colorado enrollment guide - aetna · 2014-11-19 · with aetna, you can choose the path that gets...

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14.02.164.1-CO B (11/14)

Colorado Enrollment Guide

Health and life insurance plans/policies are offered and/or underwritten by Aetna Life Insurance Company (Aetna).

At Aetna, we are committed to putting you at the center of everything we do. You can count on us to provide member tools and value-added programs that enhance your member experience.

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Welcome to Aetna!

Whatever your healthy is, we can help you get there. Everyone’s healthy is different. For your family, how you define your healthy may include what’s healthy for your budget too. We understand that, and that’s why we provide multiple plans that can help you reach your healthy while keeping your financial health on track too.

With Aetna, you can choose the path that gets you closer to your healthy. Whether your goal is lower monthly premiums, lower out-of-pocket costs at doctor’s visits or easy access to out-of-network care, we have plans that will work hard for you.

We know that part of everyone’s healthy is knowing that you’re making smart choices when it comes to your health care. So we give you the power to do that at every step along the way. Find a doctor online, check the status of a claim and compare out-of-pocket costs before you go. Our tools and resources help make sure your family’s well-being is always well-coordinated. And you’ll have the right tools to manage your health care for a healthier you. Let’s work together to find your healthy.

Table of Contents Aetna Navigator® secure member website 4Health care transparency tools 5Employee Assistance Program (EAP) 5Personal Health Record 6Informed Health® Line 7Urgent care 7Special programs for the special needs of women 7At home products discounts 8Book discounts 8Fitness discounts 8Hearing discounts 9Natural products and services discounts 9Oral health care discounts 9Vision discounts 10Weight management discounts 10Preventive care 11Medical products 12Getting to know your Aetna prescription drug plan 17Life insurance 24Finding a doctor or specialist 25How to complete the enrollment form application 26

4*If Included in your plan.

Aetna Navigator® Your secure member website

When you need up-to-date information about your health insurance plan or want information about a particular health condition, here’s where you’ll find it!

You can turn to your secure Aetna Navigator member website, a single source for online health and benefits information. It’s convenient, and easy to use:

1. Go to www.aetna.com.

2. Click on Log In/Register.

3. Register as a new user, or log in using your secure user name and password.

4. Find a wealth of credible health care information and self-service functions — available to you anytime of the day or night — from wherever you have Internet access.

Our secure website lets you:

• View information about who is covered on your plan

• Find doctors, pharmacies or hospitals using our DocFind® search tool

• Check the status of a claim or review an Explanation of Benefits (EOB)

• Contact Member Services with benefits questions (also available in Spanish)

Use Aetna Navigator’s online tools to manage your benefits and help you make more informed health decisions:

• Hospital Comparison tool – helps you decide where to receive care for specific procedures, conditions and diagnoses. You can compare hospitals based on four factors you consider important:

1. Number of patients treated per year

2. Complication rates

3. Mortality rates

4. Length of stay

• Price-A-DrugSM tool* – helps you estimate the cost of prescriptions before you buy

• Estimate the Cost of Care tool – provides average in- and out-of-network costs for certain procedures based on a geographic area

• Pharmacy benefits summary – allows you to locate retail pharmacies; order prescriptions through the Aetna Rx Home Delivery® mail-order service; search and learn about medications; and review the medications available in the Aetna Preferred Drug List (formulary)

And, if you’re interested in learning more about a particular health condition, Aetna Navigator provides credible health information resources.

• Simple Steps To A Healthier Life® is an interactive online health and wellness program that can help you turn knowledge about your health into action for making positive health changes with:

- Online health assessment

- Tailored health reports

- Personalized Action Plan and online wellness programs

- Easy-to-find health information, resources and tools

• Aetna SmartSourceSM delivers relevant health information that’s specific to you, based on where you live, your Aetna health plan, and other information.

Aetna SmartSource scans our vast resources to bring you, in a single search:

- Specialists in your local area

- Related medications, treatment options and estimated health costs

- Aetna programs that may help you manage your condition

- Easy-to-understand health articles and tips

• Aetna InteliHealth® website, our interactive consumer website for credible health, dental and wellness information provided by Harvard Medical School

• Healthwise® Knowledgebase, a user-friendly online information tool that lets you research your own issues and preferences for health information, featuring interactive and streaming videos about topics such as asthma and heart health

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* Always consult your doctor about your health care decisions. Members cannot view rates for dentists, vision providers or certain types of health care professionals with these tools.

** Clinical quality and efficiency information is based on Aexcel® designation for specialists in 12 specialty categories. You can learn more about our Aexcel designation in our Understanding Aexcel brochure available under the Learn More section of DocFind. We regularly upgrade our tools to provide the latest cost and clinical quality and efficiency information about our network providers.

***EAP is administered by Aetna Behavioral Health, LLC and Aetna Life Insurance Company.

Health care transparency tools

You can make more informed health care decisions by using our online transparency tools before visiting a doctor or hospital.*

Our transparency tools allow you to:

• View and compare rates for participating doctors

• Look up costs for medical procedures at facilities in select locations around the country and quickly identify medical specialists who are high performers in their field based on clinical quality and efficiency**

• Use at your convenience since the information is available 24/7 through Aetna Navigator and DocFind

To access our health care transparency tools, log in to Aetna Navigator. Click on Cost of Care from the home page. There, you can use the easy online instructions to:

• Check rates for doctors and specialists for common treatments and procedures.

• Compare hospital costs side by side.

• Get personalized cost estimates to find out what you’ll pay before you go.

Employee Assistance Program (EAP)***

Our Employee Assistance Program is a confidential program that gives you access to useful services and support to help manage the everyday challenges of work and home. The EAP is available at no charge to you and your family members and includes:

Choice – Find a range of resources to help balance your personal and professional lives.

Easy access – Reach EAP representatives anytime toll free at 1-866-672-5417 or on the web at www.aetnaeap.com.

Professional assistance – Our workplace-trained specialists provide confidential phone support, assessing needs and recommending an appropriate course of action. You get three phone consultations (per member) in a calendar year.

6* The Aetna Personal Health Record should not be used as the sole source of information about the member’s health history.

Personal Health RecordPut your Personal Health Record to work and make history!

Members with Aetna medical coverage can now use our Personal Health Record.*

Your Personal Health Record is a secure online tool that makes it easy to:

• Keep your health information in a single, safe place.

• Track doctor visits, prescriptions and more, for you and your family.

• Give your doctor a more complete health history.

• Receive timely, personalized health alerts and preventive care reminders.

Much of your health information is ready for you to see now

Information from your Aetna health claims automatically appear in your Personal Health Record. And, you can easily add more information. List your allergies, your family history and more. It’s up to you. The more you enter, the better picture you and your doctors will get of your overall health.

Use it to talk to your doctors with ease

The Personal Health Record can help you team up with your doctors. You can share your Personal Health Record online with individual doctors by making it available through a secure website many doctors already use. You also can print your Health Summary to share at office visits or to help you fill out medical forms when you see a new doctor.

Stay safe and healthy with alerts and reminders

Your Personal Health Record helps you get the care you need. If you’re due for a checkup or other important screening, you might see a reminder when you log in. You may also receive a message if there’s an alternative treatment that may improve your care. And, if you give us permission, you can get e-mails telling you that a new alert or reminder is in your secure Personal Health Record.

Portability ensures your personal health records go where you go

Our relationship with Microsoft makes your personal health information portable. You can safely transfer a copy of your Aetna Personal Health Record from Aetna Navigator directly to Microsoft HealthVault at www.healthvault.com/personal. Your information will be stored on this secure, web-based consumer health platform and remains available if you change jobs or health plans.

You can also print and save a PDF copy of your health record for your own files through the same Aetna Navigator location.

Print your personalized emergency card

You can print an Emergency Information Card that pulls information from several sections of your Personal Health Record. It provides first responders with your emergency contact’s name and phone number, your insurance details, any medications you are taking, allergies if you have any, and information about whether you have a living will or have designated your organs for donation. All this detail in a printout that folds and fits in your wallet.

Be sure the information in these sections is accurate and up to date, and start using your Aetna Personal Health Record as soon as your Aetna health plan is active.

It’s easy to get started.

Visit your Personal Health Record today or use our Walk Me Through guide to explore how this resource works on your own.

Visit www.aetna.com/showcase/phr/ for answers to the most common questions from our members.

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Informed Health® Line

Access to a registered nurse — 24/7! With our Informed Health Line, you can talk to a registered nurse anytime, day or night. Just call our 24-hour toll-free number (available upon enrollment). While only your doctor can diagnose, prescribe or give medical advice, the Informed Health Line nurses can provide information on thousands of health topics. They can also tell you how to ask the right questions and describe health symptoms more effectively during your next visit to your doctor. Remember, always contact your doctor first with any questions or concerns regarding your health care needs.

Urgent care

For care that is not minor, such as fractures, sprains or other urgent injuries, we contract with urgent care centers to offer you an economical alternative to visiting an emergency room. Urgent care sites are staffed with physicians to handle urgent medical needs. Typically, urgent care centers offer evening and weekend hours with no appointments needed.

Check your plan design and benefits summary to get more information about coverage and costs to visit an urgent care center. To find the closest care center near you, simply log in to Aetna Navigator, select DocFind and follow the easy online instructions.

Special programs for the special needs of women

Ongoing health managementWork, family, friends. Too much to do, too little time to do it. That’s today’s woman. Add health needs that change over time, and you’ll know why we offer services and information to help you manage your health.

Prevention programs for womenOur preventive programs can help women benefit from:

• Preventive screening reminders for breast and cervical cancer

• Culturally focused initiatives to help reduce health disparities among women of diverse ethnic backgrounds

Women’s health onlineGo to http://womenshealth.aetna.com for information on women’s health issues — from heart health, breast cancer and pregnancy to baby care and other topics important to women, as well as:

• An interactive body mass index tool

• A pregnancy guide

• USDA Food Plate recommendations

• Information on diet and nutrition

For OB/GYN care, no referrals neededFor an annual well-woman exam, unlimited visits for gynecologic problems and routine maternity care, women may schedule an appointment with participating obstetrical, gynecological or women’s health care professionals without a referral.

Beginning Right® maternity programThe Beginning Right maternity program offers information and services to expectant mothers, including care coordination by obstetrical nurses experienced in preterm labor education, breastfeeding support and more. We want to make sure expectant mothers have the information needed to make informed decisions about health care while pregnant or planning a pregnancy. Members enrolled in both our medical and dental plans, along with our Beginning Right maternity program, may also receive enhanced dental benefits (additional cleaning or treatment of periodontal (gum) disease, fully covered with no deductible) during pregnancy.

Special maternity careFrom the start of pregnancy to birth, our maternity management program offers expectant mothers services and educational materials to help give their newborns a healthy start.

Moms-to-be receive:

• Educational materials, available in English or Spanish, that cover:

- Prenatal care

- Labor and delivery

- Newborn and baby care

- Breastfeeding

- Postpartum depression

• A pregnancy risk survey and nurse care coordination for high-risk pregnancies

• A program to help you stop smoking

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1Includes two or more books combined as a special discount package.2 Participation is for new gym members only. If you belong to a gym now, or belonged recently, call GlobalFit to see if a discount applies.

Member discounts

At home products

You can get discounts on products for your home and family that best fit your needs and your life, such as Omron Healthcare, Inc. blood pressure monitors.

Books

You can save on books, DVDs, and more.

• American Cancer Society Bookstore: Save on your purchase of books, greeting cards and kits.1 Order online or by phone.

• Mayo Clinic Bookstore: Save on books and DVDs purchased online.

• Pranamaya: Save on yoga DVDs, CDs, online videos and books.

Fitness

Regular exercise can help you maintain a healthy weight and look and feel better. It can also lower your risks for:

• Alzheimer’s disease

• Depression and anxiety

• Diabetes

• Heart disease

• High blood pressure

You can save on gym memberships2 and name-brand home fitness and nutrition products that support a healthy lifestyle with services provided by GlobalFit®.

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1 The ChooseHealthy program is made available through American Specialty Health Administrators, Inc., a subsidiary of American Specialty Health Incorporated (ASH). ChooseHealthy is a federally registered trademark of ASH and used with permission herein.2 Guideline on Xylitol Use in Caries Prevention. American Academy of Pediatric Dentistry, Council on Clinical Affairs. Vol. 35, No. 6. 2011. Available at: www.aapd.org/media/policies_guidelines/g_xylitoluse.pdf. Accessed March 18, 2014.

Hearing

You can take care of your hearing and save money with Hearing Care Solutions and HearPO®.

Hearing Care Solutions • A discounted rate on hearing exams

• Hundreds of hearing aid models at low prices

• A two-year supply of batteries (up to 96 cells), then join a discount battery mail-order program

• Free in-office service of hearing aids for one year after purchase

• Free routine services (cleanings, checks and battery door replacements) for the life of the hearing aid

HearPO• A discounted rate on hearing exams

• Savings on many hearing aid styles

• A cost break on the newest hearing-aid technologies, including programmable and digital instruments from leading manufacturers

• Discounts on hearing aid repairs

• Free follow-up services for one year

• Free batteries (up to 160 cells per hearing aid)

Natural products and services

You and your family can save on specialty health care products and services, including online consultations:

• The ChooseHealthy®1 program: You’ll get a discount off the normal fee for acupuncture, chiropractic, massage therapy and nutrition services. And get a discount off the retail price of health and wellness products.

• Vital Health Network: You can get a discount off the retail price of an online consultation with a Vital Health Network doctor for one topic. Then, save more off the retail price of an online consultation for additional topics.

Oral health care

Taking care of your teeth is important. Who doesn’t enjoy a healthy smile and fresh breath?

You can take care of your teeth and save money on oral health care products from Epic Dental and Waterpik®.

Epic DentalYou can save on Epic Dental products that contain xylitol, a natural sweetener that does not cause cavities. In fact, xylitol has been shown to prevent tooth decay.2 Save on gum, mints, toothpaste and more.

WaterpikYou can save on Waterpik oral health care products that help keep your mouth as healthy as it can be.

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1�You can cancel your program membership at any time during the first seven days. Log in to the program and follow the instructions in “Payment and Account Details” under “Account Settings.” If you do not cancel during the first seven days, your credit card will be charged on the 8th day. 2 If you are already a CalorieKing member and want to get the Aetna discounted membership price, you will need to terminate your current CalorieKing Account and rejoin.3�Plus the cost of food. Plus the cost of shipping (if applicable). Offers applies to initial enrollment fee only and is valid only at participating Centers and through Jenny Craig At Home. Each offer is a separate offer and can be used only once per member. No cash value. Restrictions apply.4 The Aetna discount offers do not apply to any plan in which you are already enrolled. To receive the discounted rate, you must wait until your current plan ends.

Vision

You can take care of your vision and save with EyeMed. Get discounts on:

• Eye exams

• Eyeglass frames and lenses

• Contact lenses and solutions

• LASIK surgery

• Sunglasses (prescription and non-prescription)

• And more!

Use any eye care provider in the EyeMed nationwide network, at the following retail chains:

• Lenscrafters®

• Pearle Vision®

• Target Optical®

• Sears Optical® locations

• JCPenney Optical

You also can use any of the thousands of participating eye doctors in private practices.

You can get these discounts even if you have other vision benefit coverage. If you do have coverage, check your plan requirements first.

Weight management

You can meet your weight loss goals, get healthier and save money on CalorieKing®, Jenny Craig® and Nutrisystem®.

• CalorieKing

- Join an annual or monthly CalorieKing program. Programs have a seven-day free trial period.1

- Then save when you continue your annual program membership.2

- With either an annual or monthly program membership, you can also save on products in the CalorieKing online store.

• Jenny Craig

Choose from these offers:

- FREE 30-Day Program3

- Percent of the Jenny All Access program enrollment fee3

• Nutrisystem

- Save on any 28-Day Nutrisystem® SuccessTM weight loss meal plan.4

- Plus, get other offers from Nutrisystem when you purchase a plan.

With all programs and plans, enjoy one-on-one help, personalized menus, online tools, chat rooms and more.

Visit your secure Aetna Navigator® member website at www.aetna.com for more details about all available discounts.

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Prevention programs — helping you and your family stay healthy

Preventive care

Good health begins with prevention. So we’ve developed an array of wellness programs and services to help you and your family stay healthy through all the stages of your life.

Member health education reminders

To help prevent, detect and monitor problems early on, we mail reminders encouraging you to schedule important annual health screenings. We also send important health information, a chart of recommended preventive care guidelines and a tear-off wallet card to schedule and track this important information.

Aetna Health ConnectionsSM disease management

If you’re one of millions living with a chronic condition, the Aetna Health Connections disease management program can help. The program provides information, support and guidance for 35 health conditions, including those listed below. Our nurses use cutting-edge technology to bring you the latest clinical information for your condition.

You can learn how to:

• Manage your condition and prevent complications

• Lower your risks for other conditions

• Follow your doctors’ treatment plans

• Take your medications and alert your doctors to side effects

• Find helpful resources online and in your community

As a program participant, you will benefit from:

• A registered nurse who is specially trained to work with you to develop a personalized action plan so you can enjoy better health

• Information, education and support to help you understand and manage your condition(s)

• Referrals to clinical professionals, such as diabetes counselors and nutritionists, for specialized services and support

• Alerts and reminders when our CareEngine® technology detects a potential gap in your care

Aetna Health ConnectionsSM nurses support these conditions:

Vascular• Heart failure

• Diabetes – adult & pediatric

• Coronary artery disease (CAD)

• Peripheral artery disease (PAD)

• High blood pressure – adult & pediatric

• Cerebrovascular disease/stroke (CVA)

• High cholesterol

Pulmonary• Asthma – adult & pediatric

• Chronic obstructive pulmonary disease (COPD)

Orthopedic/Rheumatologic• Osteoporosis

• Osteoarthritis (OA)*

• Rheumatoid arthritis (RA)

• Chronic lower back pain

Gastrointestinal• Gastro esophageal reflux

disease (GERD)

• Peptic ulcer disease

• Inflammatory bowel disease (IBD) (Crohn’s Disease)

• Chronic hepatitis

Neuro-Geriatric• Geriatrics

• Migraines

• Seizures

• Parkinsonism

Cancer• General cancer

• Breast cancer

• Lung cancer

• Lymphoma/Leukemia

• Prostate cancer

• Colorectal cancer

Renal• Chronic kidney disease

• End stage renal failure

Other• Weight management –

adult & pediatric

• Cystic fibrosis – adult & pediatric

• HIV

• Hypercoagulable state

• Sickle cell disease – adult & pediatric

• Depression**

* Not scored by the Clinical Stratification and (CSID) process.**Addressed as a comorbid condition.

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Medical products

Plans your employer may offer:

Product name Product descriptionPCP required

Referrals required

Aetna Whole HealthSM – CO Front Range

With Aetna Whole Health plans you get the same types of coverage as other Aetna medical plans, but with a lower premium cost and a greater level of care coordination. You’ll save money when you use of the Aetna Whole Health network, a specially selected network of high-performing, high-quality local health care providers that are dedicated to delivering a coordinated patient experience. We strongly encourage you to designate a primary care physician who will help guide important health decisions and direct your care across other specialties and facilities in the network. See pages 14 – 16 for more detail.

Encouraged, not required

No

Health Network Only (HNOnly)

HNOnly is a health maintenance organization (HMO) that uses a network of participating providers. Each family member may select a primary care physician (PCP) participating in the Aetna network. Your PCP can provide routine and preventive care and help coordinate your total health care. You never need a referral when visiting a participating specialist for covered services. Only services rendered by a participating provider are covered, except for emergency or urgently needed care.

No No

Aetna Open Access® Managed Choice® (OAMC)

You can access any participating provider for covered services without a referral. You can choose network providers at lower out-of-pocket costs or non-network providers at higher out-of-pocket costs at any time. Emergency services are covered at the in-network coinsurance/copay level.

No No

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Health care terms to know

Premiums

The amount you pay for your insurance policy, often deducted from your paycheck.

Deductibles

The amount you pay out of pocket each year before your medical plan covers expenses. Each family member usually has a separate deductible to meet before the medical plan starts coverage.

Copayments (copay)

Flat fees charged each time you visit the doctor or use certain medical services, regardless of the cost of the procedure. Doctor’s visits and pharmaceutical purchases are often subject to copays.

Coinsurance

Your percent share of the costs for medical services. Most plans require either a coinsurance or copay — usually not both.

Coinsurance maximum or maximum out-of-pocket expense

The maximum amount you’ll have to spend before all of your medical bills are covered by the medical plan. Sometimes, certain services, such as pharmacy, may not count toward the coinsurance maximum. Copayments may still apply.

Choose the right health plan for you and your family in three easy steps:

1. How much are you spending?

Evaluate your pay stubs, receipts and canceled checks for all your medical spending and add the total amount to the total cost of your premium, copayments, deductibles and coinsurance. Think about your needs for next year. Here are some common scenarios:

• Are you or your dependents scheduled for any surgical procedures?

• Will you be seeing a specialist for a recently diagnosed condition?

• Are you or your spouse pregnant or planning a pregnancy?

2. What are your choices?

• Check with your company to see which plans are available.

• Compare the premium, deductibles, copayments and out-of-pocket maximums on each plan.

• Review the limitations on each plan: Chiropractic care, acupuncture and physical therapy are some common benefits with limited visits.

3. Choose the right plan.

• Now that you know your health care spending for the past year and the plan choices offered by your employer, determine your needs for the coming year.

• Add up what you will pay for premiums, copayments and deductibles under your new plan based on last year’s expenses or what you think might happen this year.

• Review the coinsurance maximum amount and decide if it’s affordable if a major medical condition develops.

• Remember: The most expensive plan is not necessarily the best one for you and your family.

• Complete the process by submitting the necessary paperwork and updating your doctors of any changes.

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M

* Employers and employee must reside in an eligible area. Live/work rules apply. Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas, Jefferson, Larimer and Weld counties.

**Actual results may vary since they depend on a variety of factors including Aetna Whole Health plan model.

Aetna Whole HealthSM plans in the Colorado Front Range*We’re proud to offer new Aetna Whole Health plans in the Colorado Front Range!

Our Aetna Whole Health plans feature high-performing Colorado health care organizations that have teamed up with Aetna to help improve your care while decreasing your costs.

The Aetna Whole Health – Colorado Front Range network features doctors and facilities from:

• Banner Network Colorado

• Colorado Health Neighborhoods

• New West Physicians

• Physician Health Partners

Key ingredients make the difference. We’ve designed Aetna Whole Health to:

• Reward doctors for improving patient care quality

• Lower medical cost growth over time by reducing waste, improving care coordination and closing care gaps

• Enhance each patient’s experience with innovative care management programs

• Support effective patient and primary care doctor relationships

Accountable care up close — better health, better care, better cost

That’s what you get with an Aetna Whole Health plan.

Our locally based accountable care model centers on the relationship between the primary care doctor and the patient. Through that, we strive to reach you where, when and how you live. And improve the quality, efficiency and affordability of your health care.

We strongly encourage you to designate a primary care doctor to lead your ACO care team and unlock the full benefits of this coordinated-care model.

Why it matters: Every team needs a leader. And the primary care doctor you pick will lead your Aetna Whole Health care team. Your doctor gets to know you and your medical history and sees you for your annual wellness exam and preventive screenings. If you get sick, your primary care doctor can treat you and help guide you on important health decisions. Your doctor will also direct your care across other specialties and facilities in the Aetna Whole Health – Colorado Front Range network.

• The ACO care team’s goal is to help keep you healthy or help improve your health, not just treat you when you’re sick or injured.

• The ACO care team can better coordinate care, because we share data that allows them to see how other doctors are treating you, what medicine you’re taking, lab results, health history and more.

• The ACO care team is up-to-date on medical guidelines and clinical information. This helps to spot problems early and develop personalized care plans just for you.

• The ACO team wants you to take an active and informed role in your health and health care decisions.

Finding an Aetna Whole Health – Colorado Front Range doctor or facility is easy. Follow these simple steps:

• Visit www.aetna.com/docfind for the most up-to-date information on doctors and facilities

• Type a name, specialty, procedure or condition in the “Who or what are you looking for?” box.

• Enter your ZIP code or city and state in the “Where” box.

• Select (CO) Aetna Whole Health – Colorado Front Range from the “Select a Plan” drop-down menu.

Tip: To save the most money and get the most coordinated care, use Aetna Whole Health doctors and hospitals.

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Aetna Whole HealthSM – Colorado Front Range network coverage area*

Finding an Aetna Whole Health – Colorado Front Range network doctor is easy. Follow these simple steps:

• Visit www.aetna.com/docfind for the most up-to-date information on doctors and facilities.

• Type a name, specialty, procedure or condition in the “Who or what are you looking for?” box.

• Enter your ZIP code or city and state in the “Where?” box.

• Choose (CO) Aetna Whole Health – Colorado Front Range from the “Select a Plan” drop down menu.

25

70

76

36

85

285

3436

287

WeldCounty

AdamsCounty

ArapahoeCounty

DouglasCounty

JeffersonCounty

BoulderCounty

DenverCounty

LarimerCounty

BroomfieldCounty

Loveland

Longmont

Boulder

Louisville

Brighton

Thornton

Aurora

Denver

Westminster

Wheat Ridge

Lakewood

Littleton

Lone Tree

Parker

Castle Rock

Highlands Ranch

Lafayette

Greeley

Fort Collins

Englewood

Primary care physicians

Urgent care facilities

Hospitals

For illustrative purposes only.

* Network information and counts effective as of 9/12/2014, and subject to change.

800+ primary care doctors

4,000+ specialists 31 hospitals 50+ urgent care facilities

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Aetna Whole Health – Colorado Front Range network hospitals

Adams County

Children’s Hospital Colorado

North Suburban Medical Center

Platte Valley Medical Center

St. Anthony North Hospital

University of Colorado Hospital

Arapahoe County

Littleton Adventist Hospital

The Medical Center of Aurora – North Campus

The Medical Center of Aurora – South Campus

Swedish Medical Center

Boulder County

Avista Adventist Hospital

Boulder Community Foothills Hospital

Boulder Community Hospital

Good Samaritan Medical Center

Longmont United Hospital

Denver County

Children’s Hospital Colorado at Saint Joseph Hospital

Denver Health Medical Center

National Jewish Health

Porter Adventist Hospital

Presbyterian/St. Luke’s Medical Center

Rose Medical Center

Saint Joseph Hospital

Douglas County

Castle Rock Adventist Hospital

Children’s Hospital Colorado at Parker Adventist Hospital

Children’s Hospital Colorado South Campus

Parker Adventist Hospital

Sky Ridge Medical Center

Jefferson County

Lutheran Medical Center

OrthoColorado Hospital at St. Anthony Medical Center

St. Anthony Hospital

Weld County

Banner Health’s North Colorado Medical Center

Larimer County

Banner Health’s McKee Medical Center

Always consult DocFind® for the most up-to-date information on doctors and facilities in the Aetna Whole Health – Colorado Front Range network.

*Network information and counts effective as of 9/12/2014, and subject to change without notice.

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Claritin® is a registered trademark of Schering-Plough HealthCare Products Inc.Prilosec® is a registered trademark of AstraZeneca LLP.

Getting to know your Aetna prescription drug plan

Know what drugs are covered

You and your doctor can choose from hundreds of quality, cost-effective drugs. Your plan covers brand-name and generic drugs on the Aetna Preferred Drug List. (You may also see this called a “formulary.”) It was developed based on advice from many different health care specialists. And all drugs on it are approved by the U.S. Food and Drug Administration (FDA).

Your plan also covers many drugs that are not on this list. Remember though, you’ll often pay less for drugs on our list.

To see this list or learn about medication alternatives, go to www.aetna.com/formulary.

Understand precertification and how it helps you

Some drugs need precertification before your plan will cover them. This simply means we need to approve them first for you. Doing this helps make sure the drug is being used at the right dose, for the right reasons. This helps keep you safe. It can also help you find another drug that costs less and is just as effective — something you could talk about with your doctor.

Your doctor will contact us by phone, fax or e-mail. If your request is not approved and you still want the drug, you will have to pay the full price of the prescription.

All decisions are made based on FDA guidelines and current medical findings. Learn more about this at www.aetna.com/formulary.

Start your Aetna plan with peace of mind

New plans often come with new rules. We want to help make the change easier. During the first 90 days of your plan, you can get a one-time fill for most covered drugs that need extra approvals.

In your first 90 days:• If you need a covered drug that normally needs approval

first, you’ll be able to get that drug filled once, for up to a 30-day supply without the approval.

• For clinical reasons, some drugs will still need to be approved first, even in your first 90 days. This may be because of questions about dosing, quantity or other safety concerns.

After 90 days:• You will need approval for any new drugs that your doctor

prescribes that would normally require coverage reviews.

Mandatory generic

If this applies to your plan, you must get the generic drug when a generic is available. Your doctor may make a medical exception. In that case you’ll pay the applicable copay for generic. But, if you ask for brand when a generic is available, you’ll pay the applicable copay plus the difference between the generic price and the brand price.

Over-the-counter drugs may be an option

Many health conditions can be treated safely with drugs you can get without a prescription. We call these drugs “over the counter” because you can buy them at your local stores. You don’t have to go to a pharmacy.

These drugs have been approved by the FDA as safe and effective, and they often have the same active ingredients as an original prescription version. Always talk to your doctor before taking over-the-counter drugs.

Your plan does not cover prescription drugs if a similar drug is available over the counter. This includes drugs like Claritin® and Prilosec® 20 mg. Please ask your doctor what will work best for you.

18

Specialty pharmacy medications

With your new Aetna Specialty CareRxSM benefit, you can get your first fill at a retail pharmacy. In order to receive coverage, your second fill and all other refills will need to come from a participating specialty pharmacy.

For a full list of specialty pharmacy medications, please visit www.aetnaspecialtycarerx.com.

Limitations and exclusions

Drugs that are not covered under the standard prescription drug benefit program include, but are not limited to:

• Drugs used for weight loss, including the treatment of obesity

• Over-the-counter drugs

• Nutritional supplements

• Smoking cessation aids or drugs

• Growth hormones

• Prophylactic drugs for travel

• Test agents and devices, other than diabetic test agents

• Performance, athletic performance, or lifestyle enhancement drugs and supplies

• Cosmetics or any drugs used for cosmetic purposes or to promote hair growth, including health and beauty aids

• Replacement for lost or stolen prescriptions

For a complete list of what is not covered by your prescription drug plan, refer to your plan documents after enrollment.

Find out more

Once you are enrolled, log in to Aetna Navigator, our secure member website at www.aetna.com.

You’ll find benefits and claims information, the Preferred Drug List, cost estimates and more. You can also refer to your Summary of Benefits or call us at the toll-free number on your Aetna member ID card.

19

*All family members must be enrolled in the same plan.1 MayoClinic.com. “Oral health: A window to your overall health.” Available at www.mayoclinic.com/health/dental/DE00001. May. 11, 2013 (accessed May 2014.)2�J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):20-8. doi: 10.1016/S1532-3382(12)70006-4. “State of the science: chronic periodontitis and systemic health.”

Dental productsChoose the right dental benefits and insurance plan?*

A healthy body starts with a healthy smile

Research suggests that serious gum disease, known as periodontitis, may be associated with many health problems. This is especially true if serious gum disease continues without treatment.1,2

Now, here’s the good news. Researchers are discovering that a healthy mouth may be important to your overall health.1,2

Plan features DMO® PPO Freedom-of-Choice*

DMOFreedom-of-Choice*

PPO

Coverage for preventive care • • • •

No primary care dentist requirement • •

No referrals • •

Out-of-network access • •

No claim forms • •

No deductibles • •

No dollar annual maximums • •

Need to find a participating dentist? Just visit DocFind or give us a call.

www.aetna.com/docfind

1-877-238-6200

20

*Discounts may not be available in all states.**Results will vary for different plan designs. Example does not include premiums.1Allaboutvision.com/eye-exam/importance.htm, April 2012. Accessed September 2014.2Jobson Vision Watch, Vision Council Member Benefits Report, June 2011.3Jobson Consumer Perceptions of Managed Vision Care Report 2011.

Visionoverview

See why Aetna Vision Preferred is the right choice for you

• You can go where you want and buy what you want; in- and out-of-network benefits included for most services

• Customer service and self-service tools are available seven days a week

• You’ll enjoy low out-of-pocket vision expenses

• You can choose any frame available — includes value-priced frames to high-quality designer frames with no confusing frame towers or formularies

• Discounts are available on additional eyeglass purchases and noncovered items including LASIK*

• You will receive a welcome packet that includes member an ID card, benefit summary and nearest provider locations

Keep an eye on your health

We are committed to vision wellness, patient education and the associated preventive care.

Getting vision care can help lower unnecessary costs and improve your overall health. During a routine eye exam, all aspects of vision are checked, including the eye’s structure and how well the eyes work together. Annual eye exams allow eye care providers to monitor the health of the eyes and track changes that can occur from year to year. Besides measuring vision, eye exams help find early signs of certain chronic health conditions including diabetes, high blood pressure, high cholesterol and eye disease.1

Discover the freedom to see any licensed vision office or retailer

Nearly 60 percent of eyewear dollars in the U.S. are spent at optical retailers.2 With Aetna Vision Preferred, you will have access to one of the largest national networks with over 65,000 vision office and retailers, featuring most desired national retailers,3�including LensCrafters®, Pearle Vision®, Sears® Optical , Target Optical® and JCPenney Optical. Most have evening and weekend hours, including Sundays and are located in or near shopping centers for added convenience. Can’t find your provider in our network? No problem. We reimburse for most out-of-network services, so you are covered no matter who you see for your routine eye care.

Low out-of-pocket costs

Aetna Vision Preferred offers savings in or out of network for routine eye exams, contact lenses and eyeglasses, including prescription sunglasses and designer frames.

Sample out-of-pocket costs**

Retail price

Out-of-pocket costs with Aetna Vision Preferred

Savings with Aetna Vision Preferred

Exam $114.00 $10.00 $104.00

Frames $124.41 $0 $124.41

Lenses $ 83.00 $10.00 $ 73.00

Total $321.41 $20.00 $301.41

21Discounts may not be available in all states.

Aetna Vision Preferred – Premier plan

In network Out of network

In-network amount represents member copay, plan allowance or fixed discounted fee. Out-of-network amount represents the maximum reimbursement amount.

Exam – coverage allowed for one eye exam every rolling 12 months

Routine eye exam $10 copay $25 reimbursement

Standard contact lens fit/follow $40 discounted fee Not covered

Premium contact lens fit/follow 10% off retail Not covered

Frames – coverage allowed for one eyeglass frame every rolling 12 or 24 months (rates vary by frame frequency)

Any frame available at location $130 plan allowance $65 reimbursement

Lens – coverage allowed for one pair of prescription eyeglass lenses every rolling 12 months (in lieu of contact lenses per benefit period)

Single vision lenses $10 copay $20 reimbursement

Bifocal vision lenses $10 copay $40 reimbursement

Trifocal vision lenses $10 copay $65 reimbursement

Lenticular vision lenses $10 copay $65 reimbursement

Standard progressive lenses $75 copay $40 reimbursement

Premium progressive lenses 20% discount off retail minus $120 allowance plus $75 copay = member out of pocket

$40 reimbursement

UV treatment $15 discounted fee Not covered

Tint (solid and gradient) $15 discounted fee Not covered

Standard plastic scratch coating $15 discounted fee Not covered

Standard polycarbonate lenses – child to age 19 $40 discounted fee Not covered

Standard polycarbonate lenses – adult $40 discounted fee Not covered

Standard anti-reflective coating $45 discounted fee Not covered

Contacts – coverage for one order of contact lenses every rolling 12 months (in lieu of eyeglass lenses per benefit period)

Conventional contact lenses $115 plan allowance $80 reimbursement

Disposable contact lenses $115 plan allowance $80 reimbursement

Medically necessary contact lenses $0 copay $200 reimbursement

Discounts

Available at in-network locations• 15 percent off balance over the plan allowance on conventional contact lenses

• 20 percent off balance over the plan allowance on frames

• Up to 40 percent off additional pairs of eyeglasses or prescription sunglasses

• 15 percent discount off retail or 5 percent discount off the promotional price for LASIK vision correction or PRK from U.S. Laser Network only. Call 1-800-422-6600

• 20 percent off noncovered items, including photochromic/transition and polarized lenses

• Receive significant savings after your lens benefit has been exhausted by ordering replacement contact lenses online at www.aetnavision.com


Aetna Vision Preferred – Plus plan


In-network amount represents member copay, plan allowance or fixed discounted fee. Out-of-network amount represents the maximum reimbursement amount.






Any frame available at location $130 plan allowance $65 reimbursement








$25 reimbursement



Standard plastic scratch coating $0 copay $15 reimbursement

Standard polycarbonate lenses – child to age 19 $0 copay $35 reimbursement







Discounts








Aetna Vision Preferred – Basic plan


In-networkamount represents member copay, plan allowance or fixed discounted fee. Out-of-network amount represents the maximum reimbursement amount.






Any frame available at location $100 plan allowance $50








$30 reimbursement



Standard plastic scratch coating $15 discounted fee Not covered

Standard polycarbonate lenses – child to age 19 $40 discounted fee Not covered







Discounts







24

Life Insurance — insurance solutions you can rely on

Protection for the future

Nothing is more reassuring than knowing financial resources are available when you need them most. Our products provide you and your dependents financial support when it counts. And, you’ll be glad to know that with Aetna you have access to life insurance from a company with more than 150 years of industry experience. Your financial future is in good hands.

Basic term life

The building block of financial security. Our life insurance plans come with a variety of features including:

Accelerated death benefit — Also called the “living benefit,” this benefit provides payment if you become terminally ill. This payment can be up to 75 percent of the life insurance benefit.

Premium waiver provision — With this provision, you may stay covered up to age 65 without premium payments if you become permanently and totally disabled while insured due to an illness or injury prior to age 60.

Aetna Life EssentialsYour Aetna Life coverage includes access to Aetna Life Essentials, a package of programs and resources available to you and your beneficiaries at no extra cost. The Aetna Life Essentials programs help you address health, wellness, financial and emotional needs during your life, as well as for those critical caring and support needs you and your loved ones may have at the end of your life and after you’ve passed away.

AD&D Ultra®

This progressive product provides you better financial security than typical accidental death and personal loss plans and then some. That’s because AD&D Ultra includes coverage for education or dependent child care expenses upon the death of the insured.

25*According to the Aetna Enterprise Provider Database as of August 2014. Network subject to change.

Finding a doctor or specialist

Our provider network in Colorado has more than 16,000 physicians and 92 hospitals.* So whichever plan you choose, you will be able to find the doctor, hospital or other health care provider to best suit your needs.

Start your search at www.aetna.com (or, if you are already a member, log in to Aetna Navigator). Click on Find a Doctor. Use the simple online instructions to perform a general search. You also may search for a particular physician by name, specialty or other options.

When performing a search in DocFind, you will be asked to select a plan name. Some of the names of our Colorado plans appear by their network names. Here is a quick reference to identify your plan.

Medical plan name as it appears in DocFind

Common plan names

Aetna Whole Health – Colorado Front Range

OAMC, HNOnly

Managed Choice (Open Access) OAMC

Aetna Health Network Only HNOnly

Open Choice PPO PPO

26

How to complete the enrollment form application

Please be sure to complete your enrollment form thoroughly.

The sections noted below are frequently overlooked.

1. Date of hire.

2. Select the medical plan(s) offered by your employer.

3. Insert your Social Security number here.

4. Enter your medical and/or dental provider office ID #, if applicable for your plan.

5. Sign and date here to complete the form.

GR-68901-26 (9-14) 1 CO R-POD A

NOTE: Before submitting this completed form to your employer, you may wish to protect the confidentiality of your health information by taping or stapling the form so that health information is not visible.

Colorado Employee Enrollment/Change Form(51 - 100 Eligible Employees)

INSTRUCTIONS: You, the employee, must complete this enrollment form in full or it will be returned to you resulting in a delay in processing. You are solely responsible for its accuracy and completeness. If waiving coverage, please complete Sections A and E.

Member Aetna ID Number (if available)

Company NameEffective Date New Hire

Rehire/ReinstatementNew Group EnrollmentLate EnrollmentWaiverOpen Enrollment

Add SpouseAdd Domestic PartnerAdd Dependent ChildChange of CoverageName Change

Employee TerminationRemove SpouseRemove Domestic PartnerRemove Dependent ChildCancel CoverageOther

Date of Hire

BWPClass 1 Class 2

COBRA Election for: Employee Dependent Length of Continuation: 18 36 Other Qualifying Event Original Qualifying Event Date Loss of Coverage Date

A. Employee Information – Must be completed by the employee.Social Security Number Last Name, First Name, M.I. Job Title

Home Address Apt. No. City, State ZIP Code

Work Address City, State ZIP Code

Home Telephone( ) -

Work Telephone( ) -

Primary Language Spoken (Optional) Number of Dependents including Spouse Domestic Partner/Partner in a Civil Union

Salary$

Hourly Weekly Monthly

No. of Hours Worked Per Week

Check One Full-Time 1099 Seasonal COBRAPart-Time Retired Temporary Union

B. Coverage Selection – Please print clearly, using black ink. (Shaded sections for Employer/Aetna Use Only)Control/Group No. Suffix Account Plan No. Class Code[1. Medical - Check applicable boxes.

CO Aetna Whole Health Front Range – Plan Name: Open Access Managed Choice® – OAMC - Plan Name:Health Network Only - Plan Name:PPO - Plan Name:Indemnity - Plan Name: ]

Control/Group No. Suffix Account Plan No.

[2. Dental - Check applicable boxes.Standard Plans: Dental Plan Number: FOC: DMO® or PPOVoluntary Plans: Dental Plan Number: FOC: DMO® or PPO

Before today, were you covered under this employer’s dental plan? Yes No Creditable coverage is allowed for new members enrolling in voluntary takeover groups. New hires please see below if applicable:New Hire selecting a Voluntary Plan and your Aetna plan is a takeover group: Were you covered for 12 months under a dental plan within the last 90 days that included both Preventive and Basic coverage? Discount dental and preventive-only plans do not apply. Yes No ][3. Life and Disability

See the specific Employee Application for Life and Disability Coverage.]

Control/Group No. Suffix Account Plan No.

[4. Vision Aetna Vision Preferred Yes No Check applicable box.]

2

1

GR-68901-26 (9-14) 2 CO

C. Individuals Covered - List individuals for whom you are enrolling or adding/changing/removing coverage. Insert additional sheets if necessary. NOTE FOR MEDICAL COVERAGE: While the Federal Patient Protection and Affordable Care Act mandates coverage of dependent children up to age 26, your plan may allow coverage beyond age 26. Some exceptions apply. Please refer to your plan documents or contact your benefits administrator.

Name (Last, First, M.I.)SexM/F

Social Security Number

Birthdate(MM/DD/YYYY)

CoverageElection

MedicalOffice ID

Number (if applicable)

CurrentPatient

DMO Dental Office ID Number

(if applicable)CurrentPatient

Employee1. / /

MedicalDentalVision

Yes Yes

Spouse Designated Beneficiary Partner in a Civil Union Domestic Partner2.

/ /MedicalDentalVision

Child Stepchild Other3. / /

MedicalDentalVision


MedicalDentalVision


MedicalDentalVision


MedicalDentalVision

D. Medicare Information

Name of PersonMedicare

Part AMedicare

Part BMedicare

Part D Over Age 65 Disability

End-Stage Renal Disease Effective

DateYes No Yes No Yes No Yes No Yes NoYes No Yes No Yes No Yes No Yes No

E. Declination/Waiver of Coverage – To be completed if coverage is declined or refused by an eligible employee and/or their eligible family members.

I understand I am eligible to apply for this coverage through my employer; however, I am waiving coverage as noted below.Employee: Medical Dental

Life VisionReason for declining coverage

Spousal group coverageParental group coverageCOBRA coverageMedicareMedicaidRetiree coverageAnother group plan provided by my employer

Domestic Partner group coverageInsurance through another jobTRICAREVA coverageIndividual coverage - On ExchangeIndividual coverage - Off ExchangeDo not wantOther

Spouse/Domestic Partner/Partner in Civil Union

Medical DentalLife Vision

Child(ren): Medical DentalLife Vision

I certify I have been given the right to apply for this coverage; however, I am electing not to enroll. By declining this group coverage I acknowledge that I and/or my dependents may have to wait until the plan's next anniversary date to be enrolled for group coverage. I and/or my dependents have made this decision of my/their own accord, with no pressure from my employer, my employer’s agent or the insurance carrier.Please sign here ONLY if you are declining coverage for yourself and/or your dependent(s).

I AM DECLINING COVERAGE: Employee Signature XDate (Month/Day/Year)

F. Coordination of BenefitsWill you have other health insurance at the same time as this coverage? Yes No

Name of Person Carrier Name Name of Person Carrier Name

3 4 4

GR-68901-26 (9-14) 4 CO

I. Provide details below to any boxes checked in Section H. (Continued) (If additional space is needed, attach a separate sheet and be sure to sign and date the sheet.)

Ques. No. Name of Individual

Condition/Diagnosis/Treatment

Date of Onset

Date Treatment

Ended

Names of Prescription Medication Dosage

Still Taking Medication

Yes NoYes NoYes NoYes NoYes NoYes No

Conditions of EnrollmentOn behalf of myself and the dependents listed,, I agree to or with the following:1. I acknowledge that by enrolling in the following plans, coverage is provided by the following entities (collectively referred to as “Aetna”):

• Aetna Open Access Managed Choice®, PPO, Indemnity and Dental plans: Aetna Life Insurance Company• CO Aetna Whole Health plans: Aetna Health Inc. and/or Aetna Life Insurance Company• Health Network plans: Aetna Health Inc.• Aetna VisionSM Preferred plans: Aetna Life Insurance Company; certain claims adjudication and other administrative services are provided by First

American Administrators, Inc. (an affiliate of EyeMed Vision Care, LLC) and/or its affiliates;2. I understand and agree that my employer’s application will determine coverage and that there is no coverage unless and until both the eligible

employee and employer applications have been accepted and approved by Aetna. Even if this enrollment form is approved, any misstatements or omissions may result in future claims being denied and the policy or my coverage under the policy being rescinded or reevaluated, as of the effective date, for eligibility and rating purposes.

3. I understand and agree that this Colorado Employee Enrollment/Change Request may be transmitted to Aetna or its agent by my employer or its agent. I authorize any physician, other healthcare professional, hospital or any other healthcare organization (“Providers”) including pharmaciesor pharmacy database benefit managers to give to Aetna or its agent information concerning the medical history, services or treatment provided to anyone listed on this enrollment form, including those involving mental health, substance abuse and HIV/AIDS. I further authorize Aetna to use such information and to disclose such information to affiliates, Providers, payors, other insurers, third party administrators, vendors, consultants and governmental authorities with jurisdiction when necessary for my care or treatment, payment for services, the operation of my health plan, or to conduct related activities. I have discussed the terms of this authorization with my spouse/domestic partner/partner in a civil union and competent adult dependents, and I have obtained their consent to those terms. This authorization will remain valid for the term of the coverage and for so long thereafter as allowed by law. I understand that I am entitled to receive a copy of this authorization upon request and that a photocopy is as valid as the original. This authorization is voluntary. However, I understand that if I refuse to sign this authorization form, my ability to enroll in the medical plans described above may be affected. I have the right to revoke this authorization in writing to Aetna at any time except to the extent that my information has already been used or disclosed in reliance on this authorization. However, because this information is essential to the administration of the plans, I understand that my revocation of this authorization may result in cancellation of my enrollment in the medical plans described above.

4. The plan documents will determine the rights and responsibilities of member(s) and will govern in the event they conflict with any benefits comparison, summary or other description of the plan.

5. I understand and agree that, with the exception of Aetna Rx Home Delivery® and Aetna Specialty Pharmacy, LLC, all participating providers and vendors are independent contractors and are neither agents nor employees of Aetna. Aetna Rx Home Delivery, LLC and Aetna Specialty Pharmacy, LLC, are subsidiaries of Aetna Inc. The availability of any particular provider cannot be guaranteed and provider network composition is subject to change. Notice of the change shall be provided in accordance with applicable state law.

6. I understand and agree that, with certain exceptions described in the plan documents, DMO plans only provide coverage for referred benefits, and that, in order to be covered, services must be performed either by a participating primary care physician, primary care dentist, or by the participating specialist, hospital, pharmacy, dentist, or other provider as authorized by a referral from a participating primary care physician.

7. It is unlawful to knowingly provide false, incomplete, or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines, denial of insurance benefits, and civil damages. Attention Colorado Residents: An insurer or agent who knowingly provides false or misleading information to defraud a claimant regarding insurance proceeds must be reported to the Insurance Division.

I represent that all information supplied in this form is true and complete. I have read and agree to the Conditions of Enrollment and Misrepresentation on this Colorado Employee Enrollment/Change Request. I understand that, in the event I fail to sign this form within 31 days of my eligibility date or for any reason Aetna does not receive notice of the above transaction request within a reasonable time following the event, my eligibility and my dependents’ eligibility may be affected. I am employed by the employer shown on Page 1, and I am working full time at least 25 hours per week for this employer at the regular place of business. I authorize deductions from my earnings for any contributions required for coverage and I agree to make any necessary payments as required for coverage.

If you wish to receive documents electronically, please refer to Aetna Navigator® at www.aetna.com/NavigatorEmployee SignatureX

Employee E-mail Address Date (Month/Day/Year)

This form is attached to and made a part of the group policy.

5

If you need this material translated into another language, please call Member Services at 1-888-98-AETNA (1-888-982-3862).Si usted necesita este documento en otro idioma, por favor llame a Servicios al Miembro al 1-888-98-AETNA (1-888-982-3862).This material is for information only and is neither an offer or invitation to contract. The models depicted are not Aetna members. An application must be completed to obtain coverage. Rates and benefits vary by location. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Health and life insurance plans contain exclusions and limitations. Health information programs provide general health information and are not a substitute for diagnosis or treatment by a physician or other health care professional. Discount offers provide access to discounted services and are not part of an insured plan or policy. Discount offers are rate-access offers and may be in addition to any plan benefits. Check any insurance benefits you have before using these discount offers, as those benefits may result in lower costs to you than using these discounts. Discount offers are not guaranteed and may be discontinued at any time. Aetna makes no payment to the discount vendor. The member is responsible for the full cost of the discounted services. Aetna does not endorse any vendor, product or service associated with these discount offers. Vendors are independent of Aetna, not agents or employees thereof. Programs, products and services may not be available at all times. Certain offers may not be available in some states. Products may be subject to a warranty from the manufacturer. Aetna makes no representations or warranties, and disclaims all product warranties. The discount offers have no liability for providing or guaranteeing service and assumes no liability for the quality of service rendered. Aetna may receive a percentage of the fee paid to a discount vendor. Aetna receives rebates from drug manufacturers that may be taken into account in determining the Aetna Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a subsidiary of Aetna Inc., which is a licensed pharmacy providing prescription services by mail. This pharmacy is a for-profit entity. Aetna Specialty Pharmacy refers to Aetna Specialty Pharmacy, LLC, a subsidiary of Aetna Inc., which is a licensed pharmacy that operates through specialty pharmacy prescription fulfillment. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com.

www.aetna.com

©2014 Aetna Inc. 14.02.164.1-CO B (11/14)

Review the material in this brochure and speak with your employer or human resources representative about the choices available to you.

We look forward to welcoming you and your family as our newest members!

HNOnly Member Services 1-866-529-2517

Traditional Member Services 1-888-80-AETNA (1-888-802-3862)

Visit www.aetna.com

colorado enrollment guide - aetna · 2014-11-19 · with aetna, you can choose the path that gets...

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