Customer Service(205) 558-7474 or (800) 294-7780 or

vivamemberhelp@uabmc.edu

The custom/preferred drug list is subject to change. Additionally, some drugs may require prior authorization from VIVA Health.

For a complete listing of our custom/preferred drug list, visit www.vivahealth.com.

Coverage & Value

Coverage you deserve.Value you demand.

A Product of VIVA HealtH

A Member of the Health System

www.vivahealth.com1222 14th Avenue South • Birmingham, Alabama 35205

2012For Employees

GuidebookMember

VIVA UAB Guidebook 2012

Dear UAB Employee:

For the seventeenth consecutive year, we are pleased to have the opportunity

to serve UAB employees through the VIVA UAB product. As the largest

health plan for UAB employees, we pride ourselves on offering our customers

comprehensive benefits, outstanding value, and quality providers.

If you are a current VIVA UAB member, we hope you decide to continue with

our plan. If you will be enrolling with VIVA UAB for the first time, please

remember to choose a Primary Care Physician (PCP). You will find a full VIVA

UAB provider directory at www.vivahealth.com/VIVAPhysDirectory.html

(be sure to click on the VIVA UAB link).

As a member of VIVA UAB, you have access to the world-renowned UAB

Health System for primary care, OB/GYN and other health care services.

For OB/GYN services, you also have access to providers at Medical West.

You have access to our entire network of optometrists and ophthalmologists.

VIVA UAB members under the age of 18 have access to VIVA Health’s entire

pediatric network. Please keep in mind that VIVA UAB members are not

required to obtain a PCP referral to see participating OB/GYNs at UAB,

optometrists or ophthalmologists.

If you have any questions, we invite you to contact our customer

service department at (205) 558-7474, (800) 294-7780, or by e-mail at

vivamemberhelp@uabmc.edu. You will also find valuable information

on our website at www.vivahealth.com.

Thank you for considering VIVA UAB as your health plan in 2012. We look

forward to serving you.

Sincerely,

Brad Rollow CEO/President

Worldwide Emergency and Urgent Care CoverageIf you are outside the service area and have an urgent and unforeseen need for care that can’t wait until you return home, you are covered. This includes care in a physician’s office for an unexpected illness or injury that would not be classified as an emergency, but does require immediate attention. Of course this does not include routine or elective medical services, and you must return to the service area for any follow-up care. Still, if you’re on a weekend trip or an extended vacation, you can relax knowing that you are covered. Care in an Emergency Room is only covered for treatment of emergency medical conditions.

OB/GYN NetworkVIVA UAB members must see providers at UAB Hospital or Medical West for OB/GYN related services. OB/GYN services outside of the UAB Health System network will not be covered. No referrals are required for OB/GYN services. Please refer to the website www.vivahealth.com/VIVAPhysDirectory.html for a listing of OB/GYN providers for VIVA UAB members.

Dependent Student RiderServices to treat an illness or injury for Covered Dependents will be covered while they are full-time students at an accredited educational institution located out of the Service Area. These services are subject to the Copayments described herein and are available at a $1,500 maximum benefit per calendar year. Emergencies and in-area care are covered under the appropriate sections set forth in the Certificate of Coverage.

Sabbatical Leave RiderSabbatical Leave is a period of paid leave granted to faculty members by the Employer to pursue professional development, a program of investigation, creative writing, artistry and the like. Services to treat an illness or injury for Subscribers and Covered Dependents on Sabbatical Leave will be covered while they are out of the Service Area, and are subject to the Copayments described herein and are available at a $1,500 maximum benefit per calendar year.

Grandfathered Health PlanVIVA Health believes this health plan is a “grandfathered health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, such as the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act such as the elimination of lifetime limits on the dollar value of essential health benefits.

Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to VIVA Health Customer Service at (205) 558-7474 or 1-800-294-7780. You may also contact the U.S. Department of Health and Human Services at www.healthcare.gov.

Don’t Forget…• Adult members (age 18 and over) must select a UAB doctor as their Primary

Care Physician (PCP). When you need specialty care, your PCP will refer you to UAB Health System providers (no referral required for OB/GYN and vision care providers). When you need hospital care, you will be admitted to UAB.

• All children (under age 18) enrolled in VIVA UAB must select a pediatric doctor in the VIVA Health network as their PCP.

• Female members enrolled in VIVA UAB must choose an OB/GYN provider at UAB or Medical West.

VIVA UAB provides UAB employees with outstanding benefits at an exceptional value. For the seventeenth consecutive year, we are pleased to offer a plan designed with UAB Employees and their families in mind. As a VIVA UAB member, you have access to the world-renowned UAB Health System.

Excellent Customer ServiceWe encourage you to put us to the test: When you dial the VIVA Customer Service department during normal business hours (8am-5pm, Monday through Friday), you’ll get a real person with real answers. You can also have your questions answered at the click of the mouse! By visiting our website at www.vivahealth.com, you can access all of the following information:

• VIVA UAB Schedule of Copays

• Preferred Drug Listing

• Certificate of Coverage

• Updates/News

• Send an email to vivamemberhelp@uabmc.edu to request a new ID card, change your PCP, update your mailing address or inquire about a claim.

Effective Dates: January 1, 2012 – December 31, 2012The Plan’s services with its copayments and some of the limitations are listed below. Please remember that this is only a brief listing. For further information on covered benefits, exclusions and plan guidelines please see the Certificate of Coverage. (Available on-line at www.vivahealth.com.)

Primary Care Services• Routine Physicals • Other Office Visits • Immunizations

• Hearing Exams • Illness and Injury • X-Rays and Lab

$20 Copay per visit

Specialty Care (PCP referral required)

• Physician Office Visits

• X-Ray and Laboratory Procedures

• OB/GYN Office Visits - (No PCP referral required)

– One OB/GYN preventive visit per Calendar Year

$30 Copay per visit100% Coverage$30 Copay per visit

Vision Care (No PCP referral required)

• One Routine Vision Exam Every 12 Months

• Other Eye Care Office Visits

$30 Copay per visit

Allergy Services (No PCP referral required)

• Physician Services

• Testing

$30 Copay per visit100% Coverage

Hospital Inpatient Services• Physician Services

• Semi-private Room

100% Coverage$250 Copay per admission (Waived at UAB)

Outpatient Services• Surgery/Diagnostic Services 100% Coverage

Maternity ServicesPhysician Services (Prenatal, Delivery and Postnatal Care)

Maternity Hospitalization$30 Copay per delivery (waived at UAB)

$250 Copay per admission (Waived at UAB)

Emergency Room Services (Members can use participating

urgent care facilities in urgent but non-emergency situations.)

$70 Copay per visit (Waived if admitted within

24 hours)

Emergency Ambulance Services 100% Coverage (Must be medically necessary)

Durable Medical Equipment & Prosthetic Devices

80% Coverage (Maximum benefit of $15,000

per lifetime)

Home Health Care Services 100% Coverage (Limited to 60 visits per

Calendar Year)

Chiropractic Services (PCP referral required)

• Treatment for manual manipulation of subluxations only $30 Copay per visit

Skilled Nursing Facility Services (100 days per lifetime) 100% Coverage

Diabetic SuppliesInsulin covered under prescription drug rider. For diabetic supplies

call VIVA Health.

100% Coverage

Rehabilitation Services (Requires Prior Authorization)

• Physical, Speech, and Occupational Therapy $30 Copay per visit$250 Copay per inpatient admission (Waived

at UAB)

Temporomandibular Joint Disorder• $3,500 maximum benefit per lifetime $30 Copay per visit

Sleep Disorders• 2 sleep studies per Member per Lifetime $30 Copay per visit

100% Coverage

Transplant Services 100% Coverage $250 Hospital Copay (Waived at UAB)

Mental Health & Substance Abuse Services (Inpatient copay waived at UAB)

• Inpatient

• Outpatient

$250 Copay per admission $30 Copay per visit

Residential treatment and certain diagnoses are excluded. See your Certificate of Coverage for details.

Covered Prescription DrugsGeneric Drugs

• From a Participating Pharmacy

• Mail Order

• Participating Pharmacy

Preferred Brand Drugs • From a Participating Pharmacy

• Mail Order

• Participating Pharmacy

Non-Preferred Brand Drugs • From a Participating Pharmacy

• Mail Order

• Participating Pharmacy

$15 Copay per 31-day supply$30 Copay per 90-day supply$45 Copay per 90-day supply

$35 Copay per 31-day supply$88 Copay per 90-day supply$105 Copay per 90-day supply

$60 Copay per 31-day supply$150 Copay per 90-day supply$180 Copay per 90-day supply

•When generic is available, member pays difference between generic and brand name price, plus copay.

• Check with your participating pharmacy to learn if it offers a 90-day supply at retail.

Biological Drugs, Biotechnical Drugs, and Specialty PharmaceuticalsAdministered in the home, physician’s office or on an outpatient basis. There is member out-of-pocket maximum of $2,000 per Member per Calendar Year for biological drugs, biotechnical drugs, and specialty pharmaceuticals. These drugs must be obtained from CAREMARK and can be ordered by calling 1-800-237-2767. For a listing of these drugs, see our website at www.vivahealth.com.

80% Coverage

HOSPITALSUAB Medical CenterEye Foundation HospitalUAB Highlands Hospital

PRIMARY CARE PHYSICIANS

Family/General MedicineNidhi Bansal, M.D. G39163

Marshall Boone, Jr., M.D. C72006

T. Michael Harrington, M.D.* C72336

John Holcombe, M.D.+ D40154

Robert Kynerd, M.D. E20807

Donna A. Landen, M.D. Z10028

Jennifer Miller, M.D.+ G20298

Jonathan Mize, M.D.+ G35315

B. Earl Salser, Jr., M.D. H23505

Internal Medicine - TKC Residency Clinic***Stuart J. Cohen, M.D.**,+ G85855

Mark A. Stafford, M.D.**,+ C74144

Lisa L. Willett, M.D.**,+,* G95882

James E. Williams, M.D.**,+,* C74354

Internal Medicine - Kirklin Clinic / UAB Health CentersMary Balkovetz, M.D.+ E90756

Marina Brainin, M.D.1,+ G34508

Beverly L. Carraway-Handley C73141

Analia Castiglioni, M.D+ H76962

C. Louis Cummings, M.D.+ C73226

Anna Davis, M.D.+ G43036

James Davis, M.D.+ C73242

Charles Felgner, M.D.+ C73324

Ricky Fennell, M.D.+ G92472

Patricia Garver, M.D.+ C73369

Michael J. Geer, M.D.+ F95554

David Gettinger, M.D.* C73376

Alan L. Gruman, M.D.+ E44327

Laurie Hall, M.D.+ E20867

Jason Hartig, M.D. H18391

Fred J. Herndon, Jr., M.D.+ G77840

Larry S. Hunt, M.D.+ C73499

Ryan Kraemer, M.D. Z10624

Amy LeJeune, M.D.+ G83283

J. Mark LeJeune, M.D.+ B89603

Stan Massie, M.D.+ G45060

Rebecca W. Miller, M.D.+ H84752

Laura D. Pointer, M.D.+ G40016

Frederic G. Ransom, M.D.+ C73939

Katherine G. Romp, M.D.+ G72094

Stephen Russell, M.D.+ I05557

Monita Singh, M.D.+ I68955

Erin Snyder, M.D.+,* I53275

Stephen W. Stair, M.D.+ F62103

Zachary Stone, M.D.+ Z10658

Alisha R. Thornton, M.D.+ G40763

Jennifer Vigil, M.D.+ Z10633

Ellen Weber, M.D.+ C74310

Jennie Wheeler, M.D. Z08559

PediatricsAmy J. Albert, M.D. I09370Abby M. Allen, M.D. Z10540Eva V. Allen, M.D. H40975Paul Amamoo, M.D. C76542Thomas Amason, Jr., M.D. C76545Michelle Amaya, M.D. F61561Toren Anderson, M.D. G94261

Scott A. Anderson, M.D. Z12003Jennie Andresen, M.D. F84977Carolyn Ashworth, M.D. D41086Stephen D. Barron, M.D. F99218 Robert Bashinsky, M.D. C76555Elizabeth Benton, M.D. G52662Heidi H. Blair, M.D. G40011Stephen R. Blair, M.D. C76567Theresa J. Bolus, M.D. E80654Shameza Boyd, M.D. H88023Sheridyn Breedlove, M.D. G28054Nan Brinkerhoff, M.D. C76580Tracy L. Brookings, M.D. I43996Charlotte P. Bryant, M.D. H46952Clayton A. Buie, M.D. E87620John Buttler, M.D. C76585Anne W. Byars, M.D. E45645Irving Cohen, M.D.1 C76604Lisa B. Conry, M.D. E45262Christina Cordell, M.D. Z01225C. John Cortopassi, M.D. C76611Annette Cosgrove, M.D. F43015Stuart L. Cramer, M.D. Z01720Richard S. Dabbs, M.D. C76624Delinda Davis, M.D. C76628Justin R. Davis, M.D. Z16095Derrol Dawkins, M.D. C76631Julie M. Dennis, M.D. H58402Stephanie Denton, M.D. G16615Diane P. Dietlein-Cox, M.D. F38408Mary Doyle, M.D. H29381Brian P. Dudgeon, M.D. H13753

HEALTH CENTERSUAB Health Center - HooverUAB Neurology South - HooverUAB Health Center - Hueytown

UAB Health Center - InvernessUAB Health Center - MoodyUAB Family Medicine Center - SouthsideThe Kirklin Clinic

PrimaryCare

Physicians

For a complete list of providers, including specialists,

please visit www.vivahealth.com.

Kenneth L. Elmer, M.D. C76654Helen Evans, M.D. F78306Crayton A. Fargason E82823Patrick N. Farr, M.D. H12624Jeanne Favrot, M.D. F60741Liesel French, M.D. H02207David Fugazzotto, M.D. C76667Stacey S. Gilbert, M.D. G91933R. David Glasgow, M.D. C76676Edward Goldblatt, M.D. C76681Teresa J. Goldsmith, M.D. G02049Kimberly A. Gran, M.D. Z09114Shalini R. Grant, M.D. Z09115Hilary L. Haines, M.D. Z08574Judith Habeeb, M.D. F62111Max H. Hale, M.D. G58530Joseph Hamm, M.D. C76696William E. Hardwick, Jr., M.D. E68724Alice M. Hardy, M.D. I01025Phillip Harmon, M.D. C76698Janet Harris, M.D. F78826Patricia K. Harris, M.D. I04447Jason Hartig, M.D. H18391Elizabeth H. Hodges, M.D. C76706

Alisa H. Hoffman, M.D.* G64253Francisco Huidor, M.D. H84629Richard Huie, M.D. C76713Patrick A. Hyland, M.D. C76716Lillian L. Israel, M.D. C79105DeeAnne S. Jackson, M.D. E89479Marquisha D. Jarmon, M.D. Z01600Paula B. Johnson, M.D. H79990William Johnston, Jr., M.D C76722Joseph Jolly, M.D. G61312Lauree K. Jones, M.D. F75681Allison Jones-Holt, M.D. Z00198Snehal Khatri, M.D. Z08008Carin R. Kiser, M.D. I62813Matthew A. Kutny, M.D. Z17059

Elizabeth M. Law, M.D. H87228Robert Levin, M.D. C76748Edward L. Lose, M.D. F85748Mark Lytle, M.D. F82548Stephen Mallard, M.D. G42710Jeffrey A. Malone, M.D. E23354Tamara Mason, M.D. H79989Dianne Matheson, M.D. D08211Susanne Matthews, M.D. E87624JoAnn M. Mays, M.D. D82269Allison McAfee, M.D. Z09034Jennifer E. McCain, M.D. I06018Andrew N. McCown, M.D. A03706Millie M. McDaniel, M.D. C76772Darby H. McElderry, M.D. H24606Michael M. Miller, M.D. H35160Rebecca W. Miller, M.D.+ H84752Beatrice Moore, M.D. I19890Tanikqua D. Moore, M.D. Z10055Hernan Moreno, M.D. C79111Rosalyn Morgan, M.D. C76790Shannon M. Murphy, M.D. G58531Jamie Odrezin, M.D. C76797Myung-Hi Kim Oh, M.D. D08214Brandice M. Patterson, M.D. Z16091Diana M. Patterson, M.D. Z16094Myriam Peralta-Carcelen, M.D. E10209John N. Petelos, M.D. D53288Elizabeth G. Peters, M.D. H58182Irfan Rahim, M.D. H36960Angela H. Redmond, M.D. H63042Carin A. Richard, M.D. I62813Hubert Rodriquez, M.D. C79114Joseph H. Rogers Jr., M.D. C76836Grelet Russell, M.D. Z08469Stephen Russell, M.D.+ I05557Elizabeth Sahlie, M.D. G02242Fadell Savany, M.D. F93530Patti Schroder, M.D. F76326

Kami B. Sester, M.D. H29549Marwan Shalabi, M.D. H07363Adrianna M. Shirk, M.D. Z10539Rubina Siddiqui, M.D. G18258John Simpson, M.D. E14418Hoyt T. Smith, M.D. C76864Richard Smith, M.D. D32916Robert Smith, M.D. C79119Peily Soong, M.D. I06802Anne Stafford, M.D. C76873Janie S. Stagner, M.D. H58530Keith Stansell, M.D. H18388Jacqueline Stewart, M.D. C79120Jeffery D. Stone, M.D. H65520Linda J. Stone, M.D. C76880Richard Stone, M.D. G97445Zachary Stone, M.D.+ Z10658Kelli H. Tapley, M.D. Z01240Margaret Ann Thiele, M.D. C76887Natalie H. Tibbetts, M.D. Z08330Tracy H. Tindle, M.D. G46198Leslie L. Townsend, M.D. C76891F. Bryson Waldo, M.D. C76903Terry Wall, M.D. E91805Ryan Walley, M.D. H33628James H. Wamack Jr., M.D. E56779Dell D. Ware, M.D. C79123Rebecca Webster, M.D. F32700William V. Whitaker, M.D. C76915Ann-Katrin Wilson, M.D. C76927Melisa M. Wilson, M.D. H02559Garland G. Youngblood, M.D. Z01356

* Not accepting new patients+ Admits to hospital through a hospital

based physician** Also affiliated with TKC Residency

Clinic*** Members receiving care here will be

treated by a UAB resident physician1 No Patients under 15

Coverage & Value

Coverage you deserveValue you demand.