Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Boston University Student Health Insurance Plan August 29, 2014 Aetna Student Health

Aetna Inc. Boston University Student Health Insurance Plan for Boston University Boston University makes two plans available to students on the main campus. The BASIC Plan provides benefits comparable to “Gold” plans offered through the public Marketplace (e.g. Healthcare.gov). The PLUS plan provides higher benefits, comparable to “Platinum” plans offered through the public Marketplace, at a higher premium than the BASIC Plan: 2 CoverageCoverage DatesAnnual Premium BASIC Plan (student only)8/23/14 to 8/22/15$1,941 PLUS Plan (student only)8/23/14 to 8/22/15$2,610 For premium rates and benefit description available to eligible dependents, please visit

Aetna Inc. Boston University BASIC Plan - Students 3 The Plan will pay benefits in accordance with any applicable Massachusetts insurance law. The Boston University Plan may not cover all your health care expenses. The Plan excludes coverage for certain services and contains limitations on the amounts it will pay. Please read the Boston University Plan Design and Benefits Summary carefully before deciding whether this plan is right for you. While this presentation and the Boston University Plan Design and Benefits Summary tell you about some of the important features of the Plan, other features may be important to you and some further limit what the Plan will pay. If you want to look at the full plan description, which is contained in the Master Policy issued to Boston University, you may view it at or you may contact us at (800) Additional plan maximums may also apply. Some illnesses may cost more to treat and health care providers may bill you for what the Plan does not cover. Plan informationPreferred CareNon-Preferred Care Policy Year Maximum Unlimited Medical & Prescription Drug Policy Year Deductible $150$500 Out-of-Pocket Maximum $5,000 Physician Office Visits $40 Copay, then 100% of Negotiated Charge 80% of Recognized Charge Preventive Care 100% of Negotiated Charge80% of Recognized Charge Emergency Room (Copay waived if admitted) $150 Copay, then 80% of Negotiated Charge $150 Deductible, then 80% of Recognized Charge Inpatient Hospitalization 80% of Negotiated Charge60% of Recognized Charge Prescription Drug $10 Generic Drug/ $40 Preferred-Brand Name Drug/ $60 Non-Preferred Brand Name Drug 80% of Recognized Charge

Aetna Inc. Boston University PLUS Plan - Students 4 The Plan will pay benefits in accordance with any applicable Massachusetts insurance law. The Boston University Plan may not cover all your health care expenses. The Plan excludes coverage for certain services and contains limitations on the amounts it will pay. Please read the Boston University Plan Design and Benefits Summary carefully before deciding whether this plan is right for you. While this presentation and the Boston University Plan Design and Benefits Summary tell you about some of the important features of the Plan, other features may be important to you and some further limit what the Plan will pay. If you want to look at the full plan description, which is contained in the Master Policy issued to Boston University, you may view it at or you may contact us at (800) Additional plan maximums may also apply. Some illnesses may cost more to treat and health care providers may bill you for what the Plan does not cover. Plan informationPreferred CareNon-Preferred Care Policy Year Maximum Unlimited Medical & Prescription Drug Policy Year Deductible None$250 Out-of-Pocket Maximum $3,000 Physician Office Visits $25 Copay, then 100% of Negotiated Charge 80% of Recognized Charge Preventive Care 100% of Negotiated Charge80% of Recognized Charge Emergency Room (Copay waived if admitted) $100 Copay, then 100% of Negotiated Charge $100 Deductible, then 100% of Recognized Charge Inpatient Hospitalization $250 Copay, then 100% of Negotiated Charge 80% of Recognized Charge Prescription Drug $10 Generic Drug/ $35 Preferred-Brand Name Drug/ $50 Non-Preferred Brand Name Drug 80% of Recognized Charge

Aetna Inc. Boston University Where to go for services Access to the Aetna Preferred Provider Network. Aetna Student Health has arranged for you to access a Preferred Provider Network in your local community. Acute care facilities and mental health networks are available nationally if you require care outside the immediate area of the Boston University campus. To maximize your savings and reduce your out-of-pocket expenses, select a Preferred Provider. It is to your advantage to use a Preferred Provider because savings may be achieved from the Negotiated Charges these providers have agreed to accept as payment for their services. 5 To learn more about Preferred Providers, visit

Aetna Inc. Boston University Travel assistance services Access to travel assistance services including emergency assistance – available 24/7. 6 For more information visit On Call by visiting Unlimited emergency medical evacuation and medical repatriation Medical/dental/pharmacy referral Hospital deposit arrangements Prescription drug replacement assistance Dispatch of physician Pre-trip plans 24/7 emergency travel arrangements Translation assistance Emergency travel funds and lost travel documents assistance Natural Disaster & Political Evacuation Services up to $100,000 in the event of either natural disaster making current location uninhabitable or governmental/social upheaval, placing student in imminent bodily harm

Aetna Inc. Boston University Vital Savings by Aetna ® on Dental* An optional dental discount program helping you and your dependents save. One low annual fee of $25 per student In most instances, savings range from percent on services from general dentistry and cleanings to root canals, crowns, and orthodontia (braces) No claims to file Price: $25 Student only $44 Student +1 Dependent $63 Student +2or more Dependents *Actual costs and savings vary by provider and geographic area. 7 The Vital Savings by Aetna® program (the “Program”) is not insurance. The Program does not meet the Minimum Creditable Coverage requirements in Massachusetts. It provides Members with access to discounted fees according to schedules negotiated by Aetna Life Insurance Company for the Vital Savings by Aetna discount program. The range of discounts provided under the Program will vary depending on the type of provider and type of service received. The Program does not make payments directly to the participating providers. Each Member must pay for all services or products but will receive a discount from the providers who have contracted with the Discount Medical Plan Organization to participate in the Program. Aetna Life Insurance Company, 151 Farmington Avenue, Hartford, CT 06156, BeVital, is the Discount Medical Plan Organization. Enroll online at

Aetna Inc. Boston University Value added programs Aetna Weight Management discount program: Access to discounts on the CalorieKing® Program and products, eDiets® diet plans and products, Jenny® weight loss programs and Nutrisystem® weight loss meal plans. Aetna Fitness SM discount program: Access to preferred rates on gym memberships and discounts on at-home weight loss programs, home fitness options and one-on-one health coaching services through GlobalFit®. Oral Health Care discount program: Access to discounts on oral health care products. Save on xylitol mints, mouth rinses, gum, candies and toothpaste from Epic. Additionally, receive exclusive savings on Waterpik® dental water jets and sonic toothbrushes. 8 These are not underwritten by Aetna and are NOT insurance. The member is responsible for the full cost of the discounted services. Please note that these programs are subject to change without notice. To learn more about these additional services and search for providers visit, Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Discount programs may be offered by vendors who are independent contractors and not employees or agents of Aetna or their affiliates. Aetna may receive a percentage of the fee you pay to the discount vendor. These services, programs or benefits are offered by vendors who are independent contractors and not employees or agents of Chickering Claims Administrators, Inc., Aetna Life Insurance Company or their affiliates

Aetna Inc. Boston University Value added programs (continued) Aetna Natural Products and Services SM discount program: Access to savings on complementary health care products and services, including online consultations, not traditionally covered by their health benefits plan. All products and services are provided through the ChooseHealthy® program* and Vital Health Network (VHN). Aetna Vision SM discount program: Access to discounts on vision exams, lenses and frames when a member utilizes a provider participating in the EyeMed Select Network. *The ChooseHealthy program is made available through American Specialty Health Networks, Inc. (ASH Networks) and Healthyroads, Inc. subsidiaries of American Specialty Health Incorporated (ASH). ChooseHealthy is a federally registered trademark of ASH and used with permission herein. 9 These are not underwritten by Aetna and are NOT insurance. The member is responsible for the full cost of the discounted services. Please note that these programs are subject to change without notice. To learn more about these additional services and search for providers visit, Discount programs provide access to discounted prices and are NOT insured benefits. The member is responsible for the full cost of the discounted services. Discount programs may be offered by vendors who are independent contractors and not employees or agents of Aetna or their affiliates. Aetna may receive a percentage of the fee you pay to the discount vendor. These services, programs or benefits are offered by vendors who are independent contractors and not employees or agents of Chickering Claims Administrators, Inc., Aetna Life Insurance Company or their affiliates

Aetna Inc. Boston University Contacts for assistance Aetna Student Health contacts Customer Service- (800) Aetna RX- (888) University contacts Boston University Student Accounting Services phone: (617) To file waivers: 10

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