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2017 health plan highlights for federal employees

✔ High Option HMO plan

✔ Standard Option HMO plan

✔ High-deductible health plan (HDHP)

• No deductibles plus predictable costs with the health maintenance organization (HMO) plans

• Built-in dental on the High Option HMO plan

• Extras to make the most of your plan

www.aetnafeds.com/altius

19.02.324.1 FED A (9/16)

Your health plan comes with more Altius is an Aetna company. So on top of some familiar plan features, you’ll also be able to take advantage of some great plan perks.

It all starts with your Aetna Navigator®

member website

All your plan information and extras are in one place — your secure member website. You just need to sign up.

Register at www.aetnafeds.com/altius. Then log in anytime. When you do, you can find ways to save on:

• Jawbone® wearable fitness devices

• Gym memberships and weight-loss programs

• Chiropractic care, acupuncture, massage therapy and more

Plus, your member website has tools that help you: • Find a doctor, hospital or walk-in clinic, close to home or

out of state

• Create your own personal health record and review claims

• Save money by comparing costs, using the Member Payment Estimator and Price-A-DrugSM tools

Want to test drive the tools now? Log in at www.aetnafeds.com/altius. Use “federal 3” as your user name and password.

Same networks you’re used to

You can feel good that you get access to the same doctor and hospital networks you’ve been using. Chances are your doctor is in network.

To make sure, check our directory before signing up. Go to www.aetnafeds.com/altius and click on “Find your doctor now.”

Visit doctors by phone, video or app, too

For added convenience, you can take advantage of the Teladoc® network of providers.

For $40 or less, depending on your plan, you can consult with doctors over the phone, via online video or Teladoc mobile app. Teladoc physicians are board certified and available 24 hours a day.

They can also write a prescription if medically necessary.

Once you become a member, just set up an account at www.teladoc.com/aetna.

Minor services (like fillings)

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For full plan details, service areas and rates, check your federal brochure at www.aetnafeds.com/altius.

High Option HMO — predictable costs and built-in dental

Key benefits What you pay

Physician services Preventive care $0 Routine physical $0 (one per calendar year) In office for diagnostic and treatment $20 primary care; $35 specialist In hospital, surgical center or other facility 10% coinsurance Teladoc phone or video consult $30

Hospital services Inpatient $200 a day; up to $600 per admission Outpatient 10% coinsurance

Maternity Physician care $0 for prenatal care Hospital care $200 a day; up to $600 per admission

Emergency benefits In and out of area $200 for emergency room services

Mental health/substance abuse treatment Office visits $20 copay Inpatient services $200 a day; up to $600 per admission

Prescription drugs 30-day supply at retail pharmacy $7 preferred generic; $25 preferred brand name;

40% up to $240 max copay nonpreferred

90-day supply through mail-order service $7 preferred generic; $50 preferred brand name; 40% up to $720 max copay nonpreferred

Injectable and intravenous therapy drugs 30% preferred; 50% nonpreferred

Vision care Annual routine eye exam $0 (Plus, you’ll get $100 every 24 months for eyewear reimbursement.)

Built-in dental

Preventive (like cleanings and X-rays)

Major services (like crowns)

When you visit network dentists:

$0 40% 60% See plan brochure for out-of-network coverage details.

2017 High Option HMO rates (what you pay every other week) Code Non postal Postal 1 Postal 2

Self only 9K1 $122.80 $113.57 $110.49

Self + one 9K3 $278.44 $258.61 $252.01

Self + family 9K2 $256.55 $235.49 $228.48

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$0 $0 (one per calendar year) $20 primary care; $40 specialist 15% coinsurance $40

Standard Option HMO — lower biweekly rates

Key benefits What you pay

Physician services Preventive care Routine physical In office for diagnostic and treatment In hospital, surgical center or other facility Teladoc phone or video consult

Hospital services Inpatient Outpatient

15% coinsurance 15% coinsurance

Maternity Physician care $0 for prenatal care Hospital care Nothing after $200 per admission copay

Emergency benefits In and out of area $250 for emergency room services

Mental health/substance abuse treatment Office visits $20 copay Inpatient services 15% coinsurance

Prescription drugs 30-day supply at retail pharmacy $7 preferred generic; $35 preferred brand name;

50% up to $240 max copay nonpreferred

90-day supply through mail-order service $7 preferred generic; $70 preferred brand name; 50% up to $720 max copay nonpreferred

Injectable and intravenous therapy drugs 30% preferred; 50% nonpreferred

Vision care Annual routine eye exam $0 (Plus, you'll get $100 every 24 months for eyewear reimbursement.)

2017 Standard Option HMO rates (what you pay every other week) Code Non postal Postal 1 Postal 2

Self only DK4 $60.52 $52.66 $50.24

Self + one DK6 $132.33 $115.13 $109.84

Self + family DK5 $133.66 $116.28 $110.94

What you pay

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HDHP — with a tax-free health savings account (HSA)

Key benefits

Deductible $1,300 for self only $2,600 for self + one or self + family

HSA deposits — We’ll contribute $54.16 per month for self only ($108.33 per month for self + one or self + family). You can use your HSA to help pay for your health care. Or save it — even if you leave the plan — and use it for future health expenses.

Physician services Preventive care Routine physical In office for diagnostic and treatment In hospital, surgical center or other facility Teladoc phone or video consult

$0 $0 (one per calendar year) $20 primary care after deductible; $40 specialist after deductible 10% after deductible $40 after deductible

Hospital services Inpatient 10% after deductible Outpatient 10% after deductible

Maternity Physician care 10% after deductible Hospital care 10% after deductible

Emergency benefits In and out of area $200 for emergency room services

Mental health/substance abuse treatment Office visits $20 copay after deductible Inpatient services 10% after deductible

Prescription drugs After deductible: 30-day supply at retail pharmacy $7 preferred generic; $25 preferred brand name; $50 nonpreferred (No deductible for preventive medicine)

90-day supply through mail-order service $21 preferred generic; $75 preferred brand name; $150 nonpreferred (No deductible for preventive medicine)

Injectable and intravenous therapy drugs 20% preferred; 35% nonpreferred

Vision care Annual routine eye exam $0 (Plus, you’ll get $100 every 24 months for eyewear reimbursement.)

2017 HDHP rates (what you pay every other week) Code Non postal Postal 1 Postal 2

Self only 9K4 $43.42 $37.78 $36.04

Self + one 9K6 $88.97 $77.41 $73.85

Self + family 9K5 $90.75 $78.95 $75.32

Your online benefits counselor, ALEX® can help you understand your options and pick a plan best suited to meet your needs.

Not quite sure which plan to choose? ALEX makes it easy.

Plus, he’s available 24/7 ... at www.aetnafeds.com/altius.

Ready to enroll in your Altius health plan?

Sign-up is 1-2-3 easy

Step 1: Choose a plan Review the brochure and find a plan that fits your needs.

Need help? Call us at 1-800-837-0977.

Or ask ALEX. You’ll find him at www.aetnafeds.com/altius.

Step 2: Find your plan’s enrollment code They’re listed in the rate charts in this brochure. You can also find them at www.aetnafeds.com/altius.

Step 3: Fill out the form Check with your human resources department to see if you can enroll online, using an agency system like MyPay, Employee Express or PostalEASE. Or you may need to submit a paper 2809 form.

Need a form? Go to www.aetnafeds.com/ enroll-now.php.

Health benefits and insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc. and/or Aetna Life Insurance Company (Aetna). This is a brief description of the features of this Aetna health benefits plan. Before making a decision, please read the plan’s applicable federal brochure(s). All benefits are subject to the definitions, limitations and exclusions set forth in the federal brochure. Plan features and availability may vary by location and are subject to change. Pharmacy clinical programs such as precertification, step therapy and quantity limits may apply to your prescription drug coverage. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Trademarks and logos displayed are the property of their respective owners. Discounts are not guaranteed under our contract with the FEHB program. Please see www.aetnafeds.com/altius for details. HealthEquity Inc. is an IRS-approved nonbank custodian of health savings accounts. Teladoc and the Teladoc logo are trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc and Teladoc physicians are independent contractors and are neither agents nor employees of Aetna or plans administered by Aetna. Teladoc is not available in all states. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc does not prescribe DEA-controlled substances, nontherapeutic drugs and certain other drugs because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetnafeds.com/altius.

www.aetnafeds.com/altius

©2016 Aetna Inc. 19.02.324.1-FED A (9/16)