MEDICA COMMUNITY HEALTH PLAN

MEDICA COMMUNITY HEALTH PLAN (THE COMPANY) IS ORGANIZED AND SHALL BE OPERATED FOR THE PROMOTION OF SOCIAL WELFARE, INCLUDING THE OPERATION OF A HEALTH INSURANCE ORGANIZATION AND OTHER ACTIVITIES INCIDENTAL THERETO. IT IS A WHOLLY OWNED SUBSIDIARY OF MEDICA HOLDING COMPANY (MHC) WHICH IS A NON-PROFIT, TAX EXEMPT CORPORATION. THE COMPANY IS TAX-EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(4) OF THE INTERNAL REVENUE CODE. THE COMPANY OFFERS COMPREHENSIVE HEALTH CARE COVERAGE; ALL PRODUCTS ARE MEDICARE ADVANTAGE, OR QUALIFIED HEALTH PLANS (QHPS). QHPS ARE DEFINED BY THE AFFORDABLE CARE ACT (ACA) AND FALL WITHIN THE METAL LEVELS GOLD, SILVER AND BRONZE, AS WELL AS CATASTROPHIC FOR THOSE UNDER AGE 30 OR THOSE WITH A HARDSHIP (AS DEEMED BY THE EXCHANGE). ADDITIONALLY, THE PRODUCTS FOLLOW THE RESPECTIVE ESSENTIAL HEALTH BENEFITS (EHBS), ABOVE AND BEYOND THOSE REQUIRED OF QHPS BY THE ACA, AS DETERMINED BY THE BENCHMARK/DEFAULT PLAN (AS DEFINED BY ACA) FOR WISCONSIN AND ARIZONA. THE QHP PRODUCT, ESSENTIA CHOICE CARE WITH MEDICA, IS AVAILABLE IN WESTERN WISCONSIN, NORTHERN MINNESOTA, AND EASTERN NORTH DAKOTA. THE ESSENTIA CHOICE CARE PRODUCT FEATURES ACCESS TO ESSENTIA HEALTH DOCTORS PLUS OTHERS WITH OVER 3,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, ENGAGE BY MEDICA, IS AVAILABLE IN WESTERN WISCONSIN AND SOUTHEASTERN MINNESOTA. THE ENGAGE BY MEDICA PRODUCT FEATURES ACCESS TO MAYO CLINIC HEALTH SYSTEM DOCTORS PLUS OTHERS IN NORTHERN IOWA, SOUTHERN MINNESOTA, AND WESTERN WISCONSIN, WITH OVER 12,000 PRIMARY AND SPECIALTY CARE PROVIDERS. THE QHP PRODUCT, MEDICA PINNACLE, IS AVAILABLE IN MARICOPA COUNTY, ARIZONA. THE MEDICA PINNACLE PRODUCT FEATURES ACCESS TO ARIZONA CARE NETWORK, DIGNITY HEALTH, AND PHOENIX CHILDREN'S, WITH OVER 4,400 PRIMARY AND SPECIALTY CARE PROVIDERS. THE COMPANY OFFERS MEDICARE ADVANTAGE PRODUCTS IN PORTIONS OF NEBRASKA AND IOWA, OFFERING THE MEDICA ADVANTAGE SOLUTION PRODUCT IN THE ELEVEN COUNTY OMAHA/LINCOLN/COUNCIL BLUFFS AREA. THE MEDICA ADVANTAGE SOLUTION PRODUCT OFFERS AN HMO OPTION WITH CHI HEALTH AND A BROADER NETWORK PPO OPTION. THE ADVANTAGE SOLUTION NETWORK HAS 1,600+ PRIMARY CARE AND SPECIALTY CARE DOCTORS. THE COMPANY CONTRACTS WITH PROVIDERS IN WISCONSIN, MINNESOTA, SOUTH DAKOTA, NORTH DAKOTA, NEBRASKA AND IOWA TO MAKE HEALTH CARE SERVICES AVAILABLE TO ITS ENROLLEES. THE PROVIDER CONTRACTS INCLUDE HOLD-HARMLESS PROVISIONS FOR THE PROTECTION OF POLICYHOLDERS. THE CONTRACTS HAVE A ONE- OR TWO-YEAR TERM AND MAY BE TERMINATED IMMEDIATELY FOR BREACH OF CONTRACT IF THE PROVIDER LOSES HIS/HER LICENSE TO PROVIDE CONTRACTED SERVICES. HOSPITALS ARE REIMBURSED USING A VARIETY OF METHODS INCLUDING FEE-FOR-SERVICE (FFS), DISCOUNTED FFS, PER DIEM, PER CASE AND/OR PER STAY BASIS. THE COMPANY CURRENTLY MARKETS DIRECTLY TO INDIVIDUALS, USING INDEPENDENT AGENCIES, PAYING A FLAT DOLLAR COMMISSION ON NEW AND RENEWAL BUSINESS. THE COMPANY ALSO MARKETS POLICIES DIRECTLY ONLINE AND OVER THE PHONE. DURING 2020, THE COMPANY STARTED OFFERING MEDICARE ADVANTAGE PRODUCTS IN NEBRASKA. DURING 2023, MEDICARE ADVANTAGE ENROLLMENT WAS 782 MEMBERS, OR 5.4% OF MCHP'S TOTAL ENROLLMENT. MEDICARE ADVANTAGE IS A HEALTH PLAN THAT PROVIDES ALL ENROLLEES PART A AND B BENEFITS.