Full Description

Aetna Inc. (Aetna) is a diversified healthcare benefits company. The Company offers a range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities and health care management services for Medicaid plans. Its customers include employer groups, individuals, college students, part-time and hourly workers, health plans, governmental units, government-sponsored plans, labor groups and expatriates. Aetna derives its revenues primarily from insurance premiums, administrative fees, investments and other revenue. The Company’s operations are conducted in three business segments: Health Care, Group Insurance and Large Case Pensions. Health Care products consist of medical, pharmacy benefits management, dental, behavioral health and vision plans offered on both an insured basis and an employer-funded, or administrative, basis. Group Insurance products consist of Life Insurance Products, Disability Insurance Products and Long-Term Care Insurance Products. Large Case Pensions manages a variety of retirement products (including pension and annuity products) primarily for tax qualified pension plans. In November 2009, Psychiatric Solutions, Inc. completed the sale of its employee assistance program (EAP) business to the Company. In addition, in November 2009, Aetna, Inc. completed the acquisition of Horizon Behavioral Services, LLC.

Health Care

The Company’s Health Care segment includes medical products include point of service (POS), preferred provider organization (PPO), health maintenance organization (HMO) and indemnity benefit (Indemnity) plans. Medical products also include health savings accounts (HSAs) and Aetna HealthFund, consumer-directed health plans that combine traditional POS or PPO and/or dental coverage, subject to a deductible, with an accumulating benefit account. It also offers Medicare and Medicaid products and services and specialty products, such as medical management and data analytics services, medical stop loss insurance, as well as products that provide access to its provider networks in select markets. It refers to insurance products as Insured and administrative products as ASC.

Its principal products and services are targeted specifically to large multi-site national, mid-sized and small employers. It also serves individual insureds, expatriates and, in certain markets, Medicare and Medicaid beneficiaries. Medicare and Medicaid products and services are categorized separately from its other Health Care products and services, which it refers to as Commercial. The primary Commercial products it offers are POS, PPO, HMO and Indemnity plans. Aetna also offers other products and services. Its other Commercial products and services include, ActiveHealth Management, Personal Health Record, Pharmacy, Dental, Behavioral Health, Cofinity, Stop Loss, and Other Commercial Products and Services. Through the use of its CareEngine system, its ActiveHealth Management business provides evidence-based medical management and data analytics products and services to a range of customers, including health plans, employers and others.

Through the use of its CareEngine system, its ActiveHealth Management business provides evidence-based medical management and data analytics products and services to a range of customers, including health plans, employers and others. Its Personal Health Record provides members with online access to personal information, including individual personalized messages and alerts, detailed health history based on available claims data and voluntarily submitted information and integrated information and resources to help members make informed decisions about their health care. Aetna offers pharmacy benefit management and specialty and mail order pharmacy services to its members. Its pharmacy fulfillment services are delivered by Aetna Specialty Pharmacy (ASP) and Aetna Rx Home Delivery. It offers managed dental plans on an Insured and ASC basis.

The behavioral health products provide members who experience mental health issues with integrated behavioral health benefit administration, access to a network of providers and wellness programs. Cofinity provides access to a regional health care provider network to other insurance companies, third party administrators, health plans and employers. It has operations in Michigan, Colorado and other states. It offers stop loss insurance coverage for certain employers. Under this product, it assumes the costs associated with large individual claims and/or aggregate loss experience within the employer’s plan above a pre-set annual threshold. Aetna offers a variety of other health care coverage products either as supplements to health products or as stand-alone products. In addition to Commercial health products, in select markets it also offers HMO, PPO, PFFS and prescription drug coverage for Medicare beneficiaries and participate in Medicaid and subsidized State Children’s Health Insurance Programs (SCHIP).

Aetna is a national provider of the Medicare Part D Prescription Drug Program (PDP) in all 50 states to both individuals and employer groups. Aetna offers PFFS in select markets for individuals and nationally for employer groups. It offers healthcare management services for eligible Medicaid and SCHIP individuals under multi-year contracts which are subject to annual appropriations. At December 31, 2008, Aetna had nationwide provider networks of more than 894,000 participating health care providers, including over 517,000 primary care and specialist physicians and over 5,000 hospitals.

Group Insurance

Life Insurance Products consist principally of group term life insurance coverage, the amounts of which may be fixed or linked to individual employee wage levels. It also offers voluntary spouse and dependent term life coverage, and group universal life and accidental death and dismemberment coverage. Aetna offers life products on an Insured basis. Disability Insurance Products provide employee income replacement benefits for both short-term and long-term disability. It also offers disability products with additional case management features. Similar to Health Care products, it offers disability benefits on both an Insured and employer-funded basis. It also provides absence management services, including short-term and long-term disability administration and leave management, to employers.

Long-Term Care Insurance Products provide benefits to cover the cost of care in private home settings, adult day care, assisted living or nursing facilities. Long-term care benefits were offered primarily on an Insured basis. The product was available on both a service reimbursement and disability basis. It offer Its Group Insurance products in 49 states as well as Washington, D.C., Guam, Puerto Rico, the United States Virgin Islands and Canada.

Large Case Pensions

Large Case Pensions manages a variety of retirement products (including pension and annuity products) primarily for tax qualified pension plans. Contracts provide non-guaranteed, experience-rated and guaranteed investment options through general and separate account products. Large Case Pensions’ products that use separate accounts provide contract holders with a vehicle for investments under which the contract holders assume the investment risk. Large Case Pensions earns a management fee on these separate accounts.