GovGuam Open Enrollment Retirement Supplemental Plan

Fiscal year 2020

aetnainternational.com 46.02.581.1-AM B (9/19)

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We Join YouHafa Adai! Welcome to Aetna International Thank you for placing your trust in Aetna. We are extremely honored to be joining the Guam community, providing health insurance coverage to GovGuam members. As an experienced industry leader, we are committed to providing you and your family members with the highest levels of care possible through a strong local presence that will help build healthier communities here on the Island.

We are confident the information included in this handbook will assist you in understanding your Aetna International health and wellness benefits and services. As outlined on the following pages, you will be able to choose different plan options for the FY 2020, including Aetna’s RSP plan.

Key features of your plan benefits include:

• Wellness and fitness incentive programs

• Employee Assistance benefits to help you face life’schallenges

• An extensive network of doctors and health carefacilities on island

• Enhanced access to care in the Philippines, includingreferral office support at St. Luke’s Medical Center

• Local office and support with dedicated Aetna teammembers through our on-island partner, NetCare

• Enhanced coverage for allergy testing, wellness examsand cancer screenings

• Access to Aetna’s MedQuery, a patient safety tool thathelps protect you and your family through carerecommendations

We believe every member of the Government of Guam needs more than just health insurance. You deserve a health and wellness partner with the knowledge, innovation, thought leadership and resources to help you live a healthier life, no matter where you are in the world.

Our Member Service Center is available 24/7 via local or toll-free phone, fax or email. Highly trained member service representatives will help:

• Process claims and arrange for reimbursement

• Locate health care services around the world

• Arrange medical emergency/evacuation services

• Connect members with our clinical team for specificmedical concerns

Because we’re backed by CVS Health, you will be able to take advantage of more resources, more innovation, more integrated care, lower costs and greater convenience than ever before. But, we also understand the power and convenience of being a community-focused organization with a local presence. That’s why we have committed to joining you; providing you with a local office and dedicated Aetna team members right here in Guam.

Thank you again for the trust you’ve put in us. We’re pleased to have you as a member of the Aetna family, and look forward to helping you reach your best health.

Best,

Justin Remick

Executive Director, Head of Government Programs Aetna International

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Becoming a member You will find information in this section about:

• Who is eligible

• When you can join the plan

• Who can be on your plan (who can be your dependent)

• Adding new dependents

• Special times you and your dependents can join the plan

Government of Guam eligibility requirements

You and your dependents are eligible to enroll with Aetna if you meet the eligibility requirements defined by the Government of Guam and you reside on Guam (see Government of Guam residency requirements). These include the following subscriber requirements:

• A retiree of GovGuam;

• A survivor of a retired employee of GovGuam;

• Are 65 years of age and older;

• Have Medicare Part A and Part B.

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Government of Guam residency requirements

• Enrollment in a plan shall be limited to members who live in Guam, and who do not reside outside Guam for more than 182 days per Plan Year. Children who reside off-island are eligible to enroll under the plan and shall not be denied coverage up to the attainment age of 26 years. Aetna may require substantiation from a Covered Person to determine the Covered Person’s Domicile and may deny benefits under this Agreement for lack thereof.

• For a member living in Guam, time spent receiving continuous medical care off-island, as approved and authorized by Aetna, that is not for long term maintenance treatment, shall not count toward the 182 day maximum, provided the receipt of such care precludes returning to Guam. These cases will be subject to medical case review to determine the necessity of out-of-area extended stay as well as authorization for continuation of medical care by Aetna. In addition, time spent by a parent or spouse of a member shall not count toward the 182 day maximum, provided the parent or spouse is providing necessary assistance to the covered member. However, under no circumstance can there be more than one such caregiver hereunder for any incident of care out of Guam.

When you can join the plan

As an eligible subscriber you can enroll yourself and your dependents:

• Once each Calendar Year during the annual enrollment period

• At other special times during the year (see the Special times you and your dependents can join the plan section below)

If you do not enroll yourself and your dependents when you first qualify for health benefits, you may have to wait until the next annual enrollment period to join.

Dental eligibility

Members may enroll in Aetna’s dental plan only if they are enrolled in Aetna’s medical plan.

Who can be on your plan (who can be your dependent)

You can enroll the following family members on your plan:

• Your legal spouse

• A divorced spouse where there is an order issued by a court having jurisdiction over the parties that the Subscriber continue to provide such spouse coverage under the plan, provided that no Subscriber can enroll more than one person as a spouse at a time unless one spouse is covered pursuant to a court order.

• Your domestic partner who meets the rules set by the Government of Guam and requirements under state law

- Domestic partner definition by Government of Guam: a person who: is 18 years of age or older; is of the same or opposite sex as the Subscriber; is in an exclusive mutually committed relationship with the Subscriber and intends to remain the Subscriber’s sole domestic partner; is not married to any other person; is not related to the Subscriber by blood to a degree that would prohibit marriage; and has cohabitated with the Subscriber for the two consecutive years immediately preceding the proposed enrollment.

• Your dependent children – your own or those of your spouse or domestic partner. The children must be under 26 years of age, and they include your:

- Biological children

- Stepchildren

- Legally adopted children, including any children placed with you for adoption

- Legal guardianship

- Children you are responsible for under a qualified medical support order or court-order (whether or not the child resides with you)

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Continued coverage for a disabled child

• You have the right to extend coverage for your dependent child beyond the plan age limits. If your disabled child:

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Is not able to be self supporting because of mental or physical disability, and

- Depends mainly (more than 50% of income) on you for support.

• The right to coverage will continue only as long as a physician certifies that your child still is disabled.

• We may ask you to send us proof of the disability within 90 days of the date coverage would have ended. Before we extend coverage, we may ask that your child get a physical exam. We will pay for that exam.

• We may ask you to send proof that your child is disabled after coverage is extended. We won’t ask for this proof more than once a year. You must send it to us within 31 days of our request. If you don’t, we can terminate coverage for your dependent child.

Adding new dependents

You can add the following new dependents any time during the year:

• A spouse – If you marry, you can put your spouse on your plan.

- We must receive your completed enrollment information within 31 days after the date of your marriage.

- Coverage will begin on the next pay period beginning upon receiving the enrollment form and documents

• A domestic partner – If you enter a domestic partnership, you can enroll your domestic partner on your health plan.

- We must receive your completed enrollment information within 31 days of becoming eligible to enroll in the plan.

• A newborn child – Your newborn child is covered on your health plan for the first 31 days after birth.

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To keep your newborn covered, we must receive your completed enrollment information and copy of birth certificate within 31 days of birth.

- You must still enroll the child within 31 days of birth even when coverage does not require payment of an additional premium contribution for the covered dependent.

- If you miss this deadline, your newborn will not have health benefits after the first 31 days.

• An adopted child – A child that you, or that you and your spouse or domestic partner adopts is covered on your plan for the first 31 days after the adoption is complete.

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To keep your adopted child covered, we must receive your completed enrollment information within 31 days after the adoption.

- If you miss this deadline, your adopted child will not have health benefits after the first 31 days.

• A stepchild – You may put a child of your spouse or domestic partner on your plan.

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You must complete your enrollment information and send it to us within 31 days after the date of your marriage or your Declaration of Domestic Partnership with your stepchild’s parent.

- Coverage will begin on the next pay period upon receiving proper documentation.

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Notification of change in status

It is important that you notify us of any changes in your benefit status. This will help us effectively deliver your benefits. Please notify us as soon as possible of status changes such as:

• Change of address

• Change of covered dependent status

• Enrollment in Medicare or any other health plan of any covered dependent

Special times you and your dependents can join the plan

You can enroll in these situations:

• When you did not enroll in this plan before because:

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You were covered by another health plan, and now that other coverage has ended.

- When a court orders that you cover a current spouse or domestic partner or a minor child on your health plan.

We must receive your completed enrollment information within 31 days of that date on which you no longer have the other coverage mentioned above.

Documents that may be required to enroll

The following documents may be required for enrollment:

• Marriage certificate if the spouse has a different last name than the subscriber

• Domestic partner affidavit

• Affidavit of natural child

• Birth certificate if a child’s last name differs from the subscriber

• Legal Guardianship

• Court document signed by a judge ordering legal adoption or guardianship of a minor child

Effective date of coverage

Your coverage begins on the date the Government of Guam tells us. This will be the effective date on the enrollment information sent to us to enroll you and your eligible dependents in the plan.

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File claims the easy way Aetna International’s Medicare Direct

When you have a Medicare Supplement plan, like your Aetna plan, Medicare Part A and/or B pays your claims first. Then you send a second claim to Aetna to pay any covered remaining balance.

But with Medicare Direct, we save you the trouble of having to file a second claim. Sign up for Medicare Direct and Medicare automatically forwards any remaining expenses to us — no more time-consuming paperwork to fill out. And because we receive your claims faster, we can pay them faster.

Here’s how Medicare Direct works:

1 Visit your doctor

2 Your doctor submits the claim to Medicare

3 Medicare pays its portion of the claim and sends the remaining balance directly to us

4 We pay covered expenses and notify you

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RSP plan Eligibility Provision

Retiree/Survivor Must be enrolled in Medicare Part A and B.

Dependent(s) Spouse, domestic partner; children up to age 26, regardless of student status.

All services outside of Guam, including the U.S. Mainland & Hawaii require pre-authorization.

Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Individual Deductible $0 per Plan Year $0 per Plan Year

Family Deductible $0 per Plan Year $0 per Plan Year

Individual Payment Limit $500 per Plan Year $500 per Plan Year

(Does not include deductibles, copays, precertification penalty, 50% items and also Outpatient Prescription Drugs. Includes Outpatient Prescription Drugs when outside the U.S.)

Family Payment Limit $1,000 per Plan Year. $1,000 per Plan Year

(Does not include deductibles, copays, precertification penalty, 50% items and also Outpatient Prescription Drugs. Includes Outpatient Prescription Drugs when outside the U.S.)

Lifetime Maximum Unlimited Unlimited

Hospital Services

Inpatient Private Room Limit Includes Breast Reconstructive Surgery, Cardiac Surgery, Congenital Anomaly Diseases, Elective Surgery, Maternity Care, Robotic Surgery

(Pre-Certification may be required)

20%

The institution’s semiprivate rate.

20%

The institution’s semiprivate rate.

Outpatient Includes Ambulatory Surgi-Center Care, Outpatient cataract surgery, Chemotherapy, MRI, CT scan, and other diagnostic procedures, End Stage Renal Disease / Hemodialysis, Nuclear Medicine, Inhalation Therapy, Radiation Therapy, Sleep Apnea, Vasectomy

20% 20%

Pre-certification Penalty No penalty $400

Pre-Certification for certain types of Non-Preferred care received inside the U.S. must be obtained to avoid a reduction in benefits paid for that care. Pre-Certification for Hospital

Admissions, Treatment Facility Admissions, Convalescent Facility Admissions, Home Health Care and Hospice Care is required — excluded amount applied separately to each type of expense.

Contact the service center to determine if pre- certification is needed for a procedure.

Emergency Room 20% 20%

Non-Emergency use of the Emergency Room

50% 50%

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Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Hospital Services

Urgent Care 20% 20%

Non-Urgent use of Urgent Care Provider

50% 50%

Ambulance Services 20% 20%

Physician Services

Physician Office Visit 20% 20%

Specialist Office Visit 20% 20%

Mental Health & Alcohol/Drug Abuse Services

Mental Health Inpatient Unlimited days per Plan Year

20% 20%

Mental Health Outpatient Unlimited visits per Plan Year

20% 20%

Substance Abuse Inpatient Unlimited days per Plan Year

20% 20%

Substance Abuse Outpatient Unlimited visits per Plan Year

20% 20%

Preventive Care Services

Routine Child Physical Exams No charge No charge

7 exams in the first 12 months of life, 3 exams in the 2nd 12 months of life, 3 exams in the 3rd 12 months of life, and 1 exam per 12 months thereafter to age 22

Includes Immunizations/vaccinations

Routine Adult Physical Exams No charge No charge

1 exam every 12 months up to age 65, 1 exam every 12 months age 65 and older

Includes Immunizations/vaccinations

Routine Gynecological Exams Includes 1 exam and pap smear per Plan Year

Includes sterilization and tubal ligation

No charge No charge

Routine Mammograms No charge No charge

Prostate Specific Antigen (PSA) No charge No charge

Routine Digital Rectal Exam (DRE) No charge No charge

Colorectal Cancer Screening Recommended: For all members age 50 and older

No charge No charge

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RSP plan (continued) Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Preventive Care Services

Routine Hearing Exams Includes one routine exam every 24 months

No charge No charge

Hearing Aids $500 per member, per Plan Year

20% 20%

Other Services

Skilled Nursing Facility 60 visits, per Plan Year

20% 20%

Hospice Care Facility Inpatient 30 days lifetime maximum; precertification required

20% 20%

Hospice Care Facility Outpatient 180 days lifetime maximum

No charge No charge

Home Health Care 120 visits per Plan Year, includes Private Duty Nursing

20% 20%

Acupuncture 30 visits per member, per Plan Year

20% 20%

Spinal Disorder Treatment Unlimited visits per Plan Year

20% 20%

Short Term Rehabilitation 20% 20%

(Includes coverage for Occupational, Physical and Speech Therapies; 60 combined visits per Plan Year)

Diagnostic Outpatient X-ray 20% 20%

Diagnostic Outpatient Lab 20% 20%

Blood & Blood Derivatives 20% 20%

Base Infertility Services 20% 20%

(Base plan coverage includes coverage limited to the testing and treatment of underlying condition)

Durable Medical Equipment Unlimited lifetime maximum

Including Orthopedic conditions

20% 20%

Implants Limitations apply

20% 20%

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Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Other Services

Allergy Testing Unlimited

20% 20%

Allergy Serum & Injections Does not include those on the Specialty Drugs List & Orthopedic injections

20% 20%

Organ Transplants Unlimited lifetime maximum

Includes Organ Donors

Precertification Required

20% 20%

Aids Treatment Precertification Required

20% 20%

Diabetics Supplies 20% 20%

Payment for Non-Preferred Providers See Medical Plan Caveat section

Not Applicable Professional: 105% of Medicare

Facility: 140% of Medicare

Airfare Benefit For members who meet qualifying conditions, Plan provides roundtrip airfare (Plan Approval Required)

No charge Not covered

Autism Autism covered same as any other expense. Member cost sharing is based on the type of service performed and the place of service where it is rendered.

Prescription Drug Coverage

Generic Drugs (365-day maximum supply) Includes contraceptives

$15 copay per month supply

($0 copay for 90-day Mail Order Drugs)

20%

Formulary Brand Name Drugs (365-day maximum supply) Includes contraceptives

$30 copay per month supply

($0 copay for 90-day Mail Order Drugs)

20%

Non Formulary Generic and Brand Name Drugs (365-day maximum supply) Includes contraceptives

$100 copay per month supply

($0 copay for 90-day Mail Order Drugs)

20%

Specialty Drugs (365-day maximum supply)

$100 copay per month supply Not covered

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RSP plan (continued) Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Vision Care

Routine Eye Exams (Covered under medical) Includes 1 exam every 12 months

No charge No charge

Vision Care Supplies Schedule maximums apply every 12 months

No charge up to $150 maximum

No charge up to $150 maximum

Add on Services

International Employee Assistance Program (EAP)

Included Included

Includes up to 5 counseling sessions per issue per year per enrolled member. Access benefits by calling the member service number on ID card: 800-231-7729 or collect 813-775-0190.

Services include: Cultural adjustment assistance, Marital/Family Stress, Child care and behavioral concerns, Social adaptation needs, Alcohol/Substance Abuse, Work/Life Balance and Depression.

International Disease Management

Included Included

International Maternity Management Program

Included Included

Simple Steps To A Healthier Life® Included Included

Wellness Checkpoint Included Included

Medical Plan Caveats

Payment Limits Payment limits apply per individual on a Plan Year basis. Only those out-of-pocket expenses resulting from the application of a payment percentage may be used to satisfy the payment limit. Deductibles, copays, precertification penalty and 50% items are excluded from the payment limit.

Plan Year and Per Confinement Deductibles

There is no cross-application between Plan Year and per confinement deductibles. If a member is hospitalized, he or she must meet both per confinement and Plan Year deductibles (as applicable) before the plan pays any benefits.

Coverage Maximum (Days/Visits) Coverage maximums up to a certain number of days/visits per Plan Year are reached by combining the Preferred and Non-Preferred benefits up to the limit for either one plan or the other, but not both. (Example, if the Preferred benefit is for 120 days and the Non-Preferred benefit is for 120 days, the maximum benefit is 120 days, not 240 days).

In-Network Deductible/ Coinsurance

In-Network – deductible and coinsurance may apply to pap smears, DRE tests and PSA tests if billed by an independent laboratory provider.

Maternity Care Maternity expenses are covered as any other medical expense. Coverage is provided for an employee and eligible dependents. Pregnancy benefits do not continue to be payable after coverage ends except in the event of total disability.

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Medical Plan Caveats

Ancillary Services For contracted hospitals, the non-contracted Radiologist, Anesthesiologist and Pathologist (RAPS) are paid at the preferred level, and will be subject to reasonable and customary charges. Note that this payment method may apply to other providers.

Pre-Existing Conditions No Restrictions

Pre-existing condition limitation is waived on the effective date.

Pre-existing condition limitation is waived after the effective date.

Payment for Non-Preferred Providers

We cover the cost of care differently based on whether health care providers, such as doctors and hospitals, are “in-network” or “out-of-network.” We want to help you understand how much Aetna pays for your out-of-network care in the mainland U.S. At the same time, we want to make it clear how much more you will need to pay for this out-of-network care.

As an example, when receiving care in the U.S., you may choose a doctor in our network. You may choose to visit an out-of-network doctor. If you choose a doctor who is out-of-network, your Aetna health plan may pay some of that doctor’s bill. Most of the time, you will pay a lot more money out of your own pocket if you choose to use an out-of-network doctor or hospital.

When you choose out-of-network care, Aetna limits the amount it will pay. This limit is called the “recognized” or “allowed” amount. When you choose out-of-network care, Aetna “recognizes” an amount based on what Medicare pays for these services. The Federal government sets the Medicare rate. Exactly how much Aetna “recognizes” depends on the plan you or your employer picks.

If you’re seeking out-of-network care in the mainland U.S., your charged rates may be higher — sometimes much higher — than what your Aetna plan “recognizes” or “allows.” Your doctor may bill you for the dollar amount that Aetna doesn’t recognize. You must also pay any copayments, coinsurance and deductibles under your plan. No dollar amount above the recognized charge counts toward your deductible or maximum out-of-pocket. To learn more about how we pay out-of-network benefits visit aetna.com. Type “how Aetna pays” in the search box.

You can avoid these extra costs by getting your care from Aetna’s broad network of health care providers within the mainland U.S. Go to www.aetna.com and click on “Find a Doctor” on the left side of the page. If you are already a member, sign on to your Aetna Health member site. This way of paying out-of-network doctors and hospitals applies when you choose to get care out-of-network. When you have no choice (for example: emergency room visit after a car accident), we will pay the bill as if you got care in-network. You pay your plan’s copayments, coinsurance and deductibles for your in-network level of benefits. Contact Aetna if your provider asks you to pay more. You are not responsible for any outstanding balance billed by your providers for emergency services beyond your copayments, coinsurance and deductibles.

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RSP plan (continued)

Dental PPO Plan features Member Responsibility

PARTICIPATING In-Network Inside and Outside of Guam

NON-PARTICIPATING Out-of-Network Inside and Outside of Guam

Individual Deductible $0 per Plan Year $0 per Plan Year

Family Deductible $0 per Plan Year $0 per Plan Year

Type A Expense (Diagnostic & Preventive)

No charge 30%

Includes Prophylaxis, Bitewing and full mouth series X-rays, Space Maintainers, Oral Exams, Fluoride applications, Sealants, and Periapical X-rays.

Type B Expense (Basic Restorative)

20% 30%

Includes Fillings, Simple Extractions and Oral Surgery.

Type C Expense (Major Restorative)

50% 65%

Includes Crown Lengthening, Crown Buildup, Inlays/onlays, Bridgework, Osseous surgery, Soft tissue grafts, Partial and full bony impactions, General anesthesia and intravenous sedation,

Dentures (benefit includes all relines, rebases and adjustments within 6 months of installation), Molar root canal therapy, Prosthetic repairs, and Occlusal Guards (for bruxism only).

Plan Year Maximum $1,000 $1,000

The proposed plan of benefits is underwritten by Aetna Life Insurance Company. This is only a brief summary of the benefits available. Some restrictions may apply. If you have Maryland or Washington membership, a separate policy may be required. For more specific information about the coverage details, including limitations, exclusions and other plan requirements, please refer to the Member booklet (which will be provided near the time the plan becomes effective).

This is not evidence of coverage. You must enroll and be accepted for coverage with the Coverage Administrator before these documents will be effective. In the case of a discrepancy between the Plan Documents and this document, the Plan Documents will determine the Plan of Benefits. As used herein, the term “Plan Documents” includes, but is not limited to, the Booklet, Schedule of Benefits and any Booklet Amendments/Riders including any state-specific variations, as applicable. For further details, refer to your Plan Documents. In the event of a discrepancy between the benefit grid and the Contract, between the Government of Guam and Aetna, the contract will prevail.

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It’s all about CARE

Our Care and Response Excellence (CARE) team of clinicians are your single point of contact from a trusted partner. We’ll help you make the right connections at all stages of your health and wellness journey, including:

• Providing case management and disease management

• Finding doctors, health care facilities and equipment

• Coordinating any routine and urgent care

• Advocating for you and identifying gaps in care

• Helping you get medications

• Seeking second opinions when advisable

• Offering pre-trip planning when off-island care is needed

The power of one

You will get consistent and continuous care by working one-on-one with the same clinician to address both chronic and acute conditions holistically. It’s seamless care with the best possible outcomes and it’s built right into your plan.

Finding the gaps

Aetna’s MedQuery turns member data into information doctors can use to improve care. The program uses data to alert doctors if there are opportunities to improve the quality or safety of a specific patient’s care. MedQuery applies over 9,000 clinical rules to find potential errors or gaps in care. Once those are identified, the program assigns them a severity level. MedQuery then alerts the treating doctor about these member-specific opportunities to improve care. By finding and communicating ways to improve care, MedQuery helps doctors optimize care and get you back to your best health.

Help in an emergency

If you have a covered catastrophic illness (as determined by your plan and referring provider) for which treatment is unavailable in Guam and you have met the plan eligibility requirements, we can help get you transported to the nearest facility equipped to handle your specific needs. A written medical referral from your provider and an approved pre-certification/authorization form are all you need to qualify for certain emergency medical services, including:

• Medical evacuation

• Air ambulance

• Emergency travel assistance

• Repatriation of mortal remains

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Wellness as a way of life

While physical health is critical to well-being, it’s more than that. Wellness is emotional health, financial security, feeling connected, having a sense of purpose and more. We will help you on your personal path to wellness with online resources as well as local, on-island programs and services.

Your health assessment

Taking our online Health Assessment is a great first step on the road toward better health and wellness. It only takes a few minutes and helps identify possible health risks and encourage healthy behaviors.

Wellness webinars

Our monthly webinars feature clinical experts from the CARE team discussing key health and wellness issues that matter to you.

Health fairs

As an Aetna International member, you’ll have the unique opportunity to attend health fairs led by Guam’s Public Health Department on issues of interest to Guamanians.

Resources to help with life’s demands

Life is full of challenges. Our Employee Assistance Program (EAP) helps you balance the demands of work, life and personal issues. Whether it’s finding balance between work and life, dealing with the loss of a loved one, managing anxiety or depression, or parenting advice, EAP offers you free, confidential support delivered by qualified counselors.

• Up to five free counselling sessions per concern, per year

• Multilingual, 24/7, worldwide support

• Telephone support from behavioral health experts

• Referral to legal and financial resources

When outside the United States, you can access your international EAP through the iConnectYou app on your portable device or mobile phone. The app gives you secure, confidential access to clinical counselors and work-life experts by phone, instant message, text (SMS) or video chat.

We also provide you with free access to the myStrength website and mobile app to gain inspiration and insight on achieving greater emotional health through articles, videos, mood trackers, eLearning programs and check-in reminder options.

Online health coaching

You’ll find resources to help you embrace a healthier lifestyle with our online coaching programs. Virtual health coaches motivate and support members with holistic support, educational exercises, tips and success strategies.

Informed Health® Line 24-hour access

When in the United States, you and your family members can save time, money and a trip to the emergency room by using our Informed Health Line — and it’s only a phone call or click away at no extra cost. Registered nurses help you:

• Get your medical questions answered

• Find out more about a test or procedure

• Prepare for a doctor’s appointment

• Better understand health conditions

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Health and wellness incentive program

Earn up to $200 in gift cards Make the most of your benefits to have the biggest impact on your health. Whether it’s an onsite biometric screening or your annual wellness exam, health screenings can help keep you well by identifying any current and potential health risks. With Aetna International’s member incentive, we will give you up to $200* in gift cards if you complete two out of three of these qualifying actions:

• Get a biometric screening or annual wellness exam

• Complete the online health assessment

• Attend a health coaching session (group, telephonicor one-on-one health coaching)

Gym membership included

A healthy body and mind are supported by regular exercise. That’s why gym and fitness memberships are part of our wellness benefits to our GovGuam members. To sign up simply take your medical enrollment form to any participating gym, enroll, and return a copy of your gym enrollment form to our local Aetna office. Choose from any one of the island’s best facilities, including:

• Hilton Wellness Center

• The Gym Guahan

• Paradise Fitness Center

• Urban Fitness & Dance Studios

• Custom Fitness

• International Sports Center

• CrossFit Hita

• CrossFit Latte Stone

*Completion of health screening, health assessment and one health coaching program are required to earn gift card rewards.Incentive -based activity awards will only be given for completing select wellness programs as determined by the plan sponsor.

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The information you need … anytime, anywhere When you have questions about your health, or the health of a family member, it’s important to know that you can quickly and easily find the answers you need. That’s why we’ve put it right at your fingertips — no matter where you are in the world!

On the web

Aetna Health Aetna Health gives you more tools and resources to help you manage your health and benefits online. In Guam, you can easily access Aetna Health at aetna.com, which will allow you to:

• Find U.S. doctors, hospitals and walk-in clinics

• Track your claim’s status

• Access your digital Member ID card

• Estimate costs of area hospitals, medical procedures and prescriptions

• Take your health assessment to determine your current state of health

• Take advantage of a whole host of health and wellness programs

Health Hub Health Hub is your personalized, secure member website at aetnainternational.com. It’s fast and easy to use on any device, helping you manage your benefits, find care, access your plan documents and more when you are off island. It’s optimized to work equally well on any device, including your mobile phone or tablet. Using Health Hub, you can:

• Find doctors and hospitals in Guam and nearby regions

• Access your health care plan documents

• Submit claims faster and easier

• Browse a library of health and wellness topics

On the go

No matter where you are in the world, it’s important to have easy access to the information and tools you need to make good health care decisions. Our free mobile apps put the most important and useful features of your secure member website right on your smartphone.

International Mobile Assistant app Use the International Mobile Assistance app when you’re out of the United States to:

• Submit your claims

• Search for doctors and hospitals outside the United States

• Find forms, health care resources and more; it’s free to download

Just search “Aetna International” in the App Store or Google Play store. If you haven’t already registered for Health Hub, you’ll need to do that before you can use the International Mobile Assistant app.

Aetna Mobile App Use the Aetna Mobile App when you’re on mainland United States to:

• Find doctors, hospitals, urgent care centers and walk-in clinics in the United States

• Estimate your costs

• Track your claims

The Aetna Mobile App is also free to download. Just search “Aetna Mobile App” in the App Store or Google Play store. Again, if you haven’t already registered for Health Hub, you’ll need to do that before you can use the Aetna Mobile App.

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Emergency and urgent care facilities

Guam Memorial Hospital Authority (GMHA)850 Gov Carlos G Camacho Rd, Tamuning

Phone: 647-2555/9 Fax: 649-5508

Seventh-Day Adventist Guam Clinic388 Ypao Road, Tamuning

Phone: 646-8881/2 Fax: 647-2557

IHP Medical Group655 Harmon Loop Road, Ste. 108, Harmon

Phone: 633-4447 Fax: 633-4452

Guam Regional Medical City133 Route 3, Dededo

Phone: 645-5500 Fax: 645-5501

American Medical Center1244 N. Marine Corps Drive, Upper Tumon

Phone: 647-8261/2 Fax: 647-8257

FHP Urgent Care548 N. Marine Corps Drive, Tamuning

Phone: 646-5825 Fax: 647-3532

1. Hagatña2. Agana Heights3. Sinajana4. Mongmong-Toto-Maite5. Tamuning-Tumon Harmon

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Comprehensive network

1.2 million medical providers on the U.S. mainland, across all 50 states 165,000 international providers outside of the United States, including:

650 providers in Guam

66,750 providers in the Philippines

As well as: 950 providers in Hong Kong

150 providers in Japan

40 providers in Korea

10 providers in Taiwan

Philippines • Cardinal Santos Medical Center

• Manila Doctor’s Hospital

• National Kidney and Transplant Institute

• St. Luke’s Medical Center: Global City, Manila

• St. Luke’s Medical Center: Quezon City, Manila

• The Medical City: Clark Freeport Zone, Pampanga

• The Medical City: Molo, Iloilo City

• The Medical City: Pasig City, Manila

Taiwan • Shin Kong Wu Ho-Su Memorial Hospital

• Taiwan Adventist Hospital

Hong Kong • Hong Kong Adventist Hospital: Stubbs Road

Japan • Adventist Medical Center

Korea • Samsung Medical Center

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Frequently asked questions

When is Open Enrollment?

Open Enrollment for fiscal year 2020 will run from Monday September 23 — Saturday October 12.

• You will be able to learn about the plan offerings and ask specific questions to the Department of Administration and Aetna representatives during the various Open Enrollment events that are planned throughout the week and weekend. Be on the lookout for a specific schedule with dates and times.

• Brochures with the plan designs will also be distributed to each of the department agencies.

What are some of the key benefits that will not change with Aetna plans?

There are many benefits that will not change with the move to Aetna, including:

• Local on-Island support via our Aetna office at the Julale Center.

• Plan offerings that still include the PPO 1500, HSA 2000 and the Retiree Supplemental Plan, as well as the Foster Plan. These benefits in these plans are almost identical to what you currently have with some value-added enhancements. Detailed plan booklets will be available as of September 23.

• Most of your local providers and pharmacies will still be in-network with Aetna. Provider directories will be available as of September 23.

• Access to services and providers outside of Guam, such as the U.S. mainland and the Philippines, thru the overseas benefit process. The process will be similar to how it runs today, which requires a pre-authorization.

• Gym memberships as part of Aetna’s wellness program under the Aetna plans. Additional details about the program, including a list of gyms and how to enroll, will be shared during Open Enrollment sessions.

Does everyone need to fill out a new Enrollment Form during Open Enrollment?

Please read carefully if you are required to fill out an enrollment form:

• If you are currently in Class I (Employee/Retiree or Survivor Only) and would like to stay within the same plan (PPO 1500 or HSA 2000), you will be automatically carried over. No action is required.

• For Class I, if you would like to elect a plan change or disenroll from coverage, you will need to fill out an enrollment form . You need to complete and submit the change form by the end of the Open Enrollment period on October 12.

• If you are in Class II (Employee/Retiree or Survivor with Spouse), III (Employee/Retiree or Survivor with Child/ren), or IV (Employee/Retiree or Survivor with Spouse and Children), then you are required to fill out an enrollment form to obtain coverage for the upcoming Plan Year. There is no automatic carryover for these classes. This is because we need to collect information on you and your dependent(s).

• Enrollment forms will be available thru your department agency, Open Enrollment events and other locations and means.

• You will be able to submit your completed open enrollment form to your department agency, Department of Administration or Aetna representative at an open enrollment event, or to the Aetna office at the Julale Center. Retirees may also submit their forms to the Government of Guam Retirement Fund.

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I currently have a medical or dental appointment booked on or after October 1, 2019. Do I need to take any actions to ensure my appointments are not cancelled and still covered?

• Yes. You will need to enroll with Aetna (enrollment instructions will be provided to you) and confirm that your provider is in the Aetna/NetCare network (provider listings will be distributed during open enrollment and available online). You will also need to confirm that the treatment you are seeking is covered under your Aetna policy by referring to the benefit summaries that will be distributed during open enrollment.

• When you arrive at your appointment, simply notify them of your new insurance and give them your Aetna Member ID number or a copy of your completed enrollment form.

How can I check if my provider is in- or out-of-network with Aetna?

Aetna in-network provider directories will be provided at upcoming open enrollment meetings. Once you are enrolled, you will be able to register and log in to Aetna International’s website and mobile apps, where you can search for in-network providers.

I am in active treatment that will run thru October 1, 2019 with an out-of-network provider in Guam; what should I do?

After you have completed enrollment and confirmed your provider is out-of-network, review our standard Transition of Care policy and procedure. The Transition of Care provides instructions on what to complete as a member, what your provider must complete, and instructions for submission and approval.

What is Transition of Care?

Transition of Care is a standard process where members — during an active course of covered treatment that meets clinical coverage guidelines under the care of an out-of-network provider — can extend those services for a short period of time while services are being transferred to an Aetna participating provider. Typically the extension is 90 days, unless the treatment is for services like chemotherapy, pregnancy, etc.

How do I initiate a Transition of Care?

To initiate the Transition of Care process, the member and provider need to complete Aetna International’s Transition of Care form and submit it via email/fax to our clinical team. These forms will be available at the open enrollment meetings as well as our local office at the Julale Center.

Will Aetna have an office in Guam?

Our office is located at the Julale Center, 424 West O’Brien Drive, Hagatna.

What is the phone number of the Aetna office in Guam?

Local Office 47 AETNA (472-3862)

24/7 Customer Service Toll Free: 800-231-7729 Direct or Collect: 813-775-0190

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Location: Julale Center 2nd floor, Hagatña

Address: Aetna International 424 West O’Brien Drive Julale Center Hagatña, Guam 96910

Phone:Local: 47 AETNA (472-3862) 24/7 customer service: Toll Free: 800-231-7729 Direct or collect: 813-775-0190

AetnaTM is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.

Aetna does not provide care or guarantee access to health services. Not all health services are covered, and coverage is subject to applicable laws and regulations, including economic and trade sanctions. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plans and programs are underwritten and administered by Aetna Life Insurance Company.

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