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Health Care Reform Implementation 2010 and Beyond

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Health Care Reform Implementation 2010 and Beyond

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    1. Welcome everyone. Thank you for joining us today. Our focus today is on Health Care Reform implementation and how Aetna has organized to support this process, ultimately ensuring compliance w/all facets of PPAC. Welcome everyone. Thank you for joining us today. Our focus today is on Health Care Reform implementation and how Aetna has organized to support this process, ultimately ensuring compliance w/all facets of PPAC.

    2. Agenda Agenda is straightforward We’ll start by talking about broad HC reform Give you an update on implementation of 2010 benefit, plan provisions and mandates Take a look at long-term market reform And leave time for questions Agenda is straightforward We’ll start by talking about broad HC reform Give you an update on implementation of 2010 benefit, plan provisions and mandates Take a look at long-term market reform And leave time for questions

    3. 3 Why is Aetna Involved? Bill signed into law on March 23, 2010 Represents an important milestone as ~32M Americans who were previously uninsured will have greater access to coverage for the care they need Throughout the debate, 3 challenges with the current health care system took center stage – access, cost/affordability, and quality Access – ~45M uninsured Cost/Affordability – $2.5T, 17.3% of GDP in 2009 Quality – only half of recommended care is received and more costly care does not equal higher quality care Reform law did little to impact or address cost/affordability. As the CMS chief actuary has stated, the national health expenditures under the new law for the period between 2010-2019 are estimated to be $311B more than before the reform legislation Need to address costs and quality or reform not sustainable – not enough done in this single bill, HCR will continue to evolve, and Aetna will be engaged to ensure that the fundamental needs of the health care delivery system. Bill signed into law on March 23, 2010 Represents an important milestone as ~32M Americans who were previously uninsured will have greater access to coverage for the care they need Throughout the debate, 3 challenges with the current health care system took center stage – access, cost/affordability, and quality Access – ~45M uninsured Cost/Affordability – $2.5T, 17.3% of GDP in 2009 Quality – only half of recommended care is received and more costly care does not equal higher quality care Reform law did little to impact or address cost/affordability. As the CMS chief actuary has stated, the national health expenditures under the new law for the period between 2010-2019 are estimated to be $311B more than before the reform legislation Need to address costs and quality or reform not sustainable – not enough done in this single bill, HCR will continue to evolve, and Aetna will be engaged to ensure that the fundamental needs of the health care delivery system.

    4.

    5. HCR Implementation Timeline As you know, many legislative provisions are effective this year, mostly focused on new benefit mandates and additional plan provisions/requirements. As we look ahead, there is another large wave of implementation happening in 2014, focused on insurance market reforms. Each phase provides opportunity for Aetna to leverage existing product, service and administrative capabilities, as well as opportunities for modifications and/or improvements. Aetna is fully committed to working with you, our customers, members and constituents to ensure success in the post reform market place. As you know, many legislative provisions are effective this year, mostly focused on new benefit mandates and additional plan provisions/requirements. As we look ahead, there is another large wave of implementation happening in 2014, focused on insurance market reforms. Each phase provides opportunity for Aetna to leverage existing product, service and administrative capabilities, as well as opportunities for modifications and/or improvements. Aetna is fully committed to working with you, our customers, members and constituents to ensure success in the post reform market place.

    6. Benefit & Plan Provisions / Mandates Effective 9/23 The next several slides give us a snapshot of the various provision effective 9/23 – what they are, Aetna’s actions to date and what – at a high level – is changing as a result. (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix for details]The next several slides give us a snapshot of the various provision effective 9/23 – what they are, Aetna’s actions to date and what – at a high level – is changing as a result. (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix for details]

    7. (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix” for details] (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix” for details]

    8. (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only 2010 Provisions Appendix for details]

    9. Benefit & Plan Provisions / Mandates Effective 9/23 (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details]

    10. (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details]

    11. (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details]

    12. (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details]

    13. (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details] (Walk through provisions) [Refer to Aetna-only “2010 Provisions Appendix for details]

    14. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    15. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    16. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    17. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    18. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    19. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    20. Turning our Eye To the Future A snapshot of reform provisions to be Implemented in January 1, 2014 and beyond Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans. Looking at 2014, you will note that many of the most anticipated measure of reform will take effect: Exchanges, Guaranteed issue, Individual and employer mandates These are extremely complicated issues that will require significant input from the NAIC, HHS, and other regulatory agencies prior to implementation. We will work closely with all of the key stakeholders to ensure that we are prepared for the changes ahead Need to recognize that there are a lot of changes that could occur between now and 2014 (2 new congresses, potentially a new president). So while we want to begin thinking about 2014, it is still a bit premature to start building concrete business plans.

    22. Aetna is committed to compliance with the new legislation. With first wave of provisions effective 9/23/10, we reached a significant milestone – fulfilling our obligation to implement new benefit and plan provisions/mandate. We will continue to work with regulators and NAIC to shape new regulations post 9/23. With Health Care Reform as our catalyst, we are focused on transforming the system in ways that make quality health care more affordable and help people lead healthier lives. We will keep you informed along the way.

    23. Health Care Reform Resources

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