1. GRADUATE COLLEGE

2. Emails are sent to the students official UA email address (@email.arizona.edu) during each fall and spring Open Enrollment Period. Students receive emails that pertain to their specific situation. Auto renewal – sent to those showing enrolled in previous coverage period Enrolled – sent to those showing enrolled for upcoming coverage period Not Enrolled – sent to those not showing enrolled for upcoming coverage period Departments receive a UAnnounce a couple of weeks prior to the insurance effective date regarding Open Enrollment.

3. Must enroll oneself during open enrollment UAccess Student Account Finances section, select Enroll/Cancel Coverage Campus Health Service website Graduate Assistant/Associate Benefit, select coverage period, then online enrollment/cancellation form When enrolling, there are options from which to choose: Student Health Insurance (Plan A) - Major Medical - Student only coverage Dependent coverage is available CampusCare Supplement (Plan M) - not insurance, limited to services at CHS Offered only to registered UA students Once enrolled, insurance coverage will be automatically renewed each fall and spring semester upon showing registration units, providing year round coverage. Should check UAccess Student account to confirm correct plan enrollment.

4. Provides assistance understanding the Student Health Insurance policy Liaison for claims resolution Contact information: 520-621-5002 chs-insurance@distribution.arizona.edu Detailed Benefit/Premium/Eligibility & Enrollment Information: Campus Health Service website - www.health.arizona.eduwww.health.arizona.edu Select Fees & Insurance

5. Provides assistance understanding specific benefits Permanent ID card replacements Contact information: Member Service: 866-376-7450 Pharmacy Management: 888-792-3862 On-Line Provider Directory/Aetna Navigator/Print ID Cards & Discount Programs can be located at: Aetna Student Health website - www.aetnastudenthealth.comwww.aetnastudenthealth.com Get Started… box, type in The University of Arizona (uarizona)

6. 24/7 Worldwide Medical Information & Assistance Provides coverage for serious injury/illness involving hospitalization Provides coverage for Medical Evacuation/Repatriation/Natural Disaster & Political Evacuation Access to worldwide emergency travel assistance services Provides coverage when member is traveling more than 100 miles from primary residence Member Services: Within the United States: 866-525-1956 Outside the United States: 603-328-1956

7. Campus Health Service is the Primary Care Provider under the student health insurance plan for students. A referral (obtained at Campus Health) is required for services rendered outside of Campus Health, except for Emergency Room, Participating Urgent Care Facilities, OB/GYN and Preventive Services. Dependents are not eligible to be seen at Campus Health and have direct access to participating providers with no referral requirement.

8. Students doing their studies in rural community or another state can obtain direct access to health care services with participating providers. The student needs to send an email to the Campus Health Insurance office requesting a Blanket Referral. chs-insurance@distribution.arizona.edu Email needs to contain the following: Name Student ID Number Circumstances that justify need for a Blanket Referral

9. The Student Health Insurance will remain in effect through the end of the coverage period and will not be automatically renewed the following semester if no registration units are showing in UAccess. There is an insurance option for students that have graduated through Aetna Student Health. 3-month Continuation Plan For information and to enroll Contact Aetna Student Health at 1-866-376-7450 or view at www.aetnastudenthealth.comwww.aetnastudenthealth.com

10. Per Policy Year: August 16 th - August 15 th Maximum - $1,000,000.00 Out of Pocket Limit - $1,500.00 Deductible - $350.00 Co-Insurance - 80/20 Co-Payments: Office Visit - $35.00 Urgent Care - $35.00 Emergency Room - $200.00

11. The following prescriptions only, benefits on a direct payment basis. Limited to participating pharmacies (CHS Pharmacy is not a participant) Must show insurance ID card. Generic Contraceptives- 100% coverage with waiver of deductible (can obtain at CHS Pharmacy) Diabetic Prescriptions & Supplies- 80% coverage with waiver of deductible Tobacco Cessation Medications- 80% coverage with waiver of deductible Oral Chemotherapy Medications- 80% coverage with waiver of deductible Hormone Medications- 80% coverage with waiver of deductible Weight-Loss Medications- 80% coverage with waiver of deductible

12. All other prescriptions are reimbursable under the medical portion of the plan as follows: Following a separate $500 Annual Prescription Deductible, the Plan will reimburse 80% of the Actual Charge of the next $2,500 of Prescription Expenses. After the Covered Prescription Expenses exceed $3,000; the Plan will reimburse 100% of Prescriptions up to the $1,000,000 per Policy year maximum. Can use any Pharmacy - Do not show insurance card.

13. Presented by: Aetna Student Health Introduced by: Campus Health Service