Important Information Concerning Your Rates,

the Renewability of Your Coverage

and Pre-existing Conditions

This disclosure is provided in accordance with Colorado insurance law, and applies to you if you are determined to be a Colorado Small Employer who employed no more than 50 eligible employees.

Upon your request, we will provide you with information on provisions of coverage relating to the following:

• Geographic areas served by managed care plans;
• The benefits and premiums available under all health insurance coverage for which the employer is qualified, under applicable state law;
• The minimum employer contribution and group participation rules that apply to any particular type of coverage.

Rating

The initial medical rates quoted for your group are subject to adjustment at the commencement of any subsequent rating period based upon the then-current new business rates for groups with similar case characteristics and similar benefits. Case characteristics of a group include age, geographic area and family composition.

Rates for any and all small group products being marketed in the Colorado small group market, will be given to a small employer, upon either oral or written request of such employer, within five (5) working days of the request.

Class of Business

We currently maintain a single class of business for employer groups of fewer than 51 eligible employees which includes your group. Additional classes of business may be established in the future.

Renewability

This coverage is renewable at your option, except for the following reasons:

• Non-payment of premiums;
• Fraud or intentional misrepresentation of material fact on the part of the plan sponsor with respect to group health benefit plan coverage and the individual with respect to individual coverage;
• Violation of participation or contribution rules;
• The carrier elected to discontinue offering and non-renew all of its individual, small group or large group plans delivered or issued for delivery in Colorado;
• With respect to small group health plans, an employer is no longer actively engaged in the business in which it was engaged on the effective date of the plan;
• For network plans, there are no longer any enrollees who reside or work in the service area; or;
• If the employer’s membership in a bona fide association ceases, but only if coverage is terminated uniformly without regard to any health status-related factor relating to any covered individual.

Pre-existing Conditions Provisions (Does not apply to HMO Plans)

A waiting period for pre-existing conditions will be administered in certain situations for all employees and dependents enrolling in our group plan.

Transferred Business- When coverage for a group is transferred to our group plan, we will waive any pre-existing conditions limitation for all members whose coverage becomes effective on the date of the transfer, whether they were covered under the transferred plan or not.

New Enrollees- Individuals that are added to our group plan after the plan's original effective date may be subject to a pre-existing condition limitation. Eligible employees and dependents who were covered under prior Creditable Coverage at any time within the 90 days prior to their enrollment date, will not be subject to any pre-existing condition limitation. (This 90 day period will not include any probationary period under the new coverage). Individuals with no prior coverage or individuals that had more than a 90 day gap from the date their coverage terminated to the enrollment date, will be subject to the group plan’s pre-existing conditions limitation, but that period must not exceed 180 days.

A pre-existing condition is a condition, regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received during the 180 days immediately preceding (a) the insured’s enrollment date of coverage or (b) if there is a waiting period before such enrollment the first day of the waiting.

A pre-existing condition limitation extends for a period of not more than 180 days. The pre-existing condition limitation does not apply to pregnancy; or genetic testing; or to a newborn, an adopted child under age 18, or a child placed for adoption under age 18, if the child becomes covered under this Coverage within 31 days of birth, adoption, or placement for adoption.

Creditable Coverage means benefits or coverage under:

• Medicare or Medicaid;
• an employee welfare benefit plan or group health insurance or health benefit plan;
• an individual health benefit plan;
• a state health benefits risk pool (including but not limited to the Colorado uninsurable health insurance plan); or
• Chapter 55 of title 10 of the United States Code, a medical care program of the federal Indian health service or of a tribal organization, a health plan offered under chapter 89 of title 5, United States Code, a public plan, or health benefit plan under section 5(e) of the federal "Peace Corps Act" (22 U.S.C. sec. 2504(e)).

Access Plan(s)

The Colorado Consumer Protection Standards Act for the operation of Managed Care Plans (Colorado Revised Statutes §10-16-704 (9) ), requires a carrier to maintain an "access plan" for each managed care network that the carrier offers in Colorado. In general, an access plan lists hospitals, providers, referral procedures, grievance procedures, and emergency coverage provisions.

The law requires the carrier to make its access plans (except for certain confidential information, as specified in Colorado Revised Statutes sec. 24-72-204 (3) ) available on its business premises and to provide them to any interested party upon request. To obtain additional information regarding our Colorado access plan(s), please contact your local company representative.

OPEN ENROLLMENT PERIOD APPLICABLE TO GUARANTEED ISSUE BASIC OR STANDARD HEALTH BENEFIT PLANS FOR BUSINESS GROUPS OF ONE.

In accordance with Colorado law, Aetna Life Insurance Company has established open enrollment periods for guarantee issue basic or standard plan applications from business groups of one. The open enrollment period is a period of thirty-one (31) days following the birth date of the person qualifying as a business group of one. Issuance of a basic health benefit plan and a standard health benefit plan is limited to such thirty-one day period. A copy of the applicant’s driver’s license or birth certificate must be provided as evidence of the applicant’s birthrate. In addition to the annual thirty-one day enrollment period, persons qualifying as business groups of one may apply within thirty-one days of the date of the following events: (1) the end of state or federal continuation coverage; (2) the person initially meets the business group of one definition requirements and whose birth date is more than thirty-one days after doing so; or (3) the person involuntarily loses other creditable coverage. (This event (3) does not apply in cases of failure to pay premium, fraud, or a voluntary decision on the part of the person to terminate other creditable coverage.

"COLORADO INSURANCE LAW REQUIRES ALL CARRIERS IN THE SMALL GROUP MARKET TO ISSUE ANY HEALTH BENEFIT PLAN IT MARKETS IN COLORADO TO SMALL EMPLOYERS OF 2-50 EMPLOYEES, INCLUDING A BASIC OR STANDARD HEALTH BENEFIT PLAN, UPON THE REQUEST OF A SMALL EMPLOYER TO THE ENTIRE SMALL GROUP, REGARDLESS OF THE HEALTH STATUS OF ANY OF THE INDIVIDUALS IN THE GROUP. BUSINESS GROUPS OF ONE CANNOT BE REJECTED UNDER A BASIC OR STANDARD HEALTH BENEFIT PLAN DURING OPEN ENROLLMENT PERIODS AS SPECIFIED BY LAW."

The foregoing information is subject to change based on future changes to your state's insurance law or other regulatory requirements, as well as future changes to rating practices. Any such changes will be communicated to your group.

This material has been prepared for compliance with certain Colorado disclosure requirements. The plan benefits to which these disclosures apply may be provided or administered by any of the entities listed below.  HMO benefits are provided or administered by: Aetna Health Inc.(CO), Aetna Health Inc. (DE), Aetna Health of California Inc., Aetna Health of the Carolinas Inc., Aetna Health of Georgia Inc., Aetna Health of Illinois Inc. and/or Aetna Health of Texas Inc. QPOS® and USAccess™ referred benefits may be provided or administered by: Corporate Health Insurance Company, Corporate Health Insurance Company (DE), Aetna Health of California Inc., Aetna Health of the Carolinas Inc., Corporate Health Insurance Company (GA) Corporate Health Insurance Company (IL), Corporate Health Insurance Company (TX), Aetna Health of Washington; QPOS and USAccess self-referred benefits may be provided or administered by: Corporate Health Insurance Company, Aetna Health of California Inc., Aetna Healthcare of the Carolinas Inc., Aetna Health of Washington Inc., Aetna Life Insurance Company, U.S. Health Insurance Company, and/or Corporate Health Insurance™ Company. Managed Choice, Open Choice and Traditional Choice benefits may be provided or administered by Aetna Life Insurance Company.