Premium Savings Program Broker Training

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Premium Savings Program Broker Training April 2013

We are responding to ACA changes Pricing volatility Rate shock Discontinuation of some plans Aetna is helping brokers, as well as new and existing customers, navigate their options: Premium Savings Program Standard Renewal Program 2

Aetna s Small Group Premium Savings Program Minimize disruption in a changing healthcare environment Offer options to meet your client needs and manage your Aetna business Aetna training and tools Our team is prepared We ve made the process simple 3

Participating states All small groups (2-50) have renewal options, based on state regulations. In some states, customers also may be able to benefit from our 2013 Small Group Premium Savings Program. WA OR NV CA ID UT MT WY CO ND SD NE KS MN WI IA MO IL IN MI KY OH ME VT NH NY MA RI CT PA NJ DE MD WV VA D.C. AK AZ NM HI OK TX AR LA MS TN AL GA NC SC FL Premium Savings States Other SG States 4

Client renewal options Clients have the option to: 1 Cancel their current policy and add a new 12 month policy with a new renewal date of Sept., Oct., Nov. or Dec. 2013. In some states, customers may be able to retain current benefits and rate levels through September-December 2014. 2 Maintain their existing policy and renewal cycle ending in 2014 and move to plans and rates that comply with 2014 ACA regulations at their next schedule renewal. Note: State regulations may apply to options 5

Notification deadlines: Premium Savings Program Available to new and renewing business with July-December effective dates in participating states New or Current 2013 renewal July June 1 August July 1 September August 1 October September 1 November October 1 December November 1 Premium Savings Program Notice/Decision (no UW, flat rate) 30 days Note: If a July December customer misses the deadline for the Premium Savings Program, they can use the Standard process to cancel their current policy and initiate a new one with a new renewal date (see following slide). Standard cases will be re-underwritten and receive new rates. 6

Premium Savings Program example Eligible New and renewing customers with July-Dec. effective dates in participating states New business customer Signs with Aetna in July Decides to participate in Premium Savings Program with no plan changes Notifies Aetna of decision By October 1, 2013 Signs new policy November 1 st 2013 renewal date Underwriting No change in rates or risk factor 7

Notification deadlines: Standard Notice Available to new and renewing business with January-December effective dates DESIRED Options for Renewal Dates Standard Notice (request for new quote): 90 days August 2013 May 1 June 15 September 2013 June 1 July 15 Standard Decision (signed Customer Agreement): 45 days October 2013 July 1 August 15 November 2013 August 1 September 15 December 2013 September 1 October 15 All Standard Renewal cases will go through Underwriting and receive new rates and risk factor Note: State-specific variations apply. 8

Standard Renewal example Eligible New and renewing customers with Jan.-Dec. effective dates Renewing customer Signed with Aetna in February 2013 Decides to request December 2013 renewal Notifies Aetna of intention By September 1st Submits signed Customer Agreement By October 15th Underwriting Receives new rates and risk factor 9

Summary of deadlines Premium Savings Program Summary - Participating States Group Status Current Renewal Rate Implication Notification Deadlines Existing & New Business January June YES Rate adjustment Request a quote - 90 days prior to new renewal date Decision - 45 days prior to new renewal date Existing & New Business July November NO rate adjustment Decision - 30 days prior to current renewal date *NON-Participating states - same as above except rates will always be adjusted (January - November YES rates adjustment)

Broker toolkit to facilitate client discussions Available tools Purpose Availability Dashboard Customer List Customer communication Customer agreement Provides a summary of broker s Aetna book of business and potential benefits of adopting a new policy and renewal date Includes customer-specific details and 2014 rate impact estimates Email/flyer for you to share with your clients Specific considerations and changes that occur as a result of adopting a new policy and renewal date Will be available beginning the week of May 20 Will be available beginning the week of May 20 Available on Producer World by April 19 Available on Producer World by April 19 11

Broker Dashboard sample - DRAFT Broker Dashboard Customer Summary Sample Broker Customers Likely to Benefit from a 4Q13 Renewal by Current Renewal Month Customers Likely to Benefit from a 4Q13 Renewal Purpose: To help you understand at a summary level how your Aetna Small Group business is impacted by 2014 rate changes. Value: Use this tool to help you understand the potential overall impact of change for your Aetna Small Group business. 12

Broker Dashboard sample - DRAFT Total number of Aetna customers Broker Dashboard Customer Summary Sample Broker Customers Likely to Benefit from a 4Q13 Renewal by Current Renewal Month Customers Likely to Benefit from a 4Q13 Renewal The portion of customers who could potentially benefit based on data from customer list Number of groups and subscribers that may benefit from reviewing their current policy and renewal date, by month 13

Customer List sample Group Name PSUID State Renewal Month Broker Customer List Plan Name Plan has a > $3000 Deductible Notice Required Prior to Requested Effecitve Date # of Subscribers Estimated premium change between 4Q renewal and regular oncycle renewal Customer Likely to Benefit from a 4Q13 Renewal Customer A XXXXX AZ Jan AZ PPO (2-50) $2,000 70/50 $25/$50 No 90 days 8-5% to 5% No Customer B XXXXX AZ Dec AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 11/01/2013 4-5% to 5% No Customer C XXXXX AZ Nov AZ CPOS 750 80 60 PLAN No 10/01/2013 6-5% to 5% No Customer D XXXXX AZ Feb AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 90 days 8-10% to -20% Yes Customer E XXXXX AZ Jan AZ PPO (51-100) Value Saver $10,000 100/50 Yes 90 days 29-10% to -20% Yes Customer F XXXXX AZ Jan AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 90 days 2 20% to 30% No Customer G XXXXX AZ Apr AZ PPO (2-50) $2,000 70/50 $25/$50 No 90 days 11-10% to -20% Yes Customer H XXXXX AZ Aug AZ PPO (2-50) $2,000 70/50 $25/$50 No 07/01/2013 2-5% to -10% Yes Customer I XXXXX AZ Jan AZ PPO (2-50) $750 80/60 $20/$40 No 90 days 24-5% to 5% No Customer J XXXXX AZ Jun AZ CPOS 750 80 60 PLAN No 90 days 12-10% to -20% Yes Customer K XXXXX AZ Jan AZ Banner Hlth Ntwk HSA $4000 80/50 (2-50) Yes 90 days 2 20% to 30% No Purpose: To provide you with the estimated impact of 2014 rate change at a customer-by-customer level. Value: This tool better positions you to partner with and assist your customers through this period of change. 14

Customer List sample Renewal month Plan name Estimated premium savings between 4Q renewal and regular on-cycle renewal (based on their current plan) Group Name PSUID State Renewal Month Broker Customer List Plan Name Plan has a > $3000 Deductible Notice Required Prior to Requested Effecitve Date # of Subscribers Estimated premium change between 4Q renewal and regular oncycle renewal Customer A XXXXX AZ Jan AZ PPO (2-50) $2,000 70/50 $25/$50 No 90 days 8-5% to 5% No Customer B XXXXX AZ Dec AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 11/01/2013 4-5% to 5% No Customer C XXXXX AZ Nov AZ CPOS 750 80 60 PLAN No 10/01/2013 6-5% to 5% No Customer Likely to Benefit from a 4Q13 Renewal Customer D XXXXX AZ Feb AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 90 days 8-10% to -20% Yes Customer E XXXXX AZ Jan AZ PPO (51-100) Value Saver $10,000 100/50 Yes 90 days 29-10% to -20% Yes Customer F XXXXX AZ Jan AZ (2-50) Hlth Ntwrk Option (OA) $750 80/60 No 90 days 2 20% to 30% No Customer G XXXXX AZ Apr AZ PPO (2-50) $2,000 70/50 $25/$50 No 90 days 11-10% to -20% Yes Customer H XXXXX AZ Aug AZ PPO (2-50) $2,000 70/50 $25/$50 No 07/01/2013 2-5% to -10% Yes Customer I XXXXX AZ Jan AZ PPO (2-50) $750 80/60 $20/$40 No 90 days 24-5% to 5% No Customer J XXXXX AZ Jun AZ CPOS 750 80 60 PLAN No 90 days 12-10% to -20% Yes Customer K XXXXX AZ Jan AZ Banner Hlth Ntwk HSA $4000 80/50 (2-50) Yes 90 days 2 20% to 30% No Group name Number of subscribers Note: Customers likely to benefit from a 4 th quarter 2013 renewal - cases with a yes are those with an estimated premium savings of greater than 5%. 15

Broker Dashboard & Customer List Customer analysis considerations We developed tools to help you and your customers navigate anticipated 2014 ACA changes. These tools are useful, but have their limitations, since the regulatory landscape continues to evolve. Estimates of 2014 pricing change are illustrative and do not bind Aetna Factors included in this analysis: rate up, demographics, industry and group size Factors not included in this analysis include product and rating area changes We anticipate final January 2014 pricing will be available in or around October 2013 Subscriber totals are based on the count from the last renewal period 16

The Customer Agreement has two parts Renewal Change Request Customer requests termination of current policy and issuance of new policy Acknowledges Aetna s right to adjust rates for any benefits changes Available now on Producer World New Plan Effective Date New group policy, effective date and new Plan Year Notice of consolidated renewal date will apply to ALL Aetna benefits (medical, dental, disability, life, etc.) Plan sponsor is responsible for all ERISA requirements, including SBC delivery Confirmation that Cafeteria Plan documents have been adapted, if needed Agreement that benefit accumulators will reset with the new Plan Year 17

Customer flyer We will provide you with a flyer explaining renewal options that you can share with your clients in participating states Available now in the Premium Savings Toolkit on Producer World Helps you walk your customers through their options with helpful considerations Includes an FAQ on reverse side 18

Frequently Asked Questions Included on the back of the customer flyer Will help guide you and your clients through this process Available now on Producer World in the Premium Savings Toolkit 19

Renewal change steps 1 Aetna provides you with the tools you need Broker Dashboard Customer List Customer Communication Customer Agreement 2 Brokers discuss options with customers Review tools provided Apply your knowledge of the customer and local regulatory considerations Meet with your customers to discuss options 3 Brokers submit a Customer Agreement for any renewal changes Work with your customer to fill out a Customer Agreement Submit the agreement through your new or renewal business process by the deadline 20

Important dates April 15 April 17 April 19 Now May 20 Broker webinar 1-2 p.m. ET Broker webinar 2-3 p.m. ET Broker webinar 1-2 p.m. ET Customer Agreement and flyer available on Producer World Broker toolkits available 21

Take-home messages The ACA is fundamentally transforming the Small Group marketplace for 2014. We are committed to making sure you are part of both our short- and long-term future as we prepare for 2014. We believe in the agent-driven distribution model and recognize the value you provide your clients. We want to work with you so together we can help our mutual clients navigate the health care system. 22