ÿþ<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:x="urn:schemas-microsoft-com:office:excel" xmlns:p="urn:schemas-microsoft-com:office:powerpoint" xmlns:a="urn:schemas-microsoft-com:office:access" xmlns:dt="uuid:C2F41010-65B3-11d1-A29F-00AA00C14882" xmlns:s="uuid:BDC6E3F0-6DA3-11d1-A2A3-00AA00C14882" xmlns:rs="urn:schemas-microsoft-com:rowset" xmlns:z="#RowsetSchema" xmlns:b="urn:schemas-microsoft-com:office:publisher" xmlns:ss="urn:schemas-microsoft-com:office:spreadsheet" xmlns:c="urn:schemas-microsoft-com:office:component:spreadsheet" xmlns:odc="urn:schemas-microsoft-com:office:odc" xmlns:oa="urn:schemas-microsoft-com:office:activation" xmlns:html="http://www.w3.org/TR/REC-html40" xmlns:q="http://schemas.xmlsoap.org/soap/envelope/" xmlns:rtc="http://microsoft.com/officenet/conferencing" xmlns:D="DAV:" xmlns:Repl="http://schemas.microsoft.com/repl/" xmlns:mt="http://schemas.microsoft.com/sharepoint/soap/meetings/" xmlns:x2="http://schemas.microsoft.com/office/excel/2003/xml" xmlns:ppda="http://www.passport.com/NameSpace.xsd" xmlns:ois="http://schemas.microsoft.com/sharepoint/soap/ois/" xmlns:dir="http://schemas.microsoft.com/sharepoint/soap/directory/" xmlns:ds="http://www.w3.org/2000/09/xmldsig#" xmlns:dsp="http://schemas.microsoft.com/sharepoint/dsp" xmlns:udc="http://schemas.microsoft.com/data/udc" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:sub="http://schemas.microsoft.com/sharepoint/soap/2002/1/alerts/" xmlns:ec="http://www.w3.org/2001/04/xmlenc#" xmlns:sp="http://schemas.microsoft.com/sharepoint/" xmlns:sps="http://schemas.microsoft.com/sharepoint/soap/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:udcs="http://schemas.microsoft.com/data/udc/soap" xmlns:udcxf="http://schemas.microsoft.com/data/udc/xmlfile" xmlns:udcp2p="http://schemas.microsoft.com/data/udc/parttopart" xmlns:wf="http://schemas.microsoft.com/sharepoint/soap/workflow/" xmlns:dsss="http://schemas.microsoft.com/office/2006/digsig-setup" xmlns:dssi="http://schemas.microsoft.com/office/2006/digsig" xmlns:mdssi="http://schemas.openxmlformats.org/package/2006/digital-signature" xmlns:mver="http://schemas.openxmlformats.org/markup-compatibility/2006" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns:mrels="http://schemas.openxmlformats.org/package/2006/relationships" xmlns:spwp="http://microsoft.com/sharepoint/webpartpages" xmlns:ex12t="http://schemas.microsoft.com/exchange/services/2006/types" xmlns:ex12m="http://schemas.microsoft.com/exchange/services/2006/messages" xmlns:pptsl="http://schemas.microsoft.com/sharepoint/soap/SlideLibrary/" xmlns:spsl="http://microsoft.com/webservices/SharePointPortalServer/PublishedLinksService" xmlns:Z="urn:schemas-microsoft-com:" xmlns:st="&#1;" xmlns="http://www.w3.org/TR/REC-html40"> <head> <meta http-equiv=Content-Type content="text/html; charset=unicode"> <meta name=ProgId content=Word.Document> <meta name=Generator content="Microsoft Word 12"> <meta name=Originator content="Microsoft Word 12"> <link rel=File-List href="AetnaHealthReformWeekly092809_files/filelist.xml"> <link rel=Edit-Time-Data href="AetnaHealthReformWeekly092809_files/editdata.mso"> <!--[if !mso]> <style> v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </style> <![endif]--> <title>Aetna</title> <!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> <o:DoNotRelyOnCSS/> <o:TargetScreenSize>1024x768</o:TargetScreenSize> </o:OfficeDocumentSettings> </xml><![endif]--> <link rel=themeData href="AetnaHealthReformWeekly092809_files/themedata.thmx"> <link rel=colorSchemeMapping href="AetnaHealthReformWeekly092809_files/colorschememapping.xml"> <!--[if gte mso 9]><xml> <w:WordDocument> <w:TrackMoves/> <w:TrackFormatting/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:DoNotExpandShiftReturn/> <w:BreakWrappedTables/> <w:SplitPgBreakAndParaMark/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> <m:mathPr> <m:mathFont m:val="Cambria Math"/> <m:brkBin m:val="before"/> <m:brkBinSub m:val="&#45;-"/> <m:smallFrac m:val="off"/> <m:dispDef/> <m:lMargin m:val="0"/> <m:rMargin m:val="0"/> <m:defJc m:val="centerGroup"/> <m:wrapIndent m:val="1440"/> <m:intLim m:val="subSup"/> <m:naryLim m:val="undOvr"/> </m:mathPr></w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true" DefSemiHidden="true" DefQFormat="false" DefPriority="99" LatentStyleCount="267"> <w:LsdException Locked="false" Priority="0" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Normal"/> <w:LsdException Locked="false" Priority="9" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="heading 1"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/> <w:LsdException Locked="false" Priority="39" Name="toc 1"/> <w:LsdException Locked="false" Priority="39" Name="toc 2"/> <w:LsdException Locked="false" Priority="39" Name="toc 3"/> <w:LsdException Locked="false" Priority="39" Name="toc 4"/> <w:LsdException Locked="false" Priority="39" Name="toc 5"/> <w:LsdException Locked="false" Priority="39" Name="toc 6"/> <w:LsdException Locked="false" Priority="39" Name="toc 7"/> <w:LsdException Locked="false" Priority="39" Name="toc 8"/> <w:LsdException Locked="false" Priority="39" Name="toc 9"/> <w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/> <w:LsdException Locked="false" Priority="10" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Title"/> <w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/> <w:LsdException Locked="false" Priority="11" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/> <w:LsdException Locked="false" Priority="22" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Strong"/> <w:LsdException Locked="false" Priority="20" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/> <w:LsdException Locked="false" Priority="59" SemiHidden="false" UnhideWhenUsed="false" Name="Table Grid"/> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/> <w:LsdException Locked="false" Priority="1" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 1"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 1"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 1"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/> <w:LsdException Locked="false" Priority="34" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/> <w:LsdException Locked="false" Priority="29" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Quote"/> <w:LsdException Locked="false" Priority="30" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 1"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 1"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 2"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 2"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 2"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 2"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 2"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 3"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 3"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 3"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 3"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 3"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 4"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 4"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 4"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 4"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 4"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 5"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 5"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 5"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 5"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 5"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 6"/> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 6"/> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 6"/> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 6"/> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 6"/> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title"/> <w:LsdException Locked="false" Priority="37" Name="Bibliography"/> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/> </w:LatentStyles> </xml><![endif]--> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:1; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:0 0 0 0 0 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-1610611985 1073750139 0 0 159 0;} @font-face {font-family:Tahoma; panose-1:2 11 6 4 3 5 4 4 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-520082689 -1073717157 41 0 66047 0;} @font-face {font-family:Verdana; panose-1:2 11 6 4 3 5 4 4 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-1593833729 1073750107 16 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:Calibri;} a:link, span.MsoHyperlink {mso-style-noshow:yes; mso-style-priority:99; color:blue; text-decoration:underline; text-underline:single;} a:visited, span.MsoHyperlinkFollowed {mso-style-noshow:yes; mso-style-priority:99; color:purple; text-decoration:underline; text-underline:single;} p {mso-style-priority:99; mso-margin-top-alt:auto; margin-right:0in; mso-margin-bottom-alt:auto; margin-left:0in; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:Calibri;} p.MsoAcetate, li.MsoAcetate, div.MsoAcetate {mso-style-noshow:yes; mso-style-priority:99; mso-style-link:"Balloon Text Char"; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:8.0pt; font-family:"Tahoma","sans-serif"; mso-fareast-font-family:Calibri;} span.BalloonTextChar {mso-style-name:"Balloon Text Char"; mso-style-noshow:yes; mso-style-priority:99; mso-style-unhide:no; mso-style-locked:yes; mso-style-link:"Balloon Text"; mso-ansi-font-size:8.0pt; mso-bidi-font-size:8.0pt; font-family:"Tahoma","sans-serif"; mso-ascii-font-family:Tahoma; mso-fareast-font-family:Calibri; mso-hansi-font-family:Tahoma; mso-bidi-font-family:Tahoma;} span.EmailStyle20 {mso-style-type:personal; mso-style-noshow:yes; mso-style-unhide:no; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-fareast-font-family:Calibri; mso-hansi-font-family:Calibri; mso-bidi-font-family:"Times New Roman"; color:#1F497D;} span.EmailStyle23 {mso-style-type:personal-reply; mso-style-noshow:yes; mso-style-unhide:no; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; color:#1F497D; mso-themecolor:dark2;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman","serif";} </style> <![endif]--><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="1026"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang=EN-US link=blue vlink=purple style='tab-interval:.5in'> <div class=Section1> <p class=MsoNormal style='mso-layout-grid-align:none;text-autospace:none'><font size=3 color=black face=Calibri><span style='font-size:12.0pt;font-family:"Calibri","sans-serif"; mso-bidi-font-family:Calibri;color:black'><o:p>&nbsp;</o:p></span></font></p> <p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size: 12.0pt'><o:p>&nbsp;</o:p></span></font></p> <div align=center> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=600 bgcolor=white style='width:6.25in;mso-cellspacing:0in;background:white; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=2 style='padding:0in 0in 0in 0in'> <p class=MsoNormal><a name=top></a><font size=3 face="Times New Roman"><span style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman"'><img width=120 height=100 id="_x0000_i1025" src="http://content.mkt922.com/ra/2009/1636/10/2355258/aetna_logo2.gif" border=0><img width=480 height=100 id="_x0000_i1026" src="http://content.mkt922.com/ra/2009/1636/10/2355258/header_480%5b1%5d3.gif" border=0><o:p></o:p></span></font></p> </td> </tr> <tr height=252 style='mso-yfti-irow:1;mso-yfti-lastrow:yes;height:189.0pt'> <td width=120 height=252 valign=top style='width:1.25in;padding:0in 0in 0in 0in; height:189.0pt'> <p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:12.0pt;mso-fareast-font-family:"Times New Roman"'><img width=120 height=240 id="_x0000_i1027" src="http://content.mkt922.com/ra/2009/1636/10/2355258/flag2.jpg" border=0><o:p></o:p></span></font></p> </td> <td width=480 height=252 valign=top style='width:5.0in;padding:0in 0in 0in 0in; height:189.0pt'> <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%" style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt: 0in 0in 0in 0in'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=top style='padding:11.25pt 11.25pt 11.25pt 11.25pt'> <p style='margin-bottom:12.0pt'><strong><b><font size=3 color=maroon face=Verdana><span style='font-size:12.0pt;font-family:"Verdana","sans-serif"; color:maroon'>A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country</span></font></b></strong><o:p></o:p></p> <p><strong><b><font size=2 face=Verdana><span style='font-size:10.0pt; font-family:"Verdana","sans-serif"'>Week of&nbsp;September&nbsp;28, 2009</span></font></b></strong><font size=2 face=Verdana><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"'><br> <br> <em><i><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>The Senate Finance Committee wasted no time last week in wading through a seemingly endless number of amendments to its proposed health care reform legislation (see below). The committee turned aside a number of amendments, including attempts to avert cuts to the Medicare Advantage program to help pay for expanded coverage for the uninsured. But the sparring that occurred over the issue is a good indication that emotions are running high, and the&nbsp;dispute is bound to reappear when the bill makes it to the Senate floor. Democrats and the Obama administration last week sought to reassure seniors that health care reform would not cost them their current levels of Medicare benefits, but the head of the Congressional Budget Office, Douglas Elmendorf, recently told Senators that seniors in Medicare Advantage could very well see reduced benefits. The bill's momentum continues, but some Democrats are now struggling to figure out how to vigorously support health care reform without alienating many elderly voters.</span></font></i></em><i><span style='font-style:italic'><br> <br> <em><i><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>Join us in becoming key players in the political process and help represent your perspective and your clients' interests before state and federal lawmakers. </span></font></i></em></span></i><a name="acan_html"></a><a href="http://links.mkt2614.com/ctt?kn=4&amp;m=2355258&amp;r=MTEzODI4ODU4OTQS1&amp;b=0&amp;j=MTU5MTE5Nzk2S0&amp;mt=1&amp;rt=0" target="_blank"><span style='mso-bookmark:acan_html'><em><i><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>Join ACAN </span></font></i></em></span></a><em><i><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>today. </span></font></i></em></span></font><o:p></o:p></p> <p><strong><b><font size=2 color=blue face=Verdana><span style='font-size: 10.0pt;font-family:"Verdana","sans-serif";color:blue'>Federal&nbsp;</span></font></b></strong><font size=2 face=Verdana><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"'><br> <br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>The Senate Finance Committee began its long-awaited mark-up of a health care reform bill and by the end of&nbsp;last week had slogged its way through&nbsp;about two dozen amendments, both in open session and as part of after-hours talks&nbsp;dealing with Medicare, taxes, insurance&nbsp;and delivery items.</span></font></b></strong>&nbsp;Of note are the proposed increase in the insurer tax and the defeat of several Republican amendments to soften the burden on seniors in Medicare Advantage. The individual coverage requirement is still intact, but the dollar&nbsp;penalty for noncompliance has been lowered.&nbsp;And the age rating limit of 5:1 has been reduced to 4:1, which would increase the eventual rate shock for younger insureds. Additionally, the Committee approved an amendment to dramatically increase transparency by forcing PBMs to disclose certain pricing information to government and plan sponsors.&nbsp;It seems likely&nbsp;that some member will offer an amendment to add an employer mandate to the bill as well as an amendment to replace the current co-op provision with a full-fledged government plan.&nbsp;This mark-up process&nbsp;is expected to&nbsp;continue through this week. It is likely&nbsp;that the Committee will finish by the end of the week but probably not in time to meld its product with the HELP Committee bill before the Columbus Day break.&nbsp;&nbsp;&nbsp;<br> <br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>The House Energy &amp; Commerce Committee held a mark-up last week&nbsp;to take up a handful of amendments left over from its mark-up of reform&nbsp; legislation back in July.&nbsp; </span></font></b></strong>Two major items&nbsp;include: passage of a provision to provide grants to large employers (not covered in the original bill) for establishing wellness programs; and the defeat of a provision&nbsp;that&nbsp;would have prohibited insurers from recovering insurance payments through subrogation.&nbsp; Insurers and employers worked together to&nbsp;help defeat this latter item.&nbsp;On a related House&nbsp;matter, it is becoming increasingly clear that the compromise between the House leadership and the Blue Dogs seems to be more tenuous than ever, which may well give the&nbsp;Speaker the political &quot;room&quot; to beef up the existing&nbsp;public&nbsp;plan provision in the House bill by adding back the government rate-setting provision she favors.&nbsp;<br> &nbsp;<br> <strong><b><font color=blue face=Verdana><span style='font-family:"Verdana","sans-serif"; color:blue'>States&nbsp;</span></font></b></strong><b><font color=blue><span style='color:blue;font-weight:bold'><br> </span></font></b><br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>CALIFORNIA: Governor&nbsp;Arnold Schwarzenegger signed legislation&nbsp;that subjects Medicaid (Medi-Cal) managed care plans to a tax to fund Medi-Cal and the state's Children's Health Insurance Program (Healthy Families). </span></font></b></strong>The tax, which is assessed on the plan's total operating revenue, is effective for Medi-Cal managed care plans through January 1, 2011. Approval of the measure will prevent more than 600,000 children from losing access to Healthy Families coverage. In addition, this bill has allowed the state to reopen Healthy Families enrollment and begin processing the more than 80,000 applications that were placed on a wait list.&nbsp;In other news, the California Privacy and Security Advisory Board (CalPSAB) approved&nbsp;a &quot;hybrid approach&quot; to patient consent guidelines for participation in a health insurance exchange. The approach, outlined by CalPSAB, appears to be inconsistent with federal privacy and security standards. CalPSAB is developing new privacy and security standards to enable the adoption and application of&nbsp;health information exchange&nbsp;in California.<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>CONNECTICUT:&nbsp;&nbsp;Gov.&nbsp;M. Jodi Rell is threatening to veto a bill being debated&nbsp;during a&nbsp;special&nbsp;legislative budget session because it&nbsp;represents a back-door maneuver around her veto of a controversial health care pooling bill.</span></font></b></strong> In a detailed letter to top legislators, Rell said flatly that she would veto the&nbsp;bill because it did not&nbsp;meet certain requirements. One of the troubling provisions, Rell said, is that Section 15 of the general government bill would allow&nbsp;the state comptroller, Democrat Nancy Wyman, to merge various insurance plans into the state's self-insured plan. Rell stated that&nbsp;this effectively&nbsp;would allow the comptroller to implement the pooling concept&nbsp;that she&nbsp;previously vetoed, which would&nbsp;likely result in a significant cost&nbsp;increase to the state at a time when&nbsp;the state is&nbsp;making cuts to virtually every program.<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>IOWA:&nbsp; The Iowa Health Care Coverage Commission has begun meeting to develop a plan to ensure that all Iowans have access to health care coverage that&nbsp;meets minimum standards of quality and affordability.</span></font></b></strong>&nbsp;The Commission, which has representation from a wide spectrum of stakeholders including the health insurance industry, has broken into three work groups addressing (1) coverage of uninsured and underinsured adults; (2) the use and creation of a group insurance plan to provide coverage to non-state public employees, employees of not-for-profit groups, and small employers; and (3) administration of health care reform. The Commission is required to issue its first quarterly progress report to the Iowa Legislative Council by January 1, 2010.&nbsp;<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>NEW YORK: The State Insurance Department (DOI)&nbsp;is conducting public hearings in Rochester, Newburgh and New York City to gather information about limited benefits health insurance plans.&nbsp; </span></font></b></strong>The goal is to ascertain how these policies are marketed by<strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'> </span></font></b></strong>insurers and producers, assess what disclosures are made regarding the services they cover, evaluate what&nbsp;advantages these policies provide, and determine whether additional oversight and regulation&nbsp;are&nbsp;needed. The DOI investigations have revealed that some policies are sold through telemarketing firms using unlicensed agents, which runs afoul of the New York Insurance Law and that some&nbsp;insurers issue limited benefits health plan policies as group coverage through invalid associations.&nbsp;Consumers must join the association for an additional fee in order to be eligible to purchase the coverage.&nbsp;The NYS Health Plan Association will be submitting written testimony on behalf of its members who offer limited benefits plans, to distinguish these legitimate&nbsp;products from the fraudulent types of associations being investigated by the DOI.<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>OKLAHOMA: Senate President Pro Tem Republican Glenn Coffee&nbsp;recently announced the approval of 34 interim studies and the committees that will conduct them.</span></font></b></strong>&nbsp;With nearly one-third of the studies having implications for health insurance, the list yields insights into a number of issues, especially autism, that could be the subjects of key legislation in 2010.&nbsp;&nbsp;The following&nbsp;studies are&nbsp;the most relevant to the health insurance industry, and Aetna will be watching them closely: Review of health insurance mandates; health insurance policy rescissions; high-risk pool coverage of autism spectrum disorder diagnosis and treatment; autism insurance mandates and the state s economy; issues relating to interstate purchasing of health insurance policies; and possible funding for PPO coverage of persons in rural Oklahoma.<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>TENNESSEE: Preliminary meetings are being scheduled to discuss Silent PPO legislation related to workers' compensation, </span></font></b></strong>which was defeated earlier this year<strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>.</span></font></b></strong>&nbsp; This&nbsp;is expected to be a significant issue for the 2010 legislative session. In addition, Aetna is participating in a workgroup at the Tennessee Department of Commerce and Insurance regarding implementation of&nbsp;claims data legislation passed earlier this year.&nbsp;&nbsp;<br> &nbsp;<br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>WISCONSIN: The Office of the Commissioner of Insurance (OCI) intends to publish emergency rules to comply with the federal American Recovery and Reinvestment Act&nbsp;(ARRA)&nbsp;and provisions related to continuation of employer-discounted group coverage.</span></font></b></strong>&nbsp;The&nbsp;draft rules contain&nbsp;a new COBRA eligibility category for group coverage discontinuation retroactive to May 2009. In addition, the Autism Workgroup, created under the auspices of the OCI, has developed&nbsp;an administrative rule&nbsp;to implement recently enacted legislation requiring health insurance coverage for autism spectrum disorders.&nbsp;&nbsp;The rule will be promulgated on an emergency basis and&nbsp;takes effect for insurance products that are issued or renewed on or after November 1, 2009.</span></font><font size=2><span style='font-size:10.0pt'><o:p></o:p></span></font></p> <p style='margin-bottom:12.0pt'><font size=2 face=Verdana><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"'><br> <br> <br> <strong><b><font face=Verdana><span style='font-family:"Verdana","sans-serif"'>Resources</span></font></b></strong><b><span style='font-weight:bold'><br> </span></b><br> <a name=hrw1></a><a href="http://links.mkt2614.com/ctt?kn=1&amp;m=2355258&amp;r=MTEzODI4ODU4OTQS1&amp;b=0&amp;j=MTU5MTE5Nzk2S0&amp;mt=1&amp;rt=0"><span style='mso-bookmark:hrw1'>Transforming Health Care in America</span></a><br> <a name=hrw2></a><a href="http://links.mkt2614.com/ctt?kn=2&amp;m=2355258&amp;r=MTEzODI4ODU4OTQS1&amp;b=0&amp;j=MTU5MTE5Nzk2S0&amp;mt=1&amp;rt=0"><span style='mso-bookmark:hrw2'>America's Health Insurance Plans&nbsp;</span></a></span></font><font size=2><span style='font-size:10.0pt'><o:p></o:p></span></font></p> </td> </tr> <tr style='mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=top style='padding:11.25pt 11.25pt 11.25pt 11.25pt'> <p class=MsoNormal><font size=1 color="#999999" face=Verdana><span style='font-size:7.5pt;font-family:"Verdana","sans-serif";mso-fareast-font-family: "Times New Roman";mso-bidi-font-family:Arial;color:#999999'>Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies. Those companies include Aetna Health Inc. and Aetna Health Insurance Company, </span></font><font size=1 color="#9a9a9a" face=Arial><span style='font-size:7.5pt;font-family:"Arial","sans-serif"; mso-fareast-font-family:"Times New Roman";color:#9A9A9A'>151 Farmington Avenue, Hartford, CT 06156</span></font><font size=1 color="#999999" face=Verdana><span style='font-size:7.5pt;font-family:"Verdana","sans-serif"; mso-fareast-font-family:"Times New Roman";mso-bidi-font-family:Arial; color:#999999'><br> </span></font><font size=1 color="#999999" face=Arial><span style='font-size:7.5pt;font-family:"Arial","sans-serif";mso-fareast-font-family: "Times New Roman";color:#999999'><br> <br> © 2009 Aetna Inc.<br> <br style='mso-special-character:line-break'> <![if !supportLineBreakNewLine]><br style='mso-special-character:line-break'> <![endif]></span></font><font size=2><span style='font-size:10.0pt; mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></font></p> </td> </tr> </table> </td> </tr> </table> </div> <p><font size=3 face="Times New Roman"><span style='font-size:12.0pt'><o:p>&nbsp;</o:p></span></font></p> </div> </body> </html>