor of your choice.

• Oxford’s Freedom Network gives Members access to more than 72,000 physicians2 and other providers

who practice at over 101,000 sites, and to over 230 hospitals throughout New York, New Jersey

and Connecticut

• Oxford’s Liberty Network in New York and New Jersey gives Members access to more than 46,000

Liberty Network physicians2 and other providers who practice at over 65,000 sites, plus access to

thousands more Freedom Network physicians in Connecticut, Pennsylvania and Delaware

• Women may select an OB/GYN in addition to their primary care physician (PCP)

• Members also have access to the area’s first fully credentialed network of complementary and alternative

medicine providers

The large majority of physicians in our network are either board certified or recently board eligible

2, one of the best available measures of physician quality.

We also support continuing medical education to help our doctors stay at the top of their respective fields.

• Doctors decide the appropriate care for each of their patients

• Two-thirds of providers in the tri-state area stated in a recent survey

that they would recommend Oxford to their peers or patients4

Search for a doctor online:

Step 1 Go to www.oxfordhealth.com

Step 2 Under Get to Know Oxford, click

“Search for an Oxford Doctor”

Step 3 Follow steps under Express Search

or Advanced Search, and click on

the “Search” button

To search by network:Go to Advanced Search and select doctor

type, state, county and the network

(Freedom or Liberty) associated with your plan,

then click on the “Search” button

Joint pain

Ways to

better skin

Migraines

Nutritionists

Aids to

digestion

Massage

therapy

Complementary & Alternative Medicine

3

Relax. Unwind. Stretch out. We’ve got you covered in more ways than one.

There’s more than one set way to achieve a healthy spirit, mind and body. So we created the tri-state area’s

first fully credentialed network dedicated to complementary and alternative medicine (CAM). Today, it includes

over 4,500 providers in the following fields:5

• Nutrition • Chiropractic Medicine

• Naturopathic Medicine (CTonly) • Massage Therapy

• Yoga • Acupuncture

The reason we can call our network fully credentialed is because our CAM providers must adhere to strict standards. That means:

• Meeting state licensure requirements

• Meeting clinical experience requirements and committing

to continuing education in their discipline

• Having specialty certifications, where applicable

• Meeting malpractice requirements

• Becoming recredentialed every three years

Our Members can learn more about Oxford’s CAM network at www.oxfordhealth.com.

Once there, it’s easy to search for a CAM provider.

Members may utilize Oxford’s CAM benefit by:

Contracted rate6 – (Applies to nutritionists, naturopaths [in Connecticut only], yoga instructors,

chiropractors, massage therapists and acupuncturists.) Members can visit participating CAM providers in

New York, New Jersey and Connecticut as often as they wish, without a PCP referral, at a specially negotiated

rate. Simply select a participating provider, schedule an appointment and pay the provider at the time of the

visit. This is not an insured benefit, so there is no need for a PCP referral, or paperwork. In most cases, this

contracted rate reflects a discount from the provider’s normal fee.

Standard in-network benefits – (Applies to chiropractors and naturopaths.) In certain regions,

Oxford offers benefits for specific types of CAM care. For chiropractic7 and naturopathic coverage, Members

must obtain a referral from their PCP for the initial visit. Precertification is required for any visits after the

initial visit for plans that require precertification. For naturopathic care, only a referral is required. The Member

is responsible for a copayment at the time of the visit. Members of open access, or non-gated, plans are not

required to obtain referrals to visit participating chiropractors or naturopaths.

Oxford On-Call®

living with diabetesSM

heart smartSM

oxford healthy mother,healthy babySM

active care engagementSM

healthy bonus®

complementary &alternative medicine®

active partner®

Program Logos

An

alternate

way

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ell

5 Based on 1/1/07 provider data. Includes acupuncturists, chiropractors, massage therapists, naturopaths, nutritionists and yoga instructors. Provider type and availability vary by state and plan.

6 The contracted rate is not an insured benefit, but rather a fair standardized rate for care. In most instances, this rate reflects a discount from the provider’s normal fee.7 If the Member has out-of-network coverage and accesses chiropractic care through a non-participating provider, the services will be reviewed for medical necessity.

Members and providers can either request prior approval through TRIAD Healthcare, Inc. (a national chiropractic network) by submitting the Voluntary Prior ApprovalAgreement Form, along with an Initial Care Plan Form; or submit clinical notes for medical necessity review to TRIAD after services are rendered and claims are submitted. (Note: Not all Members are included in the TRIAD arrangement.)

Laryngitis or

strep throat?

Poison ivy

or poison oak?Natural hair

loss or too

much stress?

Leg cramps or

pulled muscle?

Call now

or call later?

Indigestion or

food allergy?

Oxford On-Call®

5

Oxford On-Call®


h


healthy bonus®

Program Logos

Ou

r24

-ho

ur

health

careg

uid

ance

line

The wee hours of the morning. Lunchtime. The big holiday weekend. Who knows when you’llneed some healthcare guidance?

You may not always be able to reach your doctor, but questions about your health are always worth asking.

No matter what time of day it is. That’s why we created Oxford On-Call,® our healthcare guidance line.

Twenty-four hours a day, 365 days a year, you can speak with informative registered nurses who can help

guide you to the most appropriate source of care. In fact, all Oxford nurses have strong clinical backgrounds

and many have experience in emergency nursing.

Ice or heat? Scratchy throat or strep throat? Homesick or too much guacamole?By giving you the answers you need, our nurses can help you start feeling better.

Our nurses:

• Identify caller symptoms and recommend next

steps using one of the most advanced patient

assessment systems available

• May recommend a visit to the emergency room,

suggest an appointment with a physician or

advise how to care for a problem at home

• May make follow-up calls to promote

continuity of care

• Chat live with Members who access them

through www.oxfordhealth.com

At 3:00AM, Oxford On-Call is the next best thing to calling your mom. Especially when your mom’s asleep.

Better Breathing®

program

Ways to help manage

your diabetes

Healthy

cookbooks

Disease Management

7

Oxford On-Call®


heart smartSM



healthy bonus®


active partner®

better breathing® oxford cancersupport programSM

healthy bonus®oxford cancersupport programSM


Stacked Versions – Create As Needed

Program Logos

Oxford On-Call®


heart smartSM


ne®

oxford cancersupport programSM

healthy bonus® complementary &alternative medicine®

sions – Create As Needed

Program Logos

Oxford On-Call®


heart smartSM


a

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sions – Create As Needed

P ogram Logos

Oxford On-Call®


heart smartSM



healthy bonus®


active partner®


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Stacked Versions – Create As Needed

Program Logos

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P ogram Logos

Disease

Man

agem

ent

Education. Encouragement. Expertise. Support. More specifically, what you’ll find in every one ofour disease management programs.

Our disease management programs are developed by clinical teams and led by Oxford Medical Directors.

Through these programs, we focus on educating and encouraging Members, as well as cultivating close

communication between patient and physician. At the same time, we help keep our participating physicians

informed of the latest treatments, clinical practices and preventive guidelines.

Some of our Disease Managementprograms include:

Better Breathing® program An educational

program for children and adults with asthma. This

program aims to help Members learn more about

asthma, the medications used to treat it, monitoring

devices, and how a healthy lifestyle can help

keep asthma under control.

Living with DiabetesSM program Designed to educate

Members with diabetes on their condition and to encourage them to work

with their physician on a personal treatment plan to control their diabetes. This program

promotes the use of the most recent American Diabetes Association treatment guidelines and

provides Members with educational materials, including healthy cookbooks.

Active Care EngagementSM (ACE) program Oxford’s ACE program is a health management

program for high-risk Members with congestive heart failure (CHF), coronary artery disease and/or

diabetes. The program is designed to help Members manage their condition to improve their health status and

quality of life. Member support includes lifestyle modification, education on the disease process, symptom

management, and medication adherence.

Heart SmartSM program This program helps Members with cardiovascular disease (CVD) and

congestive heart failure (CHF) — who are not in the ACE program — understand and improve their health

and quality of life. Materials are available to help educate Members about hypertension, cholesterol management,

lifestyle modification, and the immediate and long-term needs associated with medication compliance.

Oxford Cancer Support ProgramSM Education plays an important role in the early detection of

cancer. And it’s no less important in the treatment phase. For this reason, we offer individualized case

management for Members with specific oncological diagnoses. As a part of the program, nurses and/or

social workers regularly contact our Members to provide information, support, telephonic assessments, and

educational materials. Nurses also work in concert with Members’ physicians to support and reinforce their

treatment plans and emphasize symptom management.

Childhood immunization

reminders

Tips on postnatal care

Tips for colic

Mammogram reminders

Oxford Healthy Mother, Healthy Baby®

Active Partner ®

9

A string around your finger. A Post-it® note. Awake-up call. All rolled into one. That’s the generalidea behind our Active Partner® mailings.

Preventive exams and screenings can provide Members with either a clean bill of health and piece of

mind or provide early detection of a condition which may become more serious if left unchecked. To help

keep our Members healthy, Oxford developed Active Partner preventive mailings to remind them to make

appointments for the preventive care they need. Members who have not received a preventive exam within

the recommended time period are sent reminders.

Reminder mailings:

• Childhood immunizations

• Adolescent well care

• Pap smear

• Flu vaccinations

• Mammogram

• Colorectal screening

An ounce of prevention equals our philosophy exactly. That’s why we offerour Members the following additional resources:

Healthy Mind Healthy Body® magazine

A source of the latest information on prevention, nutrition and exercise, as well as important benefit and

coverage information. Delivered to Members’ homes two times a year.

Oxford Healthy Mother, Healthy Baby®

This program complements the care expectant Members receive from their doctors with educational

information on prenatal and postnatal care, as well as childhood immunizations.

Self-Help LibrarySM

Educational guides are also available for Members with asthma, diabetes and depression to help them learn

more about self-care, treatment guidelines and how to prevent complications. Members may receive these

materials after they are diagnosed or upon request.

Oxford On-Call®


heart smartSM

oxford healthy mothhealthy babySM


healthy bonus®


active partner®


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Program Logos

Ho

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eh

elpyo

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healthy

Karate classes

Gym discounts Home fitness

equipment

Healthy Bonus® Discount Programs1

Discounts on

vitamins

11

Oxford On-Call®


heart smartSM

o


healthy bonus®


Program Logos

Discounts to the gym. Discounts to the spa. With Oxford, staying in tip-top shape just became a little easier.

We know a good thing when we see it, and it seems you do, too. That’s why we’re always looking for new

offers to add to our already popular Healthy Bonus® program.8 Apparently, helping to keep you on your toes

is what keeps us on ours.

The Healthy Bonus program includes:

Chelsea Piers 50% discount on the standard initiation fee and lowest member dues, plus discounts at the

golf center, field house and sky rink

Natural and organic products• 15% off all products at www.mothernature.com

• $50 off a one-year subscription to FIJI Water home delivery

Magazine subscriptions• Today’s Caregiver magazine, 40% off 1-yr subscription

• Pilates StyleTM magazine, 6 issues for $9.95

• Yoga Journal, 8 issues for $11

Omni Fitness• 10% on fitness equipment

• 15% off accessories

Puritan’s Pride® vitamins 10% savings on already low prices on over 1,400 products

QuitNet® Get a lifetime membership to this popular online smoking cessation program for $65, that’s 35%

off the regular price

Safe Beginnings® 20% discount on childproofing items, including safety gates, cabinet locks, outlet covers,

and window guards

The Spa Finder Company 10% off all gift certificates

STOTT PilatesTM 15% off suggested retail prices on STOTT Pilates videos and equipment

Tiger Schulmann’s KarateTM $49 for one month, plus a free uniform

Weight Management programs 15% off an online program, plus a free 45-minute consultation at

Living Lean, LLC, Rob Nevins Personalized Fat Loss Programs. Members also receive free registration to a

local meeting program, plus additional savings on a special online program at Weight Watchers®

WellQuest Fitness Network A one-time registration fee of $49 ($29 additional fee for each family

member) to WellQuest entitles Members to a discounted rate at any one of WellQuest’s fitness centers

Disco

un

tsth

atare

go

od

for

you

For a complete listing of our Healthy Bonus® offers, Members log on to www.oxfordhealth.com.

8 Offers are valid through December 31, 2007. These discounts are offered in addition to, and separate from, Members’ benefit coverage through Oxford. Thesearrangements have been made for the benefit of members, and do not represent an endorsement or guarantee on the part of Oxford. Discounts may change fromtime to time and without notice and are applicable to the items referenced only. Oxford cannot assume any responsibility for the products or services provided by vendors or the failure of vendors referenced to make available discounts negotiated with Oxford; however, Members should report any failure to receive discounts toOxford Customer Service by calling the number on their Oxford ID card.

Tell us about

that new person

in your life

Research vitamins at

PuritansPride.com

Search for the best

hospital for a

hernia operation

Search for

a doctor

Request new materials, order a

new ID card, or

check a claim

Information for new or

soon-to-be parents

www.oxfordhealth.com

13

ww

w.o

xford

h ealth

.com

You might be surprised at how much a web sitecan do for you.

At www.oxfordhealth.com, Members can search for a provider, check referrals, get a new ID card, access

their benefits and personalized healthcare information and more. All with a few simple keystrokes.

Here are some of the resources available on our Member web site:

KidsHealth® Advice for all new and expectant parents; sign up for an eNewsletter

Complementary & Alternative Medicine Get information on the program or find a provider in your area

Subimo® Healthcare AdvisorTM and PharmaAdvisorTM Online resources for researching the best

hospitals and/or treatment options, and comparing drugs or research alternatives, respectively

Healthy Bonus® Member discounts on wellness-related products and services

Oxford Healthy Mother, Healthy Baby® Information for expectant mothers to complement the care

they receive from their doctor

Healthy Mind Healthy Body® magazine Health-related articles including prevention and nutrition

Health forums Timely health and well-being information plus an audio library

Health Risk Assessment Online health assessment tool to help Members create goals for healthcare

behaviors they wish to change

At www.oxfordhealth.com,Members can:

• Search for a doctor

• Check:

- claims, benefits, referrals

• Change:

- PCP, address, e-mail, user name

• Request:

- ID card, forms, rosters

• Notify us of pregnancy and birth

• E-mail Customer Service

• View online benefit documents:

- Summary of Benefits (SOB)

- Certificate of Coverage (COC)

- riders, banner page, privacy notice

A web site that’s easy to use didn’t come easily. We’re always enhancing it basedon feedback from our Members. Then again, nothing worthwhile ever comes easy.

Members can simply click “Member” on the www.oxfordhealth.com home page and see how we’re working

to help them get into healthier habits. New users should click the “Need to Register” button and follow the

instructions.

Call us when you

have a simple question

or in a time of stress

Interactive

web site

Trained, courteous

and knowledgeable

service associates

Consistently quick

response times

All service associates receive

timely refresher courses

Customer Service

15

Good old-fashioned customer service. You know. With the emphasis on customer. And service.

At Oxford, all of our Service Associates undergo a rigorous training program and receive refreshercourses on a regular basis.

Whether it’s a simple question, a call in a time of stress, a

call from the emergency room to check benefits, or a call to

ask questions about a claim, we want to respond quickly

and accurately. When Members call, they talk to someone

specifically trained to handle their concerns. The result is

greater accountability and better response times.

Our Members can get answers to their questions in three different ways:

• Our Customer Service Department staffed with well trained Service Associates

• Our interactive web site, www.oxfordhealth.com, where Members completed

an average of 3.7 million self-service web transactions in 2006

• Oxford Express,® our interactive voice response telephone system

Many of our Members have discovered how handy our web site is. They’re using it to check benefits and

claims, search for providers, order new Member ID cards, and much more. They’re also using Oxford Express,

our interactive voice response telephone system to perform many of the same tasks. And they’re doing it all

at their convenience, whenever they want. 24 hours a day, 365 days a year.9

Because every day is different, we offer health-related programs that you can takeadvantage of night or day. Not just when you feel lousy, but when you’re feeling great,too. It’s called getting more value for your dollar. And, with Oxford products, it’s simplyone of the many benefits we build into every health plan we offer.

9 Excluding periodic downtime for server maintenance.

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© 2007 Oxford Health Plans LLC. Oxford’s HMO products are underwritten by Oxford Health Plans (NY), Inc., Oxford Health Plans (NJ), Inc. and Oxford Health Plans (CT), Inc. and Oxford’sinsurance products are underwritten by Oxford Health Insurance, Inc. and Investors Guaranty Life Insurance Company.

MS-07-302 8875 R1

www.oxfordhealth.com

you might be surprised at how much your health plan … might be surprised at how much your health...

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