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YOUR PFA WITH RSI What You Do What BCBS Does What RSI Does + You or a dependent visits a provider + BCBS will process your claim + RSI will issue payment to your provider directly + Show your BCBS ID Card + Then they will notify/pay the provider for the BB&N plan’s share of the deductible and + You pay nothing at the time of the visit + They will send a Summary of Health Plan select copays + Your doctor or provider will bill BCBS Payments to you and your provider. The + RSI will notify you via RSI’s EOB of what BB&N + Track your claims in the RSI Claims Portal for Summary is not a bill and should be saved for has paid on your behalf BB&N Employees your records! + They will let you know what portion of the bill + BCBS sends a weekly report to RSI on your claim you are responsible for paying as outlined in your RSI EOB. YOUR ID CARDS Blue Cross Blue Shield Blue Cross Blue Shield RSI RSI MEDICAL DENTAL MEDICAL PAYER CARD DEBIT CARD This is your primary health insurance This is your dental insurance card. This is your medical supplemental This is your debit card to pay for all card. Please show this card to all Please show this card to your dental payer card. This card is for your approved BCBS Rx medications and all medical providers at the time of provider at the time of service. personal reference only and has no qualified FSA and DCA expenses. service, including pharmacists. commercial value. 2024 Benefits Guide | 7

BB&N 2024 -2025 Employee Benefits Guide - Page 8 BB&N 2024 -2025 Employee Benefits Guide Page 7 Page 9