July 1, 2008

Dear State of Texas GBP Participant:

Community First Health Plans is pleased to be the health maintenance organization offered through the Texas Employees Group Benefits Program (GBP) in your service area for Plan Year 2008-2009.

Community First is a locally owned and managed HMO based in San Antonio. What this means to you is that our corporate offices are right here, and the people who are responsible for the services you receive are your neighbors. The fact that we are a non-profit/tax-exempt organization means excess revenues are retained in your community and used to improve our level of service to you.

You will find detailed information about your benefits through the ERS web site at www.ers.state.tx.us under the "Benefits" heading on the left you can click on the Summary of Benefits or EOC. A complete description of how Community First delivers its medical care and an explanation of our complaints and appeals process can be found in the Certificate of Group Health Care Coverage on our web site, as well, along with an updated Preferred Drug List, which indicates Tiers 1, 2, and 3 medications.

Effective January 1, 2008, the following changes were made to the Community First Preferred Drug List, which will apply to GBP participants for Fiscal Year 2009:

• Novolin, Novolog, Humulin, Humalog products - All forms of each of these products are now on Tier 2.
• Risperdal - All forms of Risperdal are now on Tier 2.
• Yasmin - Is now on Tier 2.
• Revatio - Prior authorization restrictions were put on Revatio for PAH. Revatio remains on Tier 3 and Viagra remains on Tier 2 with quantity limit restrictions.
• Glaucoma agents - Alphagan P and Travatan Z are on Tier 2.
• Concerta -- added to Tier 2.
• Metadate CD and SR -- removed to Tier 3.
• Lamisil generic -- Prior Authorization requirement was removed.

Please note that the Community First Pharmacy and Therapeutics Committee will meet in early July and may have changes, which will be effective September 1. Updated Preferred Drug Lists will be available at the Summer Enrollment fairs and on the web site.

To select your Primary Care Physician (PCP) from the Community First network, go to the Community First site through the ERS web site and click on "Find a Physician" at the top of the page.

What is new at Community First:

• You now can take advantage of our web-based member portal, which allows you and your dependents to review your eligibility information, check the status of your claims, order ID card replacements, and communicate with our Member Services Department in a secure environment.
• With your new ID cards on September 1, 2008, you also will receive a discount prescription card that anyone in your family who pays retail for medications can use at participating pharmacies. The discounts range from 20% to 40%, depending on the medication. We have found this program to be a successful cost-saving benefit for our members.

Medicare Benefits will be coordinated as follows:

Medicare Part A - (Hospital Insurance)

• If you have been diagnosed with end-stage renal disease, benefits will be determined in accordance with Medicare guidelines for members with end-stage renal disease.
• When Medicare benefits are primary, claims must be filed with Medicare first. You are responsible for sending the Medicare explanation of benefits form to us for determination of Community First benefits.
• In general, if you are an active, working employee, Community First is the primary payer for you and your dependents.
• If you are a GBP retiree enrolled in Medicare Part A, Medicare is the primary payer, Community First will pay the Medicare Part A deductible, and you will be responsible for any copayments.
• If you are a GBP retiree not enrolled in Medicare Part A, Community First will be the primary payer.

Medicare Part B - (Supplemental Medical Insurance)

• If you were retired and became Medicare-eligible before September 1, 1992, and are enrolled in Medicare Part B, Community First will provide benefits secondary to Medicare. If you are not enrolled in Medicare Part B, Community First will pay primary benefits.
• If you were retired and became Medicare-eligible on or after September 1, 1992, regardless of your Medicare Part B status, Community First will provide benefits secondary to Medicare Part B.
• If you choose not to enroll in Medicare Part B, you may have greater out-of-pocket expenses after Community First pays secondary benefits than an individual who is enrolled in Medicare Part B.

IMPORTANT NOTICE - Medicare Part D - (Prescription Drug Coverage)

• Since the current pharmacy program provided by your health plan is as good as or better than the Medicare Part D program, ERS recommends you do not sign up for Medicare Part D for the 2008 or 2009 Plan Years.
• If you need further Medicare Part D clarification please contact Community First at (210) 358-6262, or toll-free at 1-877-698-7032.

If the provider does not accept Medicare assignment, Community First must pay the difference between the Medicare maximum allowable and the Medicare paid amount, less the appropriate copayment.

Community First requires providers to collect copayments.

We look forward to being of service once again to the State of Texas and higher education employees, retirees and dependents.