PASADENA ISD AND AETNA WELCOME TO AETNA EFFECTIVE

PASADENA ISD AND AETNA WELCOME TO AETNA! EFFECTIVE JANUARY 1, 2012 Page 1

Pasadena ISD – Aetna Plan Comparisons PLAN FEATURES Network Health. Fund Amount contributed by Pasadena ISD Plan Coinsurance Calendar Year Deductible Individual Family Out-of-Pocket Maximum Individual Family Choice POSII Plan (Plan I) Aetna Health. Fund Choice CPOSII Plan (Plan II) In-Network Out-Network* 20% 50% In-Network Out-Network* $500 Employee $1, 000 EE+S, Ch, F 20% 50% $7, 500 person $500 person $1, 500 person $2, 500 person $22, 500 per family $1, 500 per family $4, 500 per family $7, 500 per family $3, 500 person $10, 500 family $10, 500 person $31, 500 family $5, 000 person $15, 000 family $15, 000 person $45, 000 family Lifetime Maximum Benefit Unlimited Primary Care Physician (PCP) Office Visits $25 copay 50% after ded 20% after ded 50% after ded Specialty Care Office Visits $35 copay 50% after ded 20% after ded 50% after ded 100% 50% after ded PCP or Specialist copay 50% after ded 100% ded waived 50% after ded 100% 50% after ded 20% after ded 50% after ded Preventive Care Annual routine physical: Adult and Well Child, GYN, Mammograms, Colorectal Cancer Screenings, PSA Tests Diagnostic Outpatient Lab/ X-rays/Testing (part of office visit) Diagnostic Outpatient Lab/ X-rays/Testing (Facility) Complex Imaging Services Page 2

Pasadena ISD – Aetna Plan Comparisons cont’d PLAN FEATURES Network Inpatient Hospital Services Outpatient Surgery Choice POSII Plan In-Network $500 per confinement copay, then 20% after ded Choice POSII Plan Out-Network* $500 per confinement copay, then 50% after ded Aetna Health. Fund Choice CPOSII Plan In-Network Out-Network* 20% after ded 50% after ded $250 copay, then 20% after ded same as preferred care Urgent Care Copay/Coinsurance (Copay waived if admitted) $50 copay 50% after ded 20% after ded 50% after ded Walk In Clinics $25 copay 50% after ded 20% after ded 50% after ded Emergency Room Copay/Coinsurance (Copay waived if admitted) Ambulance *Out of Network benefits are paid at the Limited Fee Schedule Page 3

Out-of-Network Limited Benefit Payment Schedule • Pasadena ISD has a Limited Out-of-Network benefit payment schedule. When you need medical care, your Aetna health benefits plan gives you and your participating physician a choice. Advise your participating physician that it is important to you that the highest level of benefit coverage is desired by ensuring to you that they refer you to only in network facilities and providers with Aetna. • Limits on authorized costs associated with Out-of-Network facilities/providers. To help curb excessive out-of-network facility/provider costs, Pasadena ISD has established a Limited Out-of-Network fee schedule that limits the Plan’s exposure to the market rate for non-emergency services and procedures. If you use an out-of-network facility or provider, you will be responsible for paying the difference between the covered amount (which is based on established rates for our geographic area) and the amount the facility charges. If you incur these expenses, they will not apply to your coinsurance maximum. • When you use a Network provider, you are protected from charges that are greater than the "allowed" amount. However, when you use an out-of-network provider, you may have to pay for any of the charges that are greater than the "allowed" amount in addition to your coinsurance and deductible. • All out-of-network provider and facility types will be included in the Limited Out-of Network benefit reimbursement. Examples include, but are not limited to: hospitals, ambulatory surgery centers, physicians, pathology laboratories, radiology centers, psychologists, master social workers, physical therapists, certified nurse anesthetists, outpatient dialysis, radiology, laboratory, sleep lab, MRI/CT etc. • NOTE: It is your responsibility to make sure your physician, facility or hospital is in-network or you will pay out-of-network costs. You can help keep costs down by using network providers. Page 4

Your Personal Website – Aetna Navigator Your easy to use Online Resource • How to use Aetna. com/Navigator program – Go to www. aetna. com – Register just like you would register for your on-line banking or other sites. Temporary LOGIN: choicepos 2 Temporary PW: choicepos 2 • Doc Find - a complete listing of Aetna participating providers. Select your provider category. You can search by city, state, zip, specialty, hospital affiliation, provider name, gender, language and education. Select the “CPOSII Open Access” network • Estimate the Cost of Care – get estimates for what you will pay for visits to doctors or common procedures • View Deductible and Plan Limits – review amounts applied to your individual and family deductibles and out-of-pocket maximums • View Explanation of Benefits – review portion of claims paid by the plan and the amount you must pay • Take a Health Assessment – Take your Simple Steps personal health risk assessment • Aetna Life Essentials – discount programs for vision care, hearing aids, fitness, etc Page 5

Aetna Health Connections – Disease Management CONFIDENTIAL PROGRAM!!! Aetna program designed to help you or your eligible family member(s) learn more about your condition and work closely with your doctor to improve your health and quality of life. Educational information is provided and for high risk members, access to a registered nurse “Health Coach” is offered. The adjacent list includes a few of the 35 conditions managed by this program. To learn more about Disease Management, login to www. aetna. com • If you receive a call or letter from Aetna please return their call or contact them as requested. All information is confidential with Aetna and is not shared with Pasadena ISD. • If you have one of the conditions listed or think you are at risk for one of these conditions, you can volunteer into the program by calling 1 -866 -269 -4500 OR make an appointment to discuss with the Aetna on-site nurse. Asthma Back Pain Cancer Cerebrovascular Disease Chronic Heart Failure Chronic Obstructive Pulmonary Disease Coronary Artery Disease Cystic Fibrosis Depression Diabetes Digestive HIV Hepatitis Hypertension Inflammatory Bowel Disease Kidney Failure Peripheral Artery Disease Rheumatoid Arthritis Sickle Cell Anemia Weight Management Page 6

Simple Steps Program Your Health Risk Assessment – CONFIDENTIAL! • Simple Steps To A Healthier Life is an interactive online health and wellness program that can help you improve or maintain your health in ways that fit your lifestyle. • You start by taking an online Health Assessment that will help identify some of your health needs. Questions focus on health habits and family health history and all answers are kept secure and confidential. Note: It is best to have your current lab and biometric results to input into the assessment (Blood pressure, cardiac CRP, total cholesterol, LDL and HDL cholesterol, triglycerides, and fasting glucose). However, even if you don’t have all of these results - you can still complete your health assessment and fill these results in at a later date). • Once your health needs are identified, you’ll receive easy-to-understand Health Reports and a personal invite to join the program most likely to help meet your needs and an Action Plan that’s just for you, suggesting a combination of Healthy Living Programs. • Choose the programs, tools and information that are right for you. Each program includes interactive tools to help you reach your health goals in a fun and interesting way. You can use an online Fitness Planner, a Healthy Shopping List and more. • Take the first step to healthier living. Visit www. simplestepslife. com. Be sure to complete or update your health assessment at www. aetna. com! ALL information is confidential and is not shared with Pasadena ISD! Page 7

NEED MORE INFORMATION? Aetna Inteli. Health® is an exclusive resource that can be accessed online (www. aetna. com) to find up-to-date health information and resources including: – – – Information on diseases & conditions Articles on lifestyle improvement Gender and age specific health issues Medication information Health assessments Quizzes Medical dictionary Health calculators (BMI, etc. ) Current health research news “How-to” slide shows Email health updates Page 8

Need questions answered FAST? ? ? Call Aetna's Informed Health® Line • Aetna's Informed Health® Line gives you easy access to credible health information. All Informed Health Line services are available 24 hours a day, 365 days a year on demand from your touch-tone phone. • If you prefer to view health information online, simply login to www. aetna. com and click on the link for the Healthwise® Knowledgebase. • 24 Hour Nurse. Line - Speak with a registered nurse who has experience in a variety of health topics at any time of the day*. • Audio Health Library - Phone in to choose from thousands of common health topics via recorded messages. Easily transfer to the Nurse Line for questions. • Healthwise® Knowledgebase - Search for detailed information about health conditions, medical tests and procedures, medications and treatment options at www. aetna. com. • To reach the 24 -Hour Nurse Line or Audio Health Library call 1 -800 -556 -1555. * Informed Health Line Nurses cannot diagnose, prescribe or give any medical advice. Contact your physician with any questions or concerns regarding your health care needs. Page 9

Choosing A Plan that is Right for You • Making the right plan choice can be a difficult decision. This decision should be based on several things such as your personal medical condition and usage of services, financial situation, and your level of comfort with coinsurance vs. copayments. The following definitions may assist you in the decision-making process. • Co-payment: the predetermined dollar amount you will pay for a service (Examples: physician office visits, urgent care, emergency room, physical therapy, counseling). • Coinsurance: percentage employee is responsible for paying up to a specific dollar amount per calendar year (Covered services paid from 50 -100% depending on the plan selected and service rendered). • Deductible: initial out-of-pocket costs that must be paid before the plan begins to pay benefits (Either $500 or $2, 500 based on plan elected). • Your Aetna Choice POS II Plans do not require you to select a network primary care physician (PCP), although selecting a PCP is encouraged. These plans also allow you to self-refer to a specialist. Your choice of provider dictates the amount you will pay in copayments, coinsurance and/or deductibles. Page 10

PASADENA AREA URGENT CARE FACILITIES Immediate Medical Care Group Pasadena Community Health 6825 Spencer Hwy Pasadena, TX 77505 (281) 335 -0606 4002 Burke Road Pasadena, TX 77504 (281) 606 -2020 Concentra Health Services, Inc. 125 East 8 th St Deer Park, TX 77536 (281) 930 -8555 NOTE: It is your responsibility to make sure your physician, facility or hospital is in-network or you will pay out-of-network costs. You can help keep costs down by using network providers. Page 11

PASADENA AREA WALK IN CLINICS H-E-B - RCMH, LLC dba Redi. Clinic 6210 Fairmont Pkwy. Pasadena, TX 77505 (866) 607 -7334 Minute. Clinic Diagnostic of Texas, LLC CVS Pharmacy – 2900 Broadway St. Pearland, TX 77581 (866) 389 -2727 Take Care Health Texas, P. C. Walgreens- 8430 Broadway St. Pearland, TX 77584 (866) 825 -3227 H-E-B - RCMH, LLC dba Redi. Clinic 2955 Gulf Freeway South League City, TX 77573 (866) 607 -7334 H-E-B - RCMH, LLC dba Redi. Clinic 701 West Parkwood Friendswood, TX 77546 (866) 607 -7334 NOTE: It is your responsibility to make sure your physician, facility or hospital is in-network or you will pay out-of-network costs. You can help keep costs down by using network providers. When utilizing these clinics, regular plan will provisions apply (ie; copays, deductibles and out of pocket limits). Page 12

Need More Information? • Aetna on-site Contact: • Deaneva Taylor • 713 -740 -0105 Page 13

What is the Cost to the Employee? • Choice POSII Plan Rates (Plan 1) Employee’s Cost • Employee $170. 00 • +Spouse $500. 00 • +Child (Children) $400. 00 • +Family $725. 00 Page 14

What is the Cost to the Employee? • Aetna Health Fund (Plan 2) Employee’s Cost • Employee $ 70. 00 • + Spouse $210. 00 • + Child (Children) $175. 00 • + Family $350. 00 Page 15