2013 Benefits and Rates at a Glance - Aetna · 2013-10-11 · Aetna 2013 Benefits and Rates-at-a-Glance for Regular Employees (working 20 hours or more per week) OPTIONAL BENEFITS

2013 and 2014Benefits and Rates-At-a-GlanceFor Regular U.S. Employees

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Aetna 2013 Benefits and Rates-at-a-Glance for Regular Employees (working 20 hours or more per week)

COMPANY-PAID BENEFITS1

Life Insurance

Business Accident Travel Insurance

Short Term Disability (STD)

Long Term Disability (LTD)

Paid Time Off (PTO) & Holidays

Wellness Works

OPTIONAL BENEFITS1 Medical Plans HRA 80 Plus HRA 80 HRA 80 Out-of-Network HSA 80 Plus HSA 80 Indemnity HSA 80 Dental Plans Dental Maintenance Organization (DMO®)

Dental PPO

Vision Benefits Aetna Vision PreferredSM Flexible Spending Accounts Health Care Dependent Care

Aetna Commuter Benefit Parking Mass Transit Wellness & Incentive Programs Healthy Lifestyles incentive program Medical Plan premium credits Wellness Reimbursement Program Adoption Assistance Program

Life Insurance Employee Supplemental Term Life Insurance Spouse/Partner Supplemental Term Life Insurance Child Term Life Insurance Accidental Death & Personal Loss (AD&PL) Insurance Employee Accidental Death & Personal Loss Insurance Spouse/Partner Accidental Death & Personal Loss Insurance Employee & Child(ren) Accidental Death & Personal Loss Insurance Employee, Spouse/Partner & Child(ren) Accidental Death & Personal Loss Insurance

Optional Long-Term Disability Insurance 10% Taxable Benefit

Financial Benefits 401(k) Plan Employee Stock Purchase Plan Employee Tuition Assistance Plan Financial Education Programs Aetna Voluntary Benefit Plans Voluntary Hospital Plan Critical Illness Plan Accident Insurance Plan

1 In general, US employees employed by Aetna or a participating company are eligible to participate in these benefit plans.


COMPANY PAID BENEFITS

Life Insurance Description

• 1x eligible pay or $50,000 (if eligible pay is more than $50,000); plan minimum is $10,000

Business Travel Accident Insurance Description

• An amount equal to the greater of $50,000 or 3x eligible pay to a maximum of $1,000,000

Short Term Disability (STD) Description

• One week waiting period • Up to 12 weeks of pay at 80% of base pay; and then up to 13 weeks of pay at 60% of base pay, if short-term disability benefits

continue to be approved

Long Term Disability (LTD) Description

• 50% of eligible pay (taxable benefit), up to a monthly maximum benefit of $15,000

Paid Time Off (PTO) & Holidays Description

• PTO: 18 to 28 days based on length of service (prorated if less than full-time) • Holidays: 8 company paid holidays

Wellness Works Description

Employee Work/Life Assistance Program • Offers a wide range of support services such as confidential counselling services, resources for elder care, child care, legal and financial matters, web-based information and more

Employee Assistance Program (EAP) • Up to 5 confidential counseling sessions for each household member

Simple Steps to A Healthier Life • Take a Health Assessment and on-line healthy living classes

Healthy Lifestyle Coaching/ Quit Tobacco Program

• Get one-on-one attention from a trained wellness coach to reach your health goals. If you’re a tobacco user, Aetna’s Tobacco Cessation Program is designed to help you quit the habit when you’re ready

Mind Body Stress Reduction Program • On-site and online stress reduction program

Employee Discount Program • There are a number of discounts that are available to you as an Aetna employee


OPTIONAL BENEFITS (shared cost or employee paid)

Medical Plans2 100% coverage for preventive care in-network for all Aetna medical plans 100% coverage for in-network, preventive eye exam every calendar year Aetna Performance Network offered and/or Aexcel in certain locations

Employer Contribution* Deductible** Coinsurance4

HSA 80 Plus Individual: $400/Family: $800 Individual: $1,600/Family: $3,200 80% (in-network)

HSA 80 Individual: $400/Family: $800 Individual: $1,800/Family: $3,600 80% (in-network)

Indemnity HSA 803 Individual: $400/Family: $800 Individual: $1,800/Family: $2,800 80%

Employer Contribution* Deductible Coinsurance4

HRA 80 Plus Individual: $400/Family: $800 Individual: $1,600/Family: $3,200 80% (in-network)

HRA 80 Individual: $400/Family: $800 Individual: $1,800/Family: $3,600 80% (in-network)

HRA 80 Out-of-Network3 Individual: $400/Family: $800 Individual: $ 900/Family: $1,800 80% * The employer contribution to the HRA Fund or HSA is prorated for mid-year entry into a plan ** The full family deductible must be met for the HSA plan of benefits to apply; there is no individual limit within the family deductible Dental Plans Description Deductible Coinsurance4

Dental Maintenance Organization (DMO®)2 • Network of Dentists • Must elect primary care dentist • No annual limit

No deductible

Preventive 100% Basic 90% Restorative 60% Orthodontics 75% (no lifetime maximum)

Description In-Network Deductible4 In-Network Coinsurance4

Dental PPO

• In-network and out-of-network coverage

• Annual Dental benefit max $2,000 • Lifetime Ortho maximum $2,000

($1,500 out-of-network)

Individual $ 50/year Family $150/year

Preventive 100% Basic 80% Restorative 60% Orthodontics 60% (50% out-of-network)

Vision Plan Description

Aetna Vision PreferredSM • Coverage for frames, lenses and contact lenses • Discounts on LASIK and additional pairs of glasses

2 As available in various areas 3 Available only if located outside a network area 4 Out-of-network benefits will be lower


OPTIONAL BENEFITS (continued)

Flexible Spending Accounts Annual Minimum Annual Maximum

Health Care $120 $2,500

Dependent Care $120 $5,000

Aetna Commuter Benefits Monthly Minimum Monthly Maximum

Transit $10 $125

Parking $10 $240 Life Insurance Description

Employee Supplemental Term Life Insurance5 1x to 5x eligible pay, up to maximum benefit of $3,000,000

Spouse/Partner Life Insurance5 $10,000 to $100,000 in $10,000 increments

Child(ren) Term Life $5,000; $10,000 or $15,000 Accidental Death & Personal Loss (AD&PL) Description

Employee 1x to 5x eligible pay to a maximum of $2,000,000

Dependent • Spouse/ Partner: 50% of employee’s optional AD&PL • Spouse/ Partner and Child(ren): 40% of employee’s optional AD&PL for spouse/partner and 5%

for each child • Child(ren) only: 25% of employee’s optional AD&PL for each child

Optional Long-Term Disability Description

Optional Long-Term disability • Additional 10% of eligible pay (taxable benefit) • Up to a monthly benefit maximum of $15,000

5 Some restrictions apply



Wealth Accumulation Description

Aetna 401(k) Plan6 Aetna Affiliate 401(k) Plan7

• Regular full-time and part-time employees and individuals employed by Aetna as temporary employees are eligible to participate

• Immediate eligibility for employee contributions • Company matching contributions

Employee Stock Purchase Plan • Discount off fair market value

Employee Tuition Assistance • $5,000 toward degree programs • $2,500 toward non-degree college course • Must be full time (40 hours) for $5,000 cap, otherwise $2,500 cap applies

Financial Education Programs • Onsite workshops and live webinars • No cost for one-on-one financial planning with certified financial planners from Financial Finesse • Full suite of tools and resources on the Financial Wellness Works website

Aetna Voluntary Benefit Plans (available through Aetna Benefits Advisor Marketplace) Description

Voluntary Hospital Plan

• Provides financial protection from out-of-pocket expenses associated with a medically necessary hospital admission

• The plan pays cash benefits directly to the participant to help pay for out-of-pocket medical expenses incurred during the hospital stay, including deductibles, day care costs, mortgage payments and other living expenses

• Benefit premiums are automatic – there are no claims forms to submit if you are enrolled in an Aetna medical plan

• Premiums are paid 100% by the employee through payroll deduction

Critical Illness Insurance Plan

• Pays cash benefits when the member or covered family member is diagnosed with a serious illness (such as heart attack, stroke or cancer)

• The plan helps pay out-of-pocket expenses associated with treatment and costs of living (such as rent, mortgage or day care costs)

• Benefits are paid directly to the participant in addition to any other medical coverage • Premiums are paid 100% by the employee through payroll deduction

Accident Insurance Plan

• Assists in covering out-of-pocket expenses associated with an accidental injury (such as dislocations, fractures and burns)

• The plan can also help protect your savings should an on- or off-the-job accidental injury occur • Benefits are paid directly to the participant in addition to any other medical coverage • Premiums are paid 100% by the employee through payroll deduction

6 In general, U.S. employees employed by Aetna or a participating company are eligible to participate in the Aetna 401(k) Plan. Meritain Health, Inc., ScripWorld, LLC and American Health Holding, Inc. (Prodigy) is not a participating company.

7 Employees of Prodigy companies are eligible to participate in the Aetna Affiliate 401(k) Plan.



Wellness & Incentive Programs Description

Healthy Lifestyles incentive program

• Earn up to $500 for employee and an additional $500 for family members • All benefits-eligible employees may participate, regardless of medical plan coverage • Incentives provided for:

• Tracking physical activity and healthy eating habits • Making progress in certain disease management programs (members only) • Completing 3 activities on the Member Health Engagement Plan (members only) • Completing a financial assessment and participating in a financial education class or

financial planning session offered through Aetna’s financial wellness program.

Medical Plan premium credits

• Medical plan premium credits are available to employees and their covered spouse/partner who are in an Aetna employee medical plan

• Credits available for: • Being in range for at least 3 of 5 metabolic syndrome risk factors; and • Being a non-tobacco user

Wellness Reimbursement Program • Up to $200 reimbursement for certain wellness expenses such as: gym memberships, exercise classes, fitness equipment, etc.

Adoption Assistance Program • Maximum $5,000 reimbursement for adoption expenses • Available to all benefits-eligible employees


Medical Plan Premium Credits Aetna currently offers two programs that you and your spouse/partner – if he/she is covered under your Aetna medical plan – can participate in that may allow you to earn premium credits on your 2013 medical plan contributions. One premium credit can be earned for each of the following: • You have not used tobacco products in the past 12 months and you complete the online attestation when you enroll in 2013 medical benefits • Your spouse/partner has not used tobacco products in the past 12 months and you complete the online attestation when you enroll in 2013 medical benefits • You participate in the voluntary metabolic syndrome testing for all five risk factors and your results show that you are in-range for at least three of the five risk factors • Your spouse/partner participates in the voluntary metabolic syndrome testing for all five risk factors and the results show that they are in-range for at least three of the five risk factors

Each premium credit earned is equal to $12.50 on a semi-monthly basis. You can earn up to two premium credits, and your spouse/partner – if he/she is covered under your Aetna medical plan – can earn up to an additional two premium credits. For more information on medical plan premium credits, refer to AccessHR. 2013 MEDICAL PLANS

Semi-Monthly Employee Contributions – Medical Plans

Medical Plans Premium Credits Earned

Annual Salary of less than $30,000 Annual Salary equal to $30,000 and less than $45,000

Annual Salary equal to $45,000 and less than $60,000

Employee Employee + Child(ren)

Employee + Spouse/Partner

Employee + Family Employee Employee +

Child(ren) Employee +

Spouse/Partner Employee +

Family Employee Employee + Child(ren)


Employee + Family

HSA 80 Plus

0 1 2 3 4

$25.00 $12.50 $ 0.00

N/A N/A

$37.70 $25.20 $12.70

N/A N/A

$75.40 $62.90 $50.40 $37.90 $25.40

$88.10 $75.60 $63.10 $50.60 $38.10

$25.00 $12.50 $ 0.00

N/A N/A

$37.70 $25.20 $12.70

N/A N/A

$75.40 $62.90 $50.40 $37.90 $25.40

$88.10 $75.60 $63.10 $50.60 $38.10

$45.86 $33.36 $20.86

N/A N/A

$69.75 $57.25 $44.75

N/A N/A

$118.10 $105.60 $ 93.10 $ 80.60 $ 68.10

$141.50 $129.00 $116.50 $104.00 $ 91.50

HSA 80

0 1 2 3 4

$25.00 $12.50 $ 0.00

N/A N/A

$36.43 $23.93 $11.43

N/A N/A

$72.86 $60.36 $47.86 $35.36 $22.86

$84.29 $71.79 $59.29 $46.79 $34.29

$25.00 $12.50 $ 0.00

N/A N/A

$36.43 $23.93 $11.43

N/A N/A

$72.86 $60.36 $47.86 $35.36 $22.86

$84.29 $71.79 $59.29 $46.79 $34.29

$40.64 $28.14 $15.64

N/A N/A

$58.56 $46.06 $33.56

N/A N/A

$101.07 $ 88.57 $ 76.07 $ 63.57 $ 51.07

$118.62 $106.12 $ 93.62 $ 81.12 $ 68.62

HRA 80 Plus

0 1 2 3 4

$40.25 $27.75 $15.25

N/A N/A

$61.15 $48.65 $36.15

N/A N/A

$107.05 $ 94.55 $ 82.05 $ 69.55 $ 57.05

$127.90 $115.40 $102.90 $ 90.40 $ 77.90

$45.45 $32.95 $20.45

N/A N/A

$68.95 $56.45 $43.95

N/A N/A

$117.40 $104.90 $ 92.40 $ 79.90 $ 67.40

$140.90 $128.40 $115.90 $103.40 $ 90.90

$56.55 $44.05 $31.55

N/A N/A

$85.60 $73.10 $60.60

N/A N/A

$139.65 $127.15 $114.65 $102.15 $ 89.65

$168.65 $156.15 $143.65 $131.15 $118.65

HRA 80

0 1 2 3 4

$32.25 $19.75 $7.25

N/A N/A

$48.70 $36.20 $23.70

N/A N/A

$90.15 $77.65 $65.15 $52.65 $40.15

$106.60 $ 94.10 $ 81.60 $ 69.10 $ 56.60

$37.45 $24.95 $12.45

N/A N/A

$56.50 $44.00 $31.50

N/A N/A

$100.55 $ 88.05 $ 75.55 $ 63.05 $ 50.55

$119.60 $107.10 $ 94.60 $ 82.10 $ 69.90

$48.55 $36.05 $23.55

N/A N/A

$73.15 $60.65 $48,15

N/A N/A

$122.75 $110.25 $ 97.75 $ 85.25 $ 72.75

$147.35 $134.85 $122.35 $109.85 $ 97.35

Indemnity HSA 80

0 1 2 3 4

$25.00 $12.50 $ 0.00

N/A N/A

$46.42 $33.92 $21.42

N/A N/A

$92.91 $80.41 $67.91 $55.41 $42.91

$114.34 $101.84 $ 89.34 $ 76.84 $ 64.34

$25.00 $12.50 $ 0.00

N/A N/A

$46.42 $33.92 $21.42

N/A N/A

$92.91 $80.41 $67.91 $55.41 $42.91

$114.34 $101.84 $ 89.34 $ 76.84 $ 64.34

$51.72 $39.22 $26.72

N/A N/A

$87.96 $75.46 $62.96

N/A N/A

$149.25 $136.75 $124.25 $111.75 $ 99.25

$184.75 $172.25 $159.75 $147.25 $134.75

HRA 80 Out-of-Network

0 1 2 3 4

$28.15 $15.65 $ 3.15

N/A N/A

$43.00 $30.50

$ 18.00 N/A N/A

$82.85 $70.35 $57.85 $45.35 $32.85

$ 97.75 $ 85.25 $ 72.75 $ 60.25 $ 47.75

$33.65 $21.15 $ 8.65

N/A N/A

$51.25 $38.75 $26.25

N/A N/A

$93.85 $81.35 $68.85 $56.35 $43.85

$111.50 $ 99.00 $ 86.50 $ 74.00 $ 61.50

$45.40 $32.90 $20.14

N/A N/A

$68.85 $56.35 $43.85

N/A N/A

$117.35 $104.85 $ 92.35 $ 79.85 $ 67.35

$140.90 $128.40 $115.90 $103.40 $ 90.90


2013 Medical Plans (continued)

Semi-Monthly Employee Contributions – Medical Plans

Medical Plan Premium Credits Earned

Annual Salary equal to $60,000 and less than $90,000

Annual Salary equal to or more than $90,000 and less than $150,000

Annual Salary equal to or more than $150,000

Employee Employee + Child(ren)


Employee + Family Employee Employee +

Child(ren) Employee +

Spouse/Partner Employee +

Family Employee Employee + Child(ren)


Employee + Family

HSA 80 Plus

0 1 2 3 4

$50.95 $38.45 $25.95

N/A N/A

$76.65 $64.15 $51.65

N/A N/A

$127.30 $114.80 $102.30 $ 89.80 $ 77.30

$153.00 $140.50 $128.00 $115.50 $103.00

$69.22 $56.72 $44.22

N/A N/A

$107.95 $95.45 $82.95

N/A N/A

$169.10 $156.60 $144.10 $131.60 $119.10

$205.20 $192.70 $180.20 $167.70 $155.20

$97.95 $85.45 $72.95

N/A N/A

$147.10 $134.60 $122.10

N/A N/A

$221.30 $208.80 $196.30 $183.80 $171.30

$270.45 $257.95 $245.45 $232.95 $220.45

HSA 80

0 1 2 3 4

$44.46 $31.96 $19.46

N/A N/A

$63.74 $51.24 $38.74

N/A N/A

$107.97 $ 95.47 $ 82.97 $ 70.47 $ 57.97

$127.25 $114.75 $102.25 $ 89.75 $ 77.25

$58.16 $45.66 $33.16

N/A N/A

$87.21 $74.71 $62.21

N/A N/A

$139.32 $126.82 $114.32 $101.82 $ 89.32

$166.40 $153.90 $141.40 $128.90 $116.40

$79.71 $67.21 $54.71

N/A N/A

$116.57 $104.07 $ 91.57

N/A N/A

$178.47 $165.97 $153.47 $140.97 $128.47

$215.34 $202.84 $190.34 $177.84 $165.34

HRA 80 Plus

0 1 2 3 4

$61.15 $48.65 $36.15

N/A N/A

$92.50 $80.00 $67.50

N/A N/A

$148.80 $136.30 $123.80 $111.30 $ 98.80

$180.15 $167.65 $155.15 $142.65 $130.15

$82.05 $69.55 $57.05

N/A N/A

$123.85 $111.35 $ 98.85

N/A N/A

$190.60 $178.10 $165.60 $153.10 $140.60

$232.40 $219.90 $207.40 $194.90 $182.40

$108.15 $ 95.65 $ 83.15

N/A N/A

$163.00 $150.50 $138.00

N/A N/A

$242.85 $230.35 $217.85 $205.35 $192.85

$297.65 $285.15 $272.65 $260.15 $247.65

HRA 80

0 1 2 3 4

$53.15 $40.65 $28.15

N/A N/A

$80.05 $67.55 $55.05

N/A N/A

$131.95 $119.45 $106.95 $ 94.45 $ 81.95

$158.85 $146.35 $133.85 $121.35 $108.85

$74.05 $61.55 $49.05

N/A N/A

$111.40 $ 98.90 $ 86.40

N/A N/A

$173.75 $161.25 $148.75 $136.25 $123.75

$211.10 $198.60 $186.10 $173.60 $161.10

$100.15 $87.65 $75.15

N/A N/A

$150.55 $138.05 $125.55

N/A N/A

$225.95 $213.45 $200.95 $188.45 $175.95

$276.35 $263.85 $251.35 $238.85 $226.35

Indemnity HSA 80

0 1 2 3 4

$59.36 $46.86 $34.36

N/A N/A

$99.40 $86.90 $74.40

N/A N/A

$164.55 $152.05 $139.55 $127.05 $114.55

$204.39 $191.89 $179.39 $166.89 $154.39

$81.61 $69.11 $56.61

N/A N/A

$133.38 $120.88 $108.38

N/A N/A

$210.12 $197.62 $185.12 $172.62 $160.12

$261.79 $249.29 $236.79 $224.29 $211.79

$122.61 $110.11 $ 97.61

N/A N/A

$194.86 $182.36 $169.86

N/A N/A

$292.10 $279.60 $267.10 $254.60 $242.10

$364.35 $351.85 $339.35 $326.85 $314.35

HRA 80 Out-of-Network

0 1 2 3 4

$50.25 $37.75 $25.25

N/A N/A

$76.15 $63.65 $51.15

N/A N/A

$127.05 $114.55 $102.05 $ 89.55 $ 77.05

$153.00 $140.50 $128.00 $115.50 $103.00

$72.35 $59.85 $47.35

N/A N/A

$109.30 $ 96.80 $ 84.30

N/A N/A

$171.30 $158.80 $146.30 $133.80 $121.30

$208.25 $195.75 $183.25 $170.75 $158.25

$ 99.95 $ 87.45 $ 74.95

N/A N/A

$150.70 $138.20 $125.70

N/A N/A

$226.45 $213.95 $201.45 $188.95 $176.45

$277.25 $264.75 $252.25 $239.75 $227.25


2013 DENTAL PLANS

Semi-Monthly Employee Contributions – Dental Plans

Dental Plans Coverage Options

Employee Employee & Child(ren) Employee & Spouse/Partner Employee & Family

Dental Maintenance Organization (DMO) $6.75 $10.45 $14.10 $17.80

Dental PPO $15.05 $23.15 $31.25 $39.35

Dental Plan of ND and SC $15.05 $23.15 $31.25 $39.35

2013 VISION PLAN

Semi-Monthly Employee Contributions – Vision Plan Vision Plan Coverage Options


Aetna Vision PreferredSM $1.82 $3.63 $3.45 $5.35


2013 LIFE INSURANCE, AD&PL and LONG-TERM DISABILITY

Employee Supplemental Term Life Insurance

Options Monthly Employee Rates (per $1,000 of coverage)* 1x to 5x eligible pay

Age <24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+

Tobacco $0.060 $0.060 $0.080 $0.090 $0.126 $0.227 $0.381 $0.599 $0.948 $1.701 $2.884 Non-tobacco $0.041 $0.048 $0.064 $0.072 $0.080 $0.135 $0.207 $0.387 $0.594 $1.118 $1.854 *Monthly cost = Eligible Pay Rounded to the next $1,000 X Multiple of Eligible Pay (1,2,3,4 or 5) = _________ / $1,000 = _________ X Monthly Employee Rate above

Spouse/Partner Supplemental Term Life Insurance

Options Monthly Employee Rates (per $1,000 of coverage) $10,000 to $100,000**

Age <24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+

Tobacco $0.07 $0.07 $0.09 $0.12 $0.17 $0.29 $0.49 $0.78 $1.23 $2.22 $3.97 Non-tobacco $0.05 $0.06 $0.08 $0.09 $0.12 $0.22 $0.33 $0.54 $0.85 $1.53 $2.76 **increments of $10,000 only

Child Term Life Insurance

Options Monthly Employee Rate

$5,000 $0.54

$10,000 $1.08

$15,000 $1.62

Accidental Death and Personal Loss (AD&PL) Insurance

Options Monthly Employee Rate (per $1,000 of coverage)

1x to 5x eligible pay

($2,000,000 maximum)

Employee $0.016

Employee and Spouse/ Partner $0.032

Employee and Child(ren) $0.024

Employee, Spouse/ Partner and Child(ren) $0.032

Long-Term Disability (LTD) Insurance

Additional Options Monthly Employee Rates ***

10% taxable benefit

Age <24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+

$0.061 $0.074 $0.101 $0.118 $0.170 $0.236 $0.323 $0.380 $0.432 $0.362 *** Monthly cost = Eligible pay ÷ 12 = _______ ÷ 100 = _______ x Monthly Employee Rate above

COMPANY-PAID BENEFITS1

Paid Time Off (PTO) & Holidays Long-Term Disability (LTD)

Life Insurance Adoption Assistance Program

Business Travel Accident Insurance Employee Work/Life Assistance Program

Short-Term Disability (STD) Employee Assistance Program

OPTIONAL BENEFITS1

Aetna 2014 Benefits and Rates-at-a-Glance for Regular U.S. Employees (working 20 hours or more per week)

Medical Plans

Open Access Select HSA 80

HealthFund HSA 80

HealthFund HRA 80

Whole Health HSA 80 (Houston, TX & Phoenix, AZ)

HealthFund HRA 80 Out-of-Network

Dental Plans

Dental Maintenance Organization (DMO®)

Dental PPO

Dental Plan of ND and SC

Vision Benefits

Aetna Vision PreferredSM

Flexible Spending Accounts

Health Care

Dependent Care

Aetna Commuter Benefit

Parking

Mass Transit

Life Insurance

Employee Supplemental Term Life Insurance

Spouse/Partner Supplemental Term Life Insurance

Child Term Life Insurance

Accidental Death & Personal Loss (AD&PL) Insurance

Employee Accidental Death & Personal Loss Insurance

Spouse/Partner Accidental Death & Personal Loss Insurance

Employee & Child(ren) Accidental Death & Personal Loss Insurance

Employee, Spouse/Partner & Child(ren) Accidental Death & Personal Loss Insurance

Optional Long-Term Disability Insurance

10% Taxable Benefit

Financial Benefits

401(k) Plan

Employee Stock Purchase Plan

Employee Tuition Assistance Program

Financial Education Programs

Aetna Voluntary Benefit Plan

Voluntary Hospital Plan

Critical Illness Plan

Accident Insurance Plan

Identity Theft Protection

Legal Plan

Wellness & Incentive Programs

Healthy Lifestyles Incentive Program

Medical Plan Premium Credits

Wellness Reimbursement Program

Financial Wellness Program

Welvie Surgical Review Incentive

Employee Discount Program

1In general, U.S. employees employed by Aetna or a participating company are eligible to participate in these benefit plans.

COMPANY PAID BENEFITS

Paid Time Off (PTO) & Holidays Description

• PTO: 18 to 28 days based on length of service (prorated if less than full-time)

• Holidays: 8 company paid holidays


• 1x eligible pay. If eligible pay is over $50,000, employees can elect to cap life insurance at $50,000. Plan minimum is $10,000.

Business Travel Accident Insurance Description

• An amount equal to the greater of $50,000 or 3x eligible pay to a maximum of $1,000,000

Short-Term Disability (STD) Description

• For new hires, benefit becomes effective on the 1st day of the month following 60-day waiting period

• One week waiting period before STD benefits are payable

• Up to 12 weeks of pay at 80% of base pay; and then up to 13 weeks of pay at 60% of base pay, if short-term disabilitybenefits continue to be approved

Long-Term Disability (LTD) Description

• For new hires, benefit becomes effective on the 1st day of the month following 60-day waiting period

• 26-week waiting period before LTD benefits are payable

• 50% of eligible pay (taxable benefit), up to a monthly maximum benefit of $15,000

Adoption Assistance Program Description

• Maximum $5,000 reimbursement for adoption expenses

• Available to all benefits-eligible employees

Employee Work/Life Assistance Program Description

• Offers a wide range of support services such as confidential counselling services, resources for elder care, child care, legal and financial matters, web-based information and more

Employee Assistance Program Description

• Up to 5 confidential counseling sessions for each household member


OPTIONAL BENEFITS (shared cost or employee paid)

100% coverage for in-network preventive care and an in-network, preventive eye exam every calendar year for all medical plans

Telephone consults available 24/7 through the Teladoc® networkMedical Plans2

Aetna Performance Network and Aexcel® offered in certain locations

Aetna Whole Health HSA plans (Accountable Care Organizations) offered in Houston, TX and Phoenix, AZ only

Employer Contribution* Deductible** Coinsurance4

Open Access Select HSA 80 Individual: $400/Family: $800 Individual: $1,300/Family: $2,600 80% (in-network)

HealthFund HSA 80 Individual: $400/Family: $800 Individual: $1,600/Family: $3,200 80% (in-network)

HealthFund HRA 80 Individual: $400/Family: $800 Individual: $1,600/Family: $3,200 80% (in-network)

Whole Health HSA 80 (Houston, TX & Phoenix, AZ) Individual: $400/Family: $800 Individual: $1,300/Family: $2,600 80% (in-network)

HRA 80 Out-of-Network3 Individual: $400/Family: $800 Individual: $1,300/Family: $2,600 80%

*The employer contribution to the HRA Fund or HSA is prorated for mid-year entry into a plan

**The full family deductible must be met for the HSA plan of benefits to apply; there is no individual limit within the family deductible2As available in various areas3Available only if located outside a network area4Out-of-network benefits will be lower

Dental Plans

Description Deductible Coinsurance4

Dental Maintenance • Network of dentists No deductible Preventive 100%Organization (DMO®)2 • Must elect primary care dentist Basic 90%

• No annual limit Restorative 60%Orthodontics 75% (no lifetime maximum)

Description In-Network Out-of-Network In-Network Out-of NetworkDeductible4 Deductible Coinsurance4 Coinsurance

Dental PPO • In-network and out-of-network coverage Individual $50/yr Individual $100/yr Preventive 100% Preventive 100%• Annual dental benefit maximum $2,000 Family $150/yr Family $300/yr Basic 80% Basic 60%• Lifetime orthodontic maximum $2,000 Restorative 60% Restorative 50%

($1,500 out-of-network) Orthodontics 60% Orthodontics 50%

Dental Plan of ND and SC • In-network and out-of-network coverage Individual $50/yr Individual $50/yr Preventive 100% Preventive 100%• Annual dental benefit maximum $2,000 Family $150/yr Family $150/yr Basic 80% Basic 80%• Lifetime orthodontic maximum $2,000 Restorative 60% Restorative 60%

Orthodontics 60% Orthodontics 60%

2As available in various areas4Out-of-network benefits will be lower



Vision Plan Description

Aetna Vision PreferredSM • Coverage for frames, lenses and contact lenses• Discounts on LASIK and additional pairs of glasses

Flexible Spending Accounts Annual Minimum Annual Maximum

Health Care $120 $2,500Dependent Care $120 $5,000

Aetna Commuter Benefits Monthly Minimum Monthly Maximum

Transit $10 $245Parking $10 $245


Employee Supplemental Term Life Insurance5 1x to 6x eligible pay, up to maximum benefit of $3,000,000

Spouse/Partner Life Insurance5 $10,000 to $100,000 in $10,000 increments, $150,000, $250,000

Child(ren) Term Life $10,000, $15,000 or $20,000

5Some restrictions apply

Accidental Death & Personal Loss (AD&PL) Description

Employee 1x to 6x eligible pay to a maximum of $2,000,000

Dependent • Spouse/Partner: 50% of employee’s optional AD&PL• Spouse/Partner and Child(ren): 40% of employee’s optional AD&PL for spouse/partner and 5% for each child• Child(ren) only: 25% of employee’s optional AD&PL for each child

Optional Long-Term Disability Description

Optional Long-Term Disability • For new hires, benefit becomes effective on the 1st day of the month following 60-day waiting period• Additional 10% of eligible pay (taxable benefit) • Up to a monthly benefit maximum of $15,000



Financial Benefits Description

Aetna 401(k) Plan6 • Regular full-time and part-time employees and individuals employed by Aetna as temporary employees are eligibleto participate

Aetna Affiliate 401(k) Plan7 • Immediate eligibility for employee contributions• Company matching contributions

Employee Stock Purchase Plan • Discount off fair market value

Employee Tuition Assistance • $5,000 toward degree programs• $2,500 toward non-degree college course• Must be full time (40 hours) for $5,000 cap, otherwise $2,500 cap applies

Financial Education Programs • Onsite workshops and live webinars• No cost for one-on-one consultations with a retirement specialist or a certified financial planner• Full suite of tools and resources on the Financial Wellness Works website

6In general, U.S. employees employed by Aetna or a participating company are eligible to participate in the Aetna 401(k) Plan. Meritain Health, Inc., ScripWorld, LLC and American Health Holding, Inc. (Prodigy) are not

participating companies.

7Employees of Prodigy companies are eligible to participate in the Aetna Affiliate 401(k) Plan.

Aetna Voluntary Benefit Plans Description

(available through Aetna Benefits Advisor Marketplace)

Voluntary Hospital Plan • Provides financial protection from out-of-pocket expenses associated with a medically necessary hospital admission• The plan pays cash benefits directly to the participant to help pay for out-of-pocket medical expenses incurred

during the hospital stay, including deductibles, day care costs, mortgage payments and other living expenses• Benefit premiums are automatic — there are no claims forms to submit if you are enrolled in an Aetna medical plan• Premiums are paid 100% by the employee through payroll deduction

Critical Illness Insurance Plan • Pays cash benefits when the member or covered family member is diagnosed with a serious illness (such as heart attack, stroke or cancer)

• The plan helps pay out-of-pocket expenses associated with treatment and costs of living (such as rent, mortgage or day care costs)

• Benefits are paid directly to the participant in addition to any other medical coverage• Premiums are paid 100% by the employee through payroll deduction

Accident Insurance Plan • Assists in covering out-of-pocket expenses associated with an accidental injury (such as dislocations, fractures and burns)

• The plan can also help protect your savings should an on- or off-the-job accidental injury occur• Benefits are paid directly to the participant in addition to any other medical coverage• Premiums are paid 100% by the employee through payroll deduction

Identity Theft Protection • Two levels of protection for personal information1. Identity Theft Protection— proactively safeguards personal information and send alerts of potential threats.2. Ultimate — most comprehensive identity theft protection service and includes monitoring of new and existing

checking and savings accounts.• Premiums are paid 100% by the employee through payroll deduction



Legal Plan Description

(available through Hyatt)

Legal Plan • Provides a wide range of legal advice and fully covered legal services for employee and eligible dependents. • The plan has a national network of over 12,000 attorneys. If a network attorney is used, covered legal services are

provided with no additional attorney fees. If a non-plan attorney is used, the plan will pay fees as determined by the plan’s fee schedule.

• Locate plan attorneys and legal information on Hyatt Legal Plan’s website on info.legalplans.com and enter the password “6090137” under the heading “Thinking about Enrolling,” or call 1-800-821-6400.

• Premiums are paid 100% by the employee through payroll deduction

Wellness & Incentive Programs Description

Healthy Lifestyles Incentive Program • Earn up to $500 for employee and an additional $500 for family members• Incentives are paid based on medical plan selection:

� If you have an HRA plan, incentives are paid into the HealthFund� If you have an HSA plan, you will elect if you want your incentives paid into your HSA account or paycheck

(taxes apply) during annual enrollment (default is HSA)� If you have waived medical coverage, you will receive your incentives in your paycheck (taxes apply)

• All benefits-eligible employees may participate, regardless of medical plan coverage• Incentives provided for:

� Tracking physical activity, healthy eating habits and other activities related to well-being� Completing three sessions with a Healthy Lifestyle Coach� Completing a financial assessment and participating in a financial education class or financial planning session � offered through Aetna’s financial wellness program

Medical Plan Premium Credits • Medical plan premium credits are available to employees and their covered spouse/partner who are in an Aetna employee medical plan

• Up to $600 in credits available for each covered employee and spouse/partner for:� Being in range for at least 3 of 5 metabolic syndrome risk factors, or, if not in range, completing an alternative

wellness program in 2014 (newly hired employees only need to participate in testing); and� Being a non-tobacco user

Wellness Reimbursement Program • Up to $200 reimbursement for certain wellness expenses such as: gym memberships, exercise classes, fitness equipment, pedometers/devices, etc.

Financial Wellness Program • A financial wellness website full of information and tips on maintaining good financial health

Welvie Incentive • A tool that helps you decide if you need elective surgery • Provides guidance on how to talk to your doctor about and possible alternatives to consider before actually

electing surgery • Earn a $25 incentive if you use the tool and complete a survey, whether or not you choose to elect surgery

Employee Discount Program • There are a number of discounts that are available to you as an Aetna employee


Medical Plan Premium Credits

Aetna currently offers two programs that you and your spouse/partner — if he/she is covered under your Aetna medical plan — can participate in that may allow you to earn premium credits on your2014 medical plan contributions.

Premium credits can be earned for each of the following:

• You and/or your spouse/partner have not used tobacco products in the past 12 months and you complete the online attestation

• You and/or your spouse/partner participate in the voluntary metabolic syndrome testing for all five risk factors and your results show that you are in range for at least three of the five risk factors

(Newly hired/eligible employees and their spouse/partner only need to participate in the voluntary metabolic syndrome testing program to receive credit for their first year in the medical plan)

Each premium credit earned is equal to $12.50 on a semi-monthly basis. You can earn up to two premium credits, and your spouse/partner — if he/she is covered under your Aetna medical plan — canearn up to an additional two premium credits. For more information on medical plan premium credits, refer to AccessHR.

2014 MEDICAL PLAN RATES

Semi-Monthly Employee Contributions — Medical Plans

Annual Salary of less than $45,000 Annual Salary equal to $45,000 and less than $60,000

Medical Plans Premium Employee Employee + Employee + Employee + Employee + Employee + Employee + Credits Child(ren) Spouse/Partner Family Employee Child(ren) Spouse/Partner FamilyEarned

Select HSA 0 $44.60 $68.70 $117.80 $141.90 $57.75 $88.40 $144.10 $174.751 $32.10 $56.20 $105.30 $129.40 $45.25 $75.90 $131.60 $162.252 $19.60 $43.70 $92.80 $116.90 $32.75 $63.40 $119.10 $149.753 N/A N/A $80.30 $104.40 N/A N/A $106.60 $137.254 N/A N/A $67.80 $91.90 N/A N/A $94.10 $124.75

HSA 80 0 $25.00 $38.05 $76.10 $89.10 $34.65 $52.55 $95.40 $113.251 $12.50 $25.55 $63.60 $76.60 $22.15 $40.05 $82.90 $100.752 $0.00 $13.05 $51.10 $64.10 $9.65 $27.55 $70.40 $88.253 N/A N/A $38.60 $51.60 N/A N/A $57.90 $75.754 N/A N/A $26.10 $39.10 N/A N/A $45.40 $63.25

HRA 80 0 $32.00 $49.05 $91.15 $108.25 $45.15 $68.80 $117.45 $141.151 $19.50 $36.55 $78.65 $95.75 $32.65 $56.30 $104.95 $128.652 $7.00 $24.05 $66.15 $83.25 $20.15 $43.80 $92.45 $116.153 N/A N/A $53.65 $70.75 N/A N/A $79.95 $103.654 N/A N/A $41.15 $58.25 N/A N/A $67.45 $91.15

Whole Health 0 $27.50 $41.80 $81.10 $95.35 $37.15 $56.30 $100.40 $119.50HSA 80 plans 1 $15.00 $29.30 $68.60 $82.85 $26.65 $43.80 $87.90 $107.00

2 $2.50 $16.80 $56.10 $70.35 $12.15 $31.30 $75.40 $94.503 N/A N/A $43.60 $57.85 N/A N/A $62.90 $82.004 N/A N/A $31.10 $45.35 N/A N/A $50.40 $69.50

HRA 80 0 $28.25 $43.55 $83.85 $99.20 $41.65 $63.65 $110.65 $132.65Out-of-Network 1 $15.75 $31.05 $71.35 $86.70 $29.15 $51.15 $98.15 $120.15






Annual Salary equal to Annual Salary equal to or more than$60,000 and less than $90,000 $90,000 and less than $150,000

Medical Plans Premium Employee Employee + Employee + Employee + Employee + Employee + Employee + Credits Child(ren) Spouse/Partner Family Employee Child(ren) Spouse/Partner FamilyEarned

Select HSA 0 $62.70 $95.85 $154.00 $187.15 $85.35 $129.80 $199.30 $243.751 $50.20 $83.35 $141.50 $174.65 $72.85 $117.30 $186.80 $231.252 $37.70 $70.85 $129.00 $162.15 $60.35 $104.80 $174.30 $218.753 N/A N/A $116.50 $149.65 N/A N/A $161.80 $206.254 N/A N/A $104.00 $137.15 N/A N/A $149.30 $193.75

HSA 80 0 $39.60 $60.00 $105.30 $125.65 $62.25 $93.95 $150.60 $182.251 $27.10 $47.50 $92.80 $113.15 $49.75 $81.45 $138.10 $169.752 $14.60 $35.00 $80.30 $100.65 $37.25 $68.95 $125.60 $157.253 N/A N/A $67.80 $88.15 N/A N/A $113.10 $144.754 N/A N/A $55.30 $75.65 N/A N/A $100.60 $132.25

HRA 80 0 $50.10 $76.20 $127.35 $153.50 $72.75 $110.20 $172.65 $210.151 $37.60 $63.70 $114.85 $141.00 $60.25 $97.70 $160.15 $197.652 $25.10 $51.20 $102.35 $128.50 $47.75 $85.20 $147.65 $185.153 N/A N/A $89.85 $116.00 N/A N/A $135.15 $172.654 N/A N/A $77.35 $103.50 N/A N/A $122.65 $160.15

Whole Health 0 $42.10 $63.75 $110.30 $131.90 $64.75 $97.70 $155.60 $188.50HSA 80 plans 1 $29.60 $51.25 $97.80 $119.40 $52.25 $85.20 $143.10 $176.00


HRA 80 0 $46.70 $71.20 $120.75 $145.25 $69.80 $105.85 $166.95 $230.00Out-of-Network 1 $34.20 $58.70 $108.25 $132.75 $57.30 $93.35 $154.45 $190.50





Annual Salary equal toor more than $150,000

Medical Plans Premium Employee Employee + Employee + Employee + Credits Child(ren) Spouse/Partner FamilyEarned

Select HSA 0 $113.65 $172.25 $255.90 $314.501 $101.15 $159.75 $243.40 $302.002 $88.65 $147.25 $230.90 $289.503 N/A N/A $218.40 $277.004 N/A N/A $205.90 $264.50

HSA 80 0 $90.55 $136.40 $207.20 $253.001 $78.05 $123.90 $194.70 $240.502 $65.55 $111.40 $182.20 $228.003 N/A N/A $169.70 $215.504 N/A N/A $157.20 $203.00

HRA 80 0 $101.05 $152.60 $229.25 $280.851 $88.55 $140.10 $216.75 $268.352 $76.05 $127.60 $204.25 $255.853 N/A N/A $191.75 $243.354 N/A N/A $179.25 $230.85

Whole Health 0 $93.05 $140.15 $212.20 $259.25HSA 80 plans 1 $80.55 $127.65 $199.70 $246.75

2 $68.05 $115.15 $187.20 $234.253 N/A N/A $174.70 $221.754 N/A N/A $162.20 $209.25

HRA 80 0 $98.65 $149.15 $224.65 $275.15Out-of-Network 1 $86.15 $136.65 $212.15 $262.65

2 $73.65 $124.15 $199.65 $250.153 N/A N/A $187.15 $237.654 N/A N/A $174.65 $225.15


2014 DENTAL PLAN RATES

Semi-Monthly Employee Contributions — Dental Plans

Dental Plans Coverage Options


Dental Maintenance Organization (DMO) $5.80 $9.05 $12.25 $15.45

Dental PPO $12.60 $19.45 $26.30 $33.20

Dental Plan of ND and SC $12.60 $19.45 $26.30 $33.20

2014 VISION PLAN RATES

Semi-Monthly Employee Contributions — Vision Plan

Vision Plan Coverage Options


Aetna Vision PreferredSM $2.40 $4.78 $4.54 $7.05

2014 LEGAL BENEFIT RATE

Employee Monthly Rate

Legal Benefit $15.60

2014 LIFE INSURANCE, AD&PL and LONG-TERM DISABILITY RATES

Options Monthly Employee Rates (per $1,000 of coverage)*

1x to 6x eligible pay Age

<24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+

Tobacco $0.060 $0.060 $0.080 $0.090 $0.126 $0.227 $0.381 $0.599 $0.948 $1.701 $2.884

Non-tobacco $0.041 $0.048 $0.064 $0.072 $0.080 $0.135 $0.207 $0.387 $0.594 $1.118 $1.854

*Monthly cost = Eligible Pay Rounded to the next $1,000 X Multiple of Eligible Pay (1, 2, 3, 4, 5 or 6) = _________ / $1,000 = _________ X Monthly Employee Rate above

Options Monthly Employee Rates (per $1,000 of coverage)

$10,000 to $250,000** Age

<24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+

Tobacco $0.07 $0.07 $0.09 $0.12 $0.17 $0.29 $0.49 $0.78 $1.23 $2.22 $3.97

Non-tobacco $0.05 $0.06 $0.08 $0.09 $0.12 $0.22 $0.33 $0.54 $0.85 $1.53 $2.76

**increments of $10,000 up to $100,000

Options Monthly Employee Rate

$10,000 $1.08

$15,000 $1.62

$20,000 $2.16

Options Monthly Employee Rate (per $1,000 of coverage)

1x to 6x eligible pay Employee $0.016

($2,000,000 maximum) Employee and Spouse/ Partner $0.032

Employee and Child(ren) $0.024

Employee, Spouse/ Partner and Child(ren) $0.032

Additional Option Monthly Employee Rates ***

Age

<24 24-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+

10% taxable benefit $0.061 $0.074 $0.101 $0.118 $0.170 $0.236 $0.323 $0.380 $0.432 $0.362

*** Monthly cost = Eligible pay ÷ 12 = _______ ÷ 100 = _______ x Monthly Employee Rate above


EmployeeSupplementalTerm LifeInsurance

Spouse/PartnerSupplementalTerm LifeInsurance

Child Term LifeInsurance

AccidentalDeath andPersonal Loss(AD&PL)Insurance

Long-TermDisability (LTD)Insurance

Documents

2013 Benefits and Rates at a Glance - Aetna · 2013-10-11 · Aetna 2013 Benefits and Rates-at-a-Glance for Regular Employees (working 20 hours or more per week) OPTIONAL BENEFITS