Background

At Aetna, we believe strongly in the power of the consumer, which is why we're developing innovative plan designs and investing in the tools, education and technology to help consumers make clear, informed decisions.

We were the first national, full-service health insurer to introduce a consumer-directed product in September 2001. Since the launch of our first-generation health reimbursement arrangement (HRA) product, the Aetna HealthFund family has expanded to include a wide variety of fund and account options; some of the broadest and most innovative offerings in the industry. These choices include the Aetna HealthFund Health Savings Account (HSA), Aetna HealthFund Retiree Reimbursement Account (RRA), Aetna HealthFund Flexible Spending Account (FSA) and Aetna HealthFund First Dollar Plan.

This variety of options makes Aetna one of the few health plans currently offering consumer-directed benefits to employers of all sizes -- ranging from small local employers to national customers with thousands of employees nationwide. And, the evolution of the product family doesn't stop there -- we continue to solicit feedback from our constituents and enhance our products to better serve their ever-changing needs.

The success of Aetna HealthFund is due in large part to the unique resources that Aetna brings to the table. These include one of the largest networks of physicians, dentists, hospitals, pharmacies and health professionals; a long history of providing innovative and dependable health benefits; extensive experience in claims payment and administration; and powerful online information resources and self-service tools.

The New Role of the Consumer

As American consumers take a more active role in managing their health benefits, they need tools, information and support to make well-informed decisions. Aetna continues to embrace the needs of health care consumers by introducing innovative health plans and continuously enhancing the decision-support tools and information that help our members make well-informed choices.

Facts At A Glance

• Consumer-directed health plans will attract 2.7 million members and capture $16 billion in premiums by 2005 and $88 billion in premiums by 2007.
  
  Forrester Research, "Consumer-Directed Health Plan Leaders Poised for Growth," July 2003



• Nine out of 10 Aetna members indicated their satisfaction with Aetna HealthFund and intend to re-enroll in the plan.
  
  Aetna HealthFund Survey, Summer 2003
  
  

Product Overview

Aetna HealthFund responds to demand for an important dimension of consumer choice by providing consumers with a fund that can be used to pay for qualified medical expenses. With Aetna HealthFund, consumers generally accrue a certain amount of money per year in their fund or account. Depending upon the type of account, this can be employer-funded, employee-funded or funded by both the employer and the employee. Definitions of each of the available funds and accounts are located in the Aetna HealthFund Glossary.

The real advantage of these funds or accounts is that they are most often combined with the protection of a traditional health plan. The health plan is generally a deductible-based medical plan that provides 100 percent preventive care coverage, for services such as annual physicals, mammograms, immunizations, and well-child care. Within the plan, consumers have the freedom to choose referral-free access to an expansive network of physicians, hospitals and other health care professionals, as well as the ability to seek out-of-network care. The plans also feature out-of-pocket maximums to protect members from catastrophic health events.

With Aetna HealthFund HRA, HSA and RRA options, unused dollars roll over to the next year. Any remaining balance may be used for qualified medical services in subsequent years, as long as the member remains enrolled in the plan. In some plan designs, employers can also offer a separate FSA that individuals can fund with pretax dollars. However, FSA funds must be used in the year in which they are accrued and cannot be rolled over to subsequent years.

As consumers take a more active role in health care decisions, they need tools and information to make informed choices. Aetna is meeting that need by providing a host of tools that offer health and benefits management information both online and via telephone, 24 hours a day, 7 days a week. These include health care pricing and quality tools, online claims and fund tracking, credible health information and health risk assessments.

Ultimately, consumers should choose Aetna HealthFund based upon an understanding of expected health care expenses, a preference for more control of their health benefit dollars and the potential to save on overall health care costs.