Quality Health Plans Benefits Healthier Living Financial .

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Quality health plans & benefitsHealthier livingFinancial well‐beingIntelligent solutionsNY Savings Plus – now available for both1‐50 and 51‐10021

How NY Savings Plus for 1‐50 worksNY 1‐50 Eligible Employees: OAEPO PlansIn‐Network – Tier 1:Maximum SavingsSavings Plus‐designated providersand facilities inthe metro NY/NJservice areaIn‐Network – Tier 2:Standard SavingsOut‐of‐Network –Tier 3Non‐designated NY /NJ specialists, plusfacilities and networkproviders outsideNY/NJ in the EPOnational networkNo out‐of‐networkcoverage, exceptemergencies

How NY Savings Plus for 51‐100 worksNY 51‐100 Eligible Employees: OAEPO PlansIn‐Network ‐ Tier 1:Maximum SavingsIn‐Network ‐ Tier 2:Standard SavingsSavings Plus‐designatedproviders and facilities inNew York/New Jersey serviceareasNon‐designated NY/NJspecialists, facilities andnetwork providers outsideNJ/NY in the EPO nationalnetworkOut‐of‐Network ‐ Tier 3No out‐of‐networkbenefits, exceptemergenciesNY 51‐100 Eligible Employees: OAMC PlansIn‐Network ‐ Tier 1:Maximum SavingsIn‐Network ‐ Tier 2:Standard SavingsSavings Plus‐designatedproviders and facilities inNew Jersey/metro New Yorkservice areasNon‐designated NY/NJspecialists, facilities andproviders outside of NJ/NYin the OAMC nationalnetworkOut‐of‐Network ‐ Tier 3Providers that are not inAetna’s OAMC nationalnetwork

Metro NY Savings Plus service area

Savings Plus Network: Provider TieringSpecialty providers for the following 12 specialties will be indicated as either Designated or Non‐Designated in‐network for NY Savings Plus plans:CardiologyCardio Thoracic SurgeryGastroenterologyGeneral ryngologyPlastic SurgeryUrologyVascular SurgeryNY and NJ hospitals will also be indicated as either Designated or Non‐Designated in‐network forSavings Plus plans.All other NY and NJ participating providers (such as, chiropractors, therapists – physical /occupational / speech) will be indicated as designated in‐network providers in the Savings Plusnetwork.

NY Savings Plus Network: Tier 1 HospitalsBellevue Hospital CenterKingsbrook Jewish Medical CenterPutnam Hospital CenterBenedictine HospitalKingston HospitalQueens Hospital CenterBeth Israel Medical Center‐Kings Highway DivLawrence Hospital CenterRichmond University Medical CenterBeth Israel Medical Center‐Petrie DivisionLincoln Hospital and Mental Health CenterBon Secours Community HospitalBronx‐Lebanon Hospital CenterLong Beach Medical CenterLutheran Medical CenterRichmond University Medical Center‐BayleySetonSouth Nassau Communities HospitalSouthampton HospitalBrookdale Hospital Medical CenterBrookhaven Memorial Hospital Medical CenterBrooklyn Hospital Center‐Caledonian CampusBrooklyn Hospital Center‐Downtown CampusCatskill Regional Medical CenterMaimonides Medical CenterMercy Medical CenterMetropolitan Hospital CenterMidHudson Regional Hospital of Westchester Med CtrMount Sinai Hospital of QueensSt. Anthony Community HospitalSt. Barnabas HospitalSt. Catherine of Siena Medical CenterSt. Charles Hospital & Rehabilitation CenterSt. Francis Hospital/The Heart CenterCatskill Regional Medical Center ‐ G. HermannMount Sinai Medical CenterSt. John's Episcopal Hospital South Shore DivConey Island HospitalDobbs Ferry Pavilion of St. Johns RiversideEastern Long Island HospitalEllenville Regional HospitalElmhurst Hospital CenterFlushing Hospital Medical CenterNew York Community Hospital of BrooklynNew York Eye and Ear InfirmaryNew York Hospital Medical Center of QueensNew York Methodist HospitalNew York Presbyterian Hospital Columbia PresbyterianNew York Presbyterian Hospital NY Cornell CampusSt. John's Riverside HospitalSt. Joseph HospitalSt. Joseph's Medical CenterSt. Luke's Cornwall HospitalSt. Luke's Cornwall HospitalSt. Luke's‐Roosevelt Hosp Ctr‐Roosevelt DivisionGood Samaritan HospitalGood Samaritan Hospital Medical CenterHarlem Hospital CenterHudson Valley Hospital CenterJacobi Medical CenterJamaica Hospital Medical CenterJohn T. Mather Memorial HospitalKings County Hospital CenterNew York Presbyterian Hospital The Allen PavilionNorth Central Bronx HospitalNorthern Dutchess HospitalNorthern Westchester Hospital CenterNyack HospitalOrange Regional Medical Center‐East Main CampusPeconic Bay Medical CenterPhelps Memorial Hospital CenterSt. Luke's‐Roosevelt Hosp Ctr‐St. Luke's DivisionStony Brook University HospitalUniversity Hospital of BrooklynVassar Brothers Medical CenterWestchester Medical CenterWhite Plains Hospital CenterWinthrop‐University Hospital26

NY Savings Plus Network: Tier 2 & OON HospitalsNY Savings Plus Tier 2 Hospitals:NYU Hospitals Center HJDNYU Hospitals Center TischMontefiore Westchester SquareMontefiore Medical Center North DivisionMontefiore Mount VernonMontefiore Medical Center/Henry & Lucy MosesMontefiore New RochelleMontefiore Medical Center/Jack D. Weiler HospitalNY Savings Plus Out‐of‐Network Hospitals:Southside HospitalPlainview HospitalForest Hills HospitalStaten Island University Hospital‐South SiteGlen Cove HospitalStaten Island University Hospital‐North SiteLong Island Jewish Medical CenterSyosset HospitalHuntington HospitalFranklin HospitalNorth Shore University HospitalMemorial Sloan Kettering Cancer CenterLenox Hill HospitalHospital for Special Surgery27

NY Savings Plus NotesGroup must be located in one of the lower 14 counties of NY stateto be eligible. Savings Plus are new plan options in the SG portfolio Savings Plus plans are targeted to employees that utilize NY /NJ providers in the specified service area Savings Plus plans are not feasible for employees that utilizeproviders outside of the service area and/or require themulti‐state solution. These employees should continue toselect broad network plansGroup situs and multi‐state solution does not apply to Savings PlusplansFollow the same Underwriting rules and workflows as the rest ofthe portfolio

DocFind – Savings PlusAetna.comSelect a PlanSelectNY SavingsPlus of MetroNY

DocFind – Savings Plus

the metro NY/NJ service area Non‐ . Coney Island Hospital New York Community Hospital of Brooklyn St. John's Riverside Hospital . Flushing Hospital Medical Center New York Presbyterian Hospital NY Cornell Campus St. Luke's‐Roosevelt HospCtr‐Roosevelt Division Good Samaritan Hospital New York

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