December 2005

Article in today's WSJ regarding Aetna's plans to publicly disclose their negotiated physician fees in Cincinnati market.

Insurer Reveals What Doctors Really Charge

To Help People Compare Fees,
Aetna Posts Some Online;
A Potential Bargaining Tool
August 18, 2005; Page D1

Aetna National Advantage™ Program
December 2005

As you may know, The Chickering Group, an Aetna Company currently provides you with the National Advantage™ Program – a program that provides your Student Health Plan with an opportunity to further control claims costs from non- PPO providers. Specifically, NAP provides access to negotiated rates for out-of network services versus paying off billed charges or reasonable and customary rates. The NAP network consists of hospitals, ancillary providers, and physicians accessed through vendor arrangements in those few instances where Aetna does not have direct contractual PPO arrangements. We have recently expanded the providers under NAP that will benefit your program.

Savings from the use of NAP range from 15 percent to 25 percent of billed charges. These savings are in addition to the significant discounts provided by the direct Aetna network.

When this service is utilized, an access fee of 25% of the cost savings will be charged to the claim cost which will be reflected on your monthly claim report under the category Access Fees. While a minimal charge, it is critical that we take advantage of negotiated rates for these non-PPO providers. In addition, students and dependents (if applicable) directly benefit from these discounts since any outof- pocket costs (coinsurance and deductibles) are based on actual contracted rates paid to the facility, not billed charges.

We are pleased to be using NAP and to be able to offer a program that will allow you to better control the medical costs of your Student Health Plan. Please contact your account management team if you have any questions regarding the National Advantage™ Program.