taking care of you! ho regis.brochure.1.12.06.pdfcurrent plan or choose to opt out of the plan....

Taking Care of You!

Table of Contents

The RegisAdvantage Career Health PlanEligibility and Enrollment Rules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Who Can Participate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

When You Can Enroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

A Multi-Level Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Moving to the Next Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Making Changes to Your Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

How Your Health Benefits Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

The Plan at Each Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

In-Network and Out-of-Network Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

Some Cost Sharing Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Your Health Care Resources . . . . . . . . . . . . . . . . . . . . . . . .7Stay Well . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Health Information Day or NIght . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Online Wellness Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Women’s Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Disease Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Stay Informed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Secure Member Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Search for Network Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Prescriptions Delivered to Your Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

The Formulary List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Save Money . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Fitness Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Vision One® Discount Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Alternative Health Care Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

For Help and Information . . . . . . . . . . . . . . . . . . . . . . . . .12

Summary of Benefits Chart . . . . . . . . . . . . . . . . . . . . . . . . .13

Taking Care of You 1

It’s that time of year again!

One where you have the

opportunity to sign up for

health benefits that can take

care of you — and help you

take care of yourself. The

RegisAdvantage Career

Health Plan is unique in the

industry because it offers

four levels of benefits for

you to choose from.

At all levels, you participate

in health plans from Aetna,

one of the nation’s leading

providers of health benefits,

programs and services.

Each plan provides coverage

for the services you need to

stay healthy, as well as the

care you need when you’re

sick or injured. Even better,

each plan offers innovative

programs and online

services that help you

better understand and use

your health care benefits,

communicate with your

doctor and make more

informed decisions and

choices.

Take some time to learn

about the RegisAdvantage

Career Health Plan and the

levels of benefits that are

available to you and your

family. Then, get ready

to enroll!

The RegisAdvantage CareerHealth Plan

2 Taking Care of You

Eligibility andEnrollment RulesWho can sign up forhealth benefits — andwhen.

Who Can ParticipateYou are eligible for the RegisAdvantageCareer Health Plan if:

n You work at least 25 hours per week.

n You have completed the one-month waiting period. (The waiting period starts on the day you're hired or the day of a qualifying life event.)

When You Can EnrollYou can sign up for health benefits duringthe annual open enrollment period or at the time you have a qualifying life event.Examples of qualifying life events are marriage, divorce, and the birth or adoptionof a child.

It’s important to remember that your planchoice is not carried over from year to year.This means you must enroll in the planeach year. You have the option of notenrolling in the plan at all, but if you changeyour mind the following year and want toenroll, you must wait until the next openenrollment period.


A Multi-Level PlanWhere you start — andwhere you can go.

The RegisAdvantage Career Health Plan hasfour benefit levels:

n Level 1 – This level of benefits has a$15,000 calendar year maximum.

n Level 2 – This level of benefits has a$25,000 calendar year maximum.

n Level 3 – This level of benefits has a$1,000,000 lifetime maximum.

n Level 4 – This level of benefits has threePPO plan options to choose from, eachwith a $2,000,000 lifetime maximum.

Moving to the Next LevelOnce you enroll in one of the four levels ofbenefits, you must stay in that plan for theyear before you can move to the next level.You have these choices during each openenrollment:

n You can stay in the level you’re in currently.

n You can move forward to the next level.

n You can move forward, stay in your current plan or choose to opt out of the plan.

Remember, when you are eligible to changelevels, you may move forward but not back.For example, if you have been in Level 3 for a year, you can either remain in Level 3,move to Level 4 or opt out of the planentirely.

Making Changes to YourCoverageYou can change your level of benefits onlyduring open enrollment. However, under certain circumstances you can make changesto your coverage at other times during theyear. These “certain circumstances” arecalled qualifying life events. Examples aremarriage, divorce, death of a spouse, and the birth or adoption of a child.

When you have a qualifying life event, youmay enroll in the plan (if you aren’t alreadyenrolled), or you may change from single tofamily coverage (or vice versa). You mayalso opt out of the plan entirely.

Want to learn evenmore about whatyour health plan cando for you?

Pop in to see our new

benefits website at

www.aetna.com/

ccg_custom/regis. There

you’ll find programs and

timely information that will

help you lose weight,

reduce stress or start a new

fitness program. You’ll be

able to take a tour of

Aetna’s powerful online

tools that can calculate the

cost of your prescription

drugs, locate a health

care professional in your

neighborhood and guide

you in making the best

health care decisions for

you and your family.


The Plan at Each LevelLevels 1 and 2The PPO plan at Levels 1 and 2 pays benefitsonly when you visit health care providerswho belong to Aetna's network (called in-network providers). If you go outside thenetwork for care, you pay the entire expenseout of your own pocket.

The plan pays up to a certain dollar amount forcovered medical expenses. For expenses overthis dollar amount, you meet a deductible, thenthe plan pays a percentage (70%) of yourremaining expenses. The plan has a calendaryear maximum, which is the most the plan willpay in benefits in a given calendar year (fromJanuary 1 to December 31). The calendar year maximum includes basic, hospital, supplemental and prescription benefits.

There are a separate deductible and separatebenefits for prescription drug expenses.Check the Summary of Benefits chart foradditional details about plan benefits andcoverage.

How Your HealthBenefits WorkA closer look at the plans.When you enroll in any level of theRegisAdvantage Career Health Plan, you participate in a type of plan called a preferred provider organization (PPO) plan.In a PPO plan, you're able to tap in to agroup, or network, of health care providersthat include doctors (both primary and specialty care), hospitals, pharmacies andfacilities such as urgent care centers. Formost types of care, you meet a deductibleeach year, then the plan pays part of yourexpenses and you pay the remaining balance.

This section covers the basics of what youshould know about the PPO plan. You'llfind more details about the plan's coverageand benefits at each of the four levels in theSummary of Benefits chart found in the backof this brochure.


Level 3The PPO plan at Level 3 pays different benefits depending on whether your care is received by an in-network provider or anout-of-network provider. When you visit in-network providers, the plan pays moreand you pay less. Before the plan pays benefits, you must meet a deductible. The plan then pays a percentage of yourcovered expenses and you pay the rest. The plan has a lifetime maximum benefit,which is the most the plan will pay in benefits during your lifetime.

For prescription drug expenses, there areseparate benefits. Refer to the Summary of Benefits chart for additional details about plan benefits and coverage.

Level 4At Level 4, there is a choice of three PPOplans — platinum, gold and silver. As youmight guess from the names, each is“worth” a different amount in benefits for you. If you look at the Summary ofBenefits chart, you’ll see what we mean. The three PPO plans at Level 4 work thesame as the plan at Level 3. You decide who will provide your care. If you choose in-network providers, the plan pays moreand you pay less. You meet a deductible and pay your share of covered expenses.There are separate benefits for prescriptiondrugs and the plan has a lifetime maximumbenefit. There is also a Traditional Plan atLevel 4. This is for employees who live outside the area served by Aetna’s PPO network. The Summary of Benefits chart in the back of this brochure provides moredetails about plan benefits and coverages of Level 4.

In-Network and Out-of-NetworkProvidersYou save money when you use in-network providers!At Levels 1 and 2, the plan pays benefits only when you choose health care providerswho belong to Aetna’s network (in-networkproviders). When you choose out-of-networkproviders, you pay the entire cost of your careout of your own pocket.

At Levels 3 and 4, the plan pays differentbenefits depending on who provides your care. When you choose in-networkproviders, you pay less out of pocket. This is because the in-network deductible islower and the percentage the plan paysafter you meet the deductible is higher.

You save time too!There are other advantages to using in-networkproviders. They file claims for you, so there’s nopaperwork to bother with. They also take careof a plan requirement called precertification, a care review that starts with a phone call toAetna. When you use in-network providers,they make the call. When you use out-of-network providers, you must make the call.

Use DocFind ® to search for in-network providers near you.When it’s time to choose a doctor or otherhealth care provider, think “in network.”You can find in-network providers by usingDocFind, Aetna’s online provider directory.To make it easy for you, a special version ofDocFind has been created exclusively forRegis employees. It’s updated three times aweek and available in English or Spanish.

To use DocFind, visit our new benefits websiteat www.aetna.com/ccg_custom/regis andclick on the DocFind page. You can search for a doctor by zip code and put in the number of miles you’re willing to travel. You can alsosearch for a particular type of doctor (primarycare or specialist, for example) or you can enterthe name of a doctor to find out if he or shebelongs to the network.


Some Cost Sharing BasicsIn the PPO plan, you share in the cost of yourcare by meeting a deductible and paying partof your covered expenses. There are also certain limits placed on what you must payand what the plan must pay. Here’s how itworks . . .

The DeductibleThe deductible is the part of your coveredexpenses you must pay each calendar year(January 1 to December 31) before the planpays benefits. Each level has a differentdeductible. In addition, there are differentdeductibles for single coverage and familycoverage.

Notice that the plan at Levels 1 and 2 hasseparate medical and prescription drugdeductibles. Also, the plan at these levelspays up to a certain dollar amount for covered services, then the deductible mustbe met in order for benefits to be paidbeyond that dollar amount.

CoinsuranceOnce you meet the deductible, the planpays part of your expenses and you pay the rest. This is called coinsurance. Forexample, if the plan pays 70% after the deductible for a certain service, you pay 30%.

CopaymentsFor certain types of expenses, you pay acopayment (or copay). This is a flat fee thatrepresents part of the real cost of a givencovered service. For example, your plan mayrequire a $10 copay for a 30-day supply ofgeneric medication.

MaximumsAt Levels 1 and 2, the plan has a calendaryear maximum. This is the most the planwill pay in benefits during a given calendaryear.

At Levels 3 and 4, the plan places a limit on the amount you must pay for coveredexpenses out of your own pocket (includingthe deductible). This limit is called the out-of-pocket maximum. Once you reachthe out-of-pocket maximum, the plan pays100% of your covered expenses for the restof the calendar year. The plan at Levels 3 and 4 also has a lifetime maximum benefit, which is the most the plan will payin benefits over your lifetime.

The Summary of Benefits chart shows thedeductibles, coinsurance, copayments, maximums and other benefit limits for each plan at each level.


Your Health CareResourcesOne of the reasons Regis has

chosen Aetna as our health care

administrator and network

provider is because of their

incredible array of programs,

services and online resources.

See how your health plan can take

care of you — and help you take

care of yourself by spending a few

minutes to learn about the health

care resources available once you

are enrolled in an Aetna plan.

These special services and

programs are easy and fun to

use. Check them out yourself

to see what they can do for you!

When you call the Informed Health Line — toll free at 1-800-556-1555 — you talk to registered nurses who can:

n Offer you information about health andwellness topics,

n Go over questions to ask your doctor,

n Tell you about certain diagnostic proceduresand possible treatment options, and

n Offer general information about the risks,benefits and costs of many medical procedures and tests.

While the Informed Health Line nurses can’tdiagnose, prescribe or give medical advice,they can help you understand your conditionand the treatment options available to you.They can also give you the information youneed to communicate with your doctor better.

Stay WellReliable information andsupport to help you stayhealthy.We all know what it takes to stay well. Eatingright, exercising regularly and kicking unhealthyhabits are great places to start! But sometimeswe need a little help. As an enrolled Aetnamember, you'll get that help from innovativewellness programs.

Health Information Day or NightThere's a lot to know about diseases andhealth conditions and how they can be treated.For example, when you go to the doctor, he orshe may tell you about different ways to treatyour illness or disease — and leave the choiceup to you. Or you may read about a new procedure or treatment that could help. Howdo you make the best decision? One way is to take advantage of the Informed Health®

Line.


Online Wellness ProgramSimple Steps To A Healthier Life® is an online wellness program that gives youpersonalized information and self-help toolsfor weight loss, stress management, fitnessand better overall health. Once you enroll,you can get started by visiting the SimpleSteps To A Healthier Life website to register.Just complete the brief online form and create a user ID and password. Then you’llbe able to:

n Take the Health Assessment, a questionnaire that helps you learn aboutyour personal health risks. The questionscover areas such as health and lifestylechoices, personal and family health history,and preventive health screenings (such asmammograms). Once you complete thequestionnaire, you’ll receive an overallhealth score, a report you can share withyour doctor and a personalized action plan.

n Take action, with interactive programsthat help you reduce your health risks.Some examples of these programs areHealthier Diet, Weight Loss, Stress Relief,Smoking Cessation, Healthy Heart andHealthy Aging. These programs help youset goals, work on step-by-step health“assignments” and track your progress.

n Look it up, with credible references and resources such as Diseases andConditions A to Z, Tests and ProceduresA to Z, the Merriam-Webster MedicalDictionary and a drug database. Need to know more about a health problem or concern? Simply look it up!

It’s all waiting for you at Simple Steps To A Healthier Life. If you are consideringenrolling in an Aetna plan, visit www.simplestepslife.com today to take an interactive tour and learn moreabout Simple Steps To A Healthier Life.

Women’s HealthWomen have unique health care needs.That’s why you can take advantage of asuite of quality programs and powerfultools that help you take control of yourhealth throughout all the stages of yourbusy life.

Moms-to-Babies Maternity ManagementProgram™. If you’re expecting, this program can help you stay well and deliver a healthier baby. An Aetna nurse will call to help you get started if you are eligible for this program. You can also call 1-800-CRADLE-1 (1-800-272-3531)to enroll yourself.


The program includes:

n Facts, tips and informationAccess educational materials (available inEnglish and Spanish) on prenatal care, laborand delivery, newborn and baby care, post-partum depression, breastfeeding, as well as dedicated information for Dad or partner.

n A special websiteAdditional women’s health informationcan be found online at http://womenshealth.aetna.com.

n A pregnancy risk surveyThis survey can help determine whether or not you could benefit from more specialized prenatal and/or postnatal care because of your medical history orpresent health.

n Case managementCare coordination by specially trainednurse case managers.

n Postpartum depression screeningLearn more about postpartum depressionand find out if you suffer from this common but often overlooked condition.

Under the Moms-to-Babies program, all careis coordinated by your Ob/Gyn doctor andAetna case managers.

Other services available to help women livehealthier lives are:

n Breast, heart, menopause and osteoporosis health careUtilize resources and tools that are dedicated specifically to women’s healthcare issues.

n Case management and education fordiabetics considering pregnancyHelping diabetic women considering pregnancy better manage their bloodsugar levels before they become pregnant.This can reduce the risk of delivering ababy with birth defects.

n Confidential genetic testing for breastand ovarian cancersProviding confidential genetic testing forwomen who have never had breast orovarian cancer, but have a strong familyhistory of the disease.

Disease Management If you’ve been diagnosed with asthma, coronary artery disease, diabetes or congestive heart failure, you know howimportant it is to take care of your condition. Aetna’s Healthy OutlookProgram® can help.* The Healthy OutlookProgram offers personalized informationand tools to help prevent or delay complications, give you good ways to manage your condition and improve your quality of life. This includes:

n Counseling by registered nurses to help you recognize and manage the signs and symptoms of your condition.

n Self-care tips to help you keep your condition under control and enjoy a healthier life.

n Free booklets, videos, newsletters and other educational materials to help you understand your condition, use medications and special equipment,and avoid health problems.

There are a number of ways to get into theHealthy Outlook Program. Your doctor oremployer can refer you, or you can call oremail Member Services at 1-888-488-4488to get started.

* Wellness programs are part of the RegisAdvantageCareer Health Plan. Please note that the HealthyOutlook Program is available only with Levels 3 and 4.


Stay InformedReliable facts, great features and cool toolsare at your fingertips.

By visiting Aetna’s website at www.aetna.com,you can stay informed about health and wellnesstopics that interest you, get cost information to help you make better decisions, order prescription refills — and so much more. Take a look . . .

Secure Member WebsiteAetna Navigator™ is your online resource forpersonalized benefits and health informationthat offers:

n Self-service features – to request IDcards, print claim forms or make changes to your personal information such as emailaddresses. You can even print temporary ID cards to use while you wait for your permanent card to arrive.

n Cost of Care tools – to learn about andcompare the cost of medical procedures,office visits, tests, diseases and conditions,and prescription drugs.

n A Hospital Comparison tool – for helpchoosing a hospital when you or a familymember needs surgery.

n Email alerts – to inform you of new information available for your viewingonline, such as preventive health carereminders and Explanation of Benefits (EOB)statements.

n Member Services – to contact someoneabout coverage and benefit questions,request ID cards, find in-network providersand make changes to your personal andfamily information.

Plus, you can go to these other great placesfrom Aetna Navigator:

n Intelihealth® – for information and lookupson thousands of health topics. You can findout how to get started on a fitness program,learn about diseases and conditions, sideeffects of prescription drugs and much more.And now you can sign up for free healthemails on the topics that mean the most toyou — whether it’s about children, seniors,women, heart health, cancer facts or healthyliving in general. Access Intelihealth fromAetna Navigator or go directly towww.intelihealth.com, fill out the user profile, choose a password and check off your areas of interest.

n Healthwise® Knowledgebase – a toolthat can help you make better decisions whenyour doctor recommends certain treatments or care. If you register for Aetna Navigator’spersonalized features, you can have access toclinical information on health topics, medicaltests and procedures, support groups andmedications.

Healthwise Knowledgebase is here to makeyou a more informed decision maker and toallow you to understand particular symptomsand become a better partner with your physician.

To see how you can take advantage of all theservices available through Aetna Navigator,feel free to visit our custom website atwww.aetna.com/ccg_custom/regisand take a tour of Aetna Navigator.

Once you are enrolled as an Aetna member,you’ll just need to register. It’s easy. Go towww.aetna.com/ccg_custom/regis andaccess the Aetna Navigator link. Provide theinformation requested to verify that you’re anAetna member, then select a user name, password and security phrase.


Search for Network ProvidersDocFind® is Aetna’s online provider directory.To make it easy for you, a special version ofDocFind has been created exclusively for Regisemployees. This feature can help simplifyyour search and is only available throughwww.aetna.com/ccg_custom/regis. Updated three times a week, DocFind givesyou the most recent information on Aetna’snetwork doctors, hospitals, pharmacies andother providers.

You can search for a doctor or facility by zip codeand put in the number of miles you’re willing totravel. You can also search by type of doctor (primary care or specialist, for example) or youcan enter the name of a doctor to find out if he or she belongs to the network.

For each provider, DocFind provides informationabout his or her credentials and practice, including education, board certification and languages spoken, as well as information aboutthe provider’s office, such as office hours, location, parking and handicapped access.

Should you visit Aetna’s website directly atwww.aetna.com, you will have access toAetna’s standard DocFind. You will need to follow the prompts in order to do your search.The site will guide you through several questionsand promt you in step 3 to select a plan category.Select “Aetna Open Access® plans.” You thenneed to pick one plan from the list. Select“Aetna Choice® POS II (Open Access).” Fromthere, continue your search.

Prescriptions Delivered toYour HomeAetna Rx Home Delivery® is a mail servicepharmacy that you can use when you or acovered family member needs prescriptionmedication on an ongoing basis (calledmaintenance medication). Some examples of maintenance medication are insulin fordiabetes, blood pressure medication and certain allergy medications.

With Aetna Rx Home Delivery, you can order up to a 90-day supply of medicationand get outstanding savings. Your medication will be delivered directly to your home within 7 to 10 days after yourorder is received. And when you need a refill, all you need to do is go towww.aetnarxhomedelivery.comand place your order. You can also call toll free to learn more about this convenient service and how to get started using it. Just dial 1-800-338-4533.

The Formulary ListWhen your doctor prescribes a drug onAetna’s formulary list, you save. The formulary is a list of preferred drugs thatincludes both brand-name and generic drugs.It also shows lower-cost alternatives for high-cost drugs. Take a look at Aetna’s formularylist online at www.aetna.com/formulary,and ask your doctor to prescribe drugs on thislist whenever possible.


Save MoneyGet discounts on fitness, vision care and alternative health care.

Another way your health plan takes care ofyou is by giving you some great ways to savemoney. Here are three discount programs you should know about:

Fitness ProgramThe Fitness Program helps make staying inshape more affordable by providing discountson health club memberships* and certain home exercise equipment through GlobalFit™.It also offers advantages such as:

n A free guest pass to try out a club beforejoining;**

n Convenient, monthly payment options;

n Sharing club memberships with coveredfamily members;

n Guest privileges at GlobalFit clubs whenyou travel.**

You can learn more about this program andfind a list of participating clubs by callingGlobalFit at 1-800-298-7800 or by visitingwww.globalfit.com/fitness.

Vision One® Discount ProgramThe Vision One Discount Program helps youand your family save on eye care products,including eyeglasses, contact lenses and solution, non-prescription sunglasses and other eye care accessories. You can also receivea discount on LASIK (laser correction) surgerythrough the program. When you need

For Help andInformationA contact list for you.

Need answers? Want to know more aboutthe programs and services we’ve justdescribed? Here’s where you'll find it!

n For information about your medical plan,call the Regis Home Office Benefits department at 1-800-492-2925 or visitwww.regisbenefits.com.

n For more about the programs, services and tools that will be available to you when you enroll, visit our custom websiteat www.aetna.com/ccg_custom/regis.

n For help with benefit and coverage questions, claims, finding in-networkproviders, requesting ID cards and otherplan services, call Member Services at 1-888-488-4488 or email them fromAetna Navigator.

Regis is committed to offering you a planthat combines the coverage you need withservices that emphasize wellness, preventivecare and better health care decision making.We hope you’ll take advantage of all yourplan has to offer and we wish you goodhealth!

products or supplies, you can choose from awide selection of optical centers nationwide,such as Sears, JCPenney, Target, certain PearleVision Centers and others. Just show yourAetna ID card and the discount will be appliedon the spot. To take advantage of this program, just visit www.aetna.com/ccg_custom/regis, click on DocFind and select Vision One within your searchor call 1-800-793-8616.

Alternative Health CareProgramAetna’s Alternative Health Care Programis a discount program with three parts:

n Natural Alternatives – for special rates on alternative therapies, including visits toacupuncturists, chiropractors, massage therapists and nutritional counselors.

n Vitamin Advantage™ – for savings onover-the-counter vitamins, as well as nutritional supplements, purchased through participating vendors.

n Natural Products – for discounts onhealth-related products, including aromatherapy, foot care and natural body care products.

You may place orders by mail, telephone, faxor online to receive savings on health-relatedproducts offered through these programs.

To find out more about the Alternative HealthCare Program, call Member Services at 1-888-488-4488 or log on to Aetna Navigatorand click on “Take Action On Your Health” to access a listing of participating providers,vendors and the latest additions to the product list.

* At some clubs, program participation may only be available to new club members.

** Not available in all areas.

LEVEL 1 AND LEVEL 2 LEVEL 1 PPO PLAN LEVEL 2 PPO PLANIn Network Out of Network In Network Out of Network

CALENDAR YEAR MAXIMUM $15,000 No coverage $25,000 No coverage (Includes basic, hospital, supplemental and prescription benefits) available. Any available. Any

expenses incurred expenses incurredfrom an out-of- from an out-of-

network doctor will network doctor will be the employee’s be the employee’s responsibility to responsibility to

pay in full. pay in full.

BASIC BENEFITS Plan Pays: Plan Pays:

Office Visit: 6 visits per member per calendar year are covered under Up to $75 per visit Up to $75 per visitthe base plan.*

Wellness Visit: 1 per member per calendar year under the base plan.* Up to $150 Up to $150

Accident Benefits* Up to $500 Up to $500

Emergency Room: 4 visits per member per calendar year are covered Up to $75 per visit Up to $75 per visitunder the base plan.*

Diagnostic X-ray and Lab: 5 procedures per member per calendar year Up to $60 Up to $60are covered under the base plan.* per procedure per procedure

HOSPITAL

Inpatient Room and Board: 5 days per member per calendar year Up to $150 per day Up to $150 per dayare covered under the base plan.*

Ancillary Services (ICU): 30 days per member per calendar year Up to $500 per day Up to $500 per dayare covered under the base plan.*

Ancillary Services (Non-ICU): 5 days per member per calendar year Up to $300 per day Up to $300 per dayare covered under the base plan.*

Intensive Care Room and Board: 30 days per member per Up to $450 per day Up to $450 per daycalendar year are covered under the base plan.*

Substance Abuse: 30 days per member per calendar year are Up to $250 per day Up to $250 per day covered under the base plan.*

Mental Health Inpatient: 60 days per member per calendar year Up to $250 per day Up to $250 per day are covered under the base plan.*

Skilled Nursing Facility Benefit: 60 days per member per Up to $250 per day Up to $250 per daycalendar year are covered under the base plan.*

Surgical (Scheduled Benefit): 1 per member per calendar year is Up to $500 Up to $500covered under the base plan.*

SUPPLEMENTAL MAJOR MEDICAL

Deductible AmountsSingle $2,500 $2,500 Family $5,000 $5,000 Payment Percentage 70% 70%

PRESCRIPTION DEDUCTIBLE

Per person $50 $50 Maximum per family $100 $100

RETAIL PRESCRIPTION DRUGS (30-day supply)

Generic $10 copay $10 copayBrand Name — Formulary 30% coinsurance; 30% coinsurance;

$30 minimum/ $30 minimum/$60 maximum $60 maximum

Brand Name — Nonformulary 50% coinsurance; 50% coinsurance; $50 minimum/ $50 minimum/$100 maximum $100 maximum

MAIL-ORDER PRESCRIPTION DRUGS (90-day supply)

Mandatory for all maintenance drugs

Generic $25 copay $25 copay Brand Name — Formulary 30% coinsurance; 30% coinsurance;

$75 minimum/ $75 minimum/$150 maximum $150 maximum

Brand Name — Nonformulary 50% coinsurance; 50% coinsurance; $125 minimum/ $125 minimum/$250 maximum $250 maximum

* Covered amounts in excess of the limits will be considered under the supplemental major medical and subject to the deductible and coinsurance.

Summary of Benefits Chart

LEVEL 3 PPO PLANIn Network Out of Network

DEDUCTIBLE AMOUNTS

Single $600 $1,200

Family $1,200 $2,400

OUT-OF-POCKET MAXIMUM

Single $3,000 None

Family $6,000 None

PAYMENT PERCENTAGE70% 40%

LIFETIME MAXIMUM BENEFIT$1,000,000 $1,000,000

OFFICE VISIT$25 copay per visit 40% after deductible

SPECIALIST PHYSICIAN VISIT$25 copay per visit 40% after deductible

DIAGNOSTIC LAB WORK AND X-RAYS70% after deductible 40% after deductible

PREVENTIVE HEALTH CARE BENEFITS: $500/Calendar year maximum per person

Routine physical exam for covered employees and dependents, including diagnostic tests and immunizations 100% No Coverage

Child preventive care services given in connection with routine pediatric care,includes PKU tests and immunizations 100% No Coverage

Routine well-women exams, including breast exam and/or mammogram,pelvic exam, Pap smear 100% No Coverage(Subject to limited number of exams as noted in plan booklet)

ROUTINE EYE EXAM

1 exam per calendar year - includes refraction 100% No Coverage

INPATIENT HOSPITAL DEDUCTIBLE

$200 deductible; then 70% $200 deductible; then 40%after annual deductible after annual deductible

EMERGENCY ROOM

$125 copay; then 70% $125 deductible; then 40% (50% for non-emergency care)

URGENT CARE (Where available)

$25 copay per visit $25 deductible per visit

DURABLE MEDICAL EQUIPMENT

70% after deductible 40% after deductible

Calendar Year Maximum $5,000 $5,000

AMBULANCE

70% 70%


Generic $15 copay No Coverage

Brand Name — Formulary 30% coinsurance; No Coverage$30 minimum/$60 maximum

Brand Name — Nonformulary 50% coinsurance; No Coverage$50 minimum/$100 maximum


Mandatory for all maintenance drugs

Generic $20 copay No Coverage

Brand Name — Formulary $40 copay No Coverage

Brand Name — Nonformulary $70 copay No Coverage

MENTAL HEALTH AND SUBSTANCE ABUSE — Inpatient Treatment


Calendar Year Maximum 30 days 30 days

MENTAL HEALTH AND SUBSTANCE ABUSE — Outpatient Treatment


Calendar Year Maximum 30 visits 30 visits

SUBSTANCE ABUSE — Inpatient and Outpatient Lifetime Maximum

$25,000 $25,000

LEVEL 4Plan PPO PLATINUM PLAN PPO GOLD PLAN PPO SILVER PLAN TRADITIONAL

PLAN

In Network Out of In Network Out of In Network Out ofNetwork Network Network

DEDUCTIBLE AMOUNTS

Single $350 $700 $350 $700 $600 $1,200 $600

Family $700 $1,400 $700 $1,400 $1,200 $2,400 $1,200

OUT-OF-POCKET MAXIMUM

Single $750 None $2,000 None $3,000 None $1,500

Family $1,500 None $4,000 None $6,000 None $3,000

PAYMENT PERCENTAGE

85% 70% 80% 50% 70% 40% 80%

LIFETIME MAXIMUM BENEFIT

$2,000,000 $2,000,000 $2,000,000 $2,000,000

OFFICE VISIT

$20 copay 70% after $20 copay 50% after $25 copay 40% after 80% afterper visit deductible per visit deductible per visit deductible deductible

SPECIALIST PHYSICIAN VISIT

$25 copay 70% after $25 copay 50% after $25 copay 40% after 80% afterper visit deductible per visit deductible per visit deductible deductible

DIAGNOSTIC LAB WORK AND X-RAYS

85% after 70% after 80% after 50% after 70% after 40% after 80% afterdeductible deductible deductible deductible deductible deductible deductible

PREVENTIVE HEALTH CARE BENEFITS: $500/Calendar year maximum per person

Routine physical exam for covered employees 100% No Coverage 100% No Coverage 100% No Coverage 100%and dependents, including diagnostic tests and immunizations

Child preventive care services given in 100% No Coverage 100% No Coverage 100% No Coverage 100%connection with routine pediatric care, includes PKU tests and immunizations

Routine well-women exams, including breast 100% No Coverage 100% No Coverage 100% No Coverage 100%exam and/or mammogram; pelvic exam; Pap smear(Subject to limited number of exams as noted in plan booklet)ROUTINE EYE EXAM

1 exam per calendar year - includes refraction 100% No Coverage 100% No Coverage 100% No Coverage 100%

INPATIENT HOSPITAL DEDUCTIBLE

$200 $200 $200 $200 $200 $200 80% afterdeductible; deductible; deductible; deductible; deductible; deductible; after annualthen 85% then 70% then 80% then 50% then 70% then 40% deductible

after annual after annual after annual after annual after annual after annualdeductible deductible deductible deductible deductible deductible

EMERGENCY ROOM

$100 copay; $100 $100 copay; $100 $125 copay; $125 80% afterthen 85% deductible; then 80% deductible; then 70% deductible deductible

(50% for non- then 70% (50% for non- then 50% (50% for non- then 40% (50% for non-emergency (50% for non- emergency emergency emergency

care) care) care) care) care)

URGENT CARE (Where available)

$20 copay $20 deductible $20 copay $20 deductible $25 copay $25 deductible 80% afterper visit per visit per visit per visit per visit per visit deductible

DURABLE MEDICAL EQUIPMENT


Calendar Year Maximum $5,000 $5,000 $5,000 $5,000 $5,000 $5,000 $5,000

continued on the next page

LEVEL 4 (continued)

Plan PPO PLATINUM PLAN PPO GOLD PLAN PPO SILVER PLAN TRADITIONALPLAN

In Network Out of In Network Out of In Network Out ofNetwork Network Network

AMBULANCE

85% 80% 80% 80% 70% 70% 80%


Generic $10 copay No Coverage $10 copay No Coverage $15 copay No Coverage $15 copay

Brand Name — Formulary 30% No Coverage 30% No Coverage 30% No Coverage 30%coinsurance; coinsurance; coinsurance; coinsurance;

$20 minimum/ $20 minimum/ $30 minimum/ $30 minimum/$40 maximum $40 maximum $60 maximum $60 maximum

Brand Name — Nonformulary 50% No Coverage 50% No Coverage 50% No Coverage 50%coinsurance; coinsurance; coinsurance; coinsurance;

$35 minimum/ $35 minimum/ $50 minimum/ $50 minimum/$70 maximum $70 maximum $100 maximum $100 maximum


Mandatory for all maintenance drugsGeneric $20 copay No Coverage $20 copay No Coverage $20 copay No Coverage $30 copay

Brand Name — Formulary $40 copay No Coverage $40 copay No Coverage $40 copay No Coverage $50 copay

Brand Name — Nonformulary $70 copay No Coverage $70 copay No Coverage $70 copay No Coverage $80 copay

MENTAL HEALTH SUBSTANCE ABUSE — Inpatient Treatment


Calendar Year Maximum 30 days 30 days 30 days 30 days 30 days 30 days 30 days

MENTAL HEALTH SUBSTANCE ABUSE — Outpatient Treatment


Calendar Year Maximum 30 visits 30 visits 30 visits 30 visits 30 visits 30 visits 30 visits

SUBSTANCE ABUSE — Inpatient and Outpatient Treatment Lifetime Maximum

$25,000 $25,000 $25,000 $25,000

This brochure highlights the major provisions of the RegisAdvantage Career Health Plan, effective March 1, 2006. Legal documents describe the plans in complete detail and govern their operation. If there is a disagreement between this brochure and any legal document, the terms of the legal document always govern.

CCG 06-0025 [H/O] (01/06)

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