Founded in 1991, CHA Health's provider network formed when a group of Kentucky hospitals joined together to develop an integrated health care delivery network. That network of physicians and hospitals contracted with self-funded and managed care organizations. In 1995 the group took the next step, became CHA Health, and provided not only the network, but also participated as a health insurer.

Today, CHA Health is a managed care organization (MCO) and a provider network with more plans to fit your needs and a dedicated customer service team whose only goal is your satisfaction. With over 125,000 commercial and self-funded members and over 11,000 providers in our network we've grown to become a large MCO committed to serving Kentucky and its neighboring states.

PRIME NETWORK

Using our fully-insured product line and our Prime Network, finding the best product at the right price has never been easier. With a broad product portfolio, designed with your goals in mind, and one of the largest choices of participating providers in Kentucky, the Prime Network gives you the best savings available through CHA Health.

PrimeCare Silver, our PPO, is similar to a traditional health insurance plan with up-front deductible and coinsurance payments, up to a maximum out-of-pocket limit. This plan makes it easy to see any physician-primary care or specialist. Members are not required to obtain a referral for specialty care or select a PCP*. Members receive the higher benefit level by using providers participating in the CHA Health Prime Network. Lower out-of-network benefits apply if you receive covered services from non-participating providers and will cost members significantly more than in-network services.

Our HMO option, PrimeCare Gold, is our mid-price product for employers. It is cost-effective and easy to use. PrimeCare Gold covers services when provided by a participating provider. On average, over 90% of CHA Health's commercial members use participating providers exclusively, so this plan effectively meets the needs of most members. Each member selects a PCP when enrolling and members may see any physician within the CHA Health Prime Network with no referral requirements for specialty care*. Healthcare providers outside the Network are not covered under PrimeCare Gold. Emergency care is covered anywhere.

PrimeCare Platinum, our POS option, offers you the cost savings of an HMO plan with an out-of-network option, resulting in more freedom of choice while managing and containing costs. In-network benefits apply to covered services received from participating providers. Out-of-network benefits apply if you elect to receive covered services from non-participating providers and could require you to pay substantially more. Each member selects a PCP when enrolling, but there are no referral requirements for specialty care*.

COMMONWEALTH NETWORK

More and more employers are discovering the advantages of self-funded health care plans. Plan options include HMO, POS and PPO with employers able to customize benefits to fit the company's needs. Utilizing CHA Health's Commonwealth Network of participating providers and our utilization management team, along with Commonwealth Administrators, LLC** serving as the TPA, we offer the self-insured employer a cost-effective, well-developed managed care approach. The result for the employer-greater control over health care costs.

PREFERRED NETWORK

Another option for companies choosing to self-fund their health benefits is our Preferred Network. Any licensed TPA may lease this network directly from CHA Health. CHA Health maintains the provider network with all other services provided by the TPA of your choice.

An unending dedication to customer satisfaction makes a real difference when it comes to selecting a managed care provider. CHA Health offers a dedicated member services team that seeks to answer questions and resolve issues. We are committed to helping members understand their health plan through open communication, a quarterly newsletter, and our Web site.

Working with providers is one of the top priorities at CHA Health. Streamlined claims administration, prior authorization and credentialing processes as well as regional service representatives reinforce our vision that sees providers as key customers of our organization.

At CHA Health, insurance agents and TPAs are an integral part of our organization. Our agent advisory committee keeps us apprised of the needs of the agent community; their valuable input has led to the development of new plan options and pricing methodologies. Over 500 agents represent CHA Health in the local community. This is especially important with small groups where local service and support are of the utmost importance.

For employers with more than 100 employees, CHA Health provides a service team, comprised of an account executive and account manager who are assigned specifically to your company. From the sales process to enrollment and renewals, your service team works closely with you to ensure smooth transitions and excellent service.

Nurse411™ provides our members with confidential and toll-free access to registered nurses 24-hours a day, 7 days a week.

Our innovative Healthy Heart program focuses on early detection and improved treatment of coronary artery disease (CAD). A simple and painless test shows how well oxygen is supplied to the heart and is an important tool in determining how well the heart is functioning. Based on the results, physicians may prescribe medication or recommend life-style changes to reduce the risk of heart disease.

Designed to address the needs of cancer patients and their families, Healthy Horizons helps guide patients through the challenging maze of cancer treatment. Patients are assigned an experienced oncology nurse who assists with coordinating all aspects of care and provides emotional support for patients and families, as well as education regarding effects of treatment, management of pain and other concerns that may arise.

Healthy Beginnings is designed to give moms and their babies a healthy start together by encouraging appropriate prenatal care, providing early and ongoing education to pregnant women, and identifying pregnant women with the potential for developing complications, such as pre-term labor. In addition to educational materials and 24-hour access to registered nurses, women assessed as potentially high risk will receive regular follow-up from nurses specially trained in obstetrical care. Nurses work closely with the member's obstetrical provider to coordinate necessary care and services.

Healthy Airways

Especially for CHA Health members with asthma and COPD (Chronic Obstructive Pulmonary Disease), Healthy Airways is a wellness program that seeks to improve the health and life of those with chronic respiratory disease.

The program focuses on self-care, prevention and intervention, education, support, quality of life improvements, and reducing complications. Real results can be measured in quality of life improvements such as reduced days of missed school and work, and a reduction in nighttime awakenings, emergency room visits, and hospital admissions.

Smoking Cessation

CHA Health and the Kentucky Department for Public Health can help you quit smoking. Members are offered a 90-day supply of nicotine replacement patches on a one-time basis if enrolled in a smoking cessation program with a trained facilitator like those offered by local health departments, health care providers, and hospitals. Coverage is limited to 12 weeks and there is a copayment of $25 for each 30-day supply of nicotine patches. Let CHA Health make healthier living easier.

OTHER BENEFITS

Prescriptions

CHA Health's Prescriptions program identifies ways to help members control medical expenses. Our three-tier copayment structure helps members do just that. It includes generic, preferred and non-preferred medications. Generic drugs are the most affordable way to obtain quality medications at the lowest copayment level. Preferred brands have no generic equivalent and are covered at a higher copay. Non-preferred brands have either an equally effective and less costly generic equivalent, or one or more preferred brand options. Non-preferred brands are covered at the highest out-of-pocket cost.

ScriptsByMail

To make life a little simpler, our Prescriptions program includes a mail-order service for your maintenance medications. CHA Health members may order their maintenance medications through the mail-safely, securely and for some, at significant savings. It's quick, easy and convenient. It's flexible too. Members can place orders by phone, mail or via the Internet at cha-health.com. The prescription is filled and shipped to the member's home within two weeks of receipt.

CHA Health Online

As your trusted partner in healthcare, we believe that making health information easy to access is important. That's why there's CHA Health Online at cha-health.com. Discover an easier way to access health information at cha-health.com.

myCHAinfo

Not quite sure what your prescription drug benefits are? Want to check the status of a claim? myCHAinfo makes it easy. By using your unique username and password to log on, security and privacy are assured. You can change your primary care physician, order replacement ID cards, update personal information, view claims status and authorizations, and view benefit information such as copayments and your Certificate of Coverage. And the best part is that myCHAinfo is available when you need it, 24-hours a day, seven days a week.

Assist America™

Accessing emergency healthcare can be a challenge when traveling more than 100 miles from home. For CHA Health members, there's one less thing to worry about with Assist America™, a program to help assure access to appropriate healthcare in the United States or anywhere in the world during an emergency. Services include consultation and evaluation, medical referrals, medical monitoring, emergency message transmission, care of minor children due to the medical incident, dispatch of medication and more.

Member Satisfaction: Each year CHA Health conducts member surveys to see how well we are meeting our members' needs. In 2002, 69.1% of respondents rated CHA Health 8, 9 or 10 on a scale of 1 to 10, representing a steady increase over the past three years. This rating is also significantly higher than the national average.

Employer Satisfaction: Ninety-four percent (94%) of existing groups renewed their coverage with CHA Health for fiscal year to date 2002. Employer surveys show increasing satisfaction with CHA Health as benefit managers around Kentucky compliment our service and recommend us to their fellow employers.

Physician Satisfaction: In a survey of providers, CHA Health outperformed the managed care industry in 58 of 59 quality and satisfaction indicators, such as "clinically appropriate utilization guidelines, quality of network hospitals, and clinical quality of drug formulary." Also, 85.4% said they are very satisfied or satisfied with CHA Health according to a Physician Satisfaction Survey conducted in the fall of 2001 by DSS Research, an independent research firm.

Large Network: CHA Health offers many choices when it comes to providers. With over 2,600 primary care physicians, 8,500 specialists, and over 600 hospitals and ancillary healthcare providers in the CHA Health Provider Network, our provider network is growing each day.

Growing Membership: CHA Health currently has over 125,000 members in its HMO, PPO, Point-of-Service (POS), and self-funded product lines.

Quality: As a managed care organization focused on quality, CHA Health collects and reports HEDIS data, which contains information on clinical performance and member satisfaction in over 50 measures. The data is sent to the National Committee for Quality Assurance (NCQA) which allow us to benchmark against national averages on specific measures of care and service. This is but one component of CHA Health's Quality Program, which the public may request an appointment to review by calling CHA Health's Member Services Department.

Preventive Care: Preventing illness and injury is the mainstay of CHA Health's approach to health care. Our clinical guidelines encourage preventive services such as immunizations, prenatal and routine pediatric care, mammography, nutrition counseling and chronic disease management.

Outreach: CHA Health strives to take an active role in the communities we serve, supporting organizations like the American Cancer Society and local Chambers of Commerce. If you know of an upcoming event, let us know by calling Community Relations at 859-232-8507.

Prompt Claims Payment: Ninety-six percent (96%) of claims are processed within 30 days.

Provider Founded: CHA Health was founded by a group of some of central and eastern Kentucky's finest medical institutions and their medical staffs.