Texas PLaN GUIDe - Aetna

1 Aetna Avenue Your Destination for Small Business Solutions . Texas PLAN GUIDe . PLANS EFFECTIVE October 1, 2010. For businesses with 2-50 eligible employees A (10/10). T e x as plan G U I D E. Health care is a journey . A etna Avenue is t h e way I n t h is GUIDe : As a small business owner , providing value to your customers and growing your business are your top priorities. Yet, today 2 Small business commitment health care is a business issue for every entrepreneur. 3 Benefits for every stage of life 6 Medical overview Small businesses need insurance benefits plans that fit their 11 Medical plan options workplace.

2 Aetna Avenue provides employers with a choice of 22 Dental overview 24 Dental plan options insurance benefits solutions. We know that choice, ease and 30 Life and disability overview reputation are as valuable to employers as they are to employees. 32 Life plan options 33 Life and disability plan options Aetna offers a variety of plans for small business from 34 Underwriting guidelines medical plans, to dental, life and disability plans. 37 Product specifications 42 Limitations and exclusions 46 Group Enrollment Checklist The federal health care reform legislation known as the Patient Protection and Affordable Care Act was signed into law on March 23, 2010.

3 A number of new reforms are effective September 23, 2010, including coverage for dependents up to age 26, elimination of lifetime benefit dollar maximums, restriction of annual dollar maximums on essential health benefits, removal of cost sharing for preventive services and elimination of pre-existing condition exclusions for dependent children under 19 years of age. Your Aetna Avenue benefit program does comply with the new reform legislation. Health/dental benefits and health/dental insurance plans, life and disability insurance/. policies plans are offered, underwritten and/or administered by Aetna Health Inc.

4 , Aetna Health Insurance Company, Aetna Dental Inc. and/or Aetna Life Insurance Company ( Aetna ). Each insurer has sole financial responsibility for its own products. MEDICAL / PHARMACY. CHOICE E ase R eputation For business owners and employees Allowing you to focus on your business In business it's everything At Aetna , we provide employers a choice Employers want to focus on their customers Your reputation is important to your D E N TA L. of insurance benefits plans. Within these and growing their business not the business. At Aetna , our reputation is benefits programs, employers can choose insurance benefits program.

5 Aetna makes just as important. With 150 years of specific plan designs that fit business and sure that our plan designs are easy to set-up, experience, we value our name, products employee needs. Employees have access administer, use and provide support to and services and focus on delivering the to a wide network of doctors and other ensure your success. right solution for your small business . providers ensuring that they have a choice Administration making it work for our reputation depends upon it. in how they receive their health care. your business Our account executives, underwriters Medical plans supporting members on Aetna 's plan designs automatically and customer service representatives their health care journey process health claim reimbursements, are committed to providing your small provide a password-protected website to business the valuable service it deserves.

6 Traditional plans keep track of accounts and are supported Preferred plans by knowledgeable service representatives. HSA-Compatible plans Secure and online, Aetna EnrollSM makes LIFE / DISABILITY. managing health benefits easy and Dental, life and disability plans eliminates time-consuming, expensive providing valuable protection paper-based processes. DMO Aetna Navigator our online resource Participating Dental Network (PDN) for employers, members and providers PDN Max Look up rates for providers, facilities Freedom-of-Choice plan design and hospitals for common services Dual Option and treatment Voluntary Simple Steps To A Healthier Life , an online health and wellness program Term Life Insurance Track medical claims online Packaged Life and Disability Discount programs for eye, dental and other health care Personal Health Record providing a complete picture of health UNDERWRITING.

7 T emporary ID cards available for members to print as needed Aetna Health ConnectionsSM disease management Our newly redesigned capabilities offer support for over 30. conditions as well as integrated care for members with multiple conditions. 1. T e x as plan G U I D E. A etna Avenue ' s commitment to small business emplo y ers We know that small business owners' insurance benefits needs are often different than a larger employer. Aetna Avenue focuses on employers with 2-50 employees and our insurance benefits programs are designed to work for this size group. We'll work with you to determine the right plans for your business and assist you through implementation.

8 A etna' s mar k et map Guiding your small business health care journey Aetna 's market map is a resource for brokers and employers to help determine the right insurance benefits plan for their business. The market map asks specific questions related to the business and employee need in order to narrow the field of plan design choices. Basic benefits for These plans fit . your employees OAMC 2500. Limiting the expense to You might be a OAMC Preferred 5000. your business OAMC $10,000 Family Basic buyer Allowing employees to buy-up and share more of the cost Employee responsibility These plans fit.

9 OAMC Preferred 2000. Consumerism's ability Do to make a difference You might be a . CPOS 3000 80% Value OAMC HSA 5000 90%. Tools and resources to you support consumerism Value seeker Innovative plan design va l u e . Traditional benefits plans These plans fit . OAMC Preferred 2000. Limiting the financial impact You might be a . on employees OAMC Preferred 3000. Traditionalist OAMC HSA 3000 90%. 2. MEDICAL / PHARMACY. Healt h insurance benefits for every stage of life Young S ingles HSA-Compatible plans Preferred plans Young singles Established families Includes singles and couples Includes married couples and without children single parents with teens and Ready to conquer the world?

10 College-aged children D E N TA L. Thinking big thoughts? Well, one of As the children get older, the entire those thoughts should be about health family's needs change. Time management coverage. Since they're probably on a is important for active parents and budget, they might want an affordable children. Teenagers still need checkups policy with lower monthly payments and care for injuries and illness, while and modest out-of-pocket costs that parents need to start thinking about Young F amilies also provides for quality preventive care, their own needs, like plan designs that prescription drug coverage and financial cover preventive care and screenings and Traditional plans protection to help safeguard their assets.