Health benefits solutions for a mobile population Today’s dynamic landscape

1. Health benefits solutions for a mobile population Today’s dynamic landscape Toby Dobbs Salomea Klunzinger September 13, 2011

2. Aetna International overview • Over 30 years experience in international expatriate market under Aetna International • One of the largest expatriate insurers with 1,500 unique plan sponsors About • Led by Sandip Patel, President of Aetna International • Over 800 employees worldwide (U.S., Europe, Asia and the Middle East) People • Over 400,000 members located worldwide • “Globally-mobile” employees including expatriates, third country nationals, U.S.-bound expatriates, key local nationals and business travelers • Government public/private health partnerships Membership • Comprehensive products for globally mobile populations including medical, dental, vision, pharmacy, life, AD&PL and LTD • Value-added services: emergency assistance, international disease and maternity management, medical management and wellness programs, and pre-trip planning • Consultative health management solutions for health care systems, government entities and plan sponsors Products & Services • 24/7 member tools • Access to over 61,000 health care professionals worldwide • Streamlined member and plan sponsor services • Local and global clinical and administrative services Value-Added

3. Why an international plan? Compensation and benefits are key to the success of expatriate assignments. Carefully selected and simplifiedglobal benefits package Appropriate and prompt handling of member health concerns + Successful Assignment

4. Health Impact The life of a globally-mobile individual

5. The expatriate experience for employers and employees United States

6. Access Cost & Affordability Quality Health Care Reform continues to act as a catalyst for needed change Market conditions change, but problems persist A solutions-based approach • Coordinated approach to the Accountable Care Act (ACA) implementation and compliance • Helping customers understand potential impacts • Strong advocate for regulations that avoid unintended consequences, minimize complexity • Focus on innovative solutions that address unmet needs for access, health care quality and affordability • Millions of uninsured Americans • Rising health care cost and health insurance premiums • Disparities in quality and cost • Fraud and waste in the system • Not enough focus on prevention and wellness

7. Goals Guiding Principles Fostering compliance with the ACA and helping customers to do the same • Effectively implement & comply with the ACA • Act as advocates for customers, members and employees in shaping regulations to avoid unintended consequences (at a federal, state & local level) • Help customers effectively navigate the new health care landscape • Collaborate with strategy and business areas to inform and shape ongoing strategic discussions and decisions • Keep customers and members at the center of efforts • Follow a disciplined, comprehensive approach to implementation • Foster compliance with the law and help customers do the same • Be a leader in making a better health care system for all Americans

8. Next stop: the United Arab Emirates United Arab Emirates

9. Coverage considerations for expatriates, third-country nationals and local nationals • The need to understand and comply with the legal and regulatory environment related to required health insurance • This includes tailoring international plans to address these regulatory and compliance requirements, and communicating this important information to your employees • Recent examples include the Czech Republic, Abu Dhabi, Saudi Arabia, etc. • For example: Abu Dhabi - mandatory health insurance for resident expatriates or local nationals; must include basic minimum health coverage through a locally licensed carrier

10. Next stop: Japan Japan

11. Providing personalized assistance when it’s needed most • In-house clinical teams to support your employees’ unique health care needs • Emergency assistance programs • Emergency evacuations due to medical conditions/lack of available, adequate facilities • Security, political and natural disaster evacuation coverage (non-medical situations) • International Employee Assistance Program (IEAP) • Helping to address personal, cultural and other adjustment concerns while living aboard • Ongoing communications and information support

12. Worldwide challenges

13. New communicable diseases are appearing and spreading through globally mobile populations Lifestyle diseases, chronic conditions and other non-communicable diseases are becoming more prevalent Health and wellness programs Wellness is a lifelong journey to optimal health, from staying healthy to managing conditions  It means treating the whole person, including their physical, mental, emotional and financial well-being Healthy/low risk Stay well (mind and body) At risk for disease/injury Identify and manage health risks to prevent disease Reduce absenteeism and on-the-job productivity loss Managing a chronic disease Manage/mitigate disease impact Identify and manage those most at risk for disability Major and catastrophic health events Provide structured programs to support return to health and productivity Manage medical care Manage disability Access to Quality Care Worldwide health vulnerability

14. Worldwide connectivity • Secure member and plan sponsor web tools • International doctor and hospital directories • Access to member personal health information • Member enrollment system (reporting, online billing, etc.) • Medical translation databases • Drug translation guides • Travel safety and security services • Mobile optimization of sites/tools for ease of use • Location-based capabilities (ability to serve contextual product content based on geographical market of user)

15. Key takeaways • Innovative, flexible and integrated health care solutions tailored to meet your specific needs • Valuable wellness and prevention tools to encourage healthy lifestyles • Personalized online services and tools to provide ease of service and meet customer and member needs

16. Our global vision Our Values We put the people who use our services at the center of everything we do Our Cause To make quality health care more affordable and more accessible Our Strategy To be the global leader in empowering people to live healthier lives

17. Comments and insights