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2014-2015 Boston UniversityStudent Health Insurance Plan

August 29, 2014

Aetna Student Health

Aetna Inc. 2Boston 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:

Coverage Coverage Dates Annual 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 www.aetnastudenthealth.com/bu.

Aetna Inc. 3Boston University

BASIC Plan - Students

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 www.aetnastudenthealth.com or you may contact us at (800) 966-7772. 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 information Preferred Care Non-Preferred Care

Policy Year Maximum Unlimited Medical & Prescription Drug

Policy Year Deductible $150 $500

Out-of-Pocket Maximum $5,000 $5,000

Physician Office Visits $40 Copay, then 100% of Negotiated Charge 80% of Recognized Charge

Preventive Care 100% of Negotiated Charge 80% 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 Charge 60% 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. 4Boston University

PLUS Plan - Students

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 www.aetnastudenthealth.com or you may contact us at (800) 966-7772. 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 information Preferred Care Non-Preferred Care

Policy Year Maximum Unlimited Medical & Prescription Drug

Policy Year Deductible None $250

Out-of-Pocket Maximum $3,000 $3,000

Physician Office Visits $25 Copay, then 100% of Negotiated Charge 80% of Recognized Charge

Preventive Care 100% of Negotiated Charge 80% 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. 5Boston 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.

To learn more about Preferred Providers, visit www.aetnastudenthealth.com/bu

Aetna Inc. 6Boston University

Travel assistance services

Access to travel assistance services including emergency assistance – available 24/7.

For more information visit On Call by visiting www.oncallinternational.com

• 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. 7Boston 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 15-50

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.

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, 1-888-BeVital, is the Discount Medical Plan Organization.Enroll online at www.aetnastudenthealth.com/bu

Aetna Inc. 8Boston 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 FitnessSM 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.

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, www.aetnastudenthealth.com.

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. 9Boston University

Value added programs (continued)

Aetna Natural Products and ServicesSM 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 VisionSM 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.

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, www.aetnastudenthealth.com.

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. 10Boston University

Contacts for assistance

Aetna Student Health contactsCustomer Service- (800) 966-7772Aetna RX- (888) 792-3862www.aetnastudenthealth.com/bu

University contactsBoston University Student Accounting Servicesphone: (617) 353-2264email: studenta@bu.eduTo file waivers: www.bu.edu/studentlink

Aetna Inc.

Thank you